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1.
Clin Oral Investig ; 2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33687555

RESUMEN

BACKGROUND: The mechanical disruption and removal of the subgingival biofilm represent the most important step in the treatment of periodontitis. However, in deep periodontal pockets, mechanical removal of the subgingival biofilm is difficult and frequently incomplete. Preliminary findings indicate that the use of amino acid buffered sodium hypochlorite (NaOCl) gel may chemically destroy the bacterial biofilm and facilitate its mechanical removal. OBJECTIVES: To clinically evaluate the efficacy of minimally invasive nonsurgical therapy (MINST) of periodontal pockets with or without local application of an amino acid buffered sodium hypochlorite (NaOCl) gel. MATERIALS AND METHODS: Forty untreated patients diagnosed with severe/advanced periodontitis (i.e. stage III/IV) with a slow/moderate rate of progression (i.e. grade A/B) were randomly allocated in two treatment groups. In the test group, the periodontal pockets were treated by means of MINST and NaOCl gel application, while in the control group, treatment consisted of MINST alone. Full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), probing depths (PD), clinical attachment levels (CAL) and gingival recessions (GR) were assessed at baseline and at 6 months following therapy. The primary outcome variable was PD reduction at sites with PD ≥ 5 mm at baseline. RESULTS: At 6 months, statistically significant differences between the two groups were found (p = 0.001) in terms of PD and CAL change. No statistically significant differences were found in terms of GR (p = 0.81). The number of sites with PD ≥ 5 mm and BOP (+) decreased statistically significantly (p = 0.001), i.e. from 85.3 to 2.2% in the test group and from 81.6 to 7.3% in the control group, respectively. Statistically significant differences between test and control groups were recorded at 6 months (p = 0.001). MINST + NaOCl compared to MINST alone decreased statistically significantly (p = 0.001) the probability of residual PDs ≥ 5 mm with BOP- (14.5% vs 18.3%) and BOP+ (2.2% vs. 7.2%). CONCLUSIONS: Within their limits, the present results indicate that (a) the use of MINST may represent a clinically valuable approach for nonsurgical therapy and (b) the application of NaOCl gel in conjunction with MINST may additionally improve the clinical outcomes compared to the use of MINST alone. CLINICAL RELEVANCE: In patients with untreated periodontitis, treatment of deep pockets by means of MINST in conjunction with a NaOCl gel may represent a valuable approach to additionally improve the clinical outcomes obtained with MINST alone.

2.
Clin Oral Investig ; 2020 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-32562077

RESUMEN

OBJECTIVES: To compare the healing of suprabony defects following treatment with either open flap debridement (OFD) and application of an enamel matrix derivative (EMD) with OFD alone. METHODS: Eighty patients with suprabony periodontal defects were randomly assigned to treatment with OFD + EMD (test) or OFD alone (control). The primary outcome variable was the difference in clinical attachment level (CAL) gain. At baseline and after 12 months, full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), probing depths (PD), gingival recessions (GR), and CAL were recorded. RESULTS: Sixty-five patients were available for the 12-month follow-up examination. At 12 months, the mean FMPS was 21.9 ± 3.0% in the OFD + EMD and 21.1 ± 2.4% in the OFD group, respectively (p = 0.30), while mean FMBS measured 20.4 ± 3.4% in the OFD + EMD group and 19.9 ± 2.9% in the OFD group (p = 0.48). Mean CAL gain at sites treated with OFD + EMD was statistically significantly different (p = 0.0001) compared with sites treated with OFD alone (3.4 ± 0.6 mm vs 1.8 ± 0.6 mm). A statistically significant difference (p = 0.0001) was found between mean PD change in the OFD + EMD (3.9 ± 0.6 mm) and OFD alone (3.2 ± 0.6 mm) treated groups and also in terms of mean GR change between treatment with OFD + EMD (0.5 ± 0.7 mm) and OFD alone (1.4 ± 1.0 mm) (p = 0.001). CONCLUSION: Within their limits, the present results indicate that in suprabony periodontal defects, the application of EMD in conjunction with OFD may additionally improve the clinical outcomes compared with OFD alone. CLINICAL RELEVANCE: In periodontal suprabony defects, the application of EMD in conjunction with OFD may additionally enhance the clinical outcomes in terms of CAL gain and PD reduction.

