Multiple maxillary periodontal abscesses as a manifestation of post-coronavirus disease 2019 mucormycosis: a case report.

BACKGROUND: Coronavirus disease 2019 makes patients more susceptible to superinfection of fungal disease as a consequence of immunological system impairment. Mucormycosis is a fungal infection that is rare but has a high mortality rate and mostly affects patients with poorly controlled diabetes mellitus or those receiving corticosteroids. CASE PRESENTATION: Here, we present a case of post-coronavirus disease 2019 mucormycosis in a 37-year-old Persian male presenting with multiple periodontal abscess with purulent discharge and necrosis of maxillary bone (without oroantral communication). Surgical debridement following antifungal therapy was the treatment of choice. CONCLUSION: Early diagnosis and immediate referral are the cornerstone of comprehensive treatment.

Risk indicators of long-term outcome of implant therapy in patients with a history of severe periodontitis or no history of periodontitis: A retrospective cohort study.

OBJECTIVE: The aim of this retrospective cohort study was to assess factors associated with peri-implant disease in partially edentulous patients with a history of severe periodontitis or no history of periodontitis. METHODS: Partially edentulous patients with a history of severe periodontitis/without history of periodontitis who received implant surgery within the past 6 to 8 years were recalled. Clinical and radiographic examinations were recorded. Periodontal probing depth, marginal bone loss (MBL) and peri-implantitis were considered as the primary outcome and peri-implant bleeding on probing (BOP) was considered as the secondary outcome. The following criteria were considered as the predictors, as well: history of severe periodontitis, gender, age, smoking, brushing frequency, recall interval, full-mouth plaque score, full-mouth bleeding score, splinted prosthesis, open/tight interproximal contact, width of keratinized mucosa, mucosal thickness, implants placed in the grafted bone and implant type. Univariate and multivariate regression analyses were utilized. RESULTS: A total of 88 patients (186 implants) fulfilled the study. Forty-seven patients (108 implants) had a history of severe periodontitis and 41 patients (78 implants) had no history of periodontitis. There was a higher chance of peri-implantitis in patients with a history of severe periodontitis (OR = 11.13; p = 0.045), implants with lack of peri-implant KM (<2 mm) and implants placed in the grafted bone (OR = 14.94, p < 0.001; OR = 4.93, p = 0.047). The risk of peri-implant MBL ≥3 mm was higher in patients with greater FMBS (OR = 1.20; p < 0.001). The chance of peri-implant BOP was independently higher in patients who brushed their teeth at most once per day (OR = 3.20; p = 0.04), higher FMBS (OR = 1.16; p < 0.001) and irregular recall visits (OR = 15.34; p = 0.001). CONCLUSIONS: Partially edentulous patients with the history of severe periodontitis, lack of peri-implant KM and implants placed in bone-grafted sites expressed higher probability of peri-implantitis. In addition, inadequate frequency of brushing (at most once daily) and irregular recall visits were associated with greater chance of peri-implant BOP.

Reconstruction of lingual sulcus in a severely atrophic mandible using a modified approach as a pre-prosthetic surgery: Case series.

Shallow lingual vestibule and lack of keratinized attached mucosa are considered risk factors for the long-term success of dental implants. This article describes a modified surgical approach accompanied by a free gingival graft to correct the shallow lingual/buccal vestibule and to increase the keratinized tissue around dental implants.

Efficacy of Nd:YAG laser-assisted periodontal therapy for the management of periodontitis: A double-blind split-mouth randomized controlled clinical trial.

