Efficacy of Acellular Dermal Matrix in Soft Tissue Augmentation Around Dental Implants: A Systematic Review and Meta-Analysis.

This study was done to perform a systematic review and meta-analysis of the studies on the efficacy of acellular dermal matrix (ADM) in increasing the soft tissue thickness (STT) and keratinized mucosal width (KMW) around dental implants. The PubMed, Scopus, Cochrane, Web of Science, and ProQuest databases were searched by July 2020 to retrieve relevant studies. Depending upon the heterogeneity of included studies, the weighted mean difference (WMD) with 95% CI was calculated using either fixed or random-effects model. Based on the meta-analysis of 6 studies, the effect of ADM on STT and KMW was significant (WMD: 1.07 [95% CI: 0.34-1.79], P = .004, and WMD: 1.99 [95% CI: 0.88-3.09], P < .001, respectively). Further, a comparison between the efficacy of the ADM and the control group, which included the autogenous soft tissue augmentation techniques, showed no statistically significant differences between groups (STT: WMD: 0.24 [95% CI: -0.26 to 0.74], P = .161 and KMW: WMD: -0.23 [95% CI: -0.68 to 0.22], P = .324). The subgroup analysis showed that simultaneous augmentation and implant placement were increased by 0.23 mm in the KMW, and the placement of ADM around loaded implants caused 0.5 mm decrease in the KMW, which was not statistically significant. Accordingly, it is possible to substitute ADM for soft tissue augmentation around dental implants.

LEVELS OF SMOKING AND PERI­IMPLANT MARGINAL BONE LOSS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

AIM: This systematic review and meta-analysis sought to determine if there was a significantly enhanced risk of peri­implant marginal bone loss (MBL) due to the increased number of cigarettes smoked per day. MATERIALS AND METHODS: Six databases, including Medline, Embase, Cochrane Library, Web of Science, Scopus, and ProQuest, were searched until February, 2021. The search terms "dental implant, oral implant, smoking, smoker, non-smoker, marginal bone loss and crestal bone loss" were used in combination to seek the articles providing data for MBL related to the smoking habit. Articles were excluded if the quantity of cigarettes smoked per day was not reported. Random-effects meta-analyses were used to pool the estimates of mean difference (MD) with 95% confidence intervals (CI). RESULTS: Eight studies were included for qualitative and 5 for quantitative synthesis. The meta-analyses revealed higher levels of MBL in patients who smoked <10 or >10 cigarettes/day than in non-smokers (<10: (MD -0.33, 95% CI -0.69-0.03 and >10: MD -0.58, 95% CI -0.96- -0.19). There was a significant risk of MBL between patients who smoked >10 and <10 cigarettes/day (MD -0.23, 95% CI -0.47-0.01). CONCLUSION: It seems the risk of MBL is steadily increasing as daily smoking increases.

Effect of leukocyte and platelet-rich fibrin on free gingival graft healing: A clinical and histological study in rabbits.

Background. Recently, the use of leukocyte- and platelet-rich fibrin (L-PRF) has been recommended due to the presence of various growth factors to increase the success of free gingival grafts (FGG). This study evaluated the effect of using L-PRF in the healing of FGG in rabbits. Methods. Twenty rabbits were randomly divided into two groups. In each group, FGG was performed in two separate sites with or without L-PRF. One of these groups was sacrificed on the 7th day and the other on the 28th day and analyzed in terms of clinical indices, including wound healing, gingi-val thickness (GT), and keratinized tissue width (KTW). Then histologic sections were obtained and stained for type and degree of inflammation and rate of vascular formation analysis. SPSS 22 was used for statistical analysis. Results. The extent of changes in GT, KTW, wound healing index, and vascular formation between the test and control groups was not statistically significant. The difference in the type of inflammation was significant only between the -7day and -28day control groups (P=0.003). The degree of inflammation between the -7day test group and the -28day control group, as well as the -7day and -28day control groups, were statistically significant (P=0.011 and P=0.002, respectively). Conclusion. Using L-PRF with FGG could improve FGG healing compared to using FGG alone, but the results were not statistically significant.

Periodontitis and cardiovascular disease: A literature review.

BACKGROUND: Cardiovascular diseases (CVDs) are in charge of many deaths worldwide including myocardial infarction (MI), hypertension (HTN), coronary atherosclerosis (CAS), infective endocarditis (IE), heart failure (HF), arterial fibrillation (AF), and peripheral artery disease (PAD). Besides, periodontitis is the sixth prevalent disease among humans and it seems that there are common risk factors between these diseases which are creating communication between prevalence and treatment. The purpose of this study is to assess the articles that reviewed the relationship between heart diseases and periodontitis. METHODS: Three databases, including PubMed, Scopus, and Web of Science were searched until November 2020. The search terms "periodontal disease, periodontitis, oral health, cardiovascular disease, atherosclerosis, myocardial infarction, hypertension, coronary heart disease, angina pectoris, arterial fibrillation, arrhythmia, and peripheral artery disease" were used in combination to identify the publications providing data. RESULTS: MI, HTN, atherosclerosis diseases for coronary artery, IE, HF, AF, and PAD were associated with periodontitis. It seems that the treatment of periodontitis may help to improve the state of mentioned heart-related diseases. However, more studies are needed to prove this relationship. CONCLUSION: The prevalence of heart diseases is more common in individuals with periodontitis.

