ABSTRACT
According to the conventional protocol, a stress-free healing period of 3-6 months is one of the most emphasized requirements for implant integration. Long duration of this period has always been a matter of patient's dissatisfaction, so recent studies have encouraged a progressive shortening of the healing period and immediate loading has been proposed to meet this purpose. The aim of this study was to evaluate the clinical response and success rate of immediately loaded implants and comparing it with delay loaded implants. This study is a clinical trial-study. 12 patients [4 males and 8 females], with age range of 28-58 years [mean age 45.9 +/- 7.7 years], presenting posterior partially edentulous maxilla or mandible, were enrolled in this study. A total of 28 Xive implants [Friadent Densply; Manheim, Germany] were placed in these patients and randomly divided into two groups [14 implants in test group and 14 implants in control group]. The diameter of the implants were 3.5 to 4.5 mm and their length were 9.5 to 13mm. One of the test group implants was excluded from the study due to lack of primary stability at surgery. Test group implants were immediately loaded within 24 hours after surgical placement with an temporary acrylic resin restoration. Control group implants were left to heal submerged for 3 to 4 months and then were loaded with FRC [GCG radia. GC Europe N.V] permanent restorations [delayed loading]. Each implant was evaluated every two months until the 8[th] month considering the following parameters: Plaque index [PI], bleeding index [BI], probing depth [PD], mobility, pain and bone resorption [BR]. Periimplant bone resorption was evaluated on periapical radiographs with standardized parallel technique, and RVG software. After data collection, Statistical analysis was performed using SPSS [Version 11.5] and by means of ANOVA and Student's t-test. The significance level was adjusted at 0.05. Two implants in the test group failed, therefore the implant surrival rates in test and control groups were 87% and 100% respectively. No significant statistical difference was observed between the two groups in plaque index and probing depth. No pain, bleeding on probing or mobility were observed in all recalls. Mean bone resorption of periimplant bone height mesially and distally after 8 month was 0.26mm +/- 0.32 in test group and 0.98mm +/- 0.59 in control group. This difference was statistically significant [P=0.011]. Periimplant bone resorption in immediate loading implants was significantly lower than that of delayed loading ones
ABSTRACT
Bacterial plaque is the most important factor in periodontal diseases and plaque control is effective in the prevention of periodontitis. Mechanical plaque control is the most reliable method in plaque reduction but because insufficient mechanical plaque control is usually performed by most patients, chemical plaque control beside mechanical plaque control is more desirable. Several chemical agents for chemical plaque control are used and chlorhexidine is the most effective agent in chemical plaque control and it causes plaque and gingival inflammation reduction. However, chlorhexidine side effects, the most common of which being tooth staining and dorsal tongue staining, are the main factors in inadequate compliance among patients. Scientists suggest the use of oxidating mouthrinses such as hydrogen peroxide and carbamide peroxide for reduction of chlorhexidine staining. The purpose in this study was to compare the induced stain and plaque and gingivitis reduction between chlorhexidine alone and hydrogen peroxide as adjunct to chlorhexidine. In this interventional Study, 30 patients with mild to moderate gingivitis referred to periodontic clinic of Mashhad Dental School [26 males, 4 females], were randomly assigned in a double-blind, 2 group parallel design study. At the beginning of the study, all subjects received scaling and root planing and polishing. After two weeks, PI, GI, and GBI were examined. Gluconate chlorhexidine 0.2% mouhrinse was prescribed for control group to be used for 30 seconds twice a day for 14 days. Subjects in the test group rinsed their mouth with hydrogen peroxide 1.5% for 30 seconds prior to chlorhexidine use twice a day for 14 days. During the study, the patients refrained from brushing. After 14 days, PI, GI, GBI and stain index were recorded again for both groups.The data were statistically analysed by t-test using SPSS 10 software. PI scores for both groups were approximately equal at the end of study. GI and GBI scores were also approximately equal at the end of the study however, reduction in these scores was slightly greater for the control group. The residual inflammation in the test group might be attributed to the used of hydrogen peroxide. The considerable reduction in both severity and extend of staining score in body region in test group was significantly lower than control group but there was no significant difference between two groups in stain severity scores in gingival region. We conclude that use of hydrogen peroxide prior to chlorhexidine may cause significant reduction in tooth staining. Moreover, hydrogen peroxide does not have negative effects on plaque and gingivitis reduction ability of chlorhexidine