The Surface Roughness of Contemporary Indirect CAD/CAM Restorative Materials That Are Glazed and Chair-Side-Finished/Polished.

The surface roughness (Ra) of indirect computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated dental restorations is crucial for their long-term durability. This study intended to evaluate the Ra of five different types of contemporary indirect CAD/CAM restorative materials with varying compositions that were glazed and finished/polished. A total of 75 specimens, disc-shaped (10 mm × 2 mm), were obtained from five materials (n = 15) (Tetric CAD, IPS e.max CAD, IPS e.max ZirCAD, CELTRA Duo, and Vita Enamic) and fabricated by CAD/CAM. One of the two surfaces for each specimen was subjected to glazing, while the other surface was subjected to finishing/polishing. The Ra of the two surfaces in micrometers (µm) was evaluated using a Profilometer, while the surface topography was examined using a scanning electron microscope. Using SPSS, the Kruskal-Wallis, post hoc Conover, and Mann-Whitney tests were used to statistically evaluate the data. A comparison of the Ra for the finished/polished surfaces of the five test materials showed significant differences (p < 0.0001). Among the finished/polished surfaces, the mean rank values of Vita Enamic were significantly higher than the other four test materials (p < 0.0001). A comparison of the Ra of glazed surfaces among the five study materials revealed significant differences (p < 0.0001). The Ra for the IPS e.max ZirCAD material was significantly higher than the rest of the four materials (p < 0.001). A comparison of the Ra for two types of surface conditioning within each of the five test materials showed a significant difference (p < 0.05). Only for IPS e.max ZirCAD was the Ra of the glazed surface significantly higher than the finished/polished surface (p < 0.0001). Significant variations in the surface roughness (Ra) were exhibited between the finished/polished and glazed surfaces of the five test materials. Hybrid ceramics showed the highest Ra values for the finished/polished surfaces, and zirconia exhibited the highest Ra values among the glazed surfaces among the tested materials. The Ra values of either finished/polished or glazed surfaces of the test materials were within the clinically acceptable range (0.2-0.5 µm), except for the glazed surface of the zirconia ceramics (0.84 µm).

Rosai-Dorfman Disease: Case Series and Literature Review.

Rosai-Dorfman Disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is an uncommon histiocytic condition characterized by massive histopathological aggregation of CD1-a negative, CD68-positive, and S100-positive histiocytes. It was initially described by Destombes in 1965 under the term "adenitis with lipid excess." However, it is named after Rosai and Dorfman who reported further histopathological features of the disease in 1969. The diagnosis of this non-Langerhans cell histiocytosis can be challenging and requires high clinical suspicion. The diagnostic process usually involves imaging, tissue biopsies, and genetic testing as needed. In this case series, we are presenting three cases of rare disease. Case 2 had both nodal and extranodal forms, which makes this case rarer than cases 1 and 3, which present with extranodal lesions.

Marginal Misfit of 3D-Printed (Selective Laser Sintered), CAD-CAM and Lost Wax Technique Cobalt Chromium Copings with Shoulder and Chamfer Finish Lines: An In-Vitro Study.

Background and Objectives: The aim was to compare the Misfit of 3D-Printed, Selective laser melting (SLM), milled (Computer aided design-Computer aided manufacture CAD-CAM) and Lost wax technique (LWT) fabricated Cobalt chromium (CoCr) alloy copings on shoulder (SH), radial shoulder (R-SH) and chamfer (CH) finish line configuration. Materials and Methods: Ninety resin, second maxillary premolar teeth were prepared for metal-ceramic crowns, equally divided into (n = 30) SH, R-SH and CH margin preparations. For each preparation design (SH, R-SH and CH), CoCr copings were prepared using SLM, CAD-CAM and LWT. This resulted in nine study groups with 10 CoCr copings each. The marginal misfit of specimens was assessed with a high-resolution digital microscope. Misfit was evaluated in vertical and horizontal dimensions in µm. Data were analyzed using ANOVA and a post hoc multiple comparisons test. Results: For vertical misfit, the highest was observed in SLM samples with chamfer margin (167.96 ± 24.1), and the least was shown by CAD-CAM samples with radial shoulder (58.8 ± 12.53). CAD-CAM and shoulder margins showed the least vertical misfit. For horizontal misfit, the maximum was observed in SLM samples with shoulder margin (137.94 ± 37.85) and the least by LWT samples with chamfer (89.38 ± 14.81). Chamfer margins and LWT samples showed the least horizontal misfit among the group samples. Fabrication technique and finish line design play a critical role in reducing the marginal misfit of CoCr copings. Conclusions: For vertical misfit, SLM copings showed poor outcomes compared to CAD-CAM specimens, however comparable outcomes to Cast specimens. SLM copings showed comparable horizontal misfit outcomes to CAD-CAM specimens and low misfit compared to Cast copings, respectively. Vertical misfit was low with shoulder margins, and horizontal misfit was better with chamfer marginal configuration.

