Treatment Durations and Whitening Outcomes of Different Tooth Whitening Systems.

Background and Objectives: Tooth whitening is a relatively conservative and effective option to treat discolored teeth. However, questions remain whether in-office or at-home tooth whitening products with short treatment durations are as effective and stable as products with longer treatment durations. Materials and Methods: Forty human third molars with intact enamel surfaces were divided into four groups of ten each, subjected to discoloration challenges with coffee for 60 h, and they were treated with four professional tooth whitening systems: two for take-home use-6% hydrogen peroxide for 30 min/d for a total of 7 h in 14 days (HP6), 10% carbamide peroxide for 10 h/d for 140 h in 14 days (CP10), as well as two for in-office use-35% HP for 10 min × 3 (HP35) for a total of 30 min and 40% HP for 20 min × 3 (HP40) for a total of 60 min. Teeth colors were assessed in the CIE L*a*b* color space with a spectrophotometer immediately and six months after whitening treatments. Surface roughness (Sa) for the treated and untreated enamel surfaces of the teeth in all groups were evaluated with a three-dimensional laser scanning microscope after six months. Results: No significant differences were found between HP6 and CP10 groups immediately after whitening (∆E 10.6 ± 1.6 vs. 11.4 ± 1.7, p > 0.05) and at six months after treatments (∆E 9.0 ± 1.9 vs. 9.2 ± 2.5, p > 0.05), or between HP35 and HP40 groups immediately after whitening (∆E 5.9 ± 1.2 vs. 5.3 ± 1.7, p > 0.05) and at six months after treatments (∆E 7.2 ± 1.6 vs. 7.7 ± 1.3, p > 0.05). The two at-home whitening systems achieved significantly better whitening outcomes than the two in-office products immediately after whitening (p < 0.05). However, at six months after treatments, the differences between at-home and in-office treatments had narrowed significantly (p > 0.05). There were no statistically significant differences with respect to the Sa values between the treated and untreated surfaces (p > 0.05). Conclusions: Tooth whitening products in the same product category have similar whitening efficacies, despite significant differences in treatment durations (7 vs. 140 h, and 30 min vs. 60 min, respectively). Take-home products achieved better whitening outcomes than in-office products, but they needed 14 to 280 times longer treatment durations.

Association between oral clefts and periodontal clinical measures: A meta-analysis.

AIM: To conduct a systematic review and to evaluate the clinical parameters for periodontal diseases in individuals with cleft lip and/or palate (CL/P). DESIGN: The authors searched six indexed databases without any linguistic limitation through July 2021. The eligibility criteria were observational studies that compared the periodontal clinical measures of individuals with CL/P to those without CL/P. A meta-analysis was conducted using random-effects models with inverse variance weighting. RESULTS: The literature search generated 1277 records, and 40 full-text articles were reviewed. Twenty-three studies comprising 3235 individuals from four continents fulfilled our selection criteria. The meta-analysis revealed a significant difference in mean plaque index scores (MD = 0.31, 95% CI = 0.22, 0.41), gingival index scores (MD = 0.50, 95% CI = 0.24, 0.77), and periodontal pocket depth (MD = 0.64, 95% CI = 0.12, 1.16) between individuals with and without CL/P. A slight increase in clinical attachment loss was detected among individuals with CL/P; however, such an increase may have little clinical significance. CONCLUSIONS: As age is positively related to periodontal disease progression, and individuals with CL/P are more likely to present with more plaque accumulation and gingival inflammation, clinicians should reinforce preventive dental care from an early age.

Effects of whitening toothpaste and bleaching treatment on resin composite discoloration caused by cigarette smoke and electronic vapor aerosol.

