Interproximal Space Research Articles

The effect of horizontal and vertical dimensions of the interproximal space on the existence of interdental papillae – A clinical study

The aim of the present study was to determine the existence of inter dental papilla according to the vertical dimension, horizontal dimension and the combined effects of the vertical and horizontal dimensions of the interproximal space on the existence of interdental papilla.182 interdental sites of 42 periodontitis patients undergoing open flap debridement were included in the study. The existence of interdental papilla was determined based on the Papilla Presence Index (PPI). The vertical dimension (VD) was measured from the alveolar crest to the contact point using UNC-15 probe. Horizontal dimension (HD) was measured from the mesial surface of the distal tooth and the distal surface of the mesial tooth at the level of the alveolar crest using castroviejocaliper. Statistical analysis was done by using independent ‘t’ test, Pearson’s Chi-square test and Trend Chi-square test.The existence of papilla was significantly higher in VD ≤ 5mm (91.5%) compared to VD > 5mm (9.8%) [p< 0.0001]. The existence of papilla was significantly higher in HD < 2mm (97%) compared to HD ≥ 2mm (1.2%) [p< 0.0001]. The contribution of both vertical dimension and horizontal dimension to the existence of papilla was about 61.6% and thus the existence of papilla may be influenced by various other factors (about 38.4%) which were not included in this study.The vertical and horizontal dimensions of the interproximal space gains significance in determining the existence of papilla and further research is needed to analyze the other factors influencing the papilla.

Patients' opinion on the use of 2 generations of power-driven water flossers and their impact on gingival inflammation.

ObjectivesTo assess patients' opinion on the use of 2 generations of power‐driven water flossers and their impact on gingival inflammation.Material & MethodsIn the present prospective cohort study 24 periodontitis patients under regular supportive periodontal therapy used daily 2 generations of a power‐driven water flosser (Sonicare AirFloss [SAF] and Sonicare AirFloss Ultra [SAFU]) for 12 weeks each. Patients were instructed to position the nozzle interproximally from the buccal aspect at each interproximal space. Patients' opinion was assessed by a questionnaire and interproximal bleeding on probing (BoP) was recorded.ResultsOverall satisfaction with SAF/SAFU was rated high, by about 80% of the patients. About 66% of the patients preferred SAF/SAFU compared to their previous interdental cleaning device and indicated that they would continue using SAF/SAFU after the study; none of the patients reported any discomfort or pain. Compared to only tooth brushing, daily use of SAF/SAFU caused a significant reduction of interproximal BoP values, which were well maintained over 6 months; that is, BoP at interproximal buccal and oral sites (pooled), as well as at interproximal buccal and oral sites separately, was proportionately reduced by 29.1%, 41.2%, and 24.8%, respectively (pooled: p = 0.027; buccal sites: p = 0.030; oral sites: p = 0.030).ConclusionPatients were very fond of the power‐driven water flossers tested herein, and daily use of the devices for 6 months (i.e., each device was used for 3 months) resulted in a significant reduction of gingival inflammation interproximally.

Trueness evaluation of digital impression: The impact of the selection of reference and test object

ObjectivesThis study evaluated the importance of defining the reference and the test object during 3D surface comparisons to assess the trueness of an intraoral scanner. Materials and methodsA maxillary complete-arch cast with interdental spaces was digitized with a high-resolution scanner to obtain the ground truth dataset [GT]. Fifteen intraoral scanning datasets [IOS] were obtained with an intraoral scanner. The trueness of the [IOS] datasets were evaluated by two different comparison procedures using a 3D analysis software: In the first comparison [REF-GT], the [GT] dataset was set as reference object and the [IOS] dataset was defined as test object. In the second comparison [REF-IOS], the [IOS] dataset were set as reference object and the [GT] dataset was defined as test object. The mean trueness of both comparisons was calculated with absolute mean deviation, (90–10)/2 percentile, and root-mean-squared (RMS) error method. Statistical significance was analyzed using the t-test (α=0.05). ResultsThe mean trueness values of [REF-GT] were 31.4(±6.1) µm for (90–10)/2 percentile, 77.0(±5.3) µm for absolute mean deviation, and 203.1(±4.8) µm for RMS error method. [REF-IOS] revealed 23.9(±4.8) µm, 28.3(±6.3) µm, and 39.6(±9.5) µm, respectively. The results differed significantly. ConclusionThe datasets obtained from the intraoral scanner captured more adequately interproximal spaces in comparison to the [GT] dataset. Therefore, the [GT] dataset defined as reference object in the analysis software for 3D comparisons revealed misleading results. Clinical significanceThe selection of the reference object and of the areas to be compared have to be defined carefully regarding complete arch scanning accuracy analysis.