3.
Clin Oral Investig ; 2020 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-32556659

RESUMEN

OBJECTIVE: Nutraceutical agents have been demonstrated as adjuncts for the treatment of several inflammatory diseases. The present study analyzed and compared new nutraceutical agent as an adjunct to Scaling and root planing (SRP) versus SRP alone for the treatment of periodontitis. MATERIALS AND METHODS: Sixty-six patients with moderate periodontitis were enrolled. Through a randomized design, the patients were randomly assigned to SRP + nutraceutical agent (test group) or SRP alone (control group). Patients were regularly examined the clinical, inflammatory mediators and visual analogue scale (VAS) changes over a 6-month period. Clinical attachment level (CAL) was the primary outcome variable chosen. Gingival crevicular fluid (GCF) inflammatory mediator change and the impact of treatment on VAS were evaluated through a linear regression model. RESULTS: Both treatments demonstrated an improvement in periodontal parameters compared with baseline. After 6 months of treatment, compared with the control group, the test group determined a significant probing depth (PD) (p = 0.003) and bleeding on probing (BOP) reduction (p < 0.001), while CAL gain was significantly obtained at 30 and 60 days after treatment (p < 0.05). In the test group, the level of inflammatory mediators was significantly reduced compared with the control group (p < 0.05). The linear regression analysis demonstrated that the nutraceutical agent exerted, in the test group, a significant influence on VAS at 6, 12, 24, and 48 h after treatment (p < 0.05). CONCLUSIONS: Nutraceutical agent resulted in a more significant reduction in clinical, inflammatory mediators and short-term pain compared with SRP alone. CLINICAL RELEVANCE: Nutraceutical agent, when combined with SRP, was demonstrated to be effective in reducing periodontal parameters and controlling the levels of inflammatory mediators and pain in patients with periodontitis.

4.
Artículo en Inglés | MEDLINE | ID: mdl-32231082

RESUMEN

Peri-implant soft tissues play a role of paramount importance, not only on the esthetic appearance, but also on the maintenance and long-term stability of implants. The present report presents the conclusions from the Consensus Conference of the South European North African Middle Eastern Implantology & Modern Dentistry Association (SENAME) (4-6 November 2016, Cairo, Egypt). The conference focused on the topic of the soft tissue around dental implants, and in particular, on the influence of implant configurations on the marginal soft tissues, soft tissue alterations after immediate, early or delayed implant placement and immediate loading, the long-term outcomes of soft tissue stability around dental implants, and soft tissue augmentation around dental implants. Thirty world experts in this field were invited to take part in this two-day event; however, only 29 experts were in the final consensus voting process.


Asunto(s)
Implantes Dentales , Mucosa Bucal , Consenso , Egipto , Humanos
5.
Clin Oral Investig ; 24(8): 2799-2808, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31776665

RESUMEN

OBJECTIVES: The aim of the present cross-sectional study was to investigate the association between serum glycosylated haemoglobin (HbA1c) levels and periodontal status in patients with periodontitis (CP) and periodontally healthy controls. Furthermore, the objectives were to determine if the periodontitis influenced the serum HbA1c levels. MATERIALS AND METHODS: A total of 93 patients with CP and 95 periodontally healthy subjects were enrolled in the present study using a cross-sectional design. At baseline, patients were examined and characterized on a regular basis for blood serum parameters and non-fasting blood samples levels. In all patients, a full periodontal examination was performed and clinical attachment loss (CAL) was the primary outcome variable chosen. The spearman correlation, a stepwise multivariable linear regression, and Jonckheere-Terpstra tests were applied in order to assess the relationship between HbA1c levels and periodontitis. RESULTS: Patients in the CP group presented a significantly higher median serum level of HbA1c [40.9 (31.2; 45.6) mmol/mol)] compared to patients in the healthy control group [35.3 (29.6; 38.6) mmol/mol)] (p < 0.001). HbA1c levels were negatively correlated with the number of teeth and positively correlated with C-reactive protein levels and all periodontal parameters (p < 0.001). Moreover, there was a significant decrease in the number of teeth when HbA1c levels increased (P-trend < 0.001), while there was a significant increase in periodontal parameters (CAL, p = 0.002); PD, p = 0.008; BOP, p < 0.001) when levels of HbA1c increased. CONCLUSIONS: Patients with CP and undiagnosed diabetes presented significantly higher serum levels of HbA1c compared to periodontally healthy controls. Moreover, the presence of periodontitis was positively correlated with serum HbA1c levels before diabetes onset. CLINICAL RELEVANCE: HbA1c levels were positively correlated with the severity of periodontitis before diabetes onset.


