Antimicrobial efficacy of antiplaque agents of common toothpastes against Porphyromonas gingivalis and Streptococcus oralis: An in vitro study.

Background: This study was designed to evaluate the antimicrobial activity of common gum protection and antiplaque toothpastes against Porphyromonas gingivalis (P. gingivalis) and Streptococcus oralis (S. oralis) as important periodontal pathogens. Materials and Methods: This experimental study investigated the antimicrobial activity of 15 commonly used toothpastes from different companies on the two common types of periopathogens, S. oralis and P. gingivalis . The antimicrobial activity of toothpaste was evaluated at three concentrations of 100%, 50%, and 25% and analyzed by agar well diffusion plate method and zone of inhibition. The obtained data were compared and statistically analyzed by SPSS software using one-way ANOVA and the least significant difference post hoc tests (α = 0.05). Results: One-way ANOVA showed that the mean diameter of the two-bacterial zone of inhibition was significantly different at 100%, 50%, and 25% concentrations of toothpastes (P < 0.001). In general, the mean diameter of the zone of inhibition was greater at 100% concentration than the other two concentrations in all toothpastes. The highest zone of inhibition of the S. oralis was in the toothpastes containing tin. Further, the highest zone of inhibition of P. gingivalis was found in the triclosan-containing toothpastes. Conclusion: Toothpastes containing triclosan had the most antimicrobial activity against P. gingivalis . Moreover, toothpastes containing tin compounds had the most antimicrobial effect against S. oralis .

Effect of two types of charcoal toothpaste on the enamel surface roughness of permanent teeth.

Background: Charcoal in the composition of some kinds of toothpaste has created concerns regarding abrasiveness and subsequent complications. Considering the popularity of charcoal toothpaste, and the manufacturers' claims that no porosity is caused by activated carbon, this study aimed to compare the effects of two charcoal kinds of toothpaste and three conventional tubes of toothpaste on enamel surface roughness of permanent primary teeth. Materials and Methods: This in vitro experimental study evaluated 75 teeth mounted in acrylic resin. Teeth were divided into five groups (n = 15). The primary surface roughness of teeth was measured by a profilometer. The teeth were then subjected to wear test in a V8 cross-brushing machine with Bencer and RP charcoal toothpaste, Crest 7, Colgate Optic White, and Bencer fresh mint toothpaste. After rinsing and drying specimens, their secondary surface roughness was measured. The mean changes in the roughness profile of specimens were analyzed by a one-sample Kolmogorov-Smirnov test at a 0.05 significance level. Results: There was no significant difference in the mean surface roughness of specimens before and after the wear test (P > 0.05). The difference in the mean wear of five types of toothpaste was not significant either (P = 0.597). The mean changes in surface roughness were 0.0685 µm for Bencer charcoal, -0.0620 µm for RP charcoal, 0.0765 µm for Crest 7, 0.1137 µm for Colgate Optic White, and 0.1052 µm for Bencer fresh mint toothpaste. Conclusion: Numerous kinds of toothpaste investigated in this study did not reveal any difference in terms of wear index; however, more studies are needed to evaluate the effectiveness and efficiency of these types of toothpaste.

Comparison of the number of bacterial colonies among four types of suture threads using simple loop method following periodontal surgery in patients with periodontitis: A single-blind randomized clinical trial.

Background: This study investigated the number of bacterial colonies in four types of suture threads, including silk, nylon, monocryl, and monocryl plus after periodontal surgery in patients with moderate-to-severe periodontitis. Materials and Methods: In this single-blind randomized clinical trial, a total of 12 patients with periodontitis who required periodontal flap surgery in all quadrants were included. One type of suture, either silk, nylon, monocryl, or monocryl plus (coated with triclosan), was used following each surgery in each quadrant. Sutures (3 mm) were removed from the mid, posterior, and anterior regions of the flap 7 days postoperatively, and placed in a tube-containing buffer medium to transfer to the culture medium in a laboratory. Then, the bacterial colonies on each culture medium were counted manually. Finally, the mean number of grown colonies (anaerobic and aerobic) was computed and compared in each group of sutures. Data were analyzed by SPSS (Version 20) using the repeated measures ANOVA and least significant difference follow-up tests (α = 0.05). Results: The findings of this study indicated a significantly higher mean number of aerobic, anaerobic, and aerobic-anaerobic colonies in silk suture than in the other three types of sutures (P < 0.05). However, no significant difference was observed among other types of sutures (P > 0.05). Conclusion: The results of this study showed that silk suture had a higher bacterial adhesion (aerobic, anaerobic, and aerobic-anaerobic) than monofilament sutures, including nylon, monocryl, and monocryl plus. Moreover, no significant difference was found among the monofilament sutures in the number of colonies grown on them.

