Journal of Advanced Periodontology and Implant Dentistry
Volume:15 Issue: 1, Jun 2023

Chronic periodontitis is the most common type of periodontitis, which is associated with calculus and plaque accumulation. Several studies have indicated that uncured periodontitis can affect the dental pulp. However, this relationship is controversial. This study aimed to compare histopathological results obtained from the dental pulp in teeth with periodontal problems and healthy teeth.

In this study, 23 teeth with periodontal problems and 23 healthy teeth were extracted. After cutting off 2 mm from the root apex, the teeth were sectioned into apical, middle, and coronal thirds. Then, the specimens were evaluated in both groups based on histopathological features.

According to the evaluations, in the middle third, the amount of inflammation was only statistically significant in the group that consisted of teeth with periodontal problems (P=0.014). There was no significant difference in fibrosis and blood vessel diameter between the two groups. Necrosis in the middle (P=0.002) and coronal thirds (P=0.004) of teeth with periodontal problems was more than the healthy teeth. The lack of odontoblastic integrity in all the sections of teeth with periodontal problems was more than that in healthy teeth (P=0.0001).

Inflammation of the periodontium in chronic periodontitis can lead to histological changes in the pulp, including an increase in inflammation, necrosis, and loss of odontoblastic integrity.

Xenograft and allograft bone substitutes are widely used to replace the missing bone in defects. Since removing the packaging of these grafts can nullify their sterilization, this study aimed to evaluate the sterility and bioactivity changes of an allograft and a xenograft following uncapping/recap.

Two types of commercial allograft and xenograft vials were unpacked and further exposed to operating room air, where implant surgery was performed for one second, ten minutes, and one hour. After three repetitions, samples were analyzed using microbiological tests and scanning electron microscopy (SEM) with energy dispersive x-ray analysis (EDX) for sterility and bioactivity evaluation.

None of the bone graft samples showed microbial growth or bioactivity-negative changes after seven days of unpacking the vials.

Despite the positive results of this study, future studies and more analysis considering influential factors are required. Also, disinfection and air exchange must still be observed during biomaterial application and bone grafting procedures.

This study aimed to compare the analgesic effects of Ibuprofen and Bromelain after periodontal surgery.

A double-blinded crossover clinical trial was conducted on 22 patients needing two crown lengthening surgeries without bone surgery or with limited bone surgery on two quadrants of the maxilla, with control and test sides. Each quadrant was randomly assigned to Bromelain (500 GUD) or Ibuprofen (400 mg). Immediately after the surgery and 6 hours after it, the first dose of the drugs was packaged in the same capsules in A and B. Postoperative pain was evaluated during the first 8 hours and on the following day using a visual analog scale (VAS).

Using the VAS, the Ibuprofen group showed significantly lower mean pain scores than the Bromelain group at 4 hours (P=0.047). In contrast, there were no significant differences between the two groups at 2, 6, 8, 10, 12, 24, and 48 hours (P>0.05).

The effectiveness of Bromelain for pain control following periodontal surgery was comparable to that of Ibuprofen. Therefore, Bromelain can be an efficient replacement for Ibuprofen in managing pain after periodontal surgery, especially in patients with gastric ulceration and increased bleeding tendency.

Polylactic-co-glycolic acid and zinc oxide (PLGA-ZnO) nanocomposite has been investigated for its antibacterial properties, which could be beneficial for adding to wound dressings after periodontal surgery. However, its cytotoxicity against human gingival fibroblasts (HGFs) remains unclear and should be evaluated.

ZnO nanoparticles were synthesized using the hydrothermal method. These metallic nanoparticles were incorporated into the PLGA matrix by the solvent/non-solvent process. The nanomaterial was evaluated by field emission scanning electron microscopy (FESEM), Fourier transform infrared (FTIR), thermogravimetric analysis (TGA), and x-ray diffraction (XRD) analyses. HGF cells were acquired from the National Cell Bank and categorized into four groups: ZnO, PLGA, ZnO-PLGA, and control. The cells were exposed to different ZnO (1, 20, 40, 60, 80, and 100 µg/mL) and PLGA (0.2, 4, 8, 12, 16, and 20 µg/mL) concentrations for 24 and 48 hours. The cytotoxicity was tested using the MTT assay. The data were analyzed using SPSS 25, and P<0.05 was considered statistically significant.