Dental plaque removal and motivation of a manual toothbrush versus an interactive power toothbrush in young people with fixed orthodontic appliances: a single examiner-blind randomized controlled clinical trial

Introduction: The goal of this 2-arm equal preliminary clinical trial was to decide the plaque expulsion efficacy (primary result) and the motivation assessment (auxiliary result) looking at a manual versus an interactive power toothbrush in orthodontic patients. Methods: Sixty teenagers with fixed orthodontic appliances who reported to the Department of Periodontics for routine oral prophylaxis in the both arches were randomized in a 1:1 proportion parallel, randomized, examiner-blindcontrolled clinical preliminary. Qualification criteria included in any event 16 characteristic teeth, 1-6 "center consideration zones," plaque score of ≥1.75, no serious caries, gingivits and periodontitis, no dental prophylaxis, no smoking, no anti-microbials, and no chlorhexidine mouth wash. Subjects were to brush solo with either an interactive power toothbrush (Oral-B Professional Care 6000, D36/EB20) with Bluetooth innovation or a customary manual toothbrush (Oral-B Indicator 35 delicate). Center consideration regions were each brushed for 10 extra seconds like inter-proximal spaces. Plaque removal was surveyed with the utilization of the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) to decide change from standard at 2 weeks followed by 6 weeks. Supervised brushing at screening and post-treatment visits recorded real brushing times. Subject-revealed motivational viewpoints were recorded at screening and week 6. Results: Fifty-nine subjects between 13-17 years finished the investigation. The interactive power toothbrush gave significantly (P\0.001) more noteworthy plaque decrease versus the manual toothbrush at 2 and 6 week as indicated by the entire mouth TMQHPI. The treatment contrast in balanced mean plaque change from standard was 0.777 (95% CI 0.614-0.940) at week 2 and 0.834 (0.686-0.981) at week 6. Mean decreases in the quantity of center consideration regions were likewise significantly more noteworthy (P \0.001) in the power brush bunch at weeks 2 and 6. Brushing times increased significantly at weeks 2 and 6 (P #0.013) versus standard baseline in the interactive powertoothbrush group only.Subject-revealed motivation was significantly increased in the interactive power tooth brush group at week 6 as opposed to screening (P #0.005). Conclusions: An interactive power toothbrush produced increased brushing times and significantly more prominent plaque removal versus a manual brush.

Effective Protocol for Daily High-quality Direct Posterior Composite Restorations. The Interdental Anatomy of the Class-2 Composite Restoration.

The importance of the interdental anatomy of a class-2 direct composite restoration is one of the most underestimated topics in direct posterior composite restorations. The proximal emergence profile of the restoration and the contact area should be designed to maximize arch continuity and to minimize food impaction. Other restorative criteria that must be fulfilled are marginal adaptation compatible with the dental and periodontal integrity, and geometry of the marginal ridge compatible with the mechanical integrity of the restoration under load. Shortcomings will result in masticatory discomfort, caries, periodontal problems and undesired movement of teeth. In vitro and in vivo studies showed that the use a contoured sectional metal matrix band with a separation clamp results in the tightest contact point. However, this matrix system also has shortcomings and does not give the expected result in all class-2 cavities. The variation in depth, width of the box, distance between the cervical cavity margin and the adjacent tooth requires customization of the interproximal space. In order to realize this, sectional matrix bands with several profiles of curvature, variation of wedges and separation clamps, and the use of teflon tape are required. In addition, dentists should follow a protocol allowing them to build a proximal composite surface that fulfills the required restorative criteria. Pre-wedging, space evaluation, interproximal clearance, correct selection, positioning and stabilization of the matrix band are important steps in this protocol.

