Comparison of morbidity at the donor site and clinical efficacy at the recipient site between two different connective tissue graft harvesting techniques from the palate: A randomized clinical trial.

Background: This study was conducted to compare the pain levels in patients and the clinical efficacy of grafts obtained using two techniques, namely de-epithelialized gingival graft (DGG) and subepithelial connective tissue graft (SCTG), in combination with coronally advanced flap (CAF) for the treatment of multiple adjacent gingival recessions. Methods: Twelve patients were treated using DGG+CAF on one side and SCTG+CAF on the other. The patients' pain levels at the surgical site, the number of analgesics taken on days 3 and 7, the mean root coverage (MRC), the percentage of complete root coverage (CRC), color match, and gingival thickness (GT) at the graft recipient site were evaluated 6 months after surgery. Results: The total number of analgesics taken during the 7-day period after surgery and pain levels at the surgical site from day 3 to day 7 were significantly higher in the DGG+CAF group compared to the SCTG+CAF group (P=0.001). In the 6-month follow-up, color match and CRC were significantly higher in the SCTG+CAF group, while GT was significantly higher in the DGG+CAF group. There was no significant difference in MRC between the two groups. Conclusion: The pain and analgesic consumption levels were higher in the DGG+CAF group compared to the SCTG+CAF group, and the recipient site had a weaker color match. However, this technique can lead to a greater increase in the thickness of the grafted area.

Comparison of Ridge Mapping and Cone Beam Computed Tomography for the Determination of Alveolar Ridge Width.

Objective: This study aimed to evaluate the accuracy of cone beam computed tomography (CBCT) and ridge mapping for linear measurement of alveolar ridge width. Materials and methods: In this cross-sectional study, 25 implant placement sites in 25 patients were selected and an acrylic stent was fabricated for each one. Three buccal-lingual point pairs were located on the stent at 4-, 7-, and 10-mm distances from the soft tissue summit of the alveolar ridge. The measurements were recorded by three examiners (two periodontists and one radiologist). Results: Both techniques (CBCT and ridge mapping) overestimated alveolar ridge width compared to direct measurements, but mean differences compared to direct measurements (gold standard) were not statistically significant. The lowest mean difference compared to direct measurements was related to the ridge mapping technique, and CBCT measurements were less accurate to measure the alveolar ridge width. Conclusion: In determining alveolar ridge width, ridge mapping and CBCT are both valid and useful. Ridge mapping provides high accuracy, simplicity, and lack of radiation exposure.

Dimensional changes of keratinized mucosa after accordion versus conventional free gingival graft around dental implants: A randomized two-arm parallel clinical trial.

OBJECTIVES: Free gingival graft (FGG) is the most effective way to increase the apico-coronal width of the keratinized mucosa. In case of limited donor tissue, the accordion technique can be used. This study compared FGG for dimensional and clinical changes using accordion and conventional methods. MATERIALS AND METHODS: Ninety-four implants with keratinized tissue deficiency (<2 mm) were randomly assigned to treatment with accordion (49 implants) and conventional (45 implants) FGG. Endpoints including apico-coronal keratinized tissue width, vertical shrinkage, vestibular depth, probing depth, bleeding on probing, and plaque index were measured. The graft harvesting and recipient bed preparation method were similar in the two groups, and the only difference was the graft length. FGG was harvested with a length 40% shorter than the mesiodistal length of the recipient area in the accordion method and as much as the recipient area in the conventional method. RESULTS: vertical graft shrinkage 1, 3, and 6 months following conventional graft placement was 12.04 ± 14.99, 17.12 ± 20.40, and 23.29 ± 24.63 percent, respectively. In the accordion graft group, the shrinkage was significantly greater with 30.10 ± 16.12, 36.99 ± 15.51, and 43.75 ± 18.78 percent at 1, 3, and 6 months, respectively (p-value < .001). Other factors did not show a clinically significant difference between the two groups. CONCLUSIONS: Comparison of vertical shrinkage changes shows that the shrinkage rate in the accordion group is significantly higher than the conventional group. REGISTRATION NUMBER: IRCT20190721044296N1 (Evaluation of dimensional changes of peri-implant attached mucosa following the treatment of free gingival graft by conventional and accordion methods; randomized clinical trial two-arm parallel).

