Magister Scientiae Dentium - MSc(Dent) / Purpose This study analyzed the dental surgical implant therapy in the past 5 years at Tygerberg Oral Health Centre, UWC Dental School, Cape Town, South Africa. The findings of this study serve as a guideline for the estimation of the prevalence in this dental hospital. The importance of this study was to aid in the establishment of the formalized electronic database for dental implant therapy. The data generated will form a foundational basis for future studies that may be conducted in the field of implantology. Methodology A retrospective cross-sectional study was conducted at the Tygerberg Oral Health Centre. The data was collected from the implant dental records for the years 2012-2017. Variables measured included the patient demographics such as age, gender, an implant placed by type, length, width, and anatomical location. Frequencies and means of data were generated using IBM SPSS v20.

Introduction: The palate is a well-established donor site for obtaining graft tissue in periodontal plastic surgery procedures. However, proximity to the adjacent teeth on the lateral aspect and the greater palatine neurovascular bundle (GPB) on the medial aspect limit the amount of graft tissue that can be obtained from the palate. Previous studies have been concerned with the location of the greater palatine foramen as well as the greater palatine artery (GPA) and have established guidelines on how to estimate the distance between the teeth and the GPB. Traditionally, clinicians follow these guidelines and choose to avoid removing graft tissue in the area close to the GPB out of fear of possible complications such as hemorrhaging and paresthesias. Objectives: The purpose of the present investigation is to locate the position of the greater palatal artery (GPA) in relation to surrounding anatomical landmarks and determine if the tissue thickness covering the GPA is sufficient to permit gingival grafts to be obtained in the area close to the GPB. Materials and methods: Cadaver dissections were performed on a total of ten (n=10) cadaver hemifaces of which 7 were partially and 3 were completely edentulous. From the greater palatine foramen to the incisive foramen, the palatal tissues of the cadavers were dissected into vertical slices of 3 mm in width perpendicular to the median palatine raphe using a double bladed scalpel. On each tissue slice, the distance from the epithelial surface to the superior border of the vessel, the diameter of the vessel, the distance from the inferiorborder of the vessel to the palatal bone, the distance from median palatine raphe to the GPA and the distance from teeth or midline of the alveolar crest to the GPA were measured using both a periodontal probe and a digital caliper. The measurements were correlated to each other, the angle of the palatal vault, an estimate of the palatal depth and the head length of the cadavers. Results: The mean thickness of the tissue above the GPA was 4.30 ± 1.61 mm with a range of 1.92 – 8.72 mm. The tissue thickness decreased consistently from the 3rd molar to the canine area with the thickest mean tissue being in the 2nd molar region with 6.25 ± 1.09 mm and shallowest mean tissue thickness in the region of the lateral incisor with 2.92 ± 0.46 mm. The mean distance of the GPA from the median palatine raphe is 10.34 ± 3.41mm ranging from 13.77 ± 1.67 mm to 6.02 ± 0.83 mm with the greatest distance being from the 3rd molar region and smallest distance being from the lateral incisor area. No statistically significant correlations were found between the angel of the palatal vault, the estimate of the palatal depth and the head length. A significant correlation (R2=0.92) was found between the total palatal tissue thickness and tissue thickness above the GPA. Discussion: There was adequate gingival tissue above the GPA to harvest tissue for free gingival grafts of 1 - 1.5 mm in thickness in the entire palate. Donor tissue for 1.5 mm thick connective tissue grafts with a 1.5 mm epithelial flap could be obtained opposing the 1st molar and posterior to it staying above the GPA. Donor site for palatal grafts can be extended in a medial and posterior direction.A Formula (Tissue Thickness above the GPA = (Total Thickness of palatal tissue - 0.967) x 0.9) has been derived, which accurately locates the GPA based on the thickness of the palatal tissue. Unique to this study were measurements from the median palatine raphe, which will provide the clinician with a new landmark to more reliably locate the GPA at various locations on the palate. Conclusion: This descriptive pilot study on human cadavers provides a formula to locate the GPA within the palate using the total palatal tissue thickness and suggests that graft tissue can be harvested from the tissue above the GPA in the entire palate for FGGs and opposing to the 1st molar and posterior to it for CTGs not exceeding 3 mm in depth.

The dental community has a broad understanding of how traditional combustible cigarettes affect the oral cavity of the dental patient but there is little research available on the effects that e-cigarettes have on the patient’s dental health. Vaping products have been marketed as a healthier option over traditional combustible cigarettes. Since they were first introduced in 2003, very little research has been performed to understand their dental implications. This project was executed to investigate the chemicals associated with these vaping products and how they possibly contribute to the progression of periodontal disease. This research project was conducted with the contribution of 23 participants who confirmed the usage of vaping products via an anonymous online survey. Participants were dental patients of record at the University of Tennessee College of Dentistry. The data collected was analyzed and it was determined that there is a positive correlation between the use of e-cigarettes and the prevalence of periodontal disease.

