How To Incise Mucosal Tissues With Dental Lasers?

Dr.de la Pena demonstates the step by step procedure for the removal of excess oral tissue with the help of dental lasers. It is a very good video for initial learning of the use dental lasers.

By: Dr. Hamid Raihan
Jaipur Dental College
Jaipur.

Latest Clinically Applicable Periodontal Researches

Antimicrobial photodynamic therapy has shown promising results when used an adjunctive therapy during the treatment of periodontitis. It enhances the bacterial killing esp Porhyromonas gingivalis and deactivates its enzymes. It also diminishes the host cytokines that impair healing.(1)
Diabetic patients under proper glycemic control can receive implants and show successful osteointegration, similar to normal individuals. The serum glycemic level and Hb A1c should be in the normal range for the success of implant osseointegration. (2)

Iron deficiency anemia in female patient is not a direct risk factor for periodontal diseases. (3)

Combined regenerative therapy  is very successful approach in the treatment of human mandibular classII furcation involvements. The combined regenerative therapy consists of a composite graft consisting of bioabsorbable hydroxyapatite and tetracycline (3:1), a guided tissue regeneration barrier, and a coronally advanced flap. (4)

Biphasic Calcium Composite a novel material proves to be equivalent to Autogenous Bone Graft and superior to Simple Flap Operation with debridement in the treatment of intrabony periodontal defects or Vertical Bone Loss. (5)
References:

1. Journal Of Periodontology 2009, Vol. 80, No. 11, Pages 1790-1798 , DOI 10.1902/jop.2009.090214
   
2. Journal Of Periodontology 2009, Vol. 80, No. 11, Pages 1719-1730 , DOI 10.1902/jop.2009.090283 
3. Journal Of Periodontology 2009, Vol. 80, No. 11, Pages 1750-1755 , DOI 10.1902/jop.2009.090209
4. Journal Of Periodontology 2009, Vol. 80, No. 11, Pages 1756-1764 , DOI 10.1902/jop.2009.080605
5. Journal Of Periodontology 2009, Vol. 80, No. 11, Pages 1774-1782 , DOI 10.1902/jop.2009.090229

PERIIMPLANTITS: Challenge in Implant Success

Periimplantitis is an inflammatory process affecting the hard and soft tissues around the functional implant with progressive marginal bone loss eventually resulting in loss of osseointegration

Etiology: Poor oral hygiene, implant design, occlusal disharmony, surgical trauma, periimplant microgap.

Pathophysiology:

Periimplantitis can occur in two different ways depending on the type of etiology:

1. Traditional pathway

Accumulation of plaque debris around the implant leads to the inflammation of periimplant tissues subsequently damaging the supporting osseous tissues.

2. Retrograde pathway

o Occlusal trauma or defective restorations causes micro fractures of the bone-implant interface leading to bone loss and loosening of implant.
o Implant contamination

Diagnostics:

(a)Clinical diagnosis: Based on the following parameters

* Bleeding on probing
* Probing depth
* Mobility
* Suppuration
* Erythema
* Flaccidity of tissues

(b)Microbiological diagnosis:

* Bacterial cultures
* Antibiotic sensitivity tests

(c)Radiological diagnosis:

* Level and amount of bone loss
* Depth of pocket

Differential diagnosis: Peri-implant mucositis

Management: 3 approaches

1. Therapeutic:

* Antimicrobials(Metronidazole, Vancomycin, Amoxicillin) +surgical debridement

* Decontamination(0.10 ml,0.12 % chlorhexidine and saline-Submucosal + 0.2 w/w Minocycline HCl –Subtopical)
* Ozone therapy
* Radiation therapy(Er:YAG laser,CO2 laser, Vector R System)

2. Surgical methods:

* Resective surgical techniques

* Guided tissue regeneration
* Bone grafts/barrier membranes

All these procedures when formulated and performed as a single management plan it is termed as Cummulative Interceptive Supportive Therapy (CISP)

About The Author:

Dr. Dipika Bumb; www.omrcafe.blogspot.com;

Contact email: drdipikabumb@gmail.com

PG,MDS Oral Medicine and Radiology

Using And Understanding Medical Statistics

Using and Understanding Medical Statistics