Efficacy of dental floss with ellipsoidal knots vs conventional dental floss for plaque removal: A split-mouth randomized trial.

To compare clinical efficacy for plaque removal between dental floss with soft ellipsoidal knots and conventional floss. We studied 33 university students (29 females and 4 males, 13 of them undergraduate/postgraduate students of dentistry), including regular and sporadic (less once/wk) users of dental floss, with interproximal spaces ≤1mm, who used floss with and without knots in a randomized manner following a split-mouth design. The Modified Navy Plaque Index (RMNPI) by Rustogi et al. was applied to determine the total removed plaque (TPI) and that removed in the gingival area (GPI) and interproximal spaces (IPI). The reduction in GPI was greater with the knotted vs conventional floss in all cases (14.77±12.38; 64.79% vs 17.38±13.66; 57.51%) and especially among no floss users (12.469±10.98; 68.02% vs 15.833±11.88; 58.55%). No statistically significant difference between floss types was found in TPI and IPI (globally or by floss utilization frequency) or in the mean GPI of floss users. Floss with ellipsoidal knots showed similar efficacy to remove plaque in patients with less experience of flossing (but without statistically significant differences) compared with flossing themselves with conventional floss, and it may be an optimal solution for patients starting to use dental floss and for those with a lesser or only sporadic history of floss utilization.

MINIMALLY INVASIVE RECONSTRUCTION OF DEFICIENT PAPILLAE WITH HYALURONIC ACID - TREATMENT PROTOCOL AND 6-MONTHS RESULTS

Increasing demands of patients for gingival esthetic and management of deficient papillae in the anterior region had stimulated minimally invasive techniques for papilla reconstruction with biological molecules. Purpose: To evaluate the effect of hyaluronic gel injections in deficient papillae and monitor the results for a 6-months period. Materials and methods: 57 class I and class II deficient papillae were included. 4 weeks after scaling and root planning hyaluronic acid gel was injected in the papillae. The injections were repeated in 20 days. Measurements of papilla height were done on the clinical photographs. The distance between the contact point (complete fill of interproximal space) to the most coronal level of the visible gingival margin was measured before treatment and on months 1, 3 and 6 and compared to baseline. Results: There was a statistically significant change in the papilla level and fill of the interproximal space, ranging from 59% papilla gain on the first month, 72% to the third month and 77% on 6 months. Conclusion: Hyaluronic acid gel is a reliable method for mini-invasive papilla augmentation, especially in class I and class II papilla deficiencies.

Modified Marionette Technique for Unassisted In-Office Access to the Submandibular Duct.

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Applying synthetic radiography to intraoral tomosynthesis: a step towards achieving 3D imaging in the dental clinic.

A practical approach to three-dimensional (3D) intraoral imaging would have many potential applications in clinical dentistry. Stationary intraoral tomosynthesis (sIOT) is an experimental 3D imaging technology that holds promise. The purpose of this study was to explore synthetic radiography as a tool to improve the clinical utility of the images generated by an sIOT scan. Extracted tooth specimens containing either caries adjacent to restorations (CAR) or vertical root fractures (VRF) were imaged by sIOT and standard dental radiography devices. Qualitative assessments were used to compare the conspicuity of these pathologies in the standard radiographs and in a set of multi-view synthetic radiographs generated from the information collected by sIOT. The sIOT-based synthetic 2D radiographs contained less artefact than the image slices in the reconstructed 3D stack, which is the conventional approach to displaying information from a tomosynthesis scan. As a single sIOT scan can be used to generate synthetic radiographs from multiple viewing angles, the interproximal space was less likely to be obscured in the synthetic images compared to the standard radiograph. Additionally, the multi-view synthetic radiographs can potentially improve the display of CAR and VRFs as compared to a single standard radiograph. This preliminary experience combining synthetic radiography and sIOT in extracted tooth models is encouraging and supports the ongoing study of this promising approach to 3D intraoral imaging with many potential applications.

