The flapless approach with and without enamel matrix derivatives for the treatment of intrabony defects: A randomized controlled clinical trial.

AIM: To compare the clinical and radiographic outcomes of flapless procedure alone or in combination with enamel matrix derivatives (EMD) in the treatment of deep intrabony defects. MATERIALS AND METHODS: Forty-six patients re-evaluated after non-surgical therapy were randomly assigned to the test (flapless with EMD) or control group (flapless alone). Clinical measurements were recorded pre-surgery and at 6 and 12 months after surgery, and radiographic measurements were taken pre-surgery and after 12 months. RESULTS: Forty-six patients completed the study. Improvements were observed in both groups at 12 months for mean clinical attachment level (CAL) gain, with significant differences between test (3.9 ± 1.1 mm) and control groups (3.0 ± 1.2) (p = .017). Probing pocket depth (PPD) reduction (4.0 ± 0.7 vs. 3.3 ± 1.4 mm) was also near to statistical significance (p = .051). Also, more sites achieved successful composite outcome measure (final PPD ≤ 4 mm and CAL gain ≥3 mm) for the regenerative treatment in the flapless + EMD group (82.6% vs. 52.2%; p = .028). In terms of radiographic outcomes, EMD yielded a greater defect bone fill than flapless treatment alone (3.0 ± 1.0 mm vs. 1.8 ± 1.5 mm; p < .001). CONCLUSIONS: The additional application of EMD during the flapless procedure for intrabony defects slightly improved clinical and radiographic outcomes. CLINICALTRIALS: gov identification number: NCT05456555.

The determination of pH of peri-implant crevicular fluid around one-piece and two-piece dental implants: A pilot study.

There are two main groups of screw-type dental implant designs: one-piece and two-piece implants. Although success rates of both of these types of implants are high, none of them avoid complications, of which the most common are peri-implant mucositis and peri-implantitis. Current clinical diagnostic parameters are relatively noninvasive and cost-efficient; however, they are often not sensitive enough and fail to determine the activity of inflammation. The purpose of this study is to determine pH of peri-implant crevicular fluid (PICF) around one-piece and two-piece implants and pH of gingival crevicular fluid (GCF) around healthy teeth and to find out if our suggested method could function accurately for determination of pH of PICF and GCF. Thermo Fisher Scientific™ Orion™ 9863BN glass microelectrode was used to determine pH of PICF around 29 one-piece (ROOTT, TRATE AG) and 29 two-piece implants (multiple manufacturers) and pH of GCF around 29 healthy teeth. pH of PICF around two-piece implants was more acidic (P < 0.001). Average pH around one-piece implants was 6.46 and around two-piece implants was 6.15. Mean pH of GCF was 6.64. pH of PICF in women around two-piece implants was more alkaline (P < 0.05); no difference was found in control and one-piece implant groups. There was no statistically significant correlation found between age and pH of PICF and GFC. Design of dental implants has an impact on pH of PICF. Glass microelectrode is an appropriate tool for accurate determination of pH in PICF.