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Background: This study aims to evaluate the effects of two different concentrations of topical hyaluronic acid (HA) on postoperative patient discomfort and wound healing of palatal donor sites after free gingival graft (FGG) surgery.Methods: Thirty-six patients requiring FGG were randomly assigned into three groups in an examiner-masked, randomized, controlled clinical trial. After harvesting palatal grafts, 0.2% and 0.8% HA gels were used in test groups 1 and 2, respectively. Gels were applied on donor sites and protected with periodontal dressing in the test groups, whereas the wound was covered only with periodontal dressing in the control group. On days 3, 7, 14, and 21, pain and burning sensation were recorded using a visual analog scale (VAS) as well as other parameters such as complete epithelization (CE) and color match on days 3, 7, 14, 21, and 42.Results: Test groups experienced less pain than the control group on days 3 and 7 (P <0.001 and P <0.001, respectively). Mean VAS score for burning sensation was higher in the control group on day 3 compared with test groups 1 and 2 (P = 0.03 and P = 0.02, respectively). CE in all patients was achieved on day 21 in both test groups, whereas it was achieved on day 42 in the control group. The test groups showed higher color match scores than the control group on days 21 (P <0.001 and P <0.001, respectively) and 42 (P = 0.004 and P = 0.002, respectively).Conclusion: Topical application of HA exhibits positive impact on postoperative pain and burning sensation, and accelerates palatal wound healing in terms of epithelization and color match. [ABSTRACT FROM AUTHOR]

Asbestos was used in dentistry as a binder in periodontal dressings and as lining material for casting rings and crucible. However, until now, only one case of malignant mesothelioma with occupational exposure to asbestos in dental practice has been reported. We present 4 pleural mesotheliomas out of 5344 cases identified in Lombardy, Italy, in 2000-2014. Three men had been working as dental laboratory technicians, with asbestos exposure for 10, 34, and 4 years, and one woman had been helping her husband for 30 years in manufacturing dental prostheses. The men described the use of asbestos as a lining material for casting rings, while the woman was not able to confirm this use. We confirm the association of malignant mesothelioma with dental technician work. Dental technicians suffering from mesothelioma should be questioned about past occupational asbestos exposure. [ABSTRACT FROM AUTHOR]

Aim To quantify bacterial equivalents before and after chemomechanical preparation using 3% sodium hypochlorite ( NaOCl) and intracanal dressing with calcium hydroxide paste ( Ca(OH)2) or 2% Chlorhexidine digluconate gel ( CHX) in necrotic pulps associated or not with apical periodontitis and to further compare this quantification with counts of anaerobic microorganisms. Methodology Prospective clinical trial in 69 single-rooted adult teeth (strict inclusion criteria); CHX group: 34; Ca(OH)2 group: 35. Bacteria samples were taken at baseline ( S1), after chemomechanical preparation ( S2) and after 14 days of intracanal dressing ( S3). Bacterial equivalents were assessed by broad-range real-time polymerase chain reaction (q PCR), and live viable bacteria measured with conventional anaerobic culture ( CFU/mL). Descriptive/inferential analysis was performed with spss vs. 20.0 (α = 0.05) using the Kruskal-Wallis, Mann-Whitney and chi-squared tests and Spearman's correlation coefficients. Results Both groups showed a significant decrease between S1 and S2 (Mann-Whitney U-test; P < 0.001) both in q PCR and in culture. In the Ca(OH)2-group, no variation was observed between S2 and S3 by q PCR and culture. In contrast, the CHX group showed a significant increase from S2 to S3 by both techniques. The two groups were only significantly different in S3 (Mann-Whitney U-test; P ≤ 0.001), with a worse performance in the CHX group. Again, these results were congruent by both approaches. Data from both approaches correlate reasonably ( rS < 0.5). Conclusions Infected root canals contained a high bacterial load, and the chemomechanical root canal preparation reduced bacterial equivalents by 99.1% and anaerobic counts by 98.5%. Intracanal dressings were not efficient at reducing bacterial load, but the 14-day intracanal dressing with Ca(OH)2 performed significantly better than CHX, particularly in cases with apical periodontitis. [ABSTRACT FROM AUTHOR]

- Aim: The objectives of this clinical study were as follows: (i) to determine the effect of frequency of calcium hydroxide [Ca(OH)2] dressing change on the apical barrier formation in immature permanent incisors with necrotic pulps and (ii) to investigate the effect of various clinical factors before and during treatment that may be associated with the frequency of Ca(OH)2 dressing changes. Methods: The study involved 21 healthy subjects, 8-12 years old. Twenty-three immature traumatized permanent maxillary central incisors were treated using Ca(OH)2 powder mixed with barium sulfate and distilled water. The progress of barrier formation was reviewed after 6 months of first placement of Ca(OH)2 and then every 3 months until the detection of an apical barrier. Clinical and radiographic evaluations were performed before and after treatment. Data were evaluated using a chi-square test. Results: Apical barrier formation was successful for all 23 teeth. Seventeen teeth (74%) needed only a single application of Ca(OH)2, while six teeth (26%) required more than one application. The average time of apical barrier formation was 30 weeks, and the mean number of Ca(OH)2 dressing changes was 1.3. A significant positive association was found between teeth that presented with displacement and the number of Ca(OH)2 dressing changes ( P = 0.004). Conclusion: An initial 6-month application of Ca(OH)2 dressing followed by 3-month replacements (usually in teeth presenting with displacement and/or sinus tracts) may be successfully used in apexification treatment. This would assist in reducing the number of Ca(OH)2 dressing changes, number of appointments, cost of treatment and radiation exposure. [ABSTRACT FROM AUTHOR]

