Inflammatory Impact on Tissues Surrounding the Dental Implant of Singular Abutments Bonded onto Titanium Base - A Randomized Controlled Trial.

Introduction: In dental implants, the biochemical connection between titanium (ti) and bony tissue has been well established. The properties of dental implants such as osseointegration and stability depend upon composition, design of the implant, connection, and design of the abutment, and additional removal of abutments. Recently, laser-generated micro-grooved surface (LSS) and TI abutments are the main focus of preventing peri-implant inflammation. Objectives: To assess the inflammatory impact of singular abutments bonded onto titanium bases on tissues surrounding the dental implant. Methods: Twenty subjects were enrolled. Only those subjects were enrolled who were scheduled to undergo prosthetic rehabilitation of missing teeth. Random division of subjects was done. Group A: Test abutment group and Group B: Control abutment group. The test abutments comprised Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) titanium abutments bonded onto titanium abutments. However, control abutments were customized and only one-piece CAD/CAM titanium abutments were enrolled.On 6 months and 12 months of follow-up, the clinical and radiographic examination was done. Assessment of the bone level changes, clinical variables, and IL-1b levels was assessed. Results: Mean IL-1b levels in Group A subjects at baseline, 6 months, and 12 months were 1.52 pg/mL, 1.69 pg/mL, and 1.55 pg/mL, respectively. Mean IL-1b levels among the patients of group B at baseline, 6 months, and 12 months were 1.56 pg/mL, 1.71 pg/mL, and 1.54 pg/mL, respectively. Conclusion: Within the limitation of the study, it can be concluded that the impact on the inflammatory condition of surrounding tissues of dental implant does not vary significantly between single abutments bonded onto Titanium bases and singular abutments.

Evaluation of low-level laser therapy and platelet-rich fibrin on donor site healing after vascularized interpositional periosteal connective tissue flap: a randomized clinical study.

AIM: To evaluate the effectiveness of platelet-rich fibrin (PRF) and low-level laser therapy (LLLT) on donor site healing after vascularized interpositional periosteal connective tissue (VIP-CT) flap. MATERIALS AND METHODS: For the present clinical study, the selected patients requiring VIP-CT flap were randomly assigned into either of the two treatment groups (VIP-CT/PRF and VIP-CT/LLLT). For VIP-CT/PRF, palatal donor site treated with platelet-rich fibrin (PRF, n = 15) after harvesting VIP-CT flap; and for VIP-CT/LLLT, palatal donor site treated with low-level laser therapy (LLLT, n = 16) after harvesting VIP-CT flap. RESULTS: The mean thickness of palatal mucosa at surgical site was increased from 2.91 ± 0.65 to 2.93 ± 0.55 mm after 1 week and to 3.02 ± 0.55 mm after 12 weeks while in PRF-treated site, while in LLLT-treated sites, palatal mucosal thickness decreased after 1 week from 3.35 ± 0.56 mm to 1.83 ± 0.48 mm and then increase to 3.35 ± 0.55 mm after 12 weeks, and the mean difference was significantly higher for PRF-treated group compared to LLLT-treated group. In regard to contour, absence of hypertrophic tissue was observed in VIP-CT/LLLT compared with VIP-CT/PRF group (40% of patients, p = 0.003) at 4 weeks. "Absence" of pain and burning sensation were observed as early as at 1 week in LLLT-treated palatal donor sites compared to PRF-treated palatal donor site after VIP-CT. Improvement in post-surgical complications like ecchymosis, tissue necrosis, swelling, and infection were observed almost 100% at 4 weeks in both the groups. CONCLUSION: Favourable clinical outcomes in terms of tissue thickness, consistency, color, contour, scar, pain, and burning sensation and patient comfort were obtained in both LLLT- and PRF-treated donor palatal sites at 12 weeks. Non-significant increase in tissue thickness was observed compared to baseline in PRF-treated donor sites at 12 weeks compared to LLLT-treated donor sites. CLINICAL SIGNIFICANCE: Both low-level laser therapy (LLLT) using 940 nm wavelength and autologous platelet-rich fibrin (PRF) can be utilized to enhance early wound healing and reduce the palatal donor site morbidity.

