The effect of ostrich acellular dermal matrix on keratinized gingival width.

Background: Xenogeneic grafts have gained attention due to advantages in compare of autografts. This study aimed to compare Xeno (ostrich) Acellular Dermal Matrix (XADM) with the free gingival graft (FGG) to increase the width of Keratinized gingiva (KGW) in dogs. Materials and Methods: This split mouth animal study was performed on 10 mixed breed dogs. The upper second premolar sites were randomly selected for grafting by XADM (test) or FGG (control). Measurements of KGW were recorded before surgery, 1, 3, and 6 months after surgery. Biopsies from grafted sites for histologic and histomorphometric evaluations were harvested 6 months after surgery. Data were analyzed by repeated measured, paired samples t-test, and Wilcoxon Signed rank test. P < 0.05 was considered statistically significant. Results: KGW increased in the two study groups after surgery with no significant statistical difference between them at any time intervals (P > 0.05). The graft shrinkage was 23% and 21% for the test and control groups, respectively, without statistically significant difference (P > 0.05). Histomorphometric evaluation showed no significant difference between the two study groups. Foreign body reaction was not seen in any of the study groups. Conclusion: Increased KWG was similar between the two study groups. With regard to FGG limitations, XADM may be assumed as a suitable alternative for FGG. It should be noted that this research was an animal study and clinical trials on human should be performed to approve the efficacy and safety of this material.

Long-term results of immediate implantation in mandibular posterior teeth with early loading: A retrospective case series.

When immediate molar implants first were proposed, submerged initial healing and delayed loading were the norm. It is now recognized that some early loading of a nonocclusal nature can stimulate faster osseointegration, although full occlusal loading is still delayed for 3 or more months. Here, we test the hypothesis that earlier occlusal loading of mandibular premolar and molar immediate implants may be possible. In this retrospective case series study, 18 mandibular molar and nine mandibular premolar teeth were atraumatically extracted and immediate implants placed 1-2 mm apical to buccal and lingual crestal bone. Periimplant gaps received particular allograft covered with acellular dermal matrix barrier. Healing abutments were placed through puncture points in the membranes to help in stabilizing the latter and to permit nonsubmerged site healing. At 6-8 weeks, each implant was evaluated for stability using the Periotest® device and restored if the Periotest® (PTV) value seen was negative. Data were analyzed by t test and MannWhitney U at a significance level of P < 0.05. Retrospective assessment of all 27 implants after 5 years' period of follow up showed all implants to have survived. Overall mean crestal bone loss was determined to be-0.25 ± 0.54 mm. Individual mean bone levels for mesial and distal surfaces were-0.24 ± 0.77 mm and-0.26 ± 0.72 mm, respectively (P = 0.78). A statistically significant difference in bone loss between genders was detected. Overall mean probing depth was 2.09 ± 0.57 mm. Based on the widely used Albrektsson criteria, the overall survival and success rate was 100%. Immediate implants placed into mandibular premolar and molar extraction sockets and allowed nonsubmerged healing may be ready for restoration at earlier times than previously thought possible.

Efficacy of antimicrobial photodynamic therapy for elimination of Aggregatibacter actinomycetemcomitans biofilm on Laser-Lok titanium discs.

BACKGROUND: Antimicrobial Photodynamic therapy (aPDT) is a novel modality suggested for treatment of peri-implantitis. This study aimed to assess the effect of aPDT with toluidine blue (TBO) and indocyanine green (ICG) and 635 nm and 808 nm diode laser on Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) biofilm formed on Laser-Lok titanium discs. MATERIALS AND METHODS: Eighty sterile Laser-Lok titanium discs were inoculated with A. actinomycetemcomitans to form biofilm and were randomly divided into 8 groups (n = 10) of control, chlorhexidine (CHX), TBO, ICG, 635 nm diode laser with 220 mW power, 808 nm diode laser with 250 mW power, 100 µg/mL TBO+635 nm diode laser and ICG+808 nm diode laser. Number of colony forming units (CFUs) on the surface of each disc was counted after the intervention. Data were analyzed using the Kruskal-Wallis test. RESULTS: Significant differences were noted in colony count among the eight groups after the intervention (P = 0.001). Pairwise comparisons with adjusted P value test showed that aPDT with TBO+635 nm laser and ICG+808 nm laser caused significant reduction of bacterial biofilm compared to the control group (P = 0.0001). TBO alone caused significant reduction of biofilm compared to the control group (P = 0.004). No other significant differences were noted (P > 0.05). CONCLUSION: Within the limitations of this study, the results showed that aPDT is a potential modality for decontamination of implant surface and reduction of A. actinomycetemcomitans biofilm in vitro. In this study, aPDT with TBO+635 nm diode laser and ICG+808 nm diode laser decreased the bacterial load on titanium discs.

