Randomized controlled clinical effectiveness of adjunct 660-nm light-emitting diode irradiation during non-surgical periodontal therapy.

BACKGROUND/PURPOSE: The irradiation of 660-nm light-emitting diodes (LEDs) has exhibited potential to accelerate oral wound healing and prevent periodontal breakdown in rodents. This study was to evaluate the clinical effectiveness of 660-nm LEDs during non-surgical periodontal therapy (NSPT). METHODS: Nineteen patients with at least one periodontitis-involved tooth in three quadrants received NSPT, and three protocols of LED light irradiation, including LED light irradiation from initial clinical assessment (T0) until the completion of scaling and root planning (T1) (LED01), LED light irradiation from T1 until re-evaluation (T2) (LED02), and no LED light irradiation (control treatment), were randomly assigned to respective quadrant. Clinical parameters were assessed at T0 and T2, and such biomarkers as IL-1ß and MMP-8 from gingival crevicular fluid were assessed at T0, T1, and T2. RESULTS: At T2, all examined sites exhibited significantly reduced probing pocket depth (PD), clinical attachment level (CAL), gingival bleeding index, plaque score, and visual analog scale. In the sites with greatest initial PD and CAL, LED01 and LED02 significantly reduced PD and CAL compared with the control treatment. IL-1ß and MMP-8 were reduced in all groups at T1 and T2, and the reduction of MMP-8 was the most notable in LED01. CONCLUSION: LED light irradiation during or after scaling and root planing assisted in the recovery of periodontium and can be used as an adjunct treatment during NSPT, specifically for sites with severe periodontal breakdown.

The Accuracy of Guided Implant Surgery With Different Fields of View of Cone-Beam Computerized Tomography.

Although a smaller size field of view (FOV) of cone-beam computerized tomography (CBCT) reduces radiation exposure, its effect on the accuracy of static computer-aided implant surgery (s-CAIS) remains unknown. This study aimed to evaluate the impact of the size of FOV on the accuracy of s-CAIS and to investigate if the arch affects this effect. A total of 32 implant sites on 8 identical scannable models (maxillae and mandibles) were randomly allocated to 2 FOV sizes: test (5 × 5 cm) and control (10 × 10 cm). All models were scanned with an intraoral scanner (IOS). With the registration of the surface scan and CBCT image, a prosthetic-driven implant position was planned. Following the fabrication of surgical templates, a single-blinded surgeon placed all implants with the fully guided s-CAIS protocol. IOS captured the implant positions with the scan body attached. Implant-planning software measured the angular deviation, 3-dimensional (3D) deviation at the crest, and 3D deviation at the apex between preplanned and actual implant positions. Two-way analysis of variance was used to analyze the effect of FOV and arch on the deviations. The size of FOV did not show a significant effect (P > .198) on angular deviation, 3D deviation at the crest, or 3D deviation at the apex. No significant difference was found when comparing the effect of the size of FOV between the maxillary and mandibular implants. In conclusion, the use of small FOV CBCT demonstrated comparable accuracy of s-CAIS to the use of medium FOV CBCT.

The effect of systemic antibiotics on periodontal regeneration: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the clinical efficacy of the use of systemic antibiotics in regenerative periodontal surgery for treating teeth affected by periodontitis. DATA SOURCES: Electronic (MEDLINE, EMBASE, LILACS, Scopus, and Cochrane) and manual literature searches for human randomized controlled trial studies published up to November 2022 were conducted by two reviewers. Meta-analysis was performed to assess probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain in groups receiving systemic antibiotics compared to those not receiving systemic antibiotics. A total of eight studies were included. While treated sites were intrabony defects in six papers, two studies focused on furcation defects. For intrabony defects, the weighted mean difference (WMD) of 0.30 mm (95% CI -0.18 to 0.78) and 0.27 mm (95% CI -0.13 to 0.66) was calculated for PPD reduction and CAL gain, respectively. The differences between antibiotics and non-antibiotics groups for PPD and CAL were not statistically significant. Quantitative analysis could not be performed for furcation defects due to the limited number of studies. However, regardless of the membrane type selection, the existing evidence indicated that antibiotics did not lead to superior clinical outcomes for furcation defects at 9 to 12 months after the regenerative procedures. CONCLUSION: Based on this meta-analysis study's findings, the use of adjunct systemic antibiotics in regenerative periodontal surgery did not appear to achieve more favorable clinical outcomes. Thus, the use of adjunct systemic antibiotics as part of the regenerative periodontal therapy might not be justifiable and should be reconsidered. (Quintessence Int 2023;54:210-219; doi: 10.3290/j.qi.b3648957).

Periodontal Regeneration with Amnion-Chorion Membrane on Root Surface: A Retrospective Case Series.

This retrospective case series investigated the clinical and radiographic outcomes in 19 intrabony defects treated with periodontal regenerative therapy utilizing a combined approach. Placing an amnion-chorion membrane (ACM) as a biologic modifier on the root surface of the periodontally diseased tooth, combined with bone substitutes and an additional ACM as a barrier membrane, the treated sites were examined 8 to 24 months after the therapy. The preoperative (baseline) mean probing pocket depth (PPD) was 7.21 ± 1.08 mm, and the mean clinical attachment level (CAL) was 7.68 ± 1.49 mm. A mean PPD reduction of 4.05 ± 1.22 mm, CAL gain of 3.68 ± 1.34 mm, and 73.91% ± 22.02% of bone fill were recorded postoperatively. Without any adverse events, root-surface application of ACM as a biologic material in periodontal regenerative therapy could be a safe and cost-effective approach.