BACKGROUND: This study aimed to explore the efficacy of Nd:YAG laser-assisted periodontal therapy for management of patients with stage II-IV periodontitis. METHODS: Patients who presented with residual periodontal pockets were enrolled. After non-surgical periodontal therapy (NSPT), test sites received Nd:YAG laser (first entrance to pocket: 3 W, 100 µs, 20 Hz; second entrance: 4 W, 600 µs, 20 Hz) and control sites received placebo (laser off). Periodontal probing depth (PPD), clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), and plaque index (PI) were recorded at baseline and 1, 2, 3, 4 and 6-month visits. RESULTS: Twenty patients completed the 6-month period. Significant reductions in PPD, CAL, BOP, and PI values and a significant increase in GR at all follow-up visits compared to the baseline (all P < 0.001) were revealed in both groups. Test sites showed significantly greater improvement in PPD (P = 0.0002) and greater increase in GR (P < 0.0001) compared to the control sites at 6-month visit. There was no difference between two groups regarding CAL gain through the study period (P = 0.23). CONCLUSION: NSPT+Nd:YAG laser with the current protocol results in greater PPD reduction compared to NSPT alone. However, this reduction is likely because of greater GR rather than attachment gain. Therefore, the adjunction of Nd:YAG laser (with the current setting) to the NSPT for the treatment of residual periodontal pockets did not ameliorate the clinical outcomes (ClinicalTrials.gov ID: NCT03365167).

Effectiveness of Different Modalities of Lip Repositioning Surgery for Management of Patients Complaining of Excessive Gingival Display: A Systematic Review and Meta-Analysis.

PURPOSE: This study is aimed at synthesizing the available evidence regarding effectiveness of various modalities (combinations of LRS tasks) and comparison between each two modalities in terms of gingival display reduction, success rate, stability of the results, patient's satisfaction, and postoperative morbidity. MATERIALS AND METHODS: The electronic databases including PubMed, Scopus, Web of Science Cochrane Library, Google Scholar databases, ClinicalTrials.gov, and WHO International Clinical Trial Registry Platform were searched up to 27th June 2020 regarding lip repositioning surgery. The modalities were defined as the combinations of the following tasks: frenectomy (yes/no), flap thickness (full/partial), and myotomy (yes/no). Meta-analyses were performed on gingival display change from baseline to months 3, 6, and 12 in each modalities using Stata (v.16). RESULTS: 38 studies (including three clinical trials, two quasiexperimental studies, seven case series, and 26 case reports) met the criteria for final inclusion. The mean gingival display reduced from baseline to 6 months (WMD = -2.90, 95% CI: -4.85 to -0.95) in the patients undergoing the "frenectomy + full-thickness flap + myotomy" modality. This parameter decreased from baseline to 6 and 12 months, respectively (WMD = -2.68, 95% CI: -3.49 to -1.86; WMD = -2.52, 95% CI: -4.40 to -0.64), in patients undergoing the "frenectomy + partial-thickness flap + without myotomy" modality. In patients who undergone the "without frenectomy + partial-thickness flap + without myotomy" modality, gingival display reduced from baseline to 6 months (WMD = -3.22, 95% CI: -5.61 to -0.84). Almost 83% of patients with modality 1 had satisfaction. CONCLUSIONS: Gingival display within the 6 months after LRS could be reduced with all modalities. Descriptively, the greatest reduction was observed in patients with the modality not including the frenulum.

Clinical Outcomes of Free Gingival Graft Following Recipient Bed Preparation with Er,Cr:YSGG Laser Versus Scalpel: A Split-Mouth Randomized Clinical Trial.

Objective: Free gingival graft (FGG) procedure is accompanied with a considerable rate of graft shrinkage. This study was aimed to assess the dimensional changes of FGG after recipient site preparation with Er,Cr:YSGG laser and surgical scalpel. Materials and methods: This split-mouth randomized clinical trial evaluated 11 patients with bilateral lack of keratinized gingiva in mandibular premolars. The test side in each patient was prepared with Er,Cr:YSGG laser (3 W power, 300 mJ energy, 10 Hz frequency, long-pulsed mode), whereas the control side was prepared by surgical scalpel. All FGGs were harvested from the palate with standard dimensions of 14 × 9 mm. The graft width, length, surface area, and shrinkage and color match were measured after 1, 3, and 6 months. Postoperative complications, including pain and bleeding were also evaluated using a questionnaire. Results: In both groups, the surface area and width of graft significantly decreased at all time points compared with baseline but the difference in this respect was not significant between the two groups (p > 0.05). In both groups, maximum shrinkage occurred within the first 3 months. In control group, the surface shrinkage in 3 months was significantly greater than the first month (p = 0.025) without significant difference between groups (p = 0.79). The two groups were not significantly different regarding pain score and bleeding score either. On the day of surgery, the test group had slightly lower pain score and higher bleeding score in comparison to the control group without significant difference. The pain and bleeding scores reduced in both groups with no significant difference (p > 0.05). Conclusions: Er,Cr:YSGG laser has promising results for preparation of FGG recipient site and yields results comparable to those of surgical scalpel.

