Evaluation of dentin features in teeth after caries removal by three techniques (chemomechanical, mechanical with a smart bur, and air-abrasion): an in vitro study.

Background: Different methods for removing dental carious lesions exist, including conventional rotary caries removal and new advanced technology like polymer-based burs, chemomechanical agents, air abrasion, and laser. Objectives: This study shows the differences in features of dentin (smear layer, patency of dentinal tubules, surface irregularities, intertubular micro porosities, and exposed dentinal tubules) among different types of caries removal techniques. Materials and Methods: An in vitro study was done on 60 primary molars with occlusal class I active caries. Teeth were divided into three groups according to a method of caries removal (G1: chemomechanical, G2: mechanical with a smart bur, and G3: air-abrasion). After complete caries excavation, the teeth were examined under a scanning electronic microscope (SEM) with the power of magnification 4,000x and 8,000x to show the morphological dentinal features with SEM microphotographs. Data obtained was analyzed using the SPSS program where Fisher exact, Kruskal-Wallis and multiple Wilcoxon sum rank tests were used. The level of significance is when the p-value is less than 0.05. Results: Generally, SEM showed the highest ratio of score 1 of smear layer presence, surface irregularities, and microporosity in all groups in both magnifications. The patency of tubules showed the highest ratio of score 1 in G1, scores 2 in both G2 and G3 in magnification 4,000x, while 8,000x there was the highest ratio of its score 1 in G1 and G2 while the G3 has score 2 as the highest score. The exposed dentinal tubules showed the highest ratio in G1 in score 3, in G2 in score 2, and in G3 in score 1 in magnification 4,000x, while 8,000x there was the highest ratio of its score 2 in both G1 and G3 while the G3 has highest score 1. The study with magnification 4,000x showed a significant difference (S) among three groups in exposed dentinal tubules with a p-value (0.012), and there was S between chemomechanical and smart, chemomechanical and air-abrasions groups with a p-value (0.041, 0.001 subsequentially). Other dentin features showed non-significant differences (NS) among or between groups in both magnifications (4,000x, 8,000x). Conclusions: All groups were effective in removing caries and can successfully treat young, scared or stressed patients. All methods of caries removal produce clinically parametric changes in the residual dentin.

Platelet-rich fibrin as an adjunct to scaling and root planing in treatment of shallow periodontal pockets: a randomized clinical trial.

OBJECTIVES: To evaluate the efficacy of platelet-rich fibrin (PRF) as an adjunct to scaling and root planing (ScRp) for healing shallow periodontal pockets. METHODS: Twelve patients with periodontitis were enrolled in this split-mouth, randomized clinical trial. A total of 24 shallow periodontal pockets (4-6 mm) were treated by either ScRp alone (control) or PRF (test). Clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PLI), as well as platelet-derived growth factor-BB (PDGF-BB) by enzyme-linked immunosorbent assay (ELISA) in gingival crevicular fluid (GCF) were measured at baseline and at 1- and 3-month follow-up visits. RESULTS: At 1- and 3-month follow-up visits, greater CAL gains (2.6 ± 0.25 mm and 3.26 ± 0.31 mm, respectively) and PPD reductions (2.58 ± 0.38 and 3.31 ± 0.39 mm, respectively) were observed in the test group compared to those in controls (CAL gain of 1.01 ± 0.49 mm and 1.43 ± 0.48 mm; PPD reduction of 1.1 ± 0.55 and 1.37 ± 0.49 mm, respectively). In addition, the increase in PDGF-BB in GCF in the test group (724.5 ± 186.09 pg/µl and 1957.5 ± 472.9 pg/µl) was significantly greater than that in controls (109.3 ± 24.07 and 614.64 ± 209.3 pg/µl) at 1- and 3-month follow-up visits, respectively. CONCLUSIONS: The noninvasive use of PRF as an adjunct to ScRp successfully improved clinical periodontal parameters and might contribute to increased PDGF-BB in GCF.

