Changes in oral home care and smoking habits during COVID-19 pandemic: A cross-sectional study.

OBJECTIVES: The coronavirus disease-19 (COVID-19) pandemic has caused disruption in the health behavior in many aspects of life. While hand hygiene was promoted as one of the precautionary measures to mitigate and contain COVID-19, oral health and smoking might have received less attention in the media campaigns. The aim of this study was to examine health behavioral changes in terms of oral home care habits, smoking, and perception of dental care during the COVID-19 pandemic. MATERIAL AND METHODS: An online survey was designed to assess oral home care, smoking habits, and attitude toward dental services of participants aged 18 years and older. The data were collected between September and November 2021. The strength of association between changes in oral home care habits, smoking, and attitude toward invasive/long dental procedures and each variable was measured by χ2 analysis. Estimates of relative risk were also calculated for all variables. Predictors of avoiding dental procedures were estimated by a binary logistic regression. RESULTS: A total of 532 participants, based in the United Arab Emirates, took part in this online survey with a response rate of 88.7%. The age of the participants ranged between 18 and 67 with mean age of 34.9 ± 9.0 years. The majority of the participants have adopted changes in their routine oral home care habits, with 82.1% of them changing the toothbrush more frequently. Participants who changed their oral home care habits were more likely to have received sufficient information on the importance of maintaining oral health. Likewise, the changes in smoking habits were significantly associated with receiving information on the relationship between smoking and the severity of the COVID-19 (p < 0.001). CONCLUSIONS: The findings showed that positive behavior toward oral home care and smoking was noticed during the pandemic particularly when public receives sufficient and up-to-date information.

Periodontal tissue changes after crown lengthening surgery: A systematic review and meta-analysis.

Introduction: Crown lengthening is one of the most common periodontal surgical procedures carried out to increase the amount of supragingival tooth structure. There is a lot of literature on crown lengthening surgeries, but very few systematic reviews comparing treated and adjacent sites over a six-month period. The purpose of this systematic review and meta-analysis was to evaluate the outcomes of crown lengthening surgery in terms of changes in periodontal clinical parameters and periodontal tissue stability between treated and adjacent sites. Methods: Electronic databases were searched up to 28 February 2022 with no restriction on publication status. A manual search of journals was also performed. Predefined inclusion and exclusion criteria were used to select the relevant articles that assessed dimensional changes in periodontal tissues after crown lengthening surgery. The risk of bias was assessed using the JBI critical appraisal checklist. Data meta-analysis was performed using a statistical software program. Results: A total of 78 studies were identified, of which, four clinical controlled trials containing 182 crown lengthening surgical procedures across 111 participants were included. Meta-analysis showed no statistically significant changes after three or six months in terms of supracrestal tissue attachment levels, bone level and probing pocket depth between treated and adjacent sites. However, clinical attachment level changes were statistically significant, favouring adjacent teeth at six months. Conclusions: Within the limitation of this systematic review, crown lengthening surgery results in stable periodontal tissues over time according to the acceptable periodontal healing parameters. Further evidence is still required to substantiate these findings.

A Retrospective Analysis of Biological Complications of Dental Implants.

Methods: A retrospective analysis of patients aged ≥18 years and having dental implants placed at Dubai Health Authority in 2010. Relevant information related to systemic-, patient-, implant-, site-, surgical- and prosthesis-related factors were collected. The strength of association between the prevalence of peri-implant mucositis and peri-implantitis and each variable was measured by chi-square analysis. A binary logistic regression analysis was performed to identify possible risk factors. Results: A total of 162 patients with 301 implant-supported restorations were included in the study. The age of the patients ranged between 19 and 72 with a mean age of 46.4 ± 11.7 years. The prevalence of peri-implant mucositis at the patient and implant levels were 44.4% and 38.2%, respectively. For peri-implantitis, the prevalence at the patient level was 5.6%, while the prevalence at the implant level was 4.0%. The binary logistic regression identified three risk factors (smoking habits, histories of treated periodontitis and lack of peri-implant maintenance) for peri-implantitis. Conclusion: Within the limitations of this study, smoking habits, history of treated periodontitis and lack of peri-implant maintenance were significant risk factors for peri-implantitis. Early detection of these factors would ensure appropriate planning and care of patients at high risk of developing peri-implant diseases.