A Simplified and Effective Method for Generation of Experimental Murine Periodontitis Model.

Periodontitis, a common disease that can lead to bone destruction, periodontal attachment loss, and tooth loss, is the major cause for oral tissue engineering. Experimental periodontitis is a suitable disease-model for studying bone regeneration and the potential therapeutic role of biomaterials on periodontal tissue engineering, as this in vivo model could be employed to mimic the natural host response under bacteria-caused oral pathological environments. Although large animals with ligature-induced periodontitis have mostly been used for experiments, a mouse model is a better choice for several reasons. Inserting ligature threads through the interproximal space between the teeth is the key step in establishing a periodontitis model, and it is easy to achieve in large animals, but difficult in mice due to the limited operating space. In this work, we provide a new and proven approach for periodontitis induction in mice using C+ nickel-titanium root canal files and stainless-steel ligature wires. The validity of this method was assessed by evaluating alveolar bone loss via micro-CT and detecting periodontal inflammation by histological staining and qPCR after the treatments. Progressive alveolar bone loss was observed from day 3 after the ligature-placement. Infiltration and accumulation of F4/80+ macrophage was also detected. In accordance with the histological results, there was upregulation of the expression levels of the inflammatory genes Il1β, Tnf-α, and Il6 in gingival tissues isolated from the ligation sites. Our results suggest that this novel method could resolve the difficulty of ligature-placement in mice and consequently contribute to further use of mouse models for studying the pathological mechanisms of periodontitis and developing potential periodontal tissue regeneration strategies. C+ files, which are made of nickel-titanium, are tough, elastic, and sufficiently thin to pass through the interproximal space between the teeth after pre-bending to form an appropriate angle, thus providing an access for ligature wire insertion. As a common tool in the dental clinic, it is familiar to researchers of oral biology, and can provide the feasibility for wide application of our method.

Efficiency of Concentrated Growth Factor in the Surgical Treatment of Multiple Adjacent Papillary Losses: A Randomized, Controlled, Examiner-Blinded Clinical Trial Using CAD/CAM.

This study aimed to create papilla with concentrated growth factor (CGF) in cases in which the interdental papilla was not able to fill the interproximal space (IPS) due to physiologic factors. A three-dimensional digital model of this space with the digital impression obtained from direct intraoral scanning of IPS was created. This study aimed to evaluate the efficacy of CGF in the regeneration of multiple adjacent papillary losses (MAPL), with the change in the IPS area calculated on intraorally scanned images obtained with digital impressions. This study included 160 teeth from 40 patients with 120 papillary losses. Patients were randomly allocated to the test group (TG) (n = 20), with 60 MAPL (three adjacent, lost interdental papillae per patient) receiving minimally invasive surgery with CGF, or the control group (CG) (n = 20), with 60 MAPL without surgery. A total of 480 images were uploaded to a software. The patients' age, gender, Plaque Index, bleeding on probing, and mean probing pocket depth values were evaluated. Papillary area (PA) were calculated between the two central, lateral-central, and lateral-canine teeth at baseline and posttreatment periods of 3, 6, and 12 months in both groups. Papillary filling percentage, keratinized-gingiva width, papillary thickness, thrombocyte, count and mean platelet volume were recorded in TG. Considering the variables in TG and CG, there was no difference in terms of age, gender, and periodontal parameters (P > .05). PA at 3, 6, and 12 months showed statistically significant differences from baseline values in TG (P < .001) but not in CG (P > .05). In TG, a moderate positive correlation was found between the midline papillary thickness and the 3-, 6-, and 12-month filling percentages (r: 0.506, P = .023; r: 0.509, P = .022; and r: 0.515, P = .02, respectively), and a high positive correlation was determined between thrombocyte count and the 6- and 12-month filling percentages (r: 0.733, P < .001; and r: 0.744, P < .001, respectively). CGF provided papillary regeneration in the treatment of MAPL and supported three-dimensional structure of the regenerated interdental papilla throughout 1 year.

