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Elimination of Distal Periodontal Po...

Singh, Medha,

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Elimination of Distal Periodontal Pockets Adjacent to Edentulous Areas: Comparison between Triangular Distal Wedge and an Alternative Trap Door Technique /

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Elimination of Distal Periodontal Pockets Adjacent to Edentulous Areas: Comparison between Triangular Distal Wedge and an Alternative Trap Door Technique // Medha Singh.
作者:	Singh, Medha,
面頁冊數:	1 electronic resource (62 pages)
附註:	Source: Masters Abstracts International, Volume: 73-06.
Contained By:	Masters Abstracts International73-06.
標題:	Dentistry. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=1502621
ISBN:	9781267055736

Elimination of Distal Periodontal Pockets Adjacent to Edentulous Areas: Comparison between Triangular Distal Wedge and an Alternative Trap Door Technique /
Singh, Medha,

Elimination of Distal Periodontal Pockets Adjacent to Edentulous Areas: Comparison between Triangular Distal Wedge and an Alternative Trap Door Technique /Medha Singh. - 1 electronic resource (62 pages)

Source: Masters Abstracts International, Volume: 73-06.

Background: Periodontal pockets on the distal surface of terminal molars present a challenge to the clinician due to anatomical and access limitations. Several surgical techniques have been proposed but healing by secondary intention and pocket recurrence are common complications. The purpose of this study was to compare the efficacy of the triangular distal wedge (TW) technique and a novel trap door (TD) technique in the elimination of distal periodontal pockets. Material and Methods: Twenty subjects, aged 25-65 years, with pockets ≥ 6 mm at the distal surface of terminal molars bilaterally were included in this prospective, single-blinded, randomized clinical trial using a split mouth design. Outcomes assessed were changes in pocket depth and clinical attachment, plaque and gingival indices, soft tissue healing and postoperative pain. Patients were followed up for 3 months. Paired t-test was used to compare the outcomes between the two techniques, with p < 0.05 indicating statistical significance. Independent 2-sample t-test was used to assess influence of potential confounders (age, sex, arch). Results: At 3 months, plaque index was reduced by 2.21 ± 0.10 % and gingival index by 1.53 ± 0.14 % from baseline at the TD group, compared to 0.84 ± 0.09 % and 0.95 ± 0.20 %, respectively for the TW group (p <0.05). Both techniques were equally effective in reducing probing depth (1.63 ± 0.11 mm for TD vs 1.89 ± 0.07 mm for TW) and increasing clinical attachment level (1.05 ± 0.09 mm for TD and 0.79 ± 0.14 mm for TW) at 3 months. Similarly, level of pain on a 1-10 visual analog scale at one week postoperatively (3.58 ± 0.33 for TD vs 4.37 ± 0.34 for TW) and soft tissue healing at 3 months (improvement of 0.82 for TD and 0.63 for TW) were comparable for the two groups. Conclusion: TD resulted in a significant reduction of pocket depth and gain in clinical attachment, demonstrating the efficacy of this alternative technique to eliminate pockets present distally to terminal molars. In addition, sites with TD showed a trend for less pain at end of week one and improved soft tissue healing at three months. The TD procedure allowed for significant reduction in plaque index and gingival index. Gingivectomy and triangular distal wedge procedures, which are considered as the treatment of choice, may result in frequent pocket recurrence and healing by secondary intention. The TD procedure permits rapid healing and less discomfort due to primary intention healing. It also allows for easier surgical access of the distal area as well as providing the ability to apically position the periodontal flap, thus exposing more tooth structure and eliminating cul-de-sacs of deep pockets.

English

ISBN: 9781267055736Subjects--Topical Terms:

828971
Dentistry.
Subjects--Index Terms:

Clinical attachment

Elimination of Distal Periodontal Pockets Adjacent to Edentulous Areas: Comparison between Triangular Distal Wedge and an Alternative Trap Door Technique /
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520 $a Background: Periodontal pockets on the distal surface of terminal molars present a challenge to the clinician due to anatomical and access limitations. Several surgical techniques have been proposed but healing by secondary intention and pocket recurrence are common complications. The purpose of this study was to compare the efficacy of the triangular distal wedge (TW) technique and a novel trap door (TD) technique in the elimination of distal periodontal pockets. Material and Methods: Twenty subjects, aged 25-65 years, with pockets ≥ 6 mm at the distal surface of terminal molars bilaterally were included in this prospective, single-blinded, randomized clinical trial using a split mouth design. Outcomes assessed were changes in pocket depth and clinical attachment, plaque and gingival indices, soft tissue healing and postoperative pain. Patients were followed up for 3 months. Paired t-test was used to compare the outcomes between the two techniques, with p < 0.05 indicating statistical significance. Independent 2-sample t-test was used to assess influence of potential confounders (age, sex, arch). Results: At 3 months, plaque index was reduced by 2.21 ± 0.10 % and gingival index by 1.53 ± 0.14 % from baseline at the TD group, compared to 0.84 ± 0.09 % and 0.95 ± 0.20 %, respectively for the TW group (p <0.05). Both techniques were equally effective in reducing probing depth (1.63 ± 0.11 mm for TD vs 1.89 ± 0.07 mm for TW) and increasing clinical attachment level (1.05 ± 0.09 mm for TD and 0.79 ± 0.14 mm for TW) at 3 months. Similarly, level of pain on a 1-10 visual analog scale at one week postoperatively (3.58 ± 0.33 for TD vs 4.37 ± 0.34 for TW) and soft tissue healing at 3 months (improvement of 0.82 for TD and 0.63 for TW) were comparable for the two groups. Conclusion: TD resulted in a significant reduction of pocket depth and gain in clinical attachment, demonstrating the efficacy of this alternative technique to eliminate pockets present distally to terminal molars. In addition, sites with TD showed a trend for less pain at end of week one and improved soft tissue healing at three months. The TD procedure allowed for significant reduction in plaque index and gingival index. Gingivectomy and triangular distal wedge procedures, which are considered as the treatment of choice, may result in frequent pocket recurrence and healing by secondary intention. The TD procedure permits rapid healing and less discomfort due to primary intention healing. It also allows for easier surgical access of the distal area as well as providing the ability to apically position the periodontal flap, thus exposing more tooth structure and eliminating cul-de-sacs of deep pockets.
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