One-year clinical outcomes following non-surgical treatment of peri-implant mucositis with adjunctive diode laser application.

BACKGROUND: Limited information is available on the application of diode laser in the treatment of peri-implant diseases. The aim of this study was to investigate the clinical efficacy of the adjunctive application of diode laser in the non-surgical treatment of peri-implant mucositis during a 12-month follow-up period. METHODS: The sample was composed of 73 systemically healthy patients with one implant diagnosed with peri-implant mucositis (bleeding on probing [BoP] with no loss of supporting bone). Implants were randomly assigned to mechanical debridement with hand and powered instruments and 980-nm diode laser application (test group, N.=38) or mechanical debridement alone (control group, N.=35). At the completion of active treatment patients were included in a periodontal maintenance program. Recalls were provided every three months in both treatment groups for reinforcement in oral hygiene instructions and professional implant cleaning with rubber cups. Baseline parameters were repeated at 3 and 12 months postoperatively. RESULTS: Intragroup analysis showed that plaque index, BoP and probing depth presented statistically significant improvements when compared with baseline values (all P<0.001). No statistically significant difference in clinical outcomes was observed between treatment groups at each time point. At 12 months no significant difference in the percentage of sites showing BoP resolution was observed between test (60.9%) and control treatment (52.6%), as well. CONCLUSIONS: Based on the present results, the adjunct use of diode laser showed little but not statistically significant additional benefits in the treatment of peri-implant mucositis after an observation period of one year.

Long-Term Prognosis of Severely Compromised Teeth Following Combined Periodontal and Orthodontic Treatment: A Retrospective Study.

This retrospective study evaluated the long-term response of periodontal tissues and survival rate of teeth with advanced attachment loss and pathologic migration in 21 periodontitis patients treated with combined periodontal and orthodontic treatment. All anterior migrated teeth were in function at the end of 10 to 15 years of maintenance. Residual probing depths and clinical attachment levels improved after treatment and remained stable through the follow-up. A total of 55 hopeless teeth were lost during active therapy, as well as 6 molars over the course of the supportive periodontal therapy (for nonperiodontal reasons). In highly compliant patients, all migrated teeth with initial unfavorable prognosis showed long-term clinical stability.

Adjunctive efficacy of diode laser in the treatment of peri-implant mucositis with mechanical therapy: A randomized clinical trial.

OBJECTIVES: Due to the inconclusive findings on the effect of laser therapy in the management of peri-implant diseases, the aim of this study was to analyze the adjunctive clinical efficacy of 980-nm diode laser (DL) irradiation in the treatment of peri-implant mucositis with mechanical debridement. MATERIAL AND METHODS: Two hundred and twenty patients with one implant diagnosed with peri-implant mucositis (probing depth [PD] ≥ 4 mm and bleeding on probing [BoP] [primary outcome]) were randomly allocated to test and control treatments. Patients in the control group (n = 110) received debridement using curettes and ultrasonic devices, while patients allocated in the test group (n = 110) received mechanical therapy in combination with DL irradiation (setting 980 nm, 2.5 W, 10 kHz, pw, 30 s). BoP, presence of plaque, and PD were recorded at baseline, 1 month, and 3 months after treatment. RESULTS: Both therapeutic modalities yielded similar clinical improvements with comparable reductions in the number of BoP-positive sites, plaque scores, and PD values at 3 months (all p-values > 0.05). Complete disease resolution was obtained in 38/110 (34.5%) implants in the test group compared with 34/110 (30.9%) implants in the control group at the end of the observation period. CONCLUSION: Based on these results, the adjunct use of DL did not yield any statistically significant clinical benefit as compared to nonsurgical mechanical treatment alone in controlling peri-implant inflammation at 3 months.

Soft tissue re-growth after osseous resective surgery with and without fibre retention technique. Four-year follow-up of a randomized clinical trial.

AIM: The aim of this study was to compare the clinical outcomes and soft tissue rebound following Fibre Retention Osseous Resective Surgery (FibReORS) and Osseous Resective Surgery (ORS) over a 48-month period. MATERIALS AND METHODS: Thirteen chronic periodontitis patients, displaying two contra-lateral posterior sextants with residual intrabony defects ≤3 mm in single-rooted or multi-rooted teeth with no or grade I furcation involvement, were treated in a split-mouth study model. ORS procedure was randomly applied on one side, while FibReORS on the contra-lateral side. Clinical measurements were recorded at 12 and 48 months after surgery. RESULTS: All 13 patients were available for the 48-month recall. At this time point, probing depth (PD) and keratinized tissue changes did not significantly differ between treatments. FibReORS-treated sites exhibited less gingival recession than ORS-treated sextants (2.1 ± 0.3 versus 2.5 ± 0.4 mm, p = .001), but comparable coronal soft tissue rebound. The mean difference of 0.4 ± 0.3 mm was consistent with higher amount of bone resection in the ORS group (0.92 ± 0.11 versus 0.38 ± 0.09 mm, p < .001). CONCLUSION: FibReORS resulted in similar PD changes and soft tissue rebound compared with ORS in posterior teeth with no or limited furcation involvement.

Three-dimensional analysis of bone remodeling following ridge augmentation of compromised extraction sockets in periodontitis patients: A randomized controlled study.

