Marginal Accuracy of CAD/CAM Frameworks Fabricated by Presintered Cobalt-Chromium Alloy: A Systematic Review and Meta-analysis.

Purpose: To evaluate the marginal accuracy of soft-milled cobalt-chromium (Co-Cr) compared to other construction methods/restorative materials in tooth/implant-supported restorations. Materials and Methods: PICO questions were defined, and a systematic search was conducted in six electronic databases. Titles and abstracts were collected and screened by two independent reviewers. After removing duplicate articles, the full texts of relevant articles were gathered, and the required information and data were extracted. Risk of bias was assessed and meta-analyses of the collected data were conducted using STATA software version 16. Results: A total of 1,914 experimental and clinical articles were reviewed, and 18 studies were selected for qualitative analysis. The 16 studies that were included in the meta-analysis showed no significant marginal gap differences between soft-milled Co-Cr and the following methods/materials: hard-milled Co-Cr (I2 = 92.9%, P = .86), casting wax (I2 = 90.9%, P = .42), laser-sintered Co-Cr (I2 = 93.3%, P = .46), and zirconia (I2 = 0.00%, P = .47). However, a significantly higher marginal accuracy of soft-milled Co-Cr was observed when compared to milled-wax casting (I2 = 93.1%, P < .001). Conclusion: The marginal gap of soft-milled Co-Cr restorations is within the acceptable clinical range and provides an accuracy similar to other available methods/materials for both the prepared implant abutment and tooth.

Relation of CAD/CAM zirconia dental implant abutments with periodontal health and final aesthetic aspects; A systematic review.

Background: Using dental implants to replacing missing teeth and satisfy both functional and aesthetic needs is one of the mainstream dental treatments. New approaches including computer-aided design and computer-assisted manufacture (CAD/CAM) have been introduced to improve these elements. This systematic review aimed to compare CAD/CAM zirconia (Zr) implant abutments with other available abutments in terms of peri-implant health and aesthetics. Material and Methods: Five electronic databases (PubMed, Web of Science, Scopus, ProQuest, and Embase) were scoured for clinical studies evaluating Zr abutments reporting on the outcomes of interest including interproximal papilla stability (PS), papilla recession (REC), pink and white esthetic score (PES, WES), marginal bone level (MBL), color, and soft tissue contour. A hand searches in English language journals until September 2020 complemented the search. Two tools of Joanna Briggs Institute and Jaded Score calculation were used for the risk of bias assessment. No quantitative synthesis of the data was done due to high heterogeneity. Results: A total of six studies from the 412 ones obtained from the search were included. The study designs were either prospective cohort (n=3) or randomized clinical trial (n=3). Papilla fill, WES, PES, and the distance from the bone crest of adjacent teeth to the contact point (CPB) and inter-tooth-implant distance (ITD) was not significantly different between Zr CAD/CAM and Zr stock abutments. However, soft tissue stability and REC index were better in Zr CAD/CAM abutments. Conclusions: Higher soft tissue stability can be achieved for Zr compared to titanium abutments with either stock or CAD/CAM abutments. Key words:Dental implants, Dental abutment, Computer-Assisted Design, Computer-Aided Manufacturing, Zirconia abutment, Soft tissue stability.

Stability of implant-abutment connection in three different systems after fatigue test.

Aim: Abutment screw loosening of implant-supported prosthesis causes a mismatch between the abutment and the implant. This screw loosening is influenced by the implant-abutment connection type, however, with contradictory results reported in different studies. The present study evaluates the stability of abutment-implant connections in three different systems before and after the fatigue test. Settings and Design: Thirty implants (4.3 mm in diameter and 12 mm in length) were divided into three groups of 10: Implantium, Zimmer, and straight internal hexagonal connection (SIC) implants. Materials and Methods: Two torques of 35 Ncm with an interval of 10 min were applied, followed by measuring removal torque value (RTV). The samples were re-torqued and then underwent a simulation of 1-year chewing clinical performance of dental implant under axial force of 400 N, with a frequency of 8 Hz (one million cycles). After fatigue test, the RTV was calculated and recorded. Statistical Analysis: The mean RTVs obtained before and after cyclic load were analyzed by SPSS version 22 software using multivariate analysis. Results: Significant differences in RTV and role of cyclic loading were found between SIC and Implantium groups (P = 0.006 and 0.021, respectively), as well as between Zimmer and SIC groups (P = 0.032 and 0.006, respectively), but not between Zimmer and Implantium groups (P = 0.771 and 0.248, respectively). Conclusion: The type of connection could affect the screw loosening, the preload loss, and the implant component stability. SIC group revealed the highest RTVs before and after cyclic loading.

