Histological examination of the effect of concentrated growth factor (CGF) on healing outcomes after maxillary sinus floor augmentation surgery.

A double-blind clinical trial was conducted to examine the effect of concentrated growth factor (CGF), a new generation of platelet derivatives, on the healing outcome of maxillary sinus floor augmentation during maxillary sinus lift surgery. The study included 9 patients referred to the Tabriz University, Faculty of Dentistry, aged 30-80 years, with bilateral posterior partial edentulous or edentulous maxilla who underwent the procedure using a split-mouth technique. After lifting the Schneiderian membrane, bovine xenograft was randomly applied on one side (for example, left maxillary sinus) and CGF on the other side (for example, right maxillary sinus). Results from alizarin red and hematoxylin-eosin staining methods showed that the percentage of bone formed in the CGF group (112.41±26.34% and 96.16±24.49%, respectively) was significantly higher than in the control group (64.99±24.96% and 60.16±16.39%, respectively) (P<0.05). In addition, after 6 months, the amount of residual graft material in the control group (xenograft) was significantly higher than in the CGF group (P<0.05). These findings demonstrate that the use of CGF during open sinus lift surgery is reliable for the placement of dental implants.

Effect of sterile tetracycline ophthalmic ointment as an adjuvant to mechanical debridement on the treatment of peri-implantitis: A randomized controlled clinical trial.

Background: Peri-implantitis is an infectious disease that affects the tissues around dental implants, with clinical signs of inflammation and irreversible loss of supporting bone. This study aimed to compare the effect of sterile topical tetracycline ophthalmic ointment as an adjuvant to mechanical debridement with mechanical debridement alone in the treatment of peri-implantitis. Methods: In this single-blind randomized clinical trial, 32 patients (16 patients in each group) with peri-implantitis were treated topically using sterile tetracycline ophthalmic ointment. Four clinical parameters, including modified bleeding index (mBI), modified plaque index (mPI), probing depth (PD), and clinical attachment level (CAL), were measured at baseline and at 3- and 6-month follow-up intervals. Results: PD reduction was statistically significant after 3 and 6 months in the test and control groups (P=0.001). Also, mPI and mBI reduction rates were significant in the test and control groups (P=0.001) after 3 and 6 months. However, in all the samples in the two groups, the mean of CAL before and after treatment was constant, with no significant difference (P>0.05). Conclusion: Using sterile ocular tetracycline ointment could be an adjunctive treatment in improving and enhancing the therapeutic effects of mechanical debridement in the treatment of peri-implantitis. (IRCT20210909052418N1).

Corrigendum to "Comparative Study on the Efficacy of Anorganic Bovine Bone (Bio-Oss) and Nanocrystalline Hydroxyapatite (Ostim) in Maxillary Sinus Floor Augmentation".

[This corrects the article DOI: 10.1155/2014/967091.].

Evaluation of the position of the posterior superior alveolar artery in relation to the maxillary sinus using the Cone-Beam computed tomography scans.

BACKGROUND: The aim of the present study was to evaluate the diameter, relationship and position of the posterior superior alveolar artery and its relationship with the alveolar ridge, the medial wall of the maxillary sinus, the prevalence of pathologic conditions and the maxillary sinus septa on CBCT images. MATERIAL AND METHODS: A total of 200 CBCT images (400 maxillary sinuses) of patients over 20 years of age were evaluated. The distances between the lower border of the artery and the alveolar crest and between the artery and the medial wall of the sinus and the diameter of the artery were measured. The position of the artery, the presence of pathologic conditions and septa were recorded in the posterior region in: a) males edentulous in the posterior region; b) males having teeth in the posterior region; c) females edentulous in the posterior region; and d) females having teeth in the posterior region. RESULTS: The mean distance between the artery and the alveolar crest, irrespective of groupings, was 16.17±1.63 mm, with significant differences between the groups (P<0.05). The mean distance between the artery and the medial wall of the sinus was 11.65±1.21 mm, with no significant differences between the groups (P=0.796). The mean diameter of the canal was 1.37±0.44 mm, with no significant differences between the 4 groups (P=0.570). The position of the artery was intraosseous in 73.2%, beneath the sinus membrane in 21.7% and external to the lateral wall of the sinus in 4.9% of the cases. The overall prevalence rates of pathologic conditions and septa in the maxillary sinus were 45.7% and 26%, respectively. CONCLUSIONS: CBCT technique is useful for such evaluations and for possible variations in maxillary sinuses and presence of septa and pathologic entities in maxillary sinuses. Key words:Maxillary sinus, maxillary artery, Cone-Beam computed tomography.

