Perception of laypersons, orthodontists, and oral and maxillofacial surgeons about the transverse occlusal plane.

INTRODUCTION: Transverse occlusal plane (TOP) should be parallel to the true horizontal lines of the face (ie, the interpupillary line [IP] and commissural line [CL]). This study aimed to investigate the opinions of laypersons, orthodontists, and oral and maxillofacial surgeons about the impact of imbalanced IP and CL on facial attractiveness. METHODS: We used a symmetrical face image as the reference. Then, using Photoshop software, we constructed the following 6 photographs: TOP roll relative to CL and IP (3° and 6°) with parallelism of CL and IP, CL roll relative to TOP and IP (3° and 6°) with parallelism of TOP and IP, TOP and CL roll relative to IP (3° and 6°). Consequently, the participants rated the photographs on the basis of their attractiveness. Kruskal-Wallis and Mann-Whitney U tests were used to compare the ratings. RESULTS: One hundred thirty-one laypersons, 22 orthodontists, and 20 surgeons participated in this study. It was found that 51.1% of laypersons, 86.4% of orthodontists, and 70% of surgeons selected the reference photograph as the most beautiful, followed by the photograph with a 3° roll of CL relative to TOP, with parallelism of TOP and IP (29% of laypersons, 31.8% of orthodontists, and 35% of surgeons). CONCLUSIONS: Most participants selected the reference photograph as the most beautiful and realized a roll in the horizontal planes up to 3°. The parallelism of the esthetic line of dentition relative to interpupillary is preferred over its parallelism relative to CL.

Is there any relationship between fixed orthodontic treatment and developmental indicators in children and adolescents? A prospective cohort study.

Background: Fixed orthodontic treatment may cause discomfort four to six weeks after the initiation of the treatment as it may change the type and amount of food consumed by children. This temporary change may have a long-term effect on the growth status of such children. This study aimed to detect the longitudinal relationship between fixed orthodontic treatment and developmental indicators in children and adolescents. Methods: The study population encompassed adolescents undergoing fixed orthodontic treatment as the exposure group (n = 30) and adolescents with no orthodontic treatment as the control group (n = 90). The patients' dental age, weight, height, body mass index (BMI), and wrist circumference were assessed at the baseline, as well as 1, 3, and 6 months after the orthodontic treatment. The significance level was set to be p = 0.05. Results: One-hundred twenty participants were included in this study. In the two groups, all growth parameters revealed an increasing trend. In the exposure group, weight-related indices (i.e., weight, BMI, and wrist circumference) decreased in the first month and then increased during the next five months. All indices in the control group and height in the exposure group exhibited a continuous increase. Conclusion: Fixed orthodontic treatment affects childhood growth indices. However, these effects are probably short-term, and the catchup growth mechanism can offset these effects and modify the changes in growth indices. A longer follow-up period is recommended to be considered by future researchers.

Prediction accuracy of Dolphin software for soft-tissue profile in Class I patients undergoing fixed orthodontic treatment.

BACKGROUND: Simulation and prediction can facilitate the decision between an extraction versus nonextraction treatment plan. This study aimed to assess the accuracy of Dolphin Imaging software in predicting profile changes in class I borderline cases. METHODS: In this retrospective study, class I borderline patients (i.e., both extraction and nonextraction treatment plans were possible for them) aged 15-35 years were enrolled. All of the cephalometric analyses were done by Dolphin Imaging software, version 11.8 Premium. The initial cephalograms were superimposed on initial photographs. The final values for the 7 angular and linear landmarks of the upper and lower incisors were extracted from post-treatment cephalograms and inserted in the "Goals" tab of the Dolphin Imaging software. Post-treatment images of patients were simulated. Final post-treatment photographs were superimposed on the simulated pictures. The differences between the real and simulated pictures were calculated in relation to the reference lines. The P value was set at 0.05. RESULTS: A total of 70 patients (36 with tooth extraction, and 34 without tooth extraction) were included. In the extraction group, the horizontal position of both lips was predicted to be significantly more protruded than it actually was, whereas in the nonextraction group, the only difference between the simulated and actual results was that the vertical position of the lower lip, which was simulated as being more inferior than it actually was. CONCLUSIONS: Despite the statistically significant differences between the real and simulated pictures, the differences were small and clinically insignificant. Prediction via Dolphin Imaging software can be an appropriate guide in extraction-nonextraction borderline cases.

Comparing the effect of preparation of the implant sites with piezosurgery and conventional drilling on the stability of implants at 5-months follow-up.