PURPOSE: To compare the effects of whitening toothpaste and bleaching with 6% hydrogen peroxide (H2O2) on discoloration of dental resin composite caused by cigarette smoke (CS) and electronic vapor product (EVP) aerosol. METHODS: 40 resin composite discs were divided into three groups: 15 each for CS and EVP aerosol exposure and 10 for air exposure (control). Exposures were performed for 15 days, with daily brushing with regular toothpaste. Two whitening sessions, including 21 days of brushing with whitening toothpaste and 3 days of treatments with take-home bleaching (6% H2O2), were performed after the exposure. Color and gloss were assessed before exposure, at every 5 days of exposure, and after each whitening session. RESULTS: After 15 days of exposure, marked discoloration of resin composite was observed in the CS group (ΔE = 23.66 ± 2.31), minimal color change in the EVP group ((ΔE = 2.77 ± 0.75), and no color change in the control group. Resin composites exposed to CS did not recover their original color after treatment with whitening toothpaste ((ΔE = 20.17 ± 2.68) or take-home bleaching ((ΔE = 19.32 ± 2.53), but those exposed to EVP aerosol reverted to baseline after treatment with whitening toothpaste ((ΔE = 0.98 ± 0.37), and no further change in color was observed following take-home bleaching. The gloss of resin composites exposed to CS, EVP aerosol, and air decreased equally with exposure time. Brushing with whitening toothpaste recovered the gloss similarly in all groups, but no further change was observed following take-home bleaching. CLINICAL SIGNIFICANCE: Aerosol from electronic vapor products induced minimal discoloration of resin composites that can be completely reverted by brushing with whitening toothpaste alone. Bleaching with 6% H2O2 did not revert discoloration caused by cigarette smoke. Whitening toothpaste could help revert the decreased gloss of resin composites.

Effects of desensitizing dentifrices on dentin tubule occlusion and resistance to erosive challenges.

BACKGROUND: Many studies have demonstrated efficacy of casein phosphopeptide (CPP) containing products for dentin tubule occlusion for treatment of dentin sensitivity, but their effectiveness under dynamic erosive challenges remains to be elucidated. The purpose of the present study was to investigate the effectiveness of a desensitizing dentifrice containing CPP in occluding dentin tubules and resisting erosive challenges in comparison to that containing polyvinyl methyl ether/maleic acid (PVM/MA) copolymers. METHODS: A total of 33 dentin discs were prepared from coronal sections of human third molars and divided into 3 groups: a toothpaste containing CPP; a toothpaste containing PVM/MA and submicron silica; and a regular toothpaste (Controls). A soft-bristle toothbrush was used to brush the dentin discs with the dentifrices for 45 strokes in 30 s at a force of approximately 200 g. The brushing cycle was repeated after immersion of the dentin discs in artificial saliva overnight. The dentin discs were then challenged in orange juice for 10 min in an incubator rocking at 120 rpm. Three fields were randomly selected on each dentin disk surface to assess dentin tubule occlusions after each brushing cycle and after orange juice challenge with a 3D laser scanning microscope. Specimen cross sections were examined with a scanning electron microscope equipped with energy dispersive spectroscopy (SEM/EDS). RESULTS: After the first and second cycles of brushing, dentin tubules were occluded on average by 56.3% and 85.7% in CPP group, 66.2% and 88.1% in PVM/MA group, and 0.0 and 13.0% in the controls, respectively. There were no statistically significant differences in dentin tubule occlusions between the CPP and PVM/MA groups after two cycles of brushing (p>0.05). After dynamic erosive challenges with orange juice, 20.3% of the dentin tubules in the CPP group, 79.1% in the PVM/MA group and none in the control remained occluded (P<0.05). SEM/EDS imaging showed that dentin tubules were blocked with plugs containing dentifrice substances in CPP and PVM/MA groups after treatments, but none in the controls. CONCLUSIONS: Desensitizing dentifrices containing CPP or PVM/MA could effectively occlude dentin tubules after two cycles of brushing. PVM/MA in combination with submicron silicon dioxide exhibited stronger resistance to dynamic erosive challenges by acidic beverages. Inorganic fillers that can enter dentin tubules and resist erosive challenges may be key for desensitizing dentifrices.

Prenatal Oral Health Care and Early Childhood Caries Prevention: A Systematic Review and Meta-Analysis.