Evaluation of topical erythropoietin application on the healing outcome of gingival graft recipient site; a randomized controlled clinical trial.

BACKGROUND: Free gingival graft (FGG) is a highly predictable method to increase the width of keratinized gingiva. Various materials have been reported to accelerate the wound healing process. Considering the positive effect of EPO on dermal wound healing this study aimed to investigate the effects of EPO on the rate of healing and degree of inflammation in free gingival grafts. METHODS: Seventeen patients with bilateral lack of keratinized gingiva in mandible were selected for this clinical trial. The surgical intervention was performed after phase I periodontal therapy. Recipient site was prepared apical to the mucogingival line, and FGG was harvested from the palate. Before graft placement, the test side and control side were treated with 1 ml of EPO 4000 IU/ml and distilled water, respectively, for 2 min. On days 7, 14, 21, 28, 60, and 90 after surgery, the grafted sites were examined by blinded observers to compare the healing and inflammation of the areas. RESULTS: All the 17 patients completed the surgeries and follow-up examinations. Direct examination revealed significantly better healing in EPO group only on the 28th day. Assessment of the photographs showed a significant value in favor of the test group at some other time points as well. The EPO group demonstrated less inflammation, which was statistically significant in many time points. The graft area was 80.88 ± 30.21 mm2 and 71.35 ± 15.62 mm2 in the EPO and control groups, respectively. The difference was not significant, though. CONCLUSIONS: Topical application of erythropoietin can accelerate the healing of gingival grafts and reduce the inflammation during healing period. The final graft outcome, nevertheless, does not seem to be influenced by EPO. Trial registration This was a split-mouth randomized controlled clinical trial (IRCT201201278830N1). The first registration date: 2016-10-22.

Effect of microthread design on the preservation of marginal bone around immediately placed implants: a 5-years prospective cohort study.

BACKGROUND: This study aimed to evaluate the effect of the microthread design at the implant neck on the preservation of marginal bone around immediately-placed implants in a 5-year follow up. METHODS: Thirty patients received 41 immediately placed implants which were randomly assigned to treatment groups with microthreaded implants (test group, n = 22) or threaded implants (control group, n = 19). Clinical and radiographic analyses were carried out after 1 and5 years. Plaque index, bleeding on probing, suppuration, probing depth and marginal bone loss were subject to evaluations. The results were analyzed with the T-test, Fisher's exact test and Mann-Whitney U test. RESULTS: No implants failed; thirty-five implants (in 27 patients); 21 microthreaded and 14 threaded implants; completed the 5 year follow up. The mean values of the marginal bone loss in microthreaded and threaded groups were 1.12 ± 0.95 mm and 0.87 ± 0.78 mm, respectively during an observation period of 70.9 ± 10.4 months; the differences in marginal bone loss and other pre-implant parameters were not significant between groups (P > 0.05). CONCLUSION: Both implant designs showed acceptable results in terms of the clinical parameters and marginal bone level. Within the limitation of this study, the results did not demonstrate any superiority of the microthread design compared to threaded one in marginal bone preservation around immediately placed implants over 5 years of loading.

The influence of harvesting free gingival graft on self-reported pain perception: A randomized two-arm parallel clinical trial.

