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Purpose: The removal of third molars (M3) is one of the most common oral-maxillofacial surgical procedures affecting periodontal tissues of neighboring second molars (M2). The aim of this study was to evaluate the periodontal status of lower M2 following the removal of unerupted lower M3 up to 5 years after removal.Patients and Methods: Primary predictor variable in this prospective cohort-study was time [baseline (BL; preoperatively), 6 and 60 months postoperatively]. The primary outcome variable was probing pocket depth (PPD). Clinical attachment level (CAL) was defined as a secondary outcome variable. Plaque index (PlI) and gingival index (GI) were assessed descriptively. All variables were compared using nonparametric tests. M3 were classified as either completely bony or partially bony unerupted. Risk factors (removed M3, type of impaction, mean BL PPD≥4 mm, gender, age) were analyzed (repeated measures ANCOVA). The significance level was set at 0.05.Results: From originally 91 subjects enrolled in this study, 39 subjects (22 females; mean age: 21.6 ± 2.5 years) contributing 39 M3 completed the study after 5 years. Average BL PPD significantly decreased at 6 (-0.50 ± 0.61 mm, P = .001), 60 months (-0.81 ± 0.56, P < .0001), as well as between 6 and 60 months (-0.31 ± 0.51 mm, P = .030). Corresponding CAL values decreased accordingly (BL-6 months: -0.37 ± 0.59 mm, P = .004; BL-60 months: -0.67 ± 0.55 mm, P < .0001; 6 to 60 months: -0.34 ± 0.48 mm, P = .004). The was confirmed as risk factor for PPD (P = .026) and CAL (P = .042) changes.Conclusions: Average PPD and CAL of mandibular M2 in young subjects improved 5 years after early removal of unerupted M3 in favor of an initial partially bony unerupted type of impaction. [ABSTRACT FROM AUTHOR]

Background: Evaluation of clinical long-term results 20 years after connective tissue grafting (CTG) or guided tissue regeneration (GTR) using bioabsorbable barriers for root coverage therapy.Methods: Initially, 15 patients with 38 Miller Class I and II recession defects underwent CTG or GTR according to random assignment. At baseline, 3, 120 ± 12, and 240 ± 12 months after surgery, data on probing depth, clinical attachment level, recession depth and width, amount of keratinized tissue, and bleeding on probing were obtained. Additionally, patients' smoking habits and participation in supportive periodontal therapy were investigated.Results: Eight patients contributing 23 recessions were available at the 240 ± 12 months follow-up. Three and 120 ± 12 months after therapy with CTG, significantly better root coverage was observed compared with baseline (3 months: 3.01 ± 1.74 mm; P = 0.003; 120 ± 12 months: 2.11 ± 1.86 mm; P < 0.024). GTR resulted in significantly better root coverage compared with baseline after 3 months (2.25 ± 1.89 mm; P < 0.012). Although there were no significant changes in the recession depth between 3 and 240 ± 12 months in both groups (CTG: P = 0.097; GTR: P = 0.190), 1.57 ± 2.12 mm (CTG) and 1.19 ± 2.31 mm (GTR) of the achieved coverage after 3 months were lost. CTG showed significantly better relative root coverage percentage than GTR after 3 (P = 0.026) and 120 (P = 0.038) months. This study failed to detect a significant difference in the stability of root coverage after 240 ± 12 months between CTG and GTR (P = 0.448) and patients' assessments of their treatment outcomes (P = 0.503).Conclusion: Long-term stability of root coverage and patient-perceived esthetic outcomes failed to show significant differences between CTG and GTR at 20 years post-surgery. [ABSTRACT FROM AUTHOR]

The treatment of drug-induced gingival overgrowth is compounded by the high recurrence rate resulting from chronic use of the medication and the persistence of other risk factors. In this case series, the treatment outcome of a nonsurgical periodontal therapy, according to the concept of full-mouth disinfection in 11 patients with drug-induced gingival overgrowth, is described. All clinical parameters improved significantly after therapy. Only 6% of teeth received further surgical treatment. The clinical situation remained stable during the recall. The present case series suggests that full-mouth disinfection might be a beneficial treatment concept for drug-induced gingival overgrowth, reducing the need for further surgical intervention. [ABSTRACT FROM AUTHOR]

