Clinical Peri-Implant Parameters and Marginal Bone Loss for Early Mandibular Implant Overdentures: A Follow-Up of 60 Months.

Background and Objectives: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed to evaluate clinical peri-implant parameters and marginal bone loss around early placed and loaded mandibular implant overdentures with a 60-month follow-up. Materials and Methods: In this prospective cohort study, 43 patients were enrolled to receive 86 early loading sub-crestal dental implants through prosthetic guides. Implant overdentures were supported by two isolated implant locator attachments between two mental foramens. Clinical peri-implant parameters, including plaque index (PI), bleeding index (BI), peri-implant pocket depth (PIPD), and marginal bone loss (MBL) were evaluated using standardized techniques at 1, 12, 24, 36, 48, and 60 months follow-up. At 60 months, complications associated with implant overdentures (IOD's) were noted. The mean comparison of peri-implant clinical parameters was performed through ANOVA test. A p-value of ≤0.05 was taken as significant. Results: Out of the total 43 enrolled patients, 8 patients were lost during follow-up; as a result, 35 patients completed the 5 years follow-up. The mean values of PI, BI, and PIPD increased with no statistical difference (p > 0.05). For marginal bone loss, an increase in the mean values was noted at different time intervals with statistical differences (p < 0.001). The most common complications noted were loosening of the abutment, occlusal adjustment, retentive locator loosening and replacement, and relining of the denture. Conclusions: Early placement of IODs failed to prevent bone loss over time and was associated with complications, predominantly consisting of abutment loosening, occlusal adjustments, broken retentive locator components, relining, and rebasing.

Evaluation of Peri-Implant Parameters and Functional Outcome of Immediately Placed and Loaded Mandibular Overdentures: A 5-year Follow-up Study.

PURPOSE: To evaluate the peri-implant parameters of immediately placed and loaded mandibular overdentures over a 5-year follow-up period. MATERIALS AND METHODS: All subjects who had been advised and planned for two-implant mandibular overdenture treatment were included in this study. The peri-implant parameters -including plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) as well as marginal bone loss (MBL) - were assessed. In addition, prosthodontic parameters including abutment-, implant- and denture-related complications were assessed. Patients were evaluated at follow-up visits, scheduled at 1, 12, 24, 36, 48, and 60 months. The data distribution was analysed with the Shapiro-Wilk test. Data within follow-up categories were compared using ANOVA and the Tukey-Kramer test. A p-value < 0.05 was considered statistically significant. RESULTS: Among the 32 participants, 19 were males and 13 were females, with a mean age of 60.5 ± 7.33. The mean plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) varied over time. However, no statistically significant difference was observed in the plaque index, bleeding index and peri-implant pocket depth over time (p > 0.05). The mean value at baseline was found to be -0.9 ± 0.3. The values increased over time, with the highest value observed at 60 months 2.6 ± 0.7, which was statistically significant (p < 0.001). CONCLUSION: Immediately placed and loaded mandibular implant overdentures using two un-splinted implants with locator attachments showed acceptable PI, BI and PIPD at the 5-year follow-up. Statistically significantly greater marginal bone loss was observed from baseline to follow-up, but it was within acceptable limits. A moderate number of restorative and abutment complications were observed during the follow-up of IODs.

Clinical, Bacterial, and Prosthodontic Parameters After Implant Abutment Disinfection Using Nd:YAG, Er,Cr:YSGG, Chlorhexidine, and Conventional Steam Before Prosthesis Delivery.