A comparative evaluation of the antimicrobial effect of chamomile, Aloe vera-green tea, and chlorhexidine mouthwashes on some oral bacterial species.

Background: Plant compounds such as Aloe vera, green tea, and chamomile have been increasingly used in recent years to achieve oral health. This study aimed to determine the antimicrobial effect of chamomile (Matrika), A. vera-green tea, and chlorhexidine (CHX) mouthwashes on some oral bacterial species. Materials and Methods: This prospective experimental study investigated the antimicrobial properties of three mouthwashes, including chamomile (Matrika), A. vera -green tea, and CHX as well as distilled water as control on five bacterial species, including Streptococcus Oralis, Streptococcus sanguis, and Streptococcus mutans as primary colonizers and Porphyromonas gingivalis and Eikenella corrodens as secondary colonizers. Colony-forming unit was used to count the colonies and disc diffusion and well diffusion methods were used to measure the diameter of zone of inhibition. Data were analyzed by SPSS (version 22) software using descriptive statistics, ANOVA, Tukey, Kruskal-Wallis, and Mann-Whitney tests (α = 0.05). Results: CHX had a significantly higher antibacterial effect than the other two mouthwashes in all three methods (P < 0.001). Further, the herbal mouthwashes in all three methods had a statistically significant effect on the bacterial species (P < 0.001). A. vera-green tea mouthwash had a significantly higher effect than chamomile mouthwash (Matrika) on all bacterial species except for S. sanguis (P < 0.05). Conclusion: The findings showed that herbal mouthwashes had potentially antibacterial effects, but these effects were significantly lower than that of CHX. However, more clinical studies are needed to prove the current findings.

Comparative Evaluation of the Accuracy of Gingival Thickness Measurement by Clinical Evaluation and Intraoral Ultrasonography.

This study aimed to investigate the accuracy of gingival thickness measurement by two methods of clinical evaluation and intraoral ultrasonography. The gingival thickness was measured in the midbuccal area of the right maxillary lateral incisor and first molar teeth in 30 individuals. For clinical measurement, a #15 K-file with rubber stops was vertically inserted 2 mm apical to the gingival margin and the length of the file in the tissue was measured using a digital caliper. Ultrasonographic measurement was performed using an intraoral probe on the gingival surface in the midbuccal area, at the entry point of the file. Statistical analysis was performed by paired t-test, correlation coefficient, and receiver operating characteristic (ROC) curve (α = 0.05). In the anterior region, the mean gingival thicknesses using ultrasonography (1.517 ± 0.293 mm) and clinical evaluation (1.610 ± 0.272 mm) were not significantly different (p = 0.434). In the posterior region, the mean gingival thicknesses were significantly different between ultrasonography (1.372 ± 0.442 mm) and clinical evaluation (1.626 ± 0.310 mm) (p = 0.006). The area under ROC curve values for ultrasonographic measurements in the anterior and posterior regions were 0.681 and 0.597, respectively. The use of ultrasonography with an intraoral probe has acceptable accuracy for the determination of gingival thickness, especially for the anterior regions.

Efficacy of Acellular Dermal Matrix in Soft Tissue Augmentation Around Dental Implants: A Systematic Review and Meta-Analysis.

