In situ shell technique for edentulous ridge augmentation.

BACKGROUND: The novel two-stage technique presented in this study is based on guided bone regeneration for three-dimensional bone augmentation. METHODS AND RESULTS: The proposed technique was performed to augment an atrophic alveolar ridge in the maxilla and mandible. This method is based on using an autogenous bone plate, a mixture of allogeneic bone graft and injectable -platelet-rich fibrin, and a bioresorbable barrier membrane. Based on the cases presented in this study, sufficient osseous regeneration was achieved to place dental implants in an ideal position. CONCLUSION: Within the limitations of the present study, it seems that in situ shell technique could be a beneficial method to augment the extremely atrophied ridges with less morbidity and shorter operative time. KEY POINTS: Why is this case new information? The cases presented a new technique using in situ autogenous plates for ridge augmentation. What are the keys to the successful management of this case? The keys to the successful management of these cases are proper flap management and less traumatic bony plate preparation. What are the primary limitations to success in this case? The primary limitation to success in this technique would be a need for high surgical skills to conduct the procedure accurately.

Comparative Evaluation of the Effect of Two Platelet Concentrates (a-PRF and L-PRF) on the Cellular Activity of Pre-osteoblastic MG-63 Cell Line: An in vitro Study.

Statement of the Problem: Currently, the reconstruction of bone defects with new platelet concentrates is considered a significant challenge in periodontics. Purpose: This study aimed to evaluate advanced- platelet rich fibrin (A-PRF) and leukocyte- and platelet rich fibrin's (L-PRF) effects on the proliferation and differentiation of MG-63 cells. Materials and Method: In this in vitro study, blood samples of five healthy non-smoking volunteers were collected and immediately centrifuged according to the two protocols of Choukroun and Ghanaati, without adding any anticoagulants, to prepare L-PRF and A-PRF. After freezing the clots for one hour, they were crushed and centrifuged once more. After culturing MG-63 cells, the effects of 20%, 10%, 1%, and 0.5% concentrations of A-PRF and L-PRF extracts on cell proliferation and mineralization were evaluated by methyl thiazolyl tetrazolium (MTT) assay and Alizarin Red staining, respectively. Results: Generally, survival and proliferation in the L-PRF group at both time intervals were higher than the A-PRF group and increased with increasing the extract concentration. However, in the A-PRF group, there were no significant differences between the different concentrations, and only the number of cells increased over time. After three days, in the study on mineralization, nodule formation was observed only in the positive control group (osteogenic). In seven days, mineralized nodules were formed in all groups with different concentrations of A-PRF, but not in any of the L-PRF groups. Conclusion: According to the results, L-PRF increased proliferation, and A-PRF exerted a positive effect on the differentiation of MG-63 cells.

Nasopalatine duct cyst as a delayed consequence of dental implant placement in the anterior maxilla: A case report.

Dental implants are now the best treatment method to replace missing teeth. However, complications may necessitate further therapeutic interventions because of anatomic limitations and mistakes during surgical procedures. In this case report, a nasopalatine duct cyst (NPDC) due to implant placement was studied. After clinical and radiographic evaluation, unilocular radiolucency with disturbance to the nasopalatine canal was observed. Following that, flap elevation was performed. Subsequently, the cyst was enucleated, and the bone defect was filled with xenograft and further covered with a resorbable membrane. Histopathology results confirmed NPDC as the definite diagnosis. After six months, the defect was completely resolved.

Histopathological Investigation of Dental Pulp Reactions Related to Periodontitis.

