Modified Sulcus Bleeding Index Research Articles

The evaluation of the effectiveness of conventional and pulsating toothbrushes on the oral health of healthy and mentally disabled pediatric patients.

Children, especially the mentally disabled, are generally incapable of obtaining adequate oral hygiene levels by manual brushing due to their lack of knowledge about oral hygiene and their limited motor skills. In order to handle those limited skills, different designs of manual and electric toothbrushes are developed and put on markets. The aim of this study was to evaluate the effectiveness of pulsating toothbrushes with easy-to-use properties, against conventional toothbrushes and to analyze their benefits on mentally disabled pediatric patients. Thirty-one healthy and 31 mentally disabled children (aged between 7 and 12) participated in this study. The effectiveness of three different toothbrushes (Oral-B Pulsar, Colgate 360° Micro Sonic Power, Oral-B Stages 3) was investigated with a cross-over study design. DMFT, dft, modified sulcus bleeding index (MOD-SBI), approximal plaque index (API) and Green and Vermillion simplified oral hygiene index (G&V OHI-S) measurements are performed to evaluate the oral hygiene status. In the mentally disabled group the manual toothbrush for MOD-SBI, and Colgate 360° Micro Sonic Power for API showed the best results respectively. The ability of tooth brushing was improved both in healthy and in disabled children during this 5 months study. Unfortunately, it was not obvious in disabled children. Persevering training for tooth brushing might be the most important regardless of the kind of toothbrush.

Is there an advantage to delayed molar implant placement in those with chronic apical periodontitis?

This paper is a single-centre, double-blinded, prospective randomised control trial, comparing immediate vs delayed implant placement clinically and radiographically in patients with chronic periodontitis, specifically assessing the molar region. Seventy-four patients were recruited to the study over a one-year period, all of whom returned for follow up throughout the study. The study adhered to the principles outlined in the Declaration of Helsinki and obtained ethical approval from the affiliated University Hospital of Qingdao. Written consent was gained from patients in line with the CONSORT guidance. The patients were recruited from the Department of Oral and Maxillofacial Surgery at the University of Qingdao between January 2019 and January 2020. The study included anyone above the age of 18, who had a molar with chronic apical periodontitis and lesions of less than 8 mm. Exclusions included pregnancy, uncontrolled diabetes, smokers, bisphosphonate use, history of head/neck tumours, coagulation disorders, and acute infections of adjacent teeth/tissue. Of the patients who met the inclusion criteria, all were randomly numbered by a stomatologist and placed into either the control group or the experimental group by a computerised system (Microsoft Excel). This study looked at the placement of 74 implants in 74 patients, including 40 female and 34 malepatients in total. The delayed implant placement allowed for healing of 3 months in the mandible and 6 months in the maxilla. The width of the implants placed was 6 mm and the lengths were between 7 mm and 12 mm.The periodontal probing depth, modified sulcus bleeding index, andmodified plaque index were all clinically examined. In terms of other parameters assessed, CBCT was used to look at alveolar bone mass. All surgery and implant placement was carried out by the same surgeon and the clinical measurements were all taken by one dentist. The results showed no significant difference in implant stability quotient immediately and 6 months post-surgery (0.110 and 0.066, respectively), when comparing the experimental and control group. Similarly, there was no significant difference in PD, mSBI or mPI between the groups. On assessment of CBCT scans however there was a significant difference between the two groups in the buccal horizontal marginal bone loss (P = 0.003), lingually there was not. Vertical bone loss also showed no significant difference in comparison. At one-year post-implant placement, there was a survival rate of 100% in both groups assessed. IBM SPSS statistics was used for statistical analysis. Multiple tests including the Shapirowilk test, the student t-test and the Mann-Whitney U-test were carried out on the data and all statistical tests were two tailed. Statistical significance was set at <0.05 throughout study of results. The conclusion of this study suggests that immediate implant placement in chronic periodontitis patients, specifically in the molar region, may be clinically viable. With flap surgery and complete removal of inflammatory granulation tissue, the study suggests no significant disadvantage to alveolar bone healing or osseointegration. The various limiting factors of this study should be taken into consideration, and it must be highlighted that longer and larger studies are necessary to allow for more accurate understanding of the long-term outcomes.

The effect of one-time abutment placement on clinical and radiographic outcomes: A 5-year randomized clinical trial.

The aim of this study was to evaluate the long-term (5 years) clinical efficacy of the one-abutment one-time protocol (test) versus the standard of care by placing the definitive abutment on the day of the prosthetic delivery (control). In this study, 39 subjects with 60 implants were randomly allocated to either the test or the control group. Changes in the radiographic interproximal bone levels (DIB), modified sulcus bleeding index, probing depth, modified plaque index, papilla fill (Jemt score), incidence of peri-implantitis and peri-implant mucositis as well as patient-reported outcomes measures (PROMs) were collected and compared at 1, 3 and 5 years. At 5 years, the control group showed a greater, although not statistically significant, change in mean DIB values (0.97 mm vs. 0.53 mm). Regarding the other clinical parameters evaluated, no statistically significant differences were observed between groups at any time point. At 5 years, 51% of the implants presented peri-implant mucositis (25.5% in the control and 23.5% in the test), and only one implant in the test group developed peri-implantitis. The connection and disconnection of healing abutments during the healing period was not associated with higher long-term bone loss. Clinical outcomes and PROMs were similar between groups.

