Sinus floor elevation and simultaneous implant placement in fresh extraction sockets: a systematic review of clinical data

Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, andWeb of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort caseseries, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.

Three-dimensional optimization and sensitivity analysis of dental implant thread parameters using finite element analysis

OBJECTIVES: This study aimed to optimize the thread depth and pitch of a recently designed dental implant to provide uniform stress distribution by means of a response surface optimization method available in finite element (FE) software. The sensitivity of simulation to different mechanical parameters was also evaluated. MATERIALS AND METHODS: A three-dimensional model of a tapered dental implant with micro-threads in the upper area and V-shaped threads in the rest of the body was modeled and analyzed using finite element analysis (FEA). An axial load of 100 N was applied to the top of the implants. The model was optimized for thread depth and pitch to determine the optimal stress distribution. In this analysis, micro-threads had 0.25 to 0.3 mm depth and 0.27 to 0.33 mm pitch, and V-shaped threads had 0.405 to 0.495 mm depth and 0.66 to 0.8 mm pitch. RESULTS: The optimized depth and pitch were 0.307 and 0.286 mm for micro-threads and 0.405 and 0.808 mm for V-shaped threads, respectively. In this design, the most effective parameters on stress distribution were the depth and pitch of the micro-threads based on sensitivity analysis results. CONCLUSION: Based on the results of this study, the optimal implant design has micro-threads with 0.307 and 0.286 mm depth and pitch, respectively, in the upper area and V-shaped threads with 0.405 and 0.808 mm depth and pitch in the rest of the body. These results indicate that micro-thread parameters have a greater effect on stress and strain values.

Gingival crevicular fluid levels of sclerostin in chronic periodontitis and healthy subjects

OBJECTIVES: Chronic periodontitis is a common inflammatory disease of the oral cavity that causes destruction of periodontal tissues and bone around the teeth. Sclerostin is a protein encoded by the SOST gene. In this study, gingival crevicular fluid (GCF) levels of sclerostin in patients with chronic periodontitis were compared with those of healthy subjects. MATERIALS AND METHODS: In this case-control study, a total of 40 subjects were enrolled and divided into the healthy group (n=23) and chronic periodontitis group (n=17). GCF samples were collected, and the concentration of sclerostin was evaluated using enzyme-linked immunosorbent assay. Comparison of significance between groups was assessed using Mann-Whitney U test. RESULTS: Sclerostin concentration was significantly higher in the chronic periodontitis group compared with the healthy group (P < 0.005). CONCLUSION: Despite the limitations of this study, sclerostin can be a possible marker for assessment of periodontal health status.

Clinical comparison of full and partial double pedicle flaps with connective tissue grafts for treatment of gingival recession

Statement of the Problem: Gingival recession has been considered as the most challenging issue in the field of periodontal plastic surgery

Purpose: The purpose of this study was to evaluate the clinical efficacy of root coverage procedures by using partial thickness double pedicle graft and compare it with full thickness double pedicle graft

Materials and Method: Eight patients, aged 15 to 58 years including 6 females and 2 males with 20 paired [mirror image] defects with class I and II gingival recession were randomly assigned into two groups. Clinical parameters such as recession depth, recession width, clinical attachment level, probing depth, and width of keratinized tissue were measured at the baseline and 6 months post-surgery. A mucosal double papillary flap was elevated and the respective root was thoroughly planed. The connective tissue graft was harvested from the palate, and then adapted over the root. The pedicle flap was secured over the connective tissue graft and sutured. The surgical technique was similar in the control group except for the prepared double pedicle graft which was full thickness

Results: The mean root coverage was 88.14% [2.83 mm] in the test group and 85.7% [2.75 mm] in the control group. No statistical differences were found in the mean reduction of vertical recession, width of recession, or probing depth between the test and control groups. In both procedures, the width of keratinized tissue increased after three months and the difference between the two groups was not statistically significant in this respect

