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1.
Clin Oral Investig ; 28(5): 288, 2024 May 09.
Article in English | MEDLINE | ID: mdl-38722451

ABSTRACT

OBJECTIVES: Total tooth loss is common in the aging population resulting in insufficient chewing function with subsequent weakening of the masticatory muscles. The study aims to evaluate the changes in thicknesses of the masseter and anterior temporal muscle in edentulous patients following the reconstruction of implant-supported fixed prostheses and compare them with the dentate individuals. MATERIALS AND METHODS: The study was designed as a prospective, single-center, controlled clinical trial. A total of 60 participants were included in the present study. The patients were divided into two groups; Group I (Test Group): 30 edentulous patients who received implant-supported fixed prostheses, Group II (Control Group): 30 dentate individuals of an age and sex-matched group. Ultrasonography was used to measure the cross-sectional thickness of the left and right musculus masseter and anterior temporalis immediately after the cementation of the prosthetic rehabilitation (T1), on the 1st (T2) and 6th (T3) months after rehabilitation and at a single time point in the control group. RESULTS: The results showed that there were significant comparison differences in muscle thickness at the baseline measurements between groups while at the end of the 6th month, these differences were not significant. The muscle thicknesses of both the masseter and anterior temporalis muscles increased significantly at T2 and T3 compared to T1 in the test group. The asymmetry index between the left and right muscles in the test group and the asymmetry differences between groups also decreased significantly at the end of the 6th month. CONCLUSION: The implant-supported fixed prostheses significantly increase the thicknesses of the masseter and anterior temporal muscle together with a decrease in the asymmetry between the left and right muscles. At six months, implant-treated patients showed similar muscle thicknesses compared to dentate individuals. CLINICAL RELEVANCE: The findings suggest that implant-supported fixed prostheses can improve the masticatory function and facial symmetry of edentulous patients.


Subject(s)
Dental Prosthesis, Implant-Supported , Masseter Muscle , Mouth, Edentulous , Temporal Muscle , Ultrasonography , Humans , Male , Female , Prospective Studies , Masseter Muscle/diagnostic imaging , Temporal Muscle/diagnostic imaging , Middle Aged , Mouth, Edentulous/rehabilitation , Mouth, Edentulous/diagnostic imaging , Aged , Treatment Outcome
2.
Clin Oral Investig ; 28(1): 61, 2023 Dec 29.
Article in English | MEDLINE | ID: mdl-38157066

ABSTRACT

OBJECTIVE: This study evaluates the impact of local and systemic administration of penicillin on the antimicrobial properties and growth factors of platelet-rich fibrin (PRF) under in vitro conditions. MATERIALS AND METHODS: The study involved 12 volunteers. Four tubes of venous blood were collected before systemic antibiotic administration. Two tubes were centrifuged at 2700 RPM for 12 min to obtain PRF, while 0.2 ml of penicillin was locally added into other two tubes. After systemic administration, blood samples were again collected and subjected to centrifugation. The release of growth factors (IGF-1, PDGF, FGF-2, and TGFß-1) was determined using the Enzyme-Linked Immunosorbent Assay (ELISA), and an antibiotic sensitivity test was performed for S. aureus and E. coli bacteria. RESULTS: Results showed that local antibiotic addition before PRF centrifugation had a significant antimicrobial effect without affecting growth factor releases. There was no statistically significant difference in antimicrobial properties between PRF prepared with systemic antibiotic administration and PRF prepared without antibiotics. MATERIALS AND METHODS: The study suggests that incorporating localized antibiotics into PRF results in strong antimicrobial effects without compromise of growth factor release. However, the combination of PRF with systemic antibiotics did not significantly enhance its antimicrobial properties compared to PRF prepared without antibiotics. CLINICAL RELEVANCE: Local addition of penicillin into PRF provides strong antimicrobial properties which may help reduce dependence on systemic antibiotic regimens, mitigating antibiotic resistance and minimizing associated side effects.


