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The effect of micro-osteoperforations on the rate of orthodontic tooth movement: A systematic review and meta-analysis

Sivarajan S, Ringgingon LP, Fayed MMS, Wey MC

Am J Orthod Dentofacial Orthop, 2020 Mar;157(3):290-304.
PMID: 32115107 DOI: 10.1016/j.ajodo.2019.10.009

INTRODUCTION: Minimally invasive micro-osteoperforations (MOPs) look promising for a routine acceleration of orthodontic tooth movement (OTM). The objective of this research was to systematically evaluate evidence regarding the effects of MOPs on the OTM rate, treatment duration, and associated complications.
METHODS: Electronic database and hand search of English literature in PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and clinical trial.gov, with author clarification were performed. The selection criteria were randomized controlled trial (RCT) comparing MOPs with conventional treatment involving both extraction and nonextraction. Cochrane's risk of bias tool and Grading of Recommendations Assessment, Development and Evaluation approach were used for quality assessment. Studies were analyzed with chi-square-based Q statistic methods, I2 index, fixed-effects, and random-effects model. Quantitative analysis was done on homogenous studies using Review Manager.
RESULTS: Eight RCTs were included for the qualitative analysis. Meta-analysis of 2 homogenous studies indicated insignificant effect with MOPs (0.01 mm less OTM; 95% CI, 0.13-0.11; P = 0.83). No difference (P >0.05) was found in anchorage loss, root resorption, gingival recession, and pain.
CONCLUSIONS: Meta-analysis of 2 low-risk of bias studies showed no effect with single application MOPs over a short observation period; however, the overall evidence was low. The quality of evidence for MOP side effects ranged from high to low. Future studies are suggested to investigate repeated MOPs effect over the entire treatment duration for different models of OTM and its related biological changes.
TRIAL REGISTRATION NUMBER: PROSPERO CDR42019118642.

Matched MeSH terms: Gingival Recession*
Fulltext Multilevel analysis of site, implant, and patient-level factors with peri-implant bleeding on probing: a cross sectional study

Nettemu SK, Nettem S, Singh VP, William SS, Gunasekaran SS, Krisnan M, et al.

Int J Implant Dent, 2021 06 10;7(1):77.
PMID: 34109477 DOI: 10.1186/s40729-021-00315-0

AIM: This study was to evaluate the association between peri-implant bleeding on probing in peri-implant diseases and its association with multilevel factors (site specific factors, implant factors, and patient level factors).
METHODOLOGY: A cross-sectional study involved consented adult patients with ≥ 1 dental implant. Two calibrated operators examined the patients. BoP was outcome variable and peri-implant gingival biotype was principal predictor variable. The effects of site, implant, and patient level factors on BoP were assessed using a multilevel logistic regression model.
RESULTS: Eighty patients for a total of 119 implants and 714 sites were included in the study. Bleeding on probing was observed in 42 implants (35.29%) with a significant higher risk observed in presence of gingival recession, thin peri-implant gingival biotype, duration of implant placement, smokers, and male patients.
CONCLUSION: Peri-implant bleeding on probing was associated with site specific, implant, and patient level factors.

Matched MeSH terms: Gingival Recession*
Fulltext Current Insight of Collagen Biomatrix for Gingival Recession: An Evidence-Based Systematic Review

Naomi R, Ardhani R, Hafiyyah OA, Fauzi MB

Polymers (Basel), 2020 Sep 13;12(9).
PMID: 32933133 DOI: 10.3390/polym12092081

Collagen (Col) is a naturally available material and is widely used in the tissue engineering and medical field owing to its high biocompatibility and malleability. Promising results on the use of Col were observed in the periodontal application and many attempts have been carried out to inculcate Col for gingival recession (GR). Col is found to be an excellent provisional bioscaffold for the current treatment in GR. Therefore, the aim of this paper is to scrutinize an overview of the reported Col effect focusing on in vitro, in vivo, and clinical trials in GR application. A comprehensive literature search was performed using EBSCOhost, Science Direct, Springer Link, and Medline & Ovid databases to identify the potential articles on particular topics. The search query was accomplished based on the Boolean operators involving keywords such as (1) collagen OR scaffold OR hybrid scaffold OR biomaterial AND (2) gingiva recession OR tissue regeneration OR dental tissue OR healing mechanism OR gingiva. Only articles published from 2015 onwards were selected for further analysis. This review includes the physicochemical properties of Col scaffold and the outcome for GR. The comprehensive literature search retrieved a total of 3077 articles using the appropriate keywords. However, on the basis of the inclusion and exclusion criteria, only 15 articles were chosen for further review. The results from these articles indicated that Col promoted gingival tissue regeneration for GR healing. Therefore, this systematic review recapitulated that Col enhances regeneration of gingival tissue either through a slow or rapid process with no sign of cytotoxicity or adverse effect.