Resonance Frequency Analysis in Assessing Implant Stability: A Retrospective Analysis.

PURPOSE: To retrospectively assess implant stability quotient (ISQ) values in patients who were followed up between 1998 and 2014 and to evaluate any correlations between ISQ and clinical parameters, such as change in marginal bone level (MBL). MATERIALS AND METHODS: A total of 173 participants (65 men and 108 women; age range 21 to 85 years) and 383 implants were included. Implant location, MBL, and ISQ were recorded at surgery and at various recall times for statistical analysis. Mixed-model analysis was applied to evaluate the impact of clinical and demographic variables (time, implant location, patient gender) on ISQ and the correlation between ISQ and MBL. The level of significance was set at P < .05. RESULTS: Of the 21 failed implants, 20 failed within 1 year of functional loading, resulting in a 10-year cumulative implant survival estimate of 95%. The failed implants had lower ISQs at surgery (52.3 ± 7.03) and baseline (52.5 ± 4.20) when compared to surviving implants (63.0 ± 10.74 at surgery and 62.3 ± 8.30 at baseline), and the difference was statistically significant at surgery (P < .05). The mean ISQs generally increased over time, but there were various patterns of changes between implants when grouped according to patient gender and implant location. There was no statistically significant correlation between the changes in ISQ and MBL (P = .211), despite an inverse relationship. CONCLUSION: Low initial ISQ values may help to identify implants at higher risk of failure. There may be various patterns of change over time in addition to an overall increase in ISQ values. Both similar and contradictory findings were found when compared to earlier literature, and a correlation between resonance frequency analysis and MBL change could not be identified. Despite limitations, the present study provides an overview of the clinical performance of RFA based on long-term clinical data.

Predicting peri-implant disease: Chi-square automatic interaction detection (CHAID) decision tree analysis of risk indicators.

BACKGROUND: Further validation of the risk indicators / predictors for peri-implant diseases is required to allow clinicians and patients to make informed decisions and optimize dental implant treatment outcomes. The aim of this study was to build prediction models, using Chi-square automatic interaction detection (CHAID) analysis, to determine which systemic-, patient-, implant-, site-, surgical- and prostheses-related risk indicators had more impact on the onset of peri-implant diseases. METHODS: A retrospective analysis of 200 patients who received implant-supported prostheses between 1998 and 2011 was conducted to evaluate the prevalences and risk indicators for peri-implant mucositis and peri-implantitis. The data were further analyzed using CHAID to produce two predictive models. RESULTS: The prevalence of peri-implant mucositis was 20.2% and 10.2% for patients and implants, respectively, while the prevalence of peri-implantitis was 10.1% at the patient level and 5.4% at the implant level. CHAID decision tree analysis identified three predictors (history of treated periodontitis, absence of regular supportive peri-implant maintenance, and use of bone graft) for peri-implant mucositis and three predictors (smoking, absence of regular supportive peri-implant maintenance, and placement of ≥2 implants) for peri-implantitis. CONCLUSIONS: Within the limitations of this study, CHAID decision tree analysis identified the most plausible risk indicators and provided two predictive models for use in a particular university setting that would allow early detection and ensure appropriate care and maintenance of patients at high risk of peri-implant diseases.

Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 5-year results from a prospective single-arm clinical trial.

