Which Histometric Analysis Approach Is More Reliable for Assessing Histological Bone Tissue Samples?

This study aims to evaluate the grid of Merz and ImageJ methods for histometric quantification, verifying which is more reliable and defining which is most suitable based on the time required to perform. Thirty histological samples of maxillary sinuses grafted with xenografts were evaluated using an optical light microscope attached to an image capture camera and connected to a microcomputer. The images were digitalized and recorded as a TIFF image, and the new bone formation was evaluated using the grid of Merz and ImageJ. The Bland-Altman analysis was used to identify the agreement between the methods and determine suitable future research options. The timing of the quantification was also performed to identify a possible advantage. The mean value for the quantification analysis timing for the grid of Merz was 194.9 ± 72.0 s and for ImageJ was 871.7 ± 264.4, with statistical significance between the groups (p = 0.0001). The Bland-Altman analysis demonstrated a concordance between the methods, due to the bias being next to the maximum concordance (-1.25) in addition to the graphic showing the scattering points next to the mean of differences and inside of limits of agreement. Thus, it was demonstrated that the grid of Merz presents reliable outcomes and advantages over the ImageJ methodology regarding the time spent to contour the areas of interest.

Clinical and Radiographic Evaluation of a Novel Triangular Implant Neck Design: A Case Series.

The objective of this study was to evaluate the clinical and radiographic behavior of a novel triangular neck implant configuration in partially edentulous patients. Sixteen patients with a mean age of 58.3 years, were rehabilitated with 25 implants inserted in the healed sites of the maxilla and mandible; implant diameter was Ø3.3 and 3.9 mm. Clinical and radiographic measurements were first performed at prosthesis delivery that served as baseline; they were further evaluated after a mean period of 15.6 months. The interproximal peri-implant bone levels were the primary outcome; the mesial and distal data were recorded and a mean value was calculated. Secondary outcomes included peri-implant probing depth (PPD) and bleeding on probing (BoP). The paired t-test was used to compare the radiographic and clinical outcomes between baseline and follow-up. The mean bone levels at the mesial and distal aspects at baseline were 0.45 (0.47) and 0.57 (0.69), respectively; at follow-up they were 0.59 (0.42) and 0.78 (0.59), respectively. The differences were not statistically significant. Similarly, no significant differences were found for the clinical parameters. Within the limitations of the present study, it could be concluded that this new triangular neck bone level implant macro-design was used successfully to treat partially edentulous patients. Larger controlled clinical studies are warranted to confirm the present radiographic and clinical findings.

Active Tactile Sensibility of Brånemark Protocol Prostheses: A Case-Control Clinical Study.

Few studies have assessed active tactile sensibility in patients rehabilitated with implants. Improved knowledge about functional tactile sensibility will contribute to several clinical applications, such as protocols for immediate loading, prosthesis design, occlusal improvement in implantology, and physiological integration of implant-supported prostheses. The present study evaluated active tactile sensibility in patients rehabilitated with Brånemark-type mandibular prostheses that impede the total mucosa-supported maxillary prosthesis. Thirty-five subjects participated in this study. The experimental group (n = 18) inclusion criteria were as follows: Brånemark-type prosthesis and a total mucosa-supported maxillary prosthesis. The control group (n = 17) was composed of participants with complete healthy dentition. Carbon foils with different thicknesses (12 µm, 24 µm, 40 µm, 80 µm, and 200 µm) were placed in the premolar region to evaluate the brink of active oral tactile sensibility. The researchers assessed the participants 120 times. After evaluation, we observed a statistical difference (p < 0.05) between the groups. Additionally, the degree of sensibility was found for all thicknesses, except for 12 µm, on both sides. There was a more significant increase in perception in the control group as the carbon thickness increased. The tactile sensibility threshold was 2.5 times greater for participants with prostheses. Thus, the tactile sensibility for mandibular implant-supported and maxillary mucosa-supported prostheses is significantly lower than that of dentate patients, which was detected above the thickness of 80 µm; in patients with natural dentition, different thicknesses were seen starting from 24 µm.

Anti-inflammatory effect of salt water and chlorhexidine 0.12% mouthrinse after periodontal surgery: a randomized prospective clinical study.

OBJECTIVES: The purpose of this study was to compare the anti-inflammatory efficacy of sodium chloride- and a 0.12% chlorhexidine mouth rinses in patients undergoing minimal invasive periodontal surgery. MATERIALS AND METHODS: Forty-seven patients with a diagnosis of periodontitis and indication for access flap procedure were randomly selected. Group A: a sodium chloride (salt)water-based mouth rinse (test group) or group B: a 0.12% chlorhexidine mouth rinse (control group) administered after surgery. Gingival Index (GI) were evaluated in the whole mouth and in the surgical site at baseline (T1), a week later (T2), and 12 weeks (T3) after the treatment. Total MMP activity was measured in GCF using a commercial kit and plate reader. Medians of total MMP activity and GI were compared for time intervals T1 vs. T2, T1 vs. T3, and T2 vs T3 using Friedman tests and Wilcoxon signed rank tests, and were also compared between test and control using Mann-WhitneyU tests at each timepoint. RESULTS: The average GI values showed significant differences between baseline and T2 (p = 0.0005) and baseline and T3 (p = 0.003) in the test group. CONCLUSION: The sodium chloride-mouth rinse use after periodontal surgery seems to have similar anti-inflammatory properties as CHX mouth rinse and can be used regularly postoperatively after periodontal surgical procedures. CLINICAL RELEVANCE: The use of salt water mouthwash showed an anti-inflammatory effect similar to CHX 0.12% after minimal invasive periodontal surgery. Salt water mouthwash is accessible to the world population and can contribute on the healing process after periodontal surgery.

