Journal of advanced periodontology & implant dentistry最新文献

Background: The present study aimed to assess the clinical and radiographic effect of strontium ranelate and metal-substituted hydroxyapatite as bone graft materials on treating chronic periodontitis among diabetes mellitus patients.

Methods: A randomized split-mouth study was conducted on 20 sites in 10 controlled type II diabetic patients suffering from chronic periodontitis. After phase I therapy, the sites were randomly allocated by a computer-generated table into two groups. Group 1: A mucoperiosteal flap was elevated in 10 sites, followed by the placement of strontium ranelate mixed with Gengigel. Group 2: A mucoperiosteal flap was elevated in 10 opposite sites, followed by the placement of metal-substituted hydroxyapatite mixed with Gengigel. Clinical parameters were assessed at baseline and 3- and 6-month intervals. Cone-beam computed tomography (CBCT) was used at baseline and after six months to assess bone gain.

Results: The two treatment modalities resulted in a statistically significant reduction in clinical parameters at the 3- and 6-month intervals compared to the mean baseline value. Intergroup comparison showed a significant reduction in probing pocket depth and clinical attachment loss in group 1 compared to group 2. Comparison of the two sides by CBCT showed a significant increase in the alveolar bone height in the SR group than the metal-substituted hydroxyapatite group.

Conclusion: Clinical and radiographic results showed a significant improvement in the two groups and provided evidence that strontium ranelate is promising in treating periodontal diseases.

Reactive lesions of soft tissue are common oral lesions that are usually non-neoplastic growths without pain; however, they can interfere with oral hygiene and plaque control, and if present in the anterior segment, they can cause esthetics problems. In this case, there was a reactive lesion at the gingiva of the left maxillary central incisor area. The particular consideration about this case was the recurrence of a peripheral ossifying fibroma as a pyogenic granuloma, indicating the association between reactive gingival lesions. The history of several recurrences due to incomplete removal shows the importance of complete excision for preventing recurrence. Therefore, the lesion was completely excised, and the mucogingival defect was successfully augmented with periodontal plastic surgery.

Background: This study aimed to develop a classification for the sagittal root positioning (SRP) of mandibular anterior teeth in terms of their anterior buccal bone for use before placing immediate implants.

Methods: A retrospective review of CBCT images was conducted on 150 patients (75 males and 75 females; mean age: 47.5 years) who met the inclusion criteria. The root position of the tooth samples was classified as buccal, middle, or lingual types according to their respective sagittal position and subtypes a, b, c, or d, according to the morphology of their osseous housing.

Results: The frequencies of the root positions of each classified group of the sample teeth were as follows: 14% buccal type, 77% middle type, and 8% lingual type; 18.0% subtype a, 4.33% subtype b, 75.55% subtype c, and 2.11% subtype d. As a complementary procedure for data collection, the sagittal position of the apex was classified into Class I (buccally angulated apex: 4.6%), Class II (apex with no angulation: 78.2%), Class III (lingually angulated apex: 0.7%) and Class IV (exposed root: 16.3%). In addition, the results of the examination of the buccal undercut showed that in 1.6%, 32.0%, and 66.3% of the sample teeth, the undercut was located coronally, medially, and apically, respectively.

Conclusion: Considering these results, the newly proposed SRP classification system can be used to study the mandibular anterior buccal bone morphology as a diagnostic tool for immediate implant treatment.

Background: Periodontal regeneration is an essential goal of periodontal therapy. Acellular dermal matrix (ADM) has been recommended as an alternative to autogenous grafts. However, since it is devoid of cells and vasculature, there are concerns regarding the biological behavior of cells on ADM. This study aimed to assess the effects of two commonly used ADMs on biological behavior, i.e., attachment and proliferation, of human gingival fibroblasts (HGFs).

