Clinical and Biochemical Evaluation of the Use of Alb-PRF versus L-PRF in Mandibular Third Molar Extractions: A Split-Mouth Randomized Clinical Trial.

Bone tissue engineering seeks biomaterials that enable cell migration, angiogenesis, matrix deposition, and tissue regeneration. Blood concentrates like platelet-rich fibrin (L-PRF) offer a cost-effective source of cells and growth factors to enhance healing. The present study aimed to evaluate heated serum albumin with liquid PRF (Alb-PRF) and L-PRF clinically and biochemically after placement in dental sockets following mandibular third molar extraction. In a controlled, split-mouth study involving 10 volunteers, 20 extracted molars were treated with either Alb-PRF or L-PRF. Post-extraction, pain, trismus, infection presence, and swelling were measured. The concentrations of different analytes in the surgical sites were also examined. The data were statistically analyzed, with significance defined at p < 0.05 (t-test). No significant difference was noted between the groups for pain and trismus, but Alb-PRF showed a significant reduction in swelling on day seven. The Alb-PRF group showed lower levels of pro-inflammatory cytokines (GM-CSF, IL-1b, IL-6, IFNy, IL-8, IL-15, RANTES, and MIP-1a) after seven days, with only higher expressions of MIP-1b, IL-1b, and MCP-1 found in the L-PRF group. Differences were observed in the release of analytes between L-PRF and Alb-PRF, with Alb-PRF significantly reducing edema after seven days. Alb-PRF reduced edema, while L-PRF increased inflammatory cytokines. When compared to L-PRF, Alb-PRF reduced edema and the release of inflammatory cytokines, suggesting promising effects in socket healing while underscoring the role of growth factors and cytokines in potential applications of blood concentrates.

Harnessing the Power of PAOO and Invisalign: An Interdisciplinary Approach to Orthodontic Care.

The present article explores the benefits of combining periodontally accelerated osteogenic orthodontics (PAOO) with Invisalign for optimal orthodontic treatment outcomes. PAOO is an interdisciplinary dental technique that minimizes complications and accelerates tooth movement while enhancing various orthodontic treatments. In conjunction with Invisalign, PAOO provides a discreet and comfortable solution for patients seeking to improve their smile. The study presents two challenging cases successfully treated using this combined approach, emphasizing the technique's potential to reduce treatment times and improve orthodontic outcomes. The interdisciplinary approach of PAOO ensures long-term success and stability by preserving periodontal structures and addressing potential bony defects. By incorporating bone grafting materials, PAOO helps prevent common concerns in traditional orthodontic treatments, such as bony defects and gingival recession. Furthermore, the combination with Invisalign offers a more aesthetically pleasing and comfortable treatment experience, allowing patients to maintain their self-esteem and confidence throughout the treatment. Despite the potential advantages, dental professionals must manage patient expectations and address potential complications to ensure the best possible results. Overall, the integration of PAOO and Invisalign demonstrates a viable alternative for patients who do not want to proceed with orthognathic surgery, enhancing patient satisfaction and overall treatment outcomes.

Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review.

Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more "simplified approach" based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.

Are the imaging-based techniques for early diagnosis of oral potentially malignant lesions effective?

Design The study was a systematic review and meta-analysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the guidelines from the Cochrane handbook for systematic reviews of interventions.Data sources Literature searches of free text and MeSH terms were performed using Medline (PubMed), Scopus, Google Scholar and the Cochrane Library (from 2000 to 30 June 2020). The search strategy was: ("oral screening devices" or "autofluorescence" or "chemiluminescence" or "optical imaging" or "imaging technique") and ("oral dysplasia" or "oral malignant lesions" or "oral precancerosis").Data analysis After identification of 1,282 potential articles, an analysis applying the eligibility criteria to the research identified 43 articles for qualitative evaluation and 34 for quantitative analysis.Results The results presented were inconsistent, both in the whole and in technique groups. There was evidence of high risk of bias in the evaluated studies. Moreover, the results were homogeneous across studies, which makes it challenging to carry out a reliable comparison of measures like specificity or positive/negative predictive values.Conclusions Imaging-based techniques for early diagnosis of potentially malignant oral lesions must improve technology and accuracy. In addition, none of the evaluated methods can substitute the oral biopsy.

