The effect of electronic cigarette use on peri-implant conditions in men: a systematic review and meta-analysis.

OBJECTIVE: To systematically review the effect of electronic cigarette (e-cigarette) use on clinical, radiographic, and immunologic peri-implant parameters in males. STUDY DESIGN: A comprehensive search of indexed databases was conducted to identify studies reporting data on both e-cigarette users and nonsmokers with implant-supported prosthesis with ≥1-year in function, up to May 2022. Marginal bone loss (MBL), probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were recorded. Peri-implant sulcular fluid volume (PISF), tumor necrosis factor alpha (TNF-α) and interleukin 1ß (IL-ß) levels were also assessed. A meta-analysis was performed using random-effect models to determine the effect of e-cigarette use in primary and secondary outcomes. RESULTS: Four cross-sectional studies were included with a total of 327 participants (165 e-cigarette users and 162 nonsmokers). All studies showed greater MBL, PI, PD, and lower BOP in e-cigarette users compared with never smokers. The meta-analysis indicated significant heterogeneity for all outcomes except MBL for distal implant surfaces, with the mean difference between e-cigarette users and nonsmokers of 0.89 mm (95% CI: 0.67-1.11, P < .01). The PISF volume, TNF-α, and IL-1ß levels were increased in e-cigarette users (P < .01) with no heterogeneity present between studies. CONCLUSIONS: E-cigarette use shows a negative effect on clinical, radiographic, and immunologic parameters of dental implants.

The Opioid Analgesic Reduction Study (OARS)-a comparison of opioid vs. non-opioid combination analgesics for management of post-surgical pain: a double-blind randomized clinical trial.

BACKGROUND: Everyday people die unnecessarily from opioid overdose-related addiction. Dentists are among the leading prescribers of opioid analgesics. Opioid-seeking behaviors have been linked to receipt of initial opioid prescriptions following the common dental procedure of third molar extraction. With each opioid prescription, a patient's risk for opioid misuse or abuse increases. With an estimated 56 million tablets of 5 mg hydrocodone annually prescribed after third molar extractions in the USA, 3.5 million young adults may be unnecessarily exposed to opioids by dentists who are inadvertently increasing their patient's risk for addiction. METHODS: A double-blind, stratified randomized, multi-center clinical trial has been designed to evaluate whether a combination of over-the-counter non-opioid-containing analgesics is not inferior to the most prescribed opioid analgesic. The impacted 3rd molar extraction model is being used due to the predictable severity of the post-operative pain and generalizability of results. Within each site/clinic and gender type (male/female), patients are randomized to receive either OPIOID (hydrocodone/acetaminophen 5/300 mg) or NON-OPIOID (ibuprofen/acetaminophen 400/500 mg). Outcome data include pain levels, adverse events, overall patient satisfaction, ability to sleep, and ability to perform daily functions. To develop clinical guidelines and a clinical decision-making tool, pain management, extraction difficulty, and the number of tablets taken are being collected, enabling an experimental decision-making tool to be developed. DISCUSSION: The proposed methods address the shortcomings of other analgesic studies. Although prior studies have tested short-term effects of single doses of pain medications, patients and their dentists are interested in managing pain for the entire post-operative period, not just the first 12 h. After surgery, patients expect to be able to perform normal daily functions without feeling nauseous or dizzy and they desire a restful sleep at night. Parents of young people are concerned with the risks of opioid use and misuse, related either to treatments received or to subsequent use of leftover pills. Upon successful completion of this clinical trial, dentists, patients, and their families will be better able to make informed decisions regarding post-operative pain management. TRIAL REGISTRATION: ClinicalTrials.gov NCT04452344 . Registered on June 20, 2020.

Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain.