BACKGROUND: Single implant crowns have become the preferred rehabilitation treatment option for replacing a missing tooth. PURPOSE: This study evaluates 5-year clinical success of using tilted implants placed immediately after extraction followed by rehabilitation with all-ceramic crowns. MATERIALS AND METHODS: Twenty-seven participants requiring 28 single implant crowns in the aesthetic zone of maxilla were recruited to participate in a single-arm clinical trial. All participants were rehabilitated according to immediate implant placement using CP grade 4 titanium implants with roughened surfaces and a 12°-angled platform. Provisional implant crowns were connected within 4 hours of implant placement and loaded according to progressive loading protocol. At 8 weeks (baseline), definitive screw-retained crowns fabricated using densely sintered zirconia abutments with the veneering porcelain were delivered. Participants were followed up to 5 years and 16 participants with 17 single implant crowns attended Year 5 recall. Data collection included changes in marginal bone levels (MBLs), mid-buccal mucosal levels (MBMLs), implant stability quotient (ISQ) values, and any prosthodontic maintenance issues. RESULTS: The mean changes in MBLs at each recall was bone fill of 0.5 ± 1.18 mm (surgery-baseline), increase of 0.1 ± 0.57 mm (baseline-Year 1), and marginal bone loss of 0.1 ± 0.25 mm (Years 1-5). A minimal change occurred with the MBMLs during the observation period. The mean ISQ value at each time point increased from 65.1 (implant placement), to 67.4 (baseline) and 69.9 (Years 1 and 5). Prosthodontic maintenance issues occurred only during the first year which included fracture of veneering ceramic and zirconia abutment as well as aesthetic concerns. CONCLUSIONS: Within the limitations of this study, the data collected would suggest that replacing a single missing tooth using titanium oral implants with 12° platform tilt and zirconia abutments can be a successful rehabilitation option in the esthetically demanding zone of anterior maxilla.

Piezoelectric versus conventional implant site preparation: A systematic review and meta-analysis.

BACKGROUND: The use of a piezoelectric device (PED) for implant site preparation (ISP) has been introduced to overcome the limitations of using conventional drills (CDs). With little and inconsistent information in the literature regarding their efficiency for preparing implant osteotomies, the objective of this systematic review was to compare the use of CDs to PEDs for ISP with regard to implant stability values, marginal bone level changes, operating time, and dental implant failure rate. METHODS: The systematic review was prepared according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature was searched for studies that assessed the use of CDs and PEDs for ISP. The Cochrane Collaboration risk of bias tool was used to evaluate the selected studies and meta-analyses were performed using statistical software. RESULTS: A total of 755 citations were identified. Of these, 4 studies with 178 implant osteotomies in 80 participants were included. The pooled estimates for the implant stability showed significant differences between the 2 surgical techniques in favor of PEDs at baseline, 8 and 12 weeks. A statistically significant difference in the operating time was also shown between the 2 techniques with more time required using PED. The differences in marginal bone level changes or implant failure rate were not statistically significant. CONCLUSIONS: With the limitations of this review in mind, PEDs appear to be a viable alternative to traditional drilling techniques for ISP. With the exception of prolonged operating time associated with the use of PEDs, both techniques were comparable in terms of the marginal bone level changes and the risk of implant failure. The favorable influence of the implant stability pattern related to the use of PEDs on the predictability of immediate and early loading protocols need to be confirmed in future studies.

Multicentre prospective evaluation of implant-assisted mandibular removable partial dentures: surgical and prosthodontic outcomes.

OBJECTIVE: To determine implant survival and prosthodontic maintenance of implant-assisted mandibular removable partial dentures in a multicentre prospective study up to 10 years. MATERIALS AND METHODS: Forty-eight participants with mandibular distal extension partial dentures were selected. A control group of 12 New Zealand participants had new conventional mandibular partial dentures made. Three test groups of 36 participants in New Zealand (n = 12), the Netherlands (n = 12) and Colombia (n = 12) had bilateral distal implants placed. Surgical and prosthodontic outcomes were documented with only healing caps placed (Stage 1) and with an attachment system (Stage 2). RESULTS: No implants failed after 3 years. Four late implant failures in three participants occurred in New Zealand (two unilateral implant failures after 5 and 8 years and two bilateral implant failures in the same participant after 6 and 10 years); two unilateral late implant failures occurred in the Netherlands and no late failures in Colombia. Implant survival rate was 92% by 10 years. Resonance frequency measurements were taken at surgery implant stability quotient (ISQ) 62.44 ± 7.46; range 40 - 79), baseline (ISQ 63.22 ± 6.17; range 50 - 74) and after 3 years (ISQ 66.38 ± 6.77; range 55 - 83). In New Zealand and Colombia, measured crestal bone levels were 2.03 ± 0.71 mm and 2.20 ± 0.81 mm, respectively, at baseline and 3 years. For Stage I, principal prosthodontic maintenance issues were loose healing caps among 10 New Zealand participants, four Colombian participants and one Netherlands participant. For Stage 2, matrix activation and overdenture puncture fractures resulted in 41 events (25 participants) in New Zealand over 10 years, whilst over 3 years, there were 14 events in nine Colombian participants and six events in five Netherlands participants. CONCLUSION: This clinical multicentre research complements previous case reports, case series, retrospective and prospective studies on the notion of implant-assisted removable partial dentures for partially edentulous patients. Late implant failures and increased prosthodontic maintenance when an attachment system is used identify the need for further research, including more robust statistical analyses.

