BACKGROUND The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation,thus ultimatel...BACKGROUND The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation,thus ultimately leading to tooth loss.CASE SUMMARY This clinical case involved a 27-year-old male patient who complained of persistent inflammation and bleeding in the upper anterior region of the gums,despite having undergone dental cleaning for at least 4 years.The dental and medical history indicated the use of removable orthodontic appliances for 8 years,after which braces were placed for 2 years.The intraoral evaluation revealed inflammation and localized suppuration in teeth 11 and 12.Measurements of 2-7 mm for probing depth and 1-5 mm for clinical attachment loss were detected,and combined bone loss was observed via radiographs.Based on the clinical and radiographic findings,localized stage III,grade C periodontitis was diagnosed.During subgingival debridement,two elastic bands emerged around the involved teeth.The bone defects persisted;therefore,they were surgically addressed using a papilla preservation flap and guided tissue regeneration(GTR).CONCLUSION The use of elastic bands of various sizes and elasticities is often essential in multiple orthodontic treatments.However,it is crucial to perform a thorough check-up for each patient during treatment and at the end of treatment to remove any remaining residue of resin,metal bands,or orthodontic bands.Additionally,it is imperative to inform the patients of the importance of attending their follow-up appointments.The use of elastic bands in orthodontics requires special care;moreover,GTR is a management option for intrabony defects associated with the iatrogenic use of bands.展开更多
Background Platelet-rich plasma （PRP） is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clea...Background Platelet-rich plasma （PRP） is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clear yet. This study was designed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral （BPBM） graft in the treatment of human intrabony defects. Methods Seventeen intrabony defects in 10 periodontitis patients were randomly treated either with PRP and BPBM （test group, n=9） or with BPBM alone （control group, n=8）. Clinical parameters were evaluated including changes in probing depth, relative attachment level （measured by Florida Probe and a stent）, and bone probing level between baseline and 1 year postoperatively. Standardized periapical radiographs of each defect were taken at baseline, 2 weeks, and 1 year postoperatively, and analyzed by digital subtraction radiography （DSR）. Results Both treatment modalities resulted in significant attachment gain, reduction of probing depth, and bone probing level at 1-year post-surgery compared to baseline. The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction： （4.78± 0.95） mm versus （3.48 ± 0.41） mm （P〈0.01）; clinical attachment gain： （4.52± 1.14） mm versus （2.85 ± 0.80） mm （P〈0.01）; bone probing reduction： （4.56±1.04） mm versus （2.88±0.79） turn （P〈0.01）; and defect bone fill： （73.41± 14.78）% versus （47.32± 11.47）% （P〈0.01）. DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group： gray increase （580±50） grays versus （220± 32） grays （P=0.0001）; area with increased gray were （5.21± 1.25） mm^2 versus （3.02± 1.22） mm^2 （P=0.0001）.Conclusions The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone. Further studies are necessary to assess the long-term effectiveness of PRP, and a larger sample size is needed.展开更多
文摘BACKGROUND The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation,thus ultimately leading to tooth loss.CASE SUMMARY This clinical case involved a 27-year-old male patient who complained of persistent inflammation and bleeding in the upper anterior region of the gums,despite having undergone dental cleaning for at least 4 years.The dental and medical history indicated the use of removable orthodontic appliances for 8 years,after which braces were placed for 2 years.The intraoral evaluation revealed inflammation and localized suppuration in teeth 11 and 12.Measurements of 2-7 mm for probing depth and 1-5 mm for clinical attachment loss were detected,and combined bone loss was observed via radiographs.Based on the clinical and radiographic findings,localized stage III,grade C periodontitis was diagnosed.During subgingival debridement,two elastic bands emerged around the involved teeth.The bone defects persisted;therefore,they were surgically addressed using a papilla preservation flap and guided tissue regeneration(GTR).CONCLUSION The use of elastic bands of various sizes and elasticities is often essential in multiple orthodontic treatments.However,it is crucial to perform a thorough check-up for each patient during treatment and at the end of treatment to remove any remaining residue of resin,metal bands,or orthodontic bands.Additionally,it is imperative to inform the patients of the importance of attending their follow-up appointments.The use of elastic bands in orthodontics requires special care;moreover,GTR is a management option for intrabony defects associated with the iatrogenic use of bands.
文摘Background Platelet-rich plasma （PRP） is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clear yet. This study was designed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral （BPBM） graft in the treatment of human intrabony defects. Methods Seventeen intrabony defects in 10 periodontitis patients were randomly treated either with PRP and BPBM （test group, n=9） or with BPBM alone （control group, n=8）. Clinical parameters were evaluated including changes in probing depth, relative attachment level （measured by Florida Probe and a stent）, and bone probing level between baseline and 1 year postoperatively. Standardized periapical radiographs of each defect were taken at baseline, 2 weeks, and 1 year postoperatively, and analyzed by digital subtraction radiography （DSR）. Results Both treatment modalities resulted in significant attachment gain, reduction of probing depth, and bone probing level at 1-year post-surgery compared to baseline. The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction： （4.78± 0.95） mm versus （3.48 ± 0.41） mm （P〈0.01）; clinical attachment gain： （4.52± 1.14） mm versus （2.85 ± 0.80） mm （P〈0.01）; bone probing reduction： （4.56±1.04） mm versus （2.88±0.79） turn （P〈0.01）; and defect bone fill： （73.41± 14.78）% versus （47.32± 11.47）% （P〈0.01）. DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group： gray increase （580±50） grays versus （220± 32） grays （P=0.0001）; area with increased gray were （5.21± 1.25） mm^2 versus （3.02± 1.22） mm^2 （P=0.0001）.Conclusions The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone. Further studies are necessary to assess the long-term effectiveness of PRP, and a larger sample size is needed.
