Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: A case report.

The ankylosis of permanent incisors is usually caused by trauma. In a growing patient, the ankylosed tooth fails to move along with the vertical growth of the remaining alveolar process, which results in an infraoccluded tooth, gingival margin disharmony and unaesthetic smile.This case report presents an 23-year-old female patient whose maxillary right central incisor (tooth number 11) had been traumatised eight years earlier. A vertical discrepancy of about 4 mm was exhibited between teeth 11 and 12. To reposition the crown and gingival margins of the ankylosed tooth to an ideal level, single-tooth dento-osseous osteotomy and distraction of the block of bone containing the tooth was planned. In order to separate the roots of adjacent teeth for opening a space for osteotomy incision, fixed orthodontic treatment with multibracket appliances was initiated on her maxilla. After five weeks, a single-tooth dento-osseous osteotomy was performed using a piezoelectric device. To move the tooth in occlusal and buccal directions, two temporary anchorage devices (miniscrews) on her mandible and interarch elastics were applied. Approximately three weeks later, the ankylosed tooth successfully had an ideal position-relative to the adjacent teeth-and a harmonious gingival margin was achieved by minor gingivoplasty on all incisors.

Effect of non-surgical periodontal treatment on three salivary adipokines in diabetic patients with periodontitis.

Background. This study investigated the effect of non-surgical periodontal treatment on clinical indices and salivary levels of visfatin, chemerin, and progranulin in diabetic patients with periodontitis. Methods. This interventional clinical trial was performed on 20 patients with type II diabetes mellitus (T2DM) with moderate to severe chronic periodontitis (periodontitis stages II or III according to the new classification of periodontal diseases). Clinical indices, including gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and plaque index (PI), were recorded and visfatin, chemerin, and progranulin adipokines levels were also measured in unstimulated saliva by ELISA technique at baseline and twelve weeks after non-surgical periodontal treatment. Results. GI dropped from 1.92±0.27 to 0.71±0.14 after the intervention (P<0.001). Also, there were significant changes in the PPD and PI (P<0.001). However, no significant changes were observed in the CAL (P<0.05). The concentrations of all three salivary adipokines decreased after treatment, but this change was statistically significant only for progranulin (P<0.05). Conclusion. Non-surgical periodontal therapy resulted in improvements in the clinical indices of GI, PPD, and PI in T2DM patients with periodontitis. Moreover, the significant reduction in the salivary level of progranulin after treatment suggests that it might be considered a target inflammatory marker in periodontal diseases.

The Effect of Platelet-Rich Fibrin (PRF), Plasma Rich in Growth Factors (PRGF), and Enamel Matrix Proteins (Emdogain) on Migration of Human Gingival Fibroblasts.

STATEMENT OF THE PROBLEM: Platelet preparations such as plasma rich in growth factors (PRGF), platelet-rich fibrin (PRF), or enamel matrix proteins (Emdogain) are commonly used for soft and hard tissue regeneration. However, their comparative effectiveness has not been extensively studied, and a consensus has yet to be reached on their efficacy. PURPOSE: The aim of this in vitro study was to compare the effect of PRF, PRGF, and Emdogain on the proliferation of human gingival fibroblasts (HGF). MATERIALS AND METHOD: Artificial wounds were made in HGF cell culture after the fibroblasts reached nearly 100% of confluence. The study groups included leukocyte and platelet-rich fibrin (LPRF), pure platelet-rich fibrin (PPRF), PRGF and Emdogain. Stained cells were photographed at 48 h and one week and the percent of wound filling was measured. Statistical analysis was performed by one-way ANOVA and p values < 0.05 were considered statistically significant. RESULTS: The highest wound filling percentages at both time intervals were observed in the PPRF group, followed by the PRGF. The lowest percentage of wound healing among test groups was observed in the LPRF while Emdogain yielded modest results. However, statistical analysis showed similar wound healing values in PRGF, PPRF, and Emdogain groups. CONCLUSION: Within the limitations of this study, PRGF, PPRF, and Emdogain were similarly effective in enhancing the fibroblast proliferation and artificial wound closure.

The effect of microthread design on magnitude and distribution of stresses in bone: A three-dimensional finite element analysis.

BACKGROUND: The researches regarding the influence of microthread design variables on the stress distribution in bone and a biomechanically optimal design for implant neck are limited. The aim of the present study is to compare the effect of different microthread designs on crestal bone stress. MATERIALS AND METHODS: Six implant models were constructed for three-dimensional finite element analysis including two thread profile (coarse and fine) with three different lengths of microthreaded neck (1 mm, 2 mm, and 3 mm). A load of 200 N was applied in two angulations (0° and 30°) relative to the long axis of the implant and the resultant maximum von Mises equivalent (EQV), compressive, tensile, and shear stresses were measured. RESULTS: Regardless of loading angle, the highest EQV stress was concentrated in the cortical bone around the implant model using a 1 mm neck of fine microthreads. Under axial loading, there was a negative correlation between the length of the microthreaded neck and stress level in both profiles. However, the same pattern was not observed for coarse microthreads under oblique loads. All types of measured stresses in all constructed models were increased with oblique loading. CONCLUSION: Peak stress levels in implant models varied with microthread profile and direction of loading. The microthread profile seemed more important than the length of the neck in reducing loading stresses exerted on the surrounding bone. Fine microthreads on a 3 mm implant neck showed consistently higher cortical bone stress than other models.