Clinical and Microbiological Effects of Photodynamic Therapy Associated with Non-surgical Treatment in Aggressive Periodontitis.

Background and aims. The aim of this study was to compare the effectiveness of adjunctive photodynamic therapy (PDT) in the treatment of aggressive periodontitis. Materials and methods. A total of 24 patients with clinical diagnosis of aggressive periodontitis received scaling and root planing (SRP) for periodontal treatment. In a split-mouth design study, the teeth of one quadrant of each arch with ≥4 mm of probing depth were selected randomly for additional treatment with PDT (test group). PDT was performed with a diode laser beam with a wavelength of 670-690 nm and a power of 75 Mw. The control group consisted of selected teeth of the contralateral quadrant (SRP only). Before any treatment, subgingival plaque samples were collected by an endodontic paper cone for microbiological analysis by real-time polymerase chain reaction (PCR) for detection of Aggregatibacter actinomycetecommitans. Clinical parameters including clinical attachment loss (CAL) as primary outcome, plaque index (PI), bleeding on probing (BOP), probing depth (PD) and gingival recession (REC) were measured at baseline and after 90 days. Inter-group and intra-group statistical analyses were performed. Results. Treatment groups showed an improvement in all the clinical parameters and a significant reduction in the counts of A. actinomycetecommitans at 90 days compared to baseline (P < 0.05). None of the periodontal parameters exhibited significant differences between the two groups (P > 0.05). Conclusion. Within the limitations of this study, the results did not show additional benefits from PDT as an adjunctive treatment for patients with aggressive periodontitis.

Comparative Study on the Efficacy of Anorganic Bovine Bone (Bio-Oss) and Nanocrystalline Hydroxyapatite (Ostim) in Maxillary Sinus Floor Augmentation.

Purpose. The aim of this study was to evaluate the efficacy of anorganic bovine bone (Bio-Oss) in comparison with nanocrystalline hydroxyapatite (Ostim) in sinus floor augmentation. Methods. Ten patients aged 40-80 were selected. All the patients needed sinus floor augmentation due to insufficient bone for simultaneous implant placement. The patients underwent panoramic radiography and cone beam computed tomography (CBCT) prior to surgical procedure. After lifting the sinus membrane, Bio-Oss and Ostim are randomly grafted at one of the two sides. Biopsies were obtained from areas identified 5 months after the surgery and before implant placement and then were prepared for histological analysis. Statistical analysis was performed with nonparametric Wilcoxon signed-rank test for comparison of histological and radiological parameters between the two groups. Results. Histological findings revealed a significant increase in percentages of new bone in the Ostim group (P = 0.015). Furthermore, new bone density was greater with Ostim compared to Bio-Oss (P = 0.038); however, the difference in height increase after surgery did not reach statistical significance (P = 0.191). Conclusion. Despite the limitations of this trial, Ostim and Bio-Oss are useful biomaterials in sinus augmentation and Ostim seems to be even more effective in new bone formation.

Efficacy of Subgingival Application of Xanthan-based Chlorhexidine Gel Adjunctive to Full-mouth Root Planing Assessed by Real-time PCR: A Microbiologic and Clinical Study.

BACKGROUND AND AIMS: The aim of this clinical investigation was to compare clinical and microbiological effectiveness of adjunctive CHX gel in the treatment of periodontitis. MATERIALS AND METHODS: Twenty-four subjects with localized or generalized moderate-to-severe chronic periodontitis underwent scaling and root planing. One tooth in each quadrant with a probing depth of >4 mm was chosen for combined gel and SRP, with contralateral tooth as control (SRP treated site). Clinical assessment was carried out at baseline and 1 and 3 months later; microbial assessment was performed by real-time PCR. Periodontal probing depth (PPD) was considered as primary outcome. RESULTS: Twenty patients completed the study. Baseline PPDs were 4.90±0.78 and 5.05±0.79 in the SRP and gel groups, respectively (P>0.05), which decreased to 3.67±0.59 and 3.7±0.83 one month after treatment and 3.25±0.65 and 3.38±0.79 three months after treatment. Although values decreased significantly in both groups after one and three months (P=0.001 in the SRP and P=0.001 in the gel group), the inter-group difference was not significant neither at one-month (P=0.47) nor at three-month (P=0.77) intervals. The only clinical parameters exhibiting statistically significant inter-group differences was BOP in both one-month (P=0.004) and three-month (P=0.0001) intervals. All the other clinical measurements showed significant decreases after one and three months in both sites but without inter-group differences. CONCLUSION: Subgingival application of xanthan chlorhexidine gel combined with scaling and root planing reduced bleed-ing of periodontal pockets. Clinical trials to evaluate effectiveness of this gel in aggressive and severe periodontitis modified by systemic factors are suggested.

