Effect of Air Polishing on the Treatment of Peri-Implant Diseases: A Systematic Review and Meta-Analysis.

Peri-implant diseases have become one of the notable biological complications of postrehabilitation with implant-supported restorations. Effective modalities for decontamination of biofilm deposits around implant surfaces are critical for resolution of the inflammation. Air polishing is one of the recommended clinical methods for treating peri-implant diseases. This systematic review assessed clinical evidence on efficacy of using air polishing technology for the management of peri-implant diseases, including peri-implant mucositis and peri-implantitis. Four electronic databases from January 1990 to December 2022 were searched to identify the relative human randomized clinical trials that applied air polishing for nonsurgical and surgical treatment of peri-implant mucositis and peri-implantitis. Twelve articles were selected. For treating peri-implant mucositis, air polishing showed a comparable effect to ultrasonic scaling in the reduction of bleeding on probing (BOP) and probing pocket depth (PPD). The nonsurgical approach of air polishing in treating peri-implantitis varied in the reduction of BOP, PPD, and clinical attachment level (CAL) in evaluated studies. Air polishing in the surgical treatment of peri-implantitis was comparable to mechanical cleaning, implantoplasty, and the use of Ti-brush, in regards to the significant reduction of BOP, PPD, and CAL, as well as the improvement of the bone level between baseline and follow-ups. The standardized mean difference with a 95% confidence interval of the studied parameters was estimated using the random effect model; however, statistical differences were not detected between air polishing and comparative modalities in the treatment of peri-implantitis. Within the limitations of this review, the application of air polishing did not result in more favorable outcomes in the treatment of peri-implant diseases compared to other modalities.

Management of Cyclosporine-Influenced Gingival Enlargement With Azithromycin.

INTRODUCTION: Management of drug-influenced gingival enlargement is challenging, and surgery is most often indicated. However, because of a unique mechanism of action, azithromycin helps in the management of gingival enlargement caused by cyclosporine. An incidental observation of the effect of azithromycin in the cyclosporine-influenced gingival enlargement by physicians in 1995 led to series of basic investigations and clinical trials confirming this observation and providing a non-surgical treatment modality. CASE PRESENTATION: In this report, successful management of cyclosporine-influenced gingival enlargement in a 39-year-old renal transplant patient with the use of azithromycin without any surgical intervention is presented. CONCLUSION: Use of azithromycin for managing cyclosporine-influenced gingival enlargement is a useful alternative or adjunct to surgical management. It is hoped that this report will raise further awareness of this non-surgical modality in patients taking cyclosporine.

Reporting Quality of Randomized Controlled Trials of Periodontal Diseases in Journal Abstracts-A Cross-sectional Survey and Bibliometric Analysis.

