Does Grafting the Jumping Gap in Immediately Placed Anterior Implants Using Vestibular Socket Therapy Influence the Labial Bone Thickness?

PURPOSE: There is no consensus in the literature on whether grafting the jumping gap (the distance between the inner surface of the labial bone plate and the implant surface) in immediately placed implants influences the thickness of the labial bone plate. This study aimed to compare the efficacy of particulate bone graft filling material and spontaneous bone healing following blood clot formation when placing immediate implants in the esthetic zone. METHODS: A double-blind randomized controlled clinical trial was conducted in a private practice on patients scheduled for immediate implant placement using the vestibular socket therapy between November and December 2019. Participants were assigned to 2 groups. In Group 1, the jumping gap was filled with a mixture of 75% autogenous bone chips and 25% deproteinized bovine bone mineral (DBBM). In Group 2, the gap was unfilled. The regenerated facial bone thickness was evaluated using CBCT. Measurements were taken at baseline before tooth extraction and 12 months postoperatively. The Mann Whitney U test was used for between group comparisons and Wilcoxon signed-rank test for within-group comparisons. RESULTS: Twenty-two patients (8 men and 14 women; mean age, 45.22 years) were randomly assigned to Group 1 or Group 2, with 11 patients each. A statistically significant difference in bone thickness was found between groups (P = .008). The mean (SD) overall bone thickness was 2.95 (0.97) mm for the particulate bone group compared to 1.45 (0.92) mm preoperatively. While, for the unfilled group, the mean (SD) overall bone thickness was 1.98 (0.56) mm compared to 0.79 (0.49) mm preoperatively. CONCLUSIONS: The results suggested that grafting the jumping gap with particulate bone graft when implementing the vestibular socket therapy enhanced the thickness of the labial bone plate of immediately placed implants in the esthetic zone.

A novel comprehensive scoring system for oral lichen planus: A validity, diagnostic accuracy, and clinical sensitivity study.

OBJECTIVES: The objective of this study was to establish and validate a new scoring system for oral lichen planus (OLP). STUDY DESIGN: Forty patients with erosive OLP were scored using a new proposed scoring system and the one suggested by Thongprasom. Statistical analysis was used to calculate inter- and intraexaminer reliability, validity, diagnostic accuracy, and clinical sensitivity for both scores. RESULTS: Concurrent validity showed a significant strong correlation between pain scale and the new score (rs = 0.846) versus Thongprasom's score (rs = 0.665). Interexaminer agreement showed a statistically significant agreement with the biopsy results (kappa = 0.74) for the new score, whereas no agreement was evident with Thongprasom's score (kappa = 0.03163). The diagnostic accuracy of the new score was area under the curve = 0.839, whereas the diagnostic accuracy of Thongprasom's score was area under the curve = 0.667. Significant differences in the scores were detected while comparing the clinical sensitivity of both systems. CONCLUSIONS: The new comprehensive scoring system could be a valid, reproducible, and sensitive tool to accurately assess the severity of OLP. In addition, the proposed scoring system is easily taught, is relatively faster to master, and does not require complicated calculations.

Efficacy of Melatonin in prevention of radiation-induced oral mucositis: A randomized clinical trial.

OBJECTIVES: Evaluating the effectiveness of melatonin in prevention of radiation-induced oral mucositis. MATERIAL AND METHODS: A randomized controlled clinical study was conducted on forty head and neck cancer (HNC) patients undergoing radiotherapy at the Department of Clinical Oncology, Alexandria University, Egypt. Patients were assigned equally to either control group who received conventional treatment or test group who received 20 mg of melatonin along with the conventional treatment. All patients were clinically evaluated for oral mucositis severity and pain at three and six weeks after the start of radiotherapy. Additionally, the total antioxidant capacity (TAC) in patients' saliva samples was assessed at the start of radiotherapy and six weeks later. RESULTS: 92.5% of all patients have experienced oral mucositis with more severity reported in the control group (30%) compared with the test group (5%). Mean pain scores decreased significantly, in the second assessment, in test group rather than the controls. TAC values showed a significant difference between the test and controls with a significant decrease in TAC in the control group. CONCLUSION: The administration of melatonin with conventional treatment has reduced severe oral mucositis development. It aided in decreasing pain and hindering the reduction of TAC resulting from radiotherapy among the test group compared with controls.