INTRODUCTION: The objective of this study is to determine whether elevated circulating plasma catecholamine levels significantly impact opioid requirements during the first 24 hours postoperative period in individuals with acute surgical pain. METHODS: We retrospectively reviewed 15 electronic medical records (EMRs) from adults 18 years and older, with confirmed elevated plasma catecholamine levels (experimental) and 15 electronic health records (EHRs) from matched-controls for age, gender, race and type of surgery, with a follow up of 24 hours postoperatively. RESULTS: The total morphine milligram equivalents (MMEs) requirements from the experimental group were not statistically different when compared with controls [44.1 (13 to 163) mg versus 47.5 (13 to 151) mg respectively; p 0.4965]. However, the intraoperative MMEs showed a significant difference, among the two groups; [(experimental) 32.5 (13. to 130) mg, (control) 15 (6.5 to 130) mg; p 0.0734]. The intraoperative dosage of midazolam showed a highly significant positive correlation to the total MMEs (p 0.0005). The subjects with both elevated plasma catecholamines and hypertension used significantly higher intraoperative MMEs compared to controls [34.1 (13 to 130) mg versus 15 (6.5 to 130) mg, respectively; p 0.0292)]. Those 51 years and younger, with elevated circulating levels of catecholamines, required significantly higher levels of both the postoperative MMEs [29.1 (0 to 45) mg versus 12 (0 to 71.5) mg; (p 0.0553)] and total MMEs [544.05 (13 to 81) mg versus 29.42 (13 to 92.5) mg; (p 0.00018), when compared to controls with history of nicotine and alcohol use. CONCLUSION: This preliminary study evaluated a biologic factor, which have promising clinical usefulness for predicting analgesic requirements that can drive clinical decisions on acute surgical pain.

Effects of whitening toothpaste and bleaching treatment on resin composite discoloration caused by cigarette smoke and electronic vapor aerosol.

PURPOSE: To compare the effects of whitening toothpaste and bleaching with 6% hydrogen peroxide (H2O2) on discoloration of dental resin composite caused by cigarette smoke (CS) and electronic vapor product (EVP) aerosol. METHODS: 40 resin composite discs were divided into three groups: 15 each for CS and EVP aerosol exposure and 10 for air exposure (control). Exposures were performed for 15 days, with daily brushing with regular toothpaste. Two whitening sessions, including 21 days of brushing with whitening toothpaste and 3 days of treatments with take-home bleaching (6% H2O2), were performed after the exposure. Color and gloss were assessed before exposure, at every 5 days of exposure, and after each whitening session. RESULTS: After 15 days of exposure, marked discoloration of resin composite was observed in the CS group (ΔE = 23.66 ± 2.31), minimal color change in the EVP group ((ΔE = 2.77 ± 0.75), and no color change in the control group. Resin composites exposed to CS did not recover their original color after treatment with whitening toothpaste ((ΔE = 20.17 ± 2.68) or take-home bleaching ((ΔE = 19.32 ± 2.53), but those exposed to EVP aerosol reverted to baseline after treatment with whitening toothpaste ((ΔE = 0.98 ± 0.37), and no further change in color was observed following take-home bleaching. The gloss of resin composites exposed to CS, EVP aerosol, and air decreased equally with exposure time. Brushing with whitening toothpaste recovered the gloss similarly in all groups, but no further change was observed following take-home bleaching. CLINICAL SIGNIFICANCE: Aerosol from electronic vapor products induced minimal discoloration of resin composites that can be completely reverted by brushing with whitening toothpaste alone. Bleaching with 6% H2O2 did not revert discoloration caused by cigarette smoke. Whitening toothpaste could help revert the decreased gloss of resin composites.

Effects of different discoloration challenges and whitening treatments on dental hard tissues and composite resin restorations.

OBJECTIVES: To compare the relative effects of cigarette smoke (CS), electronic cigarette (EC), red wine, coffee, and soy sauce on the color of enamel, dentin, and composite resin restorations, as well as the effects of whitening treatments. METHODS: Seventy premolars with composite restorations were exposed to CS, EC aerosol (a novel EC device with MESH™ technology [P4M3 version 1.0, Philip Morris International]), red wine, coffee, and soy sauce for 56 min/day for 15 days. Two whitening sessions with 6% and 35% hydrogen peroxide (H2O2) were performed on the exposed samples. Teeth exposed to CS and EC aerosol were also brushed with whitening toothpaste for 3 weeks. Color match of resin restorations was assessed, and color changes were compared after exposure and after whitening treatments. RESULTS: Discolorations in enamel, dentin, and composite resin were observed in the order of red wine > CS > soy sauce > coffee > EC. Color mismatch between enamel and resin restorations occurred only in red wine and CS groups. Brushing with whitening toothpaste removed discoloration caused by EC aerosol; H2O2 treatments were necessary to eliminate discolorations caused by coffee and soy sauce. Discolorations of dentin and resin restorations could not be completely removed by whitening treatments, and color mismatch remained in teeth exposed to red wine and CS. CONCLUSION: Red wine and CS cause significant tooth discoloration and color mismatch in enamel and resin restorations that are not reversible by whitening treatments. Tooth discoloration associated with EC aerosol was minimal and could be removed by brushing with whitening toothpaste. CLINICAL SIGNIFICANCE: Red wine drinkers and cigarette smokers have increased risks for tooth discoloration and color mismatch between enamel and composite resin restorations. Whitening treatments may not be effective in correcting the color mismatch. Tooth discoloration associated with EC aerosol is minimal.