Aims: This study aims to find an incidence of surgical re-exposure of impacted maxillary canines in our unit and to ascertain complications that lead to re-exposures. Results: Two hundred and forty-nine maxillary canine exposures were carried out on 230 patients in the period 2006–2008. The re-exposure rate was 2.0% (five out of 249 exposures) and the main complications leading to re-exposure were debonding of the gold chain in closed exposures, and early loss of periodontal dressing in open exposures. Conclusion: Re-exposures of impacted maxillary canines do occur in our unit but cases are relatively infrequent compared with other studies. Complications occurred with both open and closed exposure techniques; however, there is no evidence to suggest any one particular surgical technique contributes to an increase in the incidence of re-exposures. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the adequacy of spirally filled vs injected non-setting calcium hydroxide (NS Ca(OH)2) in the management of traumatized permanent teeth undergoing endodontic treatment for apexification, control of infection or the management of root resorption. A random selection of patients with traumatized teeth undergoing endodontic procedures was made. A total of 100 cases were assigned for placement of NS Ca(OH)2 by spiral filling and 50 cases by injection of the dressing directly into the canal. Post-operative radiographs were assessed for complete canal obturation and in particular, the density and length of the dressing within the canal. The results revealed that the injected NS Ca(OH)2 dressing consistently produced better results than the spirally placed dressings. It also completely removed the chance of instrument fracture and as a result of this trial, the department of child dental health has now adopted the use of this injectable system. [ABSTRACT FROM AUTHOR]

Aim: To determine whether application of a periodontal dressing stopped pain arising from dentine hypersensitivity, objectively assessed with evaporative and thermal stimuli and recorded with Visual Analogue Scale scoring (VAS). Materials and methods: 22 subjects completed the single-centre, subject-blind, stratified, randomized, split-mouth study, with a minimum of two sensitive teeth, in at least two different quadrants, displaying a response of ≥30 mm with VAS to evaporative stimulus. One tooth in two different quadrants was identified and randomized to test or control groups. A dressing was applied to all the sensitive teeth in the test quadrant, and either side of the chosen sensitive tooth on the control side. The test teeth were then stimulated for hypersensitivity using evaporative stimuli and then using thermal stimuli. Results: Analysis showed that dressing application produced significantly greater reduction in pain ( P < 0.0001) compared with no periodontal dressing. Single application of a dressing to sensitive dentine provided 95% pain relief associated with thermal stimulus and 85% pain relief associated with evaporative stimulus. Conclusions: Application of the dressing to sensitive teeth, dramatically reduced the pain of dentine hypersensitivity following tooth stimulation. When assessing subjects’ response to pain-evoking stimuli, perception of pain appears to be altered by sensory factors, prompting a heightened pain response. [ABSTRACT FROM AUTHOR]

Background: With the help of so-called controlled release delivery systems, the half-life period of locally administered antibiotics in gingival crevicular fluid (OCF) can be extended significantly. The aim of this study was to characterize the delivery profile of a new one-component 14% doxycycline free amine gel for local application. Pharmacokinetics of doxycycline (DOXY) were analyzed in GCF, saliva, and serum. Methods: Twenty patients with persisting or recurring pockets (probing depths ≥5 mm and bleeding on probing) after mechanical treatment (surgical or non-surgical) took part in the study. In each patient 1 periodontal defect was treated with DOXY gel. Samples of GCF saliva, and serum were obtained before application of DOXY gel; 15 minutes after application; at 2 and 5 hours; and at 1, 2, 3, 4, 7, 9, and 11 days after application. Separation and quantitative measurement of DOXY was performed with high performance liquid chromatography and UV detection at λ = 260 nm. Results: Coefficients of variation were lower than 2% (intraassay) and 4% (interassay), respectively. For concentrations between 50 to 1000 µg/ml, we found a linear relationship between expected and measured DOXY values (linear coefficient of correlation: r = 0.998). Within the first 5 hours after application, concentration of DOXY in GCF (maximum after 15 minutes 19.97 ± 5.85 mg/ml) and saliva (maximum after 15 minutes 17.83 ± 2.84 mg/ml) was similar. Then concentration fell to a lower level (28.90 ± 19.44 µg/ml) compared to GCF (577.41 ± 127.34 µg/ml) after 3 days. Up to 10 days after application, the concentration of DOXY in GCF was 34.24 µg/ml. With the exception of 1 patient, all serum samples were DOXY-negative. Conclusions: 1) After subgingival application of biodegradable 14% doxycycline gel, mean doxycycline levels in GCF that exceeded 16 µg/ml could be maintained for at least 12 days. Thus, the antimicrobial agent may be classified as a controlled release device. 2) The antibiotic effect was limited mainly to the subgingival sites of application of the doxycycline gel. 3) The doxycycline gel possesses the pharmacokinetic and clinical properties to deliver efficacious levels of antibiotics to the periodontal pocket and to maintain these levels for at least 1 week without the need of further drug retention by a periodontal dressing. [ABSTRACT FROM AUTHOR]

De Bruyne MAA, De Moor RJG, Raes FM. Necrosis of the gingiva caused by calcium hydroxide: a case report. International Endodontic Journal, 33, 67–71, 2000. Case report The present case demonstrates the possible detrimental effect of an overextension of a calcium hydroxide intracanal dressing into the periradicular and soft tissue after iatrogenic buccal root perforation of a maxillary central incisor. At first this perforation was not recognized by the dentist, which resulted in the introduction of a large amount of non-setting calcium hydroxide paste under the gingival tissues through a dehiscence on the buccal side of the root. This report describes the consequences and management of the necrosis of the buccal gingiva and mucosa, and the subsequent treatment and follow-up of the root perforation. [ABSTRACT FROM AUTHOR]