OBJECTIVES: The aim of this study was to analyze linear and volumetric hard tissue changes in severely resorbed alveolar sockets after ridge augmentation procedure and to compare them with spontaneous healing using three-dimensional cone beam computed tomography (CBCT). MATERIAL AND METHODS: Thirty patients (mean age 53.2 ± 6.3 years) requiring tooth extraction for advanced periodontitis were randomly allocated to test and control groups. The test sites were grafted using a collagenated bovine-derived bone (DBBM-C) covered with a collagen membrane, while control sites had spontaneous healing. Both groups healed by secondary intention. Linear and volumetric measurements were taken on superimposed CBCT images obtained after tooth extraction and 12 months later. RESULTS: Greater horizontal shrinkage, localized mainly in the crestal zone, was observed in the control group (4.92 ± 2.45 mm) compared to the test group (2.60 ± 1.24 mm). While both groups presented a rebuilding of the buccal wall, it was most pronounced in the grafted sockets (2.50 ± 2.12 mm vs. 0.51 ± 1.02 mm). A significant difference was also registered in the percentage of volume loss between grafted and non-grafted sites (9.14% vs. 35.16%, p-value <.0001). CONCLUSION: Alveolar sockets with extensive buccal bone deficiencies undergo significant three-dimensional volumetric alterations following natural healing. The immediate application of a slow-resorbing xenograft with a covering collagen membrane seems to be effective in improving alveolar ridge shape and dimensions, thus potentially reducing the need for adjunctive regenerative procedures at the time of implant placement.

Prevalence estimation of halitosis and its association with oral health-related parameters in an adult population of a city in North Italy.

AIM: No epidemiological data on halitosis are available from Italy. Thus, the aim of this population-based cross-sectional study was to estimate the prevalence of halitosis in an urban adult population from North Italy and to explore related oral risk indicators. MATERIALS AND METHODS: The survey used a two-stage probability sampling method to collect a representative sample of inhabitants, aged between 20 and 75 years, in the city of Turin. Seven hundred and forty-four adults were clinically examined (47% of sampled subjects) for oral malodor and periodontal conditions. Using a standardized questionnaire social, health and halitosis-related parameters were collected. Logistic models with interaction terms between tongue coating scores (TCS) and periodontal status were used to explore halitosis risk indicators. RESULTS: The prevalence estimate of halitosis according to the organoleptic assessment was 53.51% (95% CI: 48.55-58.50). A statistically significant correlation was found between organoleptic and gas chromatography measurements (p < 0.0001). Stronger associations between halitosis and periodontitis were observed in people having higher TCS: adjusted odds ratio considering low and high TCS in individuals with severe periodontitis were 2.95 and 20.77 (p ≤ 0.003). CONCLUSIONS: Due to the high prevalence of halitosis in the Turin population, its diagnosis and management should be incorporated in comprehensive dental care.

Periodontal management of a patient with severe psoriasis: A case report.

UNLABELLED: Psoriasis is a common, disfiguring and stigmatizing skin disease associated with impaired quality of life. In patients with severe psoriasis unresponsive to other treatments, cyclosporine can induce a rapid remission. Although drug-induced gingival overgrowth (GO) is a frequent side effect, in the guidelines for the use of cyclosporine for psoriasis regular dental examinations were not mentioned as an essential part of monitoring of these patients. CASE REPORT: A 59-year-old man with GO involving almost all the interdental papillae (Seymour's grading score 1-5) reported difficulties in mastication and gingival swelling. The medical history revealed severe recalcitrant psoriasis treated by oral cyclosporine. The periodontal treatment consisted of strict oral hygiene instructions, scaling, root surface instrumentation, and a 2-month interval periodontal supportive treatment. At 12 months an almost complete regression of GO was observed. A careful nonsurgical periodontal treatment combined with meticulous self-performed oral hygiene may avoid the need for surgical intervention, even in advanced cases.

Osseous resective surgery with and without fibre retention technique in the treatment of shallow intrabony defects: a split-mouth randomized clinical trial.

AIM: The aim of this split-mouth clinical trial was to compare the effectiveness of Apically Positioned Flap with Fibre Retention Osseous Resective Surgery (FibReORS) or Osseous Resective Surgery (ORS) in the treatment of periodontal pockets associated with intrabony defects ≤ 3 mm at posterior natural teeth. MATERIALS AND METHODS: Twenty-six posterior sextants requiring osseous resective surgery were selected in 13 chronic periodontitis patients: 13 sextants were randomly assigned to ORS and 13 to FibReORS. Clinical evaluation of probing depth (PD), gingival recession and clinical attachment level was performed at baseline, 6 and 12 months postoperatively. Periapical radiographs were taken prior and after surgical treatment, at 6- and 12-month follow-up. RESULTS: Ostectomy amounted to 1.0 ± 0.3 mm in the ORS group and to 0.4 ± 0.2 mm in the FibReORS group. At 12-month examination PD changes did not significantly differ between the experimental groups. ORS group showed significantly (p < 0.001) greater clinical attachment loss (2.2 ± 1.0 mm versus 1.0 ± 0.6 mm), radiographic bone resorption (0.43 ± 0.08 mm versus 0.13 ± 0.09 mm) and post-operative patient discomfort compared to FibReORS. CONCLUSION: FibReORS resulted in similar PD reduction, but less ostectomy, clinical attachment loss and patient morbidity compared to ORS.