Fracture strength of Er,Yag laser treated PMMA denture-based polymer (DBP) colonized with C. albicans, S. aureus, S.mutans, and E.coli.

AIM: To assess and equate the efficacy of different disinfection protocols autoclave, chlorhexidine (CHX), PDT utilizing Rose Bengal (RB), chitosan, and Er, Yag laser and their effect on fracture strength of PMMA denture-based polymer (DBP) colonized with C. Albicans, S. aureus, S.mutans, and E.coli. MATERIAL AND METHODS: A total of 50 (n = 10) PMMA DBP were manufactured and adulterated with the American Type Culture Collection (ATCC) of diverse microbial colonies inhabited by C. Albicans, S. aureus, S.mutans, and E.coli. The specimens were subjected to different denture disinfection approaches by randomly distributing in into five groups i.e., Er, Yag laser, RB, autoclave, CHX, and Chitosan, respectively for appraising antimicrobial effectiveness. PMMA fracture load was also assessed and statistical analysis was performed for CFU/mL (log10) of exposed C. Albicans, S. aureus, S.mutans, and E.coli by one-way ANOVA and Tukey's multiple comparison test at a significance level of p < 0.05. RESULTS: Intergroup comparison disclosed that denture disinfection with Er, Yag laser, autoclave, Chitosan, and CHX (control) validated comparable antimicrobial efficacy to denture against all inspected CFU/mL (log10) (p>0.05). The intragroup comparison revealed that DBP sanitization with Er, Yag laser, autoclave, Chitosan, RB, and CHX substantiated equivalent effective antimicrobial efficacy in plummeting CFU/mL (log10) of S. mutans and E. coli (p>0.05) but in consideration to S.aureus and C.albicans, all groups resulted in declining their count except 5µm RB activated by PDT(p < 0.05). No significant difference was perceived in fracture load of PMMA denture base among Er, Yag laser, RB, chitosan, and CHX (control) (p > 0.05) except autoclave decontamination procedure that indicated the least fracture strength of DBP when disinfected (p < 0.05). CONCLUSION: Er, Yag laser, and Chitosan activated by PDT have the potential to be used as an alternative to chlorhexidine for disinfecting Polymethyl methacrylate denture base as they demonstrated the highest antimicrobial efficacy against E. coli, C. Albicans, S aureus, and S. mutans with optimal fracture load.

Clinical, radiographic and restorative parameters for short tuberosity implants placed in smokers: a retrospective study with 5 year follow-up.

This study aimed to estimate and compare the clinical, radiographic, and restorative parameters around short tuberosity implants (STIs) placed in cigarette smokers (CS) and never smokers (NS). In this 60-month follow-up retrospective study, a total of 50 (37 males + 13 females) individuals who had received 82 dental implants were included. These participants were categorized into two groups as follows: (i) Group-1: 25 self-reported systemically healthy CS with 43 STIs; and (ii) Group-2: 25 self-reported systemically healthy NS with 39 STIs. In both groups, peri-implant plaque index (PI), probing depth (PD), bleeding on probing (BOP), and crestal bone loss (CBL) and restorative parameters were measured at 12 and 60 months of follow-up. Group comparisons were performed utilizing the Kruskal-Wallis test. The significance level was set at p < 0.05. In CS and NS, the mean age of participants was 58.5 and 60.7 years, respectively. No statistically significant differences were observed in the overall mean levels of PD and CBL around STIs among CS and NS. However, a statistically significant increase was observed in the mean scores of BOP and PI around STIs in the NS and CS at 12 and 60 months follow-up, respectively. In both groups, the loosening of the implant was the most frequently encountered type of STI failure. The outcomes of the present study suggest that STIs placed in maxillary tuberosity can show reliable clinical, radiographic, and restorative stability among cigarettes smokers and non-smokers. However, the role of smoking status and oral hygiene cannot be disregarded in this scenario.