Internal and Marginal Fit Accuracy of Pre-sintered CAD/CAM Implant-Supported Frameworks Before and After Porcelain Layering.

PURPOSE: Internal and marginal fit accuracy of an implant-supported fixed partial denture (I-FPD) along with passive fit are required for long-term clinical success. This study compared the fit accuracy of three-unit CAD/CAM-fabricated cementretained I-FPDs milled from pre-sintered cobalt-chromium (Co-Cr) and zirconia (Zr) and evaluated the effect of applying porcelain. MATERIALS AND METHODS: Two implant analogs were positioned parallel at first premolar and first molar sites in an acrylic model. Their corresponding abutments were tightened with 25-Ncm torque force. Four groups were designed: two groups of I-FPD frameworks with pre-sintered Zr (ZrF) and soft millable Co-Cr alloy (SF) blocks, and two groups by applying porcelain to the Co-Cr (SP) and Zr (ZrP) frameworks (n = 4 in each group). Absolute marginal gap (AMG), marginal gap (MG), and internal discrepancies were measured. Kolmogorov-Smirnov, Levene, one-way analysis of variance (ANOVA), and Scheffe tests were used for statistical analysis using SPSS software version 22 at a significance level of .05. RESULTS: All measured criteria were significantly different from each other (all P values < .001). The rankings from the lowest gap to the highest gap for the main criteria were as follows: MG: SF < SP < ZrF < ZrP; AMG and internal discrepancies: SF < SP < ZrP < ZrF. Comparing molars and premolars, molars had smaller MGs, larger internal discrepancies, and smaller AMG in ZrP but larger AMG in SP. CONCLUSION: All three-unit CAD/CAM-fabricated cement-retained I-FPDs were in the clinically acceptable range of fit accuracy. The lowest and highest misfit values were observed in the SF and ZrF groups, respectively.

The effect of different cleansing methods for removing temporary cement on the tensile bond force of permanently cemented implant-supported metal copings: An in vitro study.

OBJECTIVES: Complete cleaning of temporary cement before permanent cementation of cement-retained implant-supported prosthesis (CISP) when recementing the crown is critical. This study evaluated the effect of different cleaning methods for removing traces of temporary cement on the final tensile bond force (TBF) of CISP recemented with resin cement. MATERIALS AND METHODS: Seventy computer-aided design/computer-aided manufacturing metal implant-supported copings were prepared and distributed into seven groups (N = 10). Copings of six groups (60 samples) were cemented with temporary cement with eugenol and subjected to 5000 thermocycling. After debonding by a universal testing machine, the internal surfaces of the copings were cleaned using one of the six following methods: 1-an ultrasonic water bath (UW), 2-sandblasting, then washing with water (SW), 3-sandblasting and an ultrasonic water bath (SUW), 4-an ultrasonic isopropyl alcohol bath (UA), 5-sandblasting, then washing with isopropyl alcohol (SA) or 6-sandblasting and an ultrasonic isopropyl alcohol bath (SUA). Then the subjects were subsequently cemented by dual-cure self-adhesive resin cement. In the seventh group (control, N = 10), the copings were cemented by dual-cure self-adhesive resin cement without the temporization phase. The TBF was tested using a universal testing machine with a cross-head speed of 1 mm/min. Two-way analysis of variance (ANOVA) and post-hoc Tamhane tests were used for statistical analysis at a significance level of α = .05. RESULTS: The maximum mean of TBF value was observed in SUA group (845 ± 203 N), and the minimum was observed in the temporary cement group (49 ± 20 N). All groups which were cleaned with isopropyl alcohol showed significantly higher TBF values compared with those cleaned with water. CONCLUSIONS: Cleaning of the inner surface of metal copings after debonding with sandblasting and isopropyl alcohol results in the highest value of TBF by eliminating the effect of remaining eugenol and removing traces of temporary cements.

Marginal Accuracy of Lithium Disilicate Full-Coverage Single Crowns Made by Direct and Indirect Digital or Conventional Workflows: A Systematic Review and Meta-Analysis.