Objective: The use of connective tissue grafts is a proven, effective treatment modality. This study examines whether harvesting connective tissue grafts from the palate causes persistent sensory dysfunction. Methods and Materials: Fourteen patients who had received at least 1 graft were included. Neurosensory tests at the palate performed postoperatively included minimal 2-point discrimination, soft-touch discrimination, pin-tactile discrimination, and thermal discrimination. Measurements were taken at 3 sites each: 5, 10, and 15 mm from the palatal tissue margin at canines, premolars, and first molars. Results: Eight patients had 1 graft, and 6 patients had 2 grafts harvested from their palate. Twelve patients had never noticed any dysfunction. Two patients reported a persistent numbness or a rough palatal surface. Statistically significant differences between donor sites and nondonor sites were shown by 2-point discrimination 5 mm from the margin of canines (6.57 mm +/- 3.79 mm at donor sites and 4.71 mm +/- 4.14 mm at nondonor sites, P = .01). Repeated-measures analysis of variance showed statistically significant differences between donor sites and nondonor sites for measurements taken 5 and 10 mm from the margin of all included teeth (P = .02). Conclusions: Some sensory changes can occur after graft harvesting from the palate. (Quintessence Int 2009;40:479-489). [ABSTRACT FROM AUTHOR]

Connective tissue grafts (CTGs) are generally viewed as the most successful technique for root coverage. The aim of this retrospective study was to assess the long-term clinical and patient-centered esthetic results of the envelope technique for CTG. Thirty-nine defects in 20 patients (22 to 57 years of age; mean 37.8 +/- 11.5 years) had received CTG that had been harvested from the palate and grafted according to the envelope technique of Raetzke. Factors influencing root coverage were identified by multilevel analysis. The patients were also asked to judge the results of treatment. Follow-up examinations were performed 6 to 22 years (mean, 11.4 +/- 5.4 years) after surgery. Mean baseline recession was 3.1 +/- 1.3 mm (range, 1 to 6 mm). Clinical re-examination revealed mean root coverage of 89.7% +/- 25.1%. In 32 of 39 defects (82%), complete root coverage was achieved. Recessions were statistically significantly reduced by a mean of 2.7 +/- 1.2 mm (P < .001), to a postsurgical mean of 0.4 +/- 0.94 mm. Higher baseline Miller classes resulted in less favorable prognoses for complete and relative root coverage. Baseline recession height had a negative influence and location at a canine had a positive influence on the percentage of relative root coverage. All patients judged the situation at the respective teeth as improved. [ABSTRACT FROM AUTHOR]

One statement holds true for all meta-analyses of regenerative periodontal therapy: the results show a marked heterogeneity, i.e. the results of regenerative therapy vary widely. What is the reason for this? Is it left to chance whether flap surgery with regenerative procedures, such as guided tissue regeneration (GTR) or enamel matrix proteins (EMP), results in improved attachment gain or osseous filling? Or are there factors that influence therapeutic success? One thing is clear: before planning regenerative procedures, anti-infectious therapy should be completed. Patients should practice proper personal oral hygiene and, other than the defects that are to be regenerated, residual pockets should be absent. Other factors influencing the success of regenerative therapy in bony pockets and class II furcation defects are smoking, defect depth and breadth, availability of soft tissue for flap formation, position of the furcation fornix in relation to approximal bone, and tooth mobility. [ABSTRACT FROM AUTHOR]

A case of necrotizing ulcerative periodontitis (NUP), the most severe inflammatory periodontal disorder caused by plaque bacteria, is shown. Clinically, the gingiva showed distinct signs of ulceration, and radiography revealed horizontal bone loss. Indirect immunofluorescence, carried out on frozen sections of tissue specimens obtained from the NUP lesion, exhibited clear expression of atypical keratin K19, particularly in basal cells, when compared to noninflamed gingiva. Moreover, NUP tissue showed extensive intraepithelial abundance for the basement membrane component laminin-1/10 and the extracellular matrix molecule tenascin. Strong expression of integrin subunit alphav and matrix metalloproteinase-13 in conjunction with interleukin 1-beta further discriminated NUP gingival epithelium from normal tissue. The results suggest that NUP is associated with changes in the expression and topography of the analyzed molecules in the gingival epithelium, which in turn may reflect the fast progression of the disease. [ABSTRACT FROM AUTHOR]