Efficacy of Rose Bengal and Curcumin mediated photodynamic therapy for the treatment of denture stomatitis in patients with habitual cigarette smoking: A randomized controlled clinical trial.

BACKGROUND: Cigarette smoking in conjugation with bad oral hygiene is considered a typical predisposing factor for many oral diseases including denture stomatitis. This study investigated the effect of Rose Bengal (RB)-and Curcumin (CUR)-mediated photodynamic therapy (PDT) in comparison with nystatin therapy in the intervention of denture stomatitis in cigarette smokers. METHODS: Overall, 45 habitual cigarette smokers aged ~58 years having denture stomatitis were categorized into three groups: Group-I - RB-mediated PDT, Group-II - CUR-mediated PDT, and Group-III - Nystatin therapy. The primary outcome of the interest was: counts of Candida colony from denture surface and palatal mucosa, calculated as CFU/mL, whereas the prevalence of Candida species determined in 3 research groups comprised the secondary outcome. Oral swab specimens were gathered from the denture surfaces and palatal mucosa. All clinical assessments were performed at baseline, 6 weeks, and 12 weeks. RESULTS: C. albicans was the most prevalent yeast identified on both denture surfaces and palatal mucosa, followed by C. tropicalis and C. glabrata. A considerable decrease in the CFU/mL scores were observed in Group-I and Group-II at the end of the interventions and on the 12-week follow-up (p<0.05). Group-I, II, and III demonstrated clinical efficacy rates of 53%, 51%, and 49%, respectively. CONCLUSION: CUR-and RB-mediated PDT was found to be as effective as topical Nystatin therapy for the intervention of denture stomatitis among cigarette smokers.

Role of antimicrobial photodynamic therapy in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with and without dental implants.

OBJECTIVE: The aim was to assess the impact of antimicrobial photodynamic therapy (aPDT) in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with dental implants. METHODS: Type-2 diabetic and self-reported non-diabetic patients were included. Participants were divided into the following groups: Group-1: Type-2 diabetic patients with dental implants; Group-2: Non-diabetic patients with dental implants; Group-3: Type-2 diabetic patients without dental prostheses; Group-4: Non-diabetic patients without dental prostheses. In each group, participants were subdivided into 2-sub-groups. In the test-subgroup, participants received routine oral hygiene maintenance instructions (OHMI) and underwent full mouth disinfection using aPDT; and in the control-group, participants received OHMI alone. Unstimulated whole saliva samples were collected, hemoglobin A1c levels were measured and yeast colonization was assessed at baseline and at 3-months' follow-up in all groups. Sample-size estimation was done and group-comparisons were done. P-values <0.01 were considered statistically significant. RESULTS: At baseline, the mean oral yeasts colonization was significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). At baseline and at 3-months of follow-up, the mean HbA1c levels and oral yeasts colonization were significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). CONCLUSION: In the short-term, routine OHMI with adjunct aPDT is more effective in reducing whole salivary oral yeasts counts than OHMI alone in patients with and without dental implants.

Effect of scaling and root planing on the expression of anti-inflammatory cytokines (IL-4, IL-9, IL-10, and IL-13) in the gingival crevicular fluid of electronic cigarette users and non-smokers with moderate chronic periodontitis.

PURPOSE: The aim of this cross-sectional study was to investigate the effect of scaling and root planing (SRP) on the expression of anti-inflammatory cytokines (interleukin [IL]-4, IL-9, IL-10, and IL-13) in the gingival crevicular fluid (GCF) of electronic cigarette users and non-smokers with moderate chronic periodontitis (CP). METHODS: Electronic cigarette users and non-smokers with CP were included in the study. Full-mouth plaque and gingival indices, probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL) were assessed. The GCF was collected, and its volume and levels of IL-4, IL-9, IL-10, and IL-13 were assessed. These parameters were evaluated at baseline and 3 months after SRP. The sample size was estimated, and comparisons between groups were performed. P<0.05 was considered to indicate statistical significance. RESULTS: Thirty-six electronic cigarette users (47.7±5.8 years old) and 35 non-smokers (46.5±3.4 years old) with CP were included. At baseline, there were no differences in plaque index (PI), PD, CAL, MBL, and GCF IL-4, IL-9, IL-10, and IL-13 between electronic cigarette users and non-smokers. At the 3-month follow-up, there were no significant differences in PI, gingival index (GI), PD, CAL, and MBL in electronic cigarette users compared to baseline, while there were significant reductions in PI, GI, and PD among non-smokers. At the 3-month follow-up, GCF IL-4, IL-9, IL-10, and IL-13 levels were significantly elevated in both groups (P<0.05) compared to baseline. The increases in GCF IL-4, IL-9, IL-10, and IL-13 levels were significantly higher in non-smokers (P<0.05) than in electronic cigarette users at the 3-month follow-up. CONCLUSIONS: Levels of GCF IL-4, IL-9, IL-10, and IL-13 increased after SRP in electronic cigarette users and non-smokers with CP; however, the anti-inflammatory effect of SRP was more profound in non-smokers than in electronic cigarette users.