Subject(s)
Platelet-Rich Fibrin , Humans , Penicillins/metabolism , Staphylococcus aureus , Escherichia coli , Intercellular Signaling Peptides and Proteins/metabolism , Blood Platelets , Anti-Bacterial Agents/pharmacology
3.
Int J Periodontics Restorative Dent ; (7): s227-s234, 2023 Oct 24.
Article in English | MEDLINE | ID: mdl-37879060

ABSTRACT

PURPOSE: To investigate the effects of experience level on the clinical and esthetic results of coronally advanced flap (CAF) surgery. MATERIAL AND METHODS: A postgraduate student's first 40 CAF operations in the periodontology residency program were followed. The Miller Class I gingival recessions were divided into four chronologic groups (n: 10 in each). Clinical and esthetic evaluations were performed at baseline and after 6 months. The results of chronologic intervals were statistically compared. RESULTS: While the overall mean root coverage (RC) percentage was 73.6% and the complete RC was 60%, the mean RC percentages of the groups, respectively, were 45%, 55%, 86%, and 95%, showing that the mean and complete RC percentage increased as the experience level increased (P < .05). Similarly, as the experience level increased, closure of the gingival recession depth and width and esthetic scores increased, while the surgical time decreased significantly (P < .05). Complications were observed in three patients during the first interval and in two patients during the second interval, while no complications were observed in the other groups. CONCLUSIONS: This study showed that experience level can significantly affect the clinical and esthetic outcomes, operative time, and complication rates of CAF surgery. All education programs should determine how many of each surgical procedure residents must perform before they are considered experienced or expert surgeons who can work independently and predictably achieve safe, acceptable outcomes.


Subject(s)
Gingiva , Gingival Recession , Humans , Gingiva/surgery , Treatment Outcome , Gingival Recession/surgery , Surgical Flaps/surgery , Periodontics , Tooth Root/surgery , Connective Tissue
4.
Clin Oral Investig ; 27(9): 5519-5527, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37468598

ABSTRACT

OBJECTIVE: To compare a pre-operatively, chair-side made, zinc-containing surgical stent (ZN) and suturing of a gelatin-based hemostatic agent (HA) on palatal wound healing and patient morbidity after free gingival graft surgery (FGG). MATERIALS AND METHODS: Sixty patients requiring FGG were randomly divided into two groups to receive either a ZN or a sterile HA sutured on the surgical area. Patients were evaluated at 1st, 3rd, 7th, 14th, 28th, and 56th days following surgery. Overall surgical time, donor site surgical time, postoperative pain (PP), delayed bleeding (DB), changes in dietary habits (DH), burning sensation (BS), completion of re-epithelialization (CE), and patients' discomfort (PD) were evaluated. RESULTS: Donor site surgical time, PP, DB, DH, BS were statistically significantly lower in the ZN group together with faster completion of re-epithelialization compared to the HA group. CONCLUSION: Pre-operatively, chair-side made, zinc-containing surgical stents provided significant benefits for wound healing parameters and patients' postoperative morbidity after FGG harvesting. CLINICAL RELEVANCE: The results show that using Zn-containing palatal stent after free gingival graft surgery significantly reduces pain and patient morbidity during the postoperative period.


Subject(s)
Gingiva , Oral Surgical Procedures , Humans , Gingiva/transplantation , Wound Healing , Pain, Postoperative , Palate/surgery
5.
J Oral Implantol ; 48(1): 3-8, 2022 Feb 01.
Article in English | MEDLINE | ID: mdl-33270867

ABSTRACT

The aim of this study was to measure the effect of drilling speed on heat generation in the cortical bone, on primary and secondary implant stability of implants and on early and late bone healing with micro-computerized tomography (micro-CT). Sixty implants were placed in the iliac crest of 6 sheep in order to form 5 different drilling protocols: 50 rpm without saline cooling, and 400, 800, 1200, and 2000 rpm with saline cooling. Simultaneous cortical bone temperature and primary stability at the time of placement; secondary stability and the ratio between relative bone and tissue volume (BV/TV) in 2D and 3D in micro-CT analysis were evaluated after 4 and 8 weeks. The 50-rpm group had the highest cortical bone temperature and the longest operation duration with the highest primary stability. Slightly higher values of secondary stability (T2) and subsequent 2D and 3D BV/TV values were found in 1200 rpm with irrigation at 8 weeks. All groups had sufficient ISQ values at 8 weeks for loading although the micro-CT analysis showed varying percentages of bone tissue around implants. The influence of drill speed for implant osteotomy and its irrigation is minimal when it comes to changes in temperature of the cortical bone, primary and secondary implant stability, and BV/TV.


