Amino Acid-Enriched Formula for the Post-Operative Care of Extraction Sockets Evaluated by 3-D Intraoral Scanning.

BACKGROUND: Hyaluronic acid and amino acids play an important role in the wound healing process, stimulating the development of the connective tissue and the activity and proliferation of fibroblasts. The aim of the present controlled clinical study was to evaluate the clinical efficacy of a topical gel formula containing hyaluronic acid and amino acids in terms of wound closure rate, painkiller intake, and patients' reported pain and edema. METHODS: This study included patients in need of a single tooth extraction. Patients were randomized into two groups with differing post-operative care regimens. Patients in the test group used the amino acid and hyaluronic acid-based gel, while the control group did not use any product. Each parameter was measured in both groups at different time points: immediately after surgery, and after 7, 14, 30, and 60 days. RESULTS: A total of 40 patients (46.52 ± 9.84 years old) completed the observational period, and 40 extraction sockets were examined. After 7 days, the edema was significantly lower in the test group. The reported pain was lower in the test group without a significant difference, except for the first time point at 7 days. With the follow-up questionnaire, patients declared to have taken painkillers mainly during the first 7 days after surgery; however, the test group showed a lower need for painkillers than the control group. CONCLUSION: The post-operative and domiciliary use of an amino acid and hyaluronic acid-based gel for the management of soft tissue closure after tooth extraction is a valid coadjutant to reduce swelling, pain, and the need for painkillers. Additional studies are required to support the results of the present study.

The effectiveness of the information-motivation model and domestic brushing with a hypochlorite-based formula on peri-implant mucositis: A randomized clinical study.

OBJECTIVE: Management of mucositis is essential for the long-term maintenance of dental implants. This study determined the efficacy, in terms of clinical parameters, of an adjunctive domiciliary agent paired with non-surgical periodontal therapy (NSPT) for patients with peri-implant mucositis. MATERIALS AND METHODS: Patients involved in a periodontal maintenance program were randomly distributed to the domestic use of a chlorhexidine toothpaste and mouthwash (control) or a hypochlorite-based formula brushing solution (test) after diagnosis of peri-implant mucositis. A modified approach towards NSPTwas performed after 10 days of domestic use of the assigned maintenance product in both groups. Clinical and patient-related outcomes were recorded during a 90-day follow-up period. RESULTS: Forty patients completed the three-month study (20 patients per group). Both groups showed relevant clinical and patient outcome improvements after the NSPT (T2) and between T1 and T2 (p < 0 0.01), except for PPD. For the test group, the clinical improvement was significantly greater than that for the control group at the seventh-day evaluation (T1 ) in the gingival index (0-3) and FMBS (%). Favorable outcomes were maintained during the entire follow-up period. CONCLUSION: The present study showed that the modified NSPT paired with the domestic use of nitradine-based formula helps resolve peri-implant mucositis and that nitradine might represent an alternative to chlorhexidine in these cases. CLINICAL RELEVANCE: The gold standard for nonsurgical maintenance is full-mouth disinfection. A previous decontamination of the oral cavity with chlorhexidine or nitradine domiciliary for 10 days could reduce plaque and inflammation, resulting in a painless operative session. This protocol may help reduce airborne contamination and the risk of cross-infection, and during the pandemic, the protocol is safer for clinicians. In the same clinical cases, nitradine may be more efficient than chlorhexidine, and the former has no side effects such as discolouration.

Effects of Non-Surgical Periodontal Treatment on Reactive Oxygen Metabolites and Glycemic Control in Diabetic Patients with Chronic Periodontitis.

BACKGROUND: Periodontal infection may contribute to poor glycemic control and systemic inflammation in diabetic patients. The aim of the present study is to evaluate the efficacy of non-surgical periodontal treatment in diabetic patients by measuring oxidative stress outcomes. METHODS: Sixty diabetic patients with periodontitis were enrolled, treated with scaling and full-mouth disinfection, and randomly prescribed chlorhexidine mouthwash, antioxidant mouthwash, or ozone therapy. Reactive oxygen metabolites (ROMs), periodontal parameters, and glycated hemoglobin were measured at baseline and then at 1, 3, and 6 months after. RESULTS: At baseline, all patients presented with pathologic levels of plasmatic ROM (388 ± 21.36 U CARR), higher than the normal population. Probing depth, plaque index, and bleeding on probing values showed significant clinical improvements after treatment, accompanied by significant reductions of plasma ROM levels (p < 0.05). At the 6-month evaluation, the mean ROM relapsed to 332 ± 31.76 U CARR. Glycated hemoglobin decreased significantly (∆ = -0.52 units) after treatment. Both the test groups showed longer-lasting improvements of periodontal parameters. CONCLUSION: In diabetic patients, periodontal treatment was effective at reducing plasma ROM, which is an indicator of systemic oxidative stress and inflammation. The treatment of periodontal infection might facilitate glycemic control and decrease systemic inflammation.

Clinical and patient-centered outcomes post non-surgical periodontal therapy with the use of a non-injectable anesthetic product: A randomized clinical study.