BACKGROUND/PURPOSE: Free gingival graft (FGG) is used as an effective method to increase the width of keratinized tissue. However, it can cause pain at the donor site. Techniques accompanied by lesser tissue harvesting can reduce pain after surgery. The purpose of this study was to evaluate the self-reported pain perception following harvesting FGG using conventional and accordion methods. MATERIALS AND METHODS: In this randomized clinical trial study, 31 patients with a deficiency of keratinized tissue around implant were investigated. Sixteen subjects in the accordion group and 15 subjects in the control group received conventional FGG. In the accordion group, FGG was harvested with a length of 60% of the mesiodistal length of the recipient area and with the same length as the mesiodistal length of the recipient area in the conventional group. The patients were asked to record their daily pain using a numerical rating scale. RESULTS: The severity of the pain after reaching to the peak on the second day was reduced and reached zero at day 14 in both groups. Pain severity showed no significant difference between the treatment groups. The highest level of pain was reported in the conventional group in those subjects under 50 years old, and the lowest one was in the conventional group's subjects above 50 years old. There was no difference between men and women in the reported pain between the treatment groups. CONCLUSION: Harvesting graft with a smaller size in the accordion group has no effect on reducing pain. REGISTRATION NUMBER: IRCT20190721044296N1.

Linking plant and soil indices for water stress management in black gram.

Measurement of plant and soil indices as well as their combinations are generally used for irrigation scheduling and water stress management of crops and horticulture. Rapid and accurate determination of irrigation time is one of the most important issues of sustainable water management in order to prevent plant water stress. The objectives of this study are to develop baselines and provide irrigation scheduling relationships during different stages of black gram growth, determine the critical limits of plant and soil indices, and also determine the relationships between plant physiology and soil indices. This study was conducted in a randomized complete block design at the four irrigation levels 50 (I1), 75 (I2), 100 (I3 or non-stress treatment) and 125 (I4) percent of crop's water requirement with three replications in Urmia region in Iran in order to irrigation scheduling of black gram using indices such as canopy temperature (Tc), crop water stress index (CWSI), relative water content (RWC), leaf water potential (LWP), soil water (SW) and penetration resistance (Q) of soil under one-row drip irrigation. The plant irrigation scheduling was performed by using the experimental crop water stress index (CWSI) method. The upper and lower baseline equations as well as CWSI were calculated for the three treatments of I1, I2 and I3 during the plant growth period. Using the extracted baselines, the mean CWSI values for the three treatments of I1, I2 and I3 were calculated to be 0.37, 0.23 and 0.15, respectively, during the growth season. Finally, using CWSI, the necessary equations were provided to determine the irrigation schedule for the four growing stages of black gram, i.e. floral induction-flowering, pod formation, seed and pod filling and physiological maturity, as (Tc - Ta)c = 1.9498 - 0.1579(AVPD), (Tc - Ta)c = 4.4395 - 0.1585(AVPD), (Tc - Ta)c = 2.4676 - 0.0578(AVPD) and (Tc - Ta)c = 5.7532 - 0.1462(AVPD), respectively. In this study, soil and crop indices, which were measured simultaneously at maximum stress time, were used as a complementary index to remove CWSI constraints. It should be noted that in Urmia, the critical difference between the canopy temperature and air temperature (Tc - Ta), soil penetration resistance (Q), soil water (SW) and relative water content (RWC) for the whole growth period of black gram were - 0.036 °C, 10.43 MPa and 0.14 cm3 cm-3 and 0.76, respectively. Ideal point error (IPE) was also used to estimate RWC, (Tc - Ta) and LWP as well as to select the best regression model. According to the results, black gram would reduce its RWC less through reducing its transpiration and water management. Therefore, it can be used as a low-water-consuming crop. Furthermore, in light of available facilities, the farmer can use the regression equations between the obtained soil and plant indices and the critical boundaries for the irrigation scheduling of the field.

Radiographic Comparison of Bovine Bone Substitute Alone Versus Bovine Bone Substitute and Simvastatin for Human Maxillary Sinus Augmentation.

