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In humans, ascorbic acid, better known as vitamin C, is a true vitamin because humans lack the ability to synthesise it. Vitamin C exhibits a number of enzymatic and non-enzymatic effects but all are accounted for by the ability of vitamin C to donate electrons and therefore acts as a reducing agent. It has a wide range of functions. For example, it acts as co-factor for a number of enzymes including those involved in collagen hydroxylation, prevents oxidative damage to DNA and intracellular proteins, and in plasma it increases endothelium-dependent vasodilatation, and reduces extracellular oxidants from neutrophils. Deficiency in vitamin C results in the potentially fatal disease scurvy, which can be cured only by administering vitamin C. It has been shown that in individuals with gingivitis and periodontitis, plasma vitamin C levels are lower than in healthy controls. In periodontitis, a reduced capacity to absorb vitamin C may play a role. The manner in which vitamin C data are obtained from blood significantly impacts the final value obtained and therefore data validity. Plasma vitamin C levels of 56.8 μmol/l may be regarded as the optimum plasma level. In order to achieve this level, at least 200 mg vitamin C per day should be ingested. It is advisable to obtain vitamin C through the consumption of fruit and vegetables rather than supplements. [ABSTRACT FROM AUTHOR]

Abstract Objective Periodontitis is associated with cardiovascular diseases (CVD). In our previous studies a prothrombotic state has been observed in periodontitis, which contributes to the risk of CVD. The aim of this study was to investigate whether serum IgG levels against Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) in periodontitis were associated with a prothrombotic state. Materials and methods Patients with moderate (n = 38) and severe periodontitis (n = 30) and controls (n = 24) were recruited. We explored correlations between serum anti-Aa and anti-Pg IgG and plasma levels of markers of prothrombotic state (von Willebrand Factor [vWF], prothrombin fragment 1+2 [F1+2], plasminogen activator inhibitor-1 [PAI-1] and D-dimer). Multivariate analyses were performed considering several major potential contributing factors. Results Periodontitis patients showed higher anti-Aa IgG (p = 0.015) than controls but not for Pg (p = 0.320). In periodontitis patients, body mass index and anti-Aa IgG showed a positive correlation with vWF (β = 0.297, p = 0.010 and β = 0.248, p = 0.033 respectively). Conclusions In periodontitis, infection with Aa together with other well accepted risk factors for CVD, may play a role in increasing the risk for prothrombotic state.

Purpose: Ridge preservation protocols reduce crestal remodeling after tooth extraction. There is insufficient evidence on bone grafting in combination with platelet-rich plasma (PRP) or recombinant human platelet-derived growth factor (rhPDGF-BB). The aim of this study is to evaluate healing of grafted and nongrafted sockets and the effect of PRP and rhPDGF-BB on early remodeling. Materials and Methods: Forty-one patients whose treatment plan included extraction of anterior or premolar teeth were randomized into four groups. Group 1: collagen plug (control). Group 2: mineralized freeze-dried bone allograft (FDBA)/β-tricalcium phosphate (β-TCP)/collagen plug. Group 3: FDBA/β-TCP/PRP/collagen plug. Group 4: FDBA/β-TCP/rhPDGF-BB/ collagen plug. At 8 weeks, a core was harvested from the center of 41 sockets. Histomorphometric analysis took place. Differences were analyzed using one-way analysis of variance (ANOVA) or chi-square tests for continuous and categorical data. Pairwise comparisons were tested using least squares means. Spearman correlation coefficients were used to evaluate the relationship of bone growth with potential confounders. A P value < .05 was considered statistically significant. Results: ANOVA did not indicate statistical significance in age, gender, smoking, ethnicity, or race distribution. Significant differences in tissue distribution were identified between groups and between different thirds of harvested core. More new bone and amorphous organic matrix was noted in the control group. In sites where bone graft was combined with growth factors, the amount of residual particles was less than in sites where bone graft was used alone. Conclusions: Inclusion of bone replacement graft suppressed new bone formation during early healing. Inclusion of PRP and rhPDGF-BB produced less residual bone graft material, indicating more rapid turnover of bone graft. All treatment modalities achieved a significant amount of new vital bone at 8 weeks postextraction. [ABSTRACT FROM AUTHOR]

This article describes the clinical procedure and outcome of surgical treatment of gingival recessions with the adjunctive use of Emdogain gel, an enamel matrix derivative bioactive material for periodontal reconstructive surgery. Six cases with gingival recession on maxillary canines are presented with 12 months of followup. Initial gingival recession averaged 4.8 mm, with a mean probing pocket depth of 2.2 mm. At the 12-month follow-up, a mean of 3.5 mm of root coverage was observed (ie, 73% root coverage, range 60% to 100%). Probing pocket depth averaged 1.7 mm, indicating a 4-mm gain of clinical attachment (range 3 to 5 mm). On a clinical level, mucogingival surgery in combination with the application of Emdogain gel results in predictable root coverage and gain of clinical attachment while maintaining shallow pockets. [ABSTRACT FROM AUTHOR]

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