Despite the advancement of early childhood caries (ECC) prediction and treatment, ECC remains a significant public health burden in need of more effective preventive strategies. Pregnancy is an ideal period to promote ECC prevention given the profound influence of maternal oral health and behaviors on children's oral health. However, studies have shown debatable results with respect to the effectiveness of ECC prevention by means of prenatal intervention. Therefore, this study systematically reviewed the scientific evidence relating to the association between prenatal oral health care, ECC incidence, and Streptococcus mutans carriage in children. Five studies (3 randomized control trials, 1 prospective cohort study, and 1 nested case-control study) were included for qualitative assessment. Tested prenatal oral health care included providing fluoride supplements, oral examinations/cleanings, oral health education, dental treatment referrals, and xylitol gum chewing. Four studies that assessed ECC incidence reduction were included in meta-analysis using an unconditional generalized linear mixed effects model with random study effects and age as a covariate. The estimated odds ratio and 95% confidence intervals suggested a protective effect of prenatal oral health care against ECC onset before 4 years of age: 0.12 (0.02, 0.77) at 1 year of age, 0.18 (0.05, 0.63) at 2 years of age, 0.25 (0.09, 0.64) at 3 years of age, and 0.35 (0.12, 1.00) at 4 years of age. Children's S. mutans carriage was also significantly reduced in the intervention group. Future studies should consider testing strategies that restore an expectant mother's oral health to a disease-free state during pregnancy.

Does Local Ibandronate and/or Pamidronate Delivery Enhance Osseointegration? A Systematic Review.

PURPOSE: To our knowledge from indexed literature, the present study is the first one to systematically review the influence of local delivery of pamidronate (PAM) and/or ibandronate (IBA) on osseointegration enhancement. The aim of the present systematic review was to assess the efficacy of IBA and/or PAM local delivery (topically or coating on implants surfaces) in promoting osseointegration. MATERIALS AND METHODS: To address the focused question, "Does local IBA and/or PAM delivery enhances osseointegration?," indexed databases were searched without time or language restrictions up to and including May 2016 using various combinations of the following keywords: "pamidronate," "ibandronate," "bisphosphonates," "osseointegration," and "topical administration." Letters to the Editor, historic reviews, commentaries, case series, and case reports were excluded. RESULTS: Fifteen studies were included. Fourteen studies were performed in animals and 2 were clinical trials. One study reported an experimental model and a clinical trial in the same publication. Results from 12 experimental studies and 2 clinical studies reported improved biomechanical properties and/or osseointegration around implants with PAM and/or IBA. Two experimental studies showed that PAM and/or IBA did not improve osseointegration. CONCLUSIONS: On experimental grounds, local IBA and/or PAM delivery seems to enhance osseointegration; however, from a clinical perspective, further randomized control trials are needed to assess the effectiveness of IBA and PAM in promoting osseointegration around dental implants.

Effectiveness of resin-based materials against erosive and abrasive enamel wear.

OBJECTIVE: The objective of this study was to test the effectiveness of resin-based materials against erosive enamel wear under erosive and abrasive challenges by orange juice and tooth brushing. METHODS: Fifty enamel specimens from third molars were assigned to five groups: ICON resin infiltration with no etching (ICON-NE), ICON resin infiltration with 15 % HCl etching (ICON-AE), Seal & Protect sealant (S&P), Tetric EvoFlow (TEF), and control. Erosive lesions were first created on enamel, then treated with resin-based materials. Erosive and abrasive challenges by orange juice and tooth brushing were repeated after treatments. Erosive wear of the treated areas was measured with 3D scanning microscopy, and data were analyzed using ANOVA and paired t tests. RESULTS: Treatments with ICON, S&P, and TEF created a protective material coating of 4.5 ± 1.9 µm, 44.3 ± 8.1 µm, and 84.6 ± 15.7 µm in thickness on the lesion surfaces, respectively. After 15 cycles of erosive and abrasive challenges, enamel or material losses were 21.9 ± 2.3 µm for control, 24.5 ± 4.0 µm for ICON-NE, 24.6 ± 7.4 µm for ICON-AE, 11.2 ± 4.1 µm for S&P, and 3.9 ± 1.9 µm for TEF, respectively. The protective coatings were completely lost in the ICON infiltration groups but remained intact in both the S&P and TEF groups after erosive and abrasive challenges. CONCLUSION: In contrast to a resin sealant and a flowable composite, ICON infiltration resin was not effective in protecting enamel surfaces from erosive and abrasive wear. CLINICAL RELEVANCE: Sealant and flowable composite resin may create protective coatings on eroded enamel surfaces and prevent further tissue loss.

Effects of cigarette smoking on color stability of dental resin composites.

