Randomised controlled trial comparing the clinical effectiveness of mouthwashes based on essential oils, chlorhexidine, hydrogen peroxide and prebiotic in gingivitis treatment.

AIM: The present clinical study aimed to investigate the clinical efficacy of 5 types of mouthwash based on different active substances. MATERIALS AND METHODS: The study included 180 patients divided into 6 groups of 30 patients, each group rinsing with one of the following types of mouthwash based on: essential oils, combination of essential oils and 0.12% chlorhexidine, hydrogen peroxide (0.8%), prebiotic, 0.2% chlorhexidine, and placebo. All participants underwent professional mechanical plaque removal after which they were instructed to rinse with 15 ml mouthwash 2 times a day for 21 days. During the study period, patients were monitored at days 0, 14, and 21, examining oral hygiene index, gingival index, bleeding index, and presence of side effects. RESULTS: Gingival index, bleeding index, and oral hygiene index were reduced statistically significantly in all treatment groups. Adjunctive use of mouthwashes demonstrated better clinical effectiveness compared to mechanical plaque control (and placebo mouthwash). The gingival index and the plaque index were reduced most significantly in the group using mouthwash with hydrogen peroxide. The bleeding index decrease was most significant in the group using 0.2% chlorhexidine. CONCLUSIONS: All tested mouthwashes demonstrated significant clinical effectiveness in different degrees in gingivitis treatment. New formulas with prebiotic and combination of essential oils and chlorhexidine indicate promising effectiveness.

Effects of Low Level Laser Therapy on Erosive-atrophic Oral Lichen Planus.

BACKGROUND: The erosive-atrophic form of oral lichen planus (OLP) is associated with severe pain and burning sensation and is often unresponsive to treatment. Topical corticosteroids are considered as a medication of first choice but they can produce adverse effects. Therefore, new therapeutic approaches are required. AIM: The aim of this study was to investigate the effectiveness of biomodulation with diode laser in patients presenting with long-standing erosive-atrophic OLP. MATERIALS AND METHODS: Twelve patients, clinically and histologically diagnosed with OLP, participated in this study. The level of pain and the clinical scores of total 59 lesions were recorded before treatment using visual analog scale and Thongprasom sign scoring system respectively. All patients received low level laser therapy (LLLT) with diode laser (810 nm) with parameters (0.5 W, 30 s, 1.2 J/cm2) three times weekly for a month. The response rate was assessed according to the decrease in pain and sign scores. Treatment efficacy index was calculated. RESULTS: There was a significant reduction in pain after LLLT (p<0.0001). Improvement in clinical signs was achieved in 59.3% of the lesions. At the end of the treatment 5.1% of the lesions exhibited score 5; 6.8% - score 4, 11.9% of the lesions were scored 3 and 8.5% and 30.5% showed score 2 and score 1, respectively. Complete resolution was revealed in 37.3% of the lesions. All patients experienced some degree of improvement. Most of the cases showed moderate recovery. CONCLUSION: The present results indicate that LLLT is an effective and harmless modality for management of erosive-atrophic OLP.

Histological Gingival Assessment after Conventional and Laser Gingivectomy.

BACKGROUND: Gingivectomy is a procedure often performed in everyday clinical practice using numerous instruments. AIM: To evaluate and compare the gingival cut surface after gingivectomy with 6 different surgical instruments - a surgical scalpel, an Er:YAG laser, a CO2 laser, a ceramic bur, an electrocautery device, and a diode laser. MATERIALS AND METHODS: Gingivectomy using the above listed instruments was performed in 18 patients. The histological samples excised with a surgical scalpel were assigned as a control group and the other five types - as test groups. The following histological parameters were measured: coagulation layer thickness (in µm); presence or absence of a microscopic rupture and presence or absence of hemostasis in-depth. RESULTS: The best instrument of the above listed ones which demonstrated excellent results is the CO2 laser. The Er:YAG laser has a thin coagulation layer and lack of hemostasis in-depth. The diode laser has the widest coagulation layer which is an advantage from a clinical point of view. Electrocautery proved to be as effective as the diode laser, but it should not be used around metal restorations. The ceramic bur has less pronounced hemostasis in-depth. CONCLUSIONS: Modern dentistry uses a wide variety of methods that are designed to be applied in everyday practice. Good knowledge of the ways to use them, their advantages and disadvantages is essential to obtaining the optimal result depending on the clinical case.

Minimal Invasive Approach for Lips Venous Lake Treatment by 980 nm Diode Laser with Emphasis on the Aesthetic Results. А Clinical Series.

INTRODUCTION: A venous lake (VL) is a vascular lesion with common occurrence in many patients, manifested as a dark blue-to-violet compressible papule, caused by dilation of venules. The main reasons for the treatment of VL are aesthetic. The haemorrhaging episodes or impairment of oral normal functions are also under considerations. Treatment of lip VL includes surgical excision, selective photocoagulation, cryotherapy, sclerotherapy and electrodessication. The high-intensity diode laser is an option. The 980 nm diode laser is selectively absorbed by haemoglobin and selectively destroys blood vessels, minimising injury to the surrounding healthy skin. AIM: The purpose of this study was to evaluate the effectiveness of diode laser in the treatment of VL lesions with the accent on the postoperative defects and aesthetic results. METHODS: 35 patients aged 37 to 71 were included in this study. A 980 nm diode laser was used in noncontact mode, under local anaesthesia in continuous wave (2-3W, for 20-60s). All patients received only one procedure. RESULTS: Healing process was completed within 2 to 4 weeks after treatment with no scarring. None of the typical adverse effects were observed in the process of healing. CONCLUSIONS: Selective photocoagulation is an effective method for treatment of VL. Lower morbidity, minimal patient discomfort and satisfactory functional and aesthetic results are favourable for patients. To optimise the results and to reduce the adverse effects, basic knowledge on lasers and laser-tissue interactions is requisite.

