Journal of Dental Medicine

Normal 0 false false false EN-US X-NONE AR-SA Both surgical and nonsurgical treatments are definitely effective in ameliorating periodontal condition. In nonsurgical treatments, pocket elimination is not an essential part but subgingival infection control is the main objective which can eliminate inflammation, stop destruction, form new attachments, decrease pocket depth (following edema decrease) and finally result in long junctional epithelium formation. In short term, surgery can eliminate pocket depth more effectively although after a while this difference would become less. Besides, nowadays according to infectious nature of periodontal diseases systemic and local antimicrobials are used along with nonsurgical and mechanical treatments specially in rapidly progressing periodontitis, HIV related periodontitis and refractory periodontitis . Therefore, the most appropriate and simplest treatment plan should be selected according to the type of periodontal disease.

Periodontitis affected root surfaces are hypermineralized and contaminated with cytotoxic and other biologically active substances.The instrumented surface will inervitably be coverd by a smear layer following root planing with or without flap.Smear layer is resistant to saline rinsing, but may be removed with agents such as acids (e.g.citric acid), tetracyclines, EDTA, and laser.Low pH aqueous solutions such as citric acid have been used in surgical periodontal therapy mainly for two reasons, It dissolves smear layer after a relatively short exposure time and it has been claimed to selectively remove root surface associated mineral exposing collagen to varying degrees. A root surface coated with collagen appears to be a preferred surface for fibroblast attachment, a cellular event fundamental to successful periodontal wound healing.Several studies indicate the potential of tetracycline (TTE-HCL) in periodontal regeneration. Its acidic pH suggest that it can be used as a demineralization agent and removing the smear layer and exposing collagen matrix of the dentin.Chalating agent (EDTA) working at neutral pH appears preferable with respect to preserving the integrity of exposed collagen fibers, early colonization, and wound healing. In addition, etching at neutral pH has been reported preserve adjacent tissue- vitality, while etching at low pH necrotizes the fiap and adjacent periodontium.Clinical and subclinical studies have demonstrated laser waves can remove calculus and bacterial plaque and pocket epithelium and strile the root surface and can expose the dentin collagen and dentinal tublules, and leads to pronounce reducing of probing depth around teeth diseased with periodontitis.

Actinomyces species are normal residents of the mouth cavity, gastrointestinal tract and female genital tract. The genus consists of gram-positive bacteria, strictly anaerobic or microaerophilic. The bacteria are opportunists with a low virulence potential that cause actinomycosis only when the normal mucosal barriers are disrupted. The main purpose of this study was the isolation of Actinomyces strains and determining of their role in periodontal diseases. The present study was carried out on 100 patients with periodontal diseases referred to the Periodontic Department of Faculty of Dentistry. The sampling was done in 6 months with isolation of oral Actinomyces from microbial plaque and periodontal pocket. The samples were selected based on the following criteria: periodontal plaque with deep pocket (>3 mm), no antibiotic therapy for a period of at least two weeks, and lack of systemic diseases. One strain of Actinomyces viscosus and two strains of Actinomyces naeslundii were isolated from the patients with gingivitis and periodontitis. Of the 100 patients with gingivitis and periodontitis, aged between 18-57 years old, 46% were males and 54% were females. The peak incidence of the diseases (35%) was in the third age group (31-40) and the lowest incidence (10%) was in the first age group (<20). Forty patients (40%) complained of gingival disease and its bleeding with lower incidence of (42.5%) in female.

Statement of Problem: Gingival overgrowth is a side effect commonly induced by Cyclosporin treatment. The effects of Azithromycin, a macrolidic antibiotic, has been focused on gingival enlargement treatment induced by cyclosporine in numerous articles.

Purpose: The goal of the present study was to survey the effects of systemic Azithromycin in the treatment of gingival overgrowth induced by cyclosporine among renal transplant patients.

Materials and Methods: In this clinical trial study, 18 renal transplant patients (6 females and 12 males) with gingival overgrowth were studied. Samples were randomly divided into two groups: case group were treated by systemic Azithromycin and controls were treated by systemic placebo. Periodontal parameters including bleeding on probing (BOP), clinical crown length (CL), periodontal pocket depth (PPD), gingival overgrowth (GOI) and stent-IDP (vertical distant between a stent or plate with teeth occlusal planes at least from three of the most anterior contact points to mesial papillae) before treatment, two and six weeks after treatment were measured. To analyze the data, Wilcoxon and Mann-Whitney tests were used.