Relationship between maternal periodontal disease and Apgar score of newborns.

PURPOSE: The aim of this study was to evaluate the relationship between maternal periodontal disease and the health status of newborns using Apgar scores. METHODS: One hundred pregnant women with periodontal disease were included in the case series and 100 pregnant women without periodontal disease were placed in the control group, respectively. The periodontal parameters of bleeding on probing (BOP), clinical attachment loss (CAL), probing depth (PD), birth weight, and Apgar scores were recorded in both groups. T-tests and Pearson's correlation coefficient were used to determine the birth weight odds ratio to analyze the relationship between the periodontal parameters of BOP, CAL, and PD on the one hand and an Apgar score of less than 7. An unpaired Student's t-test was used to analyze differences in means between the case and control groups using SPSS ver. 13. RESULTS: The means of the ages, periodontal pocket depths, attachment loss, areas with BOP, Apgar score in the first 5 minutes and infant birth weight exhibited statistically significant differences between the case and control groups. The ratio of an Apgar score of <7 to periodontal disease was 3.14; the ratio of low birth weight risk in mothers with periodontal disease to that in mothers without periodontal disease was 2.74. Pearson's correlation coefficient revealed a significant correlation between the infant birth weight and BOP, CAL, and PD of the mother. In addition, there was a significant correlation between the Apgar score and BOP, CAL, and PD and also between the Apgar score and infant birth weight. CONCLUSIONS: The results of this study showed a significant relationship between periodontal disease and infant birth weight; in addition, there was a significant relationship between the periodontal indexes of BOP, CAL, and PD on the one hand and the Apgar score on the other.

Comparative clinical study of coronally advanced flap with and without use of plasma rich in growth factors in the treatment of gingival recession.

PURPOSE: To evaluate the clinical efficiency of the coronally advanced flap (CAF) with and without plasma rich in growth factors (PRGF) in the management of gingival recession defects. METHODS: 20 bilateral similar recession defects in six healthy non-smoker subjects were included in the present study. The test sites received PRGF as an adjunct to the coronally advanced flap (CAF) while the control sites were treated with CAF only. The clinical parameters including recession depth (RD), percentage of root coverage (RC), recession width (RW), mucogingival junction position (MGJ), width of keratinized tissue (WKT), clinical attachment level (CAL), and probing depth (PD) were measured at the baseline, 1, and 3 months post-operatively. The data were analyzed using Wilcoxon signed rank and Mann-Whitney U tests. RESULTS: After 3 months, the mean root coverage was 43 +/- 34.9% in the CAF group and 61 +/- 23.5%) in the CAF + PRGF. Both treatment protocols led to a significant improvement in all measured variables compared to the baseline values, except the width of keratinized tissue. While PRGF enhanced the outcomes of CAF especially throughout the first month post-operatively, it offered no clinical advantage over CAF alone during the subsequent 2 months.

A clinical comparison of nano-crystalline hydroxyapatite (Ostim)and autogenous bone graft in the treatment of periodontal intrabony defects

Objectives: The aim of the present study was to evaluate the efficacy of autogenous bone graft (ABG) and nanocrystallinehydroxyapatite (Ostim) in the management of human intrabony periodontal defects.Study Design: Twenty-four similar two and three wall intrabony periodontal defects with ≥5 mm probing depthsand ≥3 mm depths of intrabony component in 12 healthy patients were selected. One defect in each subject wastreated with ABG (ABG group) and the contralateral one with ABG and Ostim (Ostim group). Plaque index (GI),gingival index (PI), clinical probing depth (CPD), clinical attachment level (CAL), gingival margin level, bonefill, crestal resorption and defect resolution were measured at baseline and during reentry surgery after 6 months.Wilcoxon signed-rank test and Mann–Whitney U test were used to analyze the data.Results: Groups showed statistically significant improvements in soft and hard tissue parameters after 6 monthsexcept in gingival margin level and crestal level. However, the between-group differences after 6 months were notstatistically significant with regard to soft and hard tissue measurements.Conclusion: Within the limits of this study, both treatments resulted in marked clinical improvement, and Ostimtreatment seemed to be effective in the treatment of two&three-wall intrabony defects as well as autogenous bonegraft (AU)

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A clinical comparison of nano-crystalline hydroxyapatite (Ostim) and autogenous bone graft in the treatment of periodontal intrabony defects.