Impact of Bisphosphonate Therapy on Oral Health in Patients with Breast and Prostate Cancer and Bone Metastases: A Comprehensive Study.

This study investigates the impact of bisphosphonate therapy on the stomatognathic system in 80 patients with cancer of the breast and prostate with bone metastases. Bisphosphonates are integral for managing skeletal complications in these malignancies but are associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), affecting 0.8-18.5% of patients. BRONJ manifests with pain, neuropathy, tissue swelling, mucosal ulceration, tooth mobility, and abscesses, yet its pathogenesis remains elusive, complicating risk prediction. The research employed comprehensive dental and radiological evaluations. Dental status was assessed using DMFT and OHI-S indices, Eichner's classification, and clinical periodontal measurements like the pocket depth (PD), clinical attachment loss (CAL), and modified Sulcus Bleeding Index (mSBI). A radiological analysis included panoramic X-rays for radiomorphometric measurements and TMJ lateral radiographs. Results indicated a significant decline in oral hygiene in patients with cancer after bisphosphonate therapy, marked by increased DMFT and OHI-S scores. Periodontal health also showed deterioration, with increased PD and CAL readings. The incidence of BRONJ symptoms was noted, although exact figures are not quantified in this abstract. The study also revealed changes in radiomorphometric parameters, suggesting bisphosphonates' impact on bone density and structure. No substantial alterations were observed in TMJ function, indicating a need for extended observation to understand bisphosphonates' long-term effects on the stomatognathic system. These findings highlight the importance of continuous dental monitoring and prophylaxis in patients undergoing bisphosphonate therapy. Implementing meticulous oral care protocols is essential for mitigating BRONJ risk and managing the complex oral health challenges in patients with cancer.

Assessment of the Efficiency of Tulsi Extract as a Locally Administered Medication Agent and Its Comparison With Curcumin in the Treatment of Periodontal Pockets.

The use of locally administered medication (LAM) agents such as minocycline, metronidazole, and tetracycline as antimicrobials has drawbacks, including the development of microorganism resistance, exorbitant pricing, and limited accessibility. Thus, there is a need for safer and more affordable alternatives. Numerous natural therapies have been found to be superior in this situation. In this study, the efficacy of tulsi extract as a LAM agent was assessed and it was compared with curcumin, which is currently used for the treatment of periodontal pockets. There were three categories: each categoryhad 30 sites. Category 1 sites underwent scaling along with root planing (SRP) solely, Category 2 sites received curcumin extract as LAM in the periodontal pocket in addition to SRP, and Category 3 sites received tulsi extract as LAM in the periodontal pocket in addition to SRP. The stent was used to ensure consistent and unbiased measurementson the 30thday after treatment. Clinical attachment level (CAL) andprobing pocket depth (PPD)were measured at six points around each tooth. Results: The reduction in values of periodontal parameters such as BAPNA (Nα-benzoyl-DL-arginine-p-nitroanilide) assays, modified sulcus bleeding index (mSBI), gingival index (GI), plaque index (PI), CAL, andPPDin sites within Category 1, Category 2, and Category 3 was statistically significant. The decrease in BAPNA assay resultsindicates that tulsi extract is more effective than curcumin gel at eradicating red-complex bacteria. Although not significantly different, the decrease in PI and GI was observed to be greater when curcumin jelly was used. This suggests that curcumin jelly has a stronger impact on reducing plaque, which in turn decreases gingival inflammation. Based on the overall results of the study, it can be said that both tulsi and curcumin have similar effectiveness in reducing periodontal markers.

Serum TNF-α level and probing depth as a combined indicator for peri-implant disease.

Peri-implant disease (PID) is a general term for inflammatory diseases of soft and hard tissues that occur around implants, including peri-implant mucositis and peri-implantitis. Cytokines are a class of small molecule proteins, which have various functions such as regulating innate immunity, adaptive immunity, and repairing damaged tissues. In order to explore the characteristics and clinical significance of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10, and tumor growth factor (TGF)-β1 expression levels in serum of patients with peri-implant disease, 31 patients with PID and 31 patients without PID were enrolled. The modified plaque index (mPLI), modified sulcus bleeding index (mSBI), and peri-implant probing depth (PD) were recorded. The levels of serum TNF-α, IL-6, IL-10, and TGF-β1 were detected by ELISA. TNF-α, mPLI, mSBI, and PD levels were significantly higher in the PID group. TGF-β1 levels were significantly higher in the control group. There was a significant positive correlation between TNF-α and mPLI, mSBI, and PD. TGF-β1 was negatively associated with TNF-α, mPLI, mSBI, and PD. Multiple logistic regression analysis showed that TNF-α and PD were risk factors for the severity of PID. The receiver operating curve analysis showed that high TNF-α levels (cut-off value of 140 pg/mL) and greater PD values (cut-off value of 4 mm) were good predictors of PID severity with an area under the curve of 0.922. These results indicated that TNF-α and PD can be used as a biological indicator for diagnosing the occurrence and progression of PID.