Asunto(s)
Periodontitis , Estudios Transversales , Diabetes Mellitus Tipo 2 , Hemoglobina A Glucada , Humanos , Pérdida de la Inserción Periodontal
6.
Clin Oral Investig ; 24(6): 1971-1979, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31432311

RESUMEN

OBJECTIVE: To evaluate the effects of adjunctive delivery of a sodium hypochlorite gel in the treatment of peri-implant mucositis (PM). MATERIALS AND METHODS: Forty-six subjects with 68 implants diagnosed with PM were randomly assigned to two treatment groups. Prior to mechanical debridement, a sodium hypochlorite gel was delivered to the implants of the test group while implants of the control group received a placebo gel. Application of both test and placebo gels was repeated 5 times at baseline. The primary outcome variable was the change in pocket probing depth (PPD) between baseline and 6 months. RESULTS: After 6 months, the mean PPD decreased statistically significantly from 3.93 ± 1.09 mm to 3.04 ± 0.46 mm in the test (p = 0.0001) and from 3.68 ± 0.85 mm to 3.07 ± 0.58 mm in the control (p = 0.0001) group, respectively. No statistically significant difference (p = 0.53) was observed with respect to PPD changes from baseline to 6 months between test (0.88 ± 1.04 mm) and control group (0.61 ± 0.75 mm), respectively. The number of implants with bleeding on probing (BoP) decreased statistically significantly from 33 to 18 in the test group (p = 0.0001) and from 34 to 23 in the control group (p = 0.0001) after 6 months. CONCLUSIONS: In conclusion and within the limits of the present study, changes in PPD from baseline to 6 months were not statistically significantly different between groups. Complete resolution of mucosal inflammation was not achieved with either of the therapies. CLINICAL RELEVANCE: The present outcomes have showed that a complete resolution of peri-implant mucositis is not possible to obtain by means mechanical debridement with or without a sodium hypochlorite gel application.


Asunto(s)
Implantes Dentales , Mucositis , Periimplantitis , Hipoclorito de Sodio , Estomatitis , Geles , Humanos , Mucositis/tratamiento farmacológico , Mucositis/etiología , Periimplantitis/complicaciones , Periimplantitis/tratamiento farmacológico , Índice Periodontal , Hipoclorito de Sodio/uso terapéutico , Estomatitis/tratamiento farmacológico , Resultado del Tratamiento
7.
Oral Health Prev Dent ; 18(1): 355-361, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-31268048

RESUMEN

PURPOSE: C1-inhibitor (C1-INH) related hereditary angioedema (C1-INH-HAE) is a rare pathological condition caused by a deficiency or a functional alteration of serum protein C1-INH. Clinical manifestations are represented by recurrent, potentially life-threatening episodes of cutaneous or mucosal oedema. The present study analysed the effectiveness of a specific short-term prophylaxis protocol for the management of C1-INH-HAE patients requiring chronic periodontitis treatment. MATERIALS AND METHODS: Ten consecutive C1-INH-HAE patients with mild to moderate chronic periodontitis were treated by non-surgical periodontal therapy with a full-mouth scaling approach (FMS) in two sessions 24 h apart. All patients underwent a short-term prophylaxis protocol of acute attacks based on the association of attenuated androgen (danazol), from 5 days before the first FMS session to 2 days after the second FMS session, and C1-INH concentrate given 1 h before the first FMS session. Patients were examined for periodontal changes over a 6-month period. RESULTS: None of patients developed complications or oedema up to 1 week postoperatively. Compared to baseline, scaling and root planing (SRP) treatment yielded, at 6 months, a statistically significant improvement in probing depth (PD) (baseline: 5.24 mm ± 0.85 mm vs 6 months: 2.96 ± 0.31 mm), clinical attachment level (CAL) (baseline: 5.46 ± 0.81 vs 6 months: 3.89 ± 0.38 mm), full-mouth bleeding score (FMBS) (baseline: 27.6 ± 2.2% vs 6 months: 18.5 ± 2.1%) and in full-mouth plaque score (FMPS) (baseline: 28.6 ± 2.4% vs 6 months: 21.66 ± 3.3%). CONCLUSIONS: This study showed the clinical effectiveness of the reported prophylaxis protocol in preventing acute attacks in HAE patients requiring non-surgical periodontal treatment, with no complications up to 1 week after FMS.