Comparison of peri-implant clinical outcomes of digitally customized and prefabricated abutments: A systematic review and meta-analysis.

BACKGROUND: Digitally customized abutments are increasingly used in contemporary implant prosthodontics. PURPOSE: This systematic review and meta-analysis aimed at comparing the peri-implant clinical outcomes of digitally customized and prefabricated abutments. MATERIALS AND METHODS: The search strategies included electronic databases (PubMed, Embase, Scopus, and Cochrane clinical trials database) and related journals up to September, 2020. A qualitative and quantitative synthesis was performed on data extracted from the included studies. RESULTS: Three RCTs (number of patients = 120; number of dental implants = 120) and two prospective cohort studies (number of patients = 144; number of dental implants = 144) with one to three-year follow-up periods were included. The quantitative analyses did not demonstrate a significant difference between digitally customized and prefabricated abutments for peri-implant pocket depth (P = 0.62), plaque index (P = 0.67), bleeding on probing (P = 0.43), keratinized mucosa width (P = 0.75), and pink aesthetic score (P = 0.30) at one-year follow-up visit. The qualitative analyses for marginal bone level change, calculus accumulation, implant survival rate, implant success rate, white aesthetic score, and patient-reported outcomes did not demonstrate a significant difference between two groups during 1 to 3-year follow-up visits. CONCLUSION: The current data do not provide evidence of significant differences between two abutment fabrication methods in terms of peri-implant clinical outcomes within short-term period (CRD42020170807).

Efficacy of photobiomodulation therapy on neurosensory recovery in patients with inferior alveolar nerve injury following oral surgical procedures: a systematic review.

OBJECTIVE: The present systematic review aimed to assess the efficacy of photobiomodulation (PBM) therapy on neurosensory recovery of patients with inferior alveolar nerve injury following third molar surgery or dental implant placement. METHOD AND MATERIALS: An electronic search was carried out in Scopus, Embase, Medline, PubMed, Web of Science, Cochrane Library, and Google Scholar databases. Among 1,122 identified papers, seven articles (three RCTs, one observational study, and three case series) met the inclusion criteria.
Results: Time lapse from nerve injury to the onset of PBM therapy varied widely from 2 days to 4 years. The number of patients in each study ranged between 4 and 74. In the majority of the studies, PBM was done using a diode laser at wavelengths ?in the range of 808 to 830 nm with power of 5 to 500 mW and radiation dose of 3 to 244 J/cm2. Two out of three RCTs found significant neurosensory recovery in the patients who received PBM therapy compared to the controls. The observational study and all case series reported significant improvement in the neurosensory status following PBM therapy. The degree of neurosensory recovery was found to be greater in younger patients and those who received the treatment within 6 months following the injury.
Conclusions: Due to the limited number of well-designed RCTs and small number of patients in each study, it is not possible to make a clear conclusion about the efficacy of PBM therapy on neurosensory recovery in patients with inferior alveolar nerve injury following third molar or implant procedures. Considering the possibility of spontaneous inferior alveolar nerve recovery during this period, the conclusion based on the studies with no control group should be interpreted with caution. (Quintessence Int 2021;52:140-153; doi: 10.3290/j.qi.a45430).

Blended learning in undergraduate nursing education - A scoping review.

