The laterally moved, coronally advanced surgical technique was very effective in treating isolated gingival recessions. It combined the esthetic and root coverage advantages of the coronally advanced flap with the increase in gingival thickness and keratinized tissue associated with the laterally moved flap. The ideal gingival conditions must be present lateral to an isolated recession defect in order to render the proposed surgical technique an highly effective and predictable root coverage surgical procedure.

The aim of the study was to compare the in vivo early bacterial plaque colonization of 3 different guided tissue regeneration (GTR) membrane materials using a morphological (scanning electron microscope) method. Rectangular-shaped strips were cut from 3 periodontal membranes (expanded polytetrafluoroethylene, polyglactin 910, and polylactic acid) and glued to the buccal aspect of removable acrylic devices, which were applied to the molar-premolar region of the upper quadrants in 8 dental students. Each device held 3 strips: one ePTFE, one polyglactin 910, and one polylactic acid. The surface roughness of each membrane material was measured by means of a laser profilometer. During a 24-hour period, the students had to refrain from any oral hygiene procedures and did not use chlorhexidine mouthrinses. In each subject, one device was removed after 4 hours and the other after 24 hours. After removal, the devices were placed in a 2.5% gluteraldehyde solution to fix the membranes, which were then processed for SEM analysis. Fifty-four microscopic fields (at 200x magnification) were randomly selected and analyzed in each strip. Magnification was increased to determine the presence of bacterial morphotypes. The presence or absence of bacteria was assessed in a binomial fashion. In such a system, the field was bacteria-positive when bacteria constituted the deposits covering the surface of the membrane. The microscopic field was considered bacteria-negative when no bacteria were present. Bacteria-positive fields showing rods and filaments as prevalent bacterial morphotypes were recorded as rod-positive fields. A different pattern of plaque accumulation was demonstrated on different membrane materials. The 4-hour results indicated a statistically significant difference (P = 0.008, ANOVA) in the proportion of bacteria-positive fields among the 3 membranes; a greater amount of bacteria was demonstrated on the ePTFE membrane compared to the other 2 membranes. At 24 hours, the difference in the proportion of bacteria-positive fields was statistically significant (P = 0.002, ANOVA); a lesser amount of bacterial plaque was present on the polylactic acid membrane compared to the ePTFE and polyglactin 910 membranes. No difference in the proportion of rod/bacteria-positive fields was demonstrated among the 3 membranes at either 4 or 24 hours. It was concluded that quantitative differences in early plaque accumulation on various membranes seem to be related to the textural and structural characteristics of the surface, which is not adequately represented by the surface Ra value measured with a profilometric instrument.

No abstract

Local antibiotic administration is more effective than systemic use in preventing membrane contamination, but it does not improve clinical outcomes due to an interference of the vehicle (gel) with gingival tissues which may reduce the potential benefits derived from better control of the bacterial load.

No abstract

Clinical research has long been testing techniques of integrating biomaterials with many external factors, such as simple proteins or more complicated devices, in order to achieve the restitutio ad integrum of periodontium. This study assessed the in vitro effectiveness of platelet derivate growth factor-BB (PDGF) and insulin growth factor I (IGF); the biocompatibility of materials like Paroguide, Oclastim membranes, Gingistat sponges, Surgiplaster, and Capset; and their efficacy as carriers for the platelet derivate growth factor-BB (PDGF) and insulin growth factor I (IGF). Fibroblasts from the human periodontal ligament were incubated with growth factors free or vehiculated. Mitogenic effect was evaluated by measuring the growth rate and biocompatibility by observing cell morphology at SEM. PDGF was the most effective in stimulating cell proliferation both in solution (p < 0.001) and vehiculated (p < 0.01). Surgiplaster and Capset were more biocompatible; however, final analysis to assess their efficacy as carriers failed to disclose significant differences between experimental findings and control.

No abstract

Obstructive Sleep Apnea Syndrome (OSAS) is a chronic nocturnal respiratory disorder associated to excessive daytime sleepiness. It’s a potentially life-threatening condition. If left untreated it’s at high risk for comorbidities, such as cardiometabolic complications and neurocognitive sequelae, as well as road and workplace accidents. For this reason, OSAS has an adverse impact on economic systems: direct costs, which are the health costs necessary for diagnosis and treatment of the disorder and its correlated medical consequences and for recourse to hospital admissions, and indirect, or social, costs due to a decrease in work productivity and an increase of permanent disabilities resulting from road and workplace accidents. These patients can obtain a better quality of life only from an adequate management of the disorder and, consequently, the whole society will enjoy the benefits. This article focuses on the most relevant social and medicallegal issues correlated to OSAS and highlights the importance of a multidisciplinary approach wherein the dentist can play a significant prevention, diagnostic and treatment role.