Asunto(s)
Angioedemas Hereditarios , Periodontitis Crónica , Raspado Dental , Humanos , Aplanamiento de la Raíz , Resultado del Tratamiento
8.
Clin Oral Investig ; 24(2): 1013-1023, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31286260

RESUMEN

OBJECTIVES: To assess dimensional changes following alveolar ridge preservation using bovine-derived xenograft with 10% collagen and collagen membrane compared to ridge preservation by means of bovine-derived xenograft particles and collagen membrane or spontaneous healing in posterior sites. MATERIALS AND METHODS: Forty subjects with 40 posterior teeth or roots candidate to extraction and presenting integrity of alveolar bone walls were randomly allocated into three groups. Patients of test group were treated by ridge preservation technique using bovine-derived xenograft with 10% collagen and collagen membrane; patients of control group 1 were treated by means of bovine-derived xenograft particles and collagen membrane while in patients of control group 2, no grafting was performed. Changes in vertical and horizontal bone dimensions were compared at baseline and after 6-month observation time. RESULTS: Statistically significant differences between baseline and 6 month were observed in all groups in terms of vertical and horizontal bone resorption (p < 0.001), except for vertical resorption in control group 2. After 6-month intergroup comparisons showed not statistically significant changes between test and control groups in terms of alveolar bone changes (p > 0.05). CONCLUSIONS: Within the limits of this study, the sites grafted using bovine-derived xenograft with 10% collagen in combination with a collagen membrane showed no statistical differences in terms of vertical and horizontal bone resorption compared to control groups. CLINICAL RELEVANCE: Ridge preservation in posterior area failed to show clinically relevant benefits in sites presenting integrity of alveolar bone walls and adequate buccal bone wall thickness.


Asunto(s)
Pérdida de Hueso Alveolar , Proceso Alveolar , Aumento de la Cresta Alveolar , Animales , Bovinos , Colágeno , Xenoinjertos , Humanos , Extracción Dental , Alveolo Dental
9.
Quintessence Int ; 51(1): 28-36, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31463483

RESUMEN

OBJECTIVES: To assess the stability of soft tissues around implants by comparing mucosal recessions in patients with keratinized mucosa (test) with patients without keratinized mucosa (control) around osseointegrated dental implants. METHOD AND MATERIALS: The PICO criteria used were as follows: Population, patients with osseointegrated dental implants; Intervention/exposure, presence of a keratinized mucosa; Comparison/control, absence of keratinized mucosa; Outcome, presence or absence of peri-implant mucosal recessions (mm). DATA SOURCES: An electronic search of Medline, Embase, and Cochrane Oral Health Group specialist trials supplemented by manual searching was conducted to identify studies reporting outcomes of at least 5 years on the presence of mucosal recessions at implants with or without attached mucosa. Mucosal recession (MR) was set as primary outcome. Prospective cohort studies published in English language up to October 2018, with a mean follow-up period of at least 5 years, reporting keratinized tissue height ≥ 2 mm and < 2 mm or presence/absence of keratinized tissue, with fixed implant-supported prostheses. The homogeneity of studies was assessed by DerSimonian and Laird test (Q test). The differences in terms of gingival recession around implants reported between test groups (keratinized mucosa ≥ 2 mm) and control (keratinized mucosa < 2 mm or no keratinized mucosa) were compared. Two studies reporting 201 patients with 514 tissue level implants were selected for the final analysis. RESULTS: Due to the high heterogeneity between the selected studies, no statistical test could be performed. However, in both studies a deeper mucosal recession occurred when keratinized mucosa was < 2 mm: 0.61 ± 0.10 (-0.90; -0.32) and -1.92 ± 0.12 (-2.16; -1.68), respectively. CONCLUSION: Within their limitations, the findings indicate that after a mean observation period of at least 5 years, the presence of keratinized mucosa may lead to less mucosal recession at dental implants.


Asunto(s)
Implantes Dentales , Recesión Gingival , Implantación Dental Endoósea , Encía , Humanos , Membrana Mucosa , Estudios Prospectivos
10.
Artículo en Inglés | MEDLINE | ID: mdl-31226192

RESUMEN

The purpose of this study was to assess the healing of periodontal intrabony defects treated using enamel matrix derivative (EMD) after at least 5 years of follow-up. Six patients with seven intrabony defects were included in the study. Treatment with EMD yielded a mean clinical attachment level gain of 4.3 ± 2.4 mm, a mean probing depth reduction of 4.7 ± 2.1 mm, and a mean gingival recession increase of 0.7 ± 1.8 mm. Reentry measurements showed a complete resolution of the intrabony defect in five cases, while in two cases a residual intrabony component was recorded. The present study indicates that treatment using EMD provided good clinical outcomes maintained in most cases over a period of at least 5 years.


