Al-Hezaimi K, Rudek I, Al-Hamdan KS, Javed F, Iezzi G, Piattelli A, Wang HL. J Periodontol. 2012 Oct 22. [Epub ahead of print]

Efficacy of Acellular Dermal Matrix and Coronally Advanced Flaps for the Treatment of Induced Gingival Recession Defects: A Histomorphometric Study in Dogs.

Abstract

Background: Gingival recession (GR) defects can be treated by various methods including acellular dermal matrix (ADM) or by coronally advanced flaps (CAF). The aim of this histomorphometric experiment was to compare the efficacy of ADM and CAF for treating GR defects in dogs. Materials and methods: In eight beagle dogs, a critical size labial GR defect was surcically induced on bilateral maxillary cuspids under general anesthesia. Test-sites received ADM and CAF and control-sites underwent CAF-treatment alone. Plaque index (PI), bleeding index (BI) and gingival index (GI) were measured at 4- weeks (baseline), 8-weeks and 16-weeks. Width of keratinized gingiva (KG) was determined at baseline and at 16-weeks. Depth of recession and width of GR below the cementoenamel junction (CEJ) was also determined. After 4-months, animals were sacrificed and jaw blocks were histomorphometrically assessed for tissue thickness, distance from stent to the gingival margin and to the CEJ. Results: At 4-, 8- and 16-week intervals, there was no significant difference in the BI, GI and PI at the test- and control-sites. At 16-weeks, thickness of KG was significantly higher at the control-sites than test-sites (P<0.01). There was no difference in the midfacial recession depth and recession width at the test- and control-sites at baseline and before euthanasia (16-week). Histomorphometrically, there was no significant difference in tissue thicknesses and distances from the stent to the gingival margin and CEJ in the test- and control-sites. Conclusions: ADM might yield similar results to CAF alone and could decrease the amount of KG.

 

Javed F, Tenenbaum HC, Nogueira-Filho G, Nooh N, O'Bello Correa F, Warnakulasuriya S, Dasanayake AP, Al-Hezaimi K.

Periodontal Inflammatory Conditions Among Gutka-Chewers and Non-Chewers With and Without Prediabetes.

Background: It is known that gutka-chewing jeopardizes periodontal health; however, severity of periodontal inflammation in gutka-chewers with and without prediabetes remains unknown. The aim was to investigate the association of periodontal inflammatory conditions with gutka-chewing and pre-diabetes. Methods: In this cross-sectional study, the effect of gutka use on periodontal health was investigated among 44 individuals with prediabetes and 44 without prediabetes. Demographic information regarding age, sex, duration of prediabetes and gutka-chewing habits was collected using a questionnaire. Periodontal inflammatory conditions (plaque index [PI], bleeding on probing [BOP], probing depth [PD], marginal bone loss [MBL]), and fasting blood glucose levels (FBGL) were recorded. Group differences in periodontal inflammatory parameters were tested using univariate and multivariable analyses (alpha ≤ 5%). Results: Periodontal inflammatory parameters (PI, BOP, and PD) were significantly higher in prediabetic subjects irrespective of the gutka-chewing habit (p<0.05). Odds of periodontal inflammation in prediabetic individuals were 9 times higher compared to healthy controls (95% Confidence Interval [CI] = 3.4-23.6). Gutka chewing alone, chewing among prediabetics and chewing among healthy controls did not statistically significantly increase the odds of periodontal inflammatory conditions. Prediabetics were statistically significantly more likely to have periodontal inflammation as compared to non-prediabetics even after controlling for sex and gutka-chewing (OR=13.2; 95% CI = 4.3 - 40.7). Conclusions: In medically-healthy individuals, periodontal inflammatory conditions are worse in gutka-chewers as compared to non-chewers; whereas in patients with prediabetes, the severity of periodontal inflammation is governed by hyperglycemia as opposed to habitual gutka usage.