Maxillary Three-Implant Overdentures Opposing Mandibular Two-Implant Overdentures: 10-Year Surgical Outcomes of a Randomized Controlled Trial.

BACKGROUND: The surgical placement of four maxillary implants for overdentures may not be obligatory when opposing mandibular two-implant overdentures. PURPOSE: To determine 10-year surgical outcomes and implant success of three narrow diameter implants in edentulous maxillae with conventional loading. MATERIALS AND METHODS: Forty participants with mandibular two-implant overdentures were randomly allocated for surgery for maxillary overdentures. Using osteotomes, three implants of similar systems were placed with a one-stage procedure and 12-week loading with splinted and unsplinted prosthodontic designs. Marginal bone and stability measurements were done at surgery, 12 weeks, 1-, 2-, 5-, 7-, 10 years. RESULTS: One hundred seventeen implants were placed in 39 participants, with 35 being seen at 1 year; 29 at 2 years; 28 at 5 years; 26 at 7 years; and 23 (59%) at 10 years. Marginal bone loss was 1.35 mm between surgery and 12 weeks; 0.36 mm between 12 weeks and 1 year; 0.48 mm between 1 and 5 years; and 0.22 mm between 5 and 10 years. Implant stability quotients were 56.05, 57.54, 60.88, 58.80, 61.17 at surgery, 12 weeks, 1 year, 5 years, and 10 years. Four-field tables by implant showed success rates of 82% at 1 year; 69.2% at 2 years; 66.7% at 5 years; 61.5% at 7 years; 51.3% at 10 years. Data showed no differences between surgical technique, systems, or prosthodontic designs. CONCLUSIONS: Surgical placement with osteotomes of three narrow diameter implants for maxillary overdentures, opposing mandibular two-implant overdentures, is an acceptable approach, subject to strict patient selection. Implant success is independent of prosthodontic design.

The effect of standardised implantoplasty protocol on titanium surface roughness: an in-vitro study

Abstract: To analyse the changes of surface characteristics of machined and moderately roughened titanium disks following a standardised implantoplasty protocol. Forty titanium discs (machined: n = 20; moderately roughened: n = 20) were instrumented with one half of each disc maintained as the control (non-instrumented). The standardised implantoplasty protocol was carried out using a custom jig with the sequential change of burs: 1) Regular grit diamond [10s], 2) Super-fine grit diamond [10s], 3) Brownie(tm) silicone polisher [15s], 4) Greenie(tm) silicone polisher [15s]. Surface topography was analysed using confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Energy dispersive x-ray spectroscopy (EDS) was used to measure the elemental profiles of each disc. Quantitative analysis showed similar changes in level of roughness between the machined and moderately roughened titanium discs. CLSM demonstrated an increased roughness (Ra and Sa values) after polishing with a regular grit diamond bur when compared to the uninstrumented surfaces. Although the roughness decreased after the further polishing with the super-fine grit diamond bur, subsequent instrumentation using silicon burs tended to increase the roughness, albeit being statistically insignificant. There was a residue of silicon particles despite the irrigation after each polishing stage. The proposed implantoplasty protocol did not achieve a sufficient level of smoothness on the machined or moderately roughened titanium surfaces when compared to the Ra threshold. Further research is recommended to test the efficacy of each bur on titanium surfaces with longer duration using actual oral implants to allow better comparison.

