Erythritol powder airflow for the treatment of peri-implant mucositis: A randomized controlled clinical trial.

OBJECTIVES: Peri-implant mucositis is a biofilm-related, reversible inflammatory disease that can evolve into peri-implantitis if not adequately treated. The aim of the present randomized controlled clinical trial was to evaluate the efficacy of air-abrasive powder as compared to chlorhexidine (CHX) for the treatment of peri-implant mucositis, in terms of clinical and patient-reported outcomes (PROMs) and occurrence of peri-implantitis 12 months after treatment. METHODS: In the control group, full-mouth calculus and plaque removal was performed with ultrasound and manual devices, and a 1.0% CHX gel was applied; in the test group, supra- and subgingival biofilm removal was performed using erythritol powder with a dedicated nozzle and calculus removal was performed with ultrasonic instruments if needed. Bleeding and plaque indexes, peri-implant probing depth and tissue level were measured at 1 week, and 1, 3, 6 and 12 months after treatment, while PROMs were evaluated up to 7 days after treatment. RESULTS: Among 80 included implants, 70 were analysed at 12 months follow-up (30 in the test group, 40 in the control group, and 20 subjects). Success rates (implant-level) in terms of bleeding index were significantly different between the test (96.7%) and control group (92.5%); as for PROMs, only taste sensation was significantly better in the test group. The test group was significantly correlated to the smallest changes in peri-implant probing depth between baseline and 3 months. CONCLUSIONS: The study showed that both treatment strategies are effective. This suggests that the use of air-abrasive powders could be used as an alternative biofilm removal method instead of adjunctive treatments with antiseptics.

A Proposal for a Multidisciplinary Integrated Oral Health Network for Patients Undergoing Major Orthopaedic Surgery (IOHN-OS).

The passing of the years of life physiologically leads to the accumulation of changes in tissues in the oral cavity, influencing dentition, chewing and swallowing mechanisms, and the oral microbiota. Some diseases and medications can aggravate oral symptoms and negatively influence eating behaviours, increasing the likelihood of becoming malnourished. This could make older individuals more vulnerable to complications when undergoing major orthopaedic surgery. Hidden infection foci in the oral cavity are a recognised cause of post-operative periprosthetic joint infections. Dysfunctional oral problems might also compromise feeding after surgery when good nutrition represents a fundamental aspect of a proper recovery. To manage these shortcomings, in this article, the authors hypothesise a multidisciplinary path of care named the Integrated Oral Health Network applied to major Orthopaedic Surgery (IOHN-OS). This peri-operative initiative would include pre-operative oral health screening and risk management by a dental team, patient education programmes before and after surgery, and bedside gerodontology actions like oral care and meal and eating support for fragile individuals. The IOHN-OS has the potential to reshape the concept of suitability for major orthopaedic surgery and generate momentum for designing community-based surveillance programmes that can keep the mouths of older subjects healthy for a long time.

The Correlation between Intraorifice Distance and the Anatomical Characteristics of the Second Mesiobuccal Canal of Maxillary Molars: A CBCT Study.

Introduction: Missing anatomy is one of the main causes of endodontic failures, and accurate knowledge of teeth anatomy is a prerequisite for adequate root canal treatment. The aim of the present cone beam computed tomography (CBCT) study was to describe the anatomical characteristics of the mesiobuccal (MB) root canals of maxillary molars and to understand if a correlation exists between the position of the canal orifices and the anatomical features of the root. Methods: For the purposes of the study, a total of 100 CBCT scans of maxillary molars with two MB canals were selected and studied. The features of root canal anatomy of the MB root of the same teeth were analyzed and recorded (root length, confluence, and Vertucci classification). The distance between MB1 and MB2 orifices and the palatal orifice were recorded, as well as the distance between the orifices and the line joining the palatal orifice and the others. A statistical analysis was performed by providing descriptive measures, the measure of the correlation between different parameters, and the influence of some of these measures on the presence of a confluence between MB1 and MB2. Results: It resulted that the most frequent configuration is type II Vertucci. The length measured on the sagittal plane was significantly correlated to the presence of a confluence in the MB root. When the root length was higher than 14.56 mm, the confluence is three times more frequent than when the length is lower (OR = 3.635). The area under the curve (AUC) of the receiver operator characteristic (ROC) curve for length on the sagittal plane was 0.632 (P=0.036). Conclusions: The presence of a confluence between the MB canals of maxillary molars is correlated to the length of the root that could be measured on the sagittal plane and to the distance between the canal orifices. The relative position of the root canal orifices in relation to anatomic landmarks needs to be further explored.

