Journal of Dental Medicine

Guided Tissue Regeneration (GTR) is the most recent and common method for regeneration of class II forcation molars. However, it requires membrane, which seems expensive for most of the patients. In order to overcome this problem, Coronally Position Flap (CPF) procedure may be applied which arresting the epithelial cell down growth, follow the same aim. This study is aimed to compare GTR technique utilizing bioresorable collagen membrane and CPF utilizing citric acid. Nine patients with grade II forcation defects were selected. Defects were bilateral that randomly assigned into two groups: GTR and CPF groups. Measurements recorded at baseline and after surgery (6 months). Paired-T test was performed on these data. The following results were obtained after 6 months: In both groups significant reduction in probing pocket depth were measured in GTR and CPF groups, 1.55 Ind 1.88 mm, respectively. Also, open vertical probing depth: 0.33, 1.11 mm. Reduction in forcation weight in both groups was 0.22 mm. Bone fill was observed in 0.33% and 51% of defects. No recession was observed in GTR group, in CPF was 0.11 mm. Loss of attached gingiva was 0.34 and 0.78 mm, respectively. No significant difference was found between clinical parameters except OHPD. Comparison of means at the day (0 and 180) in each group showed the success for regeneration of forca. Considering the results, it can be concluded that CPF may substitute for GTR technique.

Background and Aim: Increasing patient demands for esthetic, put the root coverage procedures in particular attention. Periodontal regeneration with GTR based root coverage methods is the most common treatment used. The purpose of this study was to compare guided tissue regeneration (GTR) with collagen membrane and a bone graft, with sub-epithelial connective tissue graft (SCTG), in treatment of gingival recession.

Materials and Methods: In this randomized clinical trial study, eleven healthy patients with no systemic diseases who had miller’s class I or II recession defects (gingival recession  2mm) were treated with SCTG or GTR using a collagen membrane and a bone graft. Clinical measurements were obtained at baseline and 6 months after surgery. These clinical measurements included recession depth (RD), recession width (RW), probing depth (PD), and clinical attachment level (CAL). Data were analyzed using independent t test with p<0.05 as the limit of significance.

Results: Both treatment methods resulted in a statistically significant reduction of recession depth (SCTG=2.3mm, GTR=2.1mm P<0.0001). CAL gain after 6 months was also improved in both groups (SCG= 2.5mm, GTR=2.1mm), compared to baseline (P<0.0001). No statistical differences were observed in RD, RW, CAL between test and control groups. Root coverage was similar in both methods (SCTG= 74.2%, GTR= 62.6%, P=0.87).

Conclusion: Based on the results of this study, the two techniques are clinically comparable. Therefore the use of collagen membrane and a bovine derived xenograft may alleviate the need for connective tissue graft.

Background and Aim: Furcation defects are one of the most challenging problems in periodontal therapy. Regenerative treatment significantly improves the prognosis of the involved teeth. The aim of this study was to compare Bio-Oss plus 10% collagen in combination with either a bioabsorbable collagen barrier (BO/GTR), or coronally advanced flap (BO/CF), in treating human mandibular class II furcation defects.

Materials and Methods: This clinical trial included 10 patients with 10 pairs of similar periodontal defects. Each defect was randomly assigned to treatment with BO/CF or BO/GTR. Following basic therapy, baseline measurements were recorded including probing pocket depth (PPD),closed horizontal probing depth (CHPD), clinical attachment level (CAL), and gingival margin position (CEJ-GM), together with plaque and gingival indices. Hard tissue measurements were performed during surgery to determine alveolar crestal height (CEJ-AC), and vertical and horizontal open probing depth (OVPD, OHPD).After 6 months, all sites were re-entered and soft and hard tissue measurements were recorded.

Results: Both surgical procedures significantly reduced probing depth and improved clinical attachment levels, with no significant difference between groups. Gingival margin position (CEJ-GM), was improved in the BO/CF group (0.66±0.51 mm, p<0.05), but not statistically different from BO/GTR group in which remained relatively constant (0.00±0.81 mm). Vertical defect resolution was significant in each groups (BO/CF:3.17±1.47 mm, BO/GTR:3.33±0.51mm). Horizontal defect resolution was also significant with either procedure (BO/CF:3.67±1.31 mm, BO/GTR:3.80±1.83 mm), with no statistically significant difference between groups. Data were analyzed with wilcoxon and Mann-Whitney tests with p<0.05 as the level of significance.

Conclusion: Based on the results of this study, treatment of mandibular class II furcation defects with both procedures resulted in statistically significant improvement in open and closed probing measurements, with no significant difference between treatment groups. In BO/CF group there was an additional improvement in gingival recession (CEJ-GM) measurement, which could be attributed to applying crown-attached sutures by the use of orthodontic brackets.

  Background and Aims: In the last decade, several studies have reported the isolation of stem cell population from different dental sources, while their mesenchymal nature is still controversial. The aim of this study was to introduce the isolating methods for stem cells from human dental pulp and to determine their mesenchymal nature before differentiation.

  Material and methods: One of the best sources for stem cell is dental pulp tissue. Dental Pulp Stem Cells (DPSCs) would be the most convenient source of stem cells because teeth were easy to retrieve and removed throughout life. Pulp is a specialized connective tissue including blood and lymph vessels, nerves, and the interstitial fluid. DPSCs can be found within the ‘‘cell rich zone’’ of pulp. DPSCs have been isolated for the first time in 2000 by Gronthos these cells exhibited a differentiation potential for odontoblastic, adipogenic and neural cytotypes. Gronthos isolated stem cells in 2 different methods: The enzymatic digestion method and the second was out growth, these cells could be cryopreserved in liquid nitrogen. It has also been shown that human DPSCs can be used for complex structures such as pulp or woven bone formation in vivo.

  Conclusion: DPSCs originate from the cranial neural crest and have neural characteristics such as the expression of neurotrophins. Therefore, DPSCs may represent a promising source in cell therapy for neurological disorders. Characterization of these cells and determination of their potentialities in terms of specificity of regenerative response will form the foundation for development of new clinical treatment modalities, whether involving directed recruitment of the cells and seeding of stem cells at sites of injury for regeneration or use of the stem cells with appropriate scaffolds for tissue engineering solutions. Such approaches will provide an innovative and novel biologically based on new generation of clinical treatments for dental disease.