OBJECTIVE: Randomized controlled trials (RCTs) by proper design, conduct, analysis, and reporting provide reliable information in clinical care. Reporting of RCT abstracts is of equal importance as there is evidence that many clinicians will change their clinical decisions based on RCT abstracts. The reporting quality of RCT abstracts has been suboptimal. It is not clear whether the reporting quality is related to the journal metrics. The main objective of this study is to conduct a cross-sectional survey to evaluate the reporting quality of RCTs of periodontal diseases in journal abstracts and to perform a bibliometric analysis. The null hypothesis was that there is no association between the journal metrics (5-year impact factor, Eigenfactor score, and Article Influence Score), abstract metrics (word count, and number of authors), journal endorsement of Consolidated Standards of Reporting Trials (CONSORT), and the overall quality of reporting of CONSORT RCT abstract-modified checklist questions. MATERIALS: CONSORT RCT abstract extension checklist with explanation and elaboration was used and modified to assess the quality of reporting of RCT abstracts of periodontal diseases in the journal abstracts in the year 2012. Bibliometric analysis of journal metrics (5-year impact factor, Eigenfactor score, and Article Influence Score) and abstract metrics (number of authors and abstract word count), the geographic distribution, and the CONSORT-endorsing journal abstracts was compared with the reporting quality of RCT abstracts in periodontal diseases. Calibration and intrarater agreement were done before the data collection and analysis. A second reviewer was consulted for independent evaluation and clarification as needed. For descriptive analysis, the values of continuous variables were expressed as median and interquartile ranges (IQRs) and as proportion percent for binary categorical variables. For association analysis between the binary (yes/no) response variable and the continuous variable, the Mann-Whitney test (for independent samples) was used. For examining the association between 2 categorical variables, Fisher's exact test was used. The chi-square test was performed to examine the association between 2 sets of binary response variables (yes/no). A P value of < .05 was considered statistically significant. All analyses were conducted using SAS, version 9.4. RESULTS: A total of 198 RCT abstracts of periodontal diseases in the year 2012 from 57 journals were included in the study. Fifteen journals, listed as endorsers of CONSORT, contributed 108 RCT abstracts. Four journals (Journal of Periodontology, Journal of Clinical Periodontology, Clinical Oral Implants Research, and European Journal of Oral Implantology) contributed 84 of 198 RCT abstracts in 2012. European countries contributed the majority (n = 81, 40.91%) of RCT abstracts. Among 31 countries in this study, United States contributed the most RCTs (n = 28, 14.14%) followed by India (24, 12.12%), Italy (n = 22, 11.11%), and Brazil (n = 20, 10.1%). The frequency of journal metrics were 5-year impact factor (median 2.316; IQR: 1.439-2.970); Eigenfactor score (0.00474; 0.00202-0.01395); and Article Influence Score (0.553; 0.382-0.755). The number of authors in 198 RCT abstracts ranged between 2 and 20 (median n = 5, IQR: 4-6), whereas the word count ranged between 48 and 569 (median 235, IQR: 205-269). All RCT abstracts reported the experimental interventions (checklist question #5, frequency 100%). Some items were almost always reported-participant eligibility criteria (#3, 99%); comparison interventions (#6, 99.5%); specific objective or hypothesis (#7, 99.5%); primary outcome (#8, 99.5%); and reporting trial results as a summary (#16, 98.5%). All RCT abstracts never reported how the allocations were concealed (#11, 0) and the source of funding for the trials (#23, 0). Some items were almost always never reported-the number of participants included in the analysis for each intervention (#15, 2%); trial registration number (#21, 2.5%); name of trial register (#22, 2.5%); and how the randomization or sequence generation was done (#22). Dismal reporting was noted in many checklist questions including the identification of the study as randomized in the title #1, 51%; design of the trial #2, 32.8%; trial setting #4, 3.5%; randomization #10, 3.5%; blinding #12, 21.7%; details about blinding #13, 8.1%; number of participants randomized to each intervention #14, 26.3%; effect size #17, 13.6%; precision of the estimate of the effect #18, 6.1%; and adverse effects #19, 14.1%. Strikingly, there was a very high reporting of statistical significance #25, 92.4%. European countries, in particular, reported relatively better than other countries in essential questions such as #17 effect size reporting, and #18 precision (uncertainty), which have been largely unreported by rest of the countries. Finally, despite the majority of RCTs published in 2012 were by CONSORT-endorsing journals, there was no difference in the quality of reporting in majority of checklist items when compared with journals not listed as CONSORT endorsers. With few exceptions, there was no statistically significant association between the majority of the CONSORT RCT abstract checklist questions and the journal metrics and abstract metrics analyzed in this study. Unexpectedly, lower ranking journals in journal metrics reported certain essential checklist questions relatively better. CONCLUSION: The reporting quality of RCT of periodontal diseases in the journal abstracts published in 2012 needs substantial improvement. These items have been laid out in this study to help all stakeholders-authors, clinicians, researchers, peer reviewers, journal editors, and publishers to take note and help with the improvement of the same. Despite few significant associations in the bibliometric factors analyzed with better reporting, the results overall led to the failure to reject the null hypothesis that there is no association between the journal metrics, word count, and number of authors and the quality of reporting of CONSORT RCT abstract-modified checklist questions.

Full mouth rehabilitation of a young patient with partial expressions of ectodermal dysplasia: a clinical report.

Ectodermal dysplasia (ED) is a hereditary disorder characterized by the abnormal development of specific tissues and structures of ectodermal origin. This clinical report describes the multidisciplinary approach to the diagnosis and treatment of a 24-year-old patient with partial expression of ED. The treatment plan used dental implants to support fixed prostheses and ceramic restorations to establish acceptable esthetics and provide function.

A multidisciplinary approach for the rehabilitation of a patient with an excessively worn dentition: a clinical report.

This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient with a severely worn dentition. The treatment included osteotomy and immediate implant placement and loading in the mandible. The definitive restorations were implant- and tooth-supported metal ceramic restorations. These restorations were fabricated with metal occlusal surfaces at an increased occlusal vertical dimension, which provided acceptable esthetics and function.

Osteonecrosis of the jaw after implant surgery in patients treated with bisphosphonates--a presentation of six consecutive cases.

