Journal of advanced periodontology & implant dentistry最新文献

Background: This study aimed to assess the effectiveness of "a combined systemic and nonsurgical periodontal treatment" in eradicating gastric Helicobacter pylori in patients having the bacterium within their subgingival biofilm.

Methods: This randomized clinical trial (RCT) investigated 102 patients diagnosed with peptic ulcer or dyspepsia and a positive stomach test for H. pylori infection (G+). Participants with a negative test for oral infection received only triple therapy (G3, n=38), and those positive for oral infection were randomly allocated to one of the two treatment regimens: a 14-day course of triple therapy (comprising antibiotics, antimicrobials, and proton pump inhibitors) alongside periodontal therapy (G1, n=32) or triple therapy alone (G2, n=32). The effectiveness of H. pylori eradication was assessed four weeks after treatment using the H. pylori stool antigen (stool Ag) test. Data analysis was performed using SPSS 22.

Results: In the G2 and G3 groups, triple therapy achieved success rates of 52% and 84%, respectively. When periodontal therapy was integrated with triple therapy in the G1 group, the success rate was 80%. Significant differences were observed between the G1 and G2 groups (P=0.037) and also between the G3 and G2 groups (P=0.015). Conversely, no significant difference was found between the G1 and G3 groups (P>0.05).

Conclusion: Periodontal therapy has the potential to substantially increase the efficacy of H. pylori eradication regimens for gastric infections.

Background: The present study assessed the probing depth of the second molar distal aspect after the surgical removal of adjacent mandibular impacted third molars using osteotomy by a buccal window and routine crestal flaps.

Methods: In this double-blind, randomized clinical trial, 16 candidates for the surgical removal of bilateral mandibular third molars were selected, and each side's tooth was assigned to a different osteotomy group. The surgery was performed using a sulcular flap and a distal extension for one group, while the osteotomy was performed using the buccal window technique. The pocket probing depth of the adjacent second molars was calculated before and three months after the surgical removal. The data of both groups were statistically analyzed using normality and t-tests in the SPSS software. Statistical significance was set at P<0.05.

Results: At three months postoperatively, significant differences were found between the two groups regarding pocket probing depth at mesiobuccal (5.23±1.12 mm in the crestal osteotomy and 4.03±1.16 mm in the buccal window osteotomy; P<0.006), mid-distal (5.77±1.08 mm in the crestal osteotomy and 4.25±1.35 mm in the buccal window osteotomy; P<0.002), and distolingual aspects (5.46±1.34 mm in the crestal osteotomy and 3.96±1.11 mm in the crestal osteotomy; P<0.002) of the adjacent second molars. The mean pocket probing depth of the mid-distal area was significantly lower in the buccal window osteotomy.

Conclusion: According to the results, this technique can be used as an alternative to crestal osteotomy in level C impactions and Cl I and Cl II impactions regarding position towards the anterior edges of the mandibular ramus.

Background: The present study evaluated the synergistic effect of 808 nm and 660 nm diode lasers on the processes of healing and pain management following crown lengthening surgery.

Methods: This randomized clinical trial involved 20 patients who underwent surgical crown lengthening on both sides of their jaw. Following the surgery, one tooth from each patient was randomly assigned to either the case group (irradiated with 808 nm and 660 nm diode lasers as photobiomodulation [PBM] therapy) or the control group (laser device remained switched off). The early healing index (EHI), comprising clinical signs of inflammation (CSI), clinical signs of homeostasis (CSH), and clinical signs of re-epithelialization (CSR), was assessed on days 3 and 7. Pain severity was quantified on the day of surgery and 1, 3, and 7 days after surgery using a visual analog scale. The data were analyzed using the Wilcoxon test.

Results: No significant differences were observed in CSR on days 3 (P=0.18) and 7 (P=1.0), nor in CSI on day 3 (P=0.477) after surgery. However, a significant difference was identified in CSI on day 7 and in CSH on both days 3 and 7 (P<0.05) after surgery. Furthermore, the level of postoperative pain demonstrated a significant difference (P≤0.005).

Conclusion: PBM demonstrably enhanced CSI by day 7 and improved CSH by days 3 and 7, in addition to decreasing postoperative pain.

