ABSTRACT
OBJECTIVES: The purpose of this randomized controlled clinical trial was to compare and evaluate the clinical effects of concentrated growth factor (CGF) and advanced platelet-rich fibrin (A-PRF) applied together with coronally advanced flap (CAF) technique using a microsurgical approach in the treatment of type I multiple gingival recessions (GR). MATERIALS AND METHODS: Sixteen patients with multiple recession defects (Cairo type I) were included in this randomized and controlled study. Forty-five gingival recession defects were randomly equally divided into three groups (n = 15): CAF + CGF (test site); CAF + A-PRF (test site), and CAF alone (control site). Clinical attachment level (CAL), vertical gingival recession (VGR), horizontal gingival recession (HGR), gingival thickness (GT), width of keratinized gingiva (KGW), percentages of the mean (MRC), and complete root coverage (CRC), patient esthetic score (PES), and hypersensitivity score (HS) were recorded at baseline and 6 months after surgery. Patient comfort score (PCS) was evaluated at the day of surgery. RESULTS: Significant improvements were determined in CAL, VGR, HGR, KGW, and GT at 6 months when compared to baseline levels in intra-group comparisons for all groups, and also GT was increased in CAF + A-PRF and CAF + CGF compared to CAF alone at 6 months in intergroup comparisons (p < 0.05). At 6 months, MRC was detected 85.66 ± 22.68% in the CAF + CGF, 90.88 ± 20.87% in the CAF + A-PRF, and 75.10 ± 32,37% in the CAF alone, and a significant increase was detected in the CAF + A-PRF group compared to CAF alone (p < 0.05). CRC in CAF + CGF was 66.66%, in CAF + A-PRF 80% and in CAF alone was 53.33% (p > 0.05). PES and HS values showed significant improvement from baseline to 6 months for all groups and also in CAF + CGF and CAF + A-PRF compared to CAF alone at 6 months in intergroup comparisons (p < 0.05). CONCLUSIONS: The present study showed that the use of A-PRF and CGF membranes in GR therapy may have an additional benefit in GT increase and also A-PRF may increase the percentages of MRC. The use of A-PRF and CGF membranes may be beneficial in terms of improving patient-related parameters. CLINICAL RELEVANCE: A-PRF and CGF may be superior to CAF alone in terms of patient-related parameters and GT increase in multiple recession defects. TRIAL REGISTRATION NUMBER: 17578e02-00a9-4a41-8c8d-42a637143531.
Subject(s)
Gingival Recession , Platelet-Rich Fibrin , Humans , Connective Tissue , Esthetics, Dental , Gingiva , Gingival Recession/surgery , Intercellular Signaling Peptides and Proteins , Tooth Root/surgery , Treatment OutcomeABSTRACT
ABSTRACT Purpose: The purpose of this study is to evaluate the shear bond strength (SBS) of orthodontic brackets bonded to three different bulk fill composites which were previously aged. Materials and Methods: Three bulk fill composite materials were included in this study (Filtek Bulk Fill, Tetric N-Ceram bulk fill, SureFil SDR bulk fill). Each material group contained 12 samples (n=12); a total of 36 samples were bonded in the same way with maxillary premolar brackets (CB; Avex Mx, OPAL orth.). The same type brackets were bonded on each restored surface made with bulk fill composites. The SBS was examined after storing the specimens for 24 h at 37 ºC indistilled water, followed by thermal ageing (500 cycles between 5 ºC and 55 ºC). Data were analyzed statistically. The numeric data were analyzed using analysis of variance (ANOVA) with Tukey HSD post-hoc tests at α=.05. Results: There were no significant differences among the composite groups (p>0.001). However, SBS values for control group were significantly greater than shear bond strenght values for composite groups (p<0.001). Conclusion: Bond strength of orthodontic brackets on bulk fill composite surfaces was not found adequate. Therefore, this situation leads to bonding failure during orthodontic treatment. The presence of bulk fill composites on the surface to be bonded during orthodontic treatment requires an additional armamentarium.
RESUMEN Propósito: El propósito de este estudio es evaluar la resistencia al cizallamiento (SBS) de brackets de ortodonci unidos a tres compuestos de relleno masivo diferentes que fueron envejecidos previamente. Metodología: Se incluyeron tres materiales compuestos de relleno a granel en este estudio (Filtek Bulk Fill, Tetric N-Ceram bulk fill, SureFil SDR bulk fill). Cada grupo de material contenía 12 muestras (n = 12); un total de 36 muestras se unieron de la misma manera con soportes premolares maxilares (CB; Avex Mx, OPAL orth.). Los mismos soportes de tipo se unieron en cada superficie restaurada hecha con compuestos de relleno masivo. El SBS se examinó después de almacenar las muestras durante 24 horas a 37 ºC de agua no destilada, seguido de un envejecimiento térmico (500 ciclos entre 5 ºC y 55 ºC). Los datos fueron analizados estadísticamente. Los datos numéricos se analizaron mediante el análisis de varianza (ANOVA) con pruebas post hoc de Tukey HSD en α=.05. Resultados: No hubo diferencias significativas entre los grupos compuestos (p> 0,001). Sin embargo, los valores de SBS para el grupo de control fueron significativamente mayores que los valores de resistencia al cizallamiento para los grupos compuestos (p <0.001). Conclusión: La resistencia de de brackets de ortodonci en superficies compuestas de relleno en masa no se encontró adecuada. Por lo tanto, esta situación conduce a una falla de adhesión durante el tratamiento de ortodoncia. La presencia de compuestos de relleno a granel en la superficie a unir durante el tratamiento de ortodoncia requiere un arsenal adicional.
Subject(s)
Orthodontic Brackets , Shear Strength , Dental Materials/analysisABSTRACT
OBJECTIVE: Arthrocentesis and prolotherapy are nonsurgical treatments for temporomandibular joint (TMJ) diseases. This study aimed to evaluate the treatment of hypermobility, pain, and displacement of the TMJ by consecutively performing arthrocentesis and prolotherapy in the same session. MATERIALS AND METHODS: In this study, 10 adults with disc displacement and painful, hypermobile TMJ were selected. Arthrocentesis and prolotherapy were consecutively performed using a 30% dextrose solution that was simultaneously injected into five areas: posterior disc attachment, superior joint space, superior and inferior capsular attachments, and stylomandibular ligament. Paired t-test, McNemar test, and chi-square test were used to assess the maximum mouth opening, clicking sounds, pain, and subluxation of the TMJ. Patients with rheumatoid arthritis and parafunctional habits such as teeth clenching and grinding and biting of the cheeks or any other objects and those who had undergone surgery were excluded from this study. RESULTS: A total of 10 participants (36.20 ± 7.06 years old, 7 women and 3 men) received a single treatment session of combined arthrocentesis and prolotherapy at the same office visit. Subluxation frequency and pain significantly decreased after the first week of treatment (p < 0.05). Subluxation also decreased at the 3-month follow-up (p < 0.05). Clicking sound values did not significantly change at any of the follow-up time points. Maximum mouth opening values decreased at all follow-up time points compared to baseline (p < 0.05). CONCLUSION: A single session of combined arthrocentesis and prolotherapy to treat symptomatic TMJ safely and significantly improved the subluxation and pain after 1 week and subluxation after 3 months compared to baseline status. The maximum mouth opening significantly decreased at all follow-up time points. Future studies assessing multiple treatment sessions are warranted.