Clinical Effectiveness of Salvia officinalis in Periodontitis: A Split-Mouth Randomized Controlled Trial.

Background Periodontitis is a chronic inflammatory condition that destroys the tissues supporting the teeth. Conventional nonsurgical treatments, such as mechanical scaling and root surface debridement (RSD), often require adjunct therapies to enhance outcomes due to their limited efficacy in completely eradicating pathogenic microorganisms. Given the adverse effects of standard adjunctive therapies, including antibiotics and nonsteroidal anti-inflammatory drugs, Salvia officinalis (sage) presents a promising herbal alternative due to its anti-inflammatory and antimicrobial properties. This study aims to assess the local application of Salvia officinalis gel as an adjunctive to scaling and RSD to manage periodontitis. Methods We conducted a randomized, controlled split-mouth clinical trial involving 14 systemically healthy periodontitis patients. We included patients with at least 20 natural teeth, a probing pocket depth (PPD) ≥5 mm, and attachment loss ≥4 mm at a minimum of five sites. Primary outcomes measured were bleeding on probing (BOP), PPD, and relative attachment level (RAL). The Salvia officinalis gel was applied to designated test sites post-RSD, while control sites received no adjunctive treatment. Clinical parameters were recorded at baseline and a one-month follow-up visit. Results The cohort consisted of 10 men and four women, with a mean age of 37.1 ± 5.46 years. At the follow-up visit, the test group demonstrated a significant reduction in mean BOP (P = 0.0004), whereas the control group showed no significant change (P ≥ 0.05). Both groups experienced significant decreases in mean PPD and RAL from baseline to follow-up, with the test group showing greater improvements. Conclusions Salvia officinalis gel, used as an adjunct to scaling and RSD, significantly improves clinical periodontal parameters in patients with periodontitis. Its anti-inflammatory properties likely underpin the observed benefits, offering an effective and safe alternative to traditional chemical pharmaceuticals. Further research is needed to explore the long-term effects and mechanisms underlying the therapeutic benefits of Salvia officinalis in periodontal treatment.

Salivary lactate dehydrogenase and salivary total protein as potential biomarkers for screening periodontal disease.

Background: Timely diagnosis of periodontal disease is crucial for restoring healthy periodontal tissue and improving patients' prognosis. There is a growing interest in using salivary biomarkers as a noninvasive screening tool for periodontal disease. This study aimed to investigate the diagnostic efficacy of two salivary biomarkers, lactate dehydrogenase (LDH) and total protein, for periodontal disease by assessing their sensitivity in relation to clinical periodontal parameters. Furthermore, the study aimed to explore the impact of systemic disease, age, and sex on the accuracy of these biomarkers in the diagnosis of periodontal health. Materials and methods: A total of 145 participants were categorized into three groups based on their basic periodontal examination index, with 20 in the periodontally healthy group, 50 in the gingivitis group, and 75 in the periodontitis group. Salivary LDH was measured using the rate of nicotinamide adenine dinucleotide (NADH) oxidation, to measure the kinetics of LDH activity, while total protein was measured using the Lowry method. Descriptive and analytical statistical analyses were performed to examine the associations between the variables and biomarkers. Results: The results of the study demonstrated that salivary LDH was 72% sensitive, while salivary total protein was 78% sensitive in correlation to clinical periodontal parameters. The accuracy of the test was not influenced by sex, but age had a significant effect on both biomarkers, particularly LDH. Systemic disease was another factor that significantly affected the accuracy of the test. Conclusions: Although salivary LDH and total protein show promise as biomarkers for screening periodontal disease, their interpretation may be impacted by age and systemic disease. To enhance the accuracy of periodontal disease detection, the study suggests combining these biomarkers with more specific indicators and diagnostic tools.

The efficacy of non-surgical platelet-rich fibrin application on clinical periodontal parameters and periostin level in periodontitis: Clinical trial.