OBJECTIVES: To provide a comprehensive scoping review of the existing literature regarding the use of blended learning in undergraduate nursing education. To align the varied educational terms and definitions with the broad definition of blended learning. DESIGN: Scoping review following established methodology. DATA SOURCES: In consultation with library services, the academic literature was searched. Electronic databases searched included ERIC (OVID), Medline (OVID), PubMed, Nursing and Allied Health, and CINAHL Plus. REVIEW METHODS: A total of 189 potentially relevant nursing research articles published between the years of 2009 and 2019. Three reviewers independently reviewed the articles, leaving 37 relevant primary articles in the nursing field to be included in the scoping review. RESULTS: Nursing content delivered using blended learning approaches were organized into 8 themes. Themes include Professional Nursing Skills; Mental Health Nursing; Bioscience; Pharmacology, Specialty Populations; Nursing Assessment; Acute Care Nursing; and the Art of Nursing. A variety of blended learning approaches are being utilized in Undergraduate nursing education, the majority of which are happening in the classroom. CONCLUSION: This scoping review presents explicit the degrees to which blended learning is referred to in the nursing education literature and expanded the definition of blended learning to encompass the terminology associated with distributed, decentralized, hybrid, and flexible learning. There is a wide, varied, and expanding number of blended learning approaches currently being utilized in nursing education to teach a wide range of nursing content and skills. An expanded scoping review focused on blended learning in psychiatric nursing, licenced practical nursing, nurse practitioners, and all graduate level nursing education programs is recommended as is additional research into the use of blended learning in the lab or clinical setting.

Recovery of inferior alveolar nerve by photobiomodulation therapy using two laser wavelengths: A behavioral and immunological study in rat.

Postoperative sensory disturbances of inferior alveolar nerve (IAN) are major challenges in dental procedures. We aimed to investigate the effect of photobiomodulation therapy (PBMT) with 810 nm and 980 nm diode lasers on behavioral and immunological factors in a rat IAN crush model. Seventy-two rats were randomly assigned to the four groups of 810 nm laser (crush injury+810 nm laser; 6 J/cm2, 15 sessions, every 48 h), 980 nm laser (crush injury+980 nm laser; same protocol), control (crush injury without irradiation), and sham surgery (no crush injury and no irradiation). The neurosensory response of IAN was evaluated by Von Frey behavioral test before (baseline) and post-surgery in a period of one month. Changes of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), nuclear factor-kappa B (NF-κB), TNF-α, and IL-1ß, were assessed on days 2 and 30 post injury. Data were analyzed for significant differences by repeated measures and one-way ANOVA (p < .05). One day after surgery, all rats subjected to nerve injury showed significant increase in the withdrawal threshold of von Frey test compared to the baseline (p = .02 for control and p = .03 for laser groups). The threshold gradually returned to the baseline scores in 810 nm, 980 nm, and control groups from days 11, 17, and 29, respectively. There was a significant lower withdrawal threshold in 810 nm and 980 nm laser groups compared to the control group in days 11 to 19 and 9 to 23, respectively. At both time points, the levels of NGF and BDNF were significantly higher in 810 nm laser group compared to the control group. There was a significant difference between laser and control groups regarding NF-κB expression (all p values<.001). TNF-α and IL-1ß were significantly lower in laser groups compared to the control group (all p values < .001). PBMT with 810 and 980 nm diode laser protocol used in this study, promoted the neurosensory recovery of IAN after crush injury in rats. In addition, application of 810 nm diode laser was associated with more improvement in immunological responses compared to that of 980 nm laser.

Photobiomodulation Therapy for the Management of Patients With Inferior Alveolar Neurosensory Disturbance Associated With Oral Surgical Procedures: An Interventional Case Series Study.