This study was done to perform a systematic review and meta-analysis of the studies on the efficacy of acellular dermal matrix (ADM) in increasing the soft tissue thickness (STT) and keratinized mucosal width (KMW) around dental implants. The PubMed, Scopus, Cochrane, Web of Science, and ProQuest databases were searched by July 2020 to retrieve relevant studies. Depending upon the heterogeneity of included studies, the weighted mean difference (WMD) with 95% CI was calculated using either fixed or random-effects model. Based on the meta-analysis of 6 studies, the effect of ADM on STT and KMW was significant (WMD: 1.07 [95% CI: 0.34-1.79], P = .004, and WMD: 1.99 [95% CI: 0.88-3.09], P < .001, respectively). Further, a comparison between the efficacy of the ADM and the control group, which included the autogenous soft tissue augmentation techniques, showed no statistically significant differences between groups (STT: WMD: 0.24 [95% CI: -0.26 to 0.74], P = .161 and KMW: WMD: -0.23 [95% CI: -0.68 to 0.22], P = .324). The subgroup analysis showed that simultaneous augmentation and implant placement were increased by 0.23 mm in the KMW, and the placement of ADM around loaded implants caused 0.5 mm decrease in the KMW, which was not statistically significant. Accordingly, it is possible to substitute ADM for soft tissue augmentation around dental implants.

LEVELS OF SMOKING AND PERI­IMPLANT MARGINAL BONE LOSS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

AIM: This systematic review and meta-analysis sought to determine if there was a significantly enhanced risk of peri­implant marginal bone loss (MBL) due to the increased number of cigarettes smoked per day. MATERIALS AND METHODS: Six databases, including Medline, Embase, Cochrane Library, Web of Science, Scopus, and ProQuest, were searched until February, 2021. The search terms "dental implant, oral implant, smoking, smoker, non-smoker, marginal bone loss and crestal bone loss" were used in combination to seek the articles providing data for MBL related to the smoking habit. Articles were excluded if the quantity of cigarettes smoked per day was not reported. Random-effects meta-analyses were used to pool the estimates of mean difference (MD) with 95% confidence intervals (CI). RESULTS: Eight studies were included for qualitative and 5 for quantitative synthesis. The meta-analyses revealed higher levels of MBL in patients who smoked <10 or >10 cigarettes/day than in non-smokers (<10: (MD -0.33, 95% CI -0.69-0.03 and >10: MD -0.58, 95% CI -0.96- -0.19). There was a significant risk of MBL between patients who smoked >10 and <10 cigarettes/day (MD -0.23, 95% CI -0.47-0.01). CONCLUSION: It seems the risk of MBL is steadily increasing as daily smoking increases.

Evaluating systemic administration effect of propranolol on osseointegration around titanium implants: A histomorphometric study in dogs.

Background: Dental implants are known as a widely accepted and predictable method to replace missing teeth. Many factors, including using a class of drugs, such as ß-blockers, can improve the osseointegration of dental implants. This study aimed to investigate the relationship between administrating propranolol and osseointegration in dental implants. Materials and Methods: This experimental animal study was performed on four native male street dogs of 11-13 kg of weight and 16-20 months of age. The specimens underwent teeth extraction. After that, the dogs were randomly divided into two groups. The first group contains two control dogs which would receive oral saline. The second contains two dogs which would receive oral tablets of propranolol daily. After a period of healing, three titanium implants were inserted in each of speciments' left mandibular quadrant, and treatment was resumed with propranolol and saline administration in case and control group, respectively. After 4 weeks, one of control group dogs and one of case group were anesthetized, and dental implants were removed alongside the peripheral bone marrow using a trephine drill. Meanwhile, the other two dogs (1 control and 1 propranolol administered dogs) were anesthetized after 9 weeks of implant placement, and the same procedure was carried out. Results: Due to the histomorphometric assessment, the mean score of bone implant contact (BIC) in week 4 was significantly higher in case group compared to control one (68.33% vs. 20.22%). In week 9, the mean BIC score was higher in case group compared to control group (68.60% vs. 50.17%); meanwhile, in contrast to week 4, it was not statistically significant. In both case and control groups, the formation of woven and lamellar bone was more significant in week 4 rather than week 9. Conclusion: Administration of systemic ß-blockers can improve dental implants osseointegration process.

Comparative evaluation of microRNA-155 expression level and its correlation with tumor necrotizing factor α and interleukin 6 in patients with chronic periodontitis.