PURPOSE: To study the effects of cigarette smoke (CS) on the discoloration of dental resin composite compared with the aerosol from a heat-not-burn tobacco product, the Tobacco Heating System 2.2 (THS2.2). METHODS: A total of 60 discs were prepared from three commercial resin composites: Durafill VS (DVS), Filtek Supreme Ultra (FSU) and Tetric EvoCeram BulkFill (TEC). Twenty discs of each composite were divided into two groups and exposed to CS from 20 reference cigarettes (3R4F) or aerosol from 20 THS2.2 tobacco sticks per day for 3 weeks. Color, gloss and surface roughness of the composite discs were measured at baseline and after exposure and brushing with toothpaste at 1, 2 and 3 weeks. RESULTS: Color differences from the baseline (ΔE) were on average 27.1 (±3.6) in 3R4F and 3.9 (±1.5) in the THS2.2 group after 3 weeks of exposure (P< 0.0001). TEC (30.4±1.4 and FSU (28.0 ±2.5) exhibited more discoloration than DVS (23.0±1.2) in the 3R4F group (P< 0.0001). FSU (2.6 ±0.5) showed significantly less discoloration than TEC (5.3±1.5) in the THS2.2 group (P< 0.0001). Surface roughness of resin composites was not affected by either CS or THS2.2 aerosol, while surface gloss increased in the composite discs with more severe discoloration. CLINICAL SIGNIFICANCE: Cigarette smoke caused significant discoloration of dental composite resins. Reducing or eliminating the deposits derived from combustion of tobacco has the potential to minimize the impact of smoking on the color of composite resin restorations.

Does incorporating zinc in titanium implant surfaces influence osseointegration? A systematic review.

STATEMENT OF PROBLEM: Titanium implant surfaces have been modified to improve osseointegration; however, the evidence for incorporating zinc into titanium implants to improve new bone formation and osseointegration is not clear. PURPOSE: The purpose of this systematic review was to assess the efficacy of treating titanium surfaces with zinc on the osseointegration of implants. MATERIAL AND METHODS: The focused question addressed was, "Does incorporating zinc in titanium implant surfaces influence osseointegration?" Indexed databases were searched up to January 2016 using the key words "Bone to implant contact"; "implant"; "zinc"; "osseointegration." Letters to the editor, case reports/case series, historic reviews, and commentaries were excluded. The pattern of the review was customized to summarize the pertinent data. RESULTS: Ten experimental studies were included, all of which were performed in animals (5 in rabbits, 4 in rodents, and 1 in goats). The number of titanium implants placed ranged from 10 to 78. The results from all studies showed that incorporating zinc into titanium implants enhanced new bone formation and/or bone-to-implant contact around implants. One study reported that zinc enhanced the removal torque on implants. CONCLUSIONS: The current available evidence on adding zinc to titanium implants surfaces to enhance osseointegration remains unclear. Further investigation is necessary to assess its effectiveness and safety in humans and to establish a standard methodology and ideal compound for incorporating zinc ion into titanium implant surfaces in a clinical setting.

Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review.

The aim of this study was to review the cytokine profiles in the synovial fluid (SF) of patients with temporomandibular joint disorders (TMJD). Databases were searched from 1965 till September 2015 using different combinations of the following key words: "Temporomandibular joint"; "Cytokine"; "disorder"; and "synovial fluid" and "inflammation". Titles and abstracts of studies identified using the above-described protocol were screened and checked for agreement. Full-texts of articles judged by title and abstract to be relevant were read and independently evaluated. Hand-searching of the reference lists of potentially relevant original and review articles was also performed. The pattern of the present systematic review was customized to mainly summarize the relevant data. Fifteen studies were included. In 12 studies, cytokine profile of patients with TMJD was assessed using enzyme linked immunosorbent assay; and in 2 studies, histological analysis was performed to assess the cytokine profile of patients with TMJD. Patients with TMJD presented raised levels of interleukin (IL)-6 in 8 studies, IL-1beta (1ß) in 5 studies and tumor necrosis factor-alpha (TNF-α) in 5 studies. Two studies showed no significant difference in TNF-α levels in patients with and without TMJD; and IL-1ß levels were comparable in patients with and without TMJD in 2 studies. Raised levels of IL-6, TNF-α, IL-1ß, IL-8, and IFN-γ in the SF have been associated with inflammation in patients with TMJD. Cytokines IL-10, osteoclastogenesis inhibitory factor/osteoprotegerin (OCIF/OPG), and VEGF found in the SF of TMJs could have an anti-inflammatory effect.

Success rate of short dental implants supporting single crowns and fixed bridges.

