Search

Mothers' dental awareness has an important impact on their children's oral health and oral health-related behavior. The aim was to evaluate mothers’ awareness of their children’s dental health status and assessing the effect of different socio-demographic variables on their awareness. A total of 124 healthy children diagnosed to have caries were included together with their mothers. The mothers answered a selfadministrated questionnaire regarding different socio-demographic variables, their children dental status and dental history. Most of the mothers included were aware of their children’s dental status; 70 (56.5%) were aware that their children have caries. Significantly, more Saudi mothers were aware that their children have caries compared to non Saudi mothers (p = 0.04). Working mothers were also significantly more aware (p = 0.007). Most of the mothers 90 (65.3%) reported that they did not take their child to a dentist before and in those who did, pain was the main cause of their children first dental visit. Significantly, Saudi working mothers and higher (p = 0.037) percentage of mothers who took their child to a dentist were aware of their child dental status. [ABSTRACT FROM AUTHOR]

The friction and wear properties of pure poly-tetra-fluoro-ethylene (PTFE), 35% carbon filled poly-tetra-fluoro-ethylene (PTFE+35%C), and 17% glass fiber-reinforced polytetra-fluoro-ethylene (PTFE+17%GFR) sliding against stainless steel under dry sliding conditions were studied by using a pin-on-disc tribometer. The effect of applied pressure and sliding speed on tribological properties of the polymer-stainless steel combination under dry sliding conditions was investigated. Tests were carried out at sliding speeds of 0.32, 0.64, 0.96, 1.0, 1.5, and 2.0 m/s and under applied pressures of 0.17, 0.34, 0.68, 1.02, 1.76, 3.53, 5.30, and 7.07 MPa. Optical microscopy was utilized to examine the worn surfaces of pure PTFE and it's composite. The results indicated that, for pure PTFE, carbon-filled PTFE and glass fiber-reinforced PTFE composites are used in this investigation; the friction coefficient decreases with the increase in applied load values. The maximum reduction in wear rate was obtained by glass fiber-reinforced PTFE composite. The specific wear rate for pure PTFE, carbon filled PTFE composite, and glass fiber-reinforced PTFE composite were in the order of 10-13, 10-14, and 10-155 m²/N, respectively. The wear mechanism include adhesive and abrasive processes. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were to learn if the intake of systemic antibiotics during the first year of age (period of primary teeth development) was associated with an increased risk for early childhood caries during the following years; end after the first year of age (following the formation of primary teeth) was associated with a lower risk for early childhood caries during the following years. Conclusions: Children who used systemic antibiotics during the first year of age had a significantly greater risk for early childhood caries (ECC) during follow-up compared to children who did not use antibiotics. After the first year of life, only children who used systemic antibiotics at 13 to 18 months old showed a significant increase in the risk of ECC. A child's racial background was a determining factor in the association between antibiotic intake and ECC. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the risk of early childhood caries (ECC) in children who had middle ear infections (MEl) or respiratory tract infections (RTI) during early childhood. Methods: Medicaid data from Michigan were analyzed for all continuously enrolled children born in 2001 for whom enrollment, medical, and dental claims were filed during 2001-2004. Proportional hazards survival models were used to assess the risk of ECC in children who had MEl or RTI during the first year of life. Results: Included in the study were 29,485 children (51% males and 49% females). By first year of life, 47% and 69% of children had a claim for MEl and RTI, respectively. Children with at least one claim for MEl or RTI were at 29% higher risk for developing ECC compared to those with no claims (P<.001). Hispanic children with 8 or more claims showed 91% greater risk for developing ECC than those with less than 8 claims (P=.01). Conclusions: The occurrence of middle ear infections or respiratory tract infections during the first year of life is associated with a significantly increased risk for developing early childhood caries during subsequent years. Race and ethnicity are possible predictors for ECC in the studied models. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cytokines were thought to play an important role for the expansion of odontogenic cysts. The purpose of this study was to evaluate the cytokine and chemokine levels of radicular and residual cyst fluids. METHODS: Cyst fluids were aspirated from 21 patients (11 radicular and 10 residual cysts) and the levels of interleukin-1 alpha (IL-1alpha), tumor necrosis factor-alpha (TNF-alpha), monocyte chemotactic protein-1 (MCP-1), and regulated upon activation normal T cell expressed and secreted (RANTES) were determined by ELISA using commercially available kits. RESULTS: Both radicular and residual cyst fluids contained IL-1alpha, TNF-alpha, MCP-1, and RANTES, concentrations of which were significantly higher in the radicular cyst fluids than those in the residual cysts (P < 0.001 for IL-1alpha, TNF-alpha, and RANTES; P < 0.01 for MCP-1). Compared to the other mediators, the concentration of IL-1alpha was found to be highest in both of the cyst fluids. In addition, positive correlations were found between IL-1alpha, TNF-alpha, MCP-1, and RANTES in radicular and residual cyst fluids. CONCLUSION: If the radicular cyst is inadvertently left behind following tooth extraction, some degree of inflammation may carry on. Residual cysts, although to a lesser extend than radicular cysts, have the potential to expand. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Panoramic radiographs often are the first method used to screen edentulous patients before complete denture therapy. However, routine radiographic examination of edentulous patients is being questioned because of the cumulative effects and cost of radiation exposure. The purpose of this study was to determine the frequency and location of significant radiographic findings in edentulous jaws. METHOD AND MATERIALS: Panoramic radiographs from 338 patients were included in the survey (183 men, 155 women; 676 edentulous arches). The radiographs were evaluated by 1 oral radiology specialist for the following clinically significant radiographic findings: retained root fragments, impacted teeth, radiolucencies associated with cysts, radiopacities associated with localized sclerotic bone formation, location of the mental foramen on the crest, and location of the maxillary sinus close to the crest of the ridge. The data were analyzed using descriptive statistics. RESULTS: Radiographic findings were found in 47.6% (56.5% women, 43.5% men) of the edentulous patients. Fifty-two subjects (29 women, 23 men) had 67 submucosal or intrabony root remains, 50 of which were located in the maxilla. The most frequent finding was retained root fragment, followed by radiopacities. Impacted teeth were found in 11 women and 10 men. In 15 patients the mental foramen was situated at the top of the residual ridge. Of these patients, 13 were women and 2 were men. In 29 patients (14 women, 15 men) the maxillary sinus was close to the crest of the ridge. Six patients (3 women, 3 men) had a bilateral maxillary sinus close to the crest of the ridge. The other 23 patients had a unilateral maxillary sinus close to the crest of the ridge, and except for in 2 men, all were in the left side of the maxilla. CONCLUSION: Routine panoramic examination of the jaws is necessary to detect impacted teeth, retained root fragments, and other radiographic findings that may require treatment before construction of complete dentures. [ABSTRACT FROM AUTHOR]