Background: MicroRNAs are a class of small noncoding ribonucleic acids that perform a critical role in adjustment of gene expression. miRNAs-155 (miR-155) participates in controlling inflammation. Periodontitis is defined as inflammatory disorder of tissues surrounding the teeth. In this study, the expression levels of miR-155 and its target genes, tumor necrotizing factor alpha (TNF-α), and interleukin-6 (IL-6) were evaluated in a group of Iranian patients. Materials and Methods: This sectional study was performed on 10 healthy controls and 10 individuals with chronic periodontitis by means of polymerase chain reaction (PCR) test. For each individual, clinical parameters including probing depth and clinical attachment loss and blood samples were measured. Levels of miR-155, TNF-α, and IL-6 were quantified using real-time PCR (α=0/05) and the results were analyzed by Mann-Whitney U test. Results: The level of miR-155 was significantly higher in patients with chronic periodontitis (P < 0.001). A positive correlation was observed between the level of miR-155 and clinical parameters (P < 0.05). Level of miR-155 in tissue samples was correlated with blood samples although the expression level was higher in blood samples. Conclusion: As the expression level of miR-155, TNF-α, and IL-6 genes was higher in subjects with chronic periodontitis than healthy individuals, it might suggest a role for miR-155 in patients with chronic periodontitis.

Effect of leukocyte and platelet-rich fibrin on free gingival graft healing: A clinical and histological study in rabbits.

Background. Recently, the use of leukocyte- and platelet-rich fibrin (L-PRF) has been recommended due to the presence of various growth factors to increase the success of free gingival grafts (FGG). This study evaluated the effect of using L-PRF in the healing of FGG in rabbits. Methods. Twenty rabbits were randomly divided into two groups. In each group, FGG was performed in two separate sites with or without L-PRF. One of these groups was sacrificed on the 7th day and the other on the 28th day and analyzed in terms of clinical indices, including wound healing, gingi-val thickness (GT), and keratinized tissue width (KTW). Then histologic sections were obtained and stained for type and degree of inflammation and rate of vascular formation analysis. SPSS 22 was used for statistical analysis. Results. The extent of changes in GT, KTW, wound healing index, and vascular formation between the test and control groups was not statistically significant. The difference in the type of inflammation was significant only between the -7day and -28day control groups (P=0.003). The degree of inflammation between the -7day test group and the -28day control group, as well as the -7day and -28day control groups, were statistically significant (P=0.011 and P=0.002, respectively). Conclusion. Using L-PRF with FGG could improve FGG healing compared to using FGG alone, but the results were not statistically significant.

Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis.

INTRODUCTION: Evaluation of detailed features of the supporting bone is an important step in diagnosis and treatment planning for teeth with clinical attachment loss. Fractal analysis can be used as a method for evaluating the complexity of trabecular bone structures. The aim of this study was to evaluate the trabecular bone changes in periapical radiographs of patients with different stages of periodontitis using fractal analysis. METHODS: This comparative cross-sectional study was performed on patients with and without clinical attachment loss in mandibular first molars. Teeth with clinical attachment loss were divided into mild, moderate, and severe periodontitis groups. Digital periapical radiographs were obtained from the mandibular first molars using the same exposure parameters. DICOM file of the radiographs was exported to ImageJ software for fractal analysis. Three regions of interest (ROIs) were considered in each radiograph: two proximal ROIs mesial and distal to the mandibular first molar and one apical ROI. Fractal dimension (FD) values were calculated using the fractal box counting approach. Statistical analysis was performed using the chi-square test, Mann-Whitney test, intraclass correlation coefficient, and ANOVA (α = 0.05). RESULTS: FD values were significantly different between moderate and severe periodontitis and healthy periodontal bone (P < 0.05), except for the distal ROI for moderate periodontitis cases (P=0.280). However, FD values of the supporting bone in periodontally healthy teeth and teeth with mild periodontitis did not show a statistically significant difference (P > 0.05). CONCLUSION: Fractal analysis is a useful tool for evaluation of bone alterations in moderate and severe periodontitis, but was not able to detect the most initial radiographic bone signs of mild periodontitis.

The -592C>A variation of IL-10 gene and susceptibility to chronic periodontitis: A genetic association study and in-silico analysis.

