Effectiveness of an 810-nm Diode Laser in Addition to Non-surgical Periodontal Therapy in Patients With Chronic Periodontitis: A Randomized Single-Blind Clinical Trial.

Introduction: This study evaluated the effectiveness of an 810-nm diode laser as an adjunct to scaling and root planning (SRP) in improving periodontal parameters in patients with chronic periodontitis. Methods: This randomized clinical trial consisted of 36 patients (16 females and 20 males) with chronic periodontitis and pocket depths of 4-6 mm. The quadrants were randomly divided into two sides; one side of each patient was selected as the laser group (SRP + laser) and the other side served as the control group (SRP alone). An 810-nm diode laser was applied in the laser side to remove the outer gingival epithelium (1.5 W, CW) as well as the inner epithelium of the periodontal pockets (1 W, CW). The clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index (PI), and clinical attachment level (CAL) were measured at baseline and 6 and 18 weeks after therapy. Results: In both groups, there was a significant improvement in BOP, PD, PI and CAL over the course of the experiment (P < 0.001). Significantly lower BOP was found in the SRP + laser group than the SRP alone group after 6 and 18 weeks of intervention (P < 0.05). The difference in other parameters was not significant between the two groups, neither at 6 nor at 18 weeks after the treatment (P > 0.05). Conclusion: Within the limitations of this study, the association of the diode laser with standard non-surgical periodontal therapy (SRP) provided minimal additional benefits for patients with moderate chronic periodontitis.

Evaluating Vitality and Sensitivity of Teeth Adjacent to the Site of Closed Sinus Lift Surgery before and after Treatment.

The aim of this study was to evaluate the effect of closed sinus lift surgery on dental vitality and periodontal sensitivity of teeth adjacent to the surgery area. Thirty patients undergoing closed sinus lift surgery by osteotomes were evaluated for dental vitality and periodontal sensitivity of adjacent teeth. Dental vitality and sensitivity were evaluated using the electric pulp tester (EPT) and cold spray once before surgery and one week, one month, and six months after surgery. In order to increase the validity of the study, one contralateral tooth in each patient was considered the control. In the test group, the number of teeth that did not respond to EPT and cold stimuli increased from baseline to six months after surgery and showed a significant difference between the four time intervals (P = 0.015 for EPT; P = 0.007 for cold stimuli). Thus, the vitality of teeth adjacent to the closed sinus lift area was lost over time. There was no significant difference between the two groups at any time for either stimuli. According to this research, tooth sensitivity to EPT and cold stimuli was not significantly different between test subjects and controls. For both cold and electrical stimulation, the number of teeth that did not respond was highest at one week after surgery and significantly different from baseline. However, after six months postsurgery, this number decreased, indicating recovery. However, some teeth were considered necrotic in the sixth month. It can be concluded that closed sinus lift surgery may cause necrosis in adjacent teeth, but more studies are required.

Evaluating Vitality and Periodontal Sensitivity of Teeth Adjacent to the Site of Open Sinus Lift Surgery before and after Treatment: A Case Series Study.

The aim of this study was to evaluate the effect of open sinus lift surgery on dental vitality and periodontal sensitivity of teeth adjacent to a surgery area. Forty-one patients undergoing open sinus lift surgery were evaluated for dental vitality and periodontal sensitivity of adjacent teeth. Dental vitality was evaluated using an electric pulp tester and cold spray. Periodontal sensitivity of teeth in the surgery area of open sinus lift was evaluated by interview and visual analogue scale before surgery and one, three, and six weeks after surgery. In order to increase the validity of the study, one healthy tooth was considered as a control. In the experimental group, differences in periodontal sensitivity were significant between the four measured times (P < 0.001). Pretreatment compared with three weeks posttreatment, pretreatment compared with one week posttreatment, six weeks posttreatment compared with one week posttreatment, and three weeks posttreatment compared with one week posttreatment showed significant differences (P = 0.001). In the control group, the periodontal sensitivity between the four measured times did not differ significantly (P = 0.421). In the experimental group, pulpal sensitivity was significant between the four measured times (P = 0.019). It was found that the test and control groups showed significant differences in pretreatment versus six weeks posttreatment and one week posttreatment versus three weeks posttreatment (P < 0.001). Pulse sensitivity significantly changed after open sinus lift surgery, making it clear that the surgery may lead to necrosis of adjacent teeth. However, further research is needed. Also, teeth in area of the surgery may be periodontally affected, but will undergo recovery.

Immediate Nonfunctional Loading of a Single Implant in the Posterior Maxillary Area: A Randomized Clinical Trial.