PURPOSE: Several studies have compared digital intraoral scanners and conventional impressions. The accuracy of these two methods in terms of marginal accuracy of lithium disilicate crowns is not well-established, yet. The purpose of this study was to systematically review available publications on marginal fit of single-unit, full-coverage, tooth-supported lithium disilicate restorations. METHODS: Pubmed, Web of Science, Cochrane, EMBASE, and Scopus were electronically searched along with a manual search. After critical appraisal, data from selected studies were extracted and mean marginal difference with a 95% confidence interval was calculated. Meta-analysis of the collected data was conducted using STATA software. RESULTS: The meta-analysis revealed similar marginal gap values in intraoral scanners with conventional groups (p>0.05) and in intraoral scanners with extraoral canners (p>0.05). CONCLUSION: No significant difference was seen between digital and conventional impressions or intra- and extraoral scanners for marginal accuracy of lithium disilicate crowns.

Effect of different bleaching treatment protocols on shear bond strength of bonded orthodontic brackets with no-primer adhesive resin.

BACKGROUNDS: Bleaching procedure can be companied before, during, or after orthodontic treatments. However, the risk of compromised bond strength of brackets to bleached enamels is in debate. This study tried to evaluate the shear bond strength (SBS) of bonded metal brackets to the previously bleached enamels. MATERIALS AND METHODS: In this in vitro study, 60 extracted, sound, human premolars were mounted vertically in cylindrical molds. The samples were randomly divided into four groups (n = 15): Control (C); at-home bleached by 20% carbamide peroxide (HB); in-office bleached by 45% carbamide peroxide (OB); and in-office bleached by 40% hydrogen peroxide activated with diode laser (L-OB). Sixty stainless steel brackets were bonded by no-primer adhesive resin (OrthoCem). Then SBS of bonded brackets was measured after 5000 thermal cycles at 5°C and 55°C. Finally, the collected data were analyzed by one-way ANOVA, and Tukey HSD tests by using SPPS software at a significant level of 0.05 (α = 0.05). RESULTS: Group C showed significantly higher SBS values (all P < 0.001); however, there were no significant differences in SBS compared to other tests' groups with each other (all P > 0.05). CONCLUSION: The SBS of bonded orthodontic brackets were compromised after bleaching with 20% and 40% of carbamide peroxide. Diode laser activation may not eliminate the negative effect of bleaching agents on SBS of bonded orthodontic brackets, neither.

The additive effect of clonidine to lidocaine on postoperative pain management after root canal treatment on mandibular molars with symptomatic irreversible pulpitis: A prospective randomised double-blind clinical trial.

CONTEXT: Postoperative pain control has been a common challenge to clinicians in endodontics. AIMS: This double-blind randomized clinical trial assessed the efficacy of clonidine added to lidocaine for postoperative pain following endodontic treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). METHODS: One hundred participants with lower molars experiencing SIP were recruited and randomly assigned to two groups. 1.8 mL of 2% lidocaine with either epinephrine (1:80,000) or clonidine (15 µg/mL) was administered to each group via an inferior alveolar nerve block. A Heft-Parker Visual Analog Scale was used to rate preoperative pain and at 6, 12, 24, 36, 48, and 72 h following endodontic treatment. Their postoperative analgesic consumption was recorded. STATISTICAL ANALYSIS USED: The analgesic efficacy was analyzed by Chi-square test, paired t-test, and repeated measures ANOVA (P < 0.05). RESULTS: Early postoperative pain was significantly lower in the lidocaine/clonidine group than the lidocaine/epinephrine group (6 h: P = 0.038; 12 h: P = 0.031). The lidocaine/clonidine group consumed a significantly lower amount of analgesics (P = 0.048). CONCLUSIONS: The administration of clonidine added to lidocaine may reduce early postoperative pain and consumption of analgesics following endodontic treatment in lower molars with SIP.