OBJECTIVES: Chronic periodontitis (CP) is a common inflammatory disorder with a considerable impact of genetic variations in the interleukin family on predisposition to this disease. This study aimed to investigate the association between the -592C>A polymorphism of the interleukin 10 (IL-10) gene with CP risk in an Iranian population. This experimental study was followed by a meta-analysis and in silico examination. METHODS: In a case-control study, 270 subjects, including 135 patients with CP and 135 healthy controls, were enrolled. The -592C>A genotyping was performed using the PCR-RFLP method. In the meta-analysis, valid databases were systematically searched to identify relevant studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were computed to examine the association between -592C>A and CP. In silico analysis was conducted using bioinformatics tools to evaluate the impact of the -592C>A polymorphism on IL-10 gene function. RESULTS: Our case-control study revealed a significant association between polymorphism and CP risk. Overall, we found significant associations between -592C>A genetic variation and CP and stratified meta-analysis. In silico analysis revealed that this polymorphism could change the pattern of the transcription binding site upstream of the IL-10 gene. It may also alter the hsa-miR-101-3p miRNA-targeted sequence upstream of IL-10. CONCLUSIONS: Based on our results, the -592C>A variation in IL-10 may be a genetic risk factor for susceptibility to chronic periodontitis. However, further studies in different ethnicities and results adjusted for clinical and demographic characteristics are needed to obtain more accurate deductions.

Effect of systemic administration of omeprazole on osseointegration around titanium dental implants: A histomorphometric study in dogs.

BACKGROUND: Dental implants are widely accepted substitutes for replacing missing teeth. Many factors, including the use of specific drugs such as proton-pump inhibitors (PPIs) (omeprazole), can affect the success of dental implantations. The aim of this study was to investigate the relationship between the use of omeprazole and osseointegration of dental implants. MATERIALS AND METHODS: This experimental animal study was performed on eight native male dogs weighted 11-13 kg and aged 16-20 months. The dogs were divided into two groups (receivers and nonreceivers of omeprazole). After extraction of mandibular teeth, treatment was started randomly with the administration of omeprazole and saline. After a 2-month recovery period, six titanium implants were placed in the jaws of all dogs and the administration of omeprazole was continued for 2 weeks. After 4 and 12 weeks, the dogs were anesthetized and dental implants with their bone marrow were removed. The samples were examined histomorphometrically to determine osseointegration. Data were analyzed with two-way ANOVA test for 95% confidence interval. The P value was set at 0.05. RESULTS: In the microscopic examination of the samples in week 4, the levels of bone-implant contact (BIC) in the study group were significantly lower than the control group (46.37 vs. 64.37%). In 12 weeks, BIC was significantly lower than that of the control group (67.33 vs. 82.00%). The type of bone formed in week 4 in both the groups was more woven, and in the 12th week, it was mostly lamellar. CONCLUSION: Systemic administration of PPIs may interfere with osseointegration of dental implants.

Comparison of intraoral digital radiography and cone-beam computed tomography in the measurement of periodontal bone defects.

BACKGROUND: Periodontal disease has a high prevalence in many countries. Thus, the early detection of periodontal disease is important in order to obtain the most appropriate treatment plan to prevent tooth loss, and subsequently, to maintain the patient's general health. OBJECTIVES: The aim of this study was to compare the accuracy of cone-beam computed tomography (CBCT) and intraoral parallel digital radiography in measuring the dimensions of periodontal bone defects. MATERIAL AND METHODS: In this in vitro study, 236 periodontal bone defects were artificially created in dry human mandibles using a burr. Defects included horizontal, one-, two-, and three-wall defects, craters, dehiscences, and fenestrations. Intraoral digital radiographs were obtained using the parallel technique with photostimulable phosphor plates (PSP) and CBCT scans were performed. Two calibrated observers evaluated the images and measured the dimensions of the defects. Clinical probing was performed and considered as the gold standard. The measurements of digital radiography and CBCT were compared to those achieved by probing to evaluate their accuracy. RESULTS: Cone-beam computed tomography had a significantly stronger correlation with the gold standard than intraoral parallel digital imaging. In the total assessment of the periodontal defects, the intraclass correlation coefficient (ICC) was calculated at 0.93 for CBCT-probe and at 0.78 for PSP-probe (p < 0.05). CONCLUSIONS: The accuracy of CBCT was superior to that of intraoral digital radiography for measuring horizontal, one-, two-, and three-wall defects, craters, dehiscences, and fenestrations.

Comparative Evaluation of the Effects of CO2 and Er:YAG Lasers on Smear Layer Removal and Blood Cell Attachment to Tooth Root Surfaces.

