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Y. Soleimani Shayesteh , Sh. Mohseni Salehi Monfared , S. Eskandarion ,
Volume 19, Issue 3 (6-2006)
Abstract

Background and Aim: Intrabony periodontal defects are important problems in periodontology and up to now several ways have been suggested for their treatment .Treatment with enamel matrix derivatives (EMD) has been shown to enhance periodontal regeneration. There is limited information available from clinical trials regarding the performance of EMD in the treatment of periodontal intrabony defects. This study was designed to compare the clinical and radiographic effects of EMD treatment to that of open flap debridment (OFD) for two and three walled intrabony defects.

Materials and Methods: 18 patients were included in this clinical trial which have 24 two and/ or three intrabony defects. Defects were randomly divided into two groups (test and control). Defects in test group were treated with flap surgery plus EMD and in control group with open flap debridment. At baseline and at 3 and 6 months follow up, clinical and radiographic measurements were performed. Data were analyzed using Greenhouse-Geisser test with p<0.05 as the limit of significance.

Results: At 3 and 6 months, mean probing pocket depth reduction was greater in the test group (EMD) (4.33 mm and 4.70 mm) compared to the OFD group (2.54 mm and 3.09 mm). Mean values for clinical attachment gain in the EMD group after 3 and 6 months were 4.29 mm and 4.98 mm, and in OFD group were 2.83 and 2.82 mm respectively. Radiographic bone gain measured by radiovisiography technique was greater in the EMD group compared to the OFD group (4.66 mm in EMD and 1.11 mm in OFD group after 3 months and 5.78 mm in EMD and 1.39 mm in OFD group after 6 months).

Conclusion: Based on the results of this study, treatment with flap surgery and EMD compared to open flap debridment, produced more favorable clinical improvements in two and three walled intrabony defects.


Misagh Mohajer, Hassan Mesgari, Behnaz Pourian, Javad Nosrati Momvandi, Masoud Hassanzadeh,
Volume 39, Issue 0 (3-2026)
Abstract

Background and Aims: Dry socket is one of the most common complications following dental surgery. Therefore, effective prevention of dry socket can significantly improve patient recovery after tooth extraction. The aim of this study was to evaluate the effect of tranexamic acid combined with a Gelfoam carrier on the prevention of dry socket following surgical removal of impacted mandibular third molars.
Materials and Methods: This parallel randomized clinical trial was conducted in 2023 on 72 patients (40 in the intervention group and 32 in the control group) at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Islamic Azad University, Tehran Unit. In the intervention group, 250 mg of tranexamic acid powder was placed into the extraction socket and covered with Gelfoam, whereas the control group received sterile gauze only. The diagnosis of dry socket was made 2–3 days postoperatively by an independent surgeon. Statistical analysis was performed using the chi-square test, likelihood ratio, and Fisher’s exact test, with a significance level set at P<0.05.
Results: The incidence of dry socket was 7.5% in the intervention group and 34.4% in the control group. All statistical tests demonstrated a significant reduction in the occurrence of dry socket in the intervention group (P≤0.005). These findings are consistent with the physiological mechanism of tranexamic acid in inhibiting fibrinolysis and stabilizing the blood clot, resulting in a marked reduction compared with the control group.
Conclusion: Topical application of the tranexamic acid in combination with Gelfoam following extraction of impacted third molars is an effective, simple, and cost-effective method for the prevention of dry socket. For broader clinical recommendation, further studies with larger sample sizes, comparisons with existing standard preventive methods, and longer follow-up periods are suggested.


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