OBJECTIVES: The aim of this study was to compare the efficacy of bovine bone substitute (Compact Bone B. ®) alone versus bovine bone substitute and simvastatin for human maxillary sinus augmentation. MATERIALS AND METHODS: This study was conducted on 16 sinuses in eight patients. Radiographic assessments were done preoperatively (T0), immediately (T1) and at nine months after sinus grafting (T2). Alveolar bone height and density were assessed on cone beam computed tomography (CBCT) scans using Planmeca Romexis™ Imaging Software 2.2. RESULTS: The change in alveolar bone height and density between T0, T1 and T2 was significant in both groups. Alveolar bone height (h0, h1, h2) and vertical height of the grafted bone (g1, g2) in three lines (anterior, middle and posterior) were not significantly different between groups. The grafted bone height shrinkage (%) in the anterior, middle and posterior limits of the augmented area were not significantly different between groups. The existing alveolar and grafted bone density increased significantly in both groups between T1 and T2, except for the existing alveolar bone density in the control group. There were no statistically significant differences between the alveolar bone density values obtained in TI and T2 between groups, except for the existing alveolar bone density at T1. CONCLUSIONS: This study did not show any significant positive effect for simvastatin in maxillary sinus augmentation based on radiographic examination.

Modified Pedicle Grafting: A Novel Noninvasive Technique for Soft Tissue Augmentation Around Maxillary Dental Implants.

OBJECTIVES: This study sought to assess the efficacy of modified pedicle grafting as a noninvasive technique for soft tissue augmentation around maxillary dental implants. MATERIALS AND METHODS: This descriptive study was conducted on eight patients who met the inclusion criteria. Prior to the second-stage surgery for exposing the implants, the buccal keratinized mucosa width, vestibular depth, and mucosal thickness around the implants were measured. The same parameters were measured six months after the second-stage surgery and were compared with the baseline values. Also, the color match of the graft with the adjacent gingival and mucosal tissues was evaluated. RESULTS: Forty-seven maxillary implants were evaluated. The minimum and maximum gains of keratinized mucosal width were respectively equal to 0mm and 7mm, with a mean of 4.31±1.19mm. The mean vestibular depth around the implants was 9.47±1.75mm (ranging from 5mm to 12mm) six months after the surgery. At the beginning of the study, a thin mucosa surrounded the implants, but after six months, the peri-implant keratinized mucosa width increased. The color match of the graft with the adjacent gingival and mucosal tissues was excellent based on the periodontists' opinion. CONCLUSIONS: Modified pedicle grafting is a safe and predictable technique for soft tissue augmentation around maxillary implants. This technique is reliable for increasing the width of keratinized mucosa in fully and partially edentulous patients with a shallow vestibular depth. The stability of the pedicle flap is achieved by fixing the flap to the tissue around the healing abutment.

Effect of Topical Erythropoietin (EPO) on palatal wound healing subsequent to Free Gingival Grafting (FGG).

Free gingival grafting, the most predictable technique to increase the keratinized gingiva, leaves an open wound on the palate and the resulting discomfort during the healing phase is a significant concern. This study was intended to evaluate the effect of topical erythropoietin on healing of the donor site. Twelve patients lacking an attached gingiva at two sites in the mandible were included. In the test group, 1 mL of gel containing erythropoietin at a concentration of 4,000 IU mL-1 was applied to the donor site, whereas the control group was treated with 2 mL of the gel alone. On the second day after surgery, the same procedure was repeated. H2O2 was used to evaluate the amount of epithelialization. Clinical healing was compared using photographs and direct examination. The EPO group showed significantly better keratinization only on day 21. Comparison of clinical healing based on direct examination revealed significantly better healing in the test group on day 28. Furthermore, inflammation in the test group was lower than in the control group on the same day. Topical application of EPO improves palatal wound healing during the third and fourth weeks after free gingival graft procedures.

A preliminary randomized clinical trial comparing diode laser and scalpel periosteal incision during implant surgery: impact on postoperative morbidity and implant survival.