OBJECTIVE: Bone grafts (sinus lift and/or ridge augmentation) may become an obstacle for some patients who desire implant treatment. The objective of this study was to evaluate the success of six- and eight-millimeters rough surface design short dental implants, for up to 2 years in function, when compared to conventional length (11 mm) implants. MATERIALS AND METHODS: A total of 25.6-, 20.8- and 35.11-mm length implants were placed and restored in 30 subjects (11 males, 19 females) between the age of 22 and 80, following a standard protocol. Implant mobility, crestal bone loss as well as periodontal parameters were evaluated immediately after restoration placement, at 6, 12 and 24 months. RESULTS: There was one failure of one 6-mm implant during the healing phase and one restorative failure. The median crestal bone loss at 24 months was 0.45 mm for the 6-mm implants, 0.55 mm for the 8 mm implants and 0.65 mm for the 11-mm implants. The success rate for 6-mm implants was 97% and for 8-mm and 11-mm implants 100%. CONCLUSIONS: Based on this preliminary data, we conclude that rough surface design short dental implants (6 and 8 mm in length) have similar success rate when compared to 11-mm implants. Long-term data with larger number of implants and subjects are needed to confirm these results.

Effect of oral hygiene maintenance on HbA1c levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients: 2 years follow-up.

OBJECTIVE: The aim of the present 2-year follow-up study was to assess the effect of oral hygiene maintenance on hemoglobin Alc (HbA1c) levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients with varying glycemic levels. MATERIAL AND METHODS: Ninety-one individuals were divided into three groups. In group 1, 30 systemically healthy individuals were included (HbA1c < 6%). Patients in group 2 and 3, comprised of 30 patients with T2DM (HbA1c 6.1-8%); and 31 patients with T2DM (HbA1c 8.1-10%) respectively. In all groups, patients received immediately loaded bone level implants. All participants were enrolled in a 6 monthly periodontal/peri-implant maintenance program. Peri-implant bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL) were measured at 6, 12, and 24 months of follow-up. RESULTS: Mean preoperative HbA1c levels in patients in groups 1, 2, and 3 were 4.5%, 6.8%, and 8.7% respectively. In group-1, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in groups 2 and 3, there was a significant decrease in HbA1c levels at 24-months follow-up than 6-months follow-up. At 6 months follow-up, BOP, PD, and MBL were significantly higher among patients in group-3 than group-1. At 12 and 24 months follow-up, there was no significant difference in BOP, PD, and MBL in all groups. CONCLUSIONS: Oral hygiene maintenance reduces hyperglycemia and peri-implant inflammatory parameters around immediately loaded dental implants placed in type 2 diabetic patients.

Effect of Nd:YAG laser-assisted non-surgical periodontal therapy on clinical periodontal and serum biomarkers in patients with and without coronary artery disease: A short-term pilot study.

BACKGROUND/OBJECTIVE: We hypothesized that nonsurgical-periodontal-therapy (NSPT) with adjunct Nd:YAG laser therapy is more effective in reducing periodontal inflammatory parameters (plaque index [PI], bleeding-on-probing [BOP], and probing-pocket-depth [PPD]) and serum interleukin-1beta (IL-1ß) and matrix metalloproteinase-9 (MMP-9) levels in patients with and without coronary artery disease (CAD) than NSPT alone. The aim of this short-term pilot study was to assess the effect of NSPT + Nd:YAG laser therapy on periodontal parameters and serum IL-1ß and MMP-9 levels in patients with and without CAD. STUDY DESIGN: A prospective randomized clinical study was conducted on 87 patients who were divided into two groups: Group-1: 44 patients with CAD and periodontal disease (PD) and Group-2: 43 patients with PD alone. Treatment-wise, these individuals were randomly divided into two subgroups: (i) NSPT alone and (ii) NSPT + Nd:YAG laser therapy. Demographic information was collected using a self-completed questionnaire. Periodontal parameters (PI, BOP, and PPD) and serum IL-1ß and MMP-9 levels were measured at baseline and after 3 months of treatment. P-values <0.05 were considered statistically significant. RESULTS: At 3 months follow-up, PI (P < 0.01), BOP (P < 0.01), PPD ≥ 4 mm (P < 0.01), and serum IL-1ß (P < 0.01) and MMP-9 (P < 0.01) levels were significantly higher in patients treated with NSPT alone than those treated with NSPT + Nd:YAG laser therapy. Among patients that underwent NSPT + laser therapy in both groups, periodontal parameters and serum IL-1ß, and MMP-9 levels were comparable at 3-months follow-up. CONCLUSION: NSPT + Nd:YAG laser therapy may be more effective in reducing periodontal inflammation and serum IL-1ß and MMP-9 levels in patients with and without CAD than NSPT alone. Lasers Surg. Med. 48:929-935, 2016. © 2016 Wiley Periodicals, Inc.

