Novel use of chloro-aluminum phthalocyanine assisted photodynamic therapy helps in periimplant healing among smoking patients.

AIMS: To evaluate the clinical and biochemical peri­implant parameters using chloro­aluminum phthalocyanine-(CAP) mediated antimicrobial photodynamic therapy (PDT) as an adjunct to non-surgical mechanical debridement (NSD) in cigarette smokers (CS) and never-smokers (NS) with peri­implantitis. MATERIALS AND METHODS: Thirty-two patients with peri­implantitis [Group CS - 16 and Group NS - 16] were recruited for the trial. The study participants underwent two therapies: PDT + NSD and NSD alone. The clinical peri­implant parameters assessed in this clinical trial were bleeding on probing (BP), crestal bone loss (CBL) peri­implant pocket depth (PD), and peri­implant plaque scores (PS), respectively. Peri-implant crevicular fluid was sampled and the quantification of interleukin (IL)-1ß and tumor necrosis factor-alpha (TNF-α) was performed using enzyme linked immunosorbent assay (ELISA). RESULTS: BP was significantly reduced at 6 months after PDT+NSD in CS groups. Mean PD significantly reduced after both PDT+NSD and NSD subgroups within both NS and CS groups. Only at 6 months did PDT+NSD showed statistically significantly reduced IL-1ß levels in the NS group. TNF-α levels significantly reduced in CS group with PDT+NSD and NSD alone at both 3 months and 6 months follow up. CONCLUSION: CAP-assisted PDT helped to improve the clinical and cytokine levels after non-surgical peri­implant mechanical debridement in treating peri­implantitis patients in smokers.

Effect of different preparation designs and all ceramic materials on fracture strength of molar endocrowns.

OBJECTIVE: The aim was to compare the fracture strength of Molar endocrowns fabricated from different all-ceramic materials and various preparation designs. MATERIALS AND METHODS: Ninety extracted human molar teeth were root canal treated and randomly divided into three groups according to the all ceramic materials used for fabrication of the endocrowns (n = 30): (1) Lithium disilicate (IPS e.max Press); (2) Polymer infiltrated ceramic (Vita Enamic); (3) High translucency zirconia (Ceramill Zolid HT). Each group was subdivided into 3 subgroups (n = 10) according to the preparation design as 2 mm occlusal reduction, 4.5 mm occlusal reduction, and 4.5 mm occlusal reduction with 2 mm radicular extension. The endocrowns from each material were fabricated and surface treated according to the manufacturer's recommendations. After cementation with self-adhesive resin luting cement, the specimens were stored in a humid environment for 72 hours and subsequently subjected to 5000 thermal cycles. After, a compressive, static-axial load was applied using a universal testing machine until failure. Load-to-failure was recorded (N) and the specimens were examined under a stereomicroscope to determine the failure type. The data was statistically analyzed using One-way ANOVA and Tukey HSD tests at p < 0.05. RESULTS: The Lithium Disilicate endocrowns recorded the higher mean fracture strength for 4.5 mm occlusal thickness and 2 mm radicular extension at 3770.28 N and 3877.40 correspondingly. The High translucency zirconia endocrowns at conventional 2 mm thickness showed the highest mean fracture load (3533.34 N). Even though polymer infiltrated ceramic endocrowns displayed comparatively lesser fracture load; they recorded the predominantly favorable fractures. CONCLUSIONS: Increased occlusal thickness showed a significant improvement in fracture strength of lithium disilicate and polymer infiltrated ceramic molar endocrowns. Although the 2 mm radicular extension had the substantial enhancement of fracture strength in high translucency zirconia, it resulted in more unfavorable failure types.