The aim of this preliminary randomized clinical trial was to compare: (1) post-operative morbidity after application of laser or scalpel incision for flap advancement during implant surgery and bone grafting and (2) implant survival rate following flap advancement with laser or scalpel incision after 6 months of loading. Eighteen patients who were scheduled for dental implant placement and simultaneous bone grafting were randomly assigned to test or control groups. Diode laser (810 nm, 2 W, pulse interval 200 µs; pulse length 100 µs, 400-µm initiated fiber tip), or scalpel (control) was used to sever the periosteum to create a tension-free flap. Visual analogue scale (VAS) pain score, rate of nonsteroid anti-inflammatory drug (NSAID) consumption, intensity of swelling, and ecchymosis were measured for the six postsurgical days. Six months after loading, implant survival was assessed. VAS pain score (during the first four postoperative days), rate of NSAID consumption (during the first three postoperative days), and intensity of swelling (during the first five postoperative days) were significantly lower in the test group compared to the control group (All P values < 0.05). One patient in the control group experienced ecchymosis. All implants were successful in function. Application of laser for performing periosteal releasing incision reduced the incidence and severity of postoperative morbidity of the patients undergone implant surgery in conjunction with bone augmentation procedure. We did not find any detrimental effect of laser incision on the implant survival within 6 months of loading.

Effect of Topical Erythropoietin (EPO) on palatal wound healing subsequent to Free Gingival Grafting (FGG)

Abstract Free gingival grafting, the most predictable technique to increase the keratinized gingiva, leaves an open wound on the palate and the resulting discomfort during the healing phase is a significant concern. This study was intended to evaluate the effect of topical erythropoietin on healing of the donor site. Twelve patients lacking an attached gingiva at two sites in the mandible were included. In the test group, 1 mL of gel containing erythropoietin at a concentration of 4,000 IU mL-1 was applied to the donor site, whereas the control group was treated with 2 mL of the gel alone. On the second day after surgery, the same procedure was repeated. H2O2 was used to evaluate the amount of epithelialization. Clinical healing was compared using photographs and direct examination. The EPO group showed significantly better keratinization only on day 21. Comparison of clinical healing based on direct examination revealed significantly better healing in the test group on day 28. Furthermore, inflammation in the test group was lower than in the control group on the same day. Topical application of EPO improves palatal wound healing during the third and fourth weeks after free gingival graft procedures.

Evaluation of Salivary Leptin Levels in Healthy Subjects and Patients with Advanced Periodontitis.

OBJECTIVES: Leptin is a hormone-like protein produced by the adipose tissue. It plays an important role in protection of host against inflammation and infection. Some studies have reported changes in leptin levels in the gingival crevicular fluid (GCF), saliva and blood serum of patients with periodontal disease compared to healthy individuals. The aim of the present study was to compare the salivary leptin levels in patients with advanced periodontitis and healthy individuals. MATERIALS AND METHODS: In this case-control study, the salivary samples of healthy individuals and patients with advanced periodontitis with clinical attachment loss >5mm were obtained using a standardized method and the leptin levels were measured in the salivary samples by means of ELISA. The effects of the periodontal status and sex on the salivary leptin levels of both groups were statistically analyzed by two-way ANOVA. RESULTS: The means ± standard deviation (SD) of salivary leptin levels in healthy subjects and patients with advanced periodontitis were 34.27±6.88 and 17.87±5.89 pg/mL, respectively. Statistical analysis showed that the effect of sex on the salivary leptin levels was not significant (P=0.91), while the effect of advanced periodontitis on the salivary leptin levels was significant compared to healthy individuals (P<0.0001). CONCLUSIONS: In patients with advanced periodontitis, the salivary leptin levels were significantly lower compared to healthy individuals. Thus, assessment of salivary leptin can be done as a non-invasive and simple method to determine the susceptibility of patients to advanced periodontitis.

Role of Anatomic and Salivary Factors in Dental Calculus Formation in Primary and Mixed Dentition Stages.

PURPOSE: Clinical experience shows that formation of calculus is a very rare phenomenon in primary teeth, but it increases as the permanent teeth erupt. The purpose of this study was to assess the relationship between dental calculus, dental anatomy, and salivary factors in primary and mixed dentition stages. METHODS: A cross-sectional study was carried out to determine the buccolingual dimensions of the most concave and the most convex surfaces of the lingual aspect of mandibular central incisor crowns in a sample group of 120 three- to five-old children and 120 eight- to 10-year old children. Saliva samples were collected from 20 in each group. Data were analyzed using t tests. RESULTS: Significant differences were found between the ratio of the buccolingual dimensions of the most convex to the most concave areas of the lingual surfaces in primary and permanent incisors (P=0.028). Saliva analysis revealed significant differences in total protein (P=0.002), sodium (P=0.037), bicarbonate (P=0.003), and ammonia (P=0.025) between the two age groups. CONCLUSIONS: Anatomic and salivary factors may be important reasons for the differences in calculus formation.