Conclusion: Connective tissue with partial and full thickness double pedicle grafts can be successfully used for treatment of marginal gingival recession

Validity of panoramic indices to evaluate the association of bone mineral density with morphology of the mandible in osteoporotic patients

Objective: Osteoporosis is the most common metabolic disease of the bone decreasing bone mineral density [BMD] particularly in postmenopausal women. On the other hand, panoramic radiography has several applications in dentistry. It appears that by calculating some indices on panoramic radiographs, we may be able to predict the risk of osteoporosis in high-risk individuals. The present study was conducted to determine the correlation of skeletal pattern of bone and the morphology of the mandible in osteoporotic patients presenting to the Osteoporosis Clinic of Khatamolanbia Hospital and Imam Khomeini Dental Clinic in Yazd

Methods: This descriptive, analytical, cross-sectional study was conducted on 70 women aged over 45 years, whom were selected from the above-mentioned centers. The gonialangle [GA], gonial index [GI], antegonial angle [AA], mental index [MI], antegonial index [AI] and antegonial depth [AD] were calculated on panoramic radiographs of patients and their BMD was measured in the lumbar area and femoral areas using dual X-ray absorptiometry [DXA]. The correlation of panoramic indices with BMD was assessed using Spearman and Pearson's correlation tests. The difference in BMD values in different morphological patterns of the inferior cortex of the mandible was analyzed by Student t-test and in different thicknesses of the cortex using one-way ANOVA

Results: The morphology of the inferior cortex was C1 in 62.9% and C2 in 37.1%. The cortex was thin in 24.3%, moderately thick in 32.9% and thick in 42.9%. Lumbar BMD was 0.92 [0.14] and 0.75 [0.15] g/cm2, in C1 and C2, respectively [p<0.001]. Femoral BMD was 0.81 [0.13] and 0.66 [0.09] g/cm2 in C1 and C2, respectively [p<0.001]. No significant association was found between GI, AI, GA, AA and AD [based on the estimates made on panoramic radiographs] with the BMD [based on DXA estimates]

Conclusion: Use of mandibular cortex indices on panoramic radiographs may be efficient for assessment of osteoporosis. However, further multicenter studies on larger sample sizes are required

Effects of fresh mineralized dentin and cementum on socket healing: a preliminary study in dogs

OBJECTIVES: Dentin is composed of many minerals and growth factors. Based on this composition, we studied its effect as a possible regenerative material for alveolar healing. MATERIALS AND METHODS: This study was conducted using four 2.5-year-old mongrel dogs (male; weight, 25 to 30 kg). The third mandibular premolars were carefully mobilized with a dental elevator and then removed using forceps. The crown portions of the extracted teeth were removed with cutters, and the root portions of the remaining teeth were collectively trimmed as closely as possible to 350 to 500 microm. Dentin and cementum (DC) chips harvested from the extracted teeth were soaked in blood and packed into the fresh sockets (autograft). Biopsies were performed at the ends of day 14 and day 56 following implantation. Data were expressed as mean+/-standard deviation and compared with t-test results. RESULTS: The ratio of SA(bone) to total area of each probe was determined and was 170+/-16 microm2 for the control group and 71+/-14 microm2 for the DC group, a significant difference (P<0.05). CONCLUSION: DC particulate grafts offered no improvement in bone regeneration in alveolar extraction sockets.

Effect of low level laser therapy on proliferation and differentiation of the cells contributing in bone regeneration