Asunto(s)
Pérdida de Hueso Alveolar , Proteínas del Esmalte Dental , Recesión Gingival , Estudios de Seguimiento , Regeneración Tisular Guiada Periodontal , Humanos , Pérdida de la Inserción Periodontal , Bolsa Periodontal , Resultado del Tratamiento
11.
Clin Oral Investig ; 23(5): 2443-2453, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30311061

RESUMEN

OBJECTIVES: This study investigated and compared the effectiveness of a phytotherapeutic drug composed of herbal extracts on postsurgical discomfort after mandibular third molar surgery. MATERIALS AND METHODS: Eighty-two patients requiring the surgical removal of a mandibular third molar were randomly assigned to receive placebo (group 1), ibuprofen (group 2), and a phytotherapeutic drug (composed of baicalin, 190 mg; bromelain, 50 mg; escin, 30 mg) (group 3). Drugs were administered after tooth extraction twice a day for 5 days. The primary outcome, pain, was evaluated using a visual analogue scale at 2 h, 6 h, 12 h, 24 h, 48 h, and 7 and 10 days after surgery. The secondary outcomes were the changes in maximum mouth opening and facial contours (mm) between baseline and at 24 h, 72 h, and 7 and 10 days after surgery. RESULTS: Compared to the baseline, all treatments demonstrated an improvement in the primary and secondary outcomes. Moreover, compared to groups 1 and 2, patients in group 3 yielded a significant reduction of the postoperative pain score at 12 h (p < 0.001), 24 h (p = 0.010), and 48 h (p = 0.048) after surgery. The mean reduction of the swelling and trismus was similar between groups. CONCLUSIONS: The results of this study suggest that a postoperative administration of a phytotherapeutic drug was found to be effective in postoperative pain management after the surgical removal of impacted mandibular third molars. CLINICAL RELEVANCE: The phytotherapeutic drug composed of herbal extract determined a decrease in the severity of postoperative pain compared to ibuprofen and placebo.


Asunto(s)
Dolor Postoperatorio/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Extracción Dental , Diente Impactado/cirugía , Adulto , Método Doble Ciego , Edema/tratamiento farmacológico , Femenino , Humanos , Masculino , Tercer Molar/cirugía , Fitoterapia , Resultado del Tratamiento , Trismo/tratamiento farmacológico , Adulto Joven
12.
Biomed Res Int ; 2018: 8143962, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29984249

RESUMEN

Background: Considerations about heat generation, wear, and corrosion due to some macrostructural bur components (e.g., cutting lips, rake angle, flute, and helix angle) have been widely reported. However, little is known about how the microstructural components of the implant drill surface can influence the implant drill lifetime and clinical performance. Aim: To investigate accurately the surface morphology of surgical bone drill, by means of multivariate and multidimensional statistical analysis, in order to assess roughness parameters able to predict the evolution of tribological phenomena linked to heat development, wear, and corrosion occurring in clinical use. Materials and Methods: The surfaces of implant drills approximately 2.0mm in diameter made by five manufacturers were examined by means of confocal microscope with white light laser interferometry, obtaining several surface roughness parameters. Statistical multivariate analysis based on discriminant analysis showed, for each cut-off, the parameters which discriminate the manufacturers. Results: The microstructural parameters used by discriminant analysis evidenced several differences in terms of drill surface roughness between the five manufacturers. Conclusions: The observed surface roughness difference of drills is able to predict a different durability and clinical performance especially in heat generation and wear onset.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Osteotomía , Huesos , Calor
13.
Clin Oral Investig ; 22(2): 597-615, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29332231