Introduction: Inferior alveolar nerve (IAN) injury is a serious complication during intraoral surgeries. We aimed to evaluate the outcome of photobiomodulation (PBM) therapy in patients with IAN injury associated with third molar or implant procedures. Methods: Eight patients with an alteration of sensory function of the IAN after third molar or implant surgeries were enrolled in this case series study. The patients received 10 sessions of PBM therapy (810 nm diode laser, 200 mW, 10 J/cm2 per point, three times a week). Pinprick (PP) and visual analogue scale (VAS) neurosensory tests were recorded at each treatment session and 14 days after the last treatment. The association between explanatory variables and the outcome of interest was analyzed using generalized estimating equations. Results: The median percentage change of outcomes from the first to the last visit was as follows: VAS score: +125.00% (range: 50.00 to 166.67); PP score: +350% (range: 150 to 800). The duration of paresthesia was inversely correlated with changes in VAS and PP scores. No significant association was found between patients' gender or age and changes in VAS and PP scores. Conclusion: Considering the limitations of this study, PBM with the parameters used in this study presented positive effects on neurosensory recovery in patients suffering from IAN injury associated with routine intraoral procedures. Patients with shorter duration of paresthesia tended to respond more favorably to PBM therapy.

Photodynamic Inactivation of Porphyromonas gingivalis utilizing Radachlorin and Toluidine Blue O as Photosensitizers: An In Vitro Study.

Introduction:Porphyromonas gingivalis is one of the major pathogens in the development and progression of periodontal disease. Antimicrobial photodynamic therapy (aPDT) is a new approach which is sorted in non-invasive phototherapy for bacterial elimination. This in vitro study was conducted to compare photodynamic inactivation using Radachlorin and Toluidine blue O (TBO) as photosensitizers on P. gingivalis. Methods: Bacterial suspensions (200 µL) of P. gingivalis were exposed to either TBO with concentration of 0.1 mg/mL associated with portable light-emitting diode (LED) device (peak wavelength: 630 nm, output intensity: 2.000 mW/cm2, tip diameter: 6.2 mm) or 0.1% Radachlorin® and laser irradiation (InGaAlP, Peak wavelength: 662±0.1% nm, output power: 2.5 W, energy density: 6 J/cm2, fiber diameter: 2 mm). Those in control groups were subjected to laser irradiation or LED alone, Radachlorin® or TBO alone, and one group received neither photosensitizer nor light irradiation. Then counting of colony forming units (CFU) was performed to determine the bactericidal effects in each subgroup. Results: LED-based aPDT reduced the colony count of P. gingivalis more than that of TBO (P<0.001) or LED group (P=0.957). Also, laser-based aPDT had a great reduction in colony count of P. gingivalis in comparison with Radachlorin® (P<0.001) or laser irradiation alone (P=0.28). In addition, the colony count reduction of laser-based aPDT was significantly more than LED-based aPDT (P<0.05). Conclusion: Considering the results of this study, the viability of P. gingivalis was more affected by the combination of laser and Radachlorin® 0.1% in comparison with LED and TBO 0.1.

Outcomes of Alveolar Ridge Preservation With Recombinant Human Bone Morphogenetic Protein-2: A Systematic Review.

PURPOSE: The main focused question of this systematic review was as follows: Does the application of recombinant human bone morphogenetic protein-2 (rhBMP-2) placed in extraction sockets reduce the alveolar ridge changes? METHODS: A systematic literature search was performed up to February 2017. Clinical studies published in English were included. Outcome variables of interest were as follows: changes in alveolar ridge width and height, the quality of new bone, patient's safety, adverse events, and postoperative complications. RESULTS: Seven articles were included. Because of the vast heterogeneity and high risk of bias among the studies, performing a meta-analysis deemed not feasible. Application of rhBMP-2 in the extraction socket was more effective in the reduction of ridge width compared with that of ridge height. The superiority of 1.5 mg/mL rhBMP-2/absorbable collagen sponge over the carrier alone on alveolar ridge width/height remodeling was more significant when it was applied in the sockets with ≥50% buccal bone dehiscence. The limited available data showed that rhBMP-2 did not improve the quality of new bone. Antibodies against rhBMP-2 were detected in the serum in 1 trial. CONCLUSIONS: Within the limits of this review, 1.5 mg/mL rhBMP-2 might be beneficial for preserving the alveolar ridge width within extraction sockets given as to whether the cost-effectiveness is justifiable. Studies with lower risk of bias should be performed to confirm the above findings.