OBJECTIVE: Since the 1960s, there has been contradictory evidence regarding the association between periodontal pathology and the status of the pulp. The purpose of this study was to evaluate the histopathological changes of pulp tissue with severe periodontal disease, including vertical bone loss involving the major apical foramen, and compared them with the histological pulpal status of teeth with healthy periodontium. METHODS: This case-controlled study included 35 intact teeth with severe periodontitis of hopeless prognosis (test group) and 35 teeth without periodontitis extracted for orthodontic reasons (control group). For each tooth, periodontal and endodontic parameters such as probing depth and pulpal vitality were recorded, and the pulp tissue was evaluated histologically. The data were analysed with a significance level of 0.05. RESULTS: Vital pulp was observed in all specimens of both groups (P=1). Pulpal inflammation in the apical portion was observed in 81.71% of the severe periodontitis group, whereas all teeth in the control group demonstrated no signs of pulpal inflammation. Dystrophic calcification and pulp stones were observed in 7.5% of the periodontitis group and 5.7% of the healthy group (P>0.05). Pulp fibrosis was observed in 22.8% of the periodontitis group and 2.8% of the control group (P=0.012). Pulpal necrosis was not noted in either group. In the periodontitis group, internal resorption was present in 22.8% of cases (P=0.005) and external resorption was present in 80% of cases (P<0.001). In the control group, no internal or external resorption was observed in any of the specimens. No differences were noted in the study patients with regard to sex or age. CONCLUSION: Periodontal disease does not significantly affect pulp vitality and pulpal calcifications. However internal and/or external resorption was significantly different between the two groups as well as apical inflammation and pulp fibrosis.

Comparison of Antimicrobial Effects of Three Different Mouthwashes.

BACKGROUND: This study investigated the in vitro and in vivo antibacterial effects of three mouthwashes on supragingival plaque microbiota. The three mouthwashes under study were 0.2% chlorhexidine (CHX), Listerine®, and Persica (PM). Water was used as negative control. METHODS: Supragingival plaque samples were collected from 32 patients with gingivitis in the Dental School of Shahid Beheshti University of Medical Sciences in March 2014. Plaque samples were swabbed on agar plates and discs (previously immersed in the three mouthwashes) were placed on the agar. The zone of bacterial inhibition (ZOI) was measured after incubation for 24 hours. For the in vivo testing, the same plaque samples were inoculated on agar and the colony forming units (CFU) were counted. The patients were then instructed to use the mouthwashes (cases) and water (controls) for two weeks, after which plaque samples were again collected, inoculated and the CFUs were counted. RESULTS: For the ZOI test, 0.2% CHX inhibited the growth of bacteria to an average diameter of 18.38 mm, while Listerine®, PM and water caused no inhibition of bacterial growth around the discs after 24 hours. The mean bacterial count after using 0.2% CHX for two weeks decreased by 23.13 CFU. This was followed by Listerine®, with a mean reduction of 19.75 CFU. PM resulted in 13.5 CFU decrease in the mean bacterial count, while water reduced the bacterial count by only 1 CFU. CONCLUSION: 0.2% CHX inhibits bacterial growth considerably. All three mouthwashes can reduce total bacterial count after 2 weeks although with different mean bacterial count reduction.

Hyperlipidemia in patients with periodontitis.

BACKGROUND: Periodontitis is a bacterial infection, which has been classified as a local chronic inflammation. This, as well as cardiovascular disease, may share common risk factors such as smoking, diabetes, behavioral factors, aging, and male gender. The aim of this study was to evaluate the association between hyperlipidemia and periodontitis. MATERIALS AND METHODS: The levels of plasma lipids in 40 subjects with periodontitis (CPITN score III or IV, pocket depth 4 mm) with mean age 32.3 +/-1.2 years were measured and compared with those obtained from 40 age and sex matched controls. Both groups were systemically healthy according to their medical history. RESULTS: Total cholesterol (CHL) and triglycerides (TG) were significantly higher in the case group (P=0.045 and P=0.016, respectively). HDL and LDL cholesterols were higher in patients but did not have any significant differences with controls. The frequency of persons with pathologic values of TG and CHL were significantly higher in cases compared with controls. CONCLUSIONS: These results showed hyperlipidemia may be associated with periodontitis in healthy people. However, it is unclear whether periodontitis causes an increase in levels of serum lipids or hyperlipidemia is a risk factor for both periodontitis and cardiovascular disease.