RESUMEN

OBJECTIVE: The most debated topic about medication-related osteonecrosis of the jaws (MRONJ) is its therapy, as there are no definitive guidelines. The aims of this systematic review were (a) to outline the best therapeutic approach according to the stage at diagnosis and (b) to perform a meta-analysis to assess whether the drug-holiday protocol may be or not an effective method in the management of MRONJ patients. MATERIALS AND METHODS: The systematic review was performed following the PRISMA principles. Results were screened according to inclusion and exclusion criteria regarding staging before/after treatment, follow-up, and information provided by the authors. For statistical analysis, linear variables are reported as means and standard deviations, medians, and inter-quartile range (IQR); normality of data, according to the distribution of complete healing (primary outcome variable), was assessed with the Kolmogorov-Smirnov test. A p value < 0.05 was considered statistically significant for all tests. RESULTS: Thirteen studies were selected out of 1480. None of them was case-controlled or randomized. Conservative approach showed good results at early stages, but heterogeneous result at advanced stages (100% stage 0, stage I range 81-97%, stage II range 63.6-100%, stage III 73%). Surgical approach showed heterogeneous results at all stages (stage I range 0-100%, stage II range 52-100%, stage III range 50-100%). Statistical analysis showed a significantly higher prevalence of completely healed sites in patients who followed the drug-holiday protocol. CONCLUSIONS: The results suggest that the current stage-specific approach for MRONJ therapy is based on a sound clinical rationale. Conservative treatment appears to yield better outcomes at early stages, while further investigations are needed to elucidate the best protocols for the management of advanced stages. The drug-holiday protocol statistically promotes complete healing after oral surgery procedures but the application should be dictated by the condition of each patient. CLINICAL RELEVANCE: At present, early MRONJ stages should be primarily treated by means of a conservative approach while more advanced stages must be carefully evaluated. Individual decisions should be made for every single case even with respect to the drug-holiday protocol.


Asunto(s)
Osteonecrosis de los Maxilares Asociada a Difosfonatos/prevención & control , Conservadores de la Densidad Ósea/administración & dosificación , Difosfonatos/administración & dosificación , Privación de Tratamiento , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Conservadores de la Densidad Ósea/efectos adversos , Difosfonatos/efectos adversos , Humanos , Revisiones Sistemáticas como Asunto
14.
Quintessence Int ; 49(1): 69-77, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29114647

RESUMEN

OBJECTIVE: The aim of the present systematic review was to evaluate the periodontal tissue inflammation indexes in patients undergoing different orthodontic treatment. METHOD AND MATERIALS: The Cochrane Oral Health Group specialist trials, Medline, and Embase databases were used for the research. All the included studies had to report bleeding on probing (BOP) depth as primary outcome. Changes in probing depth, clinical attachment level, Gingival Index, and Periodontal Index were included in the review as secondary outcome measurements. RESULTS: Ten studies reporting on 421 patients and different types of orthodontic treatment were selected for the analysis. Owing to the heterogeneity of studies present in the literature, it was not possible to perform a meta-analysis. CONCLUSION: Within their limits, the results showed an increase of periodontal parameters after orthodontic treatment, indicating that it influences the accumulation and composition of the subgingival microbiota and subsequently induces more inflammation and higher BOP.


Asunto(s)
Ortodoncia/métodos , Periodontitis/etiología , Biopelículas , Humanos , Índice Periodontal , Periodontitis/microbiología
15.
Clin Rheumatol ; 36(12): 2733-2741, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28988297

RESUMEN

Systemic sclerosis (SSc) is a multi-system disorder that can have significant adverse effects on the health of the mouth. The aim of this study was to investigate the associations between the disease characteristics of SSc, periodontal disease (PD), and tooth loss. Fifty-four patients affected by SSc and 55 non-diseased controls were matched for age and gender. SSc was characterized in subtypes and with the mean duration of disease and the Modified Rodnan Skin Score [mRSS]. Patients were surveyed and examined through the evaluation of the periodontal parameters and the number of teeth. A logistic regression analysis showed that patients with SSc presented a higher number of missing teeth (p = 0.001) and a significant median increased odds 2.95 (95% CI 1.26 to 6.84) of PD (defined as clinical attachment loss, CAL) compared to nondiseased controls (6.83, 95% CI 1.94 to 24.36). Moreover, the fewer values of PD was correlated with mRSS in the total SSc group and with the mean duration of disease in patients with limited SSc (p = 0.007), even after adjusting this correlation with the presence of the major organ involvement. This study showed that patients with SSc presented increased odds of PD and tooth loss compared to non-diseased controls. In SSc patients, the magnitude of PD was strongly associated with the mRSS and with the mean duration of the disease. The clinicians should be aware of the potential systemic health problems related to PD.