Piezoelectric surgery vs rotary instruments for lateral maxillary sinus floor elevation: a systematic review and meta-analysis of intra- and postoperative complications.

PURPOSE: Lateral maxillary sinus floor elevation (LMSFE) is a predictable preprosthetic surgical procedure that is used to overcome the limitations of the atrophied alveolar ridge for the placement of oral implants. Techniques using piezoelectric devices (PEDs) and conventional rotary instruments have been described for LMSFE in the literature, with little information regarding their efficiency in terms of membrane perforation, operating time, and implant outcomes. The aim of this systematic review was to examine the intra- and postoperative events associated with the use of PEDs and conventional rotary instruments for LMSFE. MATERIALS AND METHODS: This systematic review was prepared according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The literature was searched for studies comparing the use of PEDs with conventional rotary instruments for LMSFE. The Cochrane Collaboration risk of bias tool was used to assess the studies selected, and meta-analyses were performed using statistical software. RESULTS: A total of 124 citations were identified. Of these, four studies with 178 LMSFEs in 120 participants were included. The pooled estimates for the risk of sinus membrane perforation did not show any significant difference between the two surgical techniques (risk ratio, 0.87; 95% confidence interval, 0.40-1.91; P = .73). Similarly, no significant difference in implant failure was found after 1 year of functional loading. The overall meta-analysis showed a statistically significant difference in the operating time between the two techniques with more time required for PED. CONCLUSION: The intra- and postoperative events associated with the use of PEDs and conventional rotary instruments for LMSFE are comparable.

Quantifying the Association Between Self-Reported Diabetes and Periodontitis in the New Zealand Population.

BACKGROUND: This study aims to investigate the association between diabetes and periodontitis in the New Zealand (NZ) adult population. METHODS: Data from two NZ national surveys (N = 2,048) were analyzed to compare estimates of the strength of the association between diabetes and periodontitis using two multivariate epidemiologic approaches (cohort and matched case-control studies). This was possible because the first survey provided participants for the second survey. Periodontitis cases were identified using 14 case definitions, including six severe definitions. The cohort study identified those with diabetes in 2006/07 and those with periodontitis in 2009 to determine the patients with diabetes odds of having periodontitis, using logistic regression modeling (adjusting for smoking status, sociodemographic, and dental characteristics). The matched case-control study identified cases of severe periodontitis in 2009 and compared their 2006/07 diabetic status with that of controls (individually matched on age group, sex, and socioeconomic status). Conditional logistic regression modeling was used for the case-control study, adjusting for ethnicity, smoking status, and dental characteristics. RESULTS: Overall, 3.6% of the periodontally examined adults reported having diabetes. There was no sex difference in diabetes prevalence, but it was greater in older age groups. Depending on the definition of periodontitis used, there were different estimates of risk for periodontitis, with odds ratios ranging from 1.91 (P = 0.01) to 3.51 (P = 0.22) using the cohort study approach. Diabetes was associated with a greater risk of having periodontitis using only two of the 14 periodontitis case definitions. No association was observed using the matched case-control study. CONCLUSIONS: The diabetes-periodontitis association in the NZ population remains unclear. This study demonstrates that the determination of the strength of a putative association is method dependent.