Objective: This 1-year prospective clinical trial was designed to assess the microbial, clinical, radiographic, and prosthetic parameters after disinfection of the implant abutment connection using Er,Cr:YSGG (erbium, chromium-doped: yttrium, scandium, gallium, and garnet) and Nd:YAG (neodymium-doped yttrium, aluminum, garnet). Materials and methods: All the patients were divided into four groups; Group I: Nd:YAG laser, Group II: Er,Cr:YSGG laser, Group III: 0.2% chlorhexidine (CHx), and Group IV: steam disinfection. Peri-implant parameters assessed included peri-implant bleeding scores (PIBS), peri-implant plaque scores (PIPS), peri-implant pocket depth (PIPD), and crestal bone loss (CBL). The peri-implant plaque samples were acquired to perform microbiological analysis to assess Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, respectively. All measurements were completed at baseline, 6 months, and 12 months postsurgery. Multiple groups were compared with the help of the Bonferroni post-hoc adjustment test (p < 0.01). Logistic regression models were utilized to assess the association between age, oral hygiene practices (brushing and flossing), and duration of implant function. Results: At the baseline level, there were no discernible differences in the peri-implant parameters between the study groups (p > 0.05). At the 6-month (p < 0.01) and 12-month (p < 0.001) follow-ups, all four study groups demonstrated a significant improvement in PIPS and PIBS, with no significant differences between the groups at baseline (p > 0.05). Based on an intergroup comparison, Group I (Nd:YAG) showed a significant decrease in PIBS when compared with the other groups. Group II showed a considerable decrease in PIPD and enhancements in CBL when compared with Groups I, III, and IV (p < 0.01). At the 6- and 12-month follow-up periods, P. gingivalis and T. denticola reduction were found to be statistically higher in Group II, whereas P. gingivalis and T. forsythia mean log CFU/mL were found to be statistically higher in Group I. Conclusions: Nd:YAG and Er,Cr:YSGG lasers both outperformed CHx and steam disinfection in terms of clinical, peri-implant, and prosthetic results when used to clean implant abutments.

Efficacy of adjunct photodynamic therapy on Candida growth and oral health quality of life in denture stomatitis patients with type 2 diabetes mellitus wearing implant-retained overdentures: A randomized clinical study.

AIM: The aim of the present clinical trial was to study the efficacy of combined miconazole and PDT in the improvement of quality of life and levels of Candida species in chronic hyperglycemic patients with denture stomatitis (DS). METHODS: One hundred patients were randomly divided into five groups; 20 each in the miconazole, PDT, miconazole+ PDT, CHX and distilled water groups. Methylene blue mediated irradiation was conducted using 600 nm diode laser with power, energy density and radiance as 100 mW, 3527 mW/cm2 and 9 J, respectively. Patients were advised to apply 2.5 ml of 2% topical miconazole four times a day. The existence of Candida spp. was detected by means of microbiological culture technique. Candida colony counts from the palates and dentures surfaces, quantified as colony forming unit (CFU)/mL were evaluated at baseline, end of 14 days, 28 days and 60 days. Oral health related quality of life was assessed with the help of a questionnaire. RESULTS: The quality of life showed significant improvement in the group where combination treatment was executed. The overall CFU/mL values were greater in the dentures in comparison to those from the palates of the patients of all the five groups. During all time periods of the study, the CFU/mL values obtained from combination treatment group showed significant differences. Candida albicans was the most predominant yeast. CONCLUSION: This study showed the effectiveness of methylene blue- PDT in combination with miconazole in improving oral health related quality of life and significantly reducing Candida CFU counts to resolve palatal inflammation in diabetic individuals with implant-supported complete dentures.

Comparison of the postoperative anti-inflammatory efficacy of chlorhexidine, saline rinses and herbal mouthwashes after mechanical debridement in patients with peri-implant mucositis: A randomized controlled trial.

AIM: The null hypothesis is that there is no difference in the post-operative anti-inflammatory efficacy of chlorhexidine (CHX), 2% saline rinses (SR) and a herbal mouthwash (MW) after non-surgical mechanical debridement (MD) for treatment of peri-implant mucositis (PiM). The aim was to compare the post-operative anti-inflammatory efficacy of CHX, 2% SR and a herbal oral rinse after non-surgical MD of PiM. MATERIALS AND METHODS: The present randomized controlled trial had a single-blinded parallel arm design. Patients diagnosed with PiM were enrolled. Demographic information was recorded. All patients underwent MD and were randomly divided into 4 groups: CHX-group: 0.12% non-alcoholic CHX; Sodium chloride (NaCl) group: 2% NaCl rinses; Herbal MW group: Herbal-based MW and H2 O group: distilled water with peppermint flavour. After MD, all the participants were advised to rinse twice daily (every 12 hrs) for 2 weeks with their respective MWs. In all groups, peri-implant modified plaque index (mPI), modified gingival index (mGI) and probing depth (PD) were measured at baseline and at 12 weeks of follow-up. Sample size was estimated using data from a pilot investigation; and group-comparisons were performed. Statistical significance was confirmed when P-values were below 0.01. RESULTS: Sixty individuals (15 patients/group) were included. At baseline, mPI, mGI and PD were comparable in all groups. At baseline, there was no significant difference in peri-implant mPI, mGI and PD in all groups. At 12-weeks' follow-up, there was a statistically significant reduction in peri-implant mPI (p < 0.01), mGI (p < 0.01) and PD (p < 0.01) in CHX, NaCl and herbal MW groups compared with H2 O group. There was no significant relation between implant location, duration for which, implants were functional, gender and peri-implant clinical parameters in all groups. CONCLUSION: After non-surgical MD, post-operative use of CHX and herbal and NaCl MWs is useful for the management of PiM in the short-term.