Asunto(s)
Periodontitis/complicaciones , Esclerodermia Sistémica/complicaciones , Pérdida de Diente/complicaciones , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Índice de Severidad de la Enfermedad
16.
Int J Periodontics Restorative Dent ; 37(5): e290-e296, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28817143

RESUMEN

The aim of this study was to evaluate the clinical remodeling of the alveolar socket following the application of bovine-derived xenograft collagen and collagen membrane compared to natural spontaneous healing during the first 6 months following tooth extraction. A total of 20 patients with 20 fresh alveolar sockets were randomly allocated into a test or control group. After a 6-month follow-up period, surgical reentry was performed and implants were placed. Significant statistical differences were recorded in terms of vertical and horizontal bone changes between the test and control groups. Within the limitations of this study, socket preservation procedures may provide more favorable conditions for subsequent implant placement.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Sustitutos de Huesos/uso terapéutico , Colágeno/uso terapéutico , Extracción Dental/efectos adversos , Alveolo Dental/cirugía , Adulto , Proceso Alveolar/patología , Proceso Alveolar/cirugía , Animales , Desarrollo Óseo , Bovinos , Implantación Dental Endoósea/métodos , Femenino , Xenoinjertos , Humanos , Masculino , Extracción Dental/métodos
17.
Clin Oral Implants Res ; 28(7): e16-e20, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27283010

RESUMEN

AIM: To evaluate surface roughness alterations at the smooth neck of dental implants after the use of eight different prophylactic procedures. MATERIALS AND METHODS: 50 tissue level implants (Institut Straumann AG, Basel, Switzerland) were used for the present investigation. The smooth collar of each implant was divided into two segments, each treated with one of eight cleaning procedures: use of a rubber cup (RCZ) or a brush (BZ) combined with an abrasive paste containing zirconium or a paste derived from perlite (RCP, BP); use of 2 composite resin burs reinforced by zirconium glass fibers (F1, F2); and use of an air-polishing system with glycine powder and two power settings (AP1, AP2). The qualitative alterations were recorded by means of a laser profilometer and the mean roughness (Ra ) and mean roughness profile depth (Rz ) were reported. Twenty untreated surfaces were used as controls. RESULTS: The implant collars treated with RCZ (Ra  = 0.33 µm, Rz  = 2.43 µm) or BZ (Ra  = 0.30 µm, Rz  = 3.70 µm) yielded the highest roughness values, followed by the surfaces treated with RCP (Ra  = 0.28 µm, Rz  = 2.02 µm), with BP (Ra  = 0.25 µm, Rz  = 2.16 µm) and by the use of F1 (Ra  = 0.27 µm, Rz  = 2.22 µm) and F2 (Ra  = 0.27 µm, Rz  = 2.04 µm). The lowest roughness values were observed in the AP1 (Ra  = 0.23 µm, Rz  = 1.60 µm) and AP2 (Ra  = 0.16 µm, Rz  = 1.06 µm) group, respectively. Implant collars treated with AP2 yielded statistically significantly lower (P = 0.01) Rz values compared with untreated surfaces. CONCLUSION: All tested procedures did not increase implant surface roughness significantly. Treatment with an air-powder abrasive system at high-pressure setting resulted in a smoothening of the implant collar surface.


Asunto(s)
Implantes Dentales , Pulido Dental/métodos , Óxido de Aluminio/química , Resinas Compuestas/química , Técnicas In Vitro , Ensayo de Materiales , Dióxido de Silicio/química , Propiedades de Superficie , Circonio/química
18.
Int J Oral Maxillofac Implants ; 31(1): 162-6, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26800173

RESUMEN

PURPOSE: The aim of this case series study was to evaluate clinical and radiographic changes of soft and hard tissues around tapered, platform-switched, laser-microtextured implants 24 months after crown placement. MATERIALS AND METHODS: Twenty tapered, platform-switched, laser-microtextured collar implants were placed in 20 patients. Full-mouth plaque score, full-mouth bleeding score, probing depth, and mucosal recession were recorded at the time of crown cementation and after 24 months follow-up. The marginal bone-level changes at the mesial and distal aspects of the implants were calculated by subtracting from baseline and 24-month implant marginal bone level. RESULTS: In terms of the full-mouth plaque score and full-mouth bleeding score, tapered, platform-switched, laser-microtextured implants showed statistically significant improvements at 6 months when compared to baseline (P < .001). Statistically significantly deeper probing depths (P < .001) were found when comparing baseline and at 24 months at mesial, lingual, and distal sites. However, no statistically significant difference was found at the buccal aspects (P = .064). Radiographic marginal bone loss at 2-year follow-up for tapered, platform-switched, laser-microtextured implants was 0.72 ± 0.16 mm and 0.67 ± 0.15 mm at the mesial and distal sites, respectively. CONCLUSION: Within the limits of this study, tapered, platform-switched, laser-microtextured implants maintained marginal bone level (less than 1 mm radiographic bone loss) as well as limited mucosa recession over a 2-year period.


