- Email: [email protected]
Mucogingival junction reverts to original position after CRF surgery
diographic evidence of internal or external pathology or abnormality postoperatively. Results.—One hundred eight teeth had IPT and 118 had FP; follow-up lasted a mean of 3 years 4 months. The success rates for the 2 procedures did not differ significantly. IPT had a 3+-year success rate of 94% and FP 70%, including 13 FPs with GIC as the final restoration; without these 13, the FP success rate was 74%, which was still significantly less than the 94% achieved with IPT. At 1 year, the success rates for FP and IPT were similar (95% and 98%, respectively), but from the second year on, IPT results were significantly better than FP outcomes. Two percent of the IPT teeth and 36% of the FP teeth were early exfoliations, for a significant difference between the 2 therapies. The outcome of 226 teeth that received a CC procedure 1 to 3 months before either IPT or FP was assessed. Fifty of 58 GIC restorations were in place before IPT or FP and were classified as successful. One hundred seventy-six teeth did not have successful GIC caries lesion control. Teeth that had a CC restoration had a 92% success rate; teeth not having the CC restoration had a 79% success rate. The IPT/FP success rate was 90% for the treatment of first primary molars with GIC CC restorations before pulpal therapy; it was 71% when no GIC CC restoration was used. Primary first molars had a combined IPT/FP success rate of 76%; primary second molars had a combined rate of 91%. Of primary molars with a history of pain, IPT had an 85% success rate and FP had a 53% success rate. No statistically significant difference in success rate was found between the groups
for those with a history of pain compatible with reversible pulpitis. No difference in success rates was linked to the type of restoration used. Discussion.—IPT achieved a higher success rate in primary molars than FP did. The use of GIC CC therapy for 1 to 3 months before vital pulp therapy improved the success of the therapy, particularly when the primary first molars were involved. Reversible pulpitis responded to IPT much more than to FP. Primary second molar therapy was significantly more successful than primary first molar therapy, mostly as a result of the lower pulpotomy success in primary first molars. Significantly earlier exfoliation was found when FP was used compared with IPT.
Clinical Significance.—How best to deal with extensive caries in the deciduous dentition is explored here. Compared are caries control with zinc oxide eugenol or glass ionomer, formocresol pulpotomy, and indirect pulp cap.
Vij R, Coll JA, Shelton P, et al: Caries control and other variables associated with success of primary molar vital pulp therapy. Pediatr Dent 26:214-220, 2004 Reprints available from JA Coll; e-mail: [email protected]
Periodontics Mucogingival junction reverts to original position after CRF surgery Background.—Relative to fixed skeletal points, the mucogingival junction (MGJ) remains stable with age, forming the border between genetically determined basal bone and the alveolar processes. Whether this position is altered when coronally repositioned flap (CRF) procedures are undertaken was evaluated. Methods.—The 13 patients had 26 Miller Class I buccal gingival recessions for which CRF procedures were done.
Measurements included location of the gingival margin (LGM), probing depth (PD), clinical attachment level (CAL), width of keratinized gingiva (WKG), and location of the MGJ (LMGJ). These were obtained at baseline and 1, 6, 12, and 60 months after surgery. Results.—Significant correlations were found between the LGM, CAL, WKG, and LMGJ at baseline and after 60 months. After 1 month the LGM was displaced coronally a
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mean of 1.50 mm and the LMGJ was displaced coronally a mean of 2.01 mm. After 60 months the mean apical displacements were 0.67 and 0.98 mm, respectively. The degree of change over time differed significantly between the LGM and LMGJ. No change or a decline was found in more than half the sites for each measurement, but 20 of 26 sites had apical positions after 60 months compared to the 1month results. The WKG alteration between 1 and 60 months was significantly associated with the LMGJ alteration. Discussion.—Half the root surfaces maintained the root coverage immediately after CRF surgery for 5 years. The change in MGJ location back to the position before treatment was more noticeable than the change in gingival margin. A significant decline in the WKG mean values after 12 months compared with baseline was noted. After 60 months the WKG tended to increase in association with the reversion of the MGJ back to its original site. Thus the CRF procedure maintains the gingival margin in correct posi-
tion in only half the cases. The MGJ tends to regain its original location, partly as a result of the apical movement of the gingival margin.