Low level laser therapy [LLLT] also known as photobiomodulation, is a treatment that uses low-level lasers or light-emitting diodes [LEDs] to change cellular function and is a clinically well accepted tool in regenerative medicine and dentistry. Considering the variety of laser, exposure, cells and study types, the exact effects of low level laser therapy seems to be unclear. The aim of this study was to review the data published in the field of the effects of low level laser therapy on proliferation and differentiation of the cells contributing in bone regeneration. To access relevant articles, an electronic search in PubMed was conducted from 2001 to April 2014. English language published papers on low level laser therapy were found using the selected keywords .The full texts of potentially suitable articles were obtained for final assessment according to the exclusion and inclusion criteria. 240 articles were found from 2001 to April 2014. Following the initial screening of titles and abstracts as well as the final screening of full texts, 22 articles completely fulfilled the inclusion criteria of this study. Wavelength used in LLLT irradiation varied between 600 to 1000 nm with an energy density of 0.04-60J/cm[2]. Although almost all studies agreed on getting positive effects from LLLT, some had opposing results. Low level laser with low-energy density range appears to exert a biostimulatory effect on bone tissue, enhance osteoblastic proliferation and differentiation on cell lines used in in vitro studies. Despite the fact that many researches have been recently done on the effects of LLLT on different cell lines, without knowing the precise mechanism and effects, we are not able to offer a clinical treatment protocol. This paper is a beginning to help further progress and extend practical use of LLLT in future

Evaluation of alveolar crest bone loss via premolar bitewing radiographs: presentation of a new method

PURPOSE: This study aimed to assess the interdental bone level in premolar bitewing radiographs while retracting the cheeks. METHODS: Seventy-two horizontal bone defects were created on dried mandibles and maxillae. The distance from the bone level to the cement-enamel junction of premolars was detected by a modified digital caliper (considered the gold standard). The reliability of all radiographs was assessed by intraclass correlation coefficient (ICC), and the validity was compared to the gold standard using the analysis of variance test. P-values less than 0.05 were considered statistically significant. RESULTS: This study showed that the reliability of radiographs without a cheek simulator and with 0.16 second exposure time was significantly higher than that of the two other groups (ICC=0.96 compared to 0.93 and 0.88, respectively). The results from the radiographs without a cheek simulator and with 0.16 second exposure time were more similar to the gold standard measures than those of the two other groups, although the difference was not statistically significant. CONCLUSIONS: Retracting the buccal soft tissue plays an important role in increasing the accuracy of radiographs in detecting the interdental alveolar bone level and produces more accurate results than increasing the exposure time, although it does not have a significant role in reliability of results.

Comparison of the reproducibility of results of a new peri-implantitis assessment system (implant success index) with the Misch classification

OBJECTIVES: The present study was conducted to determine the reproducibility of peri-implant tissue assessment using the new implant success index (ISI) in comparison with the Misch classification. MATERIALS AND METHODS: In this descriptive study, 22 cases of peri-implant soft tissue with different conditions were selected, and color slides were prepared from them. The slides were shown to periodontists, maxillofacial surgeons, prosthodontists and general dentists, and these professionals were asked to score the images according to the Misch classification and ISI. The intra- and inter-observer reproducibility scores of the viewers were assessed and reported using kappa and weighted kappa (WK) tests. RESULTS: Inter-observer reproducibility of the ISI technique between the prosthodontists-periodontists (WK=0.85), prosthodontists-maxillofacial surgeons (WK=0.86) and periodontists-maxillofacial surgeons (WK=0.9) was better than that between general dentists and other specialists. In the two groups of general dentists and maxillofacial surgeons, ISI was more reproducible than the Misch classification system (WK=0.99 versus WK non-calculable, WK=1 and WK=0.86). The intra-observer reproducibility of both methods was equally excellent among periodontists (WK=1). For prosthodontists, the WK was not calculable via any of the methods. CONCLUSION: The intra-observer reproducibility of both the ISI and Misch classification techniques depends on the specialty and expertise of the clinician. Although ISI has more classes, it also has higher reproducibility than simpler classifications due to its ability to provide more detail.