Aim: To provide an overview of the techniques of indirect pulp treatment (IPT) and the new materials used., Background: Indirect Pulp Treatment (IPT) is a conservative treatment approach that can be used in primary molars. Pulpotomy has been adopted as the treatment of choice for deep caries in primary molars. IPT showed higher success rates in recent researches., Materials and Methods: Electronic search of English scientific papers was accomplished using PubMed, ScienceDirect, and Scopus. Papers published from 1995 to 2019 were included. Search terms used were recent advances, indirect pulp treatment, mineral trioxide aggregate (MTA), biodentine, TheraCal-LC, chlorhexidine gluconate (CHX), resin-modified glass ionomer (RMGI), and calcium hydroxide., Review Results: Seventy two papers were obtained from the electronic search and references of selected studies. Thirty five papers explained recent advances in IPT materials for primary molars. MTA produces more dentinal bridging with superior quality than calcium hydroxide. Similarly, Biodentine can form reparative dentin in a very short period. TheraCal-LC has increased stability and durability with strong physical properties and low solubility. Furthermore, CHX is a chemical disinfectant which can aid in increasing the success rate of IPT when conjugated with other materials. It produced highly successful IPT when combined with RMGI or calcium hydroxide., Conclusion: IPT is the preferred treatment approach for preservation of primary dentition. CHX is an emerging material that can provide promising results in IPT when combined with other materials., Clinical Significance: Up to date, no material had replaced the popular use of calcium hydroxide in IPT. The use of CHX with RMGI can increase the success rate while preserving the advantages of the latter as it is considered the liner of choice for primary teeth, making IPT a suitable substitute for pulpotomy in primary molars., How to Cite This Article: Saber AM, El Meligy OA, Alaki SM. Recent Advances in Indirect Pulp Treatment Materials for Primary Teeth: A Literature Review. Int J Clin Pediatr Dent 2021;14(6):795-801., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; The Author(s).)

