Micro-CT evaluation of the effect of various ScRp instrumentation methods on cement loss, porosity and micro-crack formation.

OBJECTIVES: The purpose of this study was to compare the effectiveness of three different instruments on cement loss, porosity and micro-crack formation, which was not evaluated before, following scaling and root planning (SRP) using micro-computed tomography (micro-CT). METHODS: In this experimental study, 30 single-rooted extracted human teeth were used and divided into three groups. All the teeth were scanned with micro-CT before and after SRP. Group 1: SRP was performed with Gracey curettes, Group 2: SRP was performed by using an ultrasonic device, and Group 3: SRP was performed by using diamond burs. Cement loss from the root surface, porosity, and micro-crack formation in the root dentine were analysed. Micro-CT is used for qualitative and quantitative analysis of samples. The obtained data were analysed statistically (p < 0.05). RESULTS: Minimum cement loss following SRP was detected with ultrasonic scaler (26.98 mm3 ), whereas the highest was created by diamond burs (96.20 mm3 ) (p < 0.05). The total porosity values after SRP were 0.278%, 0.334% and 0.252% for Groups 1, 2 and 3, respectively. Although Group 3 had the least porosity values, there was no statistically significant difference between the groups. The highest micro-crack formation was seen in Group 2 and the lowest was in Group 1 with a significant difference (p < 0.05). CONCLUSIONS: More cement loss was observed with diamond burs. Ultrasonic devices appear to be a viable alternative to instrumentation with curettes. However, ultrasonic devices should be used carefully because of micro-crack formation since the micro-crack resulting from instrumentation with hand instruments is the least of all.

The Evaluation of the Relationship between Changes in Masseter Muscle Thickness and Tooth Clenching Habits of Bruxism Patients Treated with Botulinum Toxin A.

Background: Bruxism is defined as recurrent masticatory muscle activity. Although there is not an agreed treatment method for bruxism, the application of botulinum toxin A (BT-A) has become a reliable lately. This study aimed to evaluate the correlation between the changes in masseter muscle thickness and clenching habits in bruxism patients treated with BT-A. Methods: Twenty-five patients, 23 females and 2 males, diagnosed with possible sleep bruxism were included in the study. The Fonseca Anamnestic Index was applied to the patients to determine their clenching habits and depression levels both before the treatment, and 6 months after it. The masseter muscle thickness was measured using ultrasonography before the treatment and 3 months and 6 months after the treatment. All the patients were injected with a total of 50 U of BT-A, 25 U to each masseter. Results: A statistically significant decrease in masseter muscle thickness was observed in the ultrasonography 3 and 6 months after the BT-A treatment. There was a statistically significant decrease in the Fonseca scores, in which the teeth clenching habits of the patients were evaluated 6 months after the treatment. Although there was a decrease in the depression levels of the patients 6 months after the treatment, this difference was not statistically significant. Conclusion: When the results of this study were evaluated, it was seen that the BT-A injections are an effective, safe, and side effect-free method in the treatment of bruxism and masseter hypertrophy.

Adjunctive Systemic Azithromycin with Nonsurgical Periodontal Treatment: Effects on Clinical Parameters in Smokers with Periodontitis.

Objectives: Smokers with periodontitis are therapeutically challenging. Azithromycin (AZM) may be used as an adjunct to periodontal treatment. The aim of this randomized, double-blind, controlled clinical study was to determine the effect of azithromycin in shallow, moderate, and deep pocket depths in smokers when combined with non-surgical periodontal treatment. Material and methods: Forty-nine patients who smoked at least 20 cigarettes per day for more than 5 years were included in the study; however only 40 completed it. The number of teeth, plaque index (PI), gingival index (GI), PPD, CAL, bleeding on probing (BOP) and gingival recession were recorded at baseline and months 1, 3 and 6. The pocket depths (PD) were grouped as shallow, moderate, and deep. Twenty-four patients assigned to the AZM+ (test) group received AZM (500 mg tablets) once a day for 3 days, beginning on the first day of SRP. Results: The decline in the total number of pockets in all groups was statistically significant from baseline to 1st, baseline to 3rd, baseline to 6th; and from 1st to 3rd and 1st to 6th months. There was a statistically significant increase in the number of shallow pockets between baseline and 3rd, baseline and 6th; and 1st and 6th months (p=0.000) for both groups. Conclusion: Antibiotic administration significantly increased the number of shallow pockets at all time points. However, larger scale controlled clinical studies are needed to verify the efficiency of AZM in smoker periodontitis patients.