Assessment of interleukin-1beta and interleukin-6 in the crevicular fluid around healthy implants, implants with peri-implantitis, and healthy teeth: a cross-sectional study

OBJECTIVES: This study aimed to assess and compare the levels of interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) in the crevicular fluid around healthy implants, implants with peri-implantitis, and healthy teeth. MATERIALS AND METHODS: This study evaluated 16 dental implants in 8 patients (4 males and 4 females). These patients had at least one healthy implant and one implant with peri-implantitis next to healthy teeth. The crevicular fluid was collected using absorbent cones and transferred to the laboratory. Specimens were evaluated by ELISA for interleukin levels. Data were analyzed using repeated measures ANOVA and Bonferroni tests (P<0.05). RESULTS: Levels of IL-1beta in the crevicular fluid around implants with peri-implantitis were significantly higher than around healthy implants (P=0.002); the latter was significantly higher than around healthy teeth (P=0.015). A significant difference was found in the level of IL-6 in the crevicular fluid around implants with peri-implantitis and healthy implants (P=0.049) and also between implants with peri-implantitis and healthy teeth (P<0.001). CONCLUSION: Within the limitations of this study, significant differences exist in the levels of IL-1beta and IL-6 in the crevicular fluid of implants with peri-implantitis, healthy implants, and healthy teeth. More studies with larger sample sizes in different populations are necessary.

Receptor activator of nuclear factor kappa-B gene polymorphisms in Iranian periodontitis and peri-implantitis patients

PURPOSE: Peri-implantitis and periodontitis are inflammatory and infectious diseases of implant and tooth-supporting tissues. Recently, the role of gene polymorphisms of immune response components in the relevant pathogenesis has been investigated. The present study was the first to evaluate the relationship between two known single nucleotide polymorphisms (SNPs) of the receptor activator of nuclear factor kappa-beta (RANK) gene (rs3018362 and rs35211496) in chronic periodontitis and peri-implantitis patients in an Iranian population. METHODS: Eighty-one periodontally healthy patients, 38 patients with peri-implantitis, and 74 patients with chronic periodontitis were enrolled in this study. DNA was extracted from blood arm vein samples by using Miller's salting out technique according to the manufacturer's instructions given in the extraction kit. The concentration of DNA samples was measured using a spectrophotometer. The genetic polymorphisms of the RANK gene were evaluated using a competitive allele specific polymerase chain reaction (KBioscience allele specific PCR) technique. Differences in the frequencies of genotypes and alleles in the diseased and healthy groups were analyzed using chi-squared statistical tests (P<0.05). RESULTS: Analysis of rs35211496 revealed statistically significant differences in the expression of the TT, TC, and CC genotypes among the three groups (P=0.00). No statistically significant difference was detected in this respect between the control group and the chronic periodontitis group. The expression of the GG, GA, and AA genotypes and allele frequencies (rs3018362) showed no statistically significant difference among the three groups (P=0.21). CONCLUSIONS: The results of this study indicate that the CC genotype of the rs35211496 RANK gene polymorphism was significantly associated with peri-implantitis and may be considered a genetic determinant for peri-implantitis, but this needs to be confirmed by further studies in other populations.

Interleukin 17 receptor gene polymorphism in periimplantitis and chronic periodontitis

Gene polymorphism of cytokines influencing their function has been known as a contributing factor in the pathogenesis of inflammatory diseases of the tooth and implant supporting tissues. The aim of this study was to investigate the association of IL-17R gene polymorphism [rs879576] with chronic periodontitis and periimplantitis in an Iranian population. 73 patients with chronic periodontitis, 37 patients with periimplantitis and 83 periodontally healthy patients were enrolled in this study. 5cc blood was obtained from each subject's arm vein and transferred to tubes containing EDTA. Genomic DNA was extracted using Miller's Salting Out technique. The DNA was transferred into 96 division plates, transported to Kbioscience Institute in United Kingdom and analyzed using the Kbioscience Competitive Allele Specific PCR [KASP] technique. Chi-square and Kruskal Wallis tests were used to analyze differences in the expression of genotypes and frequency of alleles in disease and control groups [P-Value less than 0.05 was considered statistically significant]. There were no significant differences between periodontitis, periimplantitis with AA, GG, GA genotype of IL-17R gene [7M].8239]. Also comparison of frequency of alleles in SNP rs879576 of IL-17R gene between the chronic periodontitis group and periimplantitis group did not revealed statistically significant differences [P=0.8239]. The enigma of IL-17 and its polymorphism-role in periodontitis and periimplantitis is yet to be investigated more carefully throughout further research but this article demonstrates that polymorphism of IL-17R plays no significant role in incidence of chronic periodontitis and Periimplantitis