A 25-year-old male patient with skin lesions of Langerhans' cell histiocytosis (LCH) was referred for periodontal treatment because of bilateral severely inflamed ulcerative periodontal lesions at the mandibular second premolar and first molar. On the left side, significant bone loss was revealed. Anti-infectious and surgical periodontal therapy resulted in significant probing pocket depth reduction and clinical attachment gains that were maintained for up to 24 months after surgery. Biopsies were taken during periodontal surgery. Immunohistochemical staining revealed that the periodontal lesions were uncommon periodontal manifestations of LCH. Reports of oral manifestation of LCH and treatment methods are reviewed. [ABSTRACT FROM AUTHOR]

Occurrence of halitosis, breath malodour or 'bad breath' may indicate certain medical problems (e.g. periodontitis) and may cause social problems. In only 10% of all cases halitosis is caused by an internal (e.g. diabetes mellitus, oesophagitis) or ear-nose-throat problem. For the remaining 85-90% quite a wide range of different oral causes (e.g. gingivitis, periodontitis, necrotising ulcerative gingivitis and periodontitis, caries lesions with food impaction, fissurated tongue) exists. Halitosis may be assessed clinically (organoleptic) or by using instrumental devices. Together with patient history, careful examination provides information about the most likely case of malodour. With a dental cause, an effective individual oral hygiene programme should be rendered. Therapy will be targeted at reduction of oral micro-organisms, reduction of bacterial nutrients, transformation of volatile sulphur compounds into non-volatile molecules and, if required, rinsing solutions to mask halitosis. Harbouring approximately 60% of all oral bacteria, the tongue should be cleaned by the patient on a daily basis. If halitosis is caused by periodontitis, a systematic anti-infective periodontal programme eventually followed by periodontal surgery should solve the problem. [ABSTRACT FROM AUTHOR]

The majority of inflammatory periodontal diseases is caused by bacteria. Mechanical removal of bacterial deposits from the teeth by the patient (individual oral hygiene) and mechanical debridement by the dentist (professional tooth cleaning, antiinfective periodontal therapy, periodontal surgery) are effective in treatment of most cases of plaque-induced gingivitis and periodontitis. However, in particular risk patients (e.g. under elevated risk for bacterial endocarditis) periodontal procedures that cause transitory bacteremia require systemic antibiotic prophylaxis. Further, in severe cases of necrotising ulcerative gingivitis and periodontitis local therapy has to be supported by systemic antibiotics. In cases of aggressive and generalised severe chronic periodontitis that show subgingival infection with particular periodontal pathogens, especially by Actinobacillus actinomycetemcomitans, successful therapy requires systemic antibiotics adjunctively to mechanical antiinfective therapy. Therapy of persisting pockets during supportive periodontal therapy may additionally benefit from application of locally delivered antibiotic devices. [ABSTRACT FROM AUTHOR]

The article presents a commentary on clinical periodontal diagnosis and issues therein, like probing pocket depth, vertical attachment level and bleeding on probing. The clinical signs of periodontitis are periodontal pocketing, attachment loss, bone loss and subgingival inflammation. Clinical measurements of probing pocket depths and clinical assessments of vertical probing attachment loss by periodontal probes have a lower validity and have the problems of sensitivity and specificity and needs to take into consideration, the measurement errors.

Purpose: The purpose was to investigate the effect of the surgeon's dominant hand and the side (right or left) of surgical removal of third molars in the mandible on the probing pocket depth and probing attachment level on the adjacent second molars.Patients and Methods: This study included 73 patients (46 female and 27 male patients; average age, 15.9 ± 1.9 years) with 146 asymptomatically submucosal (fully covered by oral mucosa) or impacted (completely enclosed by bone) lower third molars surgically removed by a right-handed surgeon. The probing pocket depth and probing attachment level (outcome variables), as well as the gingiva and plaque indexes (other variables), were documented preoperatively and 6 months after surgical removal. Descriptive and bivariate statistics were computed, and the P value was set at .05.Results: The mean probing pocket depth decreased by 0.69 mm on the lower left second molar and by 0.64 mm on the lower right second molar over the follow-up of 6 months. The mean attachment gain was 0.45 mm for the lower left second molar and 0.40 mm for the lower right second molar. The side differences between these changes in probing pocket depth (P = .620) and probing attachment level (P = .545) were not significant. The gingival index (P = .029) and plaque index (P = .007) deteriorated significantly for the lower right compared with the lower left second molar.Conclusions: For a right-handed surgeon, the operated side had no influence on the changes in probing depth and attachment level on the adjacent second molars. [ABSTRACT FROM AUTHOR]