Evaluation of salivary calcium, phosphorus and alkaline phosphatase concentrations before and after the first phase of periodontal treatment in patients with chronic periodontitis.

Background: Evaluation of salivary biomarkers is a non-invasive, convenient, and economical method for diagnosing many diseases. Evidence shows that salivary biomarkers and periodontal disease might be correlated. This study was conducted to evaluate phase I periodontal therapy's effect on salivary concentrations of calcium, phosphorous, and alkaline phosphatase (ALP). Methods: In this descriptive, analytical study, 16 patients were selected from those referred to the Department of Oral Medicine, Faculty of Dentistry, Isfahan University of Medical Sciences, using convenience sampling. Salivary samples were collected using the drooling method. The salivary concentrations of calcium, phosphorous, and ALP were measured immediately after saliva collection, before the first phase of periodontal therapy and one month later, using a colorimetric assay. The data were analyzed with SPSS using paired t-test. P<0.05 was considered statistically significant. Results: The salivary concentrations of calcium, phosphorous, and ALP were 6.68, 20.57, and 48.31 mg/dL, respectively, before and 7.15, 22.51, and 40.37 mg/dL, respectively, after phase I periodontal therapy. There were no significant differences between the salivary levels of calcium, phosphorous, and ALP before and after phase I periodontal therapy (P>0.05). Conclusion: This study revealed that the salivary concentrations of calcium, phosphorous, and ALP remained relatively unchanged after phase I periodontal therapy.

Prevalence of orthodontic treatment need in permanent dentition of Iranian population: A systematic review and meta-analysis of observational studies.

BACKGROUND: Malocclusion is a common oral health problem and can affect the psychosocial well-being in the long term. Therefore, in the recent decades, demand for orthodontic treatment to correct malocclusion has greatly increased worldwide. This systematic review and meta-analysis was undertaken to assess existing evidence on the prevalence of orthodontic treatment need in Iran. MATERIALS AND METHODS: National and international databases were searched for articles on the prevalence of orthodontic treatment need using index of orthodontic treatment need (IOTN) and dental aesthetic index (DAI). The required data were completed by hand-searching. After applying the inclusion and exclusion criteria, the quality of articles was checked by a professional checklist. Data extraction and meta-analysis were performed. A random effects model was employed, and publication bias was checked. RESULTS: From a total of 443 articles that reported orthodontic treatment need in Iran, 24 articles were included in the meta-analysis process. Meta-analysis was performed on components of IOTN and DAI. The pooled prevalence of orthodontic treatment need based on Dental Health Component and Aesthetic Component of IOTN and DAI was 23.8% (19.5%-28.7%), 4.8% (3.3%-7%), and 16.1% (12.3%-20.8%). The results were found to be heterogeneous (P < 0.05). CONCLUSION: The results of this study revealed that orthodontic treatment need was not high in the Iranian population. Considering the differing prevalence of orthodontic treatment need based on normative index and self-perceived index, it is essential to improve the people's awareness of malocclusion and its side effects on their oral and general health.

Prevalence of Malocclusion in Permanent Dentition of Iranian Population: A Review Article.

BACKGROUND: The aim of this study was systematic review and meta-analysis of prevalence in current and relevant literature about this developmental disorder to present the profile of malocclusion in Iran. METHODS: This review study was carried out with systematically identified and critically assessed studies reporting malocclusion prevalence among Iranian population in permanent dentition. National and international databases were searched for articles about prevalence of malocclusion by Angle classification in different regions of Iran from 1994 to 2015. After applying inclusion and exclusion criteria, the quality of articles was checked by professional checklist. Data extraction and meta-analysis was performed. A random-effect model was employed. Publication bias was checked. RESULTS: Of 2768 articles, 21 cases were included. The pooled prevalence of malocclusion was about 87% (95% CI: 78.3-92.2) in Iranian population; however, the prevalence of malocclusion across individual studies varied considerably (ranging from 23.7% to 99.7%). Prevalence of normal occlusion, class I, II and III malocclusion were reported as 13.3% (CI 95%: 7.8-21.7), 50.7% (CI 95%: 42.9-58.4), 21% (CI 95%: 17.5-25.1), 5.5% (CI 95%: 3-10); respectively. Maximum prevalence of malocclusion was in the East of Iran. CONCLUSION: The results showed a high prevalence of malocclusion in Iranian population. The baseline information could be appropriately utilized for the future planning to meet the orthodontic treatment need among the Iranian population.