Comparison of the effect of hand instruments, an ultrasonic scaler, and an erbium-doped yttrium aluminium garnet laser on root surface roughness of teeth with periodontitis: a profilometer study

PURPOSE: The present study aimed to measure root surface roughness in teeth with periodontitis by a profilometer following root planning with ultrasonic and hand instruments with and without erbium-doped yttrium aluminium garnet (Er:YAG) laser irradiation. METHODS: Sixty single-rooted maxillary and mandibular teeth, extracted because of periodontal disease, were collected. The crowns and apices of the roots were cut off using a diamond bur and water coolant. The specimens were mounted in an acrylic resin block such that a plain root surface was accessible. After primary evaluation and setting a baseline, the samples were divided into 4 groups. In group 1, the samples were root planned using a manual curette. The group 2 samples were prepared with an ultrasonic scaler. In group 3, after scaling with hand instrumentation, the roots were treated with a Smart 1240D plus Er:YAG laser and in group 4, the roots were prepared with ultrasonic scaler and subsequently treated with an Er:YAG laser. Root surface roughness was then measured by a profilometer (MahrSurf M300+RD18C system) under controlled laboratory conditions at a temperature of 25degrees C and 41% humidity. The data were analyzed statistically using analysis of variance and a t-test (P<0.05). RESULTS: Significant differences were detected in terms of surface roughness and surface distortion before and after treatment. The average reduction of the surface roughness after treatment in groups 1, 2, 3, and 4 was 1.89, 1.88, 1.40, and 1.52, respectively. These findings revealed no significant differences among the four groups. CONCLUSIONS: An Er:YAG laser as an adjunct to traditional scaling and root planning reduces root surface roughness. However, the surface ultrastructure is more irregular than when using conventional methods.

The combined effect of dismantling for steam sterilization and aging on the accuracy of spring-style mechanical torque devices

PURPOSE: This study aimed to assess the combined effect of dismantling before sterilization and aging on the accuracy (+/-10% of the target torque) of spring-style mechanical torque devices (S-S MTDs). METHODS: Twenty new S-SMTDs from two different manufacturers (Nobel Biocare and Straumann: 10 of each type) were selected and divided into two groups, namely, case (group A) and control (group B). For sterilization, 100 cycles of autoclaving were performed in 100 sequences. In each sequence, 10 repetitions of peak torque values were registered for aging. To measure and assess the output of each device, a Tohnichi torque gauge was used (P<0.05). RESULTS: Before steam sterilization, all of the tested devices stayed within 10% of their target values. After 100 cycles of steam sterilization and aging with or without dismantling of the devices, the Nobel Biocare devices stayed within 10% of their target torque. In the Straumann devices, despite the significant difference between the peak torque and target torque values, the absolute error values stayed within 10% of their target torque. CONCLUSION: Within the limitations of this study, there was no significant difference between the mean and absolute value of error between Nobel Biocare and Straumann S-S MTDs.

Bacterial analysis of peri-implantitis and chronic periodontitis in Iranian subjects