Efficacy of parathyroid hormone supplementation on the osseointegration of implants: a systematic review.

OBJECTIVE: The aim of the present systematic review was to assess the efficacy of parathyroid hormone supplementation on the osseointegration of implants. METHODS: The addressed focused question was Does parathyroid hormone supplementation affect osseointegration around implants? Indexed databases were searched from 1965 up to and including April 2015 using various key words including: Bone to implant contact; implant; parathyroid hormone; and osseointegration. Letters to the Editor, case-reports/case-series, historic reviews, commentaries and articles published in languages other than English were excluded. The pattern of the present systematic review was customized to primarily summarize the pertinent data. RESULTS: Eighteen studies fulfilled the eligibility criteria. Evidence was limited to preclinical animal studies only (11 studies in rodents, 4 in dogs and 3 in rabbits). Number of titanium implants placed ranged between 20 and 80 implants. Results from 16 studies showed that PTH supplementation enhanced new bone formation and/or BIC around implants. One study suggests that PTH-coated implants improve BIC and BA. One study showed no significant difference in BIC and new bone formation around implants with PTH hydrogel placement. CONCLUSION: Efficacy of PTH supplementation on osseointegration of implants shows promising results in animal models, however further investigation is necessary to assess the effectiveness in humans.

Efficacy of Vitamin D3 Supplementation on Osseointegration of Implants.

PURPOSE: The aim was to systematically review the efficacy of vitamin D3 (VD3) supplementation on the osseointegration of implants. METHODS: The addressed focused question was "does VD3 supplementation affect osseointegration around implants?" Indexed databases were searched from 1969 up to and including March 2015 using various key words including: "Bone to implant contact"; "implant"; "vitamin D"; and "osseointegration." Letters to the editor, case reports/case series, reviews, and articles published in languages other than English were excluded. The pattern of the present systematic review was customized to primarily summarize the pertinent data. RESULTS: Six experimental studies (4 in rodents and 2 in rabbits) were included. Number of titanium implants placed ranged between 28 and 100 implants. Results from 5 studies showed that VD3 supplementation enhanced new bone formation and/or bone to implant contact (BIC) around implants. One study showed no significant difference in BIC and new bone formation around VD3 coated and noncoated implants. One study reported that insulin therapy with adjunct VD3 supplementation enhances new bone formation around implants in diabetic rats than when insulin replacement therapy is used alone. CONCLUSION: Efficacy of VD3 supplementation on osseointegration of implants remains controversial and requires further investigations.

Primary stability of implants placed at different angulations in artificial bone.

INTRODUCTION: The aim of this study was to evaluate the primary stability (PS) of titanium implants with a progressive thread design and more thread stability in the apical threads placed in artificial bone materials. MATERIALS AND METHODS: A total of 120 implants were placed in commercially available polyurethane composite bone blocks. The angulations that were chosen to place the implants in bone types II and IV were 0, 10, and 20 degrees, respectively. The implant dimensions were 11 mm in length and 3.5 mm in diameter. Two clinicians placed all implants, and an independent examiner evaluated the PS using the Osstell (ISQ) and Periotest devices. The χ test was used to evaluate the statistical differences between the PS at different angulations. RESULTS: This study showed that there was a statistically significant difference (P = 0.02) of the PS values, when measured using the Periotest values, among all 3 angulations in both bone qualities. Tilted implants with 10 degrees, angulation had a better stability than conventionally placed implants. CONCLUSIONS: The PS of dental implants is higher for implants placed in type II when compared with type IV artificial bone. A higher stability was found for implants placed with 10-degree angulations.

Ridge Preservation Techniques in the Anterior Esthetic Zone.