Comparison of Whole Salivary Cortisol and Interleukin 1-Beta Levels in Light Cigarette-Smokers and Users of Electronic Nicotine Delivery Systems before and after Non-Surgical Periodontal Therapy.

There are no studies that have compared whole salivary cortisol (CL) and interleukin 1-beta (IL-1ß) levels in cigarette-smokers (CS) and electronic nicotine delivery systems (ENDS)-users before and after non-surgical periodontal therapy (NSPT). The aim was to compare whole salivary CL and IL-1ß levels in light CS and ENDS users before and after non-surgical periodontal therapy (NSPT). Self-reported current CS, ENDS users, and non-smokers were included. A questionnaire was used to collect demographic data. All patients underwent NSPT. Periodontal parameters (probing depth (PD], gingival index (GI], clinical attachment loss (AL], plaque index (PI], and marginal bone loss (MBL]) and whole salivary CL and IL-1ß were measured at baseline. At 3-months of follow-up, clinical parameters and whole salivary CL and IL-1ß were re-assessed. p-values < 1% were arbitrated as statistically significant. Fifty-four individuals (18 CS, 18 ENDS users, and 18 non-smokers) were included. Clinical AL, MT, PD, PI, and MBL were similar in all groups at baseline. At 12-weeks of follow-up, PI (p < 0.01) and PD (p < 0.01) were high in CS and ENDS-users than non-smokers. Among non-smokers, there was a statistically significant correlation between whole salivary cortisol and IL-1ß levels at 12-weeks' follow-up (p < 0.001). There was no difference in whole salivary cortisol and IL-1ß levels in CS and ENDS users at baseline and at 12-weeks follow-up. At 12-weeks of follow-up, there was a significant reduction in IL-1ß (p < 0.01) and CL (p < 0.01) than baseline. In light CS and ENDS users without periodontal disease, clinical periodontal parameters and whole-salivary CL and Il-1ß levels remain unchanged after NSPT.

Dietary Factors Influencing the Caries Status of Adults in Karachi, Pakistan: Initial Findings.

Objective: The objective was to identify the relationship between the dietary factors related to increases in the number of dental caries among an adult population group. Methods: A cross-sectional study was conducted involving adult patients and their accompanying person, aged 18 years and above (n = 1730) visiting the dental outpatient department (OPD) of a public sector tertiary healthcare institute in Karachi, Pakistan. A 39-item Food Frequency Questionnaire (FFQ) was administered to the patients, followed by a dental caries assessment using Radke's WHO criteria. Caries assessment data were transformed into the DMFT Index (D = decayed, M = missing, F = filled teeth). Factor analysis (FA) was performed using Stata v. 11.0, followed by assessing the internal consistency of the FFQ. Multilogistic analysis was performed to explore the association between dental caries (cut-off = 5) and other independent variables, considering a p-value < 0.05 as significant. Results: The mean age of participants in the group was 32.65 ± 10.49 years. The number of female participants (934; 54%) was higher than male participants (796; 46%). Of the total, 951 (52%) participants were married. The internal consistency value for the FFQ, as measured by Cronbach's alpha, was 0.80. In addition to age and gender, out of four dietary patterns, only "cereals" were found to be significantly (p < 0.05) associated with increased DMFT. Conclusion: This study established that the high intake of cereals is a contributory factor to the high prevalence of dental caries among adults.

Influence of Concentration Levels of ß-Tricalcium Phosphate on the Physical Properties of a Dental Adhesive.