Lateral osteoperiosteal flap versus lateral pedicle flap in the treatment of class III gingival recession: A single-center, open-label trial.

Aims:The aim of this study was to compare outcomes of lateral osteoperiosteal flap (OPF) and lateral pedicle flap (LPF) in the treatment of Miller's Class III gingival recession.Materials and Methods:Twenty-two anterior maxillary and mandibular sites from 16 participants requiring mucogingival surgery for Miller's Class III gingival recession were included in the study. Eleven sites each were assigned to two groups. OPF: sites treated with lateral OPF and LPF: sites treated with LPF. Recession depth (RD) and bone level (BL) were the primary outcome variables, and probing pocket depth, clinical attachment level (CAL), and keratinized tissue width (KTW) were the secondary variables. All the variables were recorded at baseline (on the day of surgery), 3 months, and 6 months postsurgery.Results:OPF and LPF resulted in similar reduction in RD at the end of the study period (P ≤ 0.001). There was no statistically significant difference in RD between OPF and LPF at 6 months (P = 0.862). OPF-treated sites showed greater gain in BL at 3 months (P = 0.0004) and 6 months (P = 0.0002). No significant differences were seen between OPF and LPF in measures of PD, CAL, and KTW.Conclusion:Data from this 6-month trial seem to suggest that OPF can be used as an alternative procedure for treating Miller's class III recessions with adjacent edentulous sites or wide interproximal spaces. Long-term effects of OPF on the stability of root coverage outcomes are an exciting direction for future research.

Factors Influencing the Presence of Papilla between Adjacent Implants and between a Tooth and an Implant.

AimThe aim this study was to evaluate the factors that influence the presence or absence of the interproximal papilla between implants adjacent to the teeth or other implants, through clinical and radiographic evaluation.Material and MethodsThe non-probabilistic sample comprised 44 patients of both genders aged between 21 and 68 years, rehabilitated with 114 osseointegrated implants. Through a retrospective clinical study, the patients were divided according to the presence or absence of the interproximal papilla: Group 1 - Absence of Papilla, Group 2 - Partial Presence of Papilla and Group 3 - Total Presence of Papilla. The success of the implants, the periodontal biotype, and the vertical and horizontal distances of the interproximal regions included in the study were evaluated.ResultsOf the 114 implants, 46.5% were considered unsuccessful, and bleeding was present in 29.8%. The periodontal biotype presented as thin and scalloped was found in 85.1% of the regions. The evaluation of the groups according to the confirmation of the interproximal space showed a statistically significant difference (p = 0.007), with 61.9% of the wide and long interproximal spaces classified as Group 1, while 31% of the narrow and short interproximal spaces were classified as Group 3.ConclusionIt was concluded that the morphology of the interproximal space was the factor that was most strongly associated with the presence or absence of the interproximal papilla.

INTRAORAL MELANOMA OF THE INTERPROXIMAL PAPILLA: A RARE PRESENTATION

A 37-year-old woman, with no history of diseases or medical treatment, presented with an asymptomatic nonulcerated lesion, at the lower posterior gingiva. The patient had periodontitis with periodical control and the intraoral exam showed a single, hardened nodule measuring 1 × 0.5 cm, with a smooth surface and sessile base, surrounding the interproximal distal space between the first and second left lower molars. Radiographically, there was no evidence of bone compromise. Pigmentation was only seen on the lingual area. An incisional biopsy was made, providing the diagnosis of melanoma with immunohistochemical positive reaction for HMB-45 and S-100. Chest radiograph and computer tomography (CT) scan of the cervical area was required to rule out any metastatic lesion; the results were negative. The patient underwent a mandibular and neck surgery showing 1 positive lymph node out of 37 sentinel lymph nodes. She received oncologic treatment with no recurrence after 3 years.