Matched MeSH terms: Gingival Recession
Fulltext Dehiscence Treated With Non-Resorbable Gore-Tex Membrane - A Case Report

Kamin, S., Ghani, S.H.A.

Ann Dent, 1996;3(1):-.
MyJurnal

Severe gingival recession caused by dehiscence usually present a challenging task to the clinician as any mucogingival surgery without bony regeneration will not 'prevent the condition from recurring. The procedures of guided tissue regeneration ( GTR ) which allow regeneration of the lost periodontium may offer some solution to the condition. This paper reports on the use of a non-resorbable GTR membrane to treat an isolated lower incisor gingival recession associated with dehiscence.

Matched MeSH terms: Gingival Recession
Fulltext Root coverage of a wide anterior mucogingival defect with epithelial embossed connective tissue graft and its evaluation using root coverage esthetic scores

Rath A, Fernandes BA, Sidhu P, Ramamurthy P

J Indian Soc Periodontol, 2018 2 15;21(3):245-248.
PMID: 29440795 DOI: 10.4103/jisp.jisp_221_17

New and innovative surgical techniques are necessary to help the clinician ensure the best results and satisfy patient's expectations. One such periodontal problem that has been challenging to the dental practitioners and impacts the oral health quality of life of patients has been gingival recession. When present anteriorly where esthetics is a major concern, patient centric parameters too become paramount. Root coverage esthetic score (RES) evaluation helps to keep the patient outcomes in mind. This case reports the successful treatment of a wide anterior mucogingival defect using epithelial embossed connective tissue graft which was evaluated for the first time using RES.

Matched MeSH terms: Gingival Recession
Fulltext Genome Sequence of Parvimonas micra Strain A293, Isolated from an Abdominal Abscess from a Patient in the United Kingdom

Ang MY, Dymock D, Tan JL, Thong MH, Tan QK, Wong GJ, et al.

Genome Announc, 2013;1(6).
PMID: 24309744 DOI: 10.1128/genomeA.01025-13

Parvimonas micra is an important oral microbe that has the ability to grow and proliferate within oral biofilms and is involved in periodontal disease, leading to gingival bleeding, gingival recession, alveolar bone loss, and tooth mobility. However, occasionally these normally oral pathogens can cause infections at other sites in the body. We present the genome sequence of Parvimonas micra strain A293, a smooth Parvimonas micra strain isolated from an abdominal abscess from a patient at Barts Hospital, London, United Kingdom.

Matched MeSH terms: Gingival Recession
Fulltext Semilunar Papilla Preservation Flap Technique in Combination with Chorion Membrane for Pocket Reduction and Gingival Recession Coverage

Rajendran P, Bhat S, Anand M

Contemp Clin Dent, 2020 08 07;11(2):190-194.
PMID: 33110336 DOI: 10.4103/ccd.ccd_354_19

An unavoidable consequence of periodontal flap procedure is gingival recession (GR). Achieving both pocket depth reduction and GR coverage remains a challenge to periodontists. The present case report provides a new innovative technique that will enable all clinicians to achieve pocket depth reduction as well as recession coverage in esthetic zone. The clinical parameters that were assessed at baseline, 1 month, 3 months, and 6 months are probing depth (PD), clinical attachment level (CAL), height of GR (HGR), and gingival biotype. The patient reported with a faulty post and core with crown in relation to maxillary right central incisor with a PD of 8 mm and HGR of 2.5 mm. Following replacement of the crown with respect to the tooth, semilunar incision was made and flap was reflected to visualize the underlying bone. This technique does not involve the interdental papilla at the same time allows the coronal advancement of the flap. A chorion membrane was placed to accelerate the healing as well to provide stable clinical outcome. The patient was evaluated at 10 days, 1 month, 3 months, and 6 months. There was a considerable reduction in PD, GR, and thus gain in CAL. The results remained stable over a period of 6 months.