The influence of implant position and of prosthetic characteristics on the occurrence of peri-implantitis: a retrospective study on periapical radiographs.

OBJECTIVE: The present retrospective study aimed to investigate the influence of malposition on the occurrence of peri-implantitis. MATERIALS AND METHODS: The study included clinical records of systemically healthy patients with single and partial implant-supported rehabilitations and at least 1-year post-loading follow-up. The parameters collected included implant-related factors, patient-related factors, site-related factors, and prosthesis-related factors. The radiographic measurements were taken by using a dedicated software and the diagnosis of peri-implantitis was made based on all the available clinical and radiographic data. Descriptive statistics were provided for all variables. Following an exploratory approach, an implant-level analysis of factors influencing the occurrence of peri-implantitis was done through a multilevel multivariate logistic regression (mixed). RESULTS: A total of 180 implants belonging to 90 subjects were randomly selected. Malposition showed no statistically significant association with the occurrence of peri-implantitis. According to the multi-level analysis, the parameters that were significantly associated with peri-implantitis included presence / history of periodontitis (OR = 5.945, 95% CI: 1.093 - 32.334, P = 0.039) and presence of an emergence profile angle ≥ 45° (OR = 9.094, 95% CI: 2.017 - 40.995, P = 0.005). CONCLUSIONS: Implant malposition, as defined following Buser's criteria (2004), did not influence the occurrence of peri-implantitis in the selected cohort. Conversely, history of periodontitis and presence of a prosthetic emergence profile with an angle ≥ 45° were correlated to an increased risk of peri-implantitis.

CAD-CAM Titanium Meshes for GBR: A Case Series with Preliminary Histological Analysis.

Titanium has been proposed as a mesh material for GBR since the nineties. To overcome difficulties in shaping and adaptation to the defect, digital elaboration techniques were introduced to digitally print meshes capable of fitting the bone perfectly, reproduced through the CT scan of the patient. Five patients were included in this case series. CBCT data of patients were acquired and sent to the producer of the titanium mesh. 3-dimension regenerative surgery was performed with titanium meshes and a mix of Demineralized Bovine Bone Matrix (DBBM) and Autologous bone (1:1 ratio). Radiographic measures were evaluated on paraxial sections of the CBCT through a dedicated software. When possible, regenerated bone samples were obtained at implant insertion time. Four out of five regenerated areas healed without local and systemic complications. One mesh was removed after two months and two weeks because of exposition. Mean vertical bone gain was 4.3 ± 1.5 mm (range 2.5 - 7 mm). Two histologic samples were obtained. In sample n.1, Bone Tissue Area and Graft Material Area were respectively 44.4% and 12.5%. In sample n.2, the same parameters were 15.6% and 16.9% respectively.

Efficacy of biomaterials for lateral bone augmentation performed with guided bone regeneration. A network meta-analysis.

Bone regeneration is often required concomitant with implant placement to treat a bone fenestration, a dehiscence, and for contouring. This systematic review assessed the impact of different biomaterials employed for guided bone regeneration (GBR) simultaneous to implant placement on the stability of radiographic peri-implant bone levels at ≥12 months of follow-up (focused question 1), as well as on bone defect dimension (width/height) changes at re-assessment after ≥4 months (focused question 2). Only randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared different biomaterials for GBR were considered. A Bayesian network meta-analysis (NMA) was performed using a random-effects model. A ranking probability between treatments was obtained, as well as an estimation of the surface under the cumulative ranking value (SUCRA). Overall, whenever the biological principle of GBR was followed, regeneration occurred in a predictable way, irrespective of the type of biomaterial used. A lower efficacy of GBR treatments was suggested for initially large defects, despite the trend did not reach statistical significance. Regardless of the biomaterial employed, a certain resorption of the augmented bone was observed overtime. While GBR was shown to be a safe and predictable treatment, several complications (including exposure, infection, and soft tissue dehiscence) were reported, which tend to be higher when using cross-linked collagen membranes.

