Influence of placement depth and abutment connection pattern on bone remodeling around 1-stage implants: a prospective randomized controlled clinical trial.

OBJECTIVES: The aim of this study is to evaluate peri-implant marginal bone level changes in relation to crestal or subcrestal implant placement and type of fixture/abutment connection 3 months after implant placement. MATERIALS AND METHODS: The duration of the study was 3 months. A total of 105 implants were placed in 81 subjects following a one-stage surgical procedure and assigned into four groups. In the first and second groups, implants with a screwed tapered internal connection were placed subcrestally and crestally, respectively, while in the third and fourth groups, implants with an internal conical seal connection were similarly placed. Clinical recordings and standardized periapical digital radiographs were taken the day of implantation and 3 months later, before placement of the final prosthetic restoration. The modified plaque index (mPLI), modified gingival index (mGI), and probing depths (PD) were recorded at four sites around each implant, and the vertical distance between fixture/abutment junction and alveolar crest at the mesial and distal sites of each implant utilizing subtractive radiography were all measured on placement and at 3 months. RESULTS: There was no statistically significant difference between the four groups for PD. The highest values of mPLI and mGI were recorded for Group 2. The mean (±SE) peri-implant bone loss was recorded as follows: Group 1: 0.68 ± 0.07 mm, Group 2: 0.79 ± 0.06 mm, Group 3: 0.49 ± 0.06 mm, and Group 4: 0.40 ± 0.07 mm. The statistical analysis revealed significant differences in bone resorption between groups with different abutment connections. CONCLUSIONS: The connection between fixture/abutment rather than vertical implant placement in relation to alveolar bone level seems to affect peri-implant marginal bone resorption.

Tooth Wear Epidemiology and Its Associated Periodontal Health and Sociodemographic Factors in a Cluster of Senior Citizens in Northern Greece.

Tooth wear (TW) is an irreversible and cumulative phenomenon causing aesthetic and functional compromise. Increasing wear has been associated with age, and various other factors have been reported to influence its type and/or severity both in individuals and groups. Increased TW may constitute a major future problem for the elderly. The present cross-sectional study aims at determining the prevalence of TW in senior citizens from Northern Greece and evaluating the patient-level associations between TW, periodontal condition, and sociodemographic factors. A sample of 363 dentate individuals, aged between 65 and 74 years, was considered according to the WHO guidelines for national pathfinder surveys and three different dentists examined the representative population groups from different urban and rural areas in Northern Greece. The examiners were calibrated prior to the survey, with an interexaminer agreement of over 85%. The simplified TWI, community periodontal index (CPI), attachment loss (AL), plaque index (DI), calculus index (CI), and sociodemographic factors were detected and measured. TW is very prevalent among senior citizens in Northern Greece, with males having been found to experience more wear. Age and oral health status, when measured by the periodontal indices AL, DI, and CI, are significantly combined with TW in both urban and rural areas.

Attitudes of dentists regarding the restoration of root canal treated teeth: a survey in Greece.

OBJECTIVES: To investigate attitudes of Greek dentists regarding the restoration of root canal treated (RCT) teeth and to compare them to recommended guidelines. Additionally, to examine relationships between degree of dentists' professional experience or region of practice location and attitudes of restoring RCT teeth. METHOD: Data were collected from 302 dentists using a structured self-administered questionnaire. For each dentist a score was assigned reflecting the level of compliance with scientific recommendations for restoration of RCT teeth. RESULTS: 89.4% of the respondents reported that not every RCT tooth requires a post while the 46.4% stated that a post reinforces it. 76.2% of the participants believed that the ferrule design provides a reinforcement to RCT teeth. Dentists with 6-20 years of experience showed a higher level of compliance with the principles in the literature than their colleagues with less or more years of practising. No significant difference was detected between dentists practising in urban and rural areas. CONCLUSIONS: The majority of Greek dentists had knowledge in accordance with recommended guidelines, except the aspect of the reinforcement effect by the post. In contrast to the region of practice location, the degree of professional experience influenced the restoration of root-treated teeth.

Association between self-reported bruxism activity and occurrence of dental attrition, abfraction, and occlusal pits on natural teeth.

STATEMENT OF PROBLEM: It is unclear whether subjects who report tooth clenching and/or grinding have more noticeable clinical signs of dental attrition, abfractions, and occlusal pits on their natural teeth than subjects who do not report bruxism activity. PURPOSE: The purpose of this study was to determine whether there was an association between self-reported (or not reported) bruxism activity and occurrence of dental attrition (anterior, posterior), abfractions, and occlusal pits on natural teeth. MATERIAL AND METHODS: One hundred and two volunteer adult Greek subjects (mean age 44.6 +/-5.7 years) were classified into 2 groups (50 self-reported bruxers and 52 nonbruxers) according to 2 inquires regarding grinding and/or clenching of their teeth. Dental attrition (anterior, posterior) was assessed by 2 calibrated experienced examiners on diagnostic casts on a tooth-by-tooth basis, using a previously well established ordinal scale. Abfraction lesions (V-shaped, in the cervical region) and occlusal pits were recorded if these clinical signs were found on at least 2 natural teeth. Statistical comparisons between the 2 groups relative to the distribution of the occurrence of the 4 clinical signs were performed by means of the exact version of the chi-square test. The Fisher's exact test was used for the comparison of percentages. The intra- and interexaminer reliability was assessed by means of the Cohen's kappa coefficient (alpha=.05). RESULTS: The results demonstrated that there was a significant association between self-reported bruxism and occurrence of the 4 clinical signs. Although the 2 groups were significantly different according to the distribution of the 4 clinical signs, the greatest differences occurred for the anterior and posterior attrition signs. CONCLUSIONS: In this study, the occurrence of 4 clinical signs (posterior or anterior dental attrition, abfractions, and occlusal pits) was associated with self-reported bruxers. It is suggested that, primarily, signs of dental attrition may differentiate self-reported bruxers from nonbruxer subjects.