PURPOSE: Various techniques have been developed to limit resorption of the alveolar ridge after tooth extraction, and results from using them have been promising. The aim of this study was to evaluate the role and reliability of ridge preservation (RP) in the anterior esthetic zone, in anticipation of later implant placement. MATERIALS AND METHODS: Using the MEDLINE and PubMed databases, searches were performed using combinations of different terms. RESULTS: A total of 223 studies were identified, from which 55 articles were further examined. Of these, 11 studies were randomized clinical trials, controlled clinical trials, or prospective/retrospective studies with a minimum of 5 subjects and at least 3 months of follow-up. Only human studies of RP for single-rooted tooth or bicuspid sites were included. Selection criteria also excluded studies in which primary closure was obtained. CONCLUSION: Although a direct comparison of the 11 articles was difficult because of the different techniques, materials, and healing time, no single graft material seemed to be superior. However, all studies found less ridge contraction at grafted than nongrafted sites. Long-term data about the outcomes for implants placed in sites where RP was attempted are still needed.

Porous collagen-hydroxyapatite scaffolds with mesenchymal stem cells for bone regeneration.

Current bone grafting materials have significant limitations for repairing maxillofacial and dentoalveolar bone deficiencies. An ideal bone tissue-engineering construct is still lacking. The purpose of the present study was first to synthesize and develop a collagen-hydroxyapatite (Col-HA) composite through controlled in situ mineralization on type I collagen fibrils with nanometer-sized apatite crystals, and then evaluate their biologic properties by culturing with mouse and human mesenchymal stem cells (MSCs). We synthesized Col-HA scaffolds with different Col:HA ratios. Mouse C3H10T1/2 MSCs and human periodontal ligament stem cells (hPDSCs) were cultured with scaffolds for cell proliferation and biocompatibility assays. We found that the porous Col-HA composites have good biocompatibility and biomimetic properties. The Col-HA composites with ratios 80:20 and 50:50 composites supported the attachments and proliferations of mouse MSCs and hPDSCs. These findings indicate that Col-HA composite complexes have strong potentials for bone tissue regeneration.

Marginal bone loss in ball versus locator attachments in implant-retained overdentures: systematic review and meta-analysis.

OBJECTIVES: This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients. METHOD AND MATERIALS: Following PRISMA guidelines, health science librarians completed literature searches from inception to 17 March 2023 in seven databases. There were 15,686 items exported to EndNote from Embase.com, CINAHL (EBSCO), Cochrane Library, Ovid MEDLINE-ALL, PubMed, Scopus, and Web of Science. Hand-searching added four more articles. After deduplication, 6,756 items were screened for eligibility. Twenty-nine studies were assessed by full text, of which ten studies, involving 424 subjects, were included in the review. Risk of bias assessment was conducted using the Cochrane risk-of-bias tool and the Newcastle-Ottawa scale. A meta-analysis was performed to synthesize and analyze the collective data from the selected studies. RESULTS: The included studies used diverse methodologies, implant systems, and loading protocols. Most studies reported no significant difference in marginal bone loss between ball and locator attachments. The meta-analysis revealed high heterogeneity. CONCLUSION: The results of this systematic review suggest that ball and locator attachments exhibit similar performance in terms of marginal bone loss in implant-retained overdentures. However, the limited number, risk of bias, and heterogeneity of studies highlight the need for standardized research designs and larger sample sizes in future investigations to draw more definitive conclusions.

Lasers use in dental implantology.

OBJECTIVE: The purpose of this literature review was to evaluate the present use of different laser systems in implant dentistry. MATERIALS AND METHODS: A literature search of MEDLINE-PubMed for articles published, describing the use of lasers in implant dentistry, was performed and articles were critically reviewed by the investigators to determine the strength of evidence. RESULTS: The literature review reveals a limited number of randomized clinical trials with regard to laser use in dentistry. Although many case studies indicate extensive use of lasers and promising results in dental implantology, lasers may be used for uncovering submerged implants atraumatically to prevent crestal bone loss, recontouring periimplant soft tissues and sculpting emergence profile for prosthetic components, raising surgical flaps, osseous recontouring, and creating parabolic tissue architecture. Additionally, bone harvesting of block grafts, window preparation in sinus lift procedures, ridge splitting, and debridement of extraction sockets for immediate implant placement were described. CONCLUSIONS: Aside from the many benefits associated with the use of lasers in implant-related procedures, there are also risks to consider from the laser irradiation on the implant surface and the periimplant tissues. Therefore, an appropriate training on laser use is mandatory to increase the clinical outcome and to control the potential of complications.