Background: This study evaluated the impact of different regenerative biomaterial combinations on bone quality and implant stability in guided bone regeneration (GBR).

Methods: A pilot study was conducted from September 2020 to October 2023 to compare the quality of bone regeneration and implant stability following GBR using three composite graft combinations. Forty-seven patients participated in the study in three experimental groups: group A (deproteinized cancellous bovine bone [xenograft] with injectable platelet-rich fibrin [i-PRF]), group B (xenograft with autogenous bone graft in a 2:1 ratio with i-PRF), and group C (xenograft with autogenous bone graft in a 1:1 ratio with i-PRF). The implant stability quotient (ISQ) was measured at the time of implant placement. Crestal bone biopsy procedures were performed.

Results: The study found that group C, using a 1:1 ratio of xenograft and autogenous graft with i-PRF, achieved the highest new bone formation (65.83%) and demonstrated moderately high vascularization and osteoclastic activity, indicative of good remodeling potential. ISQ measurements for all groups indicated good primary stability of implants, ranging from 55 to 65 at the time of placement.

Conclusion: Combining xenograft with autogenous graft in a 1:1 ratio, along with i-PRF, yielded optimal outcomes for new bone formation in GBR procedures. However, further research is needed to address the limitations associated with i-PRF, such as lack of rigidity and faster degradation, to enhance its application in GBR procedures.

Background: The reduction of alveolar ridge volume after tooth extraction can be decreased through ridge preservation. According to previous studies, statin drugs induce osteogenesis. Therefore, this study aimed to evaluate the effect of simvastatin on the preservation and ossification of the alveolar ridge after tooth extraction.

Methods: In this single-center randomized clinical trial, 40 dental sockets in 40 patients were randomly divided into the treatment group (collagen with simvastatin) and the control group (collagen only). Histologic bone examination was performed under a light microscope two months after socket preservation at the time of dental implants. The predictable variable was using simvastatin in dental sockets. In the treatment group, collagen was used with simvastatin; in the control group, only collagen was used. The percentage of bone formation was the primary outcome, which was measured as the area of newly formed bone. In this study, inflammatory reaction, the amount of remaining bone substitute, and foreign body reaction were compared between the two groups. Covariates included age, sex, and tooth location. T-test was used for normally distributed data, while the Mann-Whitney test was used for non-normal data. P<0.05 was considered significant.

Results: The results showed that following eight weeks of simvastatin use in the treatment group, the percentage of new bone formation was significantly higher compared to the control group (treatment group vs. control group: 69.28±3.93 vs. 52.76±2.01; P=0.0001). No foreign body reaction and residual graft materials were observed in the treatment and control groups. Furthermore, the study showed an inflammatory reaction in only 23.5% of the samples in the control group (P=0.045).

Conclusion: Simvastatin significantly increased the formation of new bone in the dental socket in the treatment group.

Background: The study aimed to compare the results of cytotoxicity and in vivo irritation and sensitization tests of a new antler-derived bone substitute with those of a bovine-derived xenograft.

Methods: This study included an in vitro cytotoxicity test based on ISO 10993-5 standard. Additionally, in vivo irritation and sensitization tests were carried out according to ISO 10993-10 standard protocol.

Results: The cytotoxicity test showed a viability of 99.46±1.09% for the antler-derived bone substitute and 98.42±1.84% for the bovine xenograft (P=0.445). Furthermore, after 24 hours, no differences in morphological grade were found in both samples. The irritation test indicated a primary irritation index (PII) score of 0 for both the antler and bovine xenografts. Likewise, the sensitization test demonstrated a sensitization score of 0 for both the antler and bovine xenografts. All animals appeared clinically normal throughout the study in both in vivo tests, and all sites of the test extract and the reagent control seemed normal.

Conclusion: Both the antler-derived and bovine xenografts were found to be non-toxic, non-irritating, and non-sensitizing. Further studies should be conducted on other essential laboratory tests and animal and clinical studies.

Background: Ketorolac is classified as a non-steroidal anti-inflammatory drug. It functions by inhibiting the production of prostaglandins, thereby diminishing the local inflammatory response. This medication has the potential to alleviate postoperative complications, including pain and swelling that may occur following surgical procedures.