Evaluation of Electrosurgery and Diode Laser in Gingival Depigmentation.

Introduction: Gingival depigmentation is a surgical procedure done to eliminate or reduce gingival hyperpigmentation. Various techniques are employed such as scalpel de-epithelization, gingivectomy, electrosurgery, use of chemical agents, cryosurgery, and lasers. The present study was conducted to assess the efficacy of laser and electrosurgical procedure in reducing gingival pigmentation in terms of pain, wound healing, and recurrence of melanin pigmentation. Methodology: A prospective study was conducted on 40 subjects affected by melanin pigmentation. Group I patients were treated with electrosurgery and Group II patients with diode laser procedure. Evaluation for pain was done intraoperatively, 24 hours and 7 days using VAS. Wound healing and recurrence of pigmentation was assessed at one month and three months. Results: No significant difference was noted between the two groups for pain assessment at 7 days with P > 0.001. Both electrosurgery and laser group showed significant differences between intraoperative time period to 24 hours and 24 hours to 7 days at P < 0.001 for pain. Conclusion: Esthetic demands necessitate cosmetic gingival depigmentation procedure. Laser diode photoablation proves to be an effective and reliable technique in achieving the same.

Retrospective Evaluation of Incidental Findings of Temporomandibular Joint Region in CBCT Scans.

AIM: The present study was undertaken to investigate the occurrence of incidental findings (IFs) in the temporomandibular joint region in cone-beam computed tomography (CBCT) scans. MATERIALS AND METHODS: A total of 1,850 randomly selected scans were examined for IFs in the temporomandibular joint (TMJ) area. IFs of flattening of condyle, condylar hyperplasia, condylar hypoplasia, osteophyte, osteoarthritis, bifid condyle, subchondral pseudocyst, subchondral sclerosis, and soft tissue calcification were evaluated. Data analysis was done using SPSS version 21.0. RESULTS: A prevalence of 59.89% of IFs was noted in the present study. Flattening of the condyle was the most reported IF found in 369 (35.6%). Soft tissue calcifications were found in 294 (28.3%) and cysts in 143 (13.8%). When gender-wise distribution of TMJ IFs was evaluated, highly significant differences were noted between the gender for flattening of condyle, hyperplasia, and osteophytes at p <0.001. CONCLUSION: Dentists must critically evaluate CBCT images for evidence of IFs, so as to ensure comprehensive treatment package and early diagnosis of any disorders. CLINICAL SIGNIFICANCE: CBCT in the recent times is widely used in dentistry for diagnostic purposes. It not only reveals a valuable diagnostic information of the intended site but also the region surrounding it. Findings obtained in the region beyond the intended site are described as IFs, which becomes important in determining an appropriate therapeutic plan. The study was conducted to evaluate the occurrence of IFs in the temporomandibular joint region.

Effect of gingival displacement cord and cordless systems on the closure, displacement, and inflammation of the gingival crevice.

STATEMENT OF PROBLEM: The gingival sulcus should remain open long enough for the impression material to flow into it and completely fill the space provided by the gingival displacement. Impressions with less sulcal width have a higher incidence of voids, tearing of impression materials, and reduction in marginal accuracy. PURPOSE: The purpose of this clinical study was to investigate the closure, gingival displacement, and gingival inflammation of the gingival crevice after the use of medicated gingival displacement cord and cordless systems. MATERIAL AND METHODS: Gingival sulcus closure was studied in 40 participants. They were divided into 4 groups: 2 cord (Ultrapack, SilTrax AS) and 2 cordless (Expasyl, Traxodent Hemodent paste) methods. The labial surfaces of the maxillary right and left central incisors were evaluated. Gingival sulcus was photographed every 20 seconds from 0 to 180 seconds after the removal of the cord or cordless system. The bleeding index (BI) and gingival index (GI) were measured at day 0, day 1, and day 7. The width of the sulcal orifice was measured at the mid-buccal (MB) and transitional line angle (TLA) on a digital image, using computer software (Photoshop version 7.0; Adobe). Data were analyzed with ANOVA, Tukey honest significant difference (HSD), Kruskal-Wallis, and Mann-Whitney U tests (α=.05). RESULTS: All groups showed a sulcal width greater than 0.22 mm up to 60 seconds after the removal of the displacement materials at the MB and up to 40 seconds at the TLA. Among all groups, Expasyl showed the fastest closure. Gingival displacement in the MB area for the cord group was greater than for the cordless groups. GI and BI indices were larger for the cord group than for the cordless group at days 0 and 1. CONCLUSIONS: At up to 60 seconds, the cord and cordless techniques were equally effective. The cord group showed a greater amount of displacement than the cordless group. However, the cordless materials showed reduced frequency of changes to the gingival index.