Calcium hydroxide (CH) is often used as routine interappointment dressing during the endodontic treatment of teeth with apical periodontitis. However, it fails to consistently produced sterile root canals. The present study was set up to find out whether an antimicrobial strategy including the use of CH could be made more effective if: 1) canals were pretreated with 5% iodine potassium iodide (IPI), and 2) the dressing period was extended up to 2 months. Fifty human teeth, with radiographically verified apical periodontitis, were microbiologically sampled. After chemomechanical preparation the canals were pretreated with IPI for 3-7 days. Teeth where microorganisms persisted were then treated with CH for 2 months. Following instrumentation and dressing with IPI, 43 bacterial strains were recovered in 22 of the teeth. Samples obtained after the CH dressing period disclosed growth of 13 facultative and two strict anaerobic strains in 10 teeth. Enterococcus faecalis was identified in two specimens In conclusion, the present study gave no evidence for an increased antimicrobial effect of CH if it was left for longer periods in the root canal. Although pretreatment with IPI from a quantitative point of view did not seem to add antimicrobial power, it might reduce the frequency of persisting strains of E. faecalis. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate and compare the healing of different bone grafting materials adjacent to titanium plasma-sprayed (TPS) endosseous dental implants. Methods: Implant osteotomy sites were prepared and standardized 3-walled intrabony defects (3 mm x 5 mm x 5 mm) were created at the mesial of each implant site. Thirty-two TPS implants were placed in edentulous mandibular ridges of the 4 dogs. Periodontal dressings ware placed in the defect sites so as to create a defect simulating bone loss around an implant. After 3 months, the periodontal dressing was removed, the defect sites debrided and evaluated for size, and intra-marrow penetration performed. The graft materials tested were 1) canine demineralized freeze-dried bone allograft (cDFDBA); 2) bioactive glass granules of a broad size range 90 to 710 microns (BRG); and 3) bioactive glass granules of narrow size range 300 to 355 microns (NRG). One site on each side of the mandible was not filled and served as a control. Dogs were sacrificed 4 months after graft placement. Results: Histologically, differences in percent bone-to-implant contact in the defect area were observed between the treatment groups. cDFDBA > control=BRO=NRG with statistical significance found between cDFDBA and control (P = 0.0379), but no statistically significant difference between control or either bioactive glass material. When comparing percent bone height fill of the defect in the grafted area, cDFDBA (65.7%) was significantly better than the control (48.9%; P ≤ 0.05) with no statistically significant difference between control, broad range bioactive glass (57.3%) and narrow range bioactive glass (56.6%). When total bone area was measured, the percentage of new bone in the grafted area was cDFDBA (42.1%), broad range glass (33.1%) and narrow range glass (22.6%) with significance found between cDFDBA and NRG (P = 0.0102). The content of residual graft particles in soft tissue was significant (P = 0.0304) between cDFDBA (1.4%) and NRG (11.4%) with no significant difference between graft material for residual particle content in bone tissue. Conclusions: The results of this study indicate that percent bone-to-implant contact and percent bone height fill in an intrabony defect around titanium plasma-sprayed implants are statistically significantly higher with the use of DFDBA when compared to bioactive glass material. [ABSTRACT FROM AUTHOR]

The effect of adding two bisguanide antimicrobial agents (chlorhexidine and PHMB) on some physical properties of the light-cured periodontal dressing material Barricaid® are reported. The physical properties tested were elastic modulus, initial and 10 min recovery strains, and tear stress. The addition of both chlorhexidine and PHMB solutions reduced the elastic modulus as did water. The addition of PHMB to Barricaid® produced greater initial recovery in the strain test than either the addition of chlorhexidine or water, but there were no differences between the treatments after 10 min. Tear stress was also reduced by the addition of water and the chlorhexidine and PHMB solutions. These results suggest that as far as the physical properties of Barricaid® are concerned the addition of the antimicrobial agent PHMB had no long-term advantages over chlorhexidine. [ABSTRACT FROM AUTHOR]

The correlation between clinical periodontal parameters and histological structure of the gingiva around a single-crystal sapphire implant has been evaluated in two volunteer subjects. The implants had functioned after 6 years as the distal abutment of implant bridges in the Kennedy class II mandible. First, clinical evaluation was performed (gingival bleeding index, crevicular fluid volume, plaque index and probing depth) of the gingiva around the implant and natural teeth abutments and then a small piece of pen-implant gingiva was excised from the lingual site of the implant of each subject for histological evaluation. The clinical evaluation using the periodontal parameter indices corresponded with the histological evaluation of the pen-implant gingiva. The result suggests that it is possible for such parameters to be used in practice for judging the success of an implant. [ABSTRACT FROM AUTHOR]

The periodontal conditions of subjects with different combinations of removable dentures were studied in a representative sample of 8000 subjects, of which 90% were used for the experiment. The number of subjects with removable dentures was 1468. Subjects with removable partial dentures had significantly more pockets and deeper pockets than did those without dentures. The periodontal condition of subjects with a complete denture in the opposite jaw was significantly better than that in other subjects. This was true in both men and women. The results indicated the importance of prophylactic and maintenance care in subjects with removable partial dentures. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop standardized reproducible testing methods for evaluating physical properties of periodontal dressing materials. Three commercial compositions (Coe-Pak, Coe-Pak Hard & Fast Set and WondrPak ) were studied. Working and setting times were determined by observing the continuous changes in viscosity via the oscillating rheometer. The 24-h and 1-week tensile and shear adhesive bonds to enamel were studied by luting orthodontic lingual cleats with a standard film thickness to the orientated labial surfaces of extracted incisor and pulling them to failure. Dimensional change was studies over a period of 24-h using a linear variable differenced transformer (LVDT). The developed testing modalities have greater precision than those previously reported. the concept of 'bench time' was developed during which certain materials cannot be handled immediately after mixing. [ABSTRACT FROM AUTHOR]