Background: To assess oral health‐related quality of life (OHRQoL) after long‐term (20 years) periodontal treatment in patients with chronic periodontitis (ChP) and to compare it with the current clinical outcome and oral health status. Methods: Twenty years after therapy, 63 patients were reexamined. The dental and periodontal status and OHRQoL using the Oral Health Impact Profile‐G49 (OHIP‐G49) were assessed. Descriptive statistics, correlation analysis, and tests for differences were calculated. Results: Up to 75% of patients showed no probing depths > 5mm, bleeding on probing (BOP) ≤25%, no pain and satisfactory function. A comparatively low perceived oral impact of ChP was represented by an OHIP‐G49 overall score of 18.89 ± 21.66. The most common reported impairment was physical pain followed by "functional limitation." A correlation between oral quality standard and the OHIP‐G49 was limited to the physical pain subdomain. Conclusions: Satisfaction with oral status was perceived high by most patients treated for chronic periodontitis. A comparably high OHRQoL can be achieved and retained long‐term after periodontal treatment. The objective and subjective evaluation of oral health only correlated in the subscale "physical pain." [ABSTRACT FROM AUTHOR]

Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non‐periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non‐dental plaque biofilm–induced gingival diseases and dental plaque‐induced gingivitis. Non‐dental plaque biofilm‐induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque‐induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque‐induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non‐periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient‐centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate long-term stability of attachment achieved in infrabony defects (IBDs) by regenerative treatment.Methods: All patients who had received regenerative treatment for at least one IBD between 2004 and 2010 were screened for this retrospective case series. If complete examinations (plaque/gingival index, probing depth [PD], vertical clinical attachment level [CAL-V]) were available for patients at baseline and 12 months after surgery, they were invited for reexamination 60 ± 12 months after surgery. Reexamination involved testing for interleukin (IL)-1 polymorphism and counting number of supportive periodontal treatment (SPT) visits. Forty-one patients (24 males and 17 females; age, median: 62.0 years, lower/upper quartile: 49.8/68.3 years; six smokers, and 9 IL-1 positive) were included for analysis, each contributing one IBD.Results: Regenerative therapy resulted in significant attachment gain after 1 (median: -3 mm, lower/upper quartile: -1.5/-4 mm; P <0.001) and 5 (median: -3 mm, lower/upper quartile: -1.9/4.5 mm; P <0.001) years. The study failed to detect median change of CAL-V from 1 to 5 years after surgery (median: 0 mm; lower/upper quartile: -1/1.5 mm; P = 0.84). Multiple regression analysis identified that number of SPT visits is correlated with CAL-V gain from 1 to 5 years after surgery. IL-1 polymorphism and percentage of sites with PD >6 mm at 5-year reexamination are correlated with CAL-V loss from 1 to 5 years after surgery.Conclusions: CAL-V achieved by regenerative therapy in IBDs may have retained stability over 5 years. Frequent SPT is associated with stability. IL-1 polymorphism and generalized reinfection are associated with less stability. [ABSTRACT FROM AUTHOR]