Methods: This in vitro, experimental study was conducted on explanted and cultured HGFs. ADM types 1 and 2 (n=26; measuring 10×15 mm) were rinsed with saline solution, adapted to the bottom of 52 wells, exposed to HGFs with a cell density of 16,000 cells/mL, and incubated at 37°C for 12, 24, and 84 hours and seven days. Cell attachment was assessed 12 hours after incubation using 4›,6-diamidino-2-phenylindole (DAPI) and methyl-thiazol-diphenyl-tetrazolium (MTT) assay under a fluorescence microscope. Cell viability was assessed at 24 and 84 hours and one week using the MTT assay. Cells were then platinum-coated, and their morphology was evaluated under a scanning electron microscope (SEM). Data were analyzed using ANOVA.

Results: HGFs were evaluated in 60 samples in three groups (n=20). Cell attachment was the same in the three groups, as shown by the MTT assay and DAPI test (P=0.6). Cell viability at one week was 3.73±0.02, 2.88±0.29, and 2.13±0.24 in the control, ADM 1, and ADM 2 groups, respectively. The difference was statistically significant (P=0.01).

Conclusion: Both scaffolds were the same in terms of attachment of HGFs. However, ADM 1 was superior to ADM2 in terms of cell viability and morphology at one week. It was concluded that the quality of acellular dermal scaffolds could significantly influence cellular behaviors and tissue maturation.

Background: Preventive dentistry, including supportive periodontal therapy (SPT), is one of the most critical areas of attention. Despite SPT's importance in the long-term success of periodontal treatment, the patients' adherence to it is weak. The present study aimed to evaluate of periodontal disease's recurrence rate and its related factors in periodontal patients without regular follow-up.

Methods: A cross-sectional study was set in a specialized periodontics clinic in Tehran, Iran. Patients with periodontitis who completed periodontal therapy during 2005-2014 and did not adhere to the maintenance phase were evaluated. The periodontal history of the patients was updated. The previous diagnoses of patients according to their previous periodontal charts were revised by AAP 2015 criteria. Then, periodontal parameters were assessed, and current periodontal status was evaluated. Statistical analyses consisted of Fisher's exact test, t-test, Man-Whitney test, and Kruskal-Wallis test. Spearman's correlation coefficient was used to assess the relationship between factors and variables.

Results: Fifty patients were evaluated, including 29 males and 21 females. There was a significant relationship between the initial diagnosis and recurrence rate of periodontitis (P=0.017). There was also a significant relationship between the recurrence of periodontitis and the years elapsed since the initial treatment (P=0.027, r = 0.353). Smoking significantly affected tooth loss (P=0.001).

Conclusion: Patients with severe periodontitis need more attention to participate in supportive periodontal care. The patients must be aware of the disadvantages of neglecting this phase and be reminded of regular follow-up.

Background: This study aimed to evaluate the effect of bone-level implants in comparison with tissue-level implants on dental papilla dimensions in single-tooth implants.

Methods: In the present clinical trial, 50 patients, 24 females (48%) and 26 males (52%), were selected among patients requesting single implants in the posterior area of the jaws. The subjects were divided into two groups (n=25). The subjects in the first group were treated with a bone-level implant (Implantium, Dentium, Korea), and the subjects in the second group were treated with a tissue level implant (Implantium, Dentium, Korea). None of the implants were loaded during this period, and only the healing effect was measured. All the implants underwent one-stage surgery (none-submerged), and healing abutments were placed after implantation. The papilla heights in both the mesial and distal aspects of the adjacent teeth were measured. A periodontal probe was used to measure from the top of the papilla to the CEJ of the adjacent teeth in two time intervals. Descriptive statistics were performed using tables and Shapiro-Wilk, chi-squared, Mann-Whitney, and independent t-tests.

Results: The findings showed that the interdental papilla in TL single implants performed better than that in BL implants at the three-month interval. This difference was statistically significant on the mesial aspect but not on the distal aspect. However, the difference was not clinically significant.

Conclusion: A comparison of papilla dimensions in two implant types showed that papilla formation in TL implants was better than that in BL implants at the three-month postoperative interval.

Background: This study aimed to assess the association of haptoglobin (HP) and natural resistance-associated macrophage protein 1 (NRAMP1) alleles with the presence of heme-consuming periodontal pathogens in a group of Iranian patients with chronic periodontitis and peri-implantitis.