Salivary concentration of free LL-37 in edentulism, chronic periodontitis and healthy periodontium.

OBJECTIVE: The antimicrobial peptide LL-37, a component of innate immunity, has an important role in maintaining oral health. This study aimed to investigate the concentration of free LL-37 in whole saliva of periodontally healthy, edentulous and chronic periodontitis subjects. DESIGN: Unstimulated whole saliva was sampled from 154 subjects (76 periodontally healthy, 20 edentulous, and 58 subjects with chronic periodontitis). All participants were in good general health. The salivary LL-37 was determined by ELISA. RESULTS: The median salivary concentrations of free LL-37 were 30.5, 22.5, and 1.8ng/ml for the healthy, the chronic periodontitis and the edentulous group, respectively. The differences in concentration between the edentulous and the others were statistically significant (Mann-Whitney test, p<0.001). In the healthy subjects, women displayed significantly higher peptide concentrations compared to men (Mann-Whitney test, p<0.05). The intra-subject variation in LL-37 concentration was wider for the healthy (range 0.75-285ng/ml) and chronic periodontitis patients (range 1-207ng/ml) than for the edentulous subjects (range 0.15-4.4ng/ml). CONCLUSIONS: The present findings show that edentulism correlates with a substantial decrease in salivary levels of free LL-37, thus indicating the considerable contribution of the gingival tissues in the secretion of the peptide in the oral environment.

Heart rate, salivary α-amylase activity, and cooperative behavior in previously naïve children receiving dental local anesthesia.

PURPOSE: Psychosomatic indicators, such as heart rate (HR), salivary alpha amylase (sAA) activity, and behavior, can be used to determine stress. This study's aim was to assess the pattern of changes of salivary alpha amylase, heart rate, and cooperative behavior in previously naïve children receiving dental treatment under local anesthesia. METHODS: Included were 30 children with no prior dental experience who needed 4 or more sessions of dental treatment involving local anesthesia. In each session, sAA, HR, and behavior were assessed before and during the application of local anesthesia and at the end of the treatment. RESULTS: The highest sAA value was always observed at the end of each session; overall, the value was lower in the fourth session. HR always increased during the local anesthesia, and did not vary across sessions. No significant relationship was found between child cooperation and either sAA or HR. CONCLUSION: In this sample, child cooperation may not be an accurate indicator of stress. Based on salivary alpha amylase activity changes, dental treatment involving local anesthesia in naïve children appeared to be less stressful after 3 sessions.

Evaluation of the relationship between subjects' perception and professional assessment of esthetic treatment needs.

PURPOSE: The purposes of the present study were to (1) evaluate the esthetic dental treatment need by means of two special questionnaires, (2) determine the reliability and the construct validity of the measurement scales derived from these questionnaires, and (3) investigate the relationship between Greek subjects' perception and a professional examiner's assessment regarding the esthetic treatment need. MATERIALS AND METHODS: Participants in this survey consisted of 132 subjects (48 males with mean age 39.0 +/- 14.5 years old, 84 females with mean age 41.7 +/- 14.5 years old) with natural teeth and fixed restorations. Subjects were asked to complete a special self-evaluation questionnaire consisting of 12 items. During the next stage, all participants were clinically examined by an experienced examiner and the data collected were used to fill out a second special professional assessment questionnaire consisting of 20 items. The forms structure used were in accordance with well-established indices used in orthodontics for assessing esthetic treatment need. RESULTS: The reliability of the multiple correspondence analysis (MCA) analysis-derived scales was very satisfactory (Cronbach's a coefficient: a =0.82) for the total scale of the self-evaluation measurement. For the professional assessment scale, the reliability of the total scale was almost perfect (a=0.92). The MCA revealed one reliable factorial construct for the self-evaluation measurement scale and two reliable constructs for the professional measurement scale. Pearson's correlation coefficient indicated a very low agreement between self-evaluation and professional measurement scales. CONCLUSION: The findings of this survey suggest that there was a relative disagreement between subjects' perception and professional assessment regarding the need for esthetic dental treatment. CLINICAL SIGNIFICANCE In the present survey, the agreement between subjects' perception and clinical assessment of esthetic dental treatment need was found to be very low, which highlighted the discrepancies between patients' and dentists' perceptions of esthetic needs.