Background: The collection of subgingival plaque samples with paper points is time-consuming and accident-sensitive. However, the collection of saliva is simple and contains pathogens of all intraoral surfaces. The aim of this study is to investigate whether a sampling strategy with mouthrinse (mouthrinse sample [MSP]; test) leads to results comparable with standard sampling method (multiple site test from the deepest pocket of each quadrant [MT4]; control).Methods: In 50 patients with periodontitis, subgingival plaque was sampled from the deepest pocket of each quadrant by using paper points and by gaining saliva with saline mouthrinse. Analysis was performed using a commercially available polymerase chain reaction test for 11 periodontal pathogens.Results: Detection frequency of Aggregatibacter actinomycetemcomitans (MT4/MSP: 42%/36%), Porphyromonas gingivalis (78%/66%), Tannerella forsythia (98%/84%), Treponema denticola (94%/74%), Parvimonas micra (86%/62%), Campylobacter rectus (90%/76%), Eubacterium nodatum (64%/30%), Prevotella intermedia (58%/54%), and Eikenella corrodens (90%/82%) was higher with MT4 than MSP. For Fusobacterium nucleatum (100%/100%), there was no difference between test and control. Only detection frequency of Capnocytophaga species (68%/74%) was higher with MSP than MT4. Differences were significant for P. gingivalis, T. forsythia, T. denticola, P. micra, C. rectus, and E. nodatum.Conclusions: There is no significant difference between MT4 and MSP for detection frequency of key pathogen A. actinomycetemcomitans. Key pathogens P. gingivalis, T. forsythia, T. denticola, P. micra, C. rectus, and E. nodatum show statistically higher detection frequencies with MT4. [ABSTRACT FROM AUTHOR]

Background: The aims of the present study were to evaluate 1) defect depth and width as a prognostic factor and 2) change in defect width as a describing parameter of periodontal healing in infrabony defects treated by regenerative therapy after 6 and 24 months. Methods: In 24 patients with advanced periodontitis, 39 infrabony defects were treated by guided tissue regeneration (GTR) using expanded polytetrafluoroethylene (ePTFE) (n = 7) or bioabsorbable barriers (n = 32). Clinical parameters were assessed and 39 standardized radiographs (in triplicate) were taken before and 6 and 24 months after surgery. Using a computer-assisted analysis, the depth, width, and angle of the bony defects were measured. Results: Statistically significant vertical clinical attachment gains (CAL-V: 3.15 +/- 1.63 mm to 3.31 +/- 1.65 mm; P<0.001) and bony fill (1.30 +/- 2.53 mm; P<0.01 to 1.54 +/- 2.70 mm; P<0.005) were observed 6 and 24 months postsurgically. In a multilevel regression analysis CAL-V gain was predicted by baseline CAL-V (P <0.0001), actual smoking (P <0.05), and age (P <0.1). Bony fill could be predicted by baseline height of the infrabony component (P<0.0001), gingival index at baseline (P<0.05), and actual smoking (P <0.01). In narrow (<26 degrees) and deep (> or = 3 mm) infrabony defects bony fill was more pronounced than in wide and shallow defects (P <0.05). Conclusions: Improvement achieved by guided tissue regeneration in infrabony defects can be maintained up to 24 months after surgery. Narrow and deep infrabony defects respond radiographically and to some extent clinically more favorably to GTR therapy than wide and shallow defects. However, depth of the infrabony component was a stronger prognostic parameter than defect angle. Actual smoking impairs the results of GTR therapy in infrabony defects. [ABSTRACT FROM AUTHOR]