Endodontic Surgery of the Palatal Root of a Maxillary Molar Associated with Simultaneous Management of a Maxillary Sinus Lesion.

This case report describes a particular application of endodontic microsurgery with a palatal approach in the presence of a radiopaque lesion inside the maxillary sinus. The patient presented complaining of pain related to the first maxillary molar and events of nasal obstruction and facial pain in the cheek and nasal area. The endodontic orthograde treatment and retreatment were done, respectively, 7 and 4 years earlier. The cone-beam computed tomography (CBCT) scan taken before the treatment showed two separate lesions: one associated with the palatine root of the molar and another one inside the maxillary sinus. The patient agreed to solve both problems in one surgical step: endodontic surgery of the palatine root with palatal access with the simultaneous asportation of a lesion from the maxillary sinus floor. Complete bone healing of the periapical area and the maxillary sinus was visualized on intra-oral radiographs, and CBCT was taken one year after the treatment. As far as the authors know, no one in literature has ever described this approach and solved in such a conservative way both the problems at the tooth and in the maxillary sinus.

Effect of guided tissue regeneration on the success of surgical endodontic treatment of teeth with endodontic-periodontal lesions: A systematic review.

BACKGROUND: Endodontic-periodontal lesions may need surgical approach and the application of guided tissue regeneration (GTR) to be treated by a combined approach. OBJECTIVES: The aim of the present study was to evaluate the effects of GTR on the success (clinical and radiological healing) of teeth with endodontic-periodontal lesions treated by modern surgical endodontic treatment, by means of a systematic review of the literature. METHODS: An exhaustive electronic (Medline, Embase and Scopus searched from inception to August 2020) and manual literature search combined with strict inclusion and exclusion criteria was undertaken to identify any clinical (prospective case series or comparative trials) studies that assessed the added benefit of GTR in modern surgical endodontic treatment of teeth with endodontic-periodontal lesions. The success of the treatment was assessed based on radiographic healing and clinical evaluations. The risk of bias of the identified studies was evaluated using the Cochrane's collaboration RoB 2.0 tool and the Joanna Briggs Institute (JBI) critical appraisal tools. RESULTS: A systematic literature search for eligible reports retrieved three randomized controlled trials (RCTs) and one prospective single arm study with a total of 125 teeth in 125 subjects. One of the RCTs has a low risk of bias, while the other two raised some concerns, using the RoB 2.0 tool. Due to the heterogeneity of the results, it was not possible to perform a comparative meta-analysis and the results are presented in a narrative manner and by calculating pooled outcomes. Pooling together the data from all the included studies, the reported outcome was of complete healing in 58.4% of all cases, of scar tissue formation/incomplete healing in 24% of cases, of uncertain healing in 12.8% of cases, and of failure in 4.8% of all analysed teeth, with a follow-up ranging from 12 to 60 months. DISCUSSION: The scientific evidence about the use of GTR in modern surgical endodontic treatment of endodontic-periodontal lesion is sparse, and the available results are derived from very heterogeneous studies, thus not permitting to clarify which is the most effective treatment option in these cases. CONCLUSIONS: There is an absence of studies comparing GTR versus no GTR. REGISTRATION: The protocol for this review was registered in the PROSPERO database with the registration ID number CRD42022300470.

Mechanical Resistance of a 2.9-mm-Diameter Dental Implant With a Morse-Taper Implant-Abutment Connection.