Changes in surface characteristics of moderately roughened grade iv titanium disc following a standardised implantoplasty technique: an in-vitro study

Aim: To analyze the changes in surface characteristics of moderately roughened grade IV titanium discs following a standardized implantoplasty protocol. Materials and Method: Nine moderately roughened titanium discs (ø9.0 mm; 2-mm thickness) with a comparable surface to commercially available oral implants (Southern Implants (Pty) Ltd, Irene, South Africa) were used. One disc was used as a control sample while the remaining 8 discs were modified using a standardized technique. Each disc was divided into 4 sections of which each quadrant was instrumented in the same manner. Regular grit and superfine grit diamond burs were used for 10s each, followed by brown and green silicone burs for 15s respectively. The surface characteristics of all samples were analysed using scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), and energy dispersive x-ray spectroscopy (EDS). Results: SEM analysis of the surfaces showed that as the instrumentation progressed from diamond burs to silicone burs, surface irregularities began to diminish. However, using silicone burs tended to increase the amount of surface debris and the roughness still remained significantly higher than the control sample. EDS identified some foreign elements originating from the silicone burs that were used. Conclusion: The proposed standardized implantoplasty protocol did not decrease the roughness of the surface below that of the control disc. The clinical implications of foreign elements remaining on the titanium surfaces need further investigation.

Peri-implantitis diagnosis and treatment by New Zealand periodontists and oral maxillofacial surgeons.

OBJECTIVES: This study aimed to investigate the understanding, diagnosis and management of peri-implantitis by New Zealand periodontists and oral maxillofacial surgeons (OMFS). DESIGN: Telephone interviews (in combination with a postal and electronic survey) were conducted of all 25 periodontists and 32 OMFS listed as specialists on the New Zealand Dental Register. A seven item multi-choice and short answer questionnaire was used to investigate: their definition of peri-implantitis; the number of annual referrals received in their practice for this condition; their diagnostic, preventive and treatment strategies for peri-implantitis; and their perception of the role of general dental practitioners in its management. RESULTS: The participation rate was 84.6%. Most respondents defined peri-implantitis as a disease of multifactorial aetiology that leads to destruction of the bone supporting an implant. The average number of cases seen annually differed between periodontists (11 cases/year) and OMFS (4 cases/year). The criteria used by the respondents to diagnose peri-implantitis included increased probing depths and radiographic evidence of bone loss. Each type of specialist used mechanical debridement for treatment, but a higher proportion of OMFS performed surgical procedures as treatment. The prevention strategies used smoking cessation advice and ensuring good plaque control. All respondents agreed that peri-implantitis is an important disease that can lead to implant failure, and all acknowledged the role of general dental practitioners in diagnosis, referral for treatment and long-term implant maintenance. CONCLUSION: The definition, diagnostic criteria and management strategies used by New Zealand specialists are generally consistent with those found in the literature. No evidence-based, gold standard treatment protocol for peri-implantitis has been identified in the literature, and New Zealand specialists use a range of treatment modalities.

The use of laser therapy for dental implant surface decontamination: a narrative review of in vitro studies.

The aim of this narrative review was to critically evaluate in vitro studies assessing the efficacy of lasers in the bacterial decontamination of titanium implant surfaces. The MEDLINE, Web of Knowledge and Embase electronic databases were used to search for articles relating to the use of lasers in the bacterial decontamination of titanium specimen surfaces using predetermined search statements. Clinical studies, case reports, case series, review articles and animal models were excluded. Study selection was carried out independently and then cross-checked by two authors through abstract viewing. Eighteen articles were selected for full-text analysis. Erbium-doped yttrium-aluminium-garnet lasers had a wide range of powers capable of inducing bacterial decontamination. While carbon dioxide and gallium-aluminium-arsenide diode lasers demonstrated the ability to produce bacterial decontamination, the bacterial sensitivity to each varied depending on the species involved. There is no concensus on the laser type or settings that are optimal for bacterial decontamination of titanium implant surfaces as studies employ various test specimens, contamination methodologies, irradiation settings and protocols, and outcome measures resulting in limited study comparability. More investigations are required to provide guidelines for the use of laser therapy in the decontamination of implant surfaces.