Marginal adaptation of zirconia complete-coverage fixed dental restorations made from digital scans or conventional impressions: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Intraoral scanners have been increasingly used in recent years. However, the accuracy of digital scans as it affects marginal adaptation is unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to compare the marginal adaptation of single-unit zirconia crowns fabricated with digital scans or with conventional impressions. MATERIAL AND METHODS: The electronic databases PubMed (MEDLINE), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (ISI), Scopus, and EMBASE were searched and complemented by a manual search. Risks of bias were assessed by using a modified methodological index for nonrandomized studies (MINORS). Mean ±standard deviation (SD) values of marginal accuracy of studies were extracted for both methods. Mean marginal difference and 95% confidence interval (CI) were calculated to evaluate the marginal accuracy of each method. Pooled data were statistically analyzed by using a random-effect model. RESULTS: Seventeen studies were used to perform the meta-analysis. Subgroup analysis was performed based on intraoral scanners. Standardized mean marginal difference and 95% CI of each subgroup were as follows: Lava: -0.85 µm (95% CI: -1.67, -0.03) (P=.043); CEREC: -1.32 µm (95% CI: -2.06, -0.59) (P<.001); iTero: -0.44 µm (95% CI: -1.35, 0.47) (P=.338); TRIOS: -1.26 µm (95% CI: -2.02, -0.51) (P=.001); unknown scanner: -0.21 µm (95% CI: -1.14, 0.72); all studies: -0.89 µm (95% CI: -1.24, -0.54) (P<.001). CONCLUSIONS: Digital scanning of prepared teeth for single-unit zirconia restorations resulted in better marginal accuracy than conventional techniques using elastomeric impression materials.

Laser Treatment of Fiber Post and Final Push-Out Bond Strength: A Systematic Review and Meta-Analysis.

Purpose: This review article tries to answer this question: "What are the effects of laser surface treatment of fiber posts (FPs), compared with other surface roughening methods, on bond strength of cemented FPs?" Methods: Search was carried out in six electronic databases by focusing on defined key words. Related titles and abstracts, up to March 2019, were collected, read, and selected for quality assessments. A total of 2408 articles were included in the study at the initial stage of the searching phase. Results: Finally, seven studies were recognized to be reliable to be reviewed and meta data analysis in the study. All the studies were in vitro with a total of 340 samples. None of the Er:YAG (-0.27, 95% CI: -2.29 to 1.76; p = 0.79) and Er,Cr:YSGG (-0.04, 95% CI: -1.43 to 1.35; p = 0.95) treated samples showed any significant overall mean differences in final push-out bond strength (PBS) compared with the control groups. Conclusions: Laser pretreatment of FP surfaces might not be effective in providing high PBS. FP surface are susceptible to damage of high-level laser irradiation and might show decreased bond strength.

Effect of Resin Infiltration Technique on Improving Surface Hardness of Enamel Lesions: A Systematic Review and Meta-analysis.

OBJECTIVE: White spot lesion (WSL) is recognized as the first clinical sign of enamel caries; it is a very critical phase because it can be prevented from progression to frank caries by changing the surrounding destructive environment. The present study was undertaken to systematically review the effect of resin infiltration (RI) technique on surface hardness (SH) of WSL. METHODS: Five electronic databases were searched with proper key words. Related titles and abstracts, up to October 2018, were screened, selected, and subjected to quality assessments. After collecting data, meta-analyses were carried out to compare the effect of RI with untreated WSL and sound enamel by using the STATA software. RESULTS: A total of 4567 articles were included in the study after initial search. Finally, 10 studies were reliable enough in methodology to be included in the study. Metadata analyses, carried out on 7 studies that compared SH of RI group with untreated samples, showed a significant increase in SH with 3.66 mean difference (95% confidence interval = 2.56‒4.77, Q value = 36.07, I2 = 83.4%). However, meta-analysis on 4 studies that compared SH of RI with sound enamel showed a significant decrease in SH with -2.35 overall mean difference (95% confidence interval = -3.91-0.98, P = .00, Q value = 31.75, I2 = 90.6%). CONCLUSION: The RI technique can enhance SH of WSL; however, regaining the SH of RI-treated WSLs similar to sound enamel is doubtful. Application of RI is more effective than other methods, including application of fluoride, enamel pro-varnish, adhesive, and colloidal silica infiltration for enhancing SH of WSLs.

Effect of laser irradiation on push-out bond strength of dental fiber posts to composite resin core buildups: A systematic review and meta-analysis.