Oral lichenoid reactions may possibly be associated with abatacept: A case report and literature update.

Oral lichenoid reactions (OLRs) comprise a group of conditions with a common clinical appearance and histopathologic pattern that may be induced by several conditions or medications. This report describes an OLR possibly induced by a biologic agent. A 69-year-old woman with rheumatoid arthritis presented with a chief complaint of oral pain. The patient retroactively reported of skin lesions as well. Clinically, she had mixed red-white mucosal lesions and ulcers suggestive of an OLR. This diagnosis was supported by histopathologic findings. Withholding the putative etiologic agent, abatacept, resulted in immediate alleviation of both oral and skin lesions. Abatacept and other biologics are thought to help treat inflammation and are becoming more commonly prescribed to treat rheumatoid arthritis. However, the clinicians should explore these medications as a causative factor for OLR.

Male Infertility and Dental Health Status: A Systematic Review.

A limited number of studies have reported an association between male factor infertility (MFI) and dental health status (DHS). The aim of the present study was to assess the association between DHS and MFI through a systematic review of indexed literature. To address the focused question-"Is there a relationship between DHS and MFI?"-indexed databases were searched up to March 2016 using various key words "infertility," "periodontal disease," "periodontitis," "dental infection," "caries," and "odontogenic infection." Letters to the editor, case reports, commentaries, historic reviews, and experimental studies were excluded. In total seven studies were included in the present systematic review and processed for data extraction. All the studies reported a positive association between MFI and DHS. The number of study participants ranged between 18 and 360 individuals. Results from six studies showed a positive association between chronic periodontitis and MFI. Three studies reported a positive relationship between MFI and odontogenic infections associated to necrotic pulp, chronic apical osteitis, and radicular cysts. One study reported a relationship between caries index and MFI. From the literature reviewed, there seems to be a positive association between MFI and DHS; however, further longitudinal studies and randomized control trials assessing confounders are needed to establish real correlation. Dentists and general practitioners should be aware that oral diseases can influence the systemic health. Andrological examination should include comprehensive oral evaluation, and physicians detecting oral diseases should refer the patient to a dentist for further evaluation.

Effects of cigarette smoking on color stability of dental resin composites.

PURPOSE: To study the effects of cigarette smoke (CS) on the discoloration of dental resin composite compared with the aerosol from a heat-not-burn tobacco product, the Tobacco Heating System 2.2 (THS2.2). METHODS: A total of 60 discs were prepared from three commercial resin composites: Durafill VS (DVS), Filtek Supreme Ultra (FSU) and Tetric EvoCeram BulkFill (TEC). Twenty discs of each composite were divided into two groups and exposed to CS from 20 reference cigarettes (3R4F) or aerosol from 20 THS2.2 tobacco sticks per day for 3 weeks. Color, gloss and surface roughness of the composite discs were measured at baseline and after exposure and brushing with toothpaste at 1, 2 and 3 weeks. RESULTS: Color differences from the baseline (ΔE) were on average 27.1 (±3.6) in 3R4F and 3.9 (±1.5) in the THS2.2 group after 3 weeks of exposure (P< 0.0001). TEC (30.4±1.4 and FSU (28.0 ±2.5) exhibited more discoloration than DVS (23.0±1.2) in the 3R4F group (P< 0.0001). FSU (2.6 ±0.5) showed significantly less discoloration than TEC (5.3±1.5) in the THS2.2 group (P< 0.0001). Surface roughness of resin composites was not affected by either CS or THS2.2 aerosol, while surface gloss increased in the composite discs with more severe discoloration. CLINICAL SIGNIFICANCE: Cigarette smoke caused significant discoloration of dental composite resins. Reducing or eliminating the deposits derived from combustion of tobacco has the potential to minimize the impact of smoking on the color of composite resin restorations.

Comparison of Periodontal Parameters and Self-Perceived Oral Symptoms Among Cigarette Smokers, Individuals Vaping Electronic Cigarettes, and Never-Smokers.