Matched MeSH terms: Gingival Recession
Root Coverage of Palatal Recession Using Epithelial Embossed Connective Tissue: A Case Report

Rath A, Fernandes B, R PH, Varma S, Pavuluri AK

J Int Acad Periodontol, 2017 Jan 02;19(1):10-14.
PMID: 31473707

Labial and buccal gingival recession is a common finding in the adult population, which can occur due to various factors. When present, it can lead to an unesthetic appearance and can cause hypersensitivity. However, very limited literature is available regarding the incidence of palatal gingival recession. Many times it goes unnoticed during routine clinical examinations. Although there are no esthetic concerns in these regions, recession can cause sensitivity and pose a technical challenge in surgical correction because of poor accessibility and visibility. This case reports the treatment of a single palatal recession defect using an epithelial embossed connective tissue graft. The 12-month follow-up of the case showed significant root coverage (93.6%) and decreased sensitivity. The advantage of the harvested graft was that the connective tissue was not exposed, as it was tucked into the underlying flap, and the mucosal contour was maintained.

Matched MeSH terms: Gingival Recession
Fulltext Assessment of clinical and radiographic status of crowned teeth

Nurul Farahah Bahari, Nur Iffah Izzaty Jamal, John, Jacob

Ann Dent, 2019;26(1):8-14.
MyJurnal

This cross sectional study investigated the clinical and radiographic status of crowned teeth with and without root canal treatment. The study used secondary data from records of patients who received crown treatment at the Faculty of Dentistry, University of Malaya before 2015 and walk-in patients attending the primary care clinic between July - December 2016. The inclusion criterion was crown fitted for more than 12 months. Once identified, the patients were assessed for clinical and radiographic status. Data were entered into and analysed using SPSS Version 20 software. A total of 66 crowns [35 root canal treated (RCT) and 31 non-root canal treated (n-RCT)] were identified. Chi-square test was carried out to determine the health of crowned teeth and for its longevity in the oral cavity. There were 43 crowns (46.5% RCT; 53.5% n-RCT) with plaque accumulation, 15 (66.7% RCT; 33.3% n-RCT) with gingival swelling/recession, 17 (46.5% RCT; 53.5% n-RCT) with widening of the periodontal ligament, 13 (53.8% RCT; 46.2% n-RCT) with bone loss and 5 (60% RCT; 40% n-RCT) crowns with periapical lesion. There was no statistically significant difference except for poorer alveolar bone condition for crowns that have been in the mouth for >10 years. Based on the study, no significant adverse pulpal involvement between crown with RCT and crown without RCT was observed.

Matched MeSH terms: Gingival Recession
Clinical Outcomes of Lithium Disilicate Single Crowns after a Mean Duration of 3 Years - A Retrospective Study

Saleh Samer M, Ali TT, Abdullah H

Oral Health Prev Dent, 2018 7 22;16(3):249-257.
PMID: 30027164 DOI: 10.3290/j.ohpd.a40758

PURPOSE: To investigate the clinical performance and clinical survival rate of lithium disilicate-based core ceramic (IPS e.max Press) utilised in single crowns and to the accompanying periodontal health status.
MATERIALS AND METHODS: A total of 47 patients with 88 IPS e.max Press single crowns were examined at the Faculty of Dentistry, University of Malaya, using modified United States Public Health Service evaluation criteria (USPHS). These 88 crowned teeth included 19 vital and 69 nonvital teeth that were restored with different post and core materials. The periodontal status was compared using the plaque index (PI), gingival recession (GR), modified papillary bleeding index (MPBI) and probing pocket depth (PPD) between the crowned teeth and contralateral control (sound) teeth.
RESULTS: About 96.6% of the crowns exhibited satisfactory clinical performance. The mean survival rate at three years was 97.7%, and 100% at two years with a low incidence of fractures. There were no staitistically significant differences in the mean gingival recession (p = 0.182) and mean plaque scores (p = 0.102) between crowned and control teeth. The crowned teeth had higher mean MPBI (p = 0.000) and PPD (p = 0.051) compared to the contralateral sound teeth. Periodontal response in relation to subgingival crown margins, was statistically significantly lower regarding pocket depths (p = 0.01) and bleeding on probing (p = 0.00).
CONCLUSION: IPS e.max Press crowns exhibited satisfactory clinical performance with high survival rate. No dentinal sensitivity was recorded. Plaque retention and gingival recession were similar to contralateral control teeth. Poor periodontal health was related to the subgingival crown margins.

Matched MeSH terms: Gingival Recession