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 laser photobiomodulation on wound healing and postoperative pain following free gingival graft: A split-mouth triple-blind randomized controlled clinical trial.

BACKGROUND AND AIM: Free gingival graft (FGG) is one of the most predictable techniques for gingival augmentation. However, patient's discomfort and pain during healing period are significant concerns. The aim of this study was to assess if laser photobiomodulation (PBM) was effective in terms of enhancing wound healing and reducing postoperative pain. METHODS AND MATERIALS: Twelve patients participated in this split-mouth randomized controlled clinical trial. Each patient had a 30-day interval between the two procedures. In the test group, donor and recipient sites received diode laser (660nm, 200mW, continuous mode, time of irradiation:32s, energy density: 4J/cm2, spot size:0.5cm) immediately after FGG surgery, and 1,2,4 and 7days later. The control side received the same sequence of irradiation with the laser-off. Complete wound epithelialization of donor site and clinical wound healing and visual analogue scale (VAS) pain score of donor and recipient sites were evaluated after surgery. RESULTS: At 14 and 21days after surgery, the number of donor sites with complete epithelialization was greater in laser group compared to the placebo. After 21days, all donor sites in the test group were epithelialized completely, while at the same time, only eight donor sites in the control group showed complete epithelialization (P value=0.05). In terms of clinical healing of the recipient and donor sites, the test and control groups did not show any significant difference during the 45-day period, except at days 1 (for recipient site) and 14 (for donor site), when the test group showed better results (P values: 0.01 and 0.03, respectively). The VAS pain score did not show statistically significant difference between two groups during the study period, except for the first 3h after procedure when laser group showed greater VAS pain score (P values<0.05). CONCLUSION: PBM following FGG procedure with the parameters used in this study could accelerate the rate of epithelialization at the donor site. However, it did not reduce postoperative pain.

Intra- and Postoperative Complications of Lateral Maxillary Sinus Augmentation in Smokers vs Nonsmokers: A Systematic Review and Meta-Analysis.

PURPOSE: This meta-analysis and systematic review focused on the following question: Does tobacco smoking increase the risk of intra- or postoperative complications of lateral maxillary sinus floor elevation? MATERIALS AND METHODS: The following electronic databases were searched up to and including November 2015 without language restriction: CENTRAL, MEDLINE, Google Scholar, Scopus, Sirous, and Doaj. Studies were included if rates of intra-or postoperative complications of sinus floor elevation in smokers and nonsmokers were recorded separately. The following complications were assessed: sinus membrane perforation, bleeding, wound dehiscence, wound infection, sinusitis, hematoma, and oroantral fistula. The Critical Appraisal Skills Programme was used to assess the risk of bias in included studies. Random-effects meta-analyses were used to assess the number of each complication in smokers and nonsmokers. RESULTS: Out of 929 eligible publications, 11 articles were included. Meta-analysis of the studies revealed a significantly increased risk of developing wound dehiscence after sinus floor elevation among smokers compared with nonsmokers (Risk Ratio [RR]: 7.82; 95% confidence interval [CI]: 2.38, 25.74; P = .0007). Moreover, risk of developing wound infection was greater in smokers when prospective studies were included in the meta-analysis (RR: 5.33; 95% CI: 1.34, 21.25; P = .02). However, the meta-analysis of included studies did not show significant differences between smokers and nonsmokers concerning risk of sinus membrane perforation and bleeding during sinus floor elevation (P = .46 and P = .33, respectively). CONCLUSION: Considering the lack of randomized controlled trials and the small number of included studies, the results indicate that smoking seems to be associated with increased risk of wound dehiscence and infection after the sinus augmentation procedure.

Laser-Assisted Osteotomy for Implant Site Preparation: A Literature Review.