Clinical and radiographic assessment of narrow-diameter and regular-diameter implants in the anterior and posterior jaw: 2 to 6 years of follow-up.

PURPOSE: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. METHODS: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. RESULTS: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. CONCLUSIONS: NDIs in the anterior and posterior jaws functioned equally well in terms of peri-implant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

Influence of Bioactive, Resin and Glass Ionomer luting cements on the fracture loads of dentin bonded ceramic crowns.

OBJECTIVE: To investigate the failure loads of dentin bonded all-ceramic crowns when luted with Bioactive, resin and glass ionomer cements (GIC) in an in-vitro setting. METHODS: This study was conducted at King Saud University, Saudi Arabia, from Nov.2018 to March 2019. In this study, 60 premolar teeth were prepared for dentin-bonded ceramic crowns. Lithium disilicate ceramic crowns fabricated using CAD-CAM technique were cemented to teeth using Bioactive (ACITVA), Resin (Nexus 3 Gen) and GIC (Ketac Cem- Maxicap). Half of the bonded specimens in each group were thermocycled (50000 cycles), however the remaining half were not aged (n=10). Fracture loads of bonded crowns were assessed by exposing them to static axial occlusal loads (1mm/min) using a round ended metal probe in a Universal testing machine. Means and standard deviations among the study groups were compared with ANOVA and Tukey-Kramer multiple comparisons test. RESULTS: Highest failure loads were observed in resin group without ageing (thermocycling) (689.13±89.41 N), however, the lowest loads were observed in GIC specimens with ageing (243.16±49.03 N). Among non-aged samples, failure loads for Bioactive (480.30±47.26 N) group were less than Resin (689.13±89.41 N) samples but higher than GIC (307.51±45.29 N) specimens respectively. Among the aged specimens, Bioactive (404.42±60.43 N) showed significantly higher failure loads than GIC (243.16±49.03 N), however lower failure loads than Resin (582.33±95.95 N) samples. CONCLUSIONS: Dentin boned crowns with resin cementation showed higher failure loads than Bioactive and GIC luted crowns. Crowns luted with Bioactive cement showed acceptable failure loads for use as restoration on anterior teeth.

Bond integrity and microleakage of dentin-bonded crowns cemented with bioactive cement in comparison to resin cements: in vitro study.

OBJECTIVE: The aim was to compare restorative marginal integrity of ceramic crowns luted with bioactive and resin cements using micro-computed tomography (micro-CT) microleakage evaluations and bond strength assessment. METHODS: Thirty molar teeth were prepared by sectioning and polishing for dentin exposure for resin cement build-ups. Teeth were randomly divided among three groups of cements: (1) bioactive (ACTIVA); (2) glass ionomer cement (GIC; Ketac Cem); and (3) resin luting agent (Nexus 3). Bonding regime and build-ups (4 mm × 2 mm) were performed using the recommended protocol. For microleakage assessment, 30 premolar teeth were prepared for dentin-bonded crowns using lithium disilicate ceramic and the computer-aided design and computer-aided manufacturing technique. Crowns were cemented with standard load, cement amount, and duration using three cements (Group A: bioactive; Group B: GIC; Group C: resin) and photopolymerized. Cemented crowns were evaluated for volumetric infiltration using micro-CT (Skyscan, Bruker 1173- at 86 kV, 93 µA, 620 ms) after immersion in 50% solution of silver nitrate (AgNO3) (24 hours). Shear bond strength (SBS) was assessed by fracture of cement build-ups at a cross-head speed of 0.5 mm/min in a universal testing machine. RESULTS: Mean SBS among bioactive (21.54 ± 3.834 MPa) specimens was significantly higher than that for GIC (14.08 ± 3.25 MPa) specimens (p < 0.01), but they were comparable to resin samples (p > 0.05) (24.73 ± 4.32 MPa). Microleakage was significantly lower in crowns luted with bioactive (0.381 ± 0.134) cement compared to GIC (1.057 ± 0.399 mm3) (p < 0.01) and resin (0.734 ± 0.166 mm3) (p = 0.014) cemented crowns. The type of luting agent had a significant influence on the microleakage of crowns and bond strength to dentin (p < 0.05). CONCLUSION: Bioactive cement exhibited less microleakage and comparable SBS to resin luting agents in in vitro conditions.