Among the complications that can occur at dental implants, the fracture of any implant component is a relatively infrequent but clinically relevant problem. Because of their mechanical characteristics, small diameter implants are at higher risk of such complication. The aim of this laboratory and finite element method (FEM) study was to compare the mechanical behavior of a 2.9- and 3.3-mm-diameter implant with a conical connection under standard static and dynamic conditions, following the International Organization for Standardization (ISO) 14801:2017. Finite element analysis was performed to compare the stress distribution on the tested implant systems under a 300-N, 30° inclined force. Static tests were performed with a load cell of 2 kN; the force was applied on the experimental samples at 30° with respect to the implant-abutment axis, with an arm of 5.5 mm. Fatigue tests were performed with decreasing loads, at 2-Hz frequency, until 3 specimens survived without any damage after 2 million cycles. The emergence profile of the abutment resulted the most stressed area in finite element analysis, with a maximum stress of 5829 and 5480 MPa for 2.9- and 3.3-mm-diameter implant complex, respectively. The mean maximum load resulted in 360 N for 2.9-mm-diameter and 370 N for 3.3-mm-diameter implants. The fatigue limit was recorded to be 220 and 240 N, respectively. Despite the more favorable results of 3.3-mm-diameter implants, the difference between the tested implants could be considered clinically negligible. This is probably due to the conical design of the implant-abutment connection, which has been reported to present low stress values in the implant neck region, thus increasing the fracture resistance.

Laser treatments as an adjunct to non-surgical periodontal therapy in subjects with periodontitis and type 2 diabetes mellitus: a systematic review and meta-analysis.

OBJECTIVES: Periodontal disease and diabetes have an extensively investigated bidirectional correlation. Non-surgical periodontal treatment (NSPT) was proven to contribute to glycemic control. Moreover, it may benefit from the association of adjunctive therapies. The aim of the present systematic review is to assess the clinical efficacy of NSPT in association with laser (LT) or photodynamic therapy (PDT) in controlled or uncontrolled diabetic patients, and to grade the level of evidence. MATERIALS AND METHODS: Randomized controlled clinical trials with at least 3-month follow-up were searched in MEDLINE via OVID, EMBASE, and Cochrane Central, screened for inclusion, and grouped based on the performed treatments, follow-up time, type of diabetes, and level of glycemic control. RESULTS: Eleven RCTs with 504 total subjects were included. The adjunct of PDT showed a statistically significant 6-month difference in PD changes (with low certainty of evidence), but not in CAL changes, while a significant difference in 3-month PD and CAL changes was found with the adjunct of LT (low certainty of evidence). Patients treated with PDT registered a higher decrease in HbA1c levels at 3 months, but no significant difference was noted at 6 months; LT also led to better HbA1c changes at 3 months with a moderate certainty of evidence. CONCLUSION: Despite the promising short-term HbA1c decrease, the results should be interpreted with caution due to the small effect sizes and the statistical heterogeneity, and further evidence from well-designed RCTs is needed to support the routine use of PDT or LT in adjunct to NSPT.

Effectiveness of root resection techniques compared with root canal retreatment or apical surgery for the treatment of apical periodontitis and tooth survival: A systematic review.

BACKGROUND: To manage apical periodontitis in root filled maxillary and mandibular molars, root resection techniques may be employed to avoid the loss of the tooth. OBJECTIVES: The objectives of the study were to systematically analyse the effectiveness of root resection techniques (root resection/crown resection/root amputation) for the management of apical periodontitis with non-surgical root canal retreatment or apical surgery by the evaluation of clinical and patient-related outcomes (PROMS), in human experimental studies and longitudinal studies. METHODS: An electronic literature search in PubMed, MEDLINE via OVID interface, EMBASE and Cochrane Central, supplemented by a manual hand search of the grey literature, was performed up to 25th September 2021. Randomized controlled trials, comparative clinical trials and observational studies reporting on the outcome (tooth survival and patient-reported outcome measures with a minimum follow-up of 1 year) of root resection techniques for treating apical periodontitis were identified. The risk of bias was evaluated using the Newcastle-Ottawa scale. RESULTS: From a total of 2098 reports, 36 were considered for further screening. Three retrospective studies, published between 2018 and 2020, were included in this systematic review. A high heterogeneity in terms of protocols, study design and the reported outcomes were observed. The risk of bias was scored as low to moderate. These three studies consisted of data from 305 resected teeth, from 254 patients, with a follow-up period of 1-16.8 years. Overall, 151 teeth were extracted during the follow-up period. In these studies, root resection treatment was carried out on 42 teeth exclusively for endodontic reasons. One of these studies reported 12 out of 23 teeth lost at follow-up. None of the studies reported on PROMS. DISCUSSION: Although root resection techniques may be used for treating teeth with apical periodontitis, the data are limited. Furthermore, the studies are very heterogeneous and associated with high risk of bias. CONCLUSIONS: Given the current level of available evidence, it is not possible to recommend, or dismiss, root resection techniques for managing apical periodontitis. REGISTRATION: PROSPERO database (CRD42021260306).