Objective: To assess the reliability of radiographic signs of the relationship between impacted mandibular third molars (IMTMs) and the inferior alveolar canal (IAC), and the vertical relationship between IMTM and IAC on panoramic radiographs (PRs) as risk indicators for IAC exposure during extraction., Study Design: Seven radiographic signs regarding the appearance of roots and the IAC were assessed as present or absent on PRs. The vertical relationship between IMTM and the IAC was divided into 3 levels. The correlation between radiographic data and IAC exposure during extraction was analyzed by using χ 2 statistics and logistic regression analysis., Results: In total, 198 IMTMs were examined. In 46 cases (23.2%), the IAC was exposed during extraction. Four radiographic signs-darkening of the root, narrowing of the root, narrowing of the IAC, and diversion of the IAC-were associated with IAC exposure (P < .05). Concurrence of 2 or more of 7 radiographic signs increased the risk of IAC exposure (P < .001). The vertical relationship between IMTM and the IAC was found to be a risk indicator for IAC exposure (P < .001). No significant correlation was found between IAC exposure and inferior alveolar nerve damage (P = .148)., Conclusions: Panoramic radiography is useful for assessing the risk of IAC exposure during IMTM extraction., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Aspergilloma of the maxillary sinus is considered rare in immunocompetent patients, but a considerable increase has recently been seen in the incidence of reported cases. Dental procedures involving the antral region are thought to predispose individuals to this form of aspergillosis. Because aspergilloma shares similar clinical features with other sinus pathologies, its diagnosis may be delayed. Thus, an early diagnosis confirmed by a histopathological examination plays a crucial role in the adequate management of aspergilloma. This article provides a concise review of the reported cases of aspergilloma associated with dental procedures and reports 2 new cases of aspergilloma in middle-aged female patients, with a presentation of their cone-beam computed tomographic findings.

A benign cementoblastoma, which is another name for a true cementoma, is a rare neoplasm that develops from odontogenic ectomesenchyme. It is characterized by a mineralized mass attached to the apex of the root produced by neoplastic cementoblasts. More than 75% of cases arise in the mandible, with 90% of them manifesting in the molar and premolar regions. This neoplasm occurs most commonly in children and young adults, with males being affected slightly more than females. Radiographically, the tumor is observed as a well-defined radiopaque mass that is fused to a tooth root and is surrounded by a radiolucent rim. The treatment of benign cementoblastoma consists of removal of the lesion and extraction of the affected tooth. This report presents an unusual case of benign cementoblastoma in a 31-year-old female, presenting as a densely mineralized mass seen at the apex of the impacted right mandibular canine tooth on radiographs., Competing Interests: No potential conflict of interest relevant to this article was reported.