Subject(s)
Dental Implantation, Endosseous , Dental Implants , Animals , Bone and Bones , Cortical Bone/surgery , Dental Implantation, Endosseous/methods , Disease Models, Animal , Osteotomy , Sheep , Temperature
6.
Clin Oral Investig ; 26(3): 2751-2759, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34820724

ABSTRACT

OBJECTIVES: This randomized controlled clinical trial with 1-year follow-up compared the clinical and aesthetic results of coronally advanced flap (CAF) + connective tissue graft (CTG) positioned apical to the cemento-enamel junction (CEJ) (CAF + CTG-ACEJ) with CAF + CTG positioned on the CEJ (CAF + CTG-CEJ) for treating isolated gingival recession defects. MATERIALS AND METHODS: Thirty-eight patients with recession type 1 (RT 1) with a depth ≥ 3, gingival recessions were enrolled. Nineteen patients were randomly assigned to the CAF + CTG-ACEJ group or CAF + CTG-CEJ group. Clinical and aesthetical evaluations were made at 6 and 12 months. RESULTS: While the 6 months results showed that both surgical techniques were similar for clinical outcomes, the results achieved at the 6th month were more stable in the CAF + CTG-ACEJ group at the 12th month with significantly better recession depth, mean, and complete root coverage values and aesthetical results. CONCLUSIONS: Isolated gingival recession defects can be clinically successfully treated by both CAF + CTG-ACEJ and CAF + CTG-CEJ techniques. CLINICAL RELEVANCE: Limited studies have compared the clinical and aesthetical effects of positioning CTG apical to the CEJ for the treatment of gingival recessions. This randomized clinical study showed that CAF + CTG-ACEJ technique can provide additional benefit for the treatment. The described technique is effective in obtaining better long-term CRC stability and aesthetics.


Subject(s)
Gingival Recession , Connective Tissue/transplantation , Gingiva/transplantation , Gingival Recession/surgery , Humans , Tooth Root/surgery , Treatment Outcome
7.
Photobiomodul Photomed Laser Surg ; 39(4): 245-253, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33434103

ABSTRACT

Objective: To compare the effects of leukocyte and platelet-rich fibrin (L-PRF) and photobiomodulation therapy (PBMT)-applied L-PRF (PBMT/L-PRF) as barrier membranes on new bone formation (BV/TV) for the treatment of critical-sized bone defects. Materials and methods: The right iliac crests of five sheep were used in this experimental animal study. Eight critical-sized defects were surgically created in each sheep and a total of 40 defects were obtained. A deproteinized bovine bone graft was placed in all defects, and the defects were divided into four groups to be covered with L-PRF membrane, PBMT/L-PRF membrane, collagen membrane, or left uncovered as controls. Animals were sacrificed at 1 month. The sections obtained were histomorphometrically analyzed. Results: The results showed that the collagen group presented significantly higher values for main bone healing parameters (BV/TV, bone volume, and bone surface; p < 0.05). The PBMT/L-PRF group presented higher values than the L-PRF group and controls for these parameters though not statistically significant (p > 0.05). Conclusions: The findings show that PBMT may provide additional regenerative properties to L-PRF when used as barrier membranes. However, these results did not reach the collagen membranes, which warrants further studies for adapting the laser parameters to increase regenerative capacity of L-PRF.


Subject(s)
Platelet-Rich Fibrin , Animals , Bone Regeneration , Bone Transplantation , Cattle , Fibrin , Leukocytes , Sheep
8.
J Clin Periodontol ; 47(1): 72-80, 2020 01.
Article in English | MEDLINE | ID: mdl-31518440

ABSTRACT

AIM: The aim of this study was to determine whether the combined connective tissue graft (CTG) with injectable platelet-rich fibrin (i-PRF) with coronally advanced flap (CAF) improved root coverage of deep Miller Class I or II gingival recessions compared with CTG alone with CAF. MATERIAL AND METHODS: Seventy-two patients with Miller class I and II gingival recessions were enrolled. Thirty-six patients were randomly assigned to the test group (CAF+CTG+i-PRF [700 rpm for 3 min]) or control group (CAF+CTG). Clinical evaluations were made at 6 months. RESULTS: At 6 months, complete root coverage was obtained at 88% of the sites treated with CAF+CTG+i-PRF and 80% of the sites treated with CAF+CTG. Difference between the two groups was not statistically significant. At 6 months, the recession depth (RD) reduction and increase in keratinized tissue height (KTH) of the test sites were significantly better compared with the control sites. CONCLUSIONS: According to the results, the addition of i-PRF to the CAF+CTG treatment showed further development in terms of increasing the KTH and decreasing RD. However, this single trial is not sufficient to advocate the true clinical effect of i-PRF on recession treatment with CAF+CTG and additional trials are needed.