The objective of this study was to compare the effects of preparing for implant site osteotomy with conventional drilling or piezosurgery on the stability of oral implants after a 5 month follow-up period. Thirty patients participated in this randomized clinical trial and received two implants in posterior mandible in bone of the same quality. All surgical procedures were performed by the same surgeon. Implant stability amounts were measured by resonance frequency analysis using the Osstell Mentor device and are reported in the format of implant stability quotient (ISQ) values at baseline and 90 and 150 days after surgery. All implants were well osseointegrated. Differences in ISQ levels were statistically significant in the piezosurgery group at all time intervals, whereas those in the conventional drill group were not significant as analyzed by analysis of variance. The significance of differences between the two groups in each time interval was assessed with Student's t test. In the second interval (90 days), there were statistically significant differences in ISQ levels between the two groups at the buccal, lingual side of implants and mean of two measurements, but at baseline and 150 days, there were no significant differences between these techniques. The early increase of ISQ values in piezoelectric sites shows that piezosurgery is a less traumatic bone osteotomy method with a shorter inflammatory phase and little resorption compared with sites prepared by conventional drilling. ISQ values of up to 60-65 at the time of insertion of the implant predict a good prognosis for immediate implant loading. In this study, the ISQ values were almost always higher than this, offering the safe condition for immediate or early loading protocols after the piezoelectric method of implant site osteotomy. These results may increase predictability of immediate-loading procedure in oral implantology.

Effect of Oral Bromelain on Wound Healing, Pain, and Bleeding at Donor Site Following Free Gingival Grafting: A Clinical Trial.

OBJECTIVES: Considering the optimal efficacy of bromelain for pain relief and wound healing, this study aimed to assess the effect of bromelain on wound healing, pain, and bleeding at the donor site following free gingival grafting (FGG). MATERIALS AND METHODS: This randomized, controlled double-blind clinical trial was performed on 26 patients with gingival recession. The patients were randomly divided into two groups of bromelain and placebo (n=13). Treatment was started on the day of surgery and was continued for 10 days. Pain, bleeding, and epithelialization at the donor site were the variables evaluated in this study using a questionnaire. The level of pain was determined using a visual analog scale (VAS) considering the number of analgesic tablets taken within 7 days postoperatively. Bleeding was determined according to the patient's report, and epithelization was assessed by applying 3% hydrogen peroxide (H2O2) to the donor site. The donor site epithelialization was assessed at 7 and 10 days after surgery. RESULTS: Bromelain caused a significant reduction in pain at the donor site (2.605±0.509) compared to the placebo (4.885±0.519; P<0.05). The number of donor sites with complete epithelialization was higher in the bromelain group compared to the placebo, but this difference was not statistically significant (P>0.05). The two groups were the same regarding postoperative bleeding (P>0.05). CONCLUSIONS: The results showed that oral bromelain (500 mg/day) can be effective in the reduction of pain at the donor site after FGG and may also enhance wound healing. Oral bromelain does not increase the risk of postoperative bleeding.

Comparison of Periodontal Ligament Stem Cells Isolated from the Periodontium of Healthy Teeth and Periodontitis-Affected Teeth.

OBJECTIVES: Stem cell (SC) therapy is a promising technique for tissue regeneration. This study aimed to compare the viability and proliferation ability of periodontal ligament stem cells (PDLSCs) isolated from the periodontium of healthy and periodontitis-affected teeth to obtain an autologous, easily accessible source of SCs for tissue regeneration in periodontitis patients. MATERIALS AND METHODS: The PDLSCs were isolated from the roots of clinically healthy premolars extracted for orthodontic purposes and periodontally involved teeth with hopeless prognosis (with and without phase I periodontal treatment). Cells were cultured and viability and proliferation ability of third passage cells in each group were evaluated using the methyl thiazol tetrazolium assay. The results were statistically analyzed using t-test. RESULTS: No SCs could be obtained from periodontitis-affected teeth without phase I periodontal treatment. The viability of cells was 0.86±0.13 OD/540 in healthy group and 0.4±0.25 OD/540 in periodontitis-affected group (P=0.035). The proliferation ability (population doubling time) of cells obtained from healthy teeth was 4.22±1.23 hours. This value was 2.3±0.35 hours for those obtained from periodontitis-affected teeth (P=0.02). CONCLUSIONS: Viability and proliferation ability of cells isolated from the periodontium of healthy teeth were significantly greater than those of cells isolated from the periodontitis-affected teeth.

Radiographic Evaluation of Bone-Level Implants with Wound Dehiscence between the First- and Second-Stage Surgeries.

BACKGROUND: One of the most common complications of implant surgery is wound dehiscence followed by exposure of the implant to the oral cavity. The aim of this study was to radiographically analyze crestal bone loss around bone-level implants with wound dehiscence between the first- and second-stage surgeries. METHODS: The records of 136 implants inserted during 2013-2014 were evaluated. Patients with no history of systemic disease, drug addiction, radiotherapy, or chemotherapy were selected. Forty-eight implants had cover screws with complete or partial exposure to the oral cavity after the suture removal and before the second surgery. Digital or normal radiographs were taken after the first and during the second surgery and the distance between the implant shoulder and proximal bone crest was measured on the radiographs by 3 calibrated blinded examiners using a digital caliper. RESULTS: The mean amounts of bone loss around the exposed and nonexposed implants were 0.46 ± 0.55 and 0.32 ± 0.46 mm, respectively, with no significant differences between the two groups. CONCLUSION: Wound dehiscence between the first- and second-stage surgeries may increase crestal bone loss in some cases but can be reduced by professional follow-ups and antibacterial treatments.