OBJECTIVES: The aim of the present study was to evaluate the efficacy of autogenous bone graft (ABG) and nano-crystalline hydroxyapatite (Ostim) in the management of human intrabony periodontal defects. STUDY DESIGN: Twenty-four similar two and three wall intrabony periodontal defects with ≥5 mm probing depths and ≥3 mm depths of intrabony component in 12 healthy patients were selected. One defect in each subject was treated with ABG (ABG group) and the contralateral one with ABG and Ostim (Ostim group). Plaque index (GI), gingival index (PI), clinical probing depth (CPD), clinical attachment level (CAL), gingival margin level, bone fill, crestal resorption and defect resolution were measured at baseline and during reentry surgery after 6 months. Wilcoxon signed-rank test and Mann-Whitney U test were used to analyze the data. RESULTS: Groups showed statistically significant improvements in soft and hard tissue parameters after 6 months except in gingival margin level and crestal level. However, the between-group differences after 6 months were not statistically significant with regard to soft and hard tissue measurements. CONCLUSION: Within the limits of this study, both treatments resulted in marked clinical improvement, and Ostim treatment seemed to be effective in the treatment of two & three-wall intrabony defects as well as autogenous bone graft.

Coronally advanced flap in combination with acellular dermal matrix with or without enamel matrix derivatives for root coverage.

BACKGROUND: Coverage of gingival recession defects has been considered as a subject of interest for dental practitioners. AIM: The present study was aimed to compare the clinical outcomes of root coverage (RC) procedures, using coronally advanced flap (CAF) in combination with acellular dermal matrix (ADM) with or without enamel matrix derivatives (EMD). MATERIALS AND METHODS: A total of 36 Miller class I or II recession defects in 15 eligible patients were selected. The defects were randomly allocated to test (CAF+ADM+EMD) and control (CAF+ADM) groups. Recession depth (RD), recession width (RW), width of keratinized tissue (WKT), clinical attachment level (CAL), and the position of mucogingival junction (MGJ) were measured at baseline, two and six months after treatment. STATISTICAL ANALYSIS: Data were analyzed using repeated measures ANOVA and paired sample t-test with the patients as statistical unit. RESULTS: At two-month follow-up, the mean RC for CAF+ADM+EMD and CAF+ADM was 82.75 +/- 22 and 88.89 +/- 22 percent, respectively. However, these values did not change significantly after six months. Both treatments led to significant RC (P < 0.001), whereas no significant differences were observed in WKT, CAL, and MGJ between the study groups. CONCLUSION: The application of EMD does not improve the clinical efficacy of ADM in combination with CAF in RC procedures.

A clinical comparison of autogenous bone graft with and without autogenous periodontal ligament graft in the treatment of periodontal intrabony defects.

The aim of the present study was to evaluate the efficacy of autogenous bone graft (ABG) with and without autogenous periodontal ligament graft (PDLG) in the management of human two-wall intrabony periodontal defects. Twenty-six similar two-wall intrabony periodontal defects with >or=5 mm probing depths and >or=3 mm depths of intrabony component in 13 nonsmoking healthy patients were selected. One defect in each subject was treated with ABG alone (ABG group) and the contralateral one with ABG and PDLG (PDLG group). The primary outcomes of the study included changes in clinical probing depth (CPD) and clinical attachment level (CAL). Groups showed statistically significant improvements in soft and hard tissue parameters after 6 months. However, the between-group differences after 6 months were not statistically significant with regard to soft and hard tissue measurements except CAL gain. In the combined group, it was significantly higher than the ABG group (3.69 and 2 mm, respectively; P = 0.03). Within the limits of this study, both treatments resulted in marked clinical improvement, but combined treatment seemed to enhance the results in the treatment of two-wall intrabony defects.