Use of an antiseptic rinse (NanArgol) for the oral hygiene maintenance of subjects with fixed appliances: A randomized clinical trial.

BACKGROUND: The risk of periodontal diseases development increased in patients with malocclusion undergoing orthodontic treatment. Thus, the aim of this study was to examine the efficacy of the use of adjunctive rinses with nano-Argentum to standard oral hygiene regimen in subjects wearing fixed orthodontic appliances. MATERIALS AND METHODS: Eighty patients were observed for 1 year. They were divided in two groups: in test group patients were instructed to rinse with non-ionic colloidal silver solution according to protocol for 6 months as an adjunct to standard; in control group the patients followed the standard oral hygiene regimen. Index of efficiency of oral hygiene (PHPm), community periodontal index (CPI) and papillary-marginal-alveolar index (PMA) were evaluated before treatment and after 1 and 6 months. For statistics analysis, Mann-Whitney, Kruskal-Wallis tests and Pearson criterion were used. RESULTS: Baseline hygiene levels in two groups had no differences. Oral hygiene indices were significantly lower in the test group in comparison with control after 1 month (PHPm = 0.38 ± 0.18 and 1.19 ± 0.45, respectively, p < 0.01; PMA = 11.78 ± 8.5 and 47.25 ± 20.9, respectively, p < 0.05; CPI = 0.65 ± 0.53 and 1.53 ± 0.77, respectively, p < 0.01) and 6 months (PHPm = 0.5 ± 0.2 and 1.2 ± 0.4, respectively, p < 0.01; PMA = 11.62 ± 19.6 and 66.33 ± 27.9, respectively, p < 0.01; CPI = 0.63 ± 0.73 and 1.68 ± 0.78, respectively, p < 0.01). CONCLUSIONS: The use of the test solution as an adjunct to standard oral hygiene provided a significant beneficial effect in terms of oral hygiene in patients undergoing orthodontic treatment.

Immediate implant positioning using tooth-derived bone substitute material for alveolar ridge preservation: Preliminary results at 6 months.

OBJECTIVES: In the present study we evaluated the effectiveness of the use of a novel autologous bone substitute derived directly from processing the extracted tooth in the upper premolar area to preserve a suitable esthetic score and functionality. MATERIAL AND METHODS: Fourteen bone-level implants with platform switching were inserted in 12 patients immediately after atraumatic extraction of premolars for restorative or endodontic reasons. The implant buccal bone gap was filled using autologous tooth extracted-derived material. Clinical and radiographic parameters, including Pink Esthetic Score (PES) were evaluated at 6 months. RESULTS: A total of 10 patients accounting for 11 implants were included. PES showed a suitable esthetic result, and all the implant-prosthetic rehabilitation reported full satisfaction for masticatory function, phonetics, and aesthetics. Bone levels were stable and not affected by implant location, lesion type, or bone quality. CONCLUSION: Radiographically the autologous bone substitute used appears stable in the surgical site and there is good continuity between the autologous bone and the graft. No adverse effects such as periodontal inflammation, infection, or graft rejection was reported.

Differentiating Gender and Sex in Dental Research: A Narrative Review.

While in humans the term "sex" refers to the biological attributes that distinguish subjects as male, female, and intersex, the term "gender" refers to psychological, social, and cultural factors that strongly influence attitudes, behaviors, and relationships of individuals. Recently, it has been emphasized how the integration of these two terms in the design of the research can improve the methodology of the research itself. However, in dental research, the influence of gender has not gained enough consideration and it is often used indiscriminately as a synonym for sex. This narrative review discusses the usefulness of considering gender and sex in dental research, whose guidelines have been provided so far on this topic, and whether the top 20 dental scientific journals promote the analysis of sex and gender in their guidelines. Sex and gender analysis in dental research could be important both for analyzing biological differences such as those in the immune or neuro-immune system, cardiovascular physiology, developmental anomalies or deformities, and psychosocial differences such as lifestyle, pain experience and prevalence of chronic pain, eating behavior, and access to healthcare services. As for the specific policies for sex and gender analysis and reporting, only five out of 20 biomedical journals have included them in their editorial policy, which refers mainly to the correct use of the terms "sex" and "gender." In conclusion, we found that no specific and differentiated sex and gender analysis and reporting are required in dental journals. Their integration, which is still not routinely applied, may be improved in the future by updating editorial guidelines and developing more specific methodological recommendations.