This study compared the clinical and radiographic outcomes of immediate nonfunctional loading of implants to conventional loading in the posterior maxilla. In this single-blind randomized clinical trial, a total of 39 implants were inserted and evaluated in 32 patients. Nineteen implants were in the control group, and 20 implants were placed in the test group. The test group received implants and immediate restoration within 72 hours after surgery; the control group was followed by a conventional loading protocol 4 months after surgery. Follow-up appointments were performed at 4, 6, and 12 months. Clinical assessment included measurement of implant stability through resonance frequency analysis (RFA), probing depth around the implant in four aspects, and survival rate. Radiographic assessment, including evaluation of crestal bone loss in the mesial and distal of the implants by parallel periapical radiography, was conducted. Twenty-nine implants were followed throughout the study period, completing the entire intended follow-up. No significant difference was seen between the test and control groups in terms of crestal bone loss at any interval either in mesial or distal aspects. Also, no significant difference was found between the two groups regarding implant stability. Probing depth did not show significant differences between groups at 6 and 12 months. Only one implant in the control group failed before prosthesis loading, and no failure was observed in the test group. Average of insertion torque in the control group and the test groups were 49 and 51 N/cm, respectively. This variable also showed no significant difference between the two groups. If appropriate primary stability is achieved, nonfunctional immediate loading of implants in the posterior maxilla may have similar results to conventional loading in this area. Using this protocol, the time of edentulousness could be minimized.

Evaluation of Toothpaste Containing Aqueous Saffron Stigma Extract on Gingival Indices in Patients with Marginal Generalized Plaque-Induced Gingivitis.

BACKGROUND: Gingivitis is an inflammatory disease involving the gums. Saffron contains various forms of flavonoids, glycosides, and anthocyanin compounds that are proven to have anti-inflammatory and antioxidant effects. This study evaluates the anti-inflammatory effects of Saffron stigma on gingival indices in patients with marginal generalized plaque-induced gingivitis. METHODS: For this study, we used toothpaste containing aqueous extract of Saffron stigma. Twenty-two patients with generalized marginal gingivitis were selected. Patients were randomly divided into two equal groups of test and placebo. In each group the pocket depth index (PD), gingival index (GI), plaque index (PI) and bleeding of probing index (BOP) were measured before and one month after use. Independent t-test, Mann-Whitney test and Wilcoxon test were used for statistical analysis (P<0.05). RESULTS: The comparison between gingival indices before and one month after toothpaste usage showed a significant decrease in some measured indices at the end of the study. Saffron stigma treated group had a significant difference in reducing GI and BOP indices in comparison with the placebo group (P<0.05). However, the difference for PD and PI indices was not statistically significant (P>0.05). CONCLUSION: In this study, it was found that using aqueous extract of Saffron stigma flower containing toothpaste might have a positive effect on some gingival indices in patients with gingivitis.

Comparative study of 0.2% and 0.12% digluconate chlorhexidine mouth rinses on the level of dental staining and gingival indices.

BACKGROUND: Chlorhexidine (CHX) as a gold standard chemical agent appears to be the most effective antimicrobial agent for reduction of both plaque and gingivitis. The aim of this study was to compare the efficacy of two concentrations of digluconate chlorhexidine (CHX) solutions (0.12% and 0.20%) on gingival indices and the level of dental staining during 14 days. MATERIALS AND METHODS: in this double-blind controlled clinical trial study 60 patients with moderate to severe gingivitis aged 17-56 years were randomly selected and divided to three groups: Group I (placebo) Group II (0.12% CHX), and Group III (0.2% CHX). Patients rinsed their mouthwashes twice a day after brushing. Before the examination and after 14 days plaque index, gingival index, bleeding index, and stain index were evaluated. The data were analyzed by "Mann-Whitney" test and P value was 0.05. RESULTS: the results showed that plaque index and gingival index significantly reduced in Groups II and III in comparison with the placebo group (P < 0.0001). However, the two concentrations did not differ significantly from each other (P = 0.552). Same results were observed in term of gingival bleeding index with this different that 0.2% CHX was significantly more efficient than 0.12% CHX (P < 0.0001). CHX mouthrinse, both concentrations, significantly increased the dental staining level (intensity and area) in comparison with the placebo group. Remarkable difference also was seen between 2 CHX concentrations so that the 0.2% CHX caused much more staining on the teeth than 0.12% CHX. CONCLUSION: based on the results of this study we can conclude that the lower concentrations of CHX should be prescribed, decreasing side effects, since higher concentrations do not seem to be more effective in controlling dental plaque and gingivitis.