No description available.

Background: Unfavorable outcomes following periodontal surgeries can be attributed to impaired resolution mechanisms likely due to decreased levels of specialized pro-resolution molecules (SPM). The current study investigates if SPM substrate pools in platelet-rich plasma preparations (PRP) can be increased by essential fatty acid (EFA) and / or aspirin supplementation. Methods: Nineteen healthy volunteers were randomly assigned to take i) aspirin; ii) EFA; iii) aspirin and EFA. Four hours after intake, the lipid precursor pools in PRP were quantified using combined Liquid Chromatography tandem mass spectrometry (LC-MS/MS) and the data statistically analyzed using ANCOVA. Results: Of the 77 metabolites screened, only FFA (18:3) showed a significant interaction effect (p=0.019). By itself, neither EFA (p>0.9) nor aspirin (p>0.4) showed any difference (P>0.4). Multiple comparisons could not identify the differences between groups. Conclusions: There is inadequate data to support oral supplementation of EFA and /or aspirin to increase SPM levels in PRP.

Balance between matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) is required for normal wound healing. Chronic inflammation, such as that seen in cardiovascular and periodontal diseases, may upset this balance. The aim of this study was to determine whether initial periodontal therapy would have an effect systemically on the levels of MMP-9 and TIMP-1. Twenty-one patients with generalized chronic periodontitis were enrolled in the study. Clinical examinations were conducted and parameters measured. Scaling and root planing was performed and blood analysis done to determine the plasma concentrations of MMP-9 and serum concentrations of TIMP-1. Initial periodontal therapy resulted in improvements in gingival inflammation and plaque levels. No effect on the plasma concentrations of MMP-9 and serum concentrations of TIMP-1 could be found following therapy.

AIM: to determine if a relationship exists between TLR-2, TLR-4, TLR-9, or CD14 polymorphisms and risk for developing chronic periodontal disease in an African-American population. This is the first study conducted to determine role of SNPs in TLR genes and CD14 gene in a periodontally-diseased African-American population. Additionally, this is the first study to assess the role of TLR-9 polymorphism in periodontitis patients. METHODS: A total of 130 subjects were involved in the study. The chronic periodontitis (CP) group contained 73 subjects, and the healthy control (NP) group 57subjects. Genotyping was performed in TLR2 (G2408A), TLR4 (A896G),TLR9 (T1486C) and CD14 (C260T) genes by TaqMan® allelic discrimination using Assay-by-DesignSM SNP Genotyping Assays (Applied Biosystems). Accuracy of genotyping was confirmed by known DNA samples of each genotype and by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) analyses on selected samples. Fisher’s exact test and chi-square analyses were performed to compare genotype and allele frequencies. Within disease groups, we investigated whether SNPs were related to disease severity by step-wise logistic regression adjusted for age, gender, and smoking status. RESULTS: There was a significant difference in the distribution of specific TLR9 (T1486C) genotypes between the periodontally diseased group versus the control group. Expression of TT genotype was more prevelant in periodontally-diseased individuals compared to periodontally-healthy subjects (p<0.0001) whereas individuals expressing C allele of the TLR9 SNP (CC&CT) were more frequently found in the control group after adjusting for age, gender, and smoking status (p<0.0001) There was no statistically significant difference in the distribution of genotypes between groups for any other TLRs or CD14 polymorphism. CONCLUSION: Based on findings of this study, homozygocity for the T allele of TLR 9 polymorphism was related to chronic periodontal disease susceptibility in African Americans. Additionally, presence of the C allele at TLR-9 appeared to confer resistance to periodontal destruction. Our results showed that specific SNPs in TLR-2, -4 and CD14 genes are not related to periodontitis in African Americans.

Advanced biomaterials and sophisticated processing technologies aim to fabricate tissue-engineering scaffolds that can predictably interact within a biological environment at a cellular level. Sterilization of such scaffolds is at the core of patient safety and is an important regulatory issue that needs to be addressed prior to clinical translation. In addition, it is crucial that meticulously engineered micro- and nano- structures are preserved after sterilization. Conventional sterilization methods involving heat, steam and radiation are not compatible with engineered polymeric systems because of scaffold degradation and loss of architecture. Using electrospun scaffolds made from polycaprolactone (PCL), a low melting polymer, and employing spores of Bacillus atrophaeus as biological indicators, we compared ethylene oxide, autoclaving and 80% ethanol to a known chemical sterilant, peracetic acid (PAA), for their ability to sterilize as well as their effects on scaffold properties. PAA diluted in 20% ethanol to 1000 ppm or above, sterilized electrospun scaffolds in 15 min at room temperature while maintaining nano-architecture and mechanical properties. Scaffolds treated with PAA at 5000 ppm were rendered hydrophilic, with contact angles reduced to zero degrees. Therefore, PAA can provide economical, rapid and effective sterilization of heat-sensitive polymeric electrospun scaffolds used in tissue-engineering.