Peri-implant soft tissue status and crestal bone loss around immediately-loaded narrow-diameter implants placed in cigarette-smokers: 6-year follow-up results.

BACKGROUND: It is hypothesized that in the long-term, soft tissue inflammation (reflected by increased scores of peri-implant probing-depth [PD]) and crestal bone loss (CBL) is higher in cigarette-smoker than nonsmokers with narrow diameter implants (NDIs). PURPOSE: The aim of the present 6-years' follow-up clinical observational study was to compare the peri-implant soft tissue inflammatory parameters (plaque index [PI], gingival index [GI], and PD) and CBL around immediately-loaded NDIs placed in cigarette-smokers and nonsmokers. MATERIALS AND METHODS: In all groups, peri-implant GI, PI and PD were measured on six sites (distolingual/palatal, mesiolingual/palatal mesiobuccal, distobuccal, midlingual/palatal, and midbuccal) per implant. The CBL was gauged on digital bitewing x-rays, which were standardized using the long cone paralleling technique. CBL was demarcated as the vertical distance from 2 mm below the implant-abutment connection to the most crestally-positioned alveolar bone. RESULTS: All study-participants were male. Twenty-six cigarette smokers and twenty-five nonsmokers were included. The mean age of cigarette-smokers and nonsmokers was 45.5 ± 10.3 and 47.4 ± 9.4 years, respectively. Cigarette-smokers had a smoking history of 10.6 ± 0.4 pack years. Family history of tobacco usage was more often reported by cigarette-smokers (57.7%) than nonsmokers (20%). All cigarette-smokers and nonsmokers were aware that smoking is a risk-factor of loss of implant. Three (11.5%) of cigarette-smokers reported that they have attempted to quit smoking and 76.9% of cigarette-smokers (n = 20) reported that they had no intention to quit smoking in the future. The peri-implant P-I (P < .01), PD (P < .01) and mesial (P < .01), and distal (P < .01) CBL were significantly high in cigarette-smokers compared with nonsmokers. There was no statistically significant difference in GI among the groups. CONCLUSION: Cigarette-smoking enhances peri-implant soft tissue inflammation and increases CBL around immediately-loaded NDIs.

Efficacy of photodynamic therapy versus local nystatin in the treatment of denture stomatitis: A randomized clinical study.

AIM: The aim of the present randomized clinical study was to compare the efficacies of photodynamic inactivation (PDI) to nystatin (NST) in terms of prevalence of Candida species in cases with denture stomatitis (DS). METHODS: Thirty-six patients were randomly divided into two groups; 18 in PDI and 18 in NST. Irradiation was carried out by using the GaA1As diode laser with wavelength, mode of transmission, laser output and energy density were standardized at 660 nm, continuous mode, 100 mW power and 28 J/cm2 respectively. The PDI was applied twice a week, with an interval of at least 48 h among the sessions during four weeks. Topical nystatin oral suspension 100,000 IU was used four times daily for 15 days. The existence of Candida spp. was confirmed by employing the microbiological culture technique. Candida colony counts from the palates and dentures surfaces, quantified as colony forming unit (CFU)/mL, measured at baseline, at the end of treatments (day 15), and at follow-up (days 30 and 60) and the prevalence of Candida spp. were identified in the two groups of treatments. RESULTS: The overall CFU/mL values were higher in the dentures of the patients of both the groups than those from the palates. During all time periods of the study, the CFU/mL values obtained from both NST and PDI groups showed no significant differences. For dentures and palates, a significant reduction in mean CFU/mL values was observed on day 15 compared with baseline (day 0) in both NST and PDI groups. It can be seen that the effect size of treatments was large for the palates of patients in the NST group (1.79) and moderate for the palates of patients in the PDI group (0.63). On the other hand, the effect size was very large for the dentures for both groups (NST group = 3.01; PDI group = 1.58). C. albicans was the most common species on both dentures and palates of patients throughout the study period followed by C. tropicalis and C. glabrata. CONCLUSION: Out of all the Candida spp., C. albicans showed the highest prevalence among all species. In addition, PDI was equally effective as nystatin for the treatment of DS.