Statement of Problem: Many studies have investigated the heat generated during implant preparation, but data are needed to better predict heat generation during implant insertion., Purpose: The purpose of this study was to measure the heat generated during insertion of an implant at speeds of 30, 50, and 100 rpm, and with manual insertion., Material and Methods: Sixty-four uniform fresh bovine femoral cortical bone specimens were used. After the cortical bone was drilled, 3 different implant insertion speeds and the manual insertion of the implant were evaluated for 2 different implant diameters. The temperature was measured with 2 Teflon-insulated, type K thermocouples. Data were analyzed by 2-way ANOVA, and the Tukey honestly significant difference test (α=.05)., Results: The highest thermal change for 4.1-mm-diameter implants was found at a speed of 100 rpm (9.81°C ±2.29°C), and the lowest thermal change was 3.69°C ±0.85°C at a speed of 30 rpm. A statistically significant difference was found between 100 rpm and the other 3 insertion procedures. The highest thermal change for a 4.8-mm-diameter implant was found at a speed of 100 rpm (8.79°C ±1.53°C), and the lowest thermal change was 4.48°C ±0.85°C at a speed of 30 rpm. No statistical difference was observed with manual, 30 rpm, and 50 rpm; however, a statistically significant difference was found between 100 rpm and the other 3 insertion procedures., Conclusions: Manual implant insertion and at speeds of 30 rpm and 50 rpm generated lower heat compared with insertion at 100 rpm., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to evaluate the effects of premaxillary advancement with distraction osteogenesis (DO) on the skeletal, dental, and soft tissues., Materials and Methods: A total of 21 cases with Angle class I molar relationship and negative overjet or edge-to-edge incisor relationship were included. Due to patient relocation during fixed orthodontic treatment the results of 19 patients (9 females, 10 males) were reported. Their average chronological age was 16.18 ± 3.10 years. An individual tooth-borne distraction appliance was used. Skeletal, dental, and soft tissue changes were evaluated on cephalograms obtained before treatment (T1), at the end of the consolidation period (T2) and fixed orthodontic treatment (T3). Friedman and Wilcoxon tests were applied to determine the significant differences during T1-T2, T2-T3, and T1-T3 periods., Results: At T2 forward movements of ANS, A, and upper incisors were significant. Significant increases of SNA, ANB, and overjet were obtained. The soft tissue points of Pn, Sn, Ss, Ls showed significant anterior movement. Arch length increase of 10.76 mm was significant. At T3 the decreases of SNA and ANB angles, and FH ┴ N-A distance were significant. Pn point showed significant anterior movement. Total treatment time showed significant anterior movement of points ANS, A, and upper incisors. Significant increase of SNA and ANB angles was noted. The soft tissue points followed the movement of the underlying hard tissue., Limitation: A class III control group could not be established for ethical reasons., Conclusions: The facial profile was improved and space was obtained to solve the maxillary anterior crowding with premaxillary advancement through DO.

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Introduction: Thermal changes can occur on the external root surface when root-end cavity preparation is performed, which may damage periodontal ligament cells and alveolar bone., Objective: The purpose of this study was to evaluate the temperature changes during preparation of the root-end cavities at 1 and 3 mm to the sectioned apical root surfaces when either tungsten carbide round bur, diamond round bur or ultrasonic diamond tip was used., Methods: Root-end resection was performed at 90 degrees to the long axis of the root, 3 mm from the apex. Specimens were randomly divided into three groups of 12 teeth each for three different root-end cavity preparation techniques to be used, i.e. tungsten carbide bur, diamond bur and ultrasonic diamond retro tip.Thermocouples were used to measure temperature changes at 1 mm (T1) and 3 mm (T2) to the cutting plane during the preparations., Results: For T1, the lowest and the highest mean temperature increases of 3.53 degrees C and 4.34 degrees C were recorded for the carbide and diamond burs, respectively. For T2, the lowest and the highest mean temperature increases of 2.62 degrees C and 4.39 degrees C where recorded for the carbide and diamond burs, respectively. The mean temperatures with the ultrasonic tip were 3.68 and 3.04 degrees C at T1 and T2 region, respectively. For root-end preparation, the ultrasonic preparation technique took the shortest preparation time (10.25 sec) and the diamond bur took the longest time (28.17 sec)., Conclusion: Ultrasonic retro tips and burs caused temperature to rise from 2.62 degrees to 4.39 degrees C, and these rises were within safety levels.