ZnO nanoparticles exhibited significant toxicity at ≥40 µg/mL concentrations after 24 hours. Cell viability decreased significantly at all the tested concentrations after 48 hours of exposure. PLGA-ZnO cell viability in 24 hours was similar to the control group for all the concentrations up to 80 µg/mL.

ZnO nanoparticles could be toxic against HGF in high concentrations and with prolonged exposure. Therefore, incorporating ZnO nanoparticles into a biocompatible polymer such as PLGA could be a beneficial strategy for reducing their toxicity.

Aggregatibacter actinomycetemcomitans (Aa) plays a vital role in some destructive forms of periodontitis. While mechanical and chemical plaque control is the first step in periodontitis treatment, side effects of adjunctive chemical agents such as chlorhexidine (CHX) mouthwash have led to the application of natural alternatives with minimal side effects. Therefore, this study evaluated the antibacterial effect of the hydroalcoholic extract of Quercus infectoria (Qi) galls on Aa in vitro.

The hydroalcoholic extract of Qi was obtained by the maceration method, and Aa bacterial strain was cultured. The inhibition zone diameter was measured through the agar well diffusion method. Also, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values were determined by the broth microdilution method. All the experiments were repeated three times. 0.2% CHX was used as a control.

The inhibition zone diameter of Aa increased with increasing concentration of Qi extract. While MIC and MBC values for CHX were 0.0039 and 0.0078 mg/mL, respectively, both MIC and MBC values of the Qi extract for this bacterium were similar, i.e., 2.5 mg/mL, which was significantly higherd.

Since other in vivo studies have confirmed the other properties of this extract and its safety in terms of cytotoxicity and mutagenicity, hydroalcoholic extract of Qi may be used in mouthwashes or local delivery systems to affect periodontal biofilm.

Oral lichen planus (OLP) is a multifactorial chronic inflammatory condition with unknown etiology. This condition has been associated with Helicobacter pylori (H. pylori). This study aimed to investigate the relationship between the treatment of H. pylori infection and improvements in OLP lesions.

In this cohort study, 42 patients with erosive or ulcerative OLP lesions were evaluated in terms of H. pylori infection using the H. pylori stool antigen (HpSA) test. The patients were divided into three groups. The first group consisted of 12 H. pylori-negative patients. The second group consisted of 21 H. pylori-positive patients receiving antibacterial treatment. The third group included nine H. pylori-positive patients not willing to receive treatment. All the three groups underwent the usual OLP treatment. Patients in the second and third groups were re-evaluated by the HpSA test after two months. The efficacy indexes and visual analog scale were used to evaluate clinical improvements.

The efficiency index and pain scores were affected by the intervention (P<0.001). The logistic regression analysis showed that the severity index before treatment was significantly effective (OR=0.745 (95% CI: 0.602‒0.923; P=0.007). No statistical significance for factors affecting other variables (P>0.05) was obtained.

Pain intensity was higher in patients with H. pylori than in those without H. pylori before treatment. Also, in patients with H. pylori, the treatment affects the complete recovery rate.

Self-assessment of oral hygiene can be well-accomplished through questionnaires with questions that can logically check deliberately erroneous answers by the individual being questioned.

The standard questionnaires were distributed to children aged 9‒14 years to collect information on the personal level of oral hygiene, find the reasons for not receiving correct information from the individuals and not referring to a dentist for routine visits, and determine fears arising from previous visits and procedures.

Deliberately chosen incorrect answers comprised 6.3% of cases. Dental hygiene was expressed in the correlation of the hemorrhage index and the presence of bacteria in 72.4% of cases.

The dentist’s approach toward pediatric patients, especially young children, should encourage children to continue dental treatments and not postpone them due to pain and aggravated dental situations. The relatively small percentage of cases with high psychological stress during dental visits in this study was a positive aspect.

Horizontal ridge augmentation surgeries are common procedures in periodontics. Histological changes in soft tissues affect the success of surgery in many ways. Autologous conditioned serum (ACS) increases interleukin-1 receptor antagonist (IL-1Ra) and causes inflammation modulation. Therefore, the present study aimed to investigate the effect of ACS on histological changes and gene expression of soft tissues after horizontal ridge augmentation surgeries.