Clinical Significance.—This study concluded that coronally repositioned flap surgery failed to maintain the attachment levels originally attained and, long-term, the mucogingival junction returned to its original location.
Gürgan CA, Oruç AM, Akkaya M: Alterations in location of the mucogingival junction 5 years after coronally repositioned flap. J Periodontol 75:893-901, 2004 Reprints available from CA Gürgan, Ankara Üniversitesi, Dis¸ Hekimligi ˆ Fakültesi, Periodontoloji A.B.D., Bes¸evler 06500, Ankara, Turkey; fax: 90-312-212-39-54; e-mail: [email protected]
Plaque reduced by amine fluoride/stannous fluoride mouthrinses Background.—Antimicrobial mouthrinses play a useful adjunct role in oral hygiene. The gold standard is chlorhexidine (CHX), but it carries a number of local side effects, such as brown staining of the tongue, taste alterations, and desquamation of the oral mucosa. Thus, mouthrinses containing CHX cannot be used for long-term care. Mouthrinses containing amine fluoride/stannous fluoride (ASF) have had good short-term effects. The latest development, mouthrinses with antimicrobial host proteins such as lysozyme, lactoferrin, and lactoperoxidase (LLL), focus on enhancing or restoring the saliva’s own antimicrobial properties. The plaque inhibitory effects of 2 commercially available mouthrinses that contain ASF and LLL, respectively, were evaluated with the use of a 4-day plaque regrowth study model.
assigned. On the fifth day, disclosed plaque scores were obtained.
Methods.—Twelve volunteer subjects between ages 23 and 29 years participated in a randomized study designed with a 4 4 Latin square cross-over format. The positive control was a 0.12% CHX mouthrinse, and the negative control was a saline solution. Subjects received a professional prophylaxis treatment on the first day, then avoided toothbrushing and used only the rinses to which they were
Discussion.—The LLL rinse was no better at removing plaque than saline solution. However, the ASF-containing rinse was better than the LLL or saline solution, but not as good as the CHX product. The side effects with ASF were significantly less troublesome and less frequent than with CHX. ASF-containing mouthrinses may serve as a useful adjunct to mechanical oral hygiene as an alternative to CHX products.
56 Dental Abstracts
Results.—Compared with the saline solution and LLL solution, the ASF rinse was able to significantly inhibit plaque regrowth (30.72% reduction). However, the CHX solution achieved the lowest plaque index scores (56.9% reduction). No significant difference was found between the use of the LLL mouthrinse (4.52% reduction) and the saline solution. The CHX and ASF products did not differ significantly in plaque reduction ability on the lingual anterior surfaces. Side effects developed in a number of cases but were mild and disappeared during washout periods. Compared with the subjects using LLL or ASF, the CHX group had a significantly higher prevalence of side effects.
for those with a history of pain compatible with reversible pulpitis. No difference in success rates was linked to the type of restoration used. Discussion.—IPT achieved a higher success rate in primary molars than FP did. The use of GIC CC therapy for 1 to 3 months before vital pulp therapy improved the success of the therapy, particularly when the primary first molars were involved. Reversible pulpitis responded to IPT much more than to FP. Primary second molar therapy was significantly more successful than primary first molar therapy, mostly as a result of the lower pulpotomy success in primary first molars. Significantly earlier exfoliation was found when FP was used compared with IPT.
Clinical Significance.—How best to deal with extensive caries in the deciduous dentition is explored here. Compared are caries control with zinc oxide eugenol or glass ionomer, formocresol pulpotomy, and indirect pulp cap.
Vij R, Coll JA, Shelton P, et al: Caries control and other variables associated with success of primary molar vital pulp therapy. Pediatr Dent 26:214-220, 2004 Reprints available from JA Coll; e-mail: [email protected]
Periodontics Mucogingival junction reverts to original position after CRF surgery Background.—Relative to fixed skeletal points, the mucogingival junction (MGJ) remains stable with age, forming the border between genetically determined basal bone and the alveolar processes. Whether this position is altered when coronally repositioned flap (CRF) procedures are undertaken was evaluated. Methods.—The 13 patients had 26 Miller Class I buccal gingival recessions for which CRF procedures were done.