Subject(s)
Gingival Recession , Platelet-Rich Fibrin , Connective Tissue , Gingiva , Humans , Surgical Flaps , Tooth Root , Treatment Outcome
9.
Photomed Laser Surg ; 32(2): 67-74, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24392964

ABSTRACT

OBJECTIVE: The purpose of this randomized, controlled clinical trial was to compare the effectiveness of a new treatment approach, which consisted of laterally positioned flap (LPF) procedure combined with an external vestibular releasing incision made by a diode laser (LALPF) to LPF alone for the treatment of isolated gingival recession defects. METHODS: Thirty-two healthy patients presenting single Miller class II isolated gingival recessions with minimal loss of interdental papilla were treated with an LPF technique. Sixteen patients were randomly assigned to the test group (laser-assisted laterally positioned flap [LALPF]), and the other 16 patients were assigned to the control group (LPF). In the test group, diode laser was used for vestibular deepening in order to obtain maximum maneuverability of the advanced flap. Clinical and patient-centered parameters (visual analog scale for pain and aesthetics [VAS]) were measured at baseline, 7 days, and 6 months after the surgery. RESULTS: Complete root coverage from baseline to 6 months post-surgery was achieved for 46.7% of the control group and 81.2% of the test group (p=0.044). There were no differences in VAS pain measurements between the groups. Patient satisfaction with aesthetics was higher in LALPF group than in the LPF group. CONCLUSIONS: Six month results showed that the LALPF approach was effective for the treatment of single Miller class II gingival recessions.


Subject(s)
Gingival Recession/surgery , Laser Therapy/methods , Surgical Flaps , Adult , Female , Humans , Male , Pain Measurement , Patient Satisfaction
10.
J Clin Periodontol ; 40(11): 1025-35, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24164569

ABSTRACT

AIM: The aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing (SRP). MATERIAL AND METHODS: Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks. RESULTS: At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group. CONCLUSIONS: The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.


Subject(s)
Chronic Periodontitis/therapy , Limosilactobacillus reuteri/physiology , Probiotics/therapeutic use , Adult , Aggregatibacter actinomycetemcomitans/isolation & purification , Bacterial Load , Bacteroides/isolation & purification , Chronic Periodontitis/microbiology , Combined Modality Therapy , Dental Plaque/therapy , Dental Scaling/methods , Disinfection/methods , Double-Blind Method , Female , Follow-Up Studies , Fusobacterium nucleatum/isolation & purification , Gingival Hemorrhage/therapy , Gingival Recession/therapy , Humans , Male , Middle Aged , Periodontal Attachment Loss/therapy , Periodontal Pocket/therapy , Placebos , Porphyromonas gingivalis/isolation & purification , Prevotella intermedia/isolation & purification , Probiotics/administration & dosage , Root Planing/methods , Tablets
11.
J Clin Periodontol ; 38(11): 1055-62, 2011 Nov.
Article in English | MEDLINE | ID: mdl-22092477

ABSTRACT

AIM: Coronally advanced flap (CAF) technique and its modifications have been proposed in the literature. Low intensity laser therapy (LILT) is shown to increase wound healing. The aim of this split-mouth randomized controlled pilot study was to assess the effects of LILT with respect to root coverage after CAF procedure for the treatment of multiple-recession type defects (MRTD). MATERIAL AND METHODS: Ten patients with symmetrical 74 Miller I and II gingival recessions were included in this study (37 in test, 37 in control group). A diode laser (588 nm) was applied to test sites before and immediately after surgery, and for 5 min. daily 7 days post-operatively. Comparisons of the surgical sites were made with clinical measurements. RESULTS: Statistically significant differences were observed between test and control sites in the gingival recession depth (GRD), gingival recession width (GRW) and width of the keratinized tissue (WKT) and clinical attachment level (CAL) measurements after 1 year (p = 0.014, p = 0.015, p = 0.009 and p = 0.018 respectively). The test group presented greater complete root coverage (n = 7, 70%) compared with the control group (n = 3, 30%) after treatment. CONCLUSION: Within the limitations of this study, the results indicated that LILT may improve the predictability of CAF in multiple recessions.


Subject(s)
Gingival Recession/radiotherapy , Gingival Recession/surgery , Low-Level Light Therapy , Adult , Analysis of Variance , Female , Humans , Lasers, Semiconductor/therapeutic use , Male , Pilot Projects , Single-Blind Method , Statistics, Nonparametric , Surgical Flaps
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