The relationship of peri-implant soft tissue wound healing with implant cover screw design: Cross-sectional study.

INTRODUCTION: Dental implants are frequently preferred method for oral rehabilitation all over the world. The incidence of various complications such as incorrect prosthesis, peri-implant mucositis, and peri-implantitis is high; premature loss of implants is encountered due to osteointegration process not being completed for some unexplained reasons. However, there is no study in the literature examining the nonfunctional period of implants. Closure screws of different implant companies have different designs like surface properties, and areas, where closure screws sit, are important reservoirs for microorganism colonization. Our study aims to evaluate the inflammatory response, epithelial maturation, and epithelial-connective tissue interaction around closure screws. METHODS: For this purpose, 52 implants belonging to five different implant companies were included in the study. Tissues removed over the cover screw during fitting of healing caps were used as biopsy material and for epithelial proliferation Ki-67, for epithelium-connective tissue interaction Syndecan-1, and for macrophage activation CD-68 expressions were evaluated by immunohistochemical analysis. Scanning electron microscopy (SEM) analyzes were performed to evaluate the presence of gap between the implant and the cover screw. RESULTS: As a result of our study, intensity of subepithelial inflammation between groups wasn't statistically different. Differences in CD-68 and Syndecan-1 levels were obtained at the lamina propria level. H score of CD-68 was statistically significantly different in epithelium (p = 0.032), and H score of Syndecan-1 was different in lamina propria (p = 0.022). There wasn't a statistically significant difference between the groups for Ki-67 (p = 0.151). CONCLUSION: Our study results indicate that in addition to the implant surface morphology, the design of the closure screws is important in the inflammatory response and epithelial maturation that develops during wound healing. Although the inflammatory response is required for healing, osteointegration, and implant survival, further investigation is needed to investigate the relationship between initial neck resorption and closure screws with radiographic and microbiological examinations.

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.

Development and validation of intraoral periapical radiography-based machine learning model for periodontal defect diagnosis.

Radiographic determination of the bone level is useful in the diagnosis and determination of the severity of the periodontal disease. Various two- and three-dimensional imaging modalities offer choices for imaging pathologic processes that affect the periodontium. In recent years, innovative computer techniques, especially artificial intelligence (AI), have begun to be used in many areas of dentistry and are helping increase treatment and diagnostic performance. This study was aimed at developing a machine-learning (ML) model and assessing the extent to which it was capable of classifying periodontal defects on 2D periapical images. Eighty-seven periapical images were examined as part of this research. The existence or absence of periodontal defects in the aforementioned images were evaluated by a human observer. The evaluations were subsequently repeated using a radiomics platform. A comparison was made of all data acquired through human observation and ML techniques by SVM analysis. According to the study findings the ability of human observers and the ML model to detect periodontal defects was significantly different in comparison to the gold standard. However, ML and human observers performed similarly for the detection of periodontal defects without a significant difference. This study reveals that the prediction of periodontal defects can be achieved by combining particular radiomic features with image variables. The proposed machine leaning model can be utilized for supporting clinical practitioners and eventually substitute evaluations conducted by human observers while enhancing future levels of performance.

Comparison of the effects of different instrumentation techniques on root surface roughness and cement loss using micro-computerized tomography: An in-vitro study.

OBJECTIVES: The purpose of this study was to compare the effectiveness of three different instruments on the cement loss and roughness of the root surface following scaling and root planning (SRP) using micro-computerized tomography (micro-CT). METHODS: In this experimental study, 60 single-rooted extracted human teeth were used and divided into three groups. All teeth were scanned with micro-CT before and after SRP. Group 1: SRP was performed by Gracey-curette, Group 2: SRP was performed by using an ultrasonic device and Group 3: SRP was performed by using a piezo ultrasonic device. Cement loss and porosity of the root surface were analysed by micro-computerized tomography, which is a current imaging technique that provides high-quality images and allows for qualitative and quantitative analysis of samples. RESULTS: Results of our study revealed that initial porosity values were 1.60%, 1.25%, 1.59% for the group 1, 2, 3, and 0.93%, 0.86 and 0.80 after SRP respectively. Although Group 3 had the least surface roughness, there was no statistically significant difference between the groups. Cement loss following SRP was 47.15 µmin the piezo ultrasonic device group, 59.44 µm in the ultrasonic device, and 134.163 µm in the Gracey-curette group respectively. The highest cement loss was seen in the Gracey-curette group, and there was a significant difference between the three groups. CONCLUSIONS: In conclusion, it was observed that surface roughness decreased and similar surface roughness was obtained with all three methods, but more cementum loss was observed with Gracey-curette. Therefore, ultrasonic devices appear to be a viable alternative to manual instrumentation with curettes.

Treatment of recurrent aphthous stomatitis with Er,Cr:YSGG laser irradiation: A randomized controlled split mouth clinical study.

The present randomized controlled split mouth clinical study aimed to investigate the efficacy of Er,Cr:YSGG laser irradiation on pain reduction and healing rate of recurrent aphthous stomatitis. 40 patients with RAS were recruited for this study and RAS ulcerations of each patient were randomly assigned to the control or test group. In the test group, Er,Cr:YSGG laser with non-contact mode was used to irradiate RAS lesions. In the placebo group, RAS lesions were irradiated with the same device without laser emission. Pain was evaluated with visual analog scale (VAS) while a clinician graded healing of RAS (HRAS). In the placebo group at immediate; scores of VAS presented no statistically significance; in the test group, laser application showed significant pain reducing, at 1st day control. In the test group, a significantly healing effect at 1st day control was observed and this effect was maintained throughout the study. In the placebo group, scores of HRAS were statistically significant at controls on 3, 7, 10days. Statistically significant difference between the scores of VAS and HRAS was found for all control days except day 10 according to the intergroup comparisons. Based on these findings, Er,Cr:YSGG laser application at 0.25W without water may be appropriate to reduce pain and also accelerate the healing of RAS.

Effect of voxel size on accuracy of cone beam computed tomography-aided assessment of periodontal furcation involvement.

OBJECTIVE: To assess the accuracy of cone beam computed tomography (CBCT) images obtained at different voxel sizes in detecting ligature-induced furcation involvement. STUDY DESIGN: Furcation lesions were prepared in 36 molar teeth in rats, and 24 intact teeth served as controls. CBCT Kodak 9000 images at three different voxel sizes were acquired: 0.076 mm, 0.100 mm, and 0.200 mm. Four observers assessed 3 sets of images using a 5-point evaluation scale. κ-Coefficients were calculated for intra- and interobserver agreement. Receiver operating characteristic analysis measured the true positive rate (TPR), true negative rate (TNR), and area under the curve (AUC). Accuracy values were compared by using Mood's Median Chi-Square (α<0.05). RESULTS: Intra- and interobserver agreement ranged from 0.600 to 0.999 and from 0.366 to 0.573, respectively. Highest median AUC and true positive rate (TPR) values were obtained for voxel size of 0.076 mm. The highest median TNR values were obtained for the voxel size 0.1 mm. There were no significant differences (P≥.05) among the median AUC, TPR, or TNR values for the 3 different CBCT voxel sizes. CONCLUSIONS: Given the limitations of this study, all voxel sizes performed similarly in the detection of furcation involvement.