AIM: The aim of this study was to determine the impact of different full-mouth decontamination (FMD) protocols on the effectiveness of an intrapocket anesthetic gel in periodontal maintenance patients. METHODS: Patients undergoing the periodontal maintenance program and with the need for FMD participated in this study. Patients were randomly allocated to non-surgical periodontal therapy (NSPT) with either a preparatory 15-day decontamination phase, including chlorhexidine mouth rinse and domiciliary hygiene instructions (modified FMD: test group), or without it (FMD: control group). In both groups, NSPT was performed with the aid of a non-injectable anesthetic gel. Clinical and patient-related outcomes were recorded during a 6-month follow-up period. RESULTS: Sixty patients completed the 6-month study. Both groups experienced relevant clinical improvements after NSPT, but the test group showed a significant change in periodontal parameters already after the initial 15-day preparatory period, and overall significantly better results in periodontal outcomes when compared with the control group at the last 6-month follow up: the gingival index was 2.07 ± 1.25 in the control group and 1.13 ± 0.51 in the test group. Less pain and dental-related anxiety were perceived by patients in the test group showing a 6-month mean visual analog scale of 2.13 ± 1.25 in the control group and 1.13 ± 0.83 in the test group. CONCLUSION: The present study suggested that the modification of the standard FMD could improve the clinical efficacy of non-injectable anesthetic, along with patients' short- and mid-term appreciation and compliance.

Single-blind randomized clinical trial on the efficacy of an interdental cleaning device in orthodontic patients.

BACKGROUND: It is well-known that poor oral hygiene during orthodontic treatment may lead to development of gingivitis, probing pocket depth, hyperplastic tissue, decalcification, dental caries and white spot lesions on the coronal surfaces of teeth. METHODS: Twenty-two patients with the following inclusion criteria were enrolled in the present study: fixed orthodontic treatment, age 12-18 years, systemically healthy, no history of periodontal treatment, periodontal health or gingivitis. The following clinical parameters were collected: periodontal screening and recording, plaque control record, and bleeding on probing. Oral hygiene instructions were given and a specifically designed technique for orthodontic patients was suggested. Complete information about the mechanical interdental device were also provided. Means and standard deviations or medians and interquartile ranges for each parameter were collected. RESULTS: There was a statistically significant reduction in plaque control record on both sides. The reduction in the experimental group was significantly greater compared to controls after adjusting for baseline values. There was also a statistically significant reduction in bleeding on probing in the experiment group, but not in controls. CONCLUSIONS: The combination of manual toothbrush and mechanical interdental device demonstrated a better plaque control and gingival inflammation levels in orthodontic patients compared to manual brushing alone.

Propolis as an adjuvant to non-surgical periodontal treatment: a clinical study with salivary anti-oxidant capacity assessment.

BACKGROUND: Periodontal diseases are characteristic for the excessive release of oxidant free-radicals by the host. The aim of the present study was to evaluate the efficacy of an anti-oxidant-based formula containing propolis and herbs as an adjunctive therapy to standard non-surgical periodontal treatment (NSPT) when compared to the domiciliary use of chlorhexidine-based formulae. METHODS: Forty patients were enrolled in the present study and randomly allocated to either a control (NSPT plus chlorhexidine gel formula) group or a test (NSPT plus anti-oxidant gel formula) group. Clinical parameters for the assessment of the periodontal status were evaluated at baseline, one month, and three months after NSPT, and the salivary antioxidant capacity as well. RESULTS: There were no significant clinical differences between the two groups (P>0.05). However, patients within the test group (propolis) achieved better results in terms of oxidative stress reduction (P<0.05). CONCLUSIONS: In the present study, propolis was comparable to chlorhexidine in the clinical management of gingivitis. Further studies are needed to investigate its potential as a redox modulator for the oral microbiome.

Different corrosive effects on hydroxyapatite nanocrystals and amine fluoride-based mouthwashes on dental titanium brackets: a comparative in vitro study.

Titanium plates treated in vitro with a mouthwash containing amine fluoride (100 ppm F-) and another containing zinc-substituted carbonate-hydroxyapatite have been analyzed by scanning electron microscopy and atomic force microscopy to evaluate the modification of the surface roughness induced by treatment with these two different mouthwashes. The treatment with F--based mouthwash produces a roughness characterized by higher peaks and deeper valleys in the streaks on the titanium bracket surface compared with those observed in the reference polished titanium plates. This effect causes a mechanical weakness in the metallic dental implant causing bacterial growth and therefore promotes infection and prosthesis contamination. However, the in vitro treatment with a mouthwash containing zinc-substituted carbonate-hydroxyapatite reduced the surface roughness by filling the streaks with an apatitic phase. This treatment counteracts the surface oxidative process that can affect the mechanical behavior of the titanium dental implant, which inhibits the bacterial growth contaminating prostheses.

Effect of air polishing with glycine and bicarbonate powders on a nanocomposite used in dental restorations: an in vitro study.

Air polishing increases the surface roughness of dental restorations, enhancing bacterial adhesion. This in vitro study was the first, to the authors' knowledge, to evaluate the effect of sodium bicarbonate and glycine powders, at different application distances (2 and 7 mm) and times (5, 10, and 30 seconds), on the surface roughness of a nanocomposite material used in restorations. Untreated slides were used as controls. Surface roughness was measured using atomic force microscopy. Air polishing with glycine powder for 5 seconds, at both application distances, determined the lowest surface damage. Even with all the limitations of any in vitro analysis, this study further supports the safety of this method of air polishing.