Introduction: The tooth root surfaces are modified by different agents for better removal of the smear layer, the formation of fibrin clots, and the attachment of blood cells. This in vitro study compared the removal of the smear layer, the formation of fibrin clots and the attachment of blood cells after exposing periodontally compromised root surfaces to ER:YAG and CO2 laser beams. Methods: Eighteen dentin block samples were prepared from freshly extracted periodontally compromised teeth that were deemed hopeless, and they were divided into 3 groups: exposed to Er:YAG laser beams, exposed to CO2 laser beams, and the control group. The samples were evaluated using scanning electron microscopy and micrographs were taken. Smear layer removal and blood cell attachment were scored. Data were analyzed using Kruskal-Wallis and MannWhitney tests. Results: In the Er:YAG laser group, the smear layer was removed completely. In the specimens exposed to blood, better fibrin clot formation and blood cell attachment were observed in the Er:YAG laser group. In the CO2 laser group, the smear layer was also removed; however, there were no significant differences between the CO2 laser and control groups in fibrin clot formation and blood cell attachment. Conclusion: The application of the Er:YAG laser to the root dentin appears to result in the formation of a suitable surface for fibrin clot formation and blood cell attachment. Further clinical studies are necessary to support these results.

Levels of smoking and dental implants failure: A systematic review and meta-analysis.

AIM: The present systematic review and meta-analysis was performed to investigate if there was a significantly enhanced risk of dental implant failure due to the increased number of cigarettes smoked per day. MATERIALS AND METHODS: Four databases, including PubMed, Embase, Web of Science and Scopus, were searched until January, 2019. The search terms "dental implant, oral implant, smoking, smoker, tobacco, nicotine and non-smoker" were used in combination to identify the publications providing data for dental implant failures related to the smoking habit. Publications were excluded if the quantity of cigarettes consumed per day was not reported. Fixed- or random-effects meta-analyses were used to pool the estimates of relative risk (RR) with 95% confidence intervals (CI). RESULTS: Having additional information supplied by the authors, 23 articles were selected for final analysis. The meta-analyses based on implant- and patient-related data showed a significant increase in the RR of implant failure in patients who smoked >20 cigarettes per day compared with non-smokers (implant based: p = .001; RR: 2.45; CI: 1.42-4.22 and patient based: p < .001; RR: 4; CI: 2.72-5.89). CONCLUSION: The risk of implant failure was elevated with an increase in the number of cigarettes smoked per day.

Evaluation of salivary calcium, phosphorus and alkaline phosphatase concentrations before and after the first phase of periodontal treatment in patients with chronic periodontitis.

Background: Evaluation of salivary biomarkers is a non-invasive, convenient, and economical method for diagnosing many diseases. Evidence shows that salivary biomarkers and periodontal disease might be correlated. This study was conducted to evaluate phase I periodontal therapy's effect on salivary concentrations of calcium, phosphorous, and alkaline phosphatase (ALP). Methods: In this descriptive, analytical study, 16 patients were selected from those referred to the Department of Oral Medicine, Faculty of Dentistry, Isfahan University of Medical Sciences, using convenience sampling. Salivary samples were collected using the drooling method. The salivary concentrations of calcium, phosphorous, and ALP were measured immediately after saliva collection, before the first phase of periodontal therapy and one month later, using a colorimetric assay. The data were analyzed with SPSS using paired t-test. P<0.05 was considered statistically significant. Results: The salivary concentrations of calcium, phosphorous, and ALP were 6.68, 20.57, and 48.31 mg/dL, respectively, before and 7.15, 22.51, and 40.37 mg/dL, respectively, after phase I periodontal therapy. There were no significant differences between the salivary levels of calcium, phosphorous, and ALP before and after phase I periodontal therapy (P>0.05). Conclusion: This study revealed that the salivary concentrations of calcium, phosphorous, and ALP remained relatively unchanged after phase I periodontal therapy.

Comparative evaluation of the cortisol level of unstimulated saliva in patients with and without chronic periodontitis.