Connective tissue graft versus xenogeneic collagen matrix for soft tissue augmentation at implant sites: a randomized-controlled clinical trial.

OBJECTIVES: The purpose of this randomized clinical trial (RCT) is to compare xenogeneic collagen matrix (XCM) versus subepithelial connective tissue graft (SCTG) to increase soft tissue thickness at implant site. MATERIALS AND METHODS: The study was a randomized, parallel-group controlled investigation. Thirty patients underwent buccal soft tissue thickness augmentation at the stage of implant placement by two different methods: SCTG (control group) and XCM (test group). Primary outcome was the amount of buccal soft tissue thickness gain, 3 months after the intervention. Secondary outcomes were the operation time, the amount of keratinized mucosa (KM), pain syndrome (PS), and patients' quality of life (QL). Histologic evaluation was also performed. RESULTS: The amount of soft tissue thickness gain was 1.55±0.11 mm in SCTG group, and 1.18±0.11mm in XCM group. The difference between the SCTG and XCM was -0.366 (-0.66 to -0.07; p=0.016). Operation time with XCM was 8.4 (3.737 to 13.06) min shorter than that with the SCTG (p=0.001). KT, PS, and QL for both groups were not statistically significantly different at any time point (p>0.05). At histological examination, the general picture in both groups was similar. No significant differences between the studied groups in most indices, except for the average and maximum formation thickness, cellularity of the basal, mitotic activity and also maximum length of rete ridges. CONCLUSION: Within limitations, this study demonstrates that the use of SCTG provides a statistically significant superior soft tissue thickness gain than XCM for soft tissue augmentation procedures around implants. CLINICAL RELEVANCE: XCM can be used as the method of choice for increasing the thickness of soft tissues.

Chairside Screening for Undiagnosed Diabetes and Prediabetes in Patients with Periodontitis.

Introduction: Globally, it is estimated that half of all people with diabetes are undiagnosed. Because of the well-documented bidirectional link between diabetes and periodontitis, dentists and dental hygienists may have the possibility to screen a targeted population for diabetes during routine dental visits. The aim of the present study is to investigate the effectiveness of one device for diagnosis of diabetes/prediabetes used in one private dental practice and investigate the correlation between the levels of HbA1c and periodontal parameters. Methods: Periodontal patients that were never diagnosed with diabetes were asked to fill a risk assessment questionnaire for type 2 diabetes mellitus. PD, CAL, FMBS%, FMPS%, and HbA1c through a prick-finger test were measured before and after periodontal therapy or only once in patients following supportive periodontal therapy. Results: A total of 98 subjects were screened, and among them, one had diabetes and 30 had prediabetes. The mean value of HbA1c was 5.62% for patients with untreated periodontitis and 5.42% for periodontally treated patients. The diagnosis of diabetes resulted to be correlated to FMBS% and FMPS%, while HbA1c levels were correlated to FMBS%, FMPS%, and periodontitis grade. Conclusion: The present chairside diabetes-screening protocol allowed a consistent proportion of patients to become aware of their pathological or prepathological condition and to seek proper and timely medical care. Thus, dentists and dental hygienists could provide health promotion services and preventive measures.