PURPOSE: The aim of this study was to review the scientific evidence about the laser osteotomy in implant bed preparation. METHODS: An electronic search was performed on relevant English articles up to April 2016 in the PubMed, Scopus, and Google Scholar databases. RESULTS: Twenty-two articles (1 clinical, 13 animal, and 8 ex vivo studies) were included. Implant sites prepared by erbium family lasers and drill showed comparable results regarding the percentage of bone-to-implant contact, values of biomechanical tests, and healing process. Selection of proper laser wavelength and parameters was of paramount importance to minimize the risk of thermal bone damage. Lack of depth control and long time needed for implant site osteotomy with laser were the most challenging concerns for its clinical applicability. Computer-guided laser osteotomy showed promise for future use of laser osteotomy in clinical settings. CONCLUSION: Evidence from animal studies shows promising results regarding laser osteotomy in implant site preparation. However, because of the lack of clinical studies, it is not possible to make a conclusive result whether there is superiority of laser osteotomy in clinical practice.

Antimicrobial photodynamic therapy using diode laser activated indocyanine green as an adjunct in the treatment of chronic periodontitis: A randomized clinical trial.

INTRODUCTION: Clinical studies have shown the usefulness of antimicrobial photodynamic therapy (aPDT) as an adjunctive in periodontal therapy. These studies did not utilize indocyanine green (ICG) as a recently introduced photosensitizer. The aim of this study was to perform a full-mouth double-blind randomized controlled clinical study to test the efficacy of adjunctive aPDT with ICG compared with scaling and root planing (SRP) alone in chronic periodontitis treatment. MATERIALS AND METHODS: Fifty patients were selected for this study. All patients received SRP. Then, each patient was randomly assigned to either the test group (aPDT+SRP) or the control group (SRP). aPDT was performed with a diode laser (wavelength: 810nm, power: 200mW) and ICG as photosensitizer. The adjunctive procedure was repeated after 7, 17 and 27 days. The clinical parameters including bleeding on probing (BOP), clinical attachment loss (CAL), plaque index (PI), probing pocket depth (PPD), full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) were measured at baseline and after 1 and 3 months. RESULTS: There were no significant differences between two groups at baseline. BOP, PPD and FMBS showed significant improvements in the test group (P≤0.001). In terms of PI, FMPS and CAL, no significant differences were observed between both groups (P≥0.05). CONCLUSION: aPDT as an adjunctive approach yielded complete resolution of inflammation and significant reduction in periodontal pocket depth. However, aPDT had no additional advantages in clinical attachment gain and plaque score.

Effect of Postoperative Amoxicillin on Early Bacterial Colonization of Peri-Implant Sulcus: A Randomized Controlled Clinical Trial.

OBJECTIVES: With side effects of antibiotics taken into consideration, the necessity of antibiotic therapy after simple implant placement procedures is still a subject of debate and the existing literature on this topic is widely controversial. The aim of this study was to assess the effect of postoperative amoxicillin therapy on early colonization of peri-implant sulcus after implant placement. MATERIALS AND METHODS: In this randomized controlled clinical trial, 20 patients requiring simple implant placement were randomly allocated to test or control groups and received postoperative amoxicillin or placebo, respectively. Microbiological samples were collected on day 0 and day 7. Mann Whitney and Wilcoxon signed rank tests were utilized to evaluate changes in colony count of identified bacterial species between the test and control groups, and between day 0 and day 7. RESULTS: The decrease in the number of sensitive facultative species and the increase in the number of resistant anaerobes in amoxicillin group were statistically significant as compared to the placebo group (P=0.025 and P=0.005, respectively). The increase in the number of sensitive anaerobes in the placebo group as compared to amoxicillin group, and the decrease in the number of facultative Gram-positive cocci as compared to the placebo group were statistically significant (P=0.011 and P=0.035, respectively). CONCLUSIONS: Postoperative administration of amoxicillin resulted in an increase in the number of resistant anaerobes and a decrease in the number of sensitive facultative bacteria and facultative Gram-positive cocci, as compared to the placebo, but with no sign/symptom of infection in any group.