BACKGROUND: The bonding of fiber posts (FPs) to composite resin core buildups is a challenge due to limited penetration of resin to the polymeric matrix of FPs. This review article tries to answer this question: "What are the effects of laser surface treatment of FPs, compared to other surface roughening methods, on push-out bond strength (PBS) of FPs bonded to composite resin core buildups?" METHODS: Searches were run in seven electronic databases with a focus on proper key words. Related titles and abstracts, up to February 2019, were screened, selected, read and subjected to quality assessments. RESULTS: After the initial search, a total of 2635 articles were included in the study. Finally, 6 studies were reliable enough in methodology to be included. All the studies were in vitro with a total of 359 samples. Er:YAG (-0.05, 95% CI: -2.96 to 2.86; P = 0.97) and Er,Cr:YSGG (0.84, 95% CI: -0.12 to 1.81; P = 0.08) treated samples showed no significant overall mean differences in final PBS compared to the control groups. Moreover, pretreatment with Er,Cr:YSGG laser and sandblasting with 50 µm alumina showed an overall mean difference of -0.42 for PBS (95% CI: -1.23 to 0.39) with no significant differences. CONCLUSIONS: Laser irradiation of FPs seems to provide no significant increase in PBS values of FPs bonded to composite resin core buildups. Effects of surface treatment of FPs with laser irradiation and sandblasting with 50 µm alumina might be similar in increasing the final PBS, either.

Effects of modifying implant screw access channels on the amount of extruded excess cement and retention of cement-retained implant-supported dental prostheses: A systematic review.

STATEMENT OF PROBLEM: Cement-retained implant-supported prostheses eliminate screw loosening and enhance esthetics. However, retrievability and the possibility of removing extruded excess cement (EEC) have been problematic. PURPOSE: The purpose of this systematic review was to analyze the effects of modifying the screw access channel (SAC) on the amount of EEC and the retention of cement-retained implant-supported prostheses. MATERIAL AND METHODS: PubMed, Web of Science, Scopus, and Google Scholar databases were searched with appropriate key words. Related titles and abstracts published up to June 2017 were screened and selected on the basis of defined inclusion criteria. Full texts of all studies were read and subjected to quality assessments. After the initial search, 1521 articles were included in the study. Of these, 11 studies were subjected to critical appraisal, and 10 of them were reliable enough in methodology to be systemically reviewed. RESULTS: All the studies were in vitro and described a total of 260 specimens. According to the interpreted results, closed SACs caused lower retention with a higher amount of EEC, whereas open SACs caused the reverse. Also, as the abutment height decreased, retention decreased. CONCLUSIONS: Extending the crown's margin into the SAC, leaving the SAC open, and using internal vents in the SAC space are possible methods of modifying the SAC to gain higher retentive values. Also, the use of internal vents in the SAC system and open or partially filled SAC space reduce the amount of EEC.

Effect of Phentolamine as Reversal of Soft-Tissue Anesthesia on Post-Endodontic Pain in Patients with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial.

Introduction: Phentolamine mesylate (OraVerse) is mostly used to reverse soft tissue anesthesia after dental procedures. The aim of the present study was to evaluate the effect of the injection of OraVerse on postoperative pain after root canal treatment in patients with symptomatic irreversible pulpitis. Methods and Materials: In this randomized single-blind clinical trial study, 100 patients (50 per group) with symptomatic irreversible pulpitis in the first or second mandibular molars, randomly received either OraVerse or sham treatment after a single-visit root canal therapy. Each patient recorded their pain score, using a Heft Parker visual analogue scale, before and after 6, 12, 24, 36, 48, and 72 h of the treatment. They also monitored their soft-tissue anesthesia every 15 min for 5 h. Data were analyzed by t-test and repeated measured ANOVA statistical tests. The level of significance was set at 0.05. Results: Patients who received phentolamine had significantly higher pain scores at 6- and 12-h postoperative intervals compared with those receiving sham treatment (P=0.01 and P=0.00 respectively). Consumption of analgesics in OraVerse group was significantly higher than that of the sham group (P=0.48). Conclusion: Although phentolamine accelerated the reversal of normal soft tissue sensation after the dental visit, it increased postoperative pain in patients suffering from symptomatic irreversible pulpitis, which may limit phentolamine administration in this group.

Evaluation of Antimicrobial Effcacy of Calcium Hypochlorite as an Endodontic Irrigant on a Mixed-Culture Biofilm: An Ex vivo Study.