BACKGROUND: To the authors' knowledge, there are no studies that have compared periodontal parameters and self-perceived oral symptoms (OSs) among cigarette smokers (CSs) (group 1), individuals exclusively vaping electronic cigarettes (group 2), and never-smokers (NSs) (group 3). The aim of this study is to assess periodontal parameters and self-perceived OSs among vaping individuals, CSs, and NSs. METHODS: Ninety-four male participants (groups 1, 2, and 3: 33, 31, and 30 individuals, respectively) were included. Demographic data, self-perceived OSs, and duration and daily frequency of vaping and smoking were gathered using a questionnaire. Full-mouth plaque index (PI), bleeding on probing (BOP), probing depth (PD) ≥4 mm, and clinical attachment loss (AL) were measured; marginal bone loss (MBL) around all teeth was measured on digital radiographs. Numbers of missing teeth (MT) were also recorded. Odds ratios were calculated for OSs, and periodontal parameters were assessed using analysis of variance and Bonferroni post hoc tests. P <0.05 was considered statistically significant. RESULTS: PI (P <0.01) and PD ≥4 mm (P <0.01) were significantly higher in groups 1 and 2 than in group 3. BOP was significantly higher in group 3 than in groups 1 (P <0.01) and 2 (P <0.01). There was no difference in number of MT, clinical AL, and MBL among all groups. Gingival pain was more often reported by individuals in group 1 than by individuals in groups 2 (P <0.01) and 3 (P <0.01). CONCLUSION: Periodontal inflammation and self-perceived OSs were poorer among CSs than among vaping individuals and NSs.

Is mechanical curettage with adjunct photodynamic therapy more effective in the treatment of peri-implantitis than mechanical curettage alone?

BACKGROUND: The aim of the present study was to review the pertinent literature on the effects of mechanical curettage (MC) with and without adjunct photodynamic therapy (PDT) for the management of peri-implantitis. METHODS: The addressed focused question was "Is PDT effective in the treatment of peri-implantitis?" A search without language or time restrictions up to March 2016 was conducted using various key words. The exclusion criteria included; review papers, in vitro Studies, case reports, commentaries, interviews, and letters to the editors. RESULTS: In total 9 studies were included. Among them 5 studies were clinical and 4 were experimental. All the studies used PDT as an adjunctive to MC in their test groups. The laser wavelengths used ranged from 660nm to 830nm. One study showed significant reduction of the bleeding scores, inflammatory exudates and Aggregatibacter actinomycetemcomitans count in group with PDT as an adjunctive when compared to MC and 0.2% chlorhexidine. However, in four clinical studies comparable periodontal parameters were reported when PDT is used as an adjunct to MC was compared to MC in treatment of peri-implantitis. In three experimental studies, outcomes were significantly better in group with PDT as an adjunct to MC when compared to MC alone at follow-up. CONCLUSION: The role of PDT as an adjunct to MC in the treatment of peri-implantitis is debatable. Further longterm randomised control trails are needed to justify the role PDT as an adjunct to MC in treatment of peri-implantitis.

Effect of Nd:YAG laser-assisted non-surgical periodontal therapy on clinical periodontal and serum biomarkers in patients with and without coronary artery disease: A short-term pilot study.

BACKGROUND/OBJECTIVE: We hypothesized that nonsurgical-periodontal-therapy (NSPT) with adjunct Nd:YAG laser therapy is more effective in reducing periodontal inflammatory parameters (plaque index [PI], bleeding-on-probing [BOP], and probing-pocket-depth [PPD]) and serum interleukin-1beta (IL-1ß) and matrix metalloproteinase-9 (MMP-9) levels in patients with and without coronary artery disease (CAD) than NSPT alone. The aim of this short-term pilot study was to assess the effect of NSPT + Nd:YAG laser therapy on periodontal parameters and serum IL-1ß and MMP-9 levels in patients with and without CAD. STUDY DESIGN: A prospective randomized clinical study was conducted on 87 patients who were divided into two groups: Group-1: 44 patients with CAD and periodontal disease (PD) and Group-2: 43 patients with PD alone. Treatment-wise, these individuals were randomly divided into two subgroups: (i) NSPT alone and (ii) NSPT + Nd:YAG laser therapy. Demographic information was collected using a self-completed questionnaire. Periodontal parameters (PI, BOP, and PPD) and serum IL-1ß and MMP-9 levels were measured at baseline and after 3 months of treatment. P-values <0.05 were considered statistically significant. RESULTS: At 3 months follow-up, PI (P < 0.01), BOP (P < 0.01), PPD ≥ 4 mm (P < 0.01), and serum IL-1ß (P < 0.01) and MMP-9 (P < 0.01) levels were significantly higher in patients treated with NSPT alone than those treated with NSPT + Nd:YAG laser therapy. Among patients that underwent NSPT + laser therapy in both groups, periodontal parameters and serum IL-1ß, and MMP-9 levels were comparable at 3-months follow-up. CONCLUSION: NSPT + Nd:YAG laser therapy may be more effective in reducing periodontal inflammation and serum IL-1ß and MMP-9 levels in patients with and without CAD than NSPT alone. Lasers Surg. Med. 48:929-935, 2016. © 2016 Wiley Periodicals, Inc.

Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review.

The aim of this study was to review the cytokine profiles in the synovial fluid (SF) of patients with temporomandibular joint disorders (TMJD). Databases were searched from 1965 till September 2015 using different combinations of the following key words: "Temporomandibular joint"; "Cytokine"; "disorder"; and "synovial fluid" and "inflammation". Titles and abstracts of studies identified using the above-described protocol were screened and checked for agreement. Full-texts of articles judged by title and abstract to be relevant were read and independently evaluated. Hand-searching of the reference lists of potentially relevant original and review articles was also performed. The pattern of the present systematic review was customized to mainly summarize the relevant data. Fifteen studies were included. In 12 studies, cytokine profile of patients with TMJD was assessed using enzyme linked immunosorbent assay; and in 2 studies, histological analysis was performed to assess the cytokine profile of patients with TMJD. Patients with TMJD presented raised levels of interleukin (IL)-6 in 8 studies, IL-1beta (1ß) in 5 studies and tumor necrosis factor-alpha (TNF-α) in 5 studies. Two studies showed no significant difference in TNF-α levels in patients with and without TMJD; and IL-1ß levels were comparable in patients with and without TMJD in 2 studies. Raised levels of IL-6, TNF-α, IL-1ß, IL-8, and IFN-γ in the SF have been associated with inflammation in patients with TMJD. Cytokines IL-10, osteoclastogenesis inhibitory factor/osteoprotegerin (OCIF/OPG), and VEGF found in the SF of TMJs could have an anti-inflammatory effect.

Comparison of Clinical and Radiographic Periodontal Status Between Habitual Water-Pipe Smokers and Cigarette Smokers.

BACKGROUND: There is a dearth of studies that have compared clinical and radiologic markers of periodontal inflammation between water-pipe smokers (WPs) and cigarette smokers (CSs). The aim of the present study is to compare the clinical and radiographic periodontal status between habitual WPs and CSs. METHODS: In total, 200 males (50 WPs, 50 CSs, and 100 controls) with comparable mean age and education were included. Demographic information was recorded using a questionnaire. Periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [AL], and marginal bone loss [MBL]) and numbers of missing teeth (MT) were recorded. RESULTS: The duration of each smoking session for WPs and CSs was 50.2 ± 6.7 and 15.3 ± 0.4 minutes, respectively. Number of MT [P <0.0001], PI [P <0.0001], AL [P <0.0001], PD ≥4 mm [P <0.0001], and MBL [P <0.0001]) was significantly higher among WPs and CSs than controls. BOP was significantly higher among controls than WPs (P <0.0001) and CSs (P <0.0001). There was no statistically significant difference in the aforementioned parameters between WPs and CSs. CONCLUSIONS: Males in a Saudi Arabian community who were CSs or WPs had more MT and poorer periodontal condition than never smokers. The periodontal condition of WPs was equally as poor as CSs. Additional clinical observational studies with emphasis on sex and sociodemographic characteristics are needed.

Periodontal Inflammatory Conditions Among Smokers and Never-Smokers With and Without Type 2 Diabetes Mellitus.

