Journal of Dental Medicine

Albright syndrome is a rare condition, usually appears in the early years of life and characterized by bending or thickening of long bones. In girls, of endocrine glands disorders especially precocious puberty are the most common symptoms. Also, Brown pigments in the skin are another sing of this syndrome. Certain mucosal and skin pigments are considerable features of the disease. Etiology and pathogenesis of this disease is not clear and various histopathologic patterns are observed. In fact, this disease is substitution of bone tissue with fibrous connective tissue in which various degrees of bone resorption and repair of the lesion is recognizable.

Statement of Problem: One of the problems associated with the treatment of periodontal diseases is caused through the extension of disease toward furcation area. Several techniques in Conservative, Resective and Regenerative categories have been suggested for the treatment of furcation involvement.
Purpose: The aim of this study was to compare the results of the treatment of grade II furcation involvement in mandibular molars using an allograft material named 'Dynagraft' (a type of demineralized bone matrix) and the coronally positioned flap.

Materials and Methods: In this randomized controlled clinical trial study, twelve patients (9 females and 3 males), aged 25 to 40, suffering from bilaterally grade II furcation involvement of mandibular molars who referred to dental faculty Tehran University of medical Sciences, were investigated. The molars of one side were treated by Dynagraft whereas those of the opposite side underwent the CPF method. Measurements of the probing pocket depth (PPD), clinical attachment level (CAL), keratinized gingiva (KG) and horizontal probing depth (HPD) were recorded at baseline, 3 and 6 months after surgery. In order to investigate the bone radiographic changes, radiovisiography at the mentioned periods in addition to clinical investigation, were performed. For statistical analysis, Paired West was used.
Results: The mean PPD reduction three months and six months after the operation were 1.75 mm and 2.25mm, respectively in the Dynagraft (test) group whereas 1.26mm and 1.27mm in the CPF (control) group (P<0.005). The mean attachment gain three months and six months after the operation were 1.1 mm and 1.5mm respectively in the test group, and 0.2mm and 0.3mm in the control group (P<0.005). The mean KG reduction three months and six months after the operation were 0.5mm and 0.6mm respectively in the test group and those of the control group were 1.1mm and 1.1mm. The mean HPD reduction three months and six months after the operation were 1.55mm and 2mm respectively in the test group (P<0.005) and 0.55mm and 0.55mm in the control group (PO.01). Radiovisiography of the mentioned areas three months and six months after the operation confirmed the changes obtained from clinical measurements, showing appreciable reconstructive results (Bone filling) in the test group as compared with the control group. Moreover, root resorption was not observed.
Conclusion: Based on the results of this study, Dynagraft can be used as an appropriate material in the treatment of grade II furcation involvement in mandibular molars. However, for a through evaluation of such regenerative techniques in furcation involvement, further studies with larger population and long term follow up in addition to histologic studies are suggested.

Statement of Problem: Systemic analgesics are frequently prescribed for pain reduction following periodontal surgery. This type of treatment, however, brings about some disadvantages due to its late effect and inherent side effects. Benzydamine hydrochloride mouth wash is a non steroidal anti-inflammatory drug with local anaesthetic properties. Side effects of benzydamine are minor such as tissue numbness, burning and stinging. It brings relief to pain and inflammation rapidly.

Purpose: The goal of this study was to compare benzydamine HCL 0.15% and Acetaminophen codeine as analgesics following periodontal surgery.

Materials and Methods: This clinical study was performed on 18 patients referred to periodontics Department, Faculty of Dentistry, Tehran University of Medical Sciences. All patients were affected with chronic mild or moderate periodontitis and required surgery at least at two oral sites with similar lesions. Each patient received benzdamine HCL after first surgery and Acetaminophen codein following second operation. Pain reduction was evaluated by Visual Analog Scale (VAS). Data were analyzed with Wilcoxon-Signed and Mann-Whitney non-parametric tests. Results: Analgesic effect of Acetaminophene codeine was significantly more than that of benzydamine HCL following Reriodontal surgery (P=0.008). No significant difference was found between analgesic effects of Acetaminophene codeine and benzydamine HCL in patients with chronic mild periodontitis (P=0.9), and in cases that osteoplasty (P=0-31) or no osseous surgery (P=0.18) were performed.

Conclusion: In cases with mild post-operative pain following periodontal surgery, Benzydamine HCL and be prescribed as an analgesic. However, in other cases this mouth wash should be prescribed along with Acetaminophene codein to reduce systemic drugs consumption.