Background: The aim of this 5-year follow-up study was to clinically and radiographically evaluate the long-term results after guided tissue regeneration (GTR) therapy of Class II furcation defects using non-resorbable and bioabsorbable barriers. Methods: Nine pairs of contralateral Class II furcation defects were treated in 9 patients with advanced periodontitis. Within each patient, one defect received a non-resorbable (expanded polytetrafluoroethylene [ePTFE]; control, C) barrier and the other a bioabsorbable (polyglactin 910; test, T) barrier by random assignment. At baseline, 6, and 60 +/- 3 months after surgery, clinical parameters and standardized radiographs were obtained. Gain of bone density within furcation areas was assessed using subtraction radiography. Results: Six and 60 months after GTR therapy, statistically significant (P <0.05) horizontal attachment (CAL-H) gain was observed in both groups (C6: 1.7 +/- 0.8 mm; C60: 1.6 +/- 1.2 mm; T6: 2.0 +/- 0.7 mm; T60: 2.2 +/- 0.9 mm). However, 1 furcation assessed as Class I six months after GTR therapy with a bioabsorbable barrier had progressed to Class III after 5 years, and in another patient, 5 years after placement of an ePTFE barrier, 1 furcation had lost all the CAL-H gain that had been observed at 6 months. Subtraction analysis revealed similar area gain in both groups 6 and 60 months postsurgically (C6: 0.3 +/- 0.5; C60 1.0 +/- 1.7; T6: 0.4 +/- 0.4; T60: 1.1 +/- 1.7). Conclusions: CAL-H gain achieved after GTR therapy in Class II furcations was stable after 5 years in 16 of 18 defects. The study failed to show a statistically significant difference in stability of CAL-H gain between control and test groups 5 years after GTR therapy. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the effects of guided tissue regeneration (GTR) using 2 different bioabsorbable barriers (control: polylactide acetyltributyl citrate; test: polydioxanon). The polydioxanon barrier is an experimental membrane for GTR therapy that consists of a continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap.Methods: In 21 patients with 22 pairs of similar contralateral defects (30 intrabony and 14 Class II furcation lesions), each defect was randomly assigned for treatment with either control (c) or test (t) devices. At baseline and 12 months after surgery, clinical measurements, plaque index (PI) gingival index (GI), probing depth (PD), and vertical and horizontal clinical attachment loss (CAL-V; CAL-H) and standardized radiographs were obtained.Results: Barrier exposure was commonly observed in both groups. Four weeks after surgery 61% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (P <0.005), PD reduction (-3.08 +/- 2.29 mm [t]; -3.52 +/- 2.67 mm [c]; P <0.001) and CAL-V gain (2.44 +/- 2.29 mm [t], 2.80 mm +/- 2.21 [c]; P <0.001) 12 months after surgery in all defects. Within the intrabony defects significant bony fill (2.03 +/- 1.70 mm [t]; 1.91 +/- 1.20 mm [c]; P = 0.001), and within the furcations a significant but small CAL-H gain (0.79 +/- 0.68 mm [t]; 1.13 +/- 1.44 mm [c]; P <0.05), was observed.Conclusions: Regarding GI and PD reduction as well as CAL-V and CAL-H gain, this study failed to reveal statistically significant or clinically relevant differences between test and control 12 months postsurgically. Thus, the use of both bioabsorbable barriers in GTR therapy may be recommended. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the assessment of progression of demineralization by digital subtraction radiography. In each of 14 extracted human teeth, 2 approximal enamel demineralization lesions were induced in vitro to simulate dental caries. A modified tunnel preparation with glass ionomer fillings was performed on one lesion of every tooth as a model of caries inhibition. Every week, radiographs were obtained under standardized conditions over a period of 42 days. The radiographs were digitized and calibrated for grayscales. Reference landmarks were chosen and aligned for the different pictures by computer-assisted imaging to adjust the images for projective distortions. The images of the 7th, 14th, 21st, 28th, 35th and 42nd day were subtracted from the baseline radiograph. The mean value of gray values of the subtraction images was calculated and ANOVA tests for repeated measurements and paired t tests were used for statistical analysis. The results of the present study indicate that statistically significant gray level changes due to progression of demineralization could be detected in the radiographic images by subtraction analysis. Differences between glass ionomer-filled and nonfilled lesions failed to reach significance. The introduced method may have the potential to detect and document minute caries progression. [ABSTRACT FROM AUTHOR]

The article presents a study regarding the shared genetic risk factors of coronary artery disease (CAD) and periodontitis. The shared genetic risk factors identified by the researchers include plasmogen, antisense non-coding RNA in the INK4 locus (ANRIL) and calmodulin binding transcription activator 1(CAMTA1)/vesicle-associated membrane protein 3 (VAMP3). The researchers found these factors are members of transforming growth factor-β signaling.

Background: The aim of this study was to compare bone regeneration as assessed by subtraction radiography with clinical attachment measurements 24 months after regenerative surgery. Methods: In 24 patients with advanced periodontitis, 34 Class II and 10 Class III furcations were treated by guided tissue regeneration using expanded polytetrafluoroethylene (n = 18) or bioabsorbable barriers (n = 26). Clinical parameters were assessed and 40 pairs of standardized radiographs were taken before and 24 months after surgery. Bony gain within furcations was assessed using subtraction analysis. Results: In Class II furcations, statistically significant (P <0.001) vertical (CAL-V: 1.06+/-1.56 mm) and horizontal (CAL-H: 2.05+/-1.24 mm) attachment gain was observed 24 months postsurgically. Within Class III defects CAL-V gain was assessed 1.78+/-1.43 mm (P <0.005). CAL-H gain in buccal and lingual Class II furcations was explained by the relative density gain, baseline CAL-H, gingival index (GI) reduction, and individual patients (P <0.001) whereas, multiple regression analysis failed to show a relation between CAL-H gain and any of the subtraction parameters for interproximal furcations. Vertical attachment gain in interproximal sites was explained by net bony area gain (subtraction), PD and GI reduction, baseline CAL-V, defect type, smoking, and individual patients (P<0.001). Conclusions: There was a statistically significant correlation between clinical and radiographic improvements within furcation defects. However, this correlation was modulated by other factors such as baseline CAL-V or CAL-H, PD and GI reduction, or smoking. The relative density gain seemed to sufficiently describe bony changes related to clinical changes within buccal and lingual furcations, whereas bone area gain suitably described bony changes in interproximal Class II and III furcations. [ABSTRACT FROM AUTHOR]