In the interests of producing an improved periodontal dressing material, adhesive cements are under consideration. A new glass ionomer system-aluminoborates- shows some potential in this respect, and a relatively soluble formulation was chosen for a simple biological test in rats, by means of implantation in polypropylene tubes. As a positive control, the widely used aluminosilicate cement Aspa® was employed, and empty tubes were used as negative controls. A simple scoring system using interval measurements was employed, and showed no difference at the 5 % level between the experimental cement and either control, although slight differences were discernible between controls. The study also indicated that the side of a filled tube is not the best control for assessment of reaction at tube ends. [ABSTRACT FROM AUTHOR]

Three dressing materials were studied using two different methods of viscometry. The rheological characterizations are discussed with reference to clinical needs, and limitations of the experimental method are also considered. Suggestions are made for desirable rheological properties of future materials. [ABSTRACT FROM AUTHOR]

2 periodontal dressings, Coe-pak* and RD8 (a product under development), were assessed following periodontal surgery, using a double-blind study of randomised split-mouth design, with each patient acting as their own control. Matched sites were selected for periodontal flap surgery under local analgesia. Sites were randomly allocated to each group. The dressings were applied by a single operator and both patients and clinical assessors were blind as to the dressing employed. The dressings were assessed as to their handling properties, in addition to a 7-day post-operative assessment of the surgical sites and a subjective patient report. Maximum pain levels were relatively low (4 in a scale 0-10); subjects reported more pain and analgesics required with RD8 than with Coe-pak. This was reflected in the results of the patient assessment which indicated that 50% preferred Coe-pak, compared to 25% who preferred the RD8 dressing. The results showed RD8 to be an acceptable periodontal dressing when compared to Coe-pak. There were no statistically significant differences between treated sites in both groups with regard to post-operative plaque scores, bleeding scores or tissue healing. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the relationship between linear and area measurements of periodontal attachment loss, and to determine the root surface area on different tooth-types. Extracted permanent teeth were collected in a national survey including a systematic random sample of 500 Norwegian dentists. The response rate was 70%. Altogether 329 teeth were received, 81 of them (excluding 3rd molars) were subjected to both linear and area measurements of attachment loss. Using a dissecting microscope (10 ×), 4 to 8 duplicate linear measurements were recorded per tooth. The areas of both lost and remaining periodontal attachment were measured by a method based on controlled release of Cu and Co metal ions from coatings applied to the root surface. Linear loss of attachment for single-rooted teeth (n=63) was &xsline;=44.0% and the area loss &xsline;=49.2%. The corresponding measurements for multi-rooted teeth (n = 18) were &xsline; = 30.3% and &xsline; = 35.1%, respectively. The correlation between linear and area loss was r=0.78 for single-rooted and r-0.75 for multi-rooted teeth (p < 0.01). The lower correlation in multi-rooted teeth is probably due to the more complex root anatomy. It is concluded that there is a strong correlation between linear loss of attachment and area of periodontal support lost for teeth with early to moderate loss of attachment, and that linear measurements tend to underestimate the remaining periodontal attachment. [ABSTRACT FROM AUTHOR]

At present no information is available about biological effects on oral tissues of the photocuring periodontal dressing Barricaid®. This animal study examines histologically the tissue responses of surgical areas covered during 7 days with either Barricaid®, the eugenol-containing dressing Ward's Wondrpak® or the bionert control gel Carboxy Methyl Cellulose. One group was studied immediately after the removal of the dressings; in the other group, further healing was permitted for another week. Results after 7 days indicate acute inflammatory reactions in the test areas without significant differences between the 2 periodontal dressing materials. The control areas showed to a lesser degree basically the same tissue response. In the 2nd week, generally all areas healed. After 14 days, no differences between test- and control sites could be detected. From a biological point of view, these findings suggest no contra-indication for application of this photocuring dressing material after periodontal surgery. [ABSTRACT FROM AUTHOR]

The present study examines postoperative pain experience following 243 gingivectomies in Norwegian patients using possible combinations of 3 local anaesthetics (lidocaine -adrenalin, prilocaine-felypressin or mepivacaine) and 3 periodontal dressings (Coe-pak, Wondrpak or Nobetec). When Coe-pak was used, the mean pain score was higher (P < 0.05) in the group treated with lidocaine-adrenalin 4 to 6 h after gingivectomy than the groups treated with prilocaine- felypressin or mepivacaine. There was no significant difference between the groups treated with prilocaine-felypressin or mepivacaine. When Wondrpak or Nobetec were used, there was no significant difference between any of the local anaesthetics used. The present finding shows that the local anaesthetic combination of lidocaine-adrenalin (1:80,000) gives rise to a higher mean postoperative pain experience after gingivectomy than prilocaine-felypressin or mepivacaine. However, the relative difference in pain experience seen after gingivectomy when using the present local anaesthetic agents is masked when using an eugenol-containing periodontal dressing. Thus, the higher pain experience reported after lidocaine-adrenalin may only be clinically important when using periodontal dressings without local anaesthetic components such as eugenol. [ABSTRACT FROM AUTHOR]