Association of Periodontal Diseases with Elevation of Serum C-reactive Protein and Body Mass Index.

BACKGROUND AND AIMS: C-reactive protein (CRP) is a well-known acute-phase reactant produced by the liver in response to inflammation caused by various stimuli. Periodontal disease is a chronic infection of tooth-supporting structures characterized by attachment loss and alveolar bone loss. The aim of this study was to assess the relationship between serum C-reactive protein levels and periodontal diseases. MATERIALS AND METHODS: The study was conducted on 166 patients referring to Tabriz Faculty of Dentistry. The age range was between 35 and 59 years. 83 subjects with periodontitis according to NHANES III index as test group and 83 healthy individuals as controls participated in this study. Body mass index (BMI), waist circumference (WC), probing depth, attachment loss and CRP levels were measured in both test and control groups. Data was analyzed with Student's t-test, odds ratio (OR), Chi-square test and Spearman's correlation coefficient, using SPSS 13.0 software. RESULTS: The results revealed a statistically significant difference between all of the analyzed variables in test and control groups (P < 0.05). Classifying the test subjects into two subgroups (subjects with CRP ≥ 3 mg/l and subjects with CRP < 3 mg/l), the highest OR in females belonged to WC (OR = 6.4; 95% CI: 1.18-35.2, P = 0.02) and in males to obesity (OR = 4.8; 95% CI: 0.65-35.19, P = 0.05). Considering the correlation between obesity, overweight, WC and CRP with probing depth and attachment loss denoted that obesity presented the highest (r = 1, P = 0.00) and overweight the lowest (r = 0.4, P = 0.07) association. In females, CRP was related to the severity of periodontitis and attachment loss (r = 0.662, P = 0.00). Excluding overweight, the association between all the variables was statistically significant (P < 0.05). CONCLUSION: Our findings indicate that periodontal disease is correlated with CRP elevation and dis-eases associated with obesity.

Efficacy of open flap debridement with and without enamel matrix derivatives in the treatment of mandibular degree II furcation involvement.

The aim of the present study was the evaluation of the efficacy of open flap debridement (OFD) with and without enamel matrix derivatives (EMD) in the management of class II furcation involvement. Twenty similar bilateral class II furcation defects in ten healthy nonsmoker patients were selected. One defect in each subject was treated with OFD alone (OFD group) and the contralateral one with OFD and simultaneous application of enamel matrix derivatives (EMD group). Clinical probing depth, vertical clinical attachment level, horizontal clinical attachment level, and the location of the gingival margin, horizontal probing depth of bony defect (E-HPD), vertical depth of bone crest, vertical depth of the base of bony defect (V-DBD), and length of the intrabony defect were measured at baseline and during reentry surgery after 6 months. Wilcoxon signed-rank test and Mann-Whitney U test were used to analyze the data. Among soft tissue parameters, only horizontal attachment gain in EMD was significantly more than OFD (P = 0.002). Application of EMD significantly enhanced the horizontal (E-HPD) and vertical (V-DBD) resolution of the bony defect (P < 0.05). In conclusion, it seems that the adjunctive use of EMD enhances the efficiency of OFD in the management of mandibular class II furcation defects.

Helicobacter pylori in the dental plaque: is it of diagnostic value for gastric infection?

AIM: The aim of present study was the assessment of association of helicobacter pylori of dental plaque and stomach in a more homogenous population and also to determine the diagnostic value of dental plaque for gastric infection. MATERIALS AND METHODS: Based on the results of Rapid urease test (RUT) on specimens from gastric antrum, 88 patients with symptoms of dyspepsia were assigned into two groups of infected and non-infected with helicobacter pylori. Supragingival plaque samples were collected from mandibular first and second molar area using and sterile curette and were investigated using RUT. Statistical analysis of data was performed using chi-square test and independent t-test. RESULTS: H. pylori was detected in 34.1 % of dental plaque specimens. The prevalence of helicobacter pylori infection in dental was 31.8 % and 36.4 % in patients with and without gastric infection (P=0.6). Also the interaction of age and infection was not significant but the prevalence of H. pylori both in the dental plaque and the stomach of male patients was higher than female patients. CONCLUSION: There is not any significant association between the helicobacter pylori of the dental plaque and the stomach. Also the dental plaque can not be used as a primary diagnostic aid for gastric infection.