Our study assessed the influence of integrating 5% and 10% tricalcium phosphate (ß-TCP-Ca3(PO4)2.) nanoparticles into a dental adhesive on the adhesive's bonding. To evaluate the filler nanoparticles, scanning electron microscopy (SEM), Energy Dispersive X-Ray (EDX) spectroscopy, Fourier-transform infrared (FTIR) spectroscopy, and micro-Raman spectroscopy techniques were used. Shear Bond strength (SBS) testing, degree of conversion (DC) analysis, investigation of the adhesive-dentin interface, and biofilm experiments were conducted. The SEM micrographs revealed non-uniform agglomerates, while the EDX demonstrated the existence of oxygen 'O' (24.2%), phosphorus 'P' (17.4%) and calcium 'Ca' (60.1%) in the ß-TCP nanoparticles. The FTIR and micro-Raman spectra indicated characteristic bands for ß-TCP containing materials. The 10 wt.% ß-TCP adhesive presented the highest SBS values (NTC-10 wt.% ß-TCP: 33.55 ± 3.73 MPa, TC-10 wt.% ß-TCP: 30.50 ± 3.25 MPa), followed by the 5 wt.% ß-TCP adhesive (NTC-5 wt.% ß-TCP: 32.37 ± 3.10 MPa, TC-5 wt.% ß-TCP: 27.75 ± 3.15 MPa). Most of the detected failures after bond strength testing were adhesive in nature. The ß-TCP adhesives demonstrated suitable dentin interaction by forming a hybrid layer (with few or no gaps) and resin tags. The ß-TCP adhesives (10 wt.%) revealed lower DC values compared to control. The incorporation of 5 and 10 wt.% concentrations of ß-TCP particles resulted in an increase in SBS values. A linear decline in DC values was witnessed when the nanoparticle concentration was increased. Further research focusing on exploring the influence of higher filler concentrations on adhesive's properties is recommended.

Association of the Unstimulated Whole Salivary Cytokine IL-1ß Levels with Initial, Moderate and Severe Periodontitis. A Case Control Study.

Periodontitis (P) is a highly prevalent inflammatory disease of the oral cavity. The objective of the study was to evaluate the stages of pro-inflammatory cytokine IL-1ß in initial, moderate and severe periodontitis. One hundred and twenty two patients were included in the study. Periodontitis subjects had at least 20 natural teeth and ≥8 sites with pocket depths of >4 mm and clinical attachment loss (CAL). A questionnaire was used with respect to the socio demographic parameters which included age, gender, ethnicity, education, marital, residence and occupation. To categorize the severity of the disease, teeth were assessed for, Plaque index (PI), Bleeding on probing (BOP), CAL, missing tooth, tooth mobility and bone loss. Unstimulated whole saliva (UWS) was collected and Interleukin-1ß (IL-1ß) cytokine levels were analyzed using enzyme linked immunosorbent assay with microplate reader at 450 nm. Clinical parameters and salivary cytokine concentrations were assessed using one-way analysis of variance, whereas a correlation of cases with gender and severity of periodontitis was evaluated using chi-square test. Fifty-nine patients were healthy controls and 63 were periodontitis patients Thirty two percent (n = 20) had initial periodontitis, 40% (n = 25) suffered from moderate and 29% (n = 18) had severe periodontitis. Periodontitis subgroups were significantly different with regards to age and gender (p < 0.001). The mean PPD and CAL among the periodontitis patients (PPD, 3.52 ± 1.25 mm; CAL, 4.04 ± 1.64 mm) were significantly compromised (p < 0.05) compared to healthy controls (PPD, 1.52 ± 0.73 mm; CAL, 0.08 ± 0.28 mm). Increased levels of IL-1ß were associated with high CAL and PPD findings. UWS IL-1ß levels were higher in periodontitis patients compared to healthy individuals. In addition, cases of severe periodontitis showed significantly higher UWS IL-1ß levels compared to initial and moderate periodontitis patients. Comparative levels of salivary IL-1ß can be potentially used as a diagnostic tool for periodontitis identification and disease progression along with clinical parameters.

Shear bond characteristics and surface roughness of poly-ether-ether-ketone treated with contemporary surface treatment regimes bonded to composite resin.

AIM: To evaluate and compare the influence of contemporary surface treatments of air abrasions, sulfuric acid, and Photodynamic therapy (PDT) on the adhesive bonding and surface roughness of Poly-ether-ether-ketone (PEEK) bonded to resin composite. MATERIAL AND METHODS: One hundred and fifty PEEK (disk-shaped) specimens of 10 mm diameter and 2 mm thickness were prepared. Specimens were subjected to the following surface treatments, Control (no treatment), PDT, air abrasion using Alumina particles (110 µm) (AA-AP), Sulfuric acid (SA), and air abrasion using diamond particles (10-20 µm) AA-DP. Surface roughness (Ra) of treated samples were evaluated using surface profilometer. Universal testing machine was used to evaluate shear bond strength after composite resin build-up. Stereomicroscope was utilized for failure analysis of de-bonded samples of all five groups. Statistical analysis was performed utilizing one-way analysis of variance (ANOVA) to measure means and standard deviations of SBS among studied groups and the means of SBS were paralleled by Tukey multiple comparison tests (p > 0.05). RESULTS: The highest SBS was observed by 98% SA (19.25 ± 0.68 MPa). While specimen treated with PDT (11.69 ± 0.12 MPa) showed the lowest SBS. PEEK surface, treated with PDT and AA-DP demonstrated comparable SBS (p > 0.05). PEEK when pretreated with 98% SA (2.658 ± 0.658 µm) exhibited a significantly higher Ra value as compared to other surface-treated groups (p < 0.05). CONCLUSION: PEEK surface treated with SA showed the highest SBS and surface roughness compared to other groups. Surface roughness of PEEK treated with PDT, AA-AP, and AA-DP demonstrated no difference in Ra. PEEK surface treatment technique should be further investigated to develop reliable adhesive resin bonding.