The most important prerequisite for the success of an osseointegrated dental implant is achievement and maintenance of implant stability. The aim of the study was to measure the 208 Straumann dental implant stability quotient (ISQ) values during the osseointegration period and determine the factors that affect implant stability. A total of 164 of the implants inserted were standard surface, and 44 of them were SLActive surface. To determine implant stability as ISQ values, measurements were performed at the stage of implant placement and healing periods by the Osstell mentor. The ISQ value ranges showed a significant increase during the healing period. Except for the initial measurement, the posterior maxilla had the lowest ISQ values, and there was no significant difference among anterior mandible, posterior mandible, and anterior maxilla (P < .05). Implant length did not have a significant influence on ISQ value (P > .05). The second measurement was significantly higher in men compared with women (P < .05). The second measurement was significantly higher than the others at 4.8 mm, and for the final measurement, there were no significant differences between 4.8 and 4.1 mm, which were higher than 3.3 mm (P < .05). When comparing sandblasted, large-grit, acid-etched (SLA) and SLActive surface implants, there were no significant differences for insertion measurements, but for second measurements, SLActive was significantly higher (P = 0), and for the final measurement, there was no significant difference. It appears that repeated ISQ measurements of a specific implant have some diagnostic benefit, and the factors that affect implant stability during the healing period are presented.

Objective: The aim of this 6-month prospective randomized clinical study was to compare the effectiveness of autogenous cortical bone (ACB) and bioactive glass (BG) grafting for the regenerative treatment of intraosseous periodontal defects., Methods: Via a split-mouth design, 15 chronic periodontitis patients (7 men, 8 women; mean age, 43.47 ± 1.45 years) who had probing pocket depths (PPDs) of ⩾6 mm following initial periodontal therapy were randomly assigned to receive 2 treatments in contralateral areas of the dentition: ACB grafting and BG grafting. The parameters compared in the patients were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights., Results: Both treatment modalities resulted in significant changes in postoperative measurements when compared to preoperative values (p < 0.01). PPDs were decreased, CALs were increased, and radiographic alveolar bone heights were increased by 5.00 ± 0.28, 4.60 ± 0.21, and 5.80 ± 0.43 mm in patients treated with ACB grafting and 5.13 ± 0.32, 4.67 ± 0.27, and 5.33 ± 0.36 mm in patients treated with BG grafting, respectively. Differences between the treatments were not statistically significant (P>.05)., Conclusions: Within the limitations of this study, both ACB and BG grafting led to significant improvements in clinical and radiographic parameters 6 months postoperatively. These results suggest that either an ACB graft, which is completely safe with no associated concerns about disease transmission and immunogenic reactions, or a BG graft, which has an unlimited supply, can be selected for regenerative periodontal treatment.

Surgically assisted rapid maxillary expansion (SARME), which combines orthodontics and surgery, is a well-established therapy for transverse maxillary hypoplasia in adults after sutural closure or completion of skeletal maturation. X-rays are usually the preferred monitoring technique for this treatment. Recently, ultrasound scanning has been used successfully in the follow-up of patients undergoing distraction osteogenesis. In this study, ultrasonography (US) was used in the evaluation of bone callus formation in the midpalatal suture in 3 patients undergoing SARME. For each patient, US was performed immediately after active expansion, at 2 and 4 months of the expansion period, at the removal of the expander 6 months later, and at 2 months after expander removal. The results indicated that US might be a useful and accurate method to assess bone fill in the midpalatal suture in patients undergoing SARME. However, further studies are necessary to clarify the US scores in a larger patient group undergoing SARME.