Histologic and Histomorphometric Analyses of Peri-implant Bone from Loaded Dental Implants: A Case Report

The histological findings and histomorphometrical analyses of peri-implant tissues from nine functionally loaded dental implants from an adult cadaver were analyzed. Despite the presence of peri-implant bone loss, all implants were found to have a high degree of osseointegration, with the bone-implant contact (BIC) ranging from 69% to 88%. The mean value of the BIC was 83.2 ± 4.3% (range: 76.5 - 87.7%) for the maxillary implants and 74.4 ± 7.1% (range: 69.4 - 84.9%) for the mandibular implants. The BIC was comparable for maxillary and mandibular implants. Relatively prominent bone remodeling and resorption with soft tissue ingrowth were observed in the vertical bony defects compared to the areas without intrabony components, which might represent the sequence of bone loss around the dental implants.

Comparison of In Vitro Biofilm Formation on Titanium and Zirconia Implants.

Background: Peri-implant diseases are emerging issues in contemporary implant dentistry. As biofilms play a critical role in peri-implant diseases, the characteristic of resisting bacterial adhesion would be ideal for dental implants. The aims of the study were to compare titanium (Ti) and zirconia (Zr) implants regarding the amount of biofilm formation at different time frames and assess the distribution of biofilm on different aspects of dental implants. Methods: Biofilm was developed on Ti and Zr dental implants with a peri-implant-related multispecies model with Streptococcus oralis, Actinomyces naeslundii, Veillonella dispar, and Porphyromonas gingivalis, for 3 and 14 days. Quantitative assessment was performed with the measurement of total bacterial viability (colony forming units, CFU/mg). Scanning electron microscopy (SEM) was used to evaluate biofilm formation on different aspects of the implants. Results: Three-day-old biofilm on Ti implants was significantly higher than that on Zr implants (p < 0.001). The Ti and Zr groups were not significantly different for 14-day-old biofilm. SEM images demonstrated that 3-day-old biofilm on Zr implants was sparse while biofilm growth was more pronounced for 3-day-old biofilm on Ti implants and 14-day-old biofilm groups. It appeared that less biofilm formed on the valley compared to the thread top for 3-day-old biofilm on Zr implants. Differences between the valley and the thread top became indistinguishable with the development of mature biofilm. Conclusion: While early formed biofilms show greater accumulation on Ti implants compared to Zr implants, older biofilms between the two groups are comparable. The distribution of biofilms was not uniform on different areas of implant threads during early biofilm development.

Dental laser training and education in postgraduate periodontics programs in North America.

INTRODUCTION: The application of various lasers to treat periodontal and peri-implant diseases is gaining momentum. While laser-related dental research is ongoing, it is important to determine if current periodontal training programs are keeping pace with these new treatment modalities and actively incorporating them into their training. MATERIALS AND METHODS: An electronic survey was created to evaluate the extent to which lasers are currently being used in North American periodontal programs. A brief explanation of the study and a link to the 15-question survey was emailed to 61 periodontal program directors requesting participation in the survey. The data regarding the prevalence of laser training in all the programs, which types of laser devices are used, and which surgical procedures are performed were collected and analyzed. RESULTS: The response rate was 49.1% (n = 30). Among those responding to the survey, 76.7% (n = 23) of these programs reported providing clinical training in lasers, with the diode laser being the most frequently used (65.2%), followed by carbon dioxide (39.1%), neodymium-doped yttrium aluminum garnet (26.1%), and erbium:yttrium aluminum garnet lasers (26.1%). Two major reasons for not utilizing lasers as part of regular patient care were cost and lack of evidence to support laser efficacy. Three out of seven programs that do not currently use lasers plan to provide laser training in the future. Over half (56.7%) of program directors did not think that lasers would become the standard of periodontal/implant care within the next 10 years, while 20% of them believed that they would. CONCLUSIONS: Laser training and education in postgraduate periodontal programs is still limited, and the majority of periodontal residents are not exposed to many types of laser devices.

Periodontal Health and Systemic Conditions.

According to the new classification proposed by the recent 2017 World Workshop on Periodontal and Peri-implant Diseases and Conditions, periodontitis, necrotizing periodontal diseases, periodontitis as a manifestation of systemic diseases, and systemic diseases or conditions affecting the periodontal supporting tissues, are considered as separate entities. Scientific evidence has demonstrated that periodontal diseases are not just simple bacterial infections but rather complex diseases of multifactorial complexity that interplay with the subgingival microbes, the host immune, and inflammatory responses. Despite dental plaque biofilm being considered the primary risk factor for periodontitis in the vast majority of patients that dentists encounter on a daily basis, there are other factors that can also contribute and/or accelerate pathologic progressive attachment loss. In this article, the authors aim to briefly review and discuss the present evidence regarding the association between periodontal diseases and systemic diseases and conditions.