Sinus Floor Augmentation With Ambient Blood and an Absorbable Collagen Sponge: A Prospective Pilot Clinical Study.

PURPOSE: The aim of this study was to clinically, radiologically, and histologically evaluate a sinus augmentation technique using a resorbable collagen sponge to maintain space between the Schneiderian membrane and the residual crestal bone. MATERIALS AND METHODS: Patients with partially edentulous maxillae were clinically and radiographically evaluated for implant placement. A total of 10 consecutive patients with the bone height for implant placement (<4.0 mm) were enrolled in the study. The lateral maxillary wall was surgically exposed and the Schneiderian membrane was carefully elevated. A collagen wound dressing was placed in the antral area between the sinus floor and the raised membrane. The vertical sinus floor height was calculated using cone-beam computed tomography before the surgical procedure (baseline) and at 6 months postoperative. Immediately after the second scan, a core biopsy was removed for histological evaluation. The biopsy site was then further prepared for implant placement in the same location. RESULTS: Biopsies showed mature cancellous bone with a predominantly lamellar structure. Well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Analysis of bone height changes showed significant mean (SD) differences before and after procedures in anterior (2.67 ± 0.62 mm and 11.15 ± 1.1 mm), medial (2.98 ± 0.55 mm and 10.96 ± 0.77 mm), and posterior (3.17 ± 0.91 mm and 10.63 ± 0.51 mm) maxillary jaw locations (P = 0.005). CONCLUSION: The collagen sponge provided an effective substrate for osseous regeneration of the sinus floor.

In Vitro Influence of Prophylaxis Cleaning on Enamel Remineralization with Casein Phosphopeptide-Amorphous Calcium Phosphate.

OBJECTIVES: This randomized controlled in vitro 4-arm trial study aimed to study the remineralization potential of Recaldent™ and assess the effects of prophylaxis cleaning and MI Varnish® on enhancing this remineralization potential. MATERIAL AND METHODS: Sixty human teeth were randomly assigned into equal samples (A/B). Sample A was prophylactically cleaned, randomly divided into equal samples (1/2). Sample A1 received treatment with MI Varnish® and Recaldent™ for 30 days. Sample A2 was treated similarly but without MI Varnish®. Sample B did not receive prophylaxis cleaning and was divided into equal samples (1/2). Sample B1 was treated as A1 and sample B2 as A2. The teeth were examined for mineral composition at baseline, after the interventions (T1), and after prophylaxis cleaning (T2). Study outcomes were mineral content (% weight of carbon [C], phosphorus [P], calcium [Ca], oxygen [O], chlorine [Cl], sodium [Na] and silicon [Si]) and calcium-phosphorus ratio (Ca/P). RESULTS: All groups had similar mineral composition at baseline. At T1, sample B2 exhibited least P, Ca and Ca/P content. Samples A1 and B1 showed higher content of P and Ca, compared to B2 (A1 only exhibited higher Ca/P). Sample A2 exhibited lowest Cl and Na content. At T2, sample A1 exhibited lowest C, P, O and Si content (highest Ca/P). Sample A2 showed least Ca/P, and highest Na content. CONCLUSIONS: Teeth treated by Recaldent™ proceeded by prophylaxis cleaning or MI Varnish® showed remineralization, especially when receiving both interventions. This superior effect persisted even after a second cleaning. Further trials are necessary to provide conclusive evidence in humans.

The Efficacy of Soprolife® in Detecting in Vitro Remineralization of Early Caries Lesions.

OBJECTIVES: This randomized controlled in vitro 4-arm trial study aimed to evaluate the efficacy of SoproLife® in detecting and quantifying in vitro remineralization with early caries lesions. MATERIAL AND METHODS: Sixty human teeth were randomly assigned into four equal groups. Groups 1 and 2 were prophylactically cleaned; groups 3 and 4 were not. Group 1 received treatment with MI Varnish® and Recaldent™ for 30 days. Group 2 was treated similarly, but without MI Varnish®. Group 3 was treated as 1 and Group 4 as 2. Mineral composition was obtained using scanning electron microscopy with energy dispersive X-ray analysis SoproLife® camera images on the occlusal surfaces were analysed for grey value distribution and difference in mean intensity values (DI). Paired t-test and Mann-Whitney-U test were used for intragroup comparison between baseline and T1. Kruskal-Wallis followed by Mann-Whitney-U tests were used for inter-group comparisons at T1. RESULTS: All groups exhibited a significant increase in calcium content and calcium-to-phosphorus ratio (P < 0.05), except Group 4 (Group 1 showed the greatest increase, then Groups 3 and 2). Grey intensity values decreased in all groups (P < 0.05). Group 1 showed the greatest change in DI (16.82 [SD 12.07]), followed by Group 3 (12.46 [SD 9.41]), 2 (10.45 [SD 7.76]), and 4 (6.46 [SD 6.21]). The difference in DI was different between the compared groups (P = 0.038); Groups 1 and 3 exhibited a greater DI compared with 4 (P < 0.01). CONCLUSIONS: Within the limitations of this study, SoproLife® is effective for early detection and for longitudinally monitoring the remineralization after Recaldent™ therapy.

Relationship Between the Remaining Dentin Thickness and Coronal Pulp Status of Decayed Primary Molars.

AIMS AND OBJECTIVES: The aim of this study was to assess the correlation between the remaining dentin thickness (RDT) in deep decayed primary molars and the inflammatory status and bacterial composition of the corresponding coronal pulp. We hypothesized that RDT could be used as a reference for clinicians in assigning the indication for pulpotomy. MATERIALS AND METHODS: Pulpotomies were conducted on the cameral pulp of 48 primary molars. Microorganisms, such as Lactobacillus sp., Streptococcus sp., and Prevotella sp., were identified and quantified and levels of tumor necrosis factor-alpha (TNF-α) and interlukin-6 (IL-6) were assessed. The correlation between the pre-operative RDT based on radiographic images and inflammatory-microbial profiles in vitro was evaluated using Spearman's rho correlation coefficient. All data analysis was performed using a statistical software program (SPSS 20.0, SPSS Inc., Chicago, IL, USA). RESULTS: Immunological and microbiological studies revealed elevated levels of TNF-α and IL-6 cytokines, and Lactobacillus sp., Streptococcus sp. and Prevotella sp. in the cameral pulp with an RDT measuring up to 1.1 mm. No significant relationship could be established between RDT, inflammatory status and microbial content of the pulps. CONCLUSION: The RDT remains a key clinical factor that needs to be assessed when establishing the indication for pulpotomy. Additional parameters that can improve this therapy should be investigated in the future.