Scanning Еlectron Мicroscopy of Еnamel and Dentin of Тeeth with Hypocalcified Аmelogenesis Imperfecta.

UNLABELLED: The histological features of teeth with hypocalcified amelogenesis imperfecta (AI) have been poorly studied, which calls into question the effectiveness of modern adhesive techniques used in the treatment of these noncarious defects. AIM: The aim of this study was to investigate the morphological features of the enamel and dentin of teeth with AI using scanning electron microscopy (SEM), and compare these features with those of healthy teeth. MATERIALS AND METHODS: We examined four primary teeth extracted on indication from a 10-year-old girl with hypocalcified amelogenesis imperfecta. The same number of primary teeth extracted from healthy subjects was used as controls. The morphological characteristics of the enamel and dentin are described after investigating the teeth and photographing the specimens with scanning electron microscope. RESULTS: The SEM photos of the enamel of AI teeth show presence of external defects, incorrectly oriented enamel prisms and enlarged interprism spaces. Thickening of the peritubular dentin and partially obliterated dentinal tubules characterize the dentin of these teeth. CONCLUSION: The enamel and dentin of teeth affected by hypocalcified AI diff er considerably from normal hard dental structures in their morphological characteristics.

Morphological Study Of Border Area Of Pulp-Capping Materials And Er:YAG Laser Prepared Hard Dental Surface.

INTRODUCTION: Vital pulp therapy involves biologically based therapeutic activities aimed at restoring health and preserving the vitality of cariously or traumatically damaged pulp. Adaptation of pulp-capping materials to the prepared tooth surface may be the key to the success of biological tooth treatment. AIM: To investigate the area of adaptation of synthetic tricalcium silicate cement, calcium hydroxide cement and mineral trioxide-aggregate to the dentin surface, prepared with the help of Er:YAG dental laser. MATERIAL AND METHODS: Four extracted human tooth cavities were prepared with the help of Er:YAG dental laser (LiteTouch, Syneron, Israel), establishing microcommunication with the pulp chamber less than 1 mm in diameter. As pulp-capping materials in the cavities we used tricalcium silicate cement (Biodentine, Septodont, France), calcium hydroxide cement (Dycal) and mineral-trioxide aggregate (ProRoot MTA), stirred and administered according to manufacturers' instructions. The first material fills the whole cavity and the other two are spread in a thin layer and sealed with glass ionomer cement. Thus prepared, the samples were left for three days at 37°C in humidified environment. The samples were prepared for scanning electron microscopy (SEM) by standard methodology. The border area surfaces of the materials and the dentin were scanned using electron microscopy. RESULTS: The morphological changes occurring to the Er:YAG laser prepared dentin and the structural characteristics of the studied pulp-capping materials are demonstrated using scanograms. The border areas where good contact of materials and dentinal tubules is established are thoroughly studied. Good adaptation is seen in three-calcium silicate cement, followed by mineral trioxide aggregate and calcium hydroxide cement. CONCLUSION: The dentin surface, prepared with Er:YAG laser demonstrates a very good adaptation of the three tested pulp-capping materials.

Morphological changes in hard dental tissues prepared by Er:YAG laser (LiteTouch, Syneron), Carisolv and rotary instruments. A scanning electron microscopy evaluation.

AIM: This in vitro investigation aimed to study by means of scanning electron microscope the morphological changes in hard dental tissues after using several different methods for caries removal and cavity preparation. MATERIALS AND METHODS: Twenty freshly extracted human teeth with carious lesions were used in the study. They were assigned to four groups depending on the method used for preparation: Group 1--Cavity preparation using Er: YAG laser (LiteTouch, Syneron, Israel). Group 2--Chemomechanical preparation using colourless Carisolv gel (MediTeam AB, Savedalen, Sweden). Group 3--Mechanical rotary preparation using diamond burs and air turbine. Group 4--Mechanical rotary preparation using by steel burs and micromotor. The preparations were performed strictly according to the manufacturer's instructions for proper use of instruments. The teeth samples were prepared for histological study and investigated by a scanning electron microscope at different magnification; the morphological changes in the tissues were registered and compared. RESULTS: There were considerable differences in the surface characteristics of the dental tissues when we analysed the photomicrographs of the specimens obtained using scanning electron microscopy (SEM). The surface after laser treatment remained highly retentive with no residual smear layer; the second best results in this respect were registered when teeth were chemomechanically excavated with Carisolv gel. The mechanical methods of cavity preparation resulted in surfaces with a smear layer of dentin without any microretentions. CONCLUSION: The scanning electron microscopy of hard dental tissues prepared using steel and diamond burs showed surfaces covered with a thick smear layer that may be relevant to the subsequent bonding of adhesive restorative materials to the prepared cavity. In preparing the surface using a turbine with diamond burs the smear layer was thinner and part of the dentinal tubules orifices were open in the area of water turbulence. SEM analysis of hard dental tissues prepared with the help of colourless Carisolv gel showed a rough, retentive surface, some of the dentinal tubule lumens obstructed by denaturated collagen and surface contaminants. The teeth surfaces prepared with Er:YAG laser Lite Touch (Syneron) remained without smear layer and clearly exposed dentinal tubules orifices. The surfaces were highly retentive.