Proximal contact with implants - Problems in the implant-tooth space

In patients with implants next to natural teeth, clinicians often observe a change in the interproximal space. Although there may have been good proximal contact when the implant crown was inserted, this may have dissolved later. A gap appears to occur in 1/3 to 2/3 of the cases examined, with the mesial side usually being affected. This is mainly explained by the mesial drift of the teeth, while the implant is immobile as an "ankylosed unit".

Interproximal bone in maxillary anterior teeth in subjects with Class III facial deformity: Are there options for segmental maxillary osteotomy in “surgery first”?

Our aim was to give a morphometric description of the interproximal bone between the anterior maxillary teeth of subjects with class III facial deformity, who were candidates for segmented Le Fort I osteotomy. We measured the width of the interproximal bone from the upper right canine to the upper left canine in cone-beam computed tomographic images of 35 subjects, and identified five interproximal areas of measurement. The lower and upper measurements were established 5mm and 10mm from the cervical crest of the interproximal bone. A paired samples t test and Pearson's correlation coefficient were applied and probabilities of less than 0.05 were accepted as significant. In all the scans of interproximal bone, the apical zone was significantly wider than the inferior zone (p<0.001). The area between the central incisors was the widest, with a mean (SD) of 2.42 (0.68) mm in the lower, and 4.27 (0.99) mm in the upper, region followed by the space between the canines and lateral incisors. The minimum interproximal spaces in the lowest area were between 1.1 and 1.5mm, which suggested the potential for damage to the teeth during segmental osteotomy. The interproximal spaces were at potential risk of dental and periodontal injuries, and the area between the central incisors seemed to be most suited to interproximal osteotomies in “surgery first”.

Anatomic analysis of the equine mental foramen and rostral mandibular canal using computed tomography

ObjectivesTo characterize the anatomy of the mental foramen and determine associations with age, weight, sex and breed. Study designRetrospective descriptive study. AnimalsForty-one horses, 0.6–25.2 years and weighing 136–820 kg. MethodsComputed tomography (CT) studies of equine heads performed over 5 years were evaluated in multiplanar and three-dimensional reconstruction. Measurements obtained were positioning of the foramen along the mandible, foramen height and width, foramen–canal angulation and rostral canal mineralization. Exploratory statistical analyses investigated associations between measurements and age, weight, sex and breed. ResultsEvaluation of 41 CT studies revealed foramen positioning was one-third of the horizontal distance of the incisor–premolar space from the second premolar and one-third of the vertical distance in the mandible from the dorsal surface of interproximal space at the level of the foramen. Age was negatively correlated to horizontal positioning [r = –0.42; 95% confidence intervals (CI), –0.64 to –0.13]. Mean foramen width was 6.4 (range, 2.3–17.1) mm and height 5.6 (range, 2.1–10.3) mm. Age and foramen height (r = 0.32; 95% CI, 0.01 to 0.57) and width (r = 0.30; 95% CI, –0.01 to 0.30) were positively correlated. Thoroughbred and Warmblood/Draft horses had increased foramina heights compared with Quarter horses [analysis of variance (anova)p = 0.02]. Males had wider foramina (95% CI, –2.66 to 0.07). Angulation of the foramen–canal was mean ± standard deviation 68.3 ± 12.8° (range, 37.9–105.6°) transverse plane, 28.3 ± 4.1° (range, 18.2–39.0°) saggital plane and 41.4 ± 8.45° (range, 22.2–58.6°) dorsal plane. Older horses had decreased mineralization of the rostral canal (anova, left p = 0.015, right p = 0.025). ConclusionsThe size, shape, positioning and angulation of the mental foramen varies. Mineralization of the canal is decreased in older horses. Clinical relevanceThis study improves understanding of mental foramen anatomy and complications with needle placement.