Evaluation of a metal artifact reduction algorithm and an adaptive image noise optimization filter in the estimation of peri-implant fenestration defects using cone beam computed tomography: an in-vitro study.

OBJECTIVE: The aim of this study is to assess the effects of metal artifact reduction (MAR) and adaptive image noise enhancer (AINO) in CBCT imaging on the detection accuracy of artificially created fenestration defects in proximity to titanium and zirconium implants in sheep jaw. METHODS: Six zirconium and 10 titanium implants were planted on mandibular jaws of three sheep, and artificial defects were created. All images were obtained with a standard voxel size (0.150 mm3) and with 4 scan modes: (1) without MAR/without AINO; (2) with MAR/without AINO; (3) without MAR/with AINO; and (4) with MAR/with AINO during CBCT scanning. A total of 60 CBCT scans were produced. RESULTS: For all types of implants, intra- and inter-observer kappa values were the highest for MAR filter. The scan mode of with MAR filter was found to have the highest area under the curve (AUC), whereas the scan mode of without both MAR and AINO filters was found to have the lowest AUC values with statistical significance (p ≤ 0.05). Titanium implants were found to have higher AUC values than zirconium (p ≤ 0.05). CONCLUSION: Both MAR module and AINO filters enhance the accuracy of the detection of peri-implant fenestrations; however, the use of MAR filter solely can be recommended for detection of peri-implant fenestrations.

Dental students' ability to assess gingival health status with DAAGS software.

The aim of this study was to evaluate the ability of dental students at different levels of education (Basic, Preclinic, and Clinic groups) to assess the level of gingival health status by using the Development of Ability to Assess Gingival Status (DAAGS) computer software program designed according to the Oral Rating Index (ORI) criteria. Two hundred and thirteen dental students at three levels of dental education voluntarily participated in three DAAGS tests in which they judged twenty-four photos. The three groups were first- and second-year dental students (Basic), third- and fourth-year dental students who had not yet participated in the clinical periodontology course (Preclinic), and fifth-year dental students who had completed the clinical periodontology course (Clinic). A gold standard of each photo was shown after completing Test 1, and then Test 2 was conducted immediately. Two weeks later, the third test was performed. Analyses of differences among the groups and between the tests for each groups were carried out by using Kruskal-Wallis and Wilcoxon Sign Rank tests, respectively. Students were asked to evaluate the DAAGS by written survey. Most of the students had a positive opinion. There were significant differences among the groups for correct and irrelevant answers and overall ability (p<0.001). The Basic group showed a significant (p<0.01) improvement between Test 1 and Test 2. This improvement was greater than Preclinic students and almost equal to Clinic students. The findings from this study indicate that the DAAGS software can serve as a useful instructional tool for education.

Turkish dental students' and dentists' ability to assess gingival health status with DAAGS software.

The aim of this study was to compare the ability of final-year Turkish dental students and dentists to assess the level of gingival health status by using the Development of Ability to Assess Gingival Status (DAAGS) computer program. Forty-eight students in their final year of dental education and 240 dentists participated in DAAGS tests in which they judged twenty-four photos. The participants were organized into one group of students and five groups of dentists: those who graduated in the last five years, in the last six to ten years, in the last eleven to fifteen years, in the last sixteen to twenty years, and twenty and/or more years ago. A gold standard of each photo was shown to participants after they completed test 1; then, test 2 was conducted immediately. Participants were asked to evaluate the DAAGS by written survey. There were significant differences between the parameters of two tests for all groups. Significance levels differed for each group and both tests considering correct answers, reproducibility, irrelevant answers, and overall ability. The findings from this study indicated that the DAAGS software is easier for more recently graduated dentists to use.