Chronic periodontitis [CP] and peri-implantitis [PI] are multifactorial diseases of tooth and implant supporting apparatus. Bacterial invasion and consequent host immune response seem to play a role in relevant pathogenesis. The structural differences between tooth and implant pose preferential biofilm colonization. This study was aimed to compare the prevalence of bacteria in CP and PI. Clinical and radiographic examination performed over 69 individuals referred to Shahid Beheshti Dental School [Tehran, Iran] and four groups categorized: CP [n=22], HP [n=21], PI [n=13] and HI [n=13]. The mean age was 45.6 years, 55% of participants were female and 45% were male. Bacterial samples were collected by paper point method and transferred to Institute of Odontology, University of Gothenburg [Gothenburg, Sweden] for checkerboard DNA-DNA hybridization. Kruskal-Wallis and Mann-Whitney U tests were used to compare distribution of bacteria in four groups. Significant differences were observed for T. forsythia, P. intermedia, C. rectus, P. endodontic, P. gingivalis, T. denticola and P. tannerae [P<0.05]. The most prevalent bacteria in CP and PI were T. forsythia and P. gingivalis, respectively. In conclusion, bacterial prevalence differs significantly between tooth and implant. The most prevalent bacteria in Iranian subpopulation do not necessarily bear a resemblance to other populations. The type of implant surface may influence the biofilm. Other studies should be conducted to corroborate these findings.

Effect of hand, ultrasonic scaler and erbium-doped yttrium aluminum garnet [er: yag] laser on the morphology of root surfaces with periodontitis: a comparative in vitro scanning electron microscopy study

The main purpose of the present study was to describe the ultra structural changes which happened after treatment of the root surfaces with ultrasonic and hand devices followed by Erbium-Doped Yttrium Aluminum Garnet [Er:YAG] laser irradiation. Sixty single-rooted maxillary and mandibular teeth which had been extracted due to periodontal problems were collected. Crown and apical parts of the root were cut off using a diamond bur. The specimens were mounted on an acrylic resin in order to make a plain surface of the root accessible. The samples were assigned as following: group1: samples were root planed using conventional hand curette, group2: were prepared by ultrasonic device, group3: roots after scaling by hand instrumentation were treated by Er:YAG laser with 50 mJ/pulse and frequency of 10 Hz, group4: roots were prepared by ultrasonic scaler and consequently were treated by laser. Furthermore, the teeth were dried, sputter-coated with gold, and monitored with scanning electron microscope [SEM]. Photomicrographs from ten samples of root surfaces which were taken at magnifications up to 500X revealed that there were not any severe morphologic changes, such as melting and charring, in any group. However, the samples treated by laser irradiation showed more irregularities and distortions. Er:YAG laser setting at 50mj/pulse, as an adjunctive to traditional scaling and root planning, did not induce severe damages to root surfaces, although root surface irregularities were more pronounced in laser treated groups compare to hand instruments.

[Comparison of the clinical efficacy of scaling and root planning with and without topical application of vitamin E via tray method for treatment of chronic periodontitis: a randomized clinical trial]

Microbial plaque is the main cause of periodontal disease. Production of free oxygen radicals is an immune system mechanism to destroy invading microorganisms which per se results in further destruction of periodontal tissues. The present study sought to assess the efficacy of anti-oxidant application [vitamin E] as an adjuvant treatment following scaling and root planning in periodontal patients. For this randomized clinical trial 10 patients aged 30 to 50 years suffering from moderate to severe periodontitis with no systemic disease were selected. After scaling and root planning, 5% vitamin E for one side and placebo for the opposite side were poured in a maxillary custom tray and placed inside the mouth. Type of treatment did not have a significant effect on the understudy factors. However, time had a significant effect on the majority of indices. Healing was significantly better at week 4 following initiation of treatment compared to week 2. The values in proximal and radicular sites were -0.151, p=0.002 and -0.31, p=0.001 for pocket depth, -0.217, p=0.002 and -0.401, p=0.001 for CAL, -4.188, p=0.001 and -0.391, p=0.272 for BOP and -0.219, p=0.05 for GI, respectively. The present study showed that the effect of time was greater than the type of treatment on improvement of indices