BACKGROUND: There is a dearth of studies regarding the influence of cigarette smoking on periodontal inflammatory conditions among patients with type 2 diabetes mellitus (T2DM). The aim of the present study is to assess periodontal inflammatory conditions among smokers and never-smokers with and without T2DM. METHODS: One hundred individuals (50 patients with T2DM [25 smokers and 25 never-smokers] and 50 controls [25 smokers and 25 never-smokers]) were included. Information regarding age, sex, duration and daily frequency of smoking, duration and treatment of diabetes, and oral hygiene was recorded using a questionnaire. Periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [AL], and marginal bone loss [MBL]) were measured. Hemoglobin A1c (HbA1c) levels were also recorded. RESULTS: Mean age, monthly income status, and education levels were comparable among smokers and never-smokers with and without T2DM. Mean HbA1c levels were significantly higher among patients with T2DM (8.2% ± 0.1%) compared with controls (4.4% ± 0.3%) (P <0.05). Smokers in the control group were smoking significantly greater numbers of cigarettes (15.5 ± 2.5 cigarettes daily) compared with smokers with T2DM (6.2 ± 2.1 cigarettes daily) (P <0.05). Periodontal parameters were comparable among smokers and never-smokers with T2DM. Among controls, periodontal parameters (PI [P <0.05], AL [P <0.05], PD ≥4 mm [P <0.05], and MBL [P <0.05]) were significantly higher in smokers than never-smokers. Never-smokers with T2DM had worse periodontal status than smokers and never-smokers in the control group (P <0.05). CONCLUSIONS: Periodontal inflammatory conditions are comparable among smokers and never-smokers with T2DM. Among controls, periodontal inflammation is worse among smokers than never-smokers.

Periodontal Status and Whole Salivary Cytokine Profile Among Smokers and Never-Smokers With and Without Prediabetes.

BACKGROUND: Whole salivary interleukin (IL)-1ß and IL-6 in smokers and never-smokers with prediabetes remains uninvestigated. The aim of this study is to assess the periodontal status and whole salivary IL-1ß and IL-6 levels among smokers and never-smokers with and without prediabetes (controls). METHODS: Ninety-five males (45 with prediabetes and 50 systemically healthy controls) were included. Twenty-seven controls and 29 patients with prediabetes were smokers. Periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment loss, and marginal bone loss) were measured, and the number of missing teeth were recorded. Fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded. Unstimulated whole saliva samples were collected, unstimulated whole salivary flow rate (UWSFR) was determined, and IL-1ß and IL-6 levels were measured. P values <0.05 were considered statistically significant. RESULTS: FBG (P <0.05) and HbA1c (P <0.05) levels were higher among patients with prediabetes than controls. All patients with prediabetes were hyperglycemic. UWSFR was significantly higher among controls than among patients with prediabetes (P <0.05). Periodontal parameters and whole salivary IL-1ß and IL-6 levels were comparable among smokers and never-smokers with prediabetes. Among controls, periodontal parameters and whole salivary IL-1ß and IL-6 levels were higher among smokers than never-smokers (P <0.05). CONCLUSIONS: Among controls, periodontal inflammation was worse, and whole salivary IL-1ß and IL-6 levels are higher in smokers than never-smokers. Among patients with prediabetes, periodontal inflammation and whole salivary IL-1ß and IL-6 levels were comparable between smokers and never-smokers.

Porous collagen-hydroxyapatite scaffolds with mesenchymal stem cells for bone regeneration.

Current bone grafting materials have significant limitations for repairing maxillofacial and dentoalveolar bone deficiencies. An ideal bone tissue-engineering construct is still lacking. The purpose of the present study was first to synthesize and develop a collagen-hydroxyapatite (Col-HA) composite through controlled in situ mineralization on type I collagen fibrils with nanometer-sized apatite crystals, and then evaluate their biologic properties by culturing with mouse and human mesenchymal stem cells (MSCs). We synthesized Col-HA scaffolds with different Col:HA ratios. Mouse C3H10T1/2 MSCs and human periodontal ligament stem cells (hPDSCs) were cultured with scaffolds for cell proliferation and biocompatibility assays. We found that the porous Col-HA composites have good biocompatibility and biomimetic properties. The Col-HA composites with ratios 80:20 and 50:50 composites supported the attachments and proliferations of mouse MSCs and hPDSCs. These findings indicate that Col-HA composite complexes have strong potentials for bone tissue regeneration.

Role of clinician's experience and implant design on implant stability. An ex vivo study in artificial soft bones.