BACKGROUND: Osteonecrosis of the jaws in patients treated with bisphosphonates is mostly associated with intravenous bisphosphonates while the incidence associated with oral bisphosphonates is not significant. PURPOSE: The purpose of this paper is to describe a series of cases of jaw osteonecrosis that may be associated with dental implant placement in patients who had taken nitrogen containing bisphosphonates via oral and/or intravenous route. PATIENTS: Six female patients were treated for osteonecrosis of the jaw after implant placement. An average age was 71.8 ± 6.5 years old and they had a history of bisphosphonate use. Two patients suffered from cancer and the other patients had osteoporosis. Two osteoporosis patients had taken only oral bisphosphonate and the other patients received intravenous bisphosphonates. RESULTS: Resection of necrotized bone, implant removal, and primary closure were performed in five patients and four patients showed uneventful healing. One patient presented recurrence at the maxilla and underwent further extraction and resection. One patient presented with an exposure of the bone after implant placement was treated with an advanced flap closure, and the implants were preserved. CONCLUSION: Unusual jaw necrosis after dental implant surgery might be related with oral and/or intravenous bisphosphonates. Wide resection of necrotic bone, collagen graft, and primary closure are key factors for successful healing.

Implant treatment planning: endodontic considerations.

Implants are a predictable and effective method for replacing missing teeth. Some clinicians have advocated extraction and replacement of compromised but treatable teeth on the assumption that implants will outperform endodontically and/or periodontally treated teeth. However, evidence shows that conventional therapy is as effective as implant treatment. With data on implants developing complications long term and a lack of predictable treatment for peri-implantitis, retaining and restoring the natural dentition should be the first choice when possible.

Immediate free iliac bone graft after nonsegmental mandibular resection and delayed implant placement: a case series.

BACKGROUND: Resection of mandibular tumors without proper reconstruction may lead to unfavorable esthetic and function results. The purpose of this case series was to describe clinical results and a technique to prevent tissue loss using nonvascular iliac grafts immediately following tumor resection and long-term stability of the implants. MATERIALS AND METHODS: Three female patients presented with oral neoplasms (2 ameloblastoma and 1 ossifying fibroma). The mandibular reconstruction was performed with nonvascularized iliac grafts simultaneous with tumor removal. Subsequently, 10 dental implants were placed 6 to 9 months after reconstruction and restored. Survival and success of the implants were evaluated. RESULTS: Marginal mandibulectomy in 1 patient and buccal bone resection in 2 patients was performed; the resection sites were reconstructed with an immediate nonvascularized iliac graft. All implants survived and were successful during follow-up periods between 44 and 105 months. Mean marginal bone loss of 10 implants was 0.09 mm. CONCLUSIONS: Immediate reconstruction with nonvascularized iliac grafts following tumor resection may be a viable treatment option for nonsegmental inlay osseous defects. In these case series, the resorption of the iliac bone was minimal after 6 to 9 months consolidation periods.

Subapical osteotomy to correct dental implant malpositioning and vertical ridge deficiency: a clinical report.

This clinical report describes a subapical osteotomy to correct vertical ridge deficiency and malpositioned maxillary anterior implants. A 37-year-old woman with a noncontributory medical history presented with the chief complaint of an unesthetic implant-supported prosthesis. The maxillary left central and lateral incisors were restored with metal ceramic restorations. Gingiva-colored porcelain was fabricated to compensate for severe vertical and horizontal soft tissue deficiency. The patient was dissatisfied with the esthetics associated with the restorations and soft tissues since she presented with a high smile line and gingival display. Under general anesthesia, a subapical osteotomy was performed. The implant and ridge segment was coronally repositioned to correct the ridge deficiency. The surgical procedure and postoperative healing were uneventful. The surgical outcome was stable for a follow-up period of 3 years. The subapical osteotomy provided a satisfactory clinical outcome in managing a severely deficient residual ridge and malpositioned maxillary anterior implants as an alternative treatment to other surgical approaches.

Dynamic therapeutic approach for individuals affected with aggressive periodontitis.

Management of patients affected with aggressive periodontitis is complicated by several poorly understood etiological and modifying factors that create difficulty in establishing a universal treatment recommendation. The goal of this manuscript is to underscore the complexity of therapy and to provide some guidelines in the decision-making process and interdisciplinary therapy. A dynamic approach is presented to formulate strategies in diagnosis and treatment planning that is both patient-and site-specific.