Clinical, Bacterial, and Prosthodontic Parameters After Implant Abutment Disinfection Using Nd:YAG, Er,Cr:YSGG, Chlorhexidine, and Conventional Steam Before Prosthesis Delivery.

Objective: This 1-year prospective clinical trial was designed to assess the microbial, clinical, radiographic, and prosthetic parameters after disinfection of the implant abutment connection using Er,Cr:YSGG (erbium, chromium-doped: yttrium, scandium, gallium, and garnet) and Nd:YAG (neodymium-doped yttrium, aluminum, garnet). Materials and methods: All the patients were divided into four groups; Group I: Nd:YAG laser, Group II: Er,Cr:YSGG laser, Group III: 0.2% chlorhexidine (CHx), and Group IV: steam disinfection. Peri-implant parameters assessed included peri-implant bleeding scores (PIBS), peri-implant plaque scores (PIPS), peri-implant pocket depth (PIPD), and crestal bone loss (CBL). The peri-implant plaque samples were acquired to perform microbiological analysis to assess Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, respectively. All measurements were completed at baseline, 6 months, and 12 months postsurgery. Multiple groups were compared with the help of the Bonferroni post-hoc adjustment test (p < 0.01). Logistic regression models were utilized to assess the association between age, oral hygiene practices (brushing and flossing), and duration of implant function. Results: At the baseline level, there were no discernible differences in the peri-implant parameters between the study groups (p > 0.05). At the 6-month (p < 0.01) and 12-month (p < 0.001) follow-ups, all four study groups demonstrated a significant improvement in PIPS and PIBS, with no significant differences between the groups at baseline (p > 0.05). Based on an intergroup comparison, Group I (Nd:YAG) showed a significant decrease in PIBS when compared with the other groups. Group II showed a considerable decrease in PIPD and enhancements in CBL when compared with Groups I, III, and IV (p < 0.01). At the 6- and 12-month follow-up periods, P. gingivalis and T. denticola reduction were found to be statistically higher in Group II, whereas P. gingivalis and T. forsythia mean log CFU/mL were found to be statistically higher in Group I. Conclusions: Nd:YAG and Er,Cr:YSGG lasers both outperformed CHx and steam disinfection in terms of clinical, peri-implant, and prosthetic results when used to clean implant abutments.

Efficacy of adjunct photodynamic therapy on Candida growth and oral health quality of life in denture stomatitis patients with type 2 diabetes mellitus wearing implant-retained overdentures: A randomized clinical study.

AIM: The aim of the present clinical trial was to study the efficacy of combined miconazole and PDT in the improvement of quality of life and levels of Candida species in chronic hyperglycemic patients with denture stomatitis (DS). METHODS: One hundred patients were randomly divided into five groups; 20 each in the miconazole, PDT, miconazole+ PDT, CHX and distilled water groups. Methylene blue mediated irradiation was conducted using 600 nm diode laser with power, energy density and radiance as 100 mW, 3527 mW/cm2 and 9 J, respectively. Patients were advised to apply 2.5 ml of 2% topical miconazole four times a day. The existence of Candida spp. was detected by means of microbiological culture technique. Candida colony counts from the palates and dentures surfaces, quantified as colony forming unit (CFU)/mL were evaluated at baseline, end of 14 days, 28 days and 60 days. Oral health related quality of life was assessed with the help of a questionnaire. RESULTS: The quality of life showed significant improvement in the group where combination treatment was executed. The overall CFU/mL values were greater in the dentures in comparison to those from the palates of the patients of all the five groups. During all time periods of the study, the CFU/mL values obtained from combination treatment group showed significant differences. Candida albicans was the most predominant yeast. CONCLUSION: This study showed the effectiveness of methylene blue- PDT in combination with miconazole in improving oral health related quality of life and significantly reducing Candida CFU counts to resolve palatal inflammation in diabetic individuals with implant-supported complete dentures.