Objective: The purpose of this in vitro study was to evaluate the generated temperature of the Er:YAG laser, with three different pulse durations for apicectomy, compared with tungsten bur and surgical saw., Background Data: Apicectomy is an endodontic surgery performed to remove the root apex and curette adjacent periapical tissue because of lesions of the apical area that are not healing properly., Methods: Sixty single-rooted extracted human teeth were resected by three cutting methods: tungsten bur, surgical saw, and Er:YAG laser irradiation with three different pulse durations; pulse duration 50 μs, pulse duration 100 μs, and pulse duration 300 μs. Teflon-insulated, type K thermocouples were used to measure temperature changes during the apicectomy process. Data were analyzed using the general linear models procedure of the SPSS statistical software program., Results: Although there was no statistically significant difference for the mean values of temperature changes at 1 mm away to the cutting site of teeth, there was statistically significant difference among groups for the mean values of temperature changes at 3 mm away to the cutting site of teeth. Additionally, there was statistically significant difference among groups for the total time required for apicectomy., Conclusions: The laser irradiation with pulse duration 50 μs appears to have the lowest temperature rise and the shortest time required for apicectomy of the three pulse durations. However, Er:YAG laser for apicectomy in all pulse durations could be used safely for resection in endodontics in the presence of sufficient water.

Keratocystic odontogenic tumor (KCOT) is a benign odontogenic tumor with a potentially aggressive and infiltrative behavior. KCOT is most commonly occurred in mandible and demonstrate a unilocular, round, oval, scalloped radiolucent area, while large lesions may appear multilocular. An important characteristic of KCOT is its propensity to grow in an antero-posterior direction within medullary cavity of bone causing minimal expansion. Definitive diagnosis relies on histological examination. In this report, a KCOT that had an expansion both buccal and lingual cortical bone is described including its features in computed tomography and ultrasonographic exams. The lesion was removed surgically via an intraoral approach under local anesthesia and histologically reported as a KCOT.

Purpose: The purpose of this study was to compare the heat generated from implant drilling using stainless steel and ceramic drills., Materials and Methods: A total of 40 fresh bovine femoral cortical bone samples were used in this study. A constant drill load of 2.0 kg was applied throughout the drilling procedures via a drilling rig at a speed of 1,500 rpm. Two different implant drill types (stainless steel and ceramic) were evaluated. Heat was measured with type K thermocouple from 3 different depths. Data were subjected to the independent-sample t test and Pearson correlation analysis. The α level was set a priori at 0.05., Results: The mean maximum temperatures at the depths of 3 mm, 6 mm, and 9 mm with the stainless steel drill were 32.15°C, 35.94°C, and 37.05°C, respectively, and those with the ceramic drill were 34.49°C, 36.73°C, and 36.52°C, respectively. A statistically significant difference was found at the depth of 3 mm (P = .014) whereas there was no significant difference at the depths of 6 and 9 mm (P > .05) between stainless steel and ceramic drills., Conclusion: Within the limitations of the study, although more heat was generated in the superficial part of the drilling cavity with the ceramic drill, heat modifications seemed not to be correlated with the drill type, whether stainless steel or ceramic, in the deep aspect of the cavity. Further clinical studies are required to determine the effect of drill type on heat generation., (Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this clinical trial was to evaluate the additional benefit of using guided tissue regeneration (GTR) with autogenous cortical bone (ACB) grafting versus ACB grafting alone for the regenerative treatment of intraosseous periodontal defects., Methods: Via a split-mouth design, 12 patients with chronic periodontitis (five men, seven women; mean age, 45.3±4.6 years) who had probing pocket depths (PPDs) of ≥6 mm following initial periodontal therapy were randomly assigned to two treatments in contralateral areas of the dentition: a combination of ACB grafting and GTR (with a absorbable membrane of polylactic acid) or ACB grafting alone. The compared parameters were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights., Results: Both treatment modalities resulted in significant changes in the postoperative measurements from the preoperative values (P<.01). The reduction in the PPDs, gain in the CALs, and gain in the radiographic alveolar bone heights were 4.58±1.08, 4.25±1.06, and 5.50±2.24 mm in the patients treated with ACB grafting and GTR and 4.92±1.00, 4.50±0.80, and 5.92±1.83 mm in those treated with ACB grafting alone, respectively. The differences between the treatments were not statistically significant (P>.05)., Conclusions: Within the study limitations, both ACB grafting with GTR and ACB grafting alone lead to significant improvements in clinical and radiographic parameters at 6 months postoperatively. The combined approach does not provide any additional benefit for treating intraosseous periodontal defects.