Effect of Periodontal Dressing on Wound Healing and Patient Satisfaction Following Periodontal Flap Surgery.

OBJECTIVES: It has been claimed that periodontal dressing reduces the risk of wound infection, bleeding and granulation tissue formation and improves tissue healing. This study sought to assess the effect of periodontal dressing on wound healing and patient satisfaction following periodontal flap surgery. MATERIALS AND METHODS: This clinical trial was conducted on 33 patients presenting to Hamadan University, School of Dentistry in 2012 whose treatment plan included two periodontal surgical procedures on both quadrants of the maxilla or mandible. The variables evaluated were severity of pain, bleeding, facial swelling and ease of nutrition experienced by patient during the first 3 days after surgery and inflammation, granulation tissue formation and gingival color at 7 and 14 days. Obtained data were analyzed using SPSS version 16.0 and R software and chi-square and t-tests. RESULTS: The mean (±SD) pain score was 1.73±1.153 and 2.79±1.933 in surgical sites with and without periodontal dressing, respectively and this difference was statistically significant (P=0.005). No significant difference was noted between sites with and without periodontal dressing in terms of swelling, bleeding, gingival consistency, granulation tissue formation, gingival color and ease of nutrition (P>0.05). CONCLUSION: According to the results of the present study, patients did not experience more bleeding, facial swelling or nutritional problems without periodontal dressing; however, the level of pain experienced was lower after surgeries with the use of periodontal dressing.

A Comparative Study of Clinical Parameters in Submerged and Non submerged Implants.

AIM: The aim of this study was to evaluate and compare the radiographic bone loss and soft tissue parameters around one stage and two stage implants. MATERIALS AND METHODS: Twenty four patients with submerged implants and twenty four patients with non submerged implants at the time of loading were assessed in this prospective cohort study. The soft tissue assessment included probing depth (PD), papilla index (PI), mucosal thickness (MT) and keratinized tissue (KG); another parameter assessed was the radiographic distance between the shoulder of the implant and alveolar crest evaluated at baseline (loading time) and 3,6 and 12 months after loading in both groups.Data were analysed using repeated measures analysis of variance (ANOVA) and multiple comparisons were done using LSD method. RESULTS: The changes in the soft tissues including PD, KG, MT and PI had no significant differences in either group. The amount of bone loss 3 and 6 months after loading was significantly greater in one stage implants (0.93±0.45 mm at 3months and1.45±0.58 mm at 6months, for one stage and 0.32±0.21 mm at 3months and 0.74±0.43 mm at 6 months for two stage group). But the change of this index 12 months later was not significantly different between the two groups (1.87±0.76mm for one stage and 1.65±0.59mm for two stage group). CONCLUSION: Based on the results of this study there is no difference in hard and soft tissue changes one year after loading of one or two stage implants.

High Insertion Torque and Peri-Implant Bone Loss: Is There a Relationship?

Because primary stability has a critical role in implant osseointegration, greater insertion torque is more desirable. However, excessive pressure on the peri-implant bone may lead to bone resorption. This study evaluates the effect of insertion torque on crestal bone level. Periapical radiographs of 136 bone-level implants were assessed in this retrospective cohort study. Sixty-four implants were inserted with high insertion torques (45-70 N/cm) and 72 implants were placed with a torque in the range of 20 to 30 N/cm. The distance between implant shoulder and proximal bone crest was measured on radiographs taken immediately after the insertion and compared to those calculated after uncovering surgeries (inserting the healing abutment). The mean bone resorption around implants placed with high and lower insertion torques was 0.33 and 0.4, respectively; thus, the difference between the two groups was insignificant (p = 0.88). High insertion torques (up to 70 N/cm) did not significantly increase bone resorption around implants.

Evaluation of IL-8 gene polymorphisms in patients with periodontitis in Hamedan, Iran.

BACKGROUND: Many environmental and genetic factors are known as factors that increase the susceptibility to periodontitis. As IL-8 is a chemokine that mediate the inflammatory process in periodontal disease, we decided to evaluate the effect of its polymorphism on chronic and aggressive periodontitis. MATERIALS AND METHODS: In this cross-sectional study DNA was isolated from the whole blood of 107 periodontitis patients and 199 healthy individuals. All samples were genotyped for the IL-8 polymorphisms using the polymerase chain reaction with sequence specific primers. The distribution of the interleukin-8 genotype and allele frequencies in control and disease groups was analyzed by the Chi-square test and a P-value of < 0.05 was considered statistically significant. RESULTS: The findings revealed that the allele and genotype frequencies of A2767T, T(1)1722T(2), and C781T polymorphism of IL-8 gene were not significantly differed between controls and patients. However, there was a significant difference in the genotype frequencies of IL-8 A251T (P < 0.0001), G396T (P < 0.0001), and C1633T (P < 0.0001) gene polymorphism between the patient and the control groups. Additionally, there was a significant difference in the genotype frequencies of C1633T (P < 0.05) polymorphism of IL-8 gene between the aggressive and chronic periodontitis. CONCLUSION: IL-8 gene polymorphism may be protective against periodontitis.