Peri-implant parameters and bone metabolic markers among water-pipe users treated with photodynamic therapy.

AIM: The study aimed to evaluate the efficacy of Mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of peri­implantitis among waterpipe smokers (WPS) and non-smokers with peri­implantitis MATERIAL AND METHODS: Participants were stratified into two groups. Group 1: Subjects who smoked water pipes for the last 2 years with peri­implant disease were treated with aPDT adjunct to MD and group 2: Participants who did not use water pipes in the last 2 years but have periimplantitis (controls) were treated with MD only. Participants were scrutinized with peri­implantitis (PI) in one dental implant at least based on the inclusion and exclusion criteria. Using structured questionnaire information was gathered from participants. All participants underwent mechanical debridement (MD). Participants of WPS underwent antimicrobial photodynamic therapy (aPDT). Peri implant inflammatory parameters (PI, BI, PD, and CBL) were assessed in all participant at baseline, 3 months and 6 months follow-up. Periimplant sulcular fluid was collected for assessment of bone metabolic biomarkers RANK-L and OPG. For immunological and clinical peri­implant parameters analysis of variance (ANOVA) and Kruskal-Wallis test were used. For multiple comparisons, Bonferroni post hoc test was deployed. RESULTS: Clinical periodontal parameters at baseline were significantly different in the control group PI (49.8 ± 10.5), BI(46.8 ± 7.7), and PD (5.0 ± 1.8) compared to WPS PI (56.1 ± 12.0), BI (40.9 ± 8.3), and PD (5.6 ± 1.5) (p < 0.05). At 3 months follow-up after PDT, PI (19.1 ± 7.7) and PD (3.9 ± 1.4) were significantly lower in the control group compared to WPS group PI (23.5 ± 8.4) and PD (4.5 ± 1.2) (p < 0.05). Whereas, BI of control (16.3 ± 6.8) and WPS group (17.1 ± 5.3) at 3 months follow-up was comparable (p > 0.05). At six months follow up following PDT, PI (15.7 ± 5.5) and PD (3.4 ± 1.2) was significantly lower in the control group compared to participants with water piped users PI (18.6 ± 7.4) and PD (3.9 ± 1.3) (p < 0.05). No significant difference was noted in BI in both groups (p > 0.05). Participants treated with PDT adjunct to MD demonstrated significantly reduced mean RANK-L levels at both 3 and 6 months (p<0.05). CONCLUSION: aPDT adjunctive to MD improved periodontal parameters i.e., plaque index, pocket depth, and crestal bone loss along with metabolic marker RANK-L in water pipe smokers compared to non piped smokers.

Infection control awareness level among dental laboratory technicians, Riyadh, Saudi Arabia.

AIMS AND OBJECTIVES: Infection control is an essential part in dental practices. Potential disease transmission in the dental lab is well documented. Dental technicians should strictly adhere to the standard precautions in order to prevent potential risks of cross-contamination, thereby producing a safe environment for patients and staff. The aim of this study was to evaluate the knowledge, attitude, and practice among dental lab technicians toward infection control protocols at the dental laboratories of Riyadh. MATERIALS AND METHODS: A self-administered questionnaire will be distributed to dental lab technicians working at both private and governmental laboratories in Riyadh, Saudi Arabia. Data were collected from one hundred and twenty-one dental laboratory technicians. RESULTS: According to the findings, only 42.9% had an infection control manual display in the dental lab, 43.8% had received infection control training courses as part of their orientation, 40.4% of the technicians had a valid hepatitis B vaccination. Dental technicians are exposed to high risk of injuries, 72.7% of respondents answered Yes, when they were asked about reporting sharp injuries to laboratory administration. CONCLUSION: There was poor compliance to infection control procedures, dental techniques are at increased risk of cross-contamination and infection, they have limited orientation and knowledge on the infection control guideline and policy.