Presence of Candida species in the subgingival oral biofilm of patients with peri-implantitis.

BACKGROUND: There are no studies that have investigated the presence of Candida species in the subgingival oral biofilm (OB) of patients with peri-implantitis. PURPOSE: The aim was to assess the presence of Candida species in the subgingival OB of patients with peri-implantitis. MATERIALS AND METHODS: Individuals with (group A) and without (group B) peri-implantitis were included. Life style related and demographic data were collected using a questionnaire. In both groups, peri-implant plaque-index (PI), bleeding-on-probing (BOP), and probing-depth (PD) were evaluated and crestal bone loss (CBL) were measured on digital bitewing radiographs. In both groups, subgingival OB samples were collected using sterile paper points. Identification of Candida species was performed using ChromAgar medium and colony forming units per milliliter (CFU/mL) were determined. Statistical analysis was performed, and level of significance was set at P < 0.05. RESULTS: The mean age of individuals in groups A (n = 43) and B (n = 41) were 52.2 ± 4.4 and 55.1 ± 2.3 years, respectively. All participants were male. In groups A and B, implants were in function for 7.4 ± 1.3 and 6.8 ± 0.6 years, respectively. Scores of peri-implant PI (P < 0.001), BOP (P < 0.001), PD (P < 0.001), and CBL (P < 0.001) were significantly higher in group A than group B. Subgingival Candida was isolated from the OB of 33 (76.7%) patients in group A and 5 (12.2%) individuals in group B. The most common yeast species was Candida albicans, which was isolated from 67.4% to 60% individuals in groups A and B, respectively. The number of subgingival oral yeasts CFU/mL were significantly higher in group A (3147.54 ± 1052.6 CFU/mL) compared with group B (496.68 ± 100.2 CFU/mL; P < 0.01). CONCLUSION: Candida species (predominantly C. albicans) are present in the subgingival OB of patients with peri-implantitis. Community-based efforts toward routine oral hygiene maintenance are needed to improve oral health and minimize the risks of peri-implant diseases in populations.

Current weight of evidence of viruses associated with peri-implantitis and peri-implant health: A systematic review and meta-analysis.

The pathological role of human herpesviruses (HHVs) (Epstein-Barr virus [EBV], Human cytomegalovirus [CMV], and Herpes simplex virus [HSV]) in peri-implant health needs clarification quantitatively. To determine the weight of evidence for HHVs in patients with peri-implantitis (PI) and substantiate the significance of HHVs in peri-implant inflammation, electronic databases including EMBASE, MEDLINE, Cochrane Oral Health Group Trials Register, and Cochrane Central Register of Controlled Trials were searched from 1964 up to and including November 2018. Meta-analyses were conducted for prevalence of HHVs in PI and healthy controls. Forest plots were generated that recorded risk difference (RD) of outcomes and 95% confidence intervals (CI). Five clinical studies were considered and included. Four clinical studies reported data on EBV while three clinical studies reported data on CMV. Considering the risk of these viruses in PI, significant heterogeneity for CMV (χ2  = 53.37, p < 0.0001, I2  = 96.25%) and EBV (χ2  = 14.14, p = 0.002, I2  = 78.79%) prevalence was noticed between PI and healthy control sites. The overall RD for only EBV (RD = 0.20, 95% CI, 0.01-0.40, p = 0.03) was statistically significant between both groups. Frequencies of the viruses were increased in patients with PI compared with healthy nondiseased sites. However, the findings of the present study should be interpreted with caution because of significant heterogeneity and small number of included studies.

Survival of adjacent-dental-implants in prediabetic and systemically healthy subjects at 5-years follow-up.