Does obesity directly correlate to periodontal disease, or could it be only one of the risk factors?

Design The study was a cohort study that conformed with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting observational studies.Cohort election Obesity is identified as a risk factor for several non-communicable diseases (NCDs) and the study aimed to evaluate the risks for NCDs (for example, diabetes or high blood pressure). The study included participants from the Electric Generation Authority of Thailand. The workers were randomly selected from urban and rural areas. They were asked to answer a health survey every five years.Data analysis The authors evaluated 2,216 workers and the evaluation consisted of a sociodemographic, medical and oral health examination.Results The ten-year incidence of periodontal disease progression was 59.6 cases per 100 persons. In addition, the univariate analysis revealed that being obese was linked to a 15% higher risk of progression of periodontal disease than in non-obese subjects.Conclusions Despite the higher prevalence of periodontal disease among obese individuals, it is not considered an independent risk factor for the development of periodontitis.

Vertical Discrepancy in Height of Morse Cone Abutments Submitted to Different Torque Forces.

The present study aimed to evaluate the influence of manual torque (10 Ncm) versus clinical torque (30 Ncm), which is recommended by the manufacturer, on the total length of morse cone implant abutments. Twenty specimens were prepared and distributed into two groups: group 1 with ten analogs for morse cone type implant, and group 2 with ten morse type implants, size 4.3 × 15 cm. In each group, the distance between the implant platform to the top of the prosthetic abutment (abutment height) was measured and subjected to a torque of 10 Ncm. Then, the 30 Ncm torque was applied to the same abutment, and abutment height was measured. The distance between the top of the abutment and the implant/analog base was measured. In order to verify the clinical reproducibility of the experiment, comparisons between the abutment height of the analog at 10 Ncm and the implant at 30 Ncm were performed, showing a greater discrepancy in torque for the 10 Ncm analog (p < 0.05). In order to verify if the change in the laboratory protocol from 10 to 30 Ncm could minimize the differences in the height of the prosthetic abutments, the abutment height in groups 1 and 2 was compared with 30 Ncm, and no significant difference was observed (p > 0.05). The data indicated that the manual torque and the torque recommended by the manufacturer influence the total length of the prosthetic abutments of morse cone implants.

Silane-Coating Strategy for Titanium Functionalization Does Not Impair Osteogenesis In Vivo.

Silane-coating strategy has been used to bind biological compounds to the titanium surface, thereby making implant devices biologically active. However, it has not been determined if the presence of the silane coating itself is biocompatible to osseointegration. The aim of the present study was to evaluate if silane-coating affects bone formation on titanium using a rabbit model. For this, titanium screw implants (3.75 by 6 mm) were hydroxylated in a solution of H2SO4/30% H2O2 for 4 h before silane-coating with 3-aminopropyltriethoxysilane (APTES). A parallel set of titanium screws underwent only the hydroxylation process to present similar acid-etched topography as a control. The presence of the silane on the surface was checked by x-ray photoelectron spectroscopy (XPS), with scanning electron microscopy (SEM) and atomic force microscopy (AFM). A total of 40 titanium screws were implanted in the tibia of ten New Zealand rabbits in order to evaluate bone-to-implant contact (BIC) after 3 weeks and 6 weeks of healing. Silane-coated surface presented higher nitrogen content in the XPS analysis, while micro- and nano-topography of the surface remained unaffected. No difference between the groups was observed after 3 and 6 weeks of healing (p > 0.05, independent t-test), although an increase in BIC occurred over time. These results indicate that silanization of a titanium surface with APTES did not impair the bone formation, indicating that this can be a reliable tool to anchor osteogenic molecules on the surface of implant devices.

Clinical Comparation of Extra-Short (4 mm) and Long (>8 mm) Dental Implants Placed in Mandibular Bone: A Systematic Review and Metanalysis.

This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration's tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate (p = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly (p = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future.

What evidence is there for the use of antibiotic prophylaxis in patients with periodontal disease to decrease the risk of prosthetic joint infections?