Periodontal disease (PD) is a polymicrobial infection characterized by inflammation of the gingiva, alveolar bone resorption, and tooth loss (edentulism). Treponema denticola along with Porphyromonas gingivalis and Tannerella forsythia are among the “Red Complex” and are main etiological agents in PD. Treponemes are a member of the Spirochaeta phylum and are obligate anaerobes, that express pyruvate ferredoxin oxidoreductase (PFOR). The enzyme catalyzes the oxidation of pyruvate to acetyl-CoA and reduced ferredoxin. Amixicile is a novel bacteriostatic derivative of nitazoxanide and an inhibitor of PFOR. In light of the fact that Treponemes express PFOR, this study was conducted to investigate the susceptibility of oral Treponemes to AMX. All oral Treponemes tested were susceptible to AMX and the MIC values were determined ranging of 1.5-4.5 μg mL-1 for an initial starting cell concentration of 1.9x106 cells mL-1. Other potentially therapeutic effects for AMX for T. denticola were investigated: motility, hydrogen sulfide production, and serum sensitivity. AMX reduced overall spirochete motility by 50% at sub-MIC concentrations. There was a dose dependent decrease in H2S production in T. denticola at sub-MIC and MIC values. Furthermore, prior exposure of AMX led to increases in serum sensitivity. Taking into account the fact that other periodontal red complex bacteria express PFOR, AMX could serve as a new selective adjunctive treatment for periodontal disease.

A Subtração Radiográfica Digital (SRD) vem sendo vastamente utilizada para inúmeros fins em Odontologia. Uma de suas aplicações é a avaliação do resultado radiográfico de procedimentos regenerativos. Este estudo avaliou radiograficamente defeitos infra-ósseos de 2 ou 3 paredes tratados com a proteína derivada da matriz do esmalte (PME) e/ou o retalho de espessura total reposto (RET). Foram selecionados 11 pacientes (3 ? / 8 ?) com periodontite crônica apresentando 2 ou mais defeitos. Antes da cirurgia e após 1 ano foram coletados os dados clínicos e radiográficos. Para a padronização radiográfica foi utilizado um posicionador modificado. Revelou-se os filmes numa processadora automática. As películas foram digitalizadas (500dpi/8bits) em um escaner (SprintScan 35 Plus - Polaroid). Através do programa AxioVision v 3.0 (Carl Zeiss) mediu-se as distâncias da JEC à crista óssea (CO), ao fundo do defeito (FD). Para criar uma escala milimétrica e calibrar a mensuração foi utilizada uma tela quadriculada (2 x 2 mm). As porcentagens de mudança óssea (MO) também foram calculadas. Os resultados mostraram perda da CO de 1,8 mm para PME (MO = -20,93%), revelando diferença estatística neste grupo (p<0,02), e de 0,9 mm para RET (MO = -10,71%), sem diferença entre os grupos. Observou-se maior preenchimento do FD em RET (1,1 mm; MO = 8,14%) do que em PME (-0,6 mm; MO = -3,92%), com diferença entre os grupos (p<0,01). Dentro das limitações deste estudo, conclui-se que através da análise por SRD linear o tratamento convencional de defeitos infra-ósseos humanos promoveu melhores resultados quando comparado à aplicação da PME. / Digital Subtraction Radiographic (DSR) has been widely used for several purposes in Dentistry. Among them is the radiographic evaluation of the results of regenerative procedures. This study evaluated radiographically 2 and 3-wall infra-bony defects which were treated with matrix derivative enamel protein (PME) and/or repositioned flap (RET). Eleven patients (3 ? / 8 ?) with chronic periodontitis were selected, presenting 2 or more defects. Clinical and radiographic data were collected before surgery. A modified filmholder was used to take standardized radiographs. X-ray were developed using an automatic machine. The films were digitized (500dpi/8bits) with the scanner SprintScan 35 Plus (Polaroid). The software AxioVision v 3.0 (Carl Zeiss) was used to measure the distances from the JEC to the alveolar crest (CO), to the bottom of the defect (FD). A grid (2 x 2 mm) was used to establish a milimetric scale after calibration. The amount of bone changes (MO) was also calculated. Results have shown loss of bone at the CO of 1,8 mm (PME) (MO = -20,93%), showing statistic significance (p<0,02), and of 0,9 mm to RET group (MO = -10,71%). No significant differences could be observed when groups were compared. A better fill was observed in the RET group (1,1 mm; MO = 8,14%) than in the PME group (-0,6 mm; MO = -3,92%), showing statistical significance between groups (p<0,01). In conclusion, radiographic analysis has shown that conventional treatment of human intra-bony defects promotes better results when compared to the application of PME.