Treatment Using Functionally Fixed Prosthesis: A Case Report.

Most dental practitioners as well as their patients prefer to have fixed rather than removable prosthesis. However, there are many clinical situations that prohibit the use of the fixed treatment modality. These clinical cases can vary from, simply not having the proper number of healthy teeth and/or implants to, the esthetically challenging cases of high smile lines and severe loss of alveolar support. The approach of using a traditional removable prosthesis in these situations has always been met with severe compromises. The functionally fixed restoration is a third modality of treatment that can solve many of the problems of the removable restoration and at the same time provide the same comfort and success of the fixed prosthesis. This restoration has a pontic assembly that is removed by the patient for periodontal maintenance. This article presents a case report which describes a technique for treatment of partially edentulous maxilla with severe loss of alveolar support using a fixed removable prosthesis/Andrew's bridge.

Lateral sliding bridge flap technique along with platelet rich fibrin and guided tissue regeneration for root coverage.

Gingival recession is defined as the apical migration of the gingival margin with exposure of root surfaces. The etiology of the condition is multifactorial. Given the high rate of gingival recession defects among the general population, it is imperative that dental practitioners have an understanding of the etiology, complications and management of the condition. A recent innovation in dentistry is the preparation and use of platelet-rich fibrin (PRF) for recession defects. The article presents a case report, which highlights the use of lateral sliding bridge flap along with PRF in a collagen membrane carrier (guided tissue regeneration) for the treatment of multiple recession defects.

The comparative evaluation of xanthan gel with chlorhexidine (Chlosite) in smokers and non-smokers: A clinical and microbiological assessment.

BACKGROUND AND OBJECTIVES: Prevention of the periodontal disease progression is the primary goal of periodontal therapy. When conventional therapy is found inadequate to attain periodontal health in chronic periodontitis, local antimicrobial agents have been used as an adjunct with scaling and root planning (SRP) which has reproduced encouraging results. Hence, this study was undertaken to evaluate the new sustained released local drug Chlosite clinically and microbiologically in smokers and non-smokers. MATERIALS AND METHODS: The patients were grouped into experimental group A treated with SRP plus Chlosite (SRP + CHL), experimental group B treated with Chlosite alone (CHL), and control group C treated only with SRP alone. A total number of 141 sites from six patients (67 sites from three non-smoker patients and 74 sites from three smoker patients) participated in this study. The clinical parameters, Plaque index (PI), Gingival index (GI), Bleeding index (BI), and Relative attachment level (RAL), were recorded and subgingival plaque samples were collected and subjected to microbiological analysis. RESULTS: On comparison of smokers and non-smokers, in SRP group, non-smokers showed a higher reduction in BI and GI and smokers showed a higher reduction in PI. There was no significant gain in RAL of both smokers and non-smokers. In SRP + CHL group, non-smokers showed a higher reduction in relation to BI and GI and smokers showed a higher reduction in relation to PI. There was no significant gain in RAL of both smokers and non-smokers. In CHL group, both smokers and non-smokers showed a nonsignificant reduction in BI, GI, and RAL, but smokers showed a significant reduction in PI as compared with non-smokers. All the groups showed reduction in the microbial count of Fusobacterium nucleatum, Porphyromonas gingivalis, and Tannerella forsythia which were found to be statistically not significant when it was compared between non-smokers and smokers. INTERPRETATION AND CONCLUSION: In this study, all treatment groups were found to be efficacious in the treatment of periodontal disease as demonstrated by improvement in PI, GI, BI, and RAL. Combination of SRP and Chlosite resulted in added benefits compared with the two treatment groups.