Methods: Fifty patients with mild chronic periodontitis were randomly divided into two blinded groups of 25 patients. One group underwent scaling and root planing (SRP) with 2% ketorolac trometamol (KT) irrigation, and the other group received 0.2% chlorhexidine (CHX). Treatment was performed on the first and second molars in both mandibular quadrants. Various clinical periodontal parameters, such as plaque index (PI), bleeding on probing (BOP), pocket probing depth (PPD), clinical attachment loss (CAL ), and gingival index (GI) were carefully recorded. Patients were scheduled for follow-up visits at 3-month intervals.

Results: The CHX mouthwash and KT groups did not differ significantly in clinical periodontal parameters at baseline. Clinical outcomes demonstrated, as anticipated, statistically significant improvements in the percentages of PI, BOP, GI, PD, and CAL at 60 and 90 days compared to baseline in both groups (P<0.05). In contrast to the CHX group, the KT group's clinical periodontal parameters (PI, BOP, and GI) significantly decreased after the follow-up period.

Conclusion: KT can be recommended as a complementary treatment for individuals suffering from chronic periodontitis, as it is more effective in reducing PI, GI, and BOP compared with CHX.

Background: This study aimed to compare insertion torque (IT) and implant stability quotient (ISQ) values immediately and three months after surgery with standard drilling (SD) and osseodensification (OD) drilling methods.

Methods: In this prospective study, 39 implants with the same diameter and length were placed in 21 patients using SD (23 implants) and OD (16 implants) methods in the posterior maxilla. The amounts of IT after surgery and ISQ after surgery and three months later were evaluated. The data were extracted and statistically analyzed with PASS2 software. The difference between IT and ISQ was determined by the two-way repeated-measures ANOVA at a significance level of 0.001.

Results: Immediately after surgery, the amount of IT using the OD drilling method was 37% higher than the SD drilling (P<0.001). ISQ values after surgery did not show a significant difference between SD and OD (P1<0.176). Three months after surgery, the ISQ values in both groups were not significantly different. ISQ values for all OD and SD group experimental parameters remained above the threshold value of 68. IT values showed a positive correlation with ISQ values at baseline.

Conclusion: In the present study, the OD technique provided a higher IT rate after surgery compared to the SD method; however, no difference was seen between the two groups regarding ISQ value either after surgery or three months later.

This article introduces a minimally invasive slim V-shaped surgical technique for labial frenectomy, specifically targeting high labial frenulum attachment. Proper frenulum management is critical in dental specialties, influencing aesthetics, phonetics, and prosthetic rehabilitation outcomes. The described technique is adaptable to various types of labial frenulum, including mucosal, gingival, papillary, and papilla penetrating. It involves a slim V-shaped incision, consecutive frenulum detachment, and repositioning within the vestibule, effectively addressing potential recurrence growth. Its minimally invasive nature reduces wound expansion into neighboring structures, ensuring optimal healing and minimizing postoperative discomfort. In conclusion, the slim V-shaped surgical technique offers a promising solution, minimizing complications and maximizing treatment success for high labial frenulum attachment.

Background: Excess cement is one of the most prevalent problems with cement-retained implant-supported prostheses. The excess cement may be considered an important source of inflammation during implant application. Optimizing the design procedure for reducing excess cement is necessary for successful and safe implant applications.

Methods: This study assessed the effect of two confounding factors, i.e., emergence profile and space gap size, on the level of excess cement. Three types of emergence profiles (concave, convex, and straight) and three different gap sizes (30, 60, and 90 µm) were considered for implant design, and the level of excess cement was measured for each design.

Results: Statistical analyses using one-way ANOVA followed by post hoc P value correction revealed that the best emergence profile with the lowest excess cement was the straight profile, with statistically lower excess cement compared with concave and convex profiles (P<0.05) and no significant difference between concave and convex profiles. Furthermore, analyses showed that lower gap size was associated with lower excess cement, even though increasing the gap size from a threshold (>60 µm) made the difference significant. Interaction analysis using two-way ANOVA also indicated the interaction between the emergence profile and space gap size.

Conclusion: The results emphasized that a straight profile with a smaller gap size should be considered to reduce the excess cement. However, due to the small sample size of the study, further analyses with different types of materials, angles of deformation, and gap sizes are required to reveal the exact relationship between excess cement and the design specifications.