BACKGROUND: Long-term survival of adjacent dental implants (ADI) in prediabetic patients remained uninvestigated. PURPOSE: This 5 years' follow-up clinical study compared the survival of adjacent implants in prediabetic and nondiabetic subjects. MATERIALS AND METHODS: Prediabetic (group-A) and nondiabetic (group-B) subjects having undergone dental rehabilitation using ADI were assessed. Data about sex, age treatment and period (in years) since diagnosis of prediabetes, and family history of diabetes was gathered and haemoglobin A1c (HbA1c) levels were recorded. Dental implant related data (dimensions, loading protocol, surface characteristics, restoration type, and duration in function) was recorded. Depth of probing (PD), bleeding-on-probing (BOP), and plaque index (PI) were measured and mesial and distal crestal bone loss (CBL) were recorded. P values less than .05 were contemplated as statistically-significant. RESULTS: Seventy-nine male individuals (39 in group-A and 40 in group-B) were included. Subjects in groups -A and -B were 54.3 ± 3.6 and 51.2 ± 2.4 years old, respectively. In group-A, subjects were diagnosed with prediabetes 5.4 ± 0.2 years ago. Patients in group-A more often had a family history of diabetes than group-B. Thirty-nine and 40 ADI were placed in patients in groups -A and -B, respectively. Tooth-brushing once daily was reported by 79.5% and 82.5% individuals in groups -A and -B, respectively. Peri-implant PI (P<.001), BOP (P<.001), PD (P<.001), mesial (P<.001), and distal (P<.001) CBL and HbA1c levels (P<.001) were higher in group-A than group-B. The implant survival rate in group-A and group-B was 100% and 100%, respectively. CONCLUSION: Although ADI can survive in prediabetic patients in the long-term; soft-tissue inflammation and CBL are worse around adjacent implants in these patients compared with nondiabetic controls.

Comparison of clinical peri-implant indices and crestal bone levels around narrow and regular diameter implants placed in diabetic and non-diabetic patients: A 3-year follow-up study.

BACKGROUND: Studies evaluating and comparing clinical and radiographic peri-implant indices around narrow diameter implants (NDIs; <3.3 mm) and regular diameter implants (RDIs) in type-2 diabetes mellitus (T2DM) and non-diabetic individuals are deficient. OBJECTIVE: To estimate and compare the clinical and radiographic indices around NDIs and RDIs placed in T2DM and non-diabetic patients. MATERIALS AND METHODS: Eighty-six patients requiring implant surgery in the posterior mandible were divided into two groups (42 T2DM and 44 non-diabetic individuals). Patients were further categorized into two subgroups on the basis of diameter of implants: (1) patients with NDIs (3.3 mm ø) and (2) patients with RDIs (4.1 mm ø). Clinical indices evaluating plaque index (PI), bleeding on probing (BOP), probing depth (PD), and crestal bone levels (CBL) were recorded around all dental implants at 18 and 36 months follow up. Serum hemoglobin A1c (HbA1c) test was carried out for both groups to assess the profile of glycosylated hemoglobin at baseline, 18 and 36 months of follow up. RESULTS: The mean age of patients in T2DM group and non-diabetic group was 45.2 and 41.6 years, respectively. At 18 and 36 months follow up, mean HbA1c levels were 6.5% and 4.5% and 6.7% and 4.5% in T2DM and non-diabetic individuals, respectively. A statistically significant reduction in mean HbA1c levels from the baseline to respective follow-up periods were seen in T2DM patients. There was no statistically significant difference in the overall mean scores of PI, BOP, PD, and CBL around NDIs and RDIs among T2DM and non-diabetic patients at 18 and 36 months of follow up. CONCLUSION: NDIs show reliable clinical stability and radiographic bone levels as RDIs placed in T2DM and non-diabetic individuals, provided oral hygiene and glycemic status are strictly maintained.

Peri-implant soft tissue status and crestal bone levels around adjacent implants placed in cigarette smokers and never smokers: Five-year follow-up results.

BACKGROUND: It is hypothesized that peri-implant soft tissue inflammation and crestal bone loss (CBL) are higher around adjacent implants placed in cigarette smokers compared with never smokers. The aim of the present 5-years follow-up retrospective clinical study was to compare the peri-implant soft tissue status and CBL around adjacent implants placed in cigarette smokers and never smokers. METHODS: Cigarette smokers (group 1) and never smokers (group 2) with adjacent dental implants were included. Demographic information regarding age, sex, duration of smoking (pack-years), daily frequency of toothbrushing and most recent visit to a dentist or dental hygienist were recorded using a questionnaire. Information regarding implant dimensions (length × diameter), duration of implants in function, loading protocol (and type of restoration was recorded. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD), and mesial and distal CBL were measured. P <0.05 were considered statistically significant. RESULTS: Seventy-two male participants (37 in group 1 and 35 in group 2) were included. The mean age of individuals in groups 1 and 2 were 50.3 ± 5.4 and 48.5 ± 3.8 years, respectively. In group 1, the mean duration of cigarette smoking was 22.3 ± 1.6 pack years. A family history of smoking was more often reported by individuals in group 1 compared with group 2. In groups 1 and 2, 54 and 70 adjacent implants, respectively were placed in the regions of missing premolars and molars. All implants were delayed loaded and were fixed with non-splinted screw-retained restorations. In groups 1 and 2, toothbrushing twice daily was reported by 78.3% and 74.2% individuals, respectively. There was no statistically significant difference in peri-implant PI, BOP, PD, and mesial and distal CBL among individuals in groups 1 and 2. CONCLUSION: Peri-implant soft tissue status and crestal bone levels were comparable around adjacent dental implants placed in cigarette smokers and never smokers.

