Evaluation of the effectiveness of diode laser therapy in conjunction with nonsurgical treatment of peri-implantitis.

PURPOSE: Peri-implantitis (PI) is an inflammatory condition associated with the destruction of bone tissue around a dental implant, and diode lasers can be used to treat this disease. In this study, we aimed to evaluate the effectiveness of a 940-nm diode laser for the nonsurgical treatment of PI. METHODS: Twenty patients (8 women and 12 men) were enrolled in a split-mouth randomized controlled study. In the control group (CG), mechanical debridement with titanium curettes accompanied by airflow was performed around the implants. The test group (TG) was treated similarly, but with the use of a diode laser. Clinical measurements (plaque index, gingival index [GI], probing pocket depth [PPD], bleeding on probing [BOP], clinical attachment level, and interleukin-1ß [IL-1ß] in the peri-implant crevicular fluid) were evaluated and recorded at baseline and 3 months. IL-1ß levels were determined using the enzyme-linked immunosorbent assay method. RESULTS: The symptoms were alleviated in both groups at 3 months as assessed through clinical measurements. GI, BOP, and PPD were significantly lower in the TG than in the CG (P<0.05). The IL-1ß level increased post-treatment in both groups, but this increase was only statistically significant (P<0.05) in the CG. CONCLUSIONS: The diode laser enabled improvements in clinical parameters in the peri-implant tissue. However, it did not reduce IL-1ß levels after treatment. Further studies about the use of diode lasers in the treatment of PI will be necessary to evaluate the effects of diode lasers in PI treatment.

Gingival thicknesses of maxillary and mandibular anterior regions in subjects with different craniofacial morphologies.

INTRODUCTION: The aim of this study was to evaluate the mean gingival thicknesses of the maxillary and mandibular anterior regions in subjects with different craniofacial morphologies. METHODS: For each dental arch, 128 periodontally healthy orthodontic patients with normal values of maxillary incisor position (1/NA, angle and distance; and 1/SN, angle) and mandibular incisor position (1/NB, angle and distance; and IMPA) were enrolled in the study. Craniofacial morphology of the participants was evaluated in the sagittal (ANB angle) and vertical directions (SN/GoGn angle) on lateral cephalograms. In the sagittal direction, the subjects were divided into 3 groups as Class I, Class II, and Class III. Each group was classified as low angle, normal, or high angle in the vertical direction. Mean gingival thicknesses of the maxillary and mandibular anterior regions were determined by the ratio of the sum of gingival thickness of the relevant teeth, measured by the transgingival probing technique, to the number of teeth. RESULTS: Mean gingival thicknesses of the maxillary anterior region were 1.173 ± 0.61, 1.103 ± 0.207, and 1.130 ± 0.244 mm in the Class I, Class II, and Class III groups and 1.084 ± 0.150, 1.136 ± 0.247, and 1.159 ± 0.249 mm in the low angle, normal, and high angle groups, respectively. Mean gingival thicknesses of the mandibular anterior region were 0.710 ± 0.156, 0.741 ± 0.176, and 0.691 ± 0.157 mm in the Class I, Class II, and Class III groups and 0.705 ± 0.184, 0.701 ± 0.132, and 0.735 ± 0.174 mm in the low angle, normal, and high angle groups, respectively. No significant difference was found between the groups in terms of the mean gingival thicknesses of the maxillary and mandibular anterior regions. CONCLUSIONS: There was no significant difference between the groups in terms of the mean gingival thicknesses of the maxillary and mandibular anterior regions.

Prevalence of Dental Implants and Evaluation of Peri-implant Bone Levels in Patients Presenting to a Dental School: A Radiographic Cross-Sectional 2-Year Study.

PURPOSE: To evaluate the number of patients with dental implants who present to a dental school clinic for screening and to report the prevalence of peri-implant bone level change detected on digital panoramic radiographs of those subjects. MATERIALS AND METHODS: Patient screening files for 9,422 patients over a 2-year period were examined to see how many patients presented with dental implants. Those patients with at least one implant were further evaluated by measuring the bone level on the mesial and distal sides of the implant using the screening radiograph. RESULTS: A total of 187 patients (2%) had at least one implant. In regard to implants, 423 were examined and 146 (33%) had no detectable bone loss defined as bone level below the top of the implant. When thresholds of bone loss were evaluated, 109 implants (25%) had ≥ 2 mm of bone loss on either the mesial or distal sides or both. The median bone loss was 1.74 mm for the 277 implants with detectable bone loss and 2.97 mm for the 109 implants that had ≥ 2 mm bone loss. Interestingly, patients who were ≥ 70 years of age had significantly (P = .03) more bone loss in the mandible compared with the maxilla, while patients who were 60 to 69 years of age had significantly greater loss in the maxilla. CONCLUSION: These data reveal that for patients presenting to the dental school for a screening over a 2-year period, 1.98% had one or more dental implants. Furthermore, those patients with implants had a minimum amount of bone loss as measured from the top of the implant.

Evaluation of peri-implant crevicular fluid prostaglandin E2 levels in augmented extraction sockets by different biomaterials.

OBJECTIVES: This study compares peri-implant crevicular fluid (PICF) prostaglandin E2 (PGE2) levels, clinical parameters and implant stability quotient (ISQ) values around implants placed in augmented extraction sockets. MATERIALS AND METHODS: The sockets (24 in total) were randomly augmented using either EMD or Bio-Oss Collagen. Implant placements were performed after three months of healing. ISQ readings were evaluated at three points: at the time of surgery, at the first month and at the third month. PICF was collected for PGE2 evaluation after the first and the third months of implant surgery. RESULTS: After the first month, a higher level of PICF PGE2 was observed in the EMD group than in the Bio-Oss Collagen group, and this increase was of statistical significance; however, at the third month there was no statistically significant difference in PICF PGE2 levels between the two groups. For implants placed in EMD sites, ISQ values were statistically higher at the third month than at the first month, while no significant differences in ISQ value were detected between the first and third months in Bio-Oss Collagen sites. CONCLUSIONS: The results of this research suggest that both EMD and Bio-Oss Collagen are effective treatment modalities for stimulating the formation of new bone at extraction sites prior to implant surgery.

Enamel matrix derivative (emdogain) or subepithelial connective tissue graft for the treatment of adjacent multiple gingival recessions: a pilot study.

One treatment approach for achieving healing by regeneration is the application of enamel matrix derivative (EMD) during periodontal surgery. The aim of this randomized clinical study was to compare the efficacy of EMD with a connective tissue graft (CTG) for the treatment of adjacent Miller Class l and II multiple gingival recessions. Twelve systemically healthy subjects with at least two Miller Class I or II multiple gingival recession defects affecting adjacent teeth on both sides of the mouth were enrolled. The surgical protocol was performed for both groups. The 56 recession defects were evaluated for recession depth (RD), recession width (RW), percentage of root coverage (PRC), height of keratinized tissue (HKT), probing depth (PD), and clinical attachment level (CAL). All measurements were repeated at 6 and 12 months. The mean PRC at the final evaluation was 89% ± 17% for the coronally advanced flap (CAF) + EMD group and 93% ± 17% for the CAF + CTG group. Both treatments resulted in statistically significant decreases in RD and RW and increases in HKT at 6 and 12 months. There was also a significant CAL gain for both groups. PD remained shallow over time. The results demonstrated that both procedures were successful in treating Miller Class I and II multiple gingival recessions; however, the greater results of the CAF + CTG group did not reach a statistically significant level.