Background and Aim: Several risk factors directly affect the development of periodontal diseases. Also some systemic diseases act indirectly as predisposing and aggrevating factors. Osteoporosis is one of these factors and one of its main causes is lack of physical activity in postmenopause period. The incidence of osteoporosis is increasing in our country. The goal of this study was to evaluate the periodontal condition of women with osteoporosis and osteopenia referred to bone densitometric division of Loghman hospital in 2003 and compare to control group.

Materials and Methods: In this case control study based on BMD (Bone Mineral Density) measurement of back and thigh using DEXA method, 60 patients referred to bone densitometric division of Loghman hospital, were randomly selected. Cases were divided into three groups, 20 with osteoporosis, 20 with osteopenia and 20 normal cases. Periodontal indices consisting of plaque index (PI), tooth loss (TL), gingival recession (GR), probing pocket depth (PPD) and papilla bleeding index (PBI) were evaluated by clinical and radiographic examination. Data were analyzed by Kruskall Wallis and Dunn tests with p<0.05 as the limit of significance.

Results: PBI, PI and TL were significantly higher in osteoporotic group than osteopenic and normal group. PPD was not different in the three groups. Due to the low prevalence of recession in our study, this parameter was not included in the statistical analysis.

Conclusion: It seems that osteoporosis does not increase the incidence of periodontal diseases because it affects bone quality rather than quantity. In osteoporosis calcium deficiency and increasing age lead to decreased physical activity and ultimately affect the patient's oral hygiene performance. Thus, periodontal manifestations are presented as gingival bleeding and gingivitis.

Background and Aim: Improving esthetics is a major goal in periodontal treatments and specially reconstruction of dental papilla is of great importance. Different techniques have been developed, however the results are not completely predictable. The aim of the present study was to compare the possibility of papilla reconstruction using connective tissue graft with and without Emdogain.

Materials and Methods: In this clinical trial, 40 class II lost interdental papilla (Nordland- Tarnow classification) in 18 patients (4 male and 14 female) were studied. Samples were randomly devided into two groups. Case group was treated by connective tissue graft and emdogain (Straumann-USA) and controls were treated using connective tissue graft only. Periodontal parameters including papilla height (PH), periodontal pocket depth (PPD) and clinical attachment level (CAL) were measured before surgery, and 3 and 6 months after treatment. At the tenth days and 1 month after treatment only the papilla height was measured. Repeated measures analysis was used for data analysis with p<0.05 as the level of significance.

Results: In the control group the mean papilla height changed from 3.38 0.89 to 2.85 0.93 on the 3rd month and 2.90 0.95 on the 6th month. The mean PPD changed from 2.8  0.68 to 2.55 0.70 on the 3rd month and 3.06 1.25 on the 6th month. The mean CAL changed from 3.88 1.29 to 3.79 1.25 on the 3rd month and 4.11 1.44 on the 6th month. In test group the mean papilla height changed from 2.98 0.91 to 2.45 1.55 on the 3rd month and 2.55 1.48 on the 6th month. The mean PPD changed from 2.75 1.49 to 2.63 1.38 on the 3rd month and 2.88 1.39 on the 6th month. The mean CAL changed from 3.75 1.24 to 4.01 1.45 on the 3rd month and 4.28 1.63 on the 6th month. These differences were not significant between the studied groups (P>0.05).

Conclusion: Based on the results of this study, use of connective tissue with or without emdogain is not effective in interdental papilla reconstruction.

Background and Aims: Intrabony periodontal defects are one of the important problems in periodontal diseases. Treatment of intrabony periodontal defects with synthetic materials such as Cerasorb has been shown to enhance periodontal regeneration. The aim of this study was to compare the effect of Cerasorb with autogenous bone graft (A.B.G) as a gold standard in treatment of two to three wall periodontal defects.
Materials and Methods: In this interventional or randomized clinical trial study, 24 two to three wall intrabony defects were selected in a double blind manner. Defects were randomly (with tossing a coin) divided into two groups (test and control). Defects in test group were treated with flap surgery and Cerasorb. In control group, defects were treated with flap surgery and autogenous bone graft. At baseline and 3-month, 6-month and one-year follow up evaluations clinical and radiographic assessments were performed. Data were statistically analyzed using the paired t test, Wilcoxon and Mann-whiteny. The level of significance was set at P<0.05.
Result: At the 3-month, 6-month and one-year visits, the parameters of probing pocket depth (PPD), probing attachment level (PAL), bone level (distance between CEJ and alveolar crest), and bone density were not significantly difference in test and control groups (P>0.05). However, in each group there was significant difference in 4 parameters before and after surgery (P<0.05).
Conclusion: Treatment with Cerasorb compared to A.B.G produced the same results of improvement in two to three-wall intrabony defects. So the use of Cerasorb can be suggested for treatment of intrabony periodontal defects.