This study examines the incidence and seventy of postoperative pain after gingivectomy using one non-eugenol-containing periodontal dressing, Coe-pak (n = 76) and 2 eugenol-containing periodontal dressings, Wondrpak (n = 64) and Nobetec (n= 86). All patients were subjected to gingivectomy using 1 type of local anaesthesia (lidocaine + adrenalin) only and covering the surgical areas with either of the 3 different dressings in a randomized study. Postoperative pain was assessed on 100 mm visual analogue scales over 5 days starting immediately after surgery. No pain was reported by 22.0% of the patients after Coe-pak, 23.4% after Wondrpak and 30.2% after Nobetec. 13.2% of the patients took analgesics after Coe-pak treatment. 3.1% after Wondrpak and 1.2% after Nobetec. Mean pain score after Coe-pak was higher (P < 0.05) than after Nobetec 2 h after operation until the morning on the 3rd postoperative day. Mean pain score after Coe-pak was higher (P< 0.05) than after Wondrpak 3 h to 9 h after operation. No statistically significant difference was found between Wondrpak and Nobetec regarding mean pain score. [ABSTRACT FROM AUTHOR]

Because interdental and subgingival sites are relatively inaccessible to mouthrinsing, they necessitate alternative methods of application of anti-plaque chemicals. These include routine oral hygiene aids, surfactants to enhance uptake and retention of antimicrobials, gels and periodontal dressings. The principal modes of application that have received attention recently, apart from the systemic route, are syringe and pulsated jet irrigation and slow release compounds. Slow release devices currently receiving attention may be classified as membrane diffusion, solution of drug in polymer and solid drug dispersed in polymer matrix. The most widespread dental instance of a slow release device appears to be the use of varnishes and resins to carry fluoride. Recent attempts at devising improved methods of antimicrobial application include the testing of materials for their biodegradability or for their potential to adhere to mucosal surfaces. It is concluded that the potential exists for antimicrobials applied directly to the site of intended action to contribute significantly to dental health, particularly when employed as components of practical oral hygiene regimes. [ABSTRACT FROM AUTHOR]

Adhesion to enamel is an important aspect of periodontal dressing retention. Details of tensile and shear bond strengths are presented for three dressing materials and a positive polycarboxylate control, and the data are discussed with regard to optimum levels of retention. A level of 2 MN/m² is suggested for shear bond strength, and 1 MN/m² for tensile bond strength, under the test conditions employed. [ABSTRACT FROM AUTHOR]

A detailed review of periodontal dressings is presented, covering physical, chemical and biological aspects. Areas requiring further research are outlined, particularly in the physico-chemical sphere; and some contra-indications to particular substances are described. It is concluded that there is a definite place for dressings, but that more knowledge is required before optimal properties can be developed. [ABSTRACT FROM AUTHOR]

Forty-one patients requiring gingivectomy in one or more areas were used for a clinical evaluation of three different periodontal dressings. Sixty-five operations were performed. Whenever possible different dressings were tested in the same patient. The type of dressing was chosen randomly, applied by one operator and left in place for 1 week. The patients were supplied with analgetic tablets. At day 7 the condition of the dressing was evaluated before removal. The patients' subjective experiences of pain, swelling, bleeding and fever, as well as use of pain relieving tablets, were recorded. The wound was evaluated with regard to the degree of epithelialization, presence of denuded bone and granulation tissue. The tendency to bleeding and the sensitivity of the teeth to a water spray (15 °C) were tested. At day 14 and 21 the same evaluation procedure was repeated. In addition the presence of plaque in the operated area was assessed. One of the dressings more frequently induced pain and swelling than, the others. Tablet consumption was also higher when this dressing had been used. No statistically significant differences were found in the clinical assessment of wound healing, tendency to bleeding and the sensitivity of teeth. [ABSTRACT FROM AUTHOR]

Three commercial periodontal dressings were tested for antibacterial activity against salivary microorganisms after having been stored dry or in liquid for 1 and 2 days. Inhibition of growth of mixed salivary flora was evaluated on blood agar dishes. Also, the ability of Strep. Mutans to colonize the surface of the dressings was tested. The surface contact test indicated antibacterial activity against salivary microorganisms by freshly made Coe-pak® and Wondrpak®. Some activity could also be observed after 2 days' storage in about half the experiments. The initial bacteriostatic effect of Peripac® was limited to the setting phase. The plaque accumulation test revealed single cells only on the surfaces of Coe-pak and Wondrpak whereas Peripac seemed to be colonized by the test bacteria. [ABSTRACT FROM AUTHOR]

In a first experiment, no appreciable differences in plaque formation under periodontal packs were observed in subjects rinsing with and without 0.2 %chlorhexidine di-gluconate. In a second experiment, one gram periodontal packs were coated with 15 to 20 mg of chlorhexidine dihydrochloride powder prior to application and allowed to remain in situ for 4 days. Significantly less plaque formed under periodontal packs with chlorhexidine powder than with control packs. Chlorhexidine dihydrochloride powder may be recommended under periodontal packs for reduction of microbial plaque. [ABSTRACT FROM AUTHOR]

Effects of withholding a dressing and applying Coe-Pak after reverse bevel flap procedures in periodontal surgery were compared in 24 patients. Maxillary and mandibular posterior segments were treated using a "split-mouth" technique. Slight differences occurred between dressed and undressed segments. Gingival Index scores for the undressed segments were lower than those for the dressed segments at 7 days after operation, but by 21 and 28 days post-operatively the position was reversed. Changes in gingivaI fluid flow followed a similar pattern but were not statistically significant. The 0.18 mm difference in crevice depth of the dressed as opposed to the undressed segments noted 28 days post-operatively was statistically significant. Clinically satisfactory results were achieved in both instances. Post-operative dressing was associated with a greater incidence of pain and swelling, but a reduced incidence, of bleeding, sensitivity and eating difficulty. More patients stated a preference for no dressing should the operation have to he repeated. After reverse bevel flap procedures, no differences between dressed and undressed segments which would be likely to have, practical significance were demonstrated, and it is therefore suggested that application of a dressing should be a matter of individual preference. [ABSTRACT FROM AUTHOR]