Introduction: Calcium hypochlorite (CH) has been recently suggested as an endodontic irrigant. The aim of this investigation was to evaluate the antimicrobial efficacy of CH compared to sodium hypochlorite (NaOCl) and chlorhexidine (CHX) against multispecies biofilm in surface and deep dentinal tubules. Methods and Materials: Minimal inhibitory concentration (MIC) of irrigant agents was assessed using a microdilution method. One hundred and twenty of human maxillary incisor teeth were prepared and infected with suspension of Entrococcus faecalis, Fusobacterium nucleatum and Prevotella intermedia in an anaerobic jar for 7 days. Depending on irrigation solutions, specimens were divided into 4 groups (n=30); group 1: 2% CHX, group 2: 5.25% sodium hypochlorite, group 3: 5% calcium hypochlorite, group 4: positive control (normal saline (NS)). Fifteen remained specimens were used as negative control. Surviving bacteria were sampled before (S1) and after irrigation from surface (S2) and deep (S3) dentin. The medium turbidity was visualized with spectrophotometry. Data were analyzed using analysis of variance followed by Tukey post hoc test (α=0.05). Results: The MIC of CH against E. faecalis, F. nucleatum and P. intermedia was 25, 8 and 7.5 µg/mL respectively. There were no significant differences in S1 among the test groups. Moreover, 2% CHX and 5% CH had significantly lower medium turbidity at both S2 and S3, in comparison with 5.25% NaOCl (P=0.018 and 0.031, respectively). But there were no significant differences between 2% CHX and 5% CH at both S2 and S3 (P=0.862 and 0.978, respectively). Conclusion: Under the conditions of this ex vivo study, 5% CH and 2% CHX are more effective than 5.25% NaOCl in the reduction of mixed-culture biofilm.

Effects of laser therapy on patients who underwent rapid maxillary expansion; a systematic review.

Rapid maxillary expansion (RME) is one of the common treatments of transverse maxillary deficiency, and low-level laser therapy (LLLT) is one of the recommended solutions to enhance biological wound or bone healing. This review article aims to answer the following question: "What are the effects of LLLT, on patients who underwent surgical or non-surgical RME, in improving clinical success, wound healing, and bone regeneration?" A search in PubMed, Scopus, Web of Science, and ProQuest databases was performed, with a focus on the appropriate key words. Related articles, up to May 2017, were screened, and the full text of the randomized controlled trials (RCT) were comprehensively read and subjected to quality assessments. A total of 1804 articles were included after the initial search. Four RCTs were eligible in randomization and methodology. The applied wavelength varied from 660 to 830 nm with an output range of 40-100 mW. Also, the highest exposed energy was 420 J/cm2 and the lowest was 100 J/cm2. The exposure time differed from 20 to 84 s in each defined point in the palate. Based on the RCTs available, LLLT is better to be used at initial phase of RME, because it has some benefits in increasing the rate of bone remodeling.

Role of laser or photodynamic therapy in treatment of denture stomatitis: A systematic review.

STATEMENT OF PROBLEM: Denture stomatitis (DS) is an inflammatory oral lesion that occurs mostly in elderly denture wearers and that can negatively affect their quality of life. The conventional treatment plan for DS is topical or systemic fungicidal drug therapy, which are not without side effects. PURPOSE: The purpose of this systematic review was to evaluate the clinical outcomes of using low-level laser therapy (LLLT) or photodynamic therapy (PDT) in the treatment of DS by reviewing high-quality published articles. MATERIAL AND METHODS: The Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, Scopus, Embase, and Ovid databases were searched using appropriate key words. Related titles and abstracts published up to May 2017 were screened and selected based on defined inclusion criteria. The full texts of all selected articles were read, and citation lists were checked for missing references. All randomized controlled trials (RCT) were subjected to quality assessments. RESULTS: A total of 760 articles were included in the study after the initial search. Six studies were selected for assessment of eligibility, and 4 of them were sufficiently reliable in methodology and randomization to be included in the study. The applied wavelength varied from 455 nm to 830 nm. Also, the highest energy patients were exposed to was 122 J/cm2, and the lowest was 1 J/cm2. Exposure times ranged from 10 seconds to 26 minutes in the reviewed studies. CONCLUSIONS: Based on the available RCTs, LLLT has a significant role in the clinical treatment of DS. However, the results of PDT were similar to those of conventional antifungal therapies.

