Search

Objectives: Anti‐resorptive agents have been linked to the development of MRONJ in patients undergoing dental surgical procedures. This survey aims to explore the level of knowledge and experience of Italian Society of Periodontology and Implantology members in the management of patients treated with anti‐resorptive agents and with the risk of developing MRONJ. Materials and Methods: An 18‐item questionnaire was submitted by e‐mail to the SIdP members. Statistical analyses were carried out. Continuous variables were described as mean ± standard deviation (SD) or median, and first and third quartile according to distribution's normality. Normality of data was checked with Shapiro–Wilk test. Results: Four hundred and fifty‐one questionnaires were returned by e‐mail (32%). Most of the respondents were private practitioners (81.8%). Only 47.7% declared to be highly confident in managing patients on anti‐resorptive therapy while 92.5% reported to have performed tooth extractions and 52.3% implant surgery in patients under anti‐resorptive therapy for osteometabolic disorders. One or more MRONJ‐affected patients were encountered by 63.2% of the respondents. Conclusions: This survey highlights the need to develop a "dedicated" program both for dentists and prescribers to improve the level of cooperation and to increase the level of awareness of patients treated with anti‐resorptive agents. [ABSTRACT FROM AUTHOR]

Background: The role of vigorous root planing in the surgical treatment of gingival recession was recently questioned. The aim of the present randomized controlled split-mouth clinical study was to compare the effectiveness, in terms of root coverage, of hand and ultrasonic root instrumentation in combination with a coronally advanced flap for the treatment of isolated type recession defects. Methods: Eleven systemically and periodontally healthy subjects with bilateral recession defects (≥3 mm) of similar (≤1 mm) depth affecting contralateral teeth were enrolled in the study. Only Miller Class I gingival recession with no deep cervical abrasion or root caries/demineralization were included in the study. Control root exposures were treated with curets, whereas test roots were instrumented with ultrasonic piezoelectric devices. Randomization for test and control treatment was performed by a coin toss immediately prior to surgery. All recessions were treated with a coronally advanced flap surgical technique. The clinical reevaluation was made 6 months after surgery. Results: The two approaches resulted in a high percentage of root coverage (95.4% in the control group and 84.2% in the test group) and complete root coverage (03% in the control group and 55% in the test teeth), with no statistically significant difference between them. Clinical attachment level gains were clinically significant in both groups (3.36 ± 0.92 mm in the control group and 2.90 ± 0.70 mm in the test group), with no statistically significant difference between them. The increase in keratinized tissue height was statistically significant in both groups (0.55 ± 0.52 mm in the control group and 0.36 ± 0.67 mm in the test group), with no difference between them. Conclusions: The present study failed to demonstrate any superiority, in terms of root-coverage results, for hand instruments over ultrasonic treatment of the root surface in combination with coronally advanced flap mucogingival surgery. Further studies of longer-term duration and larger sample size could help to establish the superiority of one form of root instrumentation in conjunction with root-coverage surgery. [ABSTRACT FROM AUTHOR]

Background: Bacterial contamination of membrane material negatively affects healing after guided tissue regeneration (GTR) procedures; conversely, flap connective tissue integration on barrier material improves the clinical outcomes. The objective of this study was to evaluate the effect of topical application of antibiotics on: 1) clinical outcomes of GTR surgical procedures using titanium reinforced expanded polytetrafluoroethylene (ePTFE) periodontal membrane; 2) bacterial colonization of membrane material; and 3) flap connective tissue-membrane integration. Methods: Fifty-six deep interproximal bony defects were treated with GTR surgical procedures using titanium reinforced ePTFE periodontal membranes. Patients were randomly assigned to 1 of the 2 antimicrobial treatment groups: the test group received weekly topical application of 25% metronidazole gel and the control group received systemic antibiotics (amoxicillin plus clavulanic acid 1g/day for 14 days). Clinical outcomes were assessed at 1 year; the amount of bacterial contamination and connective tissue integration on membrane material was evaluated at time of membrane removal by means of a morphological (SEM) method. Results: No statistically significant difference was found between test and control groups in terms of clinical attachment (CAL) gain (baseline CAL - 12 months CAL; P = 0.2) and probing depth (PD) reduction (baseline PD - 12 months PD; P= 0.6). A greater increase in gingival recession (REC) (12 months REC - baseline REC) was found in the test group compared to the control group (P = 0.003). The SEM analysis revealed no statistically significant (t test) difference between test and control groups in the number of fields positive to integrated connective tissue (P = 0.32), while the number of fields positive to bacteria was statistically higher (P < 0.001) in the control group. Conclusions; Local antibiotic administration is more effective than systemic use in preventing membrane contamination, but it does not improve clinical outcomes due to an interference of the vehicle (gel) with gingival tissues which may reduce the potential benefits derived from better control of the bacterial load. [ABSTRACT FROM AUTHOR]

Background/aims: Assessment of the influence of toothbrush wear on plaque (PI) and gingival (GI) indexes., Method: 20 university students were recruited. PI and GI were recorded at the starting point (T0). Each subject received a toothbrush and toothpaste. 5 measurements of toothbrush were recorded to establish the initial size. The subjects were instructed to brush 3 x a day and to refrain from using other plaque removal aids. After 1 month (T1), the subjects were randomly divided into 2 groups: group no. 1 substituted the toothbrush at each monthly visit; group no. 2 brushed only with the toothbrush provided at T0. Recalls were scheduled after 1 (T1), 2 (T2) and 3 months (T3). PI, GI and an index of wear (WI) were calculated using 5 measurements of the toothbrush head and were recorded at recalls., Results: From T0 to T3, a significant increase of PI was found within both groups. Non-significant differences, but very close to the significant level (p= 0.063), in group no. 1 and significant differences in group no. 2 of GI were found. No significant differences of PI and GI were found between groups. Increase of the WI was registered from T0 to T3 (p<0.001)., Conclusion: Each individual is capable of maintaining low PI, even if using a toothbrush that shows evidence of wear.