Using diode laser for soft tissue incision of oral cavity

The purpose of this case report is to analyze the results of vestibuleplasty around an over-denture based on dental implants to determine the evidence on the effectiveness of laser-assisted surgery and soft tissue management in implant dentistry. The patient in this case report was a 57 year- old male who was completely edentulous, with a mandibular over denture based on 4 standard implants suffering from pain on chewing, and a general discomfort, especially in anterior segment. He received a standard gingival augmentation surgery which failed to create sufficient vestibular depth. A laser-assisted vestibuloplasty was done to make the environment suitable for making a new overdenture. There were clinically significant improvements in vestibular depth and peri implant soft tissue situation by laser. Also, bleeding during surgery was well controlled; the patient's discomfort and pain were less than the first operation done with gingival graft. Based on our clinical data and review of the literature, an evidence-based approach to the use of lasers for the management of soft tissue in oral surgery is necessary. Simply, there is insufficient evidence to suggest that any specific wavelength of laser is superior to the traditional modalities of therapy. However, improved hemostasis and patient's satisfaction can be considered as advantages of adjunctive laser therapy in some clinical situations like vestibuloplasty

Comparison of the palatal connective tissue graft as a membrane with collagen membrane in combination with Bio-Oss and PRGF for the treatment of intrabony defects: a randomized clinical trial

This randomized clinical trial was aimed at comparing the outcomes of palatal connective tissue+ Bio-Oss + PRGF versuscollagen membrane + Bio-Oss+ PRGFin the treatment of intrabny defects. Fifteen patients affected by chronic periodontitis were enrolled. Each patient had at least two intrabonydefect [>/= 3mm]. They were randomly assigned into two groups: patients treated i] with collagen membrane+PRGF+Bio-oss [control group] and ii] with palatal connective tissue as membrane + PRGF+Bio-Oss [experimental group]. Clinical and intrasurgical examinations included probing depth[PD], clinical attachment level[CAL],gingival recession[GR],defect fill[DF], alveolar crest level[AC] and defect resolution[DR] were measured at baseline and after 6 months with re-entry surgery. Statistical analysis was performed usingTwo-way Repeated Measure ANOVA and Wilcoxon. After 6 months, all of the evaluated clinical parameters showed statistically significant changes from baseline within each group [p< 0/05]. The test group showed a significantly smaller amount of gingival recession as compared with control group.[0/8mm versus 1/7mm respectively; P<0/05] But there were not any statistically differences in other clinical parameters between the test and control groups[P>0/05]: pocket depth reduction [3/7mm versus 3/5mm], clinical attachment gain [1/8mm versus 1/6mm], alveolar crest loss [1/8mm versus 1/7mm], defect fill[2/3mm versus 2/2mm] and defect resolution [4/1mm versus3/9mm]. According to the results obtained from this study it can be suggested that clinical effects of application of palatal connective tissue as a membrane and collagen membrane, in combination with Bio-Oss and PRGF in treatment of vertical bone defects, did not have any statistical significant differences except for gingival recession that was statistically smaller in connective tissue group

A comparison of magnetostrictive and piezoelectric ultrasonic scaling devices: an in vitro study

PURPOSE: The effects of magnetostrictive and piezoelectric devices on tooth surfaces seem to differ with regard to the root surface roughness they produce. This study aimed to compare the results of scaling using magnetostrictive and piezoelectric devices on extracted teeth. METHODS: Forty-four human extracted teeth were assigned to four study groups (n=11). In two groups (C100 and C200), the teeth were scaled using a magnetostrictive device and two different lateral forces: 100 g and 200 g, respectively. In the other two groups (P100 and P200), the teeth were scaled with a piezoelectric device with 100 g and 200 g of lateral force, respectively. he teeth were scaled and the data on the duration of scaling and the amount of surface were collected and analyzed using the t-test. RESULTS: The mean time needed for instrumentation for the piezoelectric and magnetostrictive devices was 50:54 and 41:10, respectively, but their difference was not statistically significant (P=0.171). For root surface roughness, we only found a statistically significantly poorer result for the C200 group in comparison to the P200 group (P=0.033). CONCLUSIONS: This study revealed that applying a piezoelectric scaler with 200 g of lateral force leaves smoother surfaces than a magnetostrictive device with the same lateral force.