In this in vitro study, we investigated the effects of the use of two different calcium hydroxide (Ca(OH)2) preparations as an intracanal dressing on the sealing ability of two different sealers were investigated. Eighty-eight freshly extracted, single-rooted maxillary anterior teeth were used. After the root canals were hand-instrumented, they were divided into six groups of 10 each. The root canals were dressed with Ca(OH)2 paste, either mixed with sterile water (in groups 1 and 2) or with glycerine (in groups 3 and 4). The dressed root canals were incubated in 100% humidity at 37°C for 7 days. In groups 5 and 6, the root canals were not dressed. After the root canal dressings were removed by irrigation with 5.25% NaOCl and reaming with a K-type file, all canals of the experimental groups were obturated with sealer and gutta-percha using a cold lateral condensation technique. Calciobiotric Root Canal Sealer, (CRCS), (in groups 1, 3 and 5) and Diaket (in groups 2,4 and 6) were used as sealers. All specimens were placed in India ink for 7 days, and the amount of apical leakage was scored. Eight further prepared specimens were dressed with Ca(OH)2 plus water or Ca(OH)2 plus glycerine and examined with scanning electron microscopy (SEM) following the removal of dressings. There was a statistical difference in the leakage patterns amongst the 6 experimental groups (P < 0.05). Specimens in group 2 exhibited less leakage than the other experimental groups, except group 4 (P < 0.05). There were no other significant interactions. SEM examination revealed that Ca(OH)2 crystals were present on the surface of smear layer in both groups where Ca(OH)2 paste had been placed, but they did not penetrate into the dentinal tubules. [ABSTRACT FROM AUTHOR]

A review of the literature of the difficult of intracanal medicaments on inflammatory resorption or occurrence of ankylosis in mature traumatized teeth is presented. The results of the studies show that calcium hydroxide and calcitonin paste eliminate inflammatory resorption. Other medicaments such as gutta- percha with sealer, antibiotics, and calcitonin reduce or almost eliminate this complication. Ankylosis or replacement resorption develops in the root surfaces of teeth with mature roots irrespective of medicaments used. However, the percentage of relative surface area of the root which develops ankylosis is significantly higher in mature teeth treated with calcium hydroxide than in teeth treated with permanent root filling. Ledermix paste targets the resorbing cells without damaging neighbouring tissue, Recommendations for the use of calcium hydroxide and Ledermix paste as intracanal dressings in traumatized mature teeth are made. [ABSTRACT FROM AUTHOR]

A 50:50 mixture of a corticosteroid/antibiotic paste and calcium hydroxide has been used clinically as a root canal dressing agent. This study investigated the effect on the release and diffusion of the corticosteroid and antibiotic components of Ledermix® paste when it was mixed with a calcium hydroxide-methyl cellulose paste. The release rates of the trace molecules were lower when the mixture was used compared with release from Ledermix alone. The results indicated that this combination of materials, when used a long-term intracanal dressing, was likely to be more effective than Ledermix alone. [ABSTRACT FROM AUTHOR]

The article presents abstracts on topics related to periodontology, including one on the biocompatibility of periodontal dressing materials, another on the addition of third molar extraction sites using a composite calcium sulfate bone allograft and one on the use of fluid forces created by a sonic toothbrush to remove plaque bacteria.

The fate of vital and devitalized grafts of mature cancellous bone from the jaws were studied in interradicular lesions in monkeys. 98 bifurcation defects were produced in premolars and molars and maintained by periodontal dressing inserted for four weeks. Ten to 15 weeks later fresh cancellous bone was transplanted into 32 defects. Other cancellous bone grafts were devitalized by boiling and transplanted into 34 bifurcations. The remaining 32 defects received no grafts. The animal's were sacrificed to yield observation periods from 0 to 90 days. After decalcification of the specimens and embedding in paraffin; serial sections were cut at 8 microns and stained. The fate of viable and dead transplants were similar during the healing of the interradicular lesions. Except for a few osteocytes which seemed to survive transplantation in the fresh cancellous bone, the osteocyte lacunae were devoid of cells in both types of transplants after 1 week. The deepest located bone grafts became incorporated in new bone developed from the interradicular septam. The more superficially located grafts were rejected or were surrounded, by a cementum-like substans. The influence, of the grafts on bone regeneration was small and based solely on their osteoconductive effect. [ABSTRACT FROM AUTHOR]

This study was designed to evaluate the effect of four commercially available dressings (Coe, PPC-Eugenol, PPC-Non Eugenol, and Ward's Wondr Pak) on a monolayer of cells, employing the cell culture assay plate assembly, Monolayers of L929 fibroblasts were grown out on the cell culture assay plates and stained with a vital stain, .01% Neutral Red, 8 mm discs of prepared periodontal dressings, as well as sterile filter paper and high density polyethylene discs, which served as controls, were placed on the monolayer. Observations were made at 1,2,6,8 and 24 hour intervals, and measurements of the toxic zones were recorded. Results indicate that all periodontal dressings tested in this system demonstrated definite cytotoxicity. Both macroscopically and microscopically, the first signs of cell damage and/or death were observed adjacent to Ward's Wondr Pak and PPC-Non Eugenol dressings. Although these two dressings produced the earliest toxic signs, after 24 hours Coe-Pak produced the most extensive zones of destruction, while PPC-Eugenol appeared to be the least toxic. [ABSTRACT FROM AUTHOR]

A modified implantation technique was used to study the early tissue reactions to three periodontal dressings (Coe-pak. Peripac, and Wondrpak). The dressings were placed in contact with an intact nonepithelialized tissue surface for 15 minutes and 3 days. The tissue reactions were assessed by histochemical and histological techniques. After 15 minutes of tissue-material contact, the most severe tissue reactions were caused by Wondrpak. When the contact period was increased to 3 days, Peripac generally showed a more severe tissue response than Wondrpak. At both contact periods Coe-pak had caused the mildest reactions.

