The authors compared the clinical results obtained in gingival recession correction treatment using free gingival and bilaminar connective subpedicle grafts. 35 patients were treated with free gingival grafts (Group A) and 35 with subpedicle grafts (Group B). Class I and II Miller gingival recessions were chosen for treatment by the 2 procedures. The degree of gingival recession (GR), keratinized tissue (KT) and the exposed root surface area (ERSA) were measured preoperatively and again 5 years post-surgery. Bilaminar connective grafting showed better results in reducing the amount of GR while both techniques significantly increased the width of KT (p > 0.05). The mean % of root coverage obtained in patients in group A was 53.19% +/- 21.48, whereas for the group B, 85.23% +/- 17.86 of exposed root surface was covered post surgical intervention (p < 0.001). In group A, only 3 patients (8.75%) showed a complete resolution of gingival recession after treatment, whereas in group B, 17 subjects (48.57%) presented with complete coverage. On the basis of these results, the authors conclude that the subpedicle graft promises better results in the coverage of exposed root surfaces when compared with the free gingival graft.

Tested individually by a group of periodontists, the RES seems to be a reliable method for assessing the esthetic outcomes of root coverage procedures.

The aim of this randomized single-blind multicenter controlled clinical trial was to clinically evaluate the effectiveness of adjunctive local controlled drug delivery in the control of bleeding on probing in mandibular class II furcations during maintenance care. 127 patients presenting with a class II mandibular furcation with bleeding on probing were included in the study. They had been previously treated for periodontitis and were participating in supportive care programs in periodontal specialty practices. Treatments consisted of scaling and root planing with oral hygiene instructions (control) and scaling and root planing and oral hygiene combined with local controlled drug delivery with tetracycline fibers (test). The following outcomes were evaluated at baseline and 3 and 6 months after therapy at the furcation site: bleeding on controlled force probing (BOP), probing pocket depth (PD) and clinical attachment levels (CAL). Levels of oral hygiene and smoking status were also assessed. Both test and controls resulted in significant improvements of BOP and PD at 3 and 6 months. The test treatment, however, resulted in significantly better improvements: BOP decreased by 52% in the control group and by 70% in the test group at 3 months; at 6 months, however, the difference was no longer significant. The test treatment resulted in a 0.5 mm greater reduction of PD than the control at 3 months, the improvement was highly significant but its duration did not extend until the 6 months evaluation. No differences were observed in terms of changes in CAL. These data indicate that addition of tetracycline fibers to mechanical therapy alone resulted in improved control of periodontal parameters during periodontal maintenance of class II mandibular furcations. Short duration of the effect, however, requires further investigations to optimize conservative treatment of these challenging defects.

Within the scope of this study, many traditional prognostic factors were ineffective in predicting future tooth loss and, therefore, were of no prognostic value. Conversely, a few specific factors at the tooth level emerged as viable prognostic factors. The use of these factors may be of great value to practitioners as predictors of tooth loss when assigning a prognosis.

On average, there were no significant differences related to IL-1 genotype in tooth loss after 10 years in a non-smoking, well-maintained periodontal population. On an individual patient basis, the IL-1 genotype, in combination with the initial bone level, seems useful at the beginning of therapy for predicting bone level variation.