Peri-impant soft tissue managements for severely resorbed ridge

Post GBR & Dental Implantations

Partial thickness flap for FGG 

FGG harvested from Palate area

Try in FGG

FGG sutured

Hemostat w Collagen sponge 

Tie over sutures

1 wk’ healing

8 wks after FGG

Implant exposures with fully preserved Periimplant keratinized mucosa

Terudermis covering partial thickness area

1 wk’s healing

3 wks’ healing

8 wks’ healing

Impression stage

Temporary restorations screw in

Final restoration

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A Manual Bristleless Toothbrush Demonstrates Slight Improvement in Gingival Recession Compared to a Conventional Soft Manual Brush

Oral Health Prev Dent 17 (2019), No. 1  (21.02.2019)

Page 75-82, doi:10.3290/j.ohpd.a41810, PubMed:30714059

Purpose: This randomized clinical trial tested whether a novel bristleless toothbrush design is more effective in preventing gingival recession in adults receiving periodontal maintenance than is a soft toothbrush with nylon bristles.

Materials and Methods: Twenty-three subjects with gingival recession were recruited who received regular periodontal maintenance care at Western University of Health Sciences Dental Center, and who did not exhibit signs of acute dental or systemic disease, occlusal discrepancies or parafunctional habits. These subjects were randomly assigned to to two groups, one using a soft nylon-bristled toothbrush, and the other using the experimental toothbrush that contains a brush head with short, soft, rubbery cones. Both groups received regular periodontal maintenance and periodontal exams by blinded examiners every 3-4 months, measuring probing depth, bleeding on probing, and plaque indices. Gingival recession was assessed clinically and through use of a stent on diagnostic casts obtained at each visit.

Results:
Average probing depths, plaque levels, and the number of sites with bleeding on probing did not change over at least 9 months. After 9 months, there was a small but statistically significant improvement in gingival recession (0.4 mm, p < 0.01) at sites with gingival recession in the experimental toothbrush group compared to the control group.

Conclusion: In periodontal maintenance patients, the bristleless toothbrush used in this study was as effective in plaque removal and prevention of gingival inflammation than a conventional toothbrush with soft nylon bristles, while increasing the possibility of gingival tissue rebound over denuded root surfaces.

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Effect of Custom-made Probiotic Chocolates on Streptococcus mutans, Plaque pH, Salivary pH and Buffering Capacity in Children – A Randomised Controlled Trial

Oral Health Prev Dent 17 (2019), No. 1  (21.02.2019)

Page 7-15, doi:10.3290/j.ohpd.a41809, PubMed:30714058

Purpose: To compare the effect of three custom-made probiotic chocolates and conventional chocolates on plaque pH, salivary pH and buffering capacity of saliva in children. The study also evaluated its antimicrobial efficacy against S. mutans.

Materials and Methods: A parallel randomised double-blinded trial was conducted in two phases. For the phase І trial, 90 children were randomly divided into 3 groups: milk (MC), white (WC) and dark chocolate (DC). Salivary pH, plaque pH and buffering capacity were assessed at baseline, 10 min, 30 min and 60 min after consumption of the chocolates. After a washout period of 20 days, the children were assigned to their respective probiotic chocolate groups and the assessments were repeated. In the phase ІІ trial, 60 children were divided into 3 groups (n = 20): probiotic milk (PMC), white (PWC) and dark chocolate (PDC). They were given probiotic chocolates for 5 consecutive days in a week. S. mutans colony count was measured at baseline, post intervention, 15 days and 30 days.

Results: All probiotic chocolates were less acidogenic than their counterparts. PWC was found to be the least acido-genic. DC was found to be the least acidogenic among plain chocolates. All probiotic chocolates were effective in reducing the S. mutans colony count.

Conclusion: Chocolates can serve as a vehicle for delivering probiotics with the added advantage of making them tooth-friendly.

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