Is arthrocentesis of temporomandibular joint with corticosteroids beneficial? A systematic review

BACKGROUND: Temporomandibular disorders (TMDs) are musculoskeletal conditions that can inhibit the normal function of temporomandibular joints (TMJs) and affect the patient's quality of life, negatively. Arthrocentesis (AC) is a minimally invasive surgical procedure used for treating TMDs. The aim of present paper is to evaluate the advantages of administrating corticosteroid (CS) during AC by reviewing high quality released articles. MATERIAL AND METHODS: Searching on Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, and Scopus databases were performed with focusing on proper key words. Related titles and abstracts, up to December 2017, were screened and selected based on inclusion criteria. The full text of all randomized controlled trials (RCTs) was extensively read and subjected to quality assessments. RESULTS: After initial search, a total of 2067 articles were included into the study. Finally, 7 studies were reliable enough in methodology and randomization to be included into the study. All of the observed studies showed improvements in jaw functions and pain relief with no statistical differences in both AC and control groups. One study reported painless maximum incisal opening in CS group than the control group. CONCLUSIONS: Based on available RCTs, the AC of TMJ with CS seems to result in similar findings to other therapeutic drugs, with no significant differences

Effect of conventional and contemporary disinfectant techniques on three peri-implantitis associated microbiotas.

PURPOSE: To evaluate the antiseptic properties of five different disinfectant techniques on three different peri-implantitis (PI) associated biofilms. METHODS: 90 implant titanium disks, with the same thickness and diameter, were prepared and randomly divided into 18 groups (n = 5) based on the microbiota strains (S. aureus, S. epidermidis and C. albicans) and using the following disinfectant techniques:soft laser therapy, photodynamic therapy (PDT), 0.12% NaOCl, 0.2% chlorhexidine, 3% H2O2, and control groups. After forming a protein layer on disk surfaces, the specimens were exposed to the microbial suspensions. After decontamination according to designated techniques, 2% Trypsin protease was administered to isolate the surviving microorganisms. Muller Hinton agar culture was used for microbiota growth. After 48-hour incubation, the standard colony forming unit (CFU) was assayed and the collected data were analyzed by Kruskal-Wallis and Mann-Whitney tests at a significance level of 0.05. RESULTS: The highest amount of CFU/ml values was shown by C. albicans, which was subjected to PDT (25.12 ± 30.23). The least disinfecting efficacy on S. epidermidis was demonstrated by the laser group (all P-values ≤ 0.01). Nevertheless, all of the groups exhibited significant differences with the control groups (all P-values < 0.01). CLINICAL SIGNIFICANCE: None of the studied disinfectant techniques had the highest lethal effects on all of the tested microbiotas. Therefore, a combination of these disinfectant techniques, for instance PDT ⁺ 3% H2O2 or 0.2% chlorhexidine, is recommended.

Application of Orthodontic Immediate Force on Dental Implants: Histomorphologic and Histomorphometric Assessment.

AIMS: Application of force to implants is helpful, especially in orthodontic-implant therapies. The aim of this study was a histomorphologic and histomorphometric evaluation of peri-implant bone after immediate orthodontic and orthopedic forces comparing them with a control group. MATERIALS AND METHODS: Eighteen dental titanium implants were inserted in the premolar region of three dogs. Implants were divided into three groups: (1) group with immediate orthodontic force of 300 NC, (2) group with immediate orthopedic force of 600 NC, and (3) control group. Implants were explanted with adequate amount of surrounding bone after 3 months and bone-implant contact (BIC), amount of lamellar bone (LB), amount of woven bone (WB), amount of inflammatory connective tissue, and the rate of the movement were investigated. ANOVA, t-test, paired t-test, and Pearson's test were used to analyze the data using SPSS software version 16 at a significant level of 0.05. RESULTS: Based on BIC, amount of lamellar and WB and the amount of inflammatory connective tissue, there was no significant difference between the three groups (300 centinewton (CN), 600-CN, and control group) (P > 0.05). In the 300-CN and 600-CN groups, the rate of movement was reported 0.41 and 0.94 with no significant differences (P = 0.38). CONCLUSION: 300-CN and 600-CN immediate static loads do not interfere with osseointegration phenomenon and it does not decrease the amount of BIC and LB. Implants can be moved by preserving osseointegration, and this movement is in direct relation with the amount of applied force.