Soft Tissue Augmentation After Tooth Extraction Improves Implant Health: Findings From a Clinical Trial.

Background Soft tissue augmentation is a critical procedure in dental implantology aimed at improving peri-implant health and aesthetics. Various materials are used for this purpose, but their comparative effectiveness remains under-researched. This study aimed to evaluate the effects of soft tissue augmentation utilizing two different materials after tooth extraction on peri-implant clinical and radiographic outcomes. Methodology A randomized controlled trial was conducted with 30 participants requiring extraction of non-restorable mandibular posterior teeth. Participants were randomly assigned to receive connective tissue graft (CTG), Fibro-gide (FG), or spontaneous healing (SH) in a 1:1:1 allocation ratio. Two months post-treatment, dental implants were placed. Six months after the functional loading of the dental implant, peri-implant health was assessed using the Plaque Accumulation Index, bleeding on probing (BOP), pocket depth, mucosal recession, and marginal bone level. Results At the six-month follow-up, the SH group exhibited significantly higher Plaque Index and BOP percentages (6.43 ± 1.23 and 70%, respectively) compared to the CTG group (0.40 ± 0.32 and 8.3%, respectively) and FG group (0.45 ± 0.44 and 9.7%, respectively). The mean probing pocket depth was also significantly higher in the control group (5.13 ± 0.64 mm), while the CTG and FG groups showed minimal changes (3.83 ± 0.39 mm for both groups). Additionally, gingival recession was higher in the control group (0.65 ± 0.18 mm) compared to the CTG and FG groups (0.03 ± 0.08 mm for both groups). Radiographic analysis revealed greater marginal bone loss in the control group (0.40 ± 0.05 mm) compared to the CTG and FG groups, which demonstrated minimal bone loss (0.17 ± 0.08 mm and 0.20 ± 0.00 mm, respectively). Conclusions The study findings indicate that FG is as effective as CTG in maintaining peri-implant health, outperforming SH. These findings suggest that FG can be a viable alternative to CTG in soft tissue augmentation after tooth extraction, offering a new option for clinicians in the management of extraction sites before dental implant placement.

Alveolar Ridge Preservation With Fibro-Gide or Connective Tissue Graft: A Randomized Controlled Trial of Soft and Hard Tissue Changes.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a novel biomaterial (FG) for alveolar ridge preservation compared to CTG in terms of soft tissue thickness and bone dimensional changes. MATERIALS AND METHODS: A randomized clinical trial was conducted on 30 patients who required extraction of 30 hopeless mandibular posterior teeth. All patients went through atraumatic tooth extraction, and then, they were randomly allocated to either a CTG, an FG, or a spontaneous healing (SH) group (1:1:1). All patients received a dental implant placed 6 months postoperatively. The soft tissue thickness and bone dimensional changes were measured before and 6 months after the procedure. RESULTS: The study's analysis revealed statistically significant differences in buccal gingival thickness and dimensional bone changes across the three examined groups after 6 months (p < 0.05). The SH group had lower gingival thickness (1.31 ± 0.65 mm) and higher vertical resorption (-1.46 ± 1.67 mm at the buccal aspect) compared with the CTG and FG groups. The CTG and FG groups had similar gingival thickness (2.42 ± 0.70 and 3.00 ± 0.71 mm, respectively) and bone width reduction (+0.86 ± 2.31 and +0.93 ± 2.38 mm, respectively), whereas the CTG group had lower vertical bone loss (-0.30 ± 1.09 mm at the buccal aspect) than the FG group (-0.47 ± 2.30 mm at the buccal aspect). CONCLUSION: FG and CTG demonstrate equivalent soft tissue thickness and comparable horizontal bone dimension outcomes in ARP.

Evaluation of the Undergraduate Learning Environment at Dental Schools in Syria.

OBJECTIVE: The learning environment plays a vital role in dental education. A positive learning environment could improve students' satisfaction, psychosocial well-being, and academic achievement. This study set out to measure the quality of the learning environment according to the Dundee Ready Educational Environment Measure (DREEM) at different dental schools in Syria. METHODS: The study included dental schools at Damascus University (DU), Tishreen University (TU), and University of Hama (HU). DU and TU are considered 2 of the largest universities in Syria. Students across all years of study were invited to complete an Arabic version of the DREEM questionnaire. RESULTS: In total, 1205 students completed the questionnaire: 650 were from DU, 309 from HU, and 243 from TU. Cronbach's alpha value of the DREEM instrument was 0.927. The total DREEM score for all universities was 108.8 ± 31.5 (n = 1205), which is 54.4% of the total score; DU scored the lowest on the DREEM scale (105.9 ± 28.5) followed by TU (111.1 ± 34.3) and HU (113.3 ± 34.4). There was a significant difference amongst the 3 universities (P = .001) with a small effect size (eta-squared = 0.01). At the subscale level, students' perception of learning (SPL) at DU and TU was perceived unfavourably, and the social self-perception of students (SSP) was negatively perceived across all universities. Clinical students scored significantly lower than their preclinical counterparts. No significant difference emerged between male and female students. CONCLUSIONS: This study provides a baseline data on the learning environment at dental schools in Syria. Although the study suggests a more positive than negative perception of the learning environment, Syrian dental schools scored considerably lower than their Arab and international counterparts. Aspects related to SPL and SSP were the most serious areas requiring improvement, and future research should focus on designing proper interventions to address them.

Gauging the learning environment at Damascus University Pharmacy School in Syria using the DREEM questionnaire: A cross-sectional study.

Introduction: This study was undertaken to provide the first record of evaluation of the educational environment of the Bachelor of Pharmacy program at Damascus University (DU), Syria using the internationally adopted Dundee Ready Education Environment Measure (DREEM) tool and compare it with other pharmacy schools around the world. Methods: A cross-sectional study was conducted at DU Pharmacy School in 2022. The validated DREEM 50-item inventory was added to Google Forms and used to collect data electronically. River sampling and snowball sampling methods were used. Data was collected during the second term between April 2022 and June 2022. Students from all years were included. Results: A total of 269 students completed the questionnaire; that is about 6.7% of the total population. The Cronbach's alpha of the DREEM questionnaire was 0.94. The total DREEM score was 89.8±32.1/200. Senior students scored significantly less on the DREEM scale than their younger counterparts. DU Pharmacy School scored significantly less on the total DREEM score than its other counterparts around the world with a large effect size (d>0.80). All subscales scored below 50% and the lowest scoring subscales were students' perception of learning (SPL=41.8%) and students' perception of the social environment (SSP=42.5%). Conclusions: The findings implied that the educational environment is in need of major improvement, especially in areas related to teaching and learning practices and the general social environment; failure to address the current issues in the learning environment might hinder learning and clinical practice of the future generation of pharmacists. This study provides a quality improvement map which could be used preciously address the areas that need most attention at DU Pharmacy School.