Bacterial colonization of titanium discs: a pilot study for evaluating implant surface deterioration

Background: Bacterial colonization of dental implant surfaces is considered the main aetiological factor in peri-implant diseases. Aim: To devise a protocol that will yield a consistent and viable biofilm on titanium specimens for the purpose of in vitro experimental investigation of microbially-induced surface deterioration and potential peri-implant therapy efficacy. Materials and Methods: Twelve Southern Implants grade 4 titanium discs, six with machined and six with moderately roughened surfaces were used in this study. Six discs were inoculated with Streptococcus oralis and incubated in brain- heart infusion under anaerobic conditions at 37o C 1, 2 and 3-days. Specimen surface characteristics were evaluated by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Energy dispersive x-ray analysis quantified the surface elemental composition of the discs. Qualitative and quantitative SEM analyses evaluated colonisation and consistency of biofilm formation. The pH of the media was determined following each incubation period. Results: There were significant differences in surface roughness between machined (Ra = 0.27μm, Sa = 1.01μm) and moderately roughened (Ra = 2.14μm, Sa= 1.34μm) surfaces. SEM revealed widespread surface irregularities (spikes, valleys and grooves) on the moderately roughened surfaces compared to the machined surfaces. pH measurements of the medium indicated an acidic level (pH = 4.4) after an initially neutral value (pH = 7.0). Colonisation of the disc surface was evident after 24 hours as a multilayered biofilm for both titanium surfaces. Conclusions: A protocol capable of yielding a consistent viable biofilm on titanium specimens has been devised. This can be used in future studies to investigate the effect of bacterial accumulation and the efficacy of peri-implant therapy on bacterial colonization on implant surfaces

Effect of a cordless retraction paste on titanium surface: a topographic, chemical and biocompatibility evaluation

Good exposure of the preparation margins and haemostasis in the sulcular gingiva are necessary for accurate impressions to produce precise restorations. The use of cordless retraction paste material in implant dentistry is a relatively novel application. However, few studies have been conducted on the use of retraction pastes and their possible interaction with implant surfaces. Recent literature has described remnants on titanium implant surfaces and expressed the need for an assessment of the biocompatibility of the exposed surface (Chang et al.). This in vitro study evaluated the effect of a cordless gingival retraction paste on sterile titanium disks. Surface chemistry was determined using energy-dispersive X-ray spectroscopy (EDS), and further investigated using laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). After exposure to retraction paste, surface chemistry alterations were identified. A fibroblast cell line (L929) was exposed to the disks and the live/dead viability/cytotoxicity assay was used to determine any effects on the proliferation and health of cells. The disks exposed to the retraction paste showed fewer dead cells compared to the unexposed disks. This was statistically significant.

Laser therapy: the future of peri-implantitis management?

Background: Peri-implantitis is an inflammatory process that leads to a loss of supporting bone around an osseointegrated implant. Currently, there is no standard of care for the treatment of peri-implantitis and clinicians are faced with a myriad of treatment choices. Aim: To evaluate articles from the previous ten years that have investigated the use of lasers in the treatment of peri-implantitis. Materials and Methods: The Pubmed electronic database of the US National Library of Medicine was used to search for articles relating to the use of lasers in the treatment of peri implantitis. Results were limited to ten years, and English articles only. Results: Ten articles were selected for review. These studies demonstrated positive treatment outcomes after 6 months with CO2 and Er:YAG lasers, however studies with follow-up of greater than 6 months showed that initial positive outcomes were not maintained throughout the observation period, coinciding with raised plaque index and bleeding scores. Conclusion: The short-term value of laser treatment has been documented, however the authors would like to see in vivo case studies demonstrating Er:YAG, CO2 and diode laser treatment of peri-implantitis with follow-up of at least 12 months, and regular observation periods.

Effect of a cordless retraction paste material on implant surfaces: an in vitro study

Cordless retraction paste material for gingival retraction in implant dentistry has recently become of interest to the clinician. However, few studies have been conducted on the use of retraction pastes and their possible interaction with implant surfaces. This in vitro study evaluated the effect of a cordless retraction paste material, Expasyl® (Acteon), on TiUnite® (Nobel Biocare) implant surfaces. Three areas of the fixtures were evaluated before and after contact with the retraction paste using scanning electron microscopy to evaluate changes in surface topography and energy-dispersive spectroscopy to identify any surface chemistry modifications. Alteration of the initial surface after exposure to Expasyl® was identified, with the implant collar showing the most changes.