Different wavelengths of laser: are they significant for treatment of denture stomatitis?: an in-vitro study.

BACKGROUND: Denture stomatitis (DS) is an inflammatory disorder that affects the mucosal surface underneath the dentures and frequently causes oral mucosal irritation, discomfort, and altered taste perception, which prevents people from consuming enough nutrients. One of the main causes of DS is an overgrowth of the fungus Candida albicans (C. albicans). A possible alternative treatment for Candida infections is thought to be laser therapy. The aim of this study was to evaluate how different wavelengths of laser would affect growth and pathogenic properties of Candida albicans. METHODS: A concentration of 106 viable cells/ml of Candida albicans were used in the preparation process. Four groups were created from the specimens. Culturing of the control group was completed with no intervention. The other 3 groups received laser radiation for 60 seconds at a power of 1W. The 2nd and 3rd groups were irradiated with diode laser at a wavelength of 940 nm and 980 nm respectively. The 4th group was irradiated with Nd-YAG laser at a wavelength of 1064 nm. Turbidimetric growth was defined as variations in the optical density of fungal growth. These measures were made at three different times: baseline, 48 hours, and 72 hours. RESULTS: In both groups of diode laser, the growth of Candida albicans showed no remarkable differences at baseline, after 48 and 72 hours using a power of 1 W and duration of 60 seconds. The Nd-YAG group showed significant increase in optical density after 48 hrs then significant decrease after 72 hrs. The optical density values in the control group showed no notable difference between the control and diode study groups at different time periods. However, the Nd:YAG group showed a statistically significant difference compared to the control and the 2 diode laser groups. CONCLUSIONS: Different laser parameters have a different effect on growth and pathogenic properties of Candida albicans. Diode laser therapy with wavelengths 940 and 980 nm used in continuous mode with power of 1 W for duration of 60 seconds can result in proliferation of Candida albicans instead of destroying them. Nd:YAG laser, used in pulsed mode, with power of 1 W for a duration of 60 seconds can be used to destroy Candida albicans and therefore, can be used as an effective treatment for denture stomatitis.

Evaluation of immediately loaded mandibular four vertical versus tilted posterior implants supporting fixed detachable restorations without versus with posterior cantilevers.

BACKGROUND: Distally inclining posterior implants may be technically challenging in certain situations. The presence of a posterior cantilever can also exert unfavorable forces on supporting implants. The aim of the present study was to evaluate and compare peri-implant soft and hard tissues around 4 mandibular interforaminal implants having tilted posterior implants with posterior cantilevers, versus vertical implants, 2 in the interforaminal region and 2 in the first molar regions, without posterior cantilevers. All implants supported full-arch fixed detachable restorations opposing complete dentures. MATERIAL AND METHODS: A total of 80 implants were placed flapless in the mandibles of 20 edentulous participants. Four implants were placed for every participant, who were randomly assigned into 2 equal groups. Axial group implants were vertically aligned, with 2 implants in the interforaminal area and 2 in the molar area. Tilted group implants have 2 anterior axial and 2 posterior distally inclined implants. Interim screw-retained prostheses converted from pre-existing dentures were immediately fabricated and loaded on the same day of surgery. After awaiting period of 3 months, all participants received fixed detachable metal acrylic resin definitive restorations. A follow-up protocol of 3, 6, and 12 months was scheduled to assess the modified gingival index, modified plaque index, peri-implant probing depth, implant stability, and marginal bone level and bone density changes. RESULTS: No statistically significant differences (P > .05) were found in the modified gingival index, modified plaque index, peri-implant probing depth, implant stability, bone density, and marginal bone level between the axial and tilted implant groups after the 1-year follow-up period. CONCLUSION: Placing 4 flapless immediately loaded implants in mandibular edentulous patients that supported full-arch fixed restorations provided high implant and prosthodontic success rates whether posterior implants were tilted with posterior cantilevers or vertically aligned without posterior cantilevers. TRIAL REGISTRATION: Pan African Clinical Trial Registry database, PACTR201907776166846. Registered 3 July 2019, www.pactr.org .