Influence of time and hydration (ageing) on flexural strength of Yttrium stabilized Zirconia polycrystals (Y-TZP) fabricated with different CAD-CAM Systems.

OBJECTIVES: To evaluate the effect of time and hydration (ageing) on flexural strength of yttrium-stabilized zirconia polycrystals (Y-TZP) zirconia fabricated from three different materials. METHODS: This in-vitro study was performed from June to September 2019. Y-TZP bars, measuring 2 x 3 x 20 mm were prepared and sintered from three different materials, Group-1: LAVA™ Zirconia (3M ESPE, US) (control) Group-2: Vita In-Ceram YZ (VITA, Germany) and Group-3: Aadva™ Zirconia (Zr) (GC Advanced technologies Inc.). 30 zirconia bars per group were prepared using sectioning of blocks with isomet saw. Followed by sintering in furnaces for recommended temperature cycles. One side of bars were polished and beveled for flexural testing. Groups of specimens were divided into subgroups of 3 (n=10) based on the ageing (distilled water in the incubator at 37ºC) durations (48 Hrs and two and half years). Ten specimens in each material groups were not aged (controls). Samples were exposed to a static force in a three-point bend test using a universal instron-testing machine until fracture. Scanning electron microscopic assessment was performed for fractured specimens for ageing. Data was analyzed using ANOVA and Tukey post hoc test. RESULTS: The mean flexural strength at baseline for Group-1: LAVA™ Zirconia, group (632.7 ± 136.5 MPa) 2: Vita In-Ceram YZ (1036.3 ± 229.6 MPa), and Group-3: Aadva™ Zirconia (1171.3 ± 266.3 MPa) were significantly different. Group-2 and Group-3 specimens showed higher strength compared to Group-1 specimens, irrespective of the ageing duration (p<0.05). Analysis of pooled data for flexural strength for materials by aging period (baseline, after 48 hours and after 2 and ½ years) showed that there was significant reduction of strength with increasing duration (p<0.05). CONCLUSIONS: Y-TZP showed variations in flexural strength depending on the material type. Ageing duration exhibited significant influence on the flexural strength of Y-TZP when comparing no ageing to two and half years. Vita In-Ceram YZ and Aadva Zirconia (Zr) showed higher and clinically acceptable flexural strength outcomes.

Assessment of self-rated pain perception and whole salivary cortisol levels among adolescents with and without temporomandibular disorders.

Objective: To assess the self-perceived pain perception (PP) and whole salivary cortisol levels (CL) among adolescents with and without temporomandibular disorders (TMD).Methods: Adolescents between 15 and 17 years were included. Participants were categorized into three groups: Group 1: patients with TMD; Group 2: nocturnalbruxers without TMD; and Group 3: controls. Demographic data CL and self-rated PP were assessed. A p-value < 0.05 was proposed as statistically significant.Results: Fifty-four patients (18 per group) were included. Scores of self-rated PP in the affected TMJ were higher in Group 1 than Group 2 (p < 0.001). Whole salivary CL were higher in groups 1 and 2 (p < 0.01) than in Group 3. Whole salivary CL were higher in Group 2 than Group 3 (p < 0.05).Conclusion: Whole salivary CL are higher in adolescents with TMD, and there is a direct relationship between self-rated PP in the TMJ area and salivary CL.

Influence of contemporary CAD-CAM milling systems on the fit and adaptation of partially stabilized Zirconia fixed partial dentures.

OBJECTIVE: To evaluate marginal fit and internal adaptation of three-unit Zr frameworks fabricated from four Zr CAD/CAM milling systems. METHODS: Fixed partial denture models were replicated (40 stone models) using Polyvinyl Siloxane impression material (PVS) and type IV stone for Zr framework fabrication. FPDs were milled with four CAD/CAM systems, Group-II: LAVAL Zirconia milled by LAVA , Group-2: Vita In-Ceram YZ milled by Cerec®, Group-3: Zirconia milled by GM1000 and Group-4: Zirconia milled by DWX-50N. Twelve marginal gap measurements per framework were performed at pre-established points, with a metallurgical microscope (Zeiss, Germany) at 500X magnification. Eight measurements of cement space per section were performed for adaptation. Data was analyzed using ANOVA and Tukey post hoc test. RESULTS: Zirconia FPD frameworks exhibited gaps ranging from 16 to 50.1 µm for marginal fit and 26.8 to 102.5 µm for internal adaptation. Group-3 [20.8 (8.3) µm & 50.3 (11.4) µm] and Group-4 [16.0 (4.0) µm & 40.2 (8.8) µm] specimens showed significantly lower marginal fit and internal adaptation gaps compared to Group-I [50.1 (13.4) µm & 100.5 (16.7) µm] and Group-2 [38.9 (8.2) µm & 102.5 (13.4) µm] specimens respectively. CONCLUSIONS: Different CAD-CAM systems for fabrication of Zr FPD frameworks displayed a significant influence on marginal fit and internal adaptation of restorations.