Platelet-rich fibrin (PRF) has been widely used in regenerative dentistry due to many growth factors produced. Periostin, a matricellular protein, is a reliable marker for tissue regeneration. Periostin is part of the cellular matrix and regulates bone homeostasis. This study aims to explore the efficacy of PRF in improvement of the clinical periodontal parameters as an adjunct to the scaling and root planing and to evaluate periostin level in gingival crevicular fluid (GCF) at baseline, 1- and 3-month recall visits. Fourteen periodontitis patients who met the inclusion criteria were recruited in this study. Two contralateral periodontal pockets with 4-6 mm in depth in each patient were selected. The sites in every participant were randomly allocated into control sites or test sites. In control sites, only conventional scaling and root planing was carried out. In test sites, however, scaling and root planing method and PRF were applied. Periostin level in GCF and clinical periodontal parameters were measured. The test sites revealed greater relative attachment gain (2.614 ± 0.606 mm and 3.321 ± 0.668 mm) than control sites (1.285 ± 0.671 mm and 1.839 ± 0.632 mm) and a significant pocket reduction (2.535 ± 0.664 mm and 3.321 ± 0.668 mm) than the control sites (1.21 ± 0.508 mm and 1.892 ± 0.655 mm) at 1- and 3-month recall visits respectively. In the test sites, level of periostin (48.83 ± 9.3 ng/µl and 98.90 ± 24.94 ng/µl) were greater than periostin levels in the control sites (42.65 ± 7.03 ng/µl and 49.29 ± 15.14 ng/µl) at 1- and 3-month recall visits respectively. In conclusion, the non-surgical application of PRF as an adjunct to scaling and root planing significantly improved the clinical periodontal parameters through raising periostin level in GCF.

Comparison of Some Salivary Characteristics in Iraqi Children with Early Childhood Caries (ECC) and Children without Early Childhood Caries.

BACKGROUND: Early Childhood Caries (ECC) is a unique form of caries that develops in temporary dentition. It has a multifactorial infectious disease. Saliva is one of the most important factors, which has an important protective effect against tooth decay when its multiple characteristics and functions are normal. The study aimed to compare some salivary characteristics in children with ECC and children without ECC. MATERIALS AND METHODS: Case-control, cross-sectional observational study. The 77 pre-schoolers aged 37 to 72 months (12 with ECC, 26 with ECC-S, and 39 without ECC) examined and we collected the stimulated saliva. The pH microelectrode was used to determine pH and buffer capacity; a formula that involves volume, collection time, and specific saliva weight was used to test the salivary flow rate. The potentiometric and phosphate methods were used to determine fluoride through spectrophotometric, colorimetric absorption techniques. RESULTS: The results got to show that there are no statistically significant differences in pH, buffer capacity, salivary flow rate, and levels of fluoride and phosphate, in children with ECC, ECC-S, and without ECC. The risk factors, such as mother's education, bottle use, brushing frequency, and previous dental care of the child are more important at the time of developing ECC than some salivary variables. CONCLUSION: The risk factors, such as mother's education, bottle use, brushing frequency, and previous dental care of the child are more important at the time of developing ECC than some salivary variables such as pH, buffer capacity, salivary flow rate, and levels of fluoride and phosphate.

Pattern of addiction and its relapse among habitual drug abusers in Lahore, Pakistan.

This study assessed the pattern of drug abuse and the reasons for relapse of addiction among male drug addicts seeking rehabilitative services in different centres in Lahore, Pakistan. A cross-sectional survey was conducted on male drug abusers from April to December 2016. Nonprobability purposive sampling was done to collect a sample of 119 participants. A structured questionnaire and in-depth interviews were used for data collection. Out of 119 participants, 71.4% were in the age group 15-35 years. Educational levels were low in the majority, with 68.1% below secondary education. Unmarried (51.3%) and unemployed (44.5%) participants were at the greatest risk of using drugs. The age of addiction in 45% of patients was < 18 years and 40% had been abusing substances for > 5 years. Reasons for starting drug abuse were recreation (37%), curiosity (34.5%), and lifechanging events (14.3%). Reasons for relapse included association with former addicts, negative reactions from family, inability to manage the craving and work/social stress.