Clinical and radiographic evaluation of implants placed with fully guided versus partially guided tissue-supported surgical guides: A split-mouth clinical study.

STATEMENT OF PROBLEM: The effect of placing implants by using a fully guided protocol versus a partially guided protocol on the peri-implant soft and hard tissues is unclear. C-shaped guide holes are often used; however, their effect on drilling and peri-implant tissues has not been thoroughly investigated. PURPOSE: The purpose of this split-mouth clinical study was to clinically and radiographically evaluate peri-implant soft and hard tissues after implant placement by using fully guided versus partially guided surgical guides with cylindrical versus C-shaped guide holes. MATERIAL AND METHODS: Adopting an 80% power of the study in calculating sample size, a total of 48 implants were placed in the mandibular interforaminal area of 12 edentulous participants. Implants were randomly divided into 2 groups: a fully guided group comprising 24 implants placed on 1 side by using a fully guided protocol and a partially guided group comprising 24 implants placed on the other side of the same participant by using a partially guided protocol. Each group was further subdivided into 2 subgroups: cylindrical, including 12 implants placed through cylindrical guide holes, and C-shaped (12 implants) placed through C-shaped guide holes. All participants were clinically evaluated in terms of a modified plaque index, modified gingival index, peri-implant probing depth, and probing attachment level at 2, 4, and 6 months. Implant stability, marginal bone level, and bone density were then evaluated immediately after implant placement at 2, 4, and 6 months. RESULTS: No statistically significant differences were found in the plaque index (P=.927), modified gingival index (P=.916), probing depth (P=.832), probing attachment level (P=.096), implant stability (P=.338), bone level (P=.063), or bone density (P=.390) between the fully guided protocol and partially guided protocol. CONCLUSIONS: The soft and hard tissues surrounding the implants placed by using fully guided surgical guides were clinically comparable with those placed by using partially guided surgical guides whether the guiding holes were cylindrical or C-shaped.

Evaluation of the accuracy of implant placement by using fully guided versus partially guided tissue-supported surgical guides with cylindrical versus C-shaped guiding holes: A split-mouth clinical study.

STATEMENT OF PROBLEM: The accuracy of partially guided implant placement protocols in comparison with fully guided protocols is still unclear. C-shaped guide holes have become popular; however, their effect on drilling and implant position accuracy has not been thoroughly investigated. PURPOSE: The purpose of this split-mouth clinical study was to evaluate the accuracy of implant placement by using fully guided versus partially guided surgical guides with cylindrical versus C-shaped guiding holes. MATERIAL AND METHODS: Adopting 80% power of the study in calculating sample size, a total of 48 implants were placed in the mandibular interforaminal area of 12 edentulous participants, who were randomly divided into 2 groups: a fully guided group, comprising 24 implants placed on 1 side by using a fully guided protocol and a partially guided group, comprising 24 implants placed on the other side in a partially guided protocol. Each group was further subdivided into 2 subgroups: cylindrical, including 12 implants placed through cylindrical guide holes, and C-shaped (12 implants) placed through C-shaped guiding holes. Postoperative cone beam computed tomography scans were made, and based on image fusion, the total deviations between the virtually preplanned and actual implant positions were determined and compared between both groups and subgroups. The linear horizontal deviation of the implant hexagon and apex, together with apical depth deviation and angular deviations between the position of the actually placed and virtually planned implants, were analyzed in 3 dimensions. The Kolmogorov-Smirnov test of normality was used. Comparisons were carried out by using the Kruskal-Wallis test. Post hoc pair-wise comparisons when the Kruskal-Wallis test was significant were carried out by using the Dunn-Sidak test (α=.05). RESULTS: No statistically significant differences were found in coronal linear deviation (P>.05), apical linear deviation (P>.05), apical depth deviation (P=.086), or angular deviation (P=.247), between the fully guided protocol and the partially guided protocol. CONCLUSIONS: The accuracy of partially guided implant placement was clinically comparable with that of fully guided placement whether the guiding holes were cylindrical or C-shaped.