Design Systematic review.Study population The present study evaluated articles about patients with prosthetic joint infections after the surgical procedure and the correlation with periodontal disease.Data analysis The evaluation was performed using case reports and previous systematic reviews.Results In this study, the authors did not include studies using qualitative analysis. They did not find studies which correlated periodontal disease with the development of a prosthetic joint infection.Conclusions In conclusion, the authors did not have evidence to support or exclude the need of antibiotic prophylaxis as a means to decrease the risk of prosthetic joint infections in patients with periodontal disease.

How can we reduce the risks of SARS-CoV-2 (COVID-19) for dentists and their patients?

Design Special report.Study population This paper presented a report about the experience of the oral and maxillofacial surgeons (OMS) of Peking University School and Hospital of Stomatology, during the COVID-19 (SARS-CoV-2) pandemic.Data analysis The experience of that department formed the content of the report.Results In this study, the authors presented an informative description of experience of treating patients under a pandemic condition. The authors offer some methods of trying to protect oro-maxillofacial surgeons, using an algorithm of diagnosis and classifying the risk of contamination and the materials required in order to avoid it.Conclusions In conclusion, the authors suggest the use of the algorithm for patient admission during the COVID-19 outbreak.

Oral Fibroma Removal With a Er,Cr:YSSG Laser.

Fibromas often occur orally and are typically due to trauma to underlying connective tissue resulting in tissue enlargement. To prevent continuing trauma to the tissue, excision may be recommended, and biopsy is often indicated for these masses to confirm their diagnosis and to rule out a potential malignant cause. This article presents a case report in which a Er,Cr:YSSG laser was utilized for excision of an oral fibroma. This approach enabled excellent tissue response compared to the use of a scalpel or monopolar electrosurgery, with minimal patient postoperative discomfort and improved healing.

How should we anaesthetise painful mandibular premolars?

Design Randomised clinical trialStudy population The present study evaluated patients of different genders aged between 18-65 years old. The study design and the language of the consent form were approved by the Ethics Committee at Tehran University of Medical Sciences (TUMS) (approval code: IR.TUMS.REC.1394.1906). The study was registered in the Iranian Registry of Clinical Trials.Data Analysis The evaluation was performed using the Heft-Parker Visual Analog Scale (HP VAS) and complemented with the electrical pulp test accuracy to determine the success of anaesthesia Results In this study, the success rate was 93.8% (95% CI 79.19-99.23) for mental/incisive nerve block (MINB), and 81.2% (95% CI 63.56-92.79) for inferior alveolar nerve block (IANB). The difference was not significant (p = 0.26). An interesting result was the combination of both techniques was 100% successful in the failed cases (2 in MINB group; 6 in IANB group).Conclusions In conclusion, MINB using 4% Articaine showed a similar success rate as IANB using 4% Articaine in local anaesthesia for mandibular premolars with irreversible pulpitis. The beginning of anaesthesia was faster for MINB, and the injection was painless. The post-injection pain for MINB was higher than for IANB. Both techniques showed similar efficacy.

The use of leukocyte- and platelet-rich fibrin in the management of soft tissue healing and pain in post-extraction sockets: A randomized clinical trial.

This study aimed to evaluate the clinical effect of leukocyte- and platelet-rich fibrin (L-PRF) to improve epithelialization and decrease postoperative pain in post-extraction sockets. Thirty two participants requiring extractions of posterior teeth were randomized into two groups: 1) extractions and socket filling with L-PRF membrane (test group) and 2) extraction with spontaneous healing (control group). One week after extraction, an assessment of soft tissue healing around the sockets was performed using the healing index. Also, postoperative pain by visual analog scale (VAS) and number of consumed analgesic tablets were recorded. In the first week, the sockets of the test group presented a significantly (mean of 3.81 ± 0.54; p = 0.0138) higher level of healing when compared to the sockets of the control group (mean of 3.18 ± 0.65). The participants of control group reported a significantly (mean of 5.12 ± 1.08; p = 0.0128) higher level of postoperative pain when compared to the test group (mean of 4 ± 1.15). Also, the control group consumed a greater number of analgesics (mean of 1.75 ± 0.85; p = 0.0136) when compared to the test group (mean of 1 ± 1.15). The results of the present study demonstrate that whenever improved healing of the extraction socket is needed, the use of L-PRF should be considered. In addition, the use of L-PRF decreases postoperative pain and discomfort.