Methods: This cross-sectional study evaluated 69 eligible chronic periodontitis and peri-implantitis patients selected from Shahid Beheshti Dental School. The periodontally diseased individuals had at least three teeth with clinical attachment loss of ≥3 mm and a probing pocket depth (PPD) of ≥3 mm in at least two quadrants. Peri-implant PPD of at least one site was ≥5 mm with or without suppuration and bleeding on probing. A plaque index of >20% and a radiographic crestal bone loss was present in at least one site around the implant. The paper point method was used for sampling from the deepest periodontal/peri-implant pocket of each tooth or implant for the DNA checkerboard hybridization technique. Statistical analyses were performed with PASW Statistics 18.0. The variables were presented as absolute and relative frequencies (%).

Results: An Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) score of 1-2 was 5.8 times more frequent in HP 2, rs1723540 G, and rs2276631 G alleles. A Porphyromonas gingivalis (P. gingivalis) score of 1-2 was 4.8 times more common in the subjects carrying HP 2, rs1723540 G, and rs2276631 G alleles compared with HP 1, rs1723540 A, and rs2276631 A alleles.

Conclusion: Within the limitations of this study, it seems that there was a relationship between HP and NRAMP1 allele frequencies and the presence of heme-consuming periodontal pathogens in the Iranian patients with chronic periodontitis and peri-implantitis evaluated in the present study.

Background: The present study aimed to evaluate the osteopromoting ability of human tooth powder and compare it to a bovine xenograft, a synthetic material, and the DFDBA allograft.

Methods: In this in vitro study, 30 teeth without caries, inflammation, and infection, which had been extracted for orthodontic reasons, were collected. The crowns were removed, pulpectomy was carried out, and the samples were ground to a powder with particles <500 µm. Osteoblast-like cells of MG-63 were cultured with the tooth powder, Cerabone, DFDBA, and Osteon II. Cell proliferation was assessed by the MTT assay at 24- and 72-hour intervals. The alizarin red test was carried out after three and five days. The alkaline phosphatase level was measured after 24, 48, and 72 hours to assess the osteoblastic activity. The results were analyzed with one-way ANOVA.

Results: According to the MTT assay, all the materials exhibited a higher proliferation rate than the control group in 24 hours. In 72 hours, DFDBA had the lowest cell proliferation rate at concentrations of 40 and 80 mg/mL. DFDBA and the positive control group were able to create calcified nodules by the alizarin red test. At the 48- and 72-hour intervals, DFDBA had the lowest alkaline phosphatase activity at a concentration of 40 mg/mL. At the 72-hour interval, bovine xenograft had the highest alkaline phosphatase level, followed by the synthetic material and tooth powder.

Conclusion: The tooth powder was able to increase cell proliferation in comparison with the bovine xenograft, the synthetic graft, and the DFDBA. However, its osteopromoting ability was less than that of the osteogenic materials.

Background: This study aimed to evaluate the effect of acellular dermal matrix allograft (ADMA) for the treatment of gingival recession as a substitute for subepithelial connective tissue graft (SCTG).

Methods: In this controlled clinical trial, 18 teeth were selected in nine subjects with bilateral gingival recession. One side was treated with SCTG and a coronally displaced flap as the control group, and the other side was treated with ADMA and a coronally displaced flap as the test group. Probing pocket depth (PPD), clinical attachment level, vertical recession depth, recession width, gingival thickness, keratinized tissue width, and the root coverage percentage were measured before the surgery and at 1-, 3-, and 6-month postoperative intervals. The healing index, pain index, and patient satisfaction were also investigated. The data were analyzed with a general linear model (GLM) repeated measures and paired t-test.

Results: All the parameters improved except for PPD; however, a comparison between the groups did not reveal statistically significant differences. Only root coverage percentage and pain index were significantly lower in the test group. The average percentage of root coverage in the control and test groups were 82.01±16.62% and 64.44±9.4%, respectively.

Conclusion: Both methods resulted in improvements in the clinical results. However, the use of the ADMA led to less pain and root coverage in comparison with the SCTG method.