EFFICACY OF 67% SODIUM BICARBONATE TOOTHPASTE FOR PLAQUE AND GINGIVITIS CONTROL: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVE: Previous studies demonstrated a dose-dependent efficacy of sodium bicarbonate when added to dentifrices for the mechanical control of dental biofilm. The present systematic review and meta-analysis aimed to evaluate the efficacy of a 67% sodium bicarbonate-based toothpaste for gingival health parameters improvement in subjects with gingivitis. MATERIALS AND METHODS: An electronic search on MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL), was performed using a combination of keywords, followed by a hand search on pertinent Journals. Randomized controlled trials (RCTs) and prospective comparative studies in English language were included. There was no publication date and language restriction. The data regarding gingival, bleeding, and plaque index were extracted from the selected studies. Included studies underwent risk-of-bias assessment. When at least 3 studies reporting the same outcome were found, a meta-analysis was undertaken, to estimate the combined effect. Trial Sequential Analysis (TSA) was also performed to evaluate the power of the meta-analysis for primary outcomes. RESULTS: The search strategy yielded 83 articles. After screening, 7 RCTs were included. Three were at high risk, one at moderate risk, and 3 at low risk-of-bias. Significant improvement of gingival index, bleeding index, and plaque index was observed in patients using 67% sodium bicarbonate toothpaste as compared with control subjects. TSA showed sufficient power for modified Gingival index and bleeding scores. CONCLUSIONS: The clinical use of 67% sodium bicarbonate toothpaste can improve periodontal health in patients with gingivitis.

The effect of the use of proton pump inhibitors, serotonin uptake inhibitors, antihypertensive, and anti-inflammatory drugs on clinical outcomes of functional dental implants: A retrospective study.

OBJECTIVE: The present retrospective study investigated the effect of chronic intake of proton pump inhibitors, selective serotonin uptake inhibitors, anti-inflammatory, and antihypertensive drugs on the survival of dental implants and on the occurrence of peri-implantitis. MATERIALS AND METHODS: Survival analyses for implant failure and peri-implantitis were performed patient level for each drug subcategory and for risk factors. The HR for each drug was calculated with adjusted models as compared with a control group made of subjects not assuming the specific drug. Multilevel logistic regression was used to explore the influence of implant-level and patient-level variables on the outcomes. RESULTS: A total of 270 subjects receiving 1118 dental implants were included, with a mean follow-up time of 5.19 ± 4.22 years. After 10 years, the survival rate was 86.9% (patient level), and according to survival analysis, 61.3% of subjects were free from peri-implantitis. The use of anti-inflammatory medicines produced a significant effect (p = .04) on peri-implantitis as compared to subjects not using the drug, with a 2.7-year drop in the mean survival time. The HR was slightly above the level of significance in a semiadjusted model (p = .058). The multilevel analysis found a significant effect on the entire sample and not when considering only subjects with implants with more than 1-year follow-up. CONCLUSIONS: We found a possible relationship between anti-inflammatory drug use and the occurrence of peri-implantitis in the examined cohort of patients, and no correlation for the other drugs.

Tooth as graft material: Histologic study.

BACKGROUND: An effective regenerative protocol is key to reestablish and maintain the hard and soft tissue dimensions over time. The choice of the graft material and its properties also could have an impact on the results. To prevent alveolar ridge dimensional changes, since numerous graft materials have been suggested and in the past years, a growing interest in teeth material has been observed as a valuable alternative to synthetic biomaterials. AIM: The aim of the study was to explore the histomorphometric outcomes of tooth derivative materials as used as bone substitute material in socket preservation procedure. METHODS: After alveolar socket preservation (ASP) procedures using autologous demineralized tooth as graft material prepared by means of an innovative device, was evaluated. A total of 101 histological samples, from 96 subjects, were analyzed by evaluating the total amount of bone (BV), residual tooth material (residual graft, TT), and vital bone (VB). The section from each sample was then split in nine subsections, resulting in 909 subsections, to allow statistical comparison between the different areas. RESULTS: It was not noticed a statistically significant difference between maxillary and mandibular sites, being the amount of VB in upper jaw sites 37.9 ± 21.9% and 38.0 ± 22.0% in lower jaw sites and the amount of TT was 7.7 ± 12.2% in maxilla and 7.0 ± 11.1% in mandibles. None of the other considered parameters, including defect type and section position, were statistically correlated to the results of the histomorphometric analysis. CONCLUSIONS: ASP procedure using demineralized autologous tooth-derived biomaterial may be a predictable procedure to produce new vital bone potentially capable to support dental implant rehabilitation.