Influence of milling systems and marginal configurations on the fit of yttrium stabilized tetragonal zirconia polycrystals (Y-TZP)' copings.

OBJECTIVE: The aim of this study was to evaluate marginal fit of yttrium tetragonal zirconia polycrystals (Y-TZP)' copings with different finish line designs fabricated with various digital scanners and milling systems. METHODS: Three model plastic teeth were prepared with three finish line designs: Design-1, continuous chamfer; Design-2, chamfer with shallow depression; Design-3, chamfer with deep depression. The "master models" were replicated using elastomeric polyvinyl siloxane impression material and poured in type IV stone generating 90 dies, 30 dies for each design. Dies were scanned and copings were milled utilizing three digital scanners and computer-aided design/computer-aided manufacturing (CAD/CAM) systems: System-1, InEos Red Scan (Sirona Dental Systems, Germany), Vitablocks® Mark II (VITA, Germany) copings milled by Cerec® inLab (Sirona Dental Systems, Germany); System-2, Cerec® AC Connect with BlueCam (Sirona Dental Systems, Germany), Vitablocks® Mark II (VITA, Germany) copings milled by Cerec® inLab (Sirona Dental Systems, Germany); and System-3, NobleProcera™ Optical Scanner (NobleBiocare™), procera zirconia coping milled by a Noble Procera™ milling machine (NobleBiocare™). Copings were seated on their respective "master models" and secured with uniform force. Eight measurements per coping were performed at pre-established points, with a metallurgical microscope (Zeiss, Germany) connected to a high precision digital video-micrometer (Javelin JV6000, California, USA) at 200 × magnification. RESULTS: The tested systems demonstrated marginal gaps ranging from 12.4 to 26.6 µm. Results for marginal fit of milled copings fabricated using three systems with different finish line designs differed significantly (p < 0.05). Procera zirconia copings scanned and milled with NobleProcera™ exhibited significantly lower marginal gaps compared to other specimen groups. However, InEos Red Scan/Vitablocks® Mark II/Cerec® inLab showed maximum marginal gaps among the study specimens. CONCLUSIONS: CAD-CAM manufactured Y-TZP' copings exhibited marginal gaps ranging from 12.49 to 26.6 µm. The CAD-CAM fabrication system was a significant factor influencing the marginal misfit of Y-TZP' copings. Margin design exhibited system dependent influence on the marginal misfit. Marginal misfit observed for all systems were within clinically acceptable parameters.

Efficacy of Scaling and Root Planing with Photobiomodulation for Treating Periodontitis in Gutka Chewers: A Randomized Controlled Trial.

Objective: To explore the influence of photobiomodulation (PBMT) as an adjuvant to scaling and root planing (SRP) for treating periodontitis among gutka chewers. Materials and methods: Self-reported smokeless-tobacco (gutka) users were enrolled; and underwent SRP with (test group) and without (control group) PBMT. Full-mouth plaque index (P-I), bleeding upon probing (BUP), probing depth (P-D) clinical attachment loss (CAL), marginal bone loss (MBL) (on mesial and distal surfaces of the teeth), and number of missing teeth were recorded before treatment and at 3 and 6 months. Group comparisons were performed and p < 0.05 was referred significant. Results: In the control group, P-I (p < 0.013), BUP (p < 0.001), and P-D (p < 0.012) were high at baseline compared with 3 months follow-up. P-I, BUP, and P-D were higher in the test group, at baseline in comparison with the 3-month (p < 0.001) and 6-month (p < 0.01) follow-up. At 3 and 6 months, scores of P-I, BUP, and P-D were high in the control compared with the test group. No difference in CAL, and mesial and distal MBL was found among patients of both groups at 3 and 6 months. Conclusions: Among gutka chewers, SRP with PBMT is more efficient than SRP alone in the management of periodontitis.