Measurements included location of the gingival margin (LGM), probing depth (PD), clinical attachment level (CAL), width of keratinized gingiva (WKG), and location of the MGJ (LMGJ). These were obtained at baseline and 1, 6, 12, and 60 months after surgery. Results.—Significant correlations were found between the LGM, CAL, WKG, and LMGJ at baseline and after 60 months. After 1 month the LGM was displaced coronally a
Volume 50 • Issue 1 • 2005 55
mean of 1.50 mm and the LMGJ was displaced coronally a mean of 2.01 mm. After 60 months the mean apical displacements were 0.67 and 0.98 mm, respectively. The degree of change over time differed significantly between the LGM and LMGJ. No change or a decline was found in more than half the sites for each measurement, but 20 of 26 sites had apical positions after 60 months compared to the 1month results. The WKG alteration between 1 and 60 months was significantly associated with the LMGJ alteration. Discussion.—Half the root surfaces maintained the root coverage immediately after CRF surgery for 5 years. The change in MGJ location back to the position before treatment was more noticeable than the change in gingival margin. A significant decline in the WKG mean values after 12 months compared with baseline was noted. After 60 months the WKG tended to increase in association with the reversion of the MGJ back to its original site. Thus the CRF procedure maintains the gingival margin in correct posi-
tion in only half the cases. The MGJ tends to regain its original location, partly as a result of the apical movement of the gingival margin.
Clinical Significance.—This study concluded that coronally repositioned flap surgery failed to maintain the attachment levels originally attained and, long-term, the mucogingival junction returned to its original location.
Gürgan CA, Oruç AM, Akkaya M: Alterations in location of the mucogingival junction 5 years after coronally repositioned flap. J Periodontol 75:893-901, 2004 Reprints available from CA Gürgan, Ankara Üniversitesi, Dis¸ Hekimligi ˆ Fakültesi, Periodontoloji A.B.D., Bes¸evler 06500, Ankara, Turkey; fax: 90-312-212-39-54; e-mail: [email protected]
Plaque reduced by amine fluoride/stannous fluoride mouthrinses Background.—Antimicrobial mouthrinses play a useful adjunct role in oral hygiene. The gold standard is chlorhexidine (CHX), but it carries a number of local side effects, such as brown staining of the tongue, taste alterations, and desquamation of the oral mucosa. Thus, mouthrinses containing CHX cannot be used for long-term care. Mouthrinses containing amine fluoride/stannous fluoride (ASF) have had good short-term effects. The latest development, mouthrinses with antimicrobial host proteins such as lysozyme, lactoferrin, and lactoperoxidase (LLL), focus on enhancing or restoring the saliva’s own antimicrobial properties. The plaque inhibitory effects of 2 commercially available mouthrinses that contain ASF and LLL, respectively, were evaluated with the use of a 4-day plaque regrowth study model.
assigned. On the fifth day, disclosed plaque scores were obtained.
Methods.—Twelve volunteer subjects between ages 23 and 29 years participated in a randomized study designed with a 4 4 Latin square cross-over format. The positive control was a 0.12% CHX mouthrinse, and the negative control was a saline solution. Subjects received a professional prophylaxis treatment on the first day, then avoided toothbrushing and used only the rinses to which they were
Discussion.—The LLL rinse was no better at removing plaque than saline solution. However, the ASF-containing rinse was better than the LLL or saline solution, but not as good as the CHX product. The side effects with ASF were significantly less troublesome and less frequent than with CHX. ASF-containing mouthrinses may serve as a useful adjunct to mechanical oral hygiene as an alternative to CHX products.
56 Dental Abstracts
Results.—Compared with the saline solution and LLL solution, the ASF rinse was able to significantly inhibit plaque regrowth (30.72% reduction). However, the CHX solution achieved the lowest plaque index scores (56.9% reduction). No significant difference was found between the use of the LLL mouthrinse (4.52% reduction) and the saline solution. The CHX and ASF products did not differ significantly in plaque reduction ability on the lingual anterior surfaces. Side effects developed in a number of cases but were mild and disappeared during washout periods. Compared with the subjects using LLL or ASF, the CHX group had a significantly higher prevalence of side effects.