The Evaluation of Enamel Matrix Derivative on the Bone Regenerative Potential of the Dental Implant with the Transcrestal Sinus Floor Elevation Approach: A Randomized, Parallel CBCT Study.

PURPOSE: To evaluate the clinical and radiographic results of simultaneous implant placement using transcrestal sinus floor elevation (TSFE) with and without enamel matrix derivative (EMD) application. MATERIALS AND METHODS: Twenty-four patients were randomly assigned into two groups: The EMD+TSFE group (n = 13 patients, 20 implants) received TSFE with EMD application, and the TSFE group (n = 11 patients, 20 implants) received TSFE without EMD application. The patients were recalled at 3 (T3) and 12 (T12) months postsurgery. The residual bone height (RBH), implant protrusion length (IPL), peri-implant sinus bone level (SBL), endo-sinus bone gain (ESBG), and implant stability (ISQ) were measured. Multivariate regressions were performed for the groups. RESULTS: At T3, the ESBG was 3.72 ± 0.85 mm in the EMD+TSFE group and 3.10 ± 0.05 mm in the TSFE group, and there were statistically significant differences (P < .05). However, there were no statistically significant differences in ESBG at T12 between the groups (P > .05). ISQ values did not show a statistical difference between the groups at T1 and T3, but at T3 in the TSFE+EMD group, there was a statistical increase in the intragroup evaluation compared to the TSFE group. CONCLUSIONS: The use of EMD in TSFE procedures is effective in new bone formation at the apical part of the implant during the early healing period, but in the long term, no significant difference was shown between cases in which EMD was or was not used in terms of new bone formation and primary and secondary stabilization.

Platform-switched implants vs platform-matched implants placed in different implant-abutment interface positions: A prospective randomized clinical and microbiological study.

BACKGROUND: Placement of the implant-abutment interface (IAI) away from the bone crest has been suggested to have positive impacts on maintenance of peri-implant tissues. PURPOSE: To assess the effects of platform-switched and platform-matched implants, taking into consideration the IAI at different positions relative to the bone crest, on clinical, radiographic, and microbiological outcomes during 12 months following functional loading. MATERIALS AND METHODS: The present prospective randomized study was performed upon 70 patients. Group I (n = 23) implants presenting a platform-switched implant-abutment connection design was inserted 1 mm subcrestally. Group II (n = 22) implants with similar properties were inserted crestally. Group III (n = 25) implants presenting a platform-matched approach with an internal hexagon connection design was inserted crestally. The periodontal parameters were assessed at baseline, and 3, 6, and 12 months postloading. Radiographic marginal bone level (MBL) changes were analyzed at the 12-month follow-up. The amount of DNA copies of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Provetalla intermedia and total bacterial mean load in peri-implant sulcus fluid (PISF) were assessed at the same periods. RESULTS: There were no significant differences among the groups with respect to the periodontal parameters for all time periods. At 12-month follow-up, the MBL changes were 0.16 ± 0.29 mm and 0.17 ± 0.23 mm for group I, 0.15 ± 0.25 mm and 0.17 ± 0.26 mm for group II, 0.17 ± 0.26 mm and for group III in mesial and distal sites, respectively. The mean total bacterial load was found significantly higher for group III compared to the other groups in the three interval times (P < .05). CONCLUSION: Implants restored with platform-switching and platform-matching performed equally regarding clinical and radiographic outcomes. Platform-matched implants inserted at the crestal level presented higher the mean bacterial total load in PISF.

Effects of Laser Photobiomodulation and Ozone Therapy on Palatal Epithelial Wound Healing and Patient Morbidity.

OBJECTIVE: The aim of this study was to compare the effects of laser photobiomodulation (PBM) and topical ozone therapy on the reepithelialization of palatal donor site wounds through clinical assessment and computer-aided image analysis and to assess the patient morbidity following free gingival graft (FGG) surgeries. MATERIAL AND METHODS: Thirty-six patients requiring FGG were randomly allocated into three groups: laser group (n = 12), ozone group (n = 12), and control group (n = 12). Epithelialization was evaluated by applying 3% hydrogen peroxide (H2O2) to the wound area and also measured by using digital image analysis (ImageJ). Bland-Altman plots were used for assessing agreement between H2O2 and ImageJ measurements. Parameters in relation to patient morbidity were assessed by using visual analog scale (VAS) on the first 3, 7, 14, and 30 days postoperatively. RESULTS: At day 14, statistically significant smaller wounds were observed with digital image analysis in the ozone group as compared with the control group (p = 0.034). However, intergroup comparison of the remaining wound area evaluated by the clinician using the H2O2 method did not reveal any significant differences (p > 0.05). Nonetheless, according to Bland-Altman analysis, the lower and upper limits showed a moderate agreement between the two measurement methods. The mean VAS sores exhibiting postoperative discomfort was observed to be significantly higher in the control group compared with the laser group (p = 0.002) and ozone group (p < 0.001) at day 7. CONCLUSIONS: Adjunctive ozone therapy could have a significantly beneficial effect on the acceleration of palatal wound healing following FGG procedures. Both PBM and ozone treatment modalities reduced postoperative discomfort as compared with spontaneous healing.

The efficacy of a fluoride chewing gum on salivary fluoride concentration and plaque pH in children.

OBJECTIVES: The purpose of this study was therefore to study the influence of different chewing times on the salivary F concentration and on the recovery of plaque pH directly after a sucrose rinse on both the chewing and the non-chewing side. METHODS: For this purpose, one piece of sugar free chewing gum was chewed to 10 healthy subjects (aged 8-10 years, 5 male and 5 female children). Subjects refrained from toothbrushing for 3 days. On the fourth day, they rinsed for 1 min with 10 microl of a 10% sucrose solutions. After 8 min, chewing gum was given and started to chew for either 5, 10, 20, 30, 45 min or control (sucrose rinse). Thus, altogether six test sessions were repeated at one week intervals. Measurements of F concentration in saliva and pH of approximal plaque were carried out at two contralateral sites for up to 60 min. RESULTS: Higher salivary F concentrations were found on the chewing side than on the non-chewing side (expressed as) (p<0.05). But, the difference between the chewing and the non-chewing side was not obvious for the plaque pH (expressed as AUC) (p>0.05). Therefore, this study showed that: (1) the F concentrations in saliva after chewing a F containing chewing gum had only small numerical differences among the various chewing times, with the exception for 5 min. All chewing time periods showed statistically significant differences between chewing and non-chewing side. (2) The prolonged chewing time increased the plaque pH recovery after a sucrose rinse (p<0.05) but there was no statistically significant difference on both of the chewing and non-chewing side (p>0.05). CONCLUSION: The results of this study indicated that a prolonged chewing time was favorable to the plaque pH recovery after a sucrose rinse and, to a certain extent, to the salivary fluoride concentration. Also it was shown that the F concentration in saliva was strongly dependent on which side the subject chewed on.