Long-term results of immediate implantation in the maxillary molar area with simultaneous sinus floor elevation by the crestal approach and early loading protocol: A retrospective case series follow-up study.

Background: This study aimed to determine the long-term survival rate of implants placed in fresh sockets of extracted maxillary molars with simultaneous sinus floor elevation and early loading protocol. Methods: Nineteen maxillary molar teeth were extracted by tooth sectioning, and the sockets were debrided. Drilling for implant placement (Either Xive, Dentsply or Axiom, Antogyr) was terminated 1 mm short of the sinus floor with a pilot drill. Then, according to Summers' technique, elevation of the Schneiderian membrane and bone grafting were performed. The implants were placed according to non-submerged procedure after sinus grafting and preparation of the desired osteotomy site. Results: The implants had been in function up to 5 years and the mean time of loading was 33.12 months. Analysis of crestal bone loss records indicated a mean of -0.054±0.56 mm of bone resorption (with a range of -0.86 to +0.90 mm). The amount of crestal bone resorption on the mesial and distal surfaces of implants was -0.02±0.559 mm and -0.09±0.59 mm, respectively (P=0.232). Survival rates and success rates were 100% and 95.45%, respectively. Conclusion: Immediate implant placement in the posterior maxilla with simultaneous sinus floor augmentation and early loading was a reliable and predictable approach.

Association of Serum Triglyceride Level and Gemfibrozil Consumption With Periodontal Status.

BACKGROUND: Hyperlipidemia is a major risk factor for cardiovascular diseases. Considering the suggested association between periodontal and cardiovascular diseases, this study sought to assess the association, if any, between serum triglyceride (TG) levels and gemfibrozil consumption with periodontal parameters. METHODS: This cross-sectional study was conducted on 90 participants, including 30 individuals with a normal lipid profile (group H), 30 patients with hypertriglyceridemia and not on medication (group N), and 30 patients with hypertriglyceridemia and taking gemfibrozil over a 3-month period (group M). Periodontal parameters including probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index were measured at four sites of each tooth. Serum levels of total cholesterol (TC), TG, low-density lipoprotein, and high-density lipoprotein were measured. RESULTS: Mean values for PD and CAL in the two hypertriglyceridemic groups were significantly higher than those of the H group (P <0.001). After controlling for confounding variables, significant linear correlations were noted between PD and BOP, PD and TC, PD and TG, and CAL and TG in each group (P <0.01). CONCLUSIONS: Patients with hypertriglyceridemia had worse periodontal status than healthy controls. Patients with hypertriglyceridemia who were taking gemfibrozil did not show significant differences in CAL and PD compared with untreated patients with hypertriglyceridemia.

Do we need keratinized mucosa for a healthy peri-implant soft tissue?

The presence of keratinized mucosa plays a fundamental role in peri-implant soft tissue health. This study assessed the impact of the width of keratinized mucosa (WKM) on peri-implant soft tissue parameters. A cross-sectional study was conducted on 110 bone-level implants in 36 patients. A minimum of 6 months had passed since the loading of implants, and the patients had at least 1 implant in 1 quadrant at the molar or premolar site restored with a single crown or fixed partial denture. The health of peri-implant soft tissue was assessed with a modified bleeding index (MBI), modified plaque index (MPI), and modified gingival index (MGI). Probing depth (PD), gingival recession (GR), and WKM were also measured. History of smoking and oral hygiene methods were recorded. A significant inverse correlation existed between WKM and the parameters MBI, MPI, MGI, and GR (P < 0.05). Values of MBI, MPI, MGI, and GR were significantly lower in areas with WKM ≥ 2 mm and higher in areas with WKM < 2 mm (P < 0.05). The WKM was greatest in subjects using the vibratory toothbrushing technique and narrowest in those using the horizontal toothbrushing technique (P < 0.05). The mean WKM was significantly greater in smokers than in nonsmokers (P < 0.05). Results of this study indicate that an association exists between WKM and peri-implant soft tissue health. A minimum of 2 mm of keratinized mucosa around implants is recommended.