BACKGROUND: Chronic periodontitis (CP) is one of the most prevalent diseases of the oral cavity with various biological and behavioral risk factors. We aimed to evaluate the association between the salivary cortisol level (SCL) of unstimulated saliva and CP in patients referred to Isfahan Dental Faculty. MATERIALS AND METHODS: In this analytic cross-sectional study, 90 patients were selected based on the presence of periodontitis and were divided into two groups: with periodontitis and without periodontitis (n = 45). First, by evaluating the level of anxiety with Spielberger State-Trait Anxiety Inventory questionnaire, each group was divided into three subgroups, each containing 15 persons. To measure the SCL in all subgroups by the enzyme-linked immunosorbent assay method, saliva samples were collected with unstimulated spitting method between 9 and 11 AM. Periodontal evaluation was done using the mean probing depth (PD), plaque index, and bleeding on probing. The obtained data were analyzed using SPSS software (version 20, IBM Corp., Armonk, N.Y., USA) and analysis of variance, independent t-test, Chi-square, Mann-Whitney, Spearman correlation, and Pearson correlation coefficient tests (α = 0.05). RESULTS: The mean level of salivary cortisol (P = 0.048) and PD (P = 0.009) in patients with periodontitis was significantly higher than those without periodontitis. There was a direct and meaningful correlation between PD and SCL (P < 0.001, r = 0.363). In both groups of participants with (P < 0.001) and without periodontitis (P < 0.001), the mean SCL in patients with high anxiety was significantly more than patients with medium and low anxiety. CONCLUSION: Our results showed that there is an increased level of salivary cortisol (as anxiety index) in patients with CP. Therefore, it seems that the probability of the occurrence of periodontitis is higher in those with increased cortisol level.

Evaluation of Effect of Low-Dose Methotrexate on Osseointegration of Implants: A Biomechanical Study on Dogs.

BACKGROUND: Methotrexate (MTX) is an immunosuppressive drug, widely used in inflammatory disturbances including rheumatoid arthritis. However, there is no consensus regarding the effect of MTX on implant osseointegration. OBJECTIVE: The purpose of this experimental study was to investigate the effect of low dose MTX on Bone-Implant Contact (BIC) of dogs. METHODS: Six mandibular premolar teeth (bilateral) of 8 mature dogs were extracted. After 3 months of healing, 6 implants (bone level, resorbable blast media surface) were inserted into the mandible of each dog (3 in each side). Dogs were randomly divided into a study group (receiving 2.5 mg/week MTX orally, 3 times per week for 4 weeks) and a control group each containing 4 dogs. In the 1st week, postoperative BIC was evaluated in 4 dogs, two from each group. In the 4th week, reverse torque and BIC were evaluated in the remaining 4 dogs. Data were analyzed with two-way ANOVA test for 95% confidence interval. RESULTS: The reverse torque test of the 4th week, showed a satisfying osseointegration. Histopathologic evaluation revealed that the BIC was significantly higher in the control group in comparison to the MTX group in the 1st and 4th week. In addition, the BIC of both groups were significantly increased in the 4th week in comparison to the 1st week in both groups. CONCLUSION: MTX has the potential to interfere with osseointegration process.

Comparison of Er:YAG Laser and Ultrasonic Scaler in the Treatment of Moderate Chronic Periodontitis: A Randomized Clinical Trial.

Introduction: Periodontitis is an inflammatory periodontal disease that leads to tooth loss. Recently laser has been introduced as an alternative treatment for periodontitis. The aim of the present study was to compare the effect of Erbium-doped Yttrium Aluminum Garnet (Er:YAG) laser with ultrasonic scaler in patients with moderate chronic periodontitis. Methods: In this randomized single-blind clinical trial, 27 patients with moderate chronic periodontitis were selected. One quadrant of the patients was treated by Er:YAG laser and the other one by ultrasonic scaler. Clinical parameters, including periodontal pocket depth (PPD), papillary bleeding index (PBI) and clinical attachment level (CAL) were measured before, as well as 6 and 12 weeks after treatment. Data were analyzed by SPSS 20 software using Friedman test, paired t test, independent t test and Mann-Whitney test. The significance level was set at 0.05. Results: The means of clinical parameters in both groups were significantly improved in the first and second follow-ups (P < 0.001). Although the means of PPD, PBI and CAL were slightly higher in the laser group than in the ultrasonic group, the differences were not statistically significant between these two groups (P > 0.05). Conclusion: Although both ultrasonic scaler and Er:YAG laser could effectively improve clinical periodontal parameters, the results did not reveal the superiority of Er:YAG laser over ultrasonic scaler or vice versa.