The aim of the present study was to clinically and radiographically compare guided tissue regeneration (GTR) therapy with bioabsorbable polyglactin 910 barriers and conventional periodontal surgery in intrabony defects. In 26 patients with advanced periodontitis, 29 teeth exhibiting interproximal intrabony defects were treated; 15 by conventional periodontal surgery (control) and 14 by GTR (test). Before and 12 months after surgery, clinical parameters were assessed and standardized radiographs were taken. On the radiographs the distances from the cemento-enamel junction (CEJ) to the alveolar crest (AC), and the CEJ to the most apical extension of the bony defect (BD) were measured using a computer-assisted analyzing device (LMSRT). Twelve months after surgery, 24 patients with 27 lesions were available for examination. For both methods statistically significant (P < 0.001) probing depth (PD) reduction (mean +/- standard deviation) of -4.49 +/- 1.94 mm (n = 13, test) and -3.22 +/- 1.48 mm (n = 14, control), as well as clinical attachment gain (CAL-V) of 3.41 +/- 1.59 mm (test) and 2.07 +/- 1.10 mm (control), was observed. Radiographic changes of the distance CEJ to AC of -0.95 +/- 1.72 mm (n = 9, test), and -0.98 +/- 1.53 mm (n = 11, control) were not significant. A significant bony fill (distance CEJ-BD) of 1.05 +/- 1.22 mm was observed for the test group (P < 0.01); the 0.68 +/- 2.04 mm bony gain for the control group was not statistically significant. The PD reduction (P < 0.05) and attachment gain (P < 0.01) in the test group was statistically significantly more favorable than in the control group. Twelve months after surgery, statistically more favorable PD reduction and attachment gain was observed using polyglactin 910 barriers than compared to conventional flap surgery. Hence, the use of bioabsorbable barriers for therapy of intrabony defects may be recommended. [ABSTRACT FROM AUTHOR]

Background: This aim of this study is to compare regenerative therapy of infrabony defects with and without administration of post-surgical systemic doxycycline (DOXY) 12 and 24 months after therapy. Methods: In each of 57 patients, one infrabony defect (depth >4 mm) was treated regeneratively using enamel matrix derivative at two centers (Frankfurt am Main and Heidelberg). By random assignment, patients received either 200 mg DOXY per day or placebo (PLAC) for 7 days after surgery. Twelve and 24 months after surgery, clinical parameters (probing depths [PDs] and vertical clinical attachment level [CAL-V]) and standardized radiographs were obtained. Missing data were managed according to the last observation carried forward. Results: Data of 57 patients (DOXY: 28; PLAC: 29) were analyzed (26 males and 31 females; mean age: 52 ± 10.2 years; 13 smokers). In both groups, significant (P<0.01) PD reduction (DOXY: 3.7 ± 2.2 mm; PLAC: 3.4 ± 1.7 mm), CAL-V gain (DOXY: 2.7 ± 1.9 mm; PLAC: 3.0 ± 1.9 mm), and bone fill (DOXY: 1.6 ± 2.7 mm; PLAC: 1.8 ± 3.0 mm) were observed 24 months after surgery. However, the differences between both groups failed to be statistically significant (PD: P = 0.574; CAL-V: P = 0.696; bone fill: P = 0.318). Conclusions: Systemic DOXY, 200 mg/day for 7 days, after regenerative therapy of infrabony defects did not result in better PD reduction, CAL-V gain, or radiographie bone fill compared with PLAC 12 and 24 months after surgery, which may be attributable to low power and, thus, random chance. [ABSTRACT FROM AUTHOR]