Oral Health Knowledge and Attitudes of Community Health Workers in East Azerbaijan, Iran.

STATEMENT OF THE PROBLEM: Prevention is the key factor in acquiring dental and oral health. Community health workers, as a part of health care networks in Iran, play an important role in delivering primary care and their knowledge and attitude directly affect the population whom they interact with in their service scope. PURPOSE: The aim of this research was to evaluate the knowledge and attitude level of community health workers regarding oral health. MATERIALS AND METHOD: This descriptive analytical study was carried out on 1170 community health workers who were employed in health offices in East Azerbaijan to evaluate their knowledge and attitude level about oral health. Data were acquired through filled out questionnaires and were analyzed by SPSS software. RESULTS: There was no significant statistical relationship between knowledge and gender (p= 0.063), level of education (p= 0.08) and the period spent from the last continuing education course (p= 0.148).However, by increasing age (p= 0.016), work experience (p=0.083) and number of attended continuing education courses (p= 0.023), the knowledge scores were reduced. No statistically significant relationships were found between attitude and any of research variables. CONCLUSION: The level of knowledge and attitude of community health workers in East Azerbaijan regarding oral health was good. There was a reverse relationship between age, work experience, and frequency of participation in continuing education courses and knowledge scores which emphasizes the necessity of continuous training and revising the method of training in education of community health workers and other staffs of health care system.

Antibacterial effect of Iranian green-tea-containing mouthrinse vs chlorhexidine 0.2%: an in vitro study.

PURPOSE: Considering the antioxidant, anti-inflammatory and antimicrobial properties of green tea, this study aimed to evaluate the antibacterial effect of mouthrinses containing green tea extract vs 0.2% chlorhexidine on selected microorganisms in vitro. MATERIALS AND METHODS: The antibacterial activity of both mouthrinses and the pure green tea extract was assessed by using disk diffusion and the minimal inhibitory concentration (MIC) methods against five microorganisms: Streptococcus mutans, Streptococcus sanguis, Enterococcus faecalis, Pseudomonas aerogenosa and Escherichia coli. Growth inhibition zones were measured in mm after 24 h of incubation at 37°C. The two mouthrinses were assessed at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256 and 512 mg/ml to determine the MIC, which was interpreted as the lowest concentration of the agent that completely inhibited the growth of the test species. RESULTS: 0.2% chlorhexidine produced a larger zone of growth inhibition than did the mouthrinse made of green tea extract (P < 0.01). Paradoxically, the growth inhibition zones of the tested bacteria were significantly larger in pure extract of green tea than in 0.2% chlorhexidine (P < 0.01). The chlorhexidine mouthrinse inhibited the growth of all tested species and exhibited significantly lower MICs than did the green tea mouthrinse (P < 0.01). CONCLUSIONS: Even though the mouthrinse made with green tea extract presented an in vitro antimicrobial activity inferior to 0.2% chlorhexidine, the pure extract had considerable bactericidal effect.

Tobacco cessation practices of senior dental students in Iran.

OBJECTIVE: Tobacco use is prevalent in Iran, especially among men. The aim was to assess cessation practices and identify perceived barriers to delivery of tobacco cessation services by Iranian senior dental students. DESIGN: Descriptive, cross-sectional study. SETTING: Iran, Schools of Dentistry, 2009-2010. PARTICIPANTS: 370 (response rate 82%) officially registered senior dental students selected through stratified random sampling. INTERVENTION: Students at 11 dental schools throughout the country completed the survey. MAIN OUTCOME MEASURE: Students' practice of the US Clinical Practice Guideline 5 As (ask, advise, assess, assist, arrange); interest in training; intention and barriers addressing tobacco use in dental settings. RESULTS AND CONCLUSIONS: Respondents were primarily female (67.8%). The students were far more likely to be actively involved in asking, advising and assessing patients to quit than in assisting and arranging. Most respondents (68.5%) agreed that it is within the scope of dental practice to help smokers quit. The most important barriers to providing cessation services included perceived patient resistance (44%) and lack of a supportive organisation (36%). This was the first assessment of approaches to tobacco users by dental students in Iran. Although there clearly is room for improvement, the interest of the students toward tobacco cessation is encouraging.