78 rats weighing 180-200 g were used to assess the bone tissue responses to three periodontal dressings (Coc-pak, Peripac and Ward's Wondrpak). The dressings were implanted subcutaneously on periosteal covered and denuded bone. Sham operated animals served as controls and a comparison between the responses produced by the three dressings were made. In one series the dressings remained in situ for 3, 7, 14, 30 and 90 days. Osteocyte damage of varying extent was recorded for all materials. Remodelling of the bone surface adjacent to the dressing was observed. Bone resorption was never found in the ground defect produced to denude the bone tissue, but repair of the defect by bone formation was observed after long observation periods. This repair was retarded in some animals where Ward's Wondrpak had been implanted. In another series Ward's Wondrpak was implanted against bone for three days, then re-operated to remove the dressing and the defect allowed to heal for 30 days. The test group exhibited empty bone lacunae and the repair of the defect was retarded or lacking. [ABSTRACT FROM AUTHOR]

Polyethylene tubes filled with various dental materials were placed as subcutaneous implants in rats. A scoring system for no, slight, moderate and severe reaction was established on the basis of the tissue response to a variety of materials for the evaluation of long term implants (30 or 90 days). Short term implants (7 or 14 days) were evaluated by deciding whether or not an effect from the material could be found in addition to the operative trauma. The scoring system was used to evaluate the reactions to three periodontal dressings. Tissue from the short term implantation periods exhibited marked reactions to most implants. Long term implantation revealed that a difference in the tissue response to the three dressings was present. For two of the materials the initial irritation was followed by an innocuous state, but from the third dressing a continous irritation of the tissue was observed. [ABSTRACT FROM AUTHOR]

The article presents information on articles related to periodontology and published in various journals. Some of the titles are: "Effects of a Chemical Carcinogen Applied to Hamster Gingiva," by S. Al-Ani and G. Shklar; "An Oral brushing Technique for Rigid patient Control," by G.R. App; "In Vitro Effect of Urea on Artificial Calculus Formation," by C.M. Belting and D.L. Belting; "Effects of Periodontal Dressings on Tissue Culture Cells," by K.K. Kreth, E.R. Zimmermann and "Validity of Anterior Segment Gingival Scores in Epidemiological Studies," by A.B. Wade.

The article lists several periodontal devices approved by the U.S. Food and Drug Administration (FDA) from March to May 2005 under the 510(k) notifications. The devices include Hager Reso-Pack Periodontal Dressing from Hager Worldwide Inc., the Guided Surgery Concept from Nobel Biocare USA LLC and the Bicon Orthodontic Implant System from Bicon Inc. Information on the classification of each device, their substantial equivalence and description are provided.

The approximate shear bond strength of subgingival calculus was measured on freshly extracted teeth. The experimental method was validated on polycarboxylate controls. The object was to specify a suitable upper limit for periodontal dressing adhesion, and a level of 4.0MN/m² is suggested by these results [ABSTRACT FROM AUTHOR]

A case is reported in which endodontic treatment of an upper central incisor was delayed by repeated failure of the temporary dressing. The cause of failure was not identified until a sewing needle was found lodged in the canal. The patient had repeatedly removed the dressing, possibly in an effort to gain attention. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 30-year-old patient who reported with pruritus and erythema on the left side of the hard palate in the maxillary first molar tooth 24 hour following the application of visible light cure periodontal dressing containing urethane dimethacrylate, camphorquinone, and butylated hydroxytoluene (BHT). The patient was diagnosed with allergic contact stomatitis.

Presenting problem: An 8-year-old boy presented with a facial cellulitis. This appeared to be associated with the right maxillary lateral incisor. Clinical management: There was no history of dental trauma. It was reported that a primary supplemental tooth had been present in the right premaxilla. On examination the right maxillary lateral incisor had a deep palatal pit and was grade 3 mobile. There was evidence of a tooth erupting palatal to this tooth. The radiographic examination suggested the right lateral incisor tooth was supplemental, invaginated and had an apical radiolucent area. The acute infection was managed by extirpating the pulp and dressing the supplemental tooth with non-setting calcium hydroxide. It was later removed under inhalation sedation and local anaesthetic. The ectopic tooth was monitored and subsequently erupted palatally. This may require orthodontic interception in the future for the correction of a crossbite. Discussion: The prevalence of supernumerary teeth in the permanent dentition has been reported as 0.1–3.8%. They are less frequently seen in the primary dentition. However, it is not uncommon for a child to present with dental anomalies in both dentitions. In this case study, the subject had a supplemental lateral incisor in both the primary and permanent dentition. The permanent supplemental tooth was invaginated, confirmed by histological examination. The cellulitis was therefore caused by the invaginated odontome. [ABSTRACT FROM AUTHOR]