OBJECTIVES: Clinical experience in implant placement is important in order to prevent implant failures. However, the implant design affects the primary implant stability (PS) especially in poor quality bones. Therefore, the aim of this study was to compare the effect of clinician surgical experience on PS, when placing different type of implant designs. METHODS: A total of 180 implants (90 parallel walled-P and 90 tapered-T) were placed in freshly slaughtered cow ribs. Bone quality was evaluated by two examiners during surgery and considered as 'type IV' bone. Implants (ø 5 mm, length: 15 mm, Osseotite, BIOMET 3i, Palm Beach Gardens, FL, USA) were placed by three different clinicians (master/I, good/II, non-experienced/III, under direct supervision of a manufacturer representative; 30 implants/group). An independent observer assessed the accuracy of placement by resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. Two-way analysis of variance (ANOVA) and Tukey's post hoc test were used to detect the surgical experience of the clinicians and their interaction and effects of implant design on the PS. RESULTS: All implants were mechanically stable. The mean ISQ values were: 49.57(± 18.49) for the P-implants and 67.07(± 8.79) for the T-implants. The two-way ANOVA showed significant effects of implant design (p < .0001), clinician (p < .0001), and their interaction (p < .0001). The Tukey's multiple comparison test showed significant differences in RFA for the clinician group I/II (p = .015) and highly significant (p < .0001) between I/III and II/III. The P-implants presented (for I, II, and III) mean ISQ values 31.25/49.18/68.17 and the T-implants showed higher ISQ values, 70.15/62.08/68.98, respectively. Clinicians I and II did not show extreme differences for T-implants (p = .016). In contrast, clinician III achieved high ISQ values using P- and T-implants following the exact surgical protocol based on the manufacturer guidelines. T-implants provided high stability for experienced clinicians compared with P-implants. CONCLUSION: T-implants achieved greater PS than the P-implants. All clinicians consistently achieved PS; however, experienced clinicians achieved higher ISQ values with T-implants in poor quality bone.

Lasers use in dental implantology.

OBJECTIVE: The purpose of this literature review was to evaluate the present use of different laser systems in implant dentistry. MATERIALS AND METHODS: A literature search of MEDLINE-PubMed for articles published, describing the use of lasers in implant dentistry, was performed and articles were critically reviewed by the investigators to determine the strength of evidence. RESULTS: The literature review reveals a limited number of randomized clinical trials with regard to laser use in dentistry. Although many case studies indicate extensive use of lasers and promising results in dental implantology, lasers may be used for uncovering submerged implants atraumatically to prevent crestal bone loss, recontouring periimplant soft tissues and sculpting emergence profile for prosthetic components, raising surgical flaps, osseous recontouring, and creating parabolic tissue architecture. Additionally, bone harvesting of block grafts, window preparation in sinus lift procedures, ridge splitting, and debridement of extraction sockets for immediate implant placement were described. CONCLUSIONS: Aside from the many benefits associated with the use of lasers in implant-related procedures, there are also risks to consider from the laser irradiation on the implant surface and the periimplant tissues. Therefore, an appropriate training on laser use is mandatory to increase the clinical outcome and to control the potential of complications.

Prevalence of torus mandibularis in Rochester, New York, region.

The purpose of this study was to investigate the prevalence of torus mandibularis within a population residing in the Rochester, New York, region. During a comprehensive initial exam, utilizing clinical inspection and palpation, 1,323 subjects were examined for any tori in the mandibular area. Of the 1,323 subjects studied, 37.8% had tori mandibularis, with a higher frequency occurring in male patients (overall mean age: 40 years). In the Rochester, New York, area the observations noted a high prevalence of torus mandibularis (37.8%), with a mean population age of 40 years; 52% of the tori were observed in men.

The presence of the mandibular incisive canal: a panoramic radiographic examination.

PURPOSE: The mandibular incisive canal (MIC) is the anterior extension of the mandibular canal and its presence is of interest in surgical procedures in the chin region. The aim of this study was to investigate the presence of a MIC in panoramic radiographs (OPGs). METHODS: One thousand forty-five OPGs were randomly chosen from patient population. The data collected included patient characteristics and MIC presence/absence according to the type of the dentition. Measurements (in mm) were performed evaluating the following: (A) minimum and (B) maximum distance from the alveolar ridge; (C) thickness and (D) length of the canal; and (E) distance (in bilateral cases) between the canals. RESULTS: The MIC was found in 2.7% of the patients. CONCLUSIONS: This study demonstrates the frequency of the MIC in OPGs and suggests that this anatomical structure should be considered to prevent injury during surgery.