  This double-blind split-mouth clinical trial was performed on patients needing implants with horizontal ridge augmentation (n=21). The control and intervention groups were considered split-mouth in two areas of the patients’ oral soft tissues. A collagen membrane impregnated with ACS was used on the test side, and only a collagen membrane was used on the control side. After four months, histological changes in soft tissues, such as the amount of connective tissue collagen, fibroblast and inflammatory cell counts, and expression of the IL-1β gene, were evaluated.

The fibroblast counts in the ACS group were significantly higher than in the control group. In addition, ACS caused a significant increase in the amount of collagen in the soft tissues compared to the control group (P<0.01). However, the number of inflammatory cells was similar in the two groups (P>0.05). IL-1β gene expression was not significantly different between the case and control groups.

Under the limitations of the present study and based on the results of histological examinations, ACS increased the number of fibroblasts and the amount of collagen in soft tissues without affecting inflammatory cells (P=0.562).

Pain after periodontal surgeries is one of the most common complications. Echium amoenum is among the important therapeutic herbs in Iranian traditional medicine. Various studies have shown its pain control properties. This study aimed to evaluate this herb’s efficacy in controlling pain after periodontal surgeries.

In this randomized clinical trial, 50 patients referred to Tabriz Dental School for clinical crown lengthening surgery were divided into two equal groups: control and test. In the test group (using Echium amoenum), 24 hours before surgery, Echium amoenum was administered to the patient at home every 12 hours, and a dose of Echium amoenum was administered one hour before the procedure. The postoperative pain was assessed using VAS 30 minutes, 1 hour, and 3 hours after the surgery and VRS 24, 48, and 72 hours postoperatively. A chi-squared test was used to compare the pain severity between the two groups.

The VAS index was significantly lower in the Echium amoenum group compared to the control group (30 minutes, 1 hour, and 3 hours after the procedure) (P<0.05). In both groups, pain severity increased significantly up to 3 hours postoperatively (P<0.05). In the first 24 hours, the VRS index of the Echium amoenum group was significantly lower than that of the control group (P<0.05), with no significant differences between the two groups at 48 and 72 hours (P>0.05).

Conclusion:

 The Echium amoenum herb reduced the pain severity after clinical crown lengthening surgeries.

Tightening and loosening of the prosthetic components of the implant are carried out with various screw designs. This study compared the rate of deformation of the abutment screw in two hexagonal and star screw head designs after consecutive tightening and loosening.

In this study, two fixtures were mounted vertically in die stone blocks using a surveyor. Then the corresponding abutment (with a diameter of 4.5 mm and a gingival height of 2 mm; Dio-SM and Dio-UF system) was mounted on each fixture. In each fixture, six abutment screws from each manufacturer were used (12 abutment screws in total). The abutment screw head of the Dio-UF system is hexagonal, and the abutment screw head of the Dio-SM system is star-shaped. The samples were examined under a stereomicroscope (Nikon C-DS) at a magnification of ×50. The image of each abutment screw head (6 abutment screws in each group) was prepared before the procedural steps and after 5, 10, and 15 times of tightening and loosening with 25-Ncm torque using a stereomicroscope. Then the differences in the surface areas of consecutive specimens (0, 5, 10, and 15 consecutive tightening and loosening rounds) between hexagonal and star-shaped abutment screws were calculated. The study results were reported via descriptive statistical methods (mean ± standard deviation). Statistical analysis was performed using SPSS 24, and the significance level was defined at P<0.05.

 Increasing the number of tightening and loosening rounds increased the screw head surface area in both hexagonal and star shapes. At all stages, the changes in the star-shaped screw head were greater than in the hexagonal screw. These changes were statistically significant at all stages (P<0.05). In addition, there was a statistically significant difference between the area values and the number of tightening and loosening rounds separately in both screw types (P<0.001). Also, the surface areas of the head of both screws in all tightening and loosening rounds were significantly different (P<0.001).

Increasing the number of tightening and loosening rounds increased the screw head surface area in both hexagonal and star-shaped geometrical forms. Also, the extent of area changes at all stages in star-shaped screw heads was greater than in hexagonal screws.