Relationship between obesity and periodontal status in a sample of young Iranian adults.

AIM: To examine the possible relationship between body weight and periodontal disease in a sample of the young Iranian population. DESIGN: An analytical (Case-Control) study. PARTICIPANTS: Eighty individuals aged 18 to 34 years (40 normal and 40 overweight and obese subjects) were evaluated in this study. METHODS: The periodontal examination consisted of: Plaque Index (PLI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL). Body Mass Index (BMI) and Waist circumference (WC) were used as measures of overall and abdominal fat content. Socio-demographic variables and periodontal disease risk factors (age, gender, education, time elapsed since last dental visit, smoking and diabetes) were evaluated as covariates. The statistical tests used were: Kolmogorov-Smirnov, Independent Samples T-test, ANOVA, Exact fisher, Chi-Square test and Spearman's rank correlation (Rsp). RESULTS: PPD and CAL were significantly higher in the case group compared to control (2.82 +/- 0.4 versus 2.56 +/- 0.36, P < 0.002 and 1.98 +/- 0.5 versus 1.63 +/- 0.335, P < 0.000 respectively). Subjects with a high waist circumference had significant differences of PPD and CAL when compared to normal waist circumference subjects (P < 0.000). There were also positive correlations between measures of overall fat content BMI and PPD (Rsp = 0.33), CAL (Rsp = 0.39) and age (Rsp = 0.42) on one side and the measure of WC and PPD (Rsp = 0.32), CAL (Rsp = 0.44), age (Rsp = 0.48) and PLI (Rsp = 0.3) on the other. CONCLUSION: The results indicate that overall and abdominal obesity were associated with the extent of periodontal disease in a sample of Iranian young individuals and therefore prevention and management of obesity may be an additional factor for improving periodontal health.

Effect of general health and sociocultural variables on periodontal status of pregnant women.

BACKGROUND: The influence of sociocultural variables, pre-existing conditions of general, oral and dental health and hormonal changes on periodontal status during pregnancy has been reported in some clinical studies and there has been speculation about the effects of these parameters on periodontal health during pregnancy. MATERIALS AND METHODS: This study evaluates the periodontal condition (plaque index, gingival index, probing pocket depth and clinical attachment level) of 140 pregnant women and its relationship to demographic (age, professional level and education) and clinical variables (previous pregnancy, gestation period, previous periodontal maintenance, previous live births and health status). All periodontal data were recorded by the same examiner. Statistical tests used were ANOVA, ANCOVA, Kolmogorov-Smirnov, Kruskal-Wallis and Spearman's rank correlation. The level of statistical significance was established at p< or =0.05. RESULTS: There were statistically significant differences between plaque index levels across educational level categories, the plaque index decreased as the level of education increased (p=0.0068). Clinical attachment loss was also significantly higher in patients not holding a salaried position (p=0.045). Plaque indexes were significantly higher in patients who did not have regular periodontal visits than in patients who did visit regularly (p=0.05). Differences between gingival index levels across different age categories were obvious, with gingival indexes increasing with age (p=0.014). There were strong positive correlations between gingival index and clinical attachment level (Rsp=0.76) and gingival index and probing pocket depth (Rsp=0.72). CONCLUSIONS: The results of the present study suggest that there is an inverse relationship between education level and plaque index. Gingivitis due to accumulation of plaque was related to previous periodontal maintenance, age and education level. So it might be suggested that special government-supported education and behavioral modification programs of periodontal disease prevention for pregnant women is useful.