Results: Most of the measured indices, among case and control groups, were significantly improved, after two weeks (P<0.05). No statistically significant differences were found between two groups except for BOP index (P<0.05). In other words, more BOP improvement was observed in the case group after six weeks comparing to the control group.

Conclusion: Considering the findings of this study, one can assume that the reported effects of Azithromycine on gingival overgrowth, induced by cyclosporine is somehow exaggerated and the effects attributed this medicine is probably inflammation reduction.

Statement of Problem: Elimination of porphyromonas gingivalis (p.g) from subgingival area in order to successfully treatment out comes in patients with Aggressive periodntitis AP is necessary.

Purpose: The aim of this study was the evaluation of non-surgical treatment efficacy in reduction of bacterial population in deep pockets.

Materials and Methods: In this randomized clinical trial study we evaluated the result of non- surgical therapy on reduction of p.g count from deep pockets of patients with aggressive periodontitis that had at least one (p.g plus) deep pocket (>5mm) in each quadrant. At first stage of non-surgical treatment intra pocket irrigation with chlorhexidin was done after scaling and root planning for all patients. In second stage (one week later) antibiotics including amoxicillin- metronidazol prescribed for ten days. At base line, one, six and twelve weeks after beginning of therapy, microbial samples, plaque index, bleeding on probing index and probing pocket index were recorded.

Result: There was statistically important difference between one and six weeks after treatment with base line in colony count of p.g and all of clinical indices. But in 12 weeks after therapy just, PI and PPD had statistical difference with base line. In this stage, colony count and BOP was reduced but this reduction had not statistically important difference with base line.

Conclusion: Thus in present study our non- surgical strategy in elimination of p.g and clinical improvement was successful in short time but three month after therapy recurrence of disease happened in some patients.

Background and Aims: The precision of periodontal pocket measurements with periodontal probe is related to different factors. Some of these are related to examiner. The purpose of this study was to compare the right-handed and left-handed dental students in the measurement of periodontal pocket depth (PPD).
Materials and Methods: Eight systemically healthy adult patients (mean age of 35 years) with 0.5-6 mm periodontal pocket depth and a minimum of 20 teeth were examined by 4 right-handed and 4 left-handed students of dentistry (mean age of 25 years). These students were trained for periodontal examination probe depth measurements with Williams probe. Measurements were inserted in SPSS software and analyzed with Iintraclass correlation coefficient (ICCS) and T-test.
Results: There was statistically significant difference in the measurement of PPD between right-handed and left-handed examiners in the whole mouth (P<0.05), but this difference (0.08 mm) was not clinically significant. The most difference was found in the posterior teeth of mandible at right quadrant (mean=0.2 mm). Analyses of each pair of same handed and different handed examiners with T-test and ICCS showed that these measurements were nearly similar and reproducible.
Conclusion: There was no clinically significant difference in measurement of PPD between right-handed and left-handed examiners.

Background and Aims: Periodontitis is one of the most common oral diseases with the various incidence rates in different populations. A number of bacteria are considered as the major etiologic agents of periodontitis. The aim of the present study was to determine the prevalence of periodontopathogen bacteria in patients using both PCR and culture techniques.
Materials and Methods: In this study, one-hundred patients (including 62 females and 38 males with an average age of 49±11.5 years) with adult periodontitis referred to periodontics department of School of Dentistry/Tehran University of Medical Sciences were investigated. The samples were taken and sent immediately to the laboratory for culture and molecular evaluation. The PCR was performed using specific primers and the statistical analysis of data was performed using SPSS statistic software and McNemar test.
Results: The results demonstrated that the total detection rate in culture method was 64%. The rate of Aggregatibacter actinomycetemcomitans (Aa) was 28% which was significantly higher than that of Porphyromonas gingivalis (Pg) (6%) and Prevotella intermedia (Pi) (3%). 27% of cases showed mixed bacterial growth. 65% of patients were positive using molecular method. The rate of Aa (30%) was significantly higher than that of Pg (7%) and Pi (5%). The mixed PCR positive rate containing of Aa, Pg and Pi was (23%).
Conclusion: In this study, it was found that most of the bacteria isolated using culture and molecular methods were Aa, Pg and Pi, respectively. Although the detection frequencies of both techniques were similar, the specificity, sensitivity and bacterial detection speed of the PCR technique is obviously higher. Therefore, the use of molecular techniques is strongly recommended. However, both techniques seem to be suitable for microbiological diagnostics.