Background. This research aimed to evaluate the clinical characteristics of pain and wound healing and serological inflammatory markers after full-mouth implantation in one session compared to several sessions. Methods. A single-masked clinical trial was conducted on 20 patients (n=10) receiving full-mouth implants. Patients were randomly divided into two groups. The first group was operated under general anesthesia in one session and the second group in multi-sessions. Inflammation level was evaluated through white blood cell (WBC) and serum C-reactive protein (CRP) before and after surgery by a blood test. Pain and early wound healing (EHS) assessment was conducted after surgery with VAS and EHS indicators, respectively. Serological and clinical parameters were compared by repeated-measures ANOVA and Sidak and Man-Whitney U tests, respectively, using SPSS 20. Results. The CRP level 48 hours postoperatively was not different in the two groups; however, seven days after treatment, it was higher in the multi-session group than in the single-session approach. The WBC was not different between the two groups at evaluated intervals. Serum levels of WBC and CRP increased 48 hours postoperatively and decreased seven days later. EHS showed no difference between the two groups at the three investigated intervals. The amount of VAS 24 and 48 hours and 7 days postoperatively was higher in multi-session surgery than in the one-session approach. In both groups, VAS was not different at 24 and 48 hours postoperatively and decreased over seven days. Conclusion. Full-mouth implant surgery under general anesthesia in one session caused less inflammation and pain postoperatively while presenting the same wound-healing process as the multi-session surgery
The aim of this study was to evaluate the clinical efficiency of the subepithelial connective tissue graft (SCTG) with and without plasma rich in growth factor (PRGF) in the treatment of gingival recessions.Twenty bilateral buccal gingival Miller's Class I and II recessions were selected. Ten of the recessions were treated with SCTG and PRGF (test group). The rest ten of the recessions were treated with SCTG (control group). The clinical parameters including recession depth (RD), percentage of root coverage (RC), mucogingival junction (MGJ) position, clinical attachment level (CAL), and probing depth (PD) were measured at the baseline, and 1 and 3 months later. The data were analyzed using the Wilcoxon signed rank and Mann-Whitney U tests.After 3 months, both groups showed a significant improvement in all of the mentioned criteria except PD. Although the amount of improvement was better in the SCTG+PRGF group than the SCTG only group, this difference was not statistically significant. The mean RC was 70.85±12.57 in the test group and 75.83±24.68 in the control group.Both SCTG+PRGF and SCTG only result in favorable clinical outcomes, but the added benefit of PRGF is not evident.
The use of photodynamic therapy (PDT) has been evaluated as an adjunctive technique for bacterial decontamination of implants with peri-implantitis. Given the controversies over the efficacy of the application of PDT to treat peri-implant diseases, the present clinical study aimed to evaluate the posttherapeutic clinical parameters and cytokine levels in peri-implant crevicular fluid in patients with peri-implant mucosal inflammation, receiving mechanical debridement (MD) alone or in association with PDT.In this double-blinded randomized clinical trial, 52 patients with peri-implant mucosal inflammation were selected and they were randomly assigned to 2 treatment groups: a MD group and an MD + PDT group using an 805 nm laser and indocyanine green (ICG). Although the decrease in bleeding on probing was the primary outcome, pocket depth, PUS, pain on probing, clinical attachment level, gingival recession, tumor necrosis factor-α, interleukin (IL)-1β, IL-6 and matrix metalloproteinase-8 were also evaluated at baseline, 2-week, and 3-month postintervention. Repeated measure analysis of variance was used to analyze inter-group differences and a P ≤ 0.05 was considered for significant differences between tested parameters.Statistically significant improvements (P < 0.001) were detected for all variables after comparison of baseline data with those collected at each time interval of the study. Nevertheless, the inter-group comparisons of these variables between the baseline, 2-week, and 3-month intervals did not reveal any significant decrease in sites treated with either MD alone or MD + PDT.The application of PDT using 805-nm laser and ICG as an adjunct therapy to MD did not provide any additional improvements in the clinical or biologic parameters of peri-implant mucosal inflammation.
Purpose:The aim of the present clinical trial was to compare pain during injection of anterior middle superior alveolar (AMSA) technique with that of infiltration injection technique in the maxilla in periodontal flap surgeries of patients referring to the Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences.Methods: Twenty subjects with an age range of 20 to 40 years were selected for the present study.One side of the maxilla was randomly selected as the test side and the other as the control side using a flip of a coin.AMSA technique was used on the test side and infiltration technique was used on the control side for anesthesia.On both sides 2% lidocaine containing 1:80,000 epinephrine was used for anesthesia.The operator obtained the visual analogue scale for each patient immediately after the injection and immediately after surgery.Data was analyzed using descriptive statistical methods (frequency percentages, means and standard deviations) and Wilcoxon's test using SPSS ver.13 (SPSS Inc.).Statistical significance was defined at P < 0.05.Results: There were no statistically significant differences in pain during injection between the two techniques (P = 0.856).There were statistically significant differences in postoperative pain between the two injection techniques (P = 0.024).Conclusions: Postoperative pain in AMSA injection technique was less than that in the infiltration technique.Therefore, the AMSA technique is preferable in the periodontal surgeries for the anesthesia of palatal tissues given the fact that it has other advantages, too.