Aim: To compare the clinical benefit of a periodontal dressing applied after a one-stage full-mouth disinfection (OSFMD) in patients with chronic periodontitis up to 3 months after therapy., Material and Methods: This randomized, controlled split-mouth study included 24 patients. After OSFMD, a test and a control side were selected by means of a computer-generated randomization list. Test sides received a periodontal dressing (Coepak(®) ) for 7 days and the control sides received no periodontal dressing. After 7 days the periodontal dressing was removed and the pain experience was recorded. After 3 months, the clinical periodontal parameters were recorded., Results: The periodontal dressing group showed a significant (p < 0.05) additional pocket depth reduction and additional clinical attachment gain for the moderate pockets of single- and multi-rooted teeth compared with the control group. A significant (p < 0.05) lower percentage of sites with probing pocket depth ≥5 mm were shown for the periodontal dressing group compared with the control group (2.7 ± 16.3% versus 4.8 ± 21.4%). The pain intensity was significantly reduced when using a periodontal dressing (5.13 ± 0.89 versus 3.42 ± 1.27)., Conclusion: The use of a periodontal dressing for 7 days after a OSFMD offers an additional short-term clinical improvement and lowers the pain intensity., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background and Objective: The 4-META/MMA-TBB [4-(2-methacryloxyethyl)trimellitic anhydride/methyl methacrylate-tributylborane] resin is widely used as a dental adhesive. It has also been applied in the dressing of gingival wound surfaces following periodontal surgery. However, its effect on the regeneration and/or cell attachment of the oral epithelium remains to be clarified. To evaluate the effect of the resin applied as a wound dressing, we investigated expression of laminin 5, integrin beta(4) and cytokeratin 14 in regenerating oral epithelium treated with this resin following gingivectomy from the viewpoint of cell attachment and differentiation., Material and Methods: The resin was applied to the entire wound surface in rats after gingival surgery, and regenerating epithelium was examined immediately and at 1, 3, 5, 7 and 14 days later. The resin was removed 2 weeks after application in some animals and tissue further examined at 1, 3, 5 and 7 days later., Results: Regenerating epithelium under the resin was not keratinized, but became keratinized immediately after removal of the resin. Laminin 5 and integrin beta(4) were immunolocalized in the basal lamina, the internal basal lamina, in marginal cells of the regenerating epithelium and at the resin-regenerating epithelium interface. Cytokeratin 14 localized in the regenerating epithelium underneath the resin, as well as in healthy and regenerated junctional epithelial cells., Conclusion: These results suggest that this resin covers the wound surface and that the regenerating epithelium biologically adheres to the resin during the initial process of its regeneration.

Objectives: It is not clear if periodontal dressing influences the long-term results in a non-surgical treatment procedure., Material and Methods: The periodontal parameters (pre-baseline) of 36 patients with aggressive periodontitis were obtained before the patients were treated initially (1st step) by a dental hygienist, who completely removed the supra- and subgingival concrements. Baseline parameters were raised 3 weeks after the 1st step, before the 2nd therapy step was conducted. It consisted of a non-surgical procedure, which comprised a closed full-mouth manual root curettage (root planing), immediate systemic application of metronidazole, and the placement of a periodontal dressing (Vocopac, Voco). The patients were randomized to two test groups having their periodontal packs removed after 3-4 days (group 1, n=12) and 7-8 days (group 2, n=12), respectively and a control group (n=12) without periodontal dressing. Clinical parameters were raised again after 6 and 24 months., Results: Six and 24 months later, changes in probing pocket depth (PPD) and probing attachment level (PAL) were observed in all three groups compared with baseline, but the difference was significant in group 2 only. In addition, group 2 showed a greater reduction in mean PPD and also a significantly greater gain of attachment in comparison with the controls., Conclusion: Wound dressing has a positive effect on clinical long-term results using a two-step non-surgical procedure. Moreover, removing the dressing after 7-8 days leads to clearly better results than removing it earlier.

The present investigation was undertaken to quantitate the osseous changes which occur throughout the entire circumferential extent of infrabony periodontal defects in patients with optimal plaque control. Fifteen defects were selected in nine patients. Periodontal surgery was scheduled after each patient had shown an ability to practice efficient plaque removal. Muco-periosteal flaps were raised and the osseous defects debrided. The dimensions of each defect were measured at several specific location points within the defect. The flaps were replaced at their original location and, post-operatively, optimal plaque control was maintained in the area (Mean Plaque Index 0.04). Six to 8 months after the initial surgery all areas were re-operated and the osseous defects were remeasured at the same specific location points. Each defect showed osseous regeneration at every location point. The mean initial osseous defect depth at a location point was 3.5 mm and the mean amount of bone regeneration which occurred was 2.5 mm. Crestal alveolar bone resorption occurred at almost half of the location points and averaged 0.7 mm. Eleven of the 15 defects had resolved completely. There were isolated areas where a shallow defect persisted in the remaining four defects. The behavior of an osseous defect throughout its circumferential extent was characterized by a combination of coronal bone regeneration (mean 77%) and marginal bone resorption (mean 18%). Infrabony periodontal defects may predictably remodel after surgical debridement and establishment of optimal plaque control.

The clinical results achieved were compared when a group of 21 patients requiring gingivectomies in comparable bilateral segments received a dressing or a chlorhexidine mouthwash during the first post-operative week. Initial pre-operative conditions were comparable. In each of the two treatments highly significant reductions in pocket depths were achieved; the sizes of the reductions were of clinical significance (greater than 1.5 mm). The observed difference (0.16 mm) between the two treatments in favour of the mouthwash, although significant at the conventional 5% level, was clinically unimportant. More patients preferred the dressing as a post-operative treatment, and the clinical implications of the patients' preferences are discussed.