Proinflammatory cytokine levels and peri-implant parameters among cigarette smokers, individuals vaping electronic cigarettes, and non-smokers.

BACKGROUND: Tobacco smoking compromises the prognosis of dental implant treatment and is associated with increased risk of peri-implant bone loss and increased implant failure rate. There is a dearth of studies that have compared clinical, radiographic, and immunological peri-implant parameters among cigarette smokers (CS), individuals vaping e-cigarettes (e-cigs), and non-smokers (NS). This study aimed to compare clinical and radiographic peri-implant parameters and levels of matrix metalloproteinase (MMP)-9 and interleukin (IL)-1ß levels among CS, individuals' vaping e-cigs, and NS. METHODS: Thirty-two CS (group 1), 31 individuals vaping e-cigs (group 2), and 32 NS (group 3) were included. Demographic- and implant-related data were collected using a structured baseline questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded and marginal bone loss (MBL) were assessed using standardized digital radiographs. Enzyme-linked immunosorbent assay was used to assess levels of MMP-9 and IL-1ß in peri-implant sulcular fluid. Pearson correlation coefficient was used to analyze for correlations of MMP-9 and IL-1ß levels with peri-implant parameters. RESULTS: BOP showed significantly higher values in group 3 as compared with groups 1 and 2 (P < 0.01). PI (P < 0.01), PD ≥ 4 mm (P < 0.01), and mean concentrations of MMP-9 (P < 0.001) and IL-1ß (P < 0.01) were significantly higher in groups 1 and 2 than group 3. MBL was significantly higher in group 1 as compared with group 2 and group 3 (P < 0.01). Significant positive correlations were found between MMP-9 (P = 0.0198) and IL-1ß (P = 0.0047) levels and MBL in group 1; and a significant positive correlation between IL-1ß and MBL in group 2 (P = 0.0031). CONCLUSIONS: Peri-implant health was compromised among CS than vaping individuals and NS. Increased levels of proinflammatory cytokines in CS and vaping individuals may suggest greater peri-implant inflammatory response.

Clinical and radiographic peri-implant variables around short dental implants in type 2 diabetic, prediabetic, and non-diabetic patients.

BACKGROUND: Clinical and radiographic status around short dental implants in patients with different glycemic levels remains unexplored. PURPOSE: To determine the clinical and radiographic bone level (RBL) around short dental implants in type-2 diabetes mellitus (T2DM), prediabetic, and non-diabetic patients. MATERIALS AND METHODS: Participants were grouped into three groups based on HbA1c levels: T2DM (Group-1); prediabetic patients (Group-2); and non-diabetic subjects (Group-3). Clinical recordings included the assessment of peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD). Radiographic analysis included evaluation of standardized periapical digital radiographs using specialized software and image analyzer. RESULTS: Clinical peri-implant parameters including PI and BOP were statistically significantly higher in group-1 (P < .01) and group 2 (P < .05) as compared to group-3. Mean PD was statistically significantly higher in group-1 patients compared to group-3 (P < .01). Radiographic bone loss was significantly higher in both group-1 (P < .01) and group-2 (P < .05) patients as compared to patients in group 3. RBL showed statistically significant difference among T2DM patients even after adjusting for HbA1c, total cholesterol, and body mass index (P < .05) and statistically significant difference in prediabetic patients after adjusting for only HbA1c (P < .05). CONCLUSION: Clinical and radiographic peri-implant parameters are compromised around short dental implants in type-2 diabetes mellitus patients. Further longitudinal studies are needed to compare clinical performance of short dental implants with standard dental implants placed in patients with different glycemic level.