Oral health status, knowledge, attitude and practice of patients with heart disease.

BACKGROUND: The aim of this study was to investigate knowledge, attitude and practice (KAP) of cardiovascular disease (CVD) patients about their oral health status. METHODS: In this cross-sectional study, we analyzed the data of 150 CVD patients that collected by a self-administered questionnaire consists of demographic characteristics and KAP. Oral health indicators calculated based on the results of oral examination by an expert dentist. RESULTS: CVD patients had an overall moderate level of knowledge and attitude, but their practice was lower than moderate. There were important associations between knowledge scores with gender, education, residential area and financial status, between attitude scores with education and residential area, and between practice scores with education and financial status. There were no associations between KAP and age, marital status or job. Significant positive correlations were found between KAP components. Significant negative correlations were found between oral hygiene index with knowledge and practice. CONCLUSION: The practice of heart disease patients about their oral health was poor, and declares that increasing awareness and attitude may not promote practice. Efficient programs are needed to promote oral health practice of adult populations in special groups.

Effect of Microthread Design on Marginal Bone Level Around Dental Implants Placed in Fresh Extraction Sockets.

PURPOSE: This study was designed to compare radiographically the effect of microthread on the coronal portion of the fixture on marginal bone level (MBL) around immediately placed dental implants in human subjects. MATERIAL AND METHODS: Forty-one roughened surface screw type Dentium oral implants (Dentium) were inserted in fresh extraction sockets of the anterior segment of maxilla of 30 patients. The implants were selected randomly using either microthread design on coronal portion of the fixture (Implantium) (test group) or without microthread thread design (Superline) (control group). MBL was measured using digital subtraction radiography technique after 3, 6, and 12 months. RESULTS: At month 3, the microthread groups have been associated with more marginal bone loss than the control group (P = 0.04). At months 6 and 12, both groups had comparable bone levels (P = 0.21). CONCLUSION: The microthread design of the implant collar could not have a positive effect in maintaining the MBL around implants placed in fresh extraction socket in anterior maxilla.

Periosteal Releasing Incision With Diode Laser in Guided Bone Regeneration Procedure: A Case Series.

Introduction: Periosteal releasing incision (PRI) is nearly always essential to advance the flap sufficiently for a tension-free flap closure in bone augmentation procedures. However, hematoma, swelling, and pain are recognized as the main consequences of PRI with scalpel. The aim of this case series was to investigate the effectiveness of laser-assisted PRI in guided bone regeneration (GBR) procedure. In addition, postoperative hematoma, swelling, and pain and implant success were assessed. Methods: Seventeen patients needed GBR were included in this study. Diode laser (940 nm, 2 W, pulse interval: 1 ms, pulse length: 1 ms, contact mode, 400-µm fiber tip) was used in a contact mode to cut the periosteum to create a tension-free flap. Facial hematoma, swelling, pain, and the number of consumed nonsteroidal anti-inflammatory drugs (NSAIDs) were measured for the six postoperative days. Six months after implant loading, implant success was evaluated. Results: Minimal bleeding was encountered during the procedure. A tension-free primary closure of the flap was achieved in all cases. The clinical healing of the surgical area was uneventful. None of the patients experienced hematoma, ecchymosis, or intense swelling after surgery. The mean value of maximum pain (visual analogue scale - VAS) was 20.59 ± 12.10 mm (mild pain). Patients did not need to use NSAID after four postoperative days. All implants were successful and functional and none of them failed after 6 months of implant loading. Conclusion: This study revealed the effectiveness of laser-assisted PRI in GBR procedure. This technique was accompanied with minimal sequelae at the first postoperative week. All implants were successful and no complication was noted during the course of this study.

Evaluation of Platform Switching on Crestal Bone Stress in Tapered and Cylindrical Implants: A Finite Element Analysis.

