The effect of conventional versus electronic cigarette use on treatment outcomes of peri-implant disease.

AIM: To compare changes in clinical periodontal parameters (gingival consistency, colour, BOP, PI, PD) and changes of salivary inflammatory biomarkers (IL-1 ß, IL-6, MMP-8, TNF- α and TIMP-1 between conventional, electronic cigarette smokers and non-smokers after peri-implant treatment. METHODS: Study participants were grouped into three groups (i) Conventional cigarette smokers (ii) Electronic cigarette smokers and (iii) non-smokers respectively. A total of 60 adult patients aged (40-56 years) with 60 implants with active per-impantitis was included.Clinical and Biological parameters were evaluated before surgical treatment at baseline, one, six and twelve month post treatment. Pearson's chi-square test was used to compare the distribution of the categorical while Two-way repeated analysis of variance was used to compare the mean values of quantitative outcome variables among all study groups across the 4 time points. RESULTS: A total of 60 subjects (60 implants) were selected and classified into three groups as per their smoking method 20 participants in each group with one single targeted implant diagnosis with active peri-implantitis. The gingival colour, the change was statistically significant at one year of post treatment.The gingival consistency distribution across the three groups is not statistically significant at baseline, but it is statistically significant at one-month (p = 0.001), six months (p = 0.029) and at the completion of one-year (p = 0.018) post treatment. The plaque index of 100% of non-smokers had changed to '0' and 35% change in cigarettes and 30% change in electronic smokers which is statistically significant (p = 0.016).The prevalence of BOP was observed in the three groups as 72%, 76.5% and 88.9% at baseline. The mean values of PD have shown statistically significant change across the three groups over the four-time intervals of observation (p = 0.024). The comparison of mean values of IL-1 ß, IL-6 and TIMP-1 has shown statistically significant change across the three groups over the four intervals of observation (p < 0.0001). CONCLUSIONS: Electronic cigarette smoking was found to be most prevalent risk indicator for peri-implantitis. Compromised response of peri-implantitis treatment both clinically and biologically was found more among electronic cigarette smokers when compared to conventional cigarette smokers and non-smokers. TRIAL REGISTRATION: This case-control study was conducted at King Saud University's Dental College, Riyadh, Saudi Arabia, in accordance with "Helsinki Declaration of Human Studies" and approved by the Institutional Review Board (Reference no: 87563).

The effect of using mobile applications for improving oral hygiene in patients with orthodontic fixed appliances: a randomised controlled trial.

OBJECTIVE: To investigate the effect of using mobile applications active reminders to improve oral hygiene in comparison to verbal oral hygiene instructions. DESIGN: Two-arm parallel randomised controlled trial. SETTING: orthodontic clinics at two branches of a university hospitals of the college of dentistry of Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia. PARTICIPANTS: Forty-four 12-year-old and older subjects. METHOD: Subjects undergoing orthodontic treatment with fixed appliances were randomly assigned to one of two groups using simple randomisation. Group I: subjects received a mobile application that sends active reminders of oral hygiene three times a day (n = 22). Group II: subjects received verbal oral hygiene instructions verbally during their routine orthodontic visits (n = 22). Two primary outcomes were assessed using plaque index (PI) and gingival index (GI) for Ramfjord teeth to evaluate the level of oral hygiene at baseline and after 4 weeks. RESULTS: Mean differences for PI and GI for group I were reduced from T1 to T2 (P < 0.05, P < 0.05) but did not significantly change for group II (P > 0.05, P > 0.05). Both PI and GI significantly reduced for group I compared to group II between T1 and T2 (P < 0.05, P < 0.05). CONCLUSIONS: PI and GI all significantly decreased after 4 weeks of using active reminders of oral hygiene instructions on mobile application compared to verbal oral hygiene instructions. The study was registered at clinicaltrials.gov with number: NCT03109769.

Evaluation of the marginal fit of full contoured zirconia, lithium disilicate and metal crowns fabricated using CAD-CAM: An in vitro study.

Introduction: The marginal fit of any dental restoration is vital to its long-term success. Lack of adequate fit is potentially detrimental to both the tooth and the supporting periodontal tissues. The purpose of this study was to evaluate the marginal fit of monolithic zirconia, monolithic lithium disilicate and monolithic metal crowns and compare the three groups. Methods: The study was conducted by fabricating ten samples for each group, total of 30 samples. A premolar stainless steel die was used to standardize the preparation. PVS putty material was used to make impressions of the model and was poured using type IV die stone. The samples were all fabricated using CAD-CAM. The marginal gap was measured by SEM, and the results were analysed using SPSS software. Results: The mean marginal gap of zirconia, metal and lithium disilicate crowns was 79.49 µm, 46.83 µm and 70.79 µm, respectively. Discussion: The metal group showed the lowest marginal gap among the groups. This difference in marginal fit is due to the sintering process where the organic binders in soft metal burn out and the metallic powder particles are being sintered (caked) without creating a fused phase. Clinical Significance: Marginal fit plays a very important role in the long-term success of a crown. Discrepancy in marginal fit results in food and plaque accumulation causing caries and periodontal breakdown, eventuating the failure of the restoration. A perfect marginal fit would enhance the longevity of any indirect restoration. Knowledge about which indirect restoration has the best marginal fit is critical.

The prevalence of radix molaris in the mandibular first molars of a Saudi subpopulation based on cone-beam computed tomography.

OBJECTIVES: The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2). RESULTS: Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed. CONCLUSIONS: The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.