The present study evaluated the most common reasons for replacing amalgam restorations in a university clinic.A total of 217 restorations which needed to be replaced were clinically and radiographically evaluated in a period of 4 months. The frequencies of reasons for replacing amalgam restorations were calculated: The assessed items included recurrent caries, tooth structure fracture (functional or non-functional cusps), amalgam bulk fracture, amalgam marginal fracture, proximal overhangs, and esthetics. Data were analyzed using Fischer's exact test.Both in vital teeth and teeth which had undergone root canal therapy, the most common reason for amalgam replacement was cusp fracture, with the fracture of non-functional cusps being statistically significant. Recurrent caries was the second most common reason for amalgam replacement. In Class I restorations, the most common reasons were recurrent caries and esthetics, with no statistical significance. The most frequent problem in Class II restorations was fracture of non-functional cusps, with a statistical significance in three-surface restorations.According to the results, failing to reduce undermined cusps and neglectful caries removal are the reasons for majority of amalgam restoration replacements. These issues should be emphasized in the curriculum for dental students and continuing education courses.
Introduction: The high success rate of implants has made implant-based prostheses attractive to edentulous patients. Osseointegration lasts 4-6 months, increasing to 6-8 months in cases requiring bone grafts and guided bone regeneration. Many efforts have been made to accelerate osseointegration, including low level laser (LLL) and light emitting diode (LED) photobiomodulation. Material and methods:Twelve patients underwent bimaxillary immediate implant surgery with particulate bone grafts between the socket wall and the implant, and the transmucosal abutment was attached on implants at the same time. The intervention side was exposed to LED radiation for 20 minutes a day one day preoperatively and 10 consecutive sessions, starting from the day of surgery. A trained operator measured and recorded the implant stability quotient (ISQ) value on both sides immediately after surgery as well as one month and three months postoperatively. Results: The ISQ value was 37.54 on the non-irradiated side immediately after surgery; it decreased to 35.09 one month postoperatively and increased to 46.45 at three months after the operation. The ISQ value was 36.73 on the irradiated side immediately after surgery and it increased to 47.36 and 71.18 at one month and three months postoperatively, respectively. There were significant differences between the ISQ values on the irradiated side at all the three time intervals, but also a significant difference on the non-irradiated side, except for two other two time intervals of immediately and one month after surgery. Although there was no significant difference between the two sides in terms of the ISQ value immediately after surgery, the ISQ value was significantly higher on the irradiated versus non-irradiated side at one month and three months postoperatively. Conclusion:Low level laser radiation resulted in a favorable increase in the ISQ value in three months. Light emitting diode has lso led to a clinically significant increase in the ISQ value after three months because implants with ISQ values >54 could be loaded.
Bacterial contamination of dental unit water supplies (DUWS) has attracted a lot of attention in recent years due to the emergence of serious infectionsin susceptible dental patients. The aim of the present study was to evaluate the presence of gram-negative bacterial contamination in DUWS at Tabriz University of Medical Sciences Faculty of Dentistry.This descriptive study was carried out on 51 active dental units in different departments. Con-tamination was determined by taking samples from the unit's water supply before dental procedures and the use of specific culture media. The cultures were evaluated after 48 hours.Gram-negative bacterial contamination was identical in all the departments. In the departments on the ground floor, namely Departments of Periodontics and Oral and Maxillofacial Surgery, Pseudomonas contamination was observed in 71% of units; in the departments on the first floor, namely Departments of Prosthodontics, Orthodontics and Pedodon-tics, 46.8% of the units had Pseudomonas contamination; and in the departments on the second floor, namely Departments of Operative Dentistry and Endodontics, 37.7% of the units demonstrated Pseudomonas contamination.Gram-negative bacterial contamination was evident in the evaluated DUWS. The contamination type was identical but the number of contaminated units decreased with the increase in the height of the floors.
Background and aims. The aim of this investigation was to compare clinical and microbiological effectiveness of adjunctive photodynamic therapy (PDT) in the treatment of periodontitis. Materials and methods. Twenty-four subjects (14 women and 10 men) diagnosed with moderate to severe chronic periodontitis underwent scaling and root planing (SRP). One tooth in each quadrant (probing depth >4 mm) was selected for combined PDT and SRP (PDT group) with the contralateral tooth (SRP group), as a control site (SRP-treated site). Clinical assessment was carried out at baseline and 1 and 3 month later. Microbial assessment was carried out by real-time PCR. Periodontal probing depth (PPD) was considered as the primary outcome. Results. Baseline PPDs were 4.86±0.77 and 4.04±0.65 in the SRP and PDT groups, respectively (P>0.05), which decreased to 3.65±0.58 in the SRP and 3.86±0.56 in the PDT groups after one month and to 3.20±0.68 in the SRP and 3.34±0.56 in the PDT groups three months later. Although values decreased significantly in both groups after one (P=0.001 in the SRP and P=0.001 in the PDT groups) and three months (P=0.001 in the SRP and P=0.001 in the PDT groups) the inter-group differences were not significant after one (P=0.25) and three months (P=0.51). Clinical measurements showed significant decreases after one and three months at both sites, without inter-group differences, except for bleeding on probing after one (P=0.004) and three months (P=0.0001). Conclusion. Subgingival application of PDT combined with scaling and root planing could not improve clinical and microbiological results.
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