Oral Rehabilitation of Young Adult with Amelogenesis Imperfecta

Amelogenesis imperfecta is a heterogeneous group of hereditary disorders that affect the enamel formation of the primary and permanent dentitions while the remaining tooth structure is normal. Appropriate patient care is necessary to prevent adverse effects on dental oral health, dental disfigurement, and psychological well-being. This clinical report presents a 27-year-old Chinese male with amelogenesis imperfecta (AI) and his restorative management. This clinical report presents a 27-year-old Chinese male with AI and his restorative management. Extraoral examination showed a skeletal class III profile and increased lower facial proportion. Intraorally, all the permanent dentition was hypoplastic with noticeable tooth surface loss and a yellow-brown appearance. This was complicated with a mild maloc-clusion and food packing on his posterior teeth. The patient wanted to improve his appearance and masticatory efficiency. Orthodontic treatment was performed to treat the mild malocclu-sion and create physiological interproximal spacing to minimize tooth preparation and facilitate oral hygiene. This report demonstrates how a multidisciplinary approach for the management of AI can achieve a predictable, functional, and esthetic outcome. Orthodontic treatment facilitated a conservative prosthodontic treatment outcome by selectively increasing interproximal space, minimizing tooth preparation, correcting posterior bilateral cross-bite, as well as an anterior reverse overjet and derotation of the canines. This case report demonstrates the effective restoration of AI using a multidisciplinary approach to overcome crowding using a relatively conservative approach.

Effect of PRF and Allograft Use on Immediate Implants at Extraction Sockets with Periapical Infection -Clinical and Cone Beam CT Findings.

Immediate implant placement can be successful, even at infected sites. The adjunctive effects of concomitant use of platelet-rich fibrin (PRF) and decalcified freeze-dried bone allografts (DFDBA) at periapically infected sites remains to be determined, however. The purpose of this prospective study was to investigate the effect of combined use of PRF and DFDBA on immediate implant survival at tooth extraction sites exhibiting periapical lesions. Implants were immediately placed in 8 patients under a standard chemotherapeutic protocol. Adin titanium implants were used in all cases. The combination of PRF and DFDBA was used to fill the gap between the implant body and the surrounding socket wall. The final restoration was placed after 3 months. The full-mouth plaque, gingival bleeding index, and gingival esthetics scores were assessed at 3, 6, and 12 months. Cone beam computed tomography images obtained at baseline and at 12 months after implant loading were analyzed. The plaque index scores showed statistically significant differences at 3, 6, and 12 months (p<0.05). The gingival bleeding index score showed no significant difference. No difference was noted in buccal gingival level on the implant surface or adjacent teeth at 91.7% of sites. Complete closure of the interproximal space was seen in 91.7% of the implant sites. Crestal bone levels on all implant surfaces were non-significant. Implant survival was 91.67% at 12 months. The adjunctive use of PRF with DFDBA at periapically infected sites yielded a significant reduction in bone resorption and accelerated bone healing during the initial post-extraction stage. A significant improvement was achieved in the gingival esthetic score at the interproximal and midfacial surfaces. The combined use of growth factors with pre- and postoperative broadspectrum antibiotics over a short time resulted in a higher implant survival rate at the end of the 1 year post-restoration period.

Influence of dental materials on cells of the equine periodontium.

Therapy for equine periodontal disease can include filling of the periodontal pockets and widened interproximal spaces. Recommended dental materials are generally adopted from human dentistry. To evaluate the biocompatibility of dental materials for equine periodontal fillings invitro. In vitro experiments. Four different dental materials (PeriCare® , Provicol® , Calxyl® and Honigum) were tested on equine periodontal fibroblasts. Possible cytotoxic effects were assessed microscopically and by MTT assay, and the expression of inflammatory marker genes was measured by qRT-PCR. PeriCare® and Provicol® had no effects on the cells, whereas Honigum and Calxyl® were associated with severe cytotoxic effects. The results of this invitro study need to be confirmed by clinical studies. Before adapting dental materials from human dentistry, it is crucial to initially test them in a specific equine model.