Clinical and radiographic assessment of narrow-diameter and regular-diameter implants in the anterior and posterior jaw: 2 to 6 years of follow-up.

PURPOSE: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. METHODS: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. RESULTS: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. CONCLUSIONS: NDIs in the anterior and posterior jaws functioned equally well in terms of peri-implant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

Influence of body fat in patients with dental implant rehabilitation treated with adjunctive photodynamic therapy.

BACKGROUND: Obesity appears to govern peri-implant hard and soft tissue health. We hypothesized that adjunctive photodynamic therapy (aPDT), improves clinical peri-implant perimeters and alleviates peri-implant crevicular fluid (PICF) levels of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and high sensitivity C-reactive protein (hsCRP) in obese with moderate peri-implantitis. The current clinic-laboratory study aimed to determine whether obesity influences the outcomes of aPDT in patients with moderate peri-implantitis. METHODS: A total of 49 patients (24 obese and 25 non-obese) with moderate periodontitis receiving aPDT were included. Clinical characteristics including peri-implant probing depth (PIPD), peri-implant bleeding on probing (PIBOP), and peri-implant plaque index (PIPI) were measured. PICF levels of TNF-a, IL-6 and hsCRP were assessed using enzyme-linked immunosorbent assay (ELISA). Both clinical and cytokine assessments were performed at baseline, three months and six months, respectively. Intra-group comparisons of changes in clinical parameters pre and post PDT was performed using Friedman test. Comparison of changes of TNF-a, IL-6 and hsCRP levels within group was performed using Kruskal-Wallis test. RESULTS: When compared with the baseline, a considerable reduction in PIPI, PIBOP and PIPD was observed in obese as well as non-obese patients at three- and six-months follow-up. At three months follow-up, a statistically significant difference was observed in PIPI (p < 0.05), PIBOP (p < 0.05) and PIPD (p < 0.05) among obese and non-obese individuals. Additionally, when compared with the baseline, a statistically significant difference was noticed in PICF volume (p < 0.05) and levels of TNF-α (p < 0.05) and IL-6 (p < 0.05) in non-obese as well as obese at three- and six-months follow-up. CONCLUSION: With the application of aPDT, considerable improvement was observed in peri-implant inflammatory parameters among obese and non-obese patients with moderate peri-implantitis. Obesity did not appear to influence aPDT outcome in patients with moderate peri-implantitis.

Assessment of advanced glycation end products in the peri-implant sulcular fluid among moderate cigarette-smokers and nonsmokers with peri-implantitis.

BACKGROUND: It is hypothesized that the levels of advanced glycation end products (AGEs) are higher in the peri-implant sulcular fluid (PISF) of cigarette-smokers than nonsmokers with peri-implantitis. PURPOSE: The purpose was to compare the levels of AGEs in the PISF among moderate cigarette-smokers and nonsmokers with peri-implantitis. MATERIALS AND METHODS: Cigarette-smokers and nonsmokers with peri-implantitis and nonsmokers without peri-implantitis were included. A questionnaire was used to gather information related to smoking habit, duration of implants in function and demographic traits. In all groups, peri-implant plaque index (PI), gingival index (GI), crestal bone loss (CBL) and probing depth (PD). The PISF was collected and levels of AGEs were measured. Group comparisons were performed and P < .01 was nominated as pointer of statistical significance. RESULTS: Fourteen smokers with peri-implantitis (12 males and 2 females), 15 nonsmokers with peri-implantitis (14 males and 1 female) and 15 nonsmokers without peri-implantitis (13 males and 2 females) were included. Smokers with peri-implantitis had a smoking history of 22.7 ± 0.3 pack years. The mesial and distal CBL, PI, and PD were significantly higher in smokers with peri-implantitis than nonsmokers with (P < .01) and without peri-implantitis (P < .01). The GI was significantly higher in smokers (P < .01) and nonsmokers with peri-implantitis (P < .01) compared with nonsmokers without peri-implantitis. The levels of AGEs were significantly higher among smokers with peri-implantitis (552.8 ± 87.2 pg/mL) (P < .01) compared with nonsmokers with (141.6 ± 64.9 pg/mL) and without (88.1 ± 27.3 pg/mL) peri-implantitis. The levels of AGEs were significantly higher among nonsmokers with (141.6 ± 64.9 pg/mL) (P < .01) than without (88.1 ± 27.3 pg/mL) peri-implantitis. CONCLUSION: The levels of AGEs expressed in the PISF are higher among moderate cigarette-smokers than nonsmokers with peri-implantitis.