Asunto(s)
Pérdida de Hueso Alveolar/clasificación , Grabado Dental/métodos , Diseño de Implante Dental-Pilar , Implantes Dentales de Diente Único , Rayos Láser , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Estudios de Casos y Controles , Cementación/métodos , Coronas , Índice de Placa Dental , Prótesis Dental de Soporte Implantado , Femenino , Estudios de Seguimiento , Recesión Gingival/clasificación , Humanos , Masculino , Persona de Mediana Edad , Índice Periodontal , Bolsa Periodontal/clasificación , Radiografía de Mordida Lateral , Propiedades de Superficie
19.
Clin Oral Implants Res ; 27(2): e68-73, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25496020

RESUMEN

OBJECTIVES: The aim of this study was to compare the efficacy of different instruments on biofilm removal from implant supported restorations. MATERIALS AND METHODS: The study was designed as comparative multicenter clinical study including patients proceeding from the Milan, Naples, and Buenos Aires, with a peri-implant mucositis. Implants enrolled for the study were allocated in 4 groups and treated with ultrasonic scalers with plastic tips, with titanium curettes, with airflow with glycine powder, and with rubber cup and polishing paste, respectively. mPI was assessed at baseline, immediately after therapy, at 1, 3, and 6 months. mBI, PD, and REC were assessed at baseline, 1, 3, and 6 months. All parameters were recorded on six sites per implant. Kruskal-Wallis and Mann-Whitney tests were used to compare groups and centers. A generalized linear model for repeated measures was chosen for inter-group comparison. An intra-group comparison was performed with repeated measure ANOVA test to assess differences between baseline and recalls. RESULTS: A total of 89 patients (39 males, 50 females) were enrolled in the study, and 141 implants were available for the analysis. 55 implants were enrolled in University of Buenos Aires, 32 in University of Milan, and 54 in University of Naples. There were no significant differences between the four groups in inflammatory status reduction of peri-implant mucosa. CONCLUSIONS: Non-surgical therapy is effective in reducing peri-implant mucositis. Sonic scaler with plastic tip and rubber cup with polishing paste showed higher efficacy when compared with titanium curettes or airflow with glycine powder.


Asunto(s)
Biopelículas , Raspado Dental/instrumentación , Periimplantitis/terapia , Instrumentos Dentales , Diseño de Equipo , Femenino , Humanos , Masculino , Índice Periodontal , Propiedades de Superficie , Resultado del Tratamiento
20.
Artículo en Inglés | MEDLINE | ID: mdl-26509991

RESUMEN

The purpose of the present prospective randomized study was to evaluate the influence of Laser-Lok microtextured surface on soft tissue peri-implant parameters and esthetics around immediate, functionally loaded implants for single-tooth replacement in the esthetic zone. This study included 77 patients divided into two groups based on different implants used: the control group had BioHorizons tapered internal non-Laser-Lok-type implants (NLL; n = 39) and the test group had BioHorizons tapered internal Laser-Lok-type implants (LL; n = 39). Outcome measures were survival, radiographic marginal bone-level changes, soft tissue parameters, and esthetics. One implant was lost in the test group and one in the control group, for a total survival rate of 96.1% after 3 years. Radiographically, mean crestal bone loss ± standard deviation was 0.59 ± 0.27 mm in the LL group compared with 1.17 ± 0.31 mm in the NLL group. A mean gain in papilla level of 0.41 ± 0.34 mm and 0.17 ± 0.36 mm was observed in the LL and the NLL groups, respectively, while the level of the midfacial peri-implant mucosa remained stable in both groups with no statistically significant differences (0.08 ± 0.42 mm for the LL group vs 0.06 ± 0.36 mm for the NLL group). The mean probing depth values in the LL and NLL groups were 0.58 ± 0.2 mm and 1.89 ± 0.3 mm, respectively. Within the limitations of this study, it was demonstrated that the clinical and esthetic outcome of immediate functional loading was more favorable for LL implants than for NLL implants.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales de Diente Único , Encía/anatomía & histología , Anciano , Papila Dental/anatomía & histología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Osteogénesis , Estudios Prospectivos , Radiografía Dental , Resultado del Tratamiento
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