PURPOSE: To analyze and compare the stress distribution around tapered and cylindrical implants and investigate how different abutment diameters influence crestal bone stress levels. MATERIALS AND METHODS: Six finite element models of an abutment (5 mm, 4.3 mm, and 3.5 mm in diameter) and supporting implants (tapered and cylindrical) were designed. A vertical force of 100 N and a 15-degree oblique force of 100 N were applied separately on the occlusal surface, and von Misses stresses were evaluated in the cortical and cancellous bone. RESULTS: Higher stress was observed under oblique loading than under vertical loading of both tapered and cylindrical implants. Tapered implants demonstrated more stress under both vertical and oblique loading. Platform switching reduced peri-implant crestal bone stress in all models under vertical and oblique forces. The peri-implant crestal bone around tapered implants experienced 4.8% more stress under vertical loading and 35% more stress under oblique loading in comparison to bone around cylindrical implants (2.62 MPa with vertical loading, 8.11 MPa under oblique loading). Oblique loads resulted in much higher stress concentrations in the peri-implant crestal bone than vertical loads (238% in cylindrical and 308% in tapered implants). When the abutment diameter decreased, both models showed reductions of stress in the crestal bone under both types of loading. CONCLUSION: In this finite element analysis, tapered implants increased crestal bone stress upon loading, and platform switching minimized the stress transmitted to the crestal bone in both tapered and parallel wall implants.

Frequency of Dental Implants Placed in the Esthetic Zone in Dental Clinic of Tehran University: A Descriptive Study.

OBJECTIVES: Anterior maxilla, known as the esthetic zone, plays an important role in facial and smile esthetics. This study assessed the frequency of implant treatments in the esthetic zone of patients presenting to Dental Implant Department of Tehran University during 2002-2012. MATERIALS AND METHODS: This descriptive study was conducted on dental records of patients receiving implant treatment during 2002-2012. Patient records were retrieved from the archives and patient demographics, implant characteristics, failure rate, prevalence of complications and implant systems were collected. The data were reported as frequency and percentage. RESULTS: Of a total of 2,381 implants placed in the mentioned time period, 492 (20.8%) had been placed in the anterior maxilla and 531 (22.3%) had been placed in the anterior mandible from canine to canine. Timing of implant placement was immediate in 12.0%, early in 0.5% and late in 87.4%. Survival rate was 99.1%. Rate of failure was 0.8%. Failure rate was 0.4% in the maxillary and 1.1% in the mandibular canine to canine region. Complications were reported in 10.1% of patients. Rate of complications was 18.3% in the maxillary canine to canine, 8.9% in the mandibular canine to canine, 18.1% in the maxillary first premolar to first premolar and 9.5% in the mandibular first premolar to first premolar. The frequency of bone grafts placed in these areas was 17.6%, 33.9%, 13.6%, 32.1% and 14.3%, respectively. CONCLUSION: Of implants placed in our center, around 20% were in the anterior maxilla, and delayed implant placement was the most commonly adopted technique.

Cementogenesis in Patients with Localized Aggressive Periodontitis.

OBJECTIVES: The aim of this study was to determine the cementum thickness in the first molars of patients with localized aggressive periodontitis (LAP) compared to healthy individuals. MATERIALS AND METHODS: This case-control study compared eight first molar teeth affected by LAP with eight third molar teeth of healthy individuals. The teeth were disinfected by immersion in 10% buffered formalin solution for three days and were then sectioned. External mesial root surfaces (middle one-third) were evaluated under a stereomicroscope by a blinded pathologist to determine the mean thickness of cementum. SPSS software (version 16.0) and t-test were used for statistical analysis. RESULTS: Histological examination revealed a significant difference between the two groups in terms of the amount of cementogenesis (P<0.001) .The thickness of cementum was higher in the control group (105.16±11.5 µm) than in LAP patients (86.44±7.3 µm). CONCLUSION: This study demonstrated the presence of cementum hypoplasia in mesial root surfaces of first molars affected by LAP.