In vitro microbiological analysis on antibacterial, anti-inflammatory, and inhibitory action on matrix metalloproteinases-8 of commercially available chlorhexidine digluconate mouth rinses.

AIM: Chlorhexidine (CHX) mouthrinses are known to have a beneficial effect in the management of periodontal disease. The present study was designed to investigate the antibacterial, anti-inflammatory, and matrix metalloproteinases-8 (MMP-8) inhibition efficacy of eight commercially available CHX mouthrinses from the Dominican Republic. METHODS: The study samples are categorized into two categories, eight commercially available CHX mouthrinses were case sample group, and positive and negative controls used in the study are categorized as control sample group. Antibacterial activity of the samples was evaluated on bacterial strains obtained from American Type Culture Collection (ATCC, Rockville, MD USA) which were Porphyromonas gingivalis, Fusobacterium nucleatum, Eikenella corrodens, and Aggregatibacter actinomycetemcomitans. RESULTS: The study samples 1, 2, 3, 5, 6, and 8 showed significant higher antibacterial efficacy and sample 4 and 7 were less effective. Samples 1, 2, 3, 5, and 6 showed higher antibacterial efficacy with no bacterial colonies formation in dilution assay method, whereas sample 8 showed smaller colonies of bacterial growth. The halo diameter found to be average in sample 8 with 13 mm, whereas sample 9 showed 12.5 + 3.48 mm, sample 1 was with a mean of 11.79 + 3.51 mm. The smaller halo diameter and minimal antibacterial activity were observed in samples 4 (mean of 3.5 + 5.95 mm) and 7 (3.5 + 7.70 mm). All eight samples showed statistically significant higher MMP-8 inhibition activity with P < 0.0001. CONCLUSION: Commercially available CHX digluconate mouthrinses showed the difference in plaque inhibition with 0.12 and 0.15% concentration.

Antimicrobial photodynamic therapy for the treatment of periodontitis and peri-implantitis: An American Academy of Periodontology best evidence review.

BACKGROUND: This systematic review evaluates the efficacy of antimicrobial photodynamic therapy (aPDT), as an adjunct to non-surgical or surgical therapy, on clinical and patient-centered outcomes in patients with periodontitis or peri-implantitis. METHODS: Randomized controlled trials (RCTs) with a follow-up duration ≥ 3 months that evaluated mechanical root/implant surface debridement (i.e., scaling and root planing [SRP] or implant surface scaling [ISS]) versus SRP or ISS plus aPDT for the treatment of adult patients (≥ 18 years old) with moderate-to-severe chronic (CP)/aggressive periodontitis (AgP) or peri-implantitis, respectively, were considered eligible for inclusion. The MEDLINE, EMBASE, and CENTRAL databases were searched for articles published up to and including March 2017. Random-effects meta-analyses were used throughout the review using continuous data (i.e., mean changes from baseline), and pooled estimates were expressed as weighted mean differences with their associated 95% confidence intervals. Additionally, summaries are presented of the included RCTs, critical remarks of the literature, and evidence quality rating/strength of recommendation of laser procedures. RESULTS: Of 729 potentially eligible articles, 28 papers (26 studies) were included in the review. Individual study outcomes and four sets of meta-analysis showed potential statistical significant benefit of aPDT in improving clinical attachment level (CAL) (non-surgical treatment of AgP) and probing depth (PD) (non-surgical treatment of AgP and CP). However, the comparative differences in clinical outcomes were modest (< 1 mm), and the level of certainty for different therapies was considered low-to-moderate (i.e., more information would be necessary to allow for a reliable and definitive estimation of effect/magnitude of therapies on health outcomes). Overall, most of the strengths of clinical recommendations of aPDT were guided by the expert opinion. CONCLUSIONS: aPDT may provide similar clinical improvements in PD and CAL when compared with conventional periodontal therapy for both periodontitis and peri-implantitis patients. The restricted base of evidence for some treatment approaches and conditions precludes additional conclusions.

Mast cell concentration in the wound healing process of incisions made by different instruments.

The aim of this study was to compare the concentration of mast cells (MCs) in the healing process of incisions. Thirty rats were submitted to six linear incisions each, performed in the dorsal skin by carbon dioxide (CO(2)) and diode lasers, electrocautery and conventional scalpel. The animals were euthanized at intervals of 0 h, 24 h, 48 h, 72 h, 7 days and 14 days after the incisions had been made. Histological sections were obtained and stained with toluidine blue for identification of MCs, which were manually counted by conventional microscopy in 20 microscopic fields in the border of the incision, near the granulation tissue, or in the area of new collagen formation, depending on intervals. The concentration of MCs was significantly higher in the wounds made by scalpel than in those made by other techniques at 48 h and 72 h. After 72 h the number of MCs was also significantly higher after electrocautery than after incisions made by 4 W CO(2) laser. On days 7 and 14, there was no significant difference in the MC count among the different types of incisions. In summary, the MC concentration varied after different surgical incisions at early phases of wound healing. At the end of the healing process, however, there were similar MC concentrations around the incisions, suggesting that, in standard incisions in the surgical techniques studied, the wound healing process ultimately occurred in a similar pattern.