The stability of implants and microbiological effects following photobiomodulation therapy with one-stage placement: A randomized, controlled, single-blinded, and split-mouth clinical study.

BACKGROUND: Studies have reported a positive effect on bone healing and the elimination of microorganisms placed on the titanium implants, while others have not confirmed the positive photobiomodulation therapy (PBMT) effects on bone regeneration and bone structure around the implants. PURPOSE: The aim of the present study was to address the following questions: Does PBMT improve implant stability and affect microbiota around dental implants in the early stage of osseointegration? MATERIALS AND METHODS: This study was designed as randomized-controlled prospective, split mouth, single-blinded clinical trial. Implants were randomly divided into two groups and implants placed in the test group were treated with Gallium-aluminum-arsenide (GaAlAs) diode laser with PBMT immediately after surgery and for 15 days (n = 47). In the control group, implants were not irradiated(n = 46). The primary stability of the implants was measured by the Resonance frequency analysis (RFA) after insertion and the secondary stability values were recorded at 30th, 60th, and 90th days after surgery as implant stability quotient (ISQ). The hand-held RFA was held perpendicular to the jaw line as indicated by the manufacturer for buccal-lingual (BL), mesial-distal (MD), and lingual-buccal (LB) measurement and different measurements were analyzed as separately. RESULTS: Significantly higher magnetic RFA values were achieved on the 90th day in all measurement sides for both groups. ISQ levels in groups at baseline and the day-30, 60, and 90. ISQ readings were not statistically significant between test and control groups for each time point. A statistically significant increase in ISQ reading for BL, MD, and LB dimensions in both groups was noted from baseline to the day-90 (P < .05). CONCLUSION: It was concluded that PBMT did not have a clinically significant effect on implant stabilization, especially in terms of ISQ values at early alveolar bone healing term. Clinical trial number is NCT04495335.

The Effects of Transcutaneous and Intraoral Low-Level Laser Therapy After Extraction of Lower Third Molars: A Randomized Single Blind, Placebo Controlled Dual-Center Study.

OBJECTIVE AND BACKGROUND: The surgical removal of impacted third molars is one of the most common procedures performed by oral and maxillofacial surgeons. The purpose of this study is to determine whether either transcutaneous or intraoral low-level laser therapy (LLLT) reduces postoperative pain and assists in the healing of mandibular third molar extraction. MATERIALS AND METHODS: This randomized, placebo controlled, single-blind, split-mouth design study was conducted on 60 patients with full bony impacted similar position mandibular third molars bilaterally. The patients were divided into two groups of 30 each: transcutaneous LLLT and intraoral LLLT and the other side of each group treated with nonactive laser (60 teeth). The laser treatment consisted of administering laser energy immediately before and after the extraction procedure with gallium aluminum arsenide (GaAlAs) 830 nm diode lasers. Postoperative pain and healing of the sockets were compared in transcutaneous and intraoral group with placebo for 1 week following the extraction. Descriptive and bivariate statistics was computed, and the p-value was set at 0.05. RESULTS: Intraoral LLLT application resulted in a statistically significant reduction of postoperative pain in comparison with transcutaneous laser group and placebo. The unhealed socket numbers were compared in two groups at seventh day and no differences were observed. CONCLUSIONS: The results of this study suggest that single-session intraoral LLLT is more effective than extraoral application for reducing postoperative pain. It was postulated that the differences between skin and mucosa could have effect on the results. Although intraoral use would allow closer application to the surgical site, the size of some laser devices precludes their use intraorally.

The effects of dental pulp stem cells on bone regeneration in rat calvarial defect model: micro-computed tomography and histomorphometric analysis.

OBJECTIVE: Stem cell therapies may be applicable to all fields of medicine, including craniomaxillofacial surgery. Dental pulp stem cells also have significant osteogenic properties. This study aimed to evaluate the influence of dental pulp stem cells on bone regeneration and to ascertain whether or not there was any superiority over traditional methods. DESIGN: In this study, 15 non-immunodeficient Wistar albino rats were used. The rats were divided into three groups: (1) untreated control group; (2) hydroxyapatite tri-calcium-phosphate (HA/TCP) paste; (3) human dental pulp derived stem cells (DPSC) mixed with HA/TCP paste (HA/TCP+DSPC group, n=10). Two symmetrical full-thickness cranial defects were created on each parietal region (10 defects for each group). The animals were sacrificed 8 weeks post-surgery and samples were analyzed by microcomputer tomography (µ-CT) and histomorphometry. RESULTS: The calcification rate and bone mineral density (BMD) values in Group 3 were found to be significantly higher than in the other two groups. Radiographically, bone regeneration was greater in Group 2 compared with the control group. However, there was no significant difference between Groups 2 and 1 in respect of histological analysis. CONCLUSIONS: According to the results of the present study, DPSCs may be a suitable factor for bone tissue engineering because they can be easily obtained and differentiate into bone cells.

Osteonecrosis of the jaw in patients with multiple myeloma treated with zoledronic acid.

Intravenous bisphosphonates-the potent inhibitors of osteoclast-mediated bone resorption are among the most commonly prescribed drugs in the management of multiple myeloma (MM). Zoledronic acid (ZA) is a new generation potent intravenous bisphosphonate that has been approved for the treatment and prevention of bone lesions, and/or hypercalcemia associated with MM. Osteonecrosis of the jaw (ONJ) is an emerging serious side effect of the new generation bisphosphonates with a growing number of reports related to this pathological entity. ONJ usually appears following oral surgical and dental procedures but sometimes occur spontaneously. These cases are mostly seen and treated by dentists and oral surgeons. The aim of this study was to discuss the frequency, characteristics, risk factors, management and histopathological features of ZA induced ONJ based on the literature and illustrated with five own cases. Thirty-two patients with MM who received ZA for a median period of 26.5 +/- 18.7 months (min: 5 months, max: 76 months) were evaluated. ONJ was detected in five patients and mean drug duration time was 34 months. The frequency was 15% and the patients were usually symptomatic. There was no significant difference in terms of the duration of ZA in patients with and without ONJ. Management of these established cases were performed with medical treatment, minor debridement, sequestrectomy, and combining bone resection with autologous platelet rich plasma. Our data indicate that ZA therapy has a major role in the development of ONJ a fact that should be considered by physicians treating MM patients.