Efficacy of autologous platelet rich fibrin (PRF) and hydroxyapatite bioactive glass (HABG) in the management of intra bony defects -A randomized controlled trial

The ultimate aim of periodontal therapy is regeneration. Traditionally, many techniques and agents were used. The therapeutic outcome in treatment of intra bony defects can be augmented with the use of growth factors alongside bone grafts. The present clinical trial was designed to assess the efficacy of an alloplastic composite graft and the combination of autologous platelet rich fibrin with the graft in the management of intra bony defects. A total of 45 systemically healthy patients with intra bony defects indicated for flap surgery were selected from the outpatient department of periodontics. The patients were divided into three groups with the help of a computer generated random number table. Age, sex, and periodontal parameters (probing pocket depth, clinical attachment level, gingival marginal level, plaque index, modified sulcus bleeding index) and presence of intra bony defects were recorded. The defects in group I patients were treated with autologous PRF along with the graft, group II with graft, and group III with open flap debridement alone. All the patients were recalled at 3, 6, 9 months after surgery, and the periodontal parameters were recorded in each recall. The baseline parameters were compared with 9 month post op periodontal parameters by non parametric test for ANOVA (Kruskal Wallis). Maximum pocket depth reduction (5.86±1.03) maximum gain in attachment (4.64± 1.08), reduction in modified sulcus bleeding index were seen in group I, which is statistically significant between the groups. Though change in gingival marginal level is minimum for group I (1.21± 0.42), it was not statistically significant. Group I showed the maximum percentage of sites with bone fill (92.9%) which was also statistically significant when analyzed by the chi-square test. The Combination of autologous PRF with the hydroxy apatite bioglass graft in the management of intra bony defects showed improved clinical and radiographic outcome.

Clinical and Radiographic Evaluation of Short Locking-Taper Implants Supporting Single Crowns in the Posterior Region: A 12-Year Retrospective Study.

Few studies have reported the outcomes of short implants with a follow-up time longer than 10 years. This retrospective study aimed to evaluate the long-term outcomes of the short locking-taper implants supporting single crowns in the posterior region. Patients who received short locking-taper implants (≤ 8 mm) supporting single crowns in the posterior region from 2008 to 2010 were included. The clinical outcomes, radiographic outcomes, and patient satisfaction were recorded. As a result, a total of 18 patients with 34 implants were included. The cumulative survival rate was 91.4% and 83.3% at implant level and patient level, respectively. Tooth brush habit and history of periodontitis were significantly associated with implant failure (P < .05). The median marginal bone loss (MBL) was 0.24 mm (interquartile range: 0.01 to 0.98). Biologic and technical complications occurred in 14.7% and 17.8% implants, respectively. The mean modified sulcus bleeding index and mean peri-implant probing depths were 0.52 ± 0.63 and 2.38 ± 0.79 mm, respectively. All patients were at least quite satisfied, with the majority of patients being fully satisfied (88.9%) with the treatment. Within the limitations of this study, the short locking-taper implants supporting single crowns in the posterior region achieved promising outcomes in the long-term follow-up.

Indocyanine green based antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment in periodontal maintenance patients: a clinico-microbiological study

Background: Antimicrobial Photodynamic therapy for the treatment of periodontitis is being increasingly gaining attention but at present, very limited data are available on the clinical and microbiological outcomes obtained following Indocyanine Green as the photosensitizer in Maintenance patients. The objective was to evaluate the efficiency of Indocyanine(ICG)-green based photodynamic therapy as an adjunct to scaling and root planing in patients enrolled in maintenance therapy. Methodology: Using a split mouth study design, 24 participants enrolled in the maintenance therapy, having diagnosed as Periodontitis, were randomly subjected to scaling and root planing(SRP). The test group additionally received ICG-based (Aurogreen®, Aurolabs, Madurai, India,1mg/ml) aPDT with an 810nm diode laser. Clinical assessment of Plaque index, modified Sulcus bleeding index, Probing pocket depth, Clinical loss of attachment and microbiological analysis of A. actinomycetemcomitans, P. gingivalis, T. forsythia and F.nucleatum were performed at baseline and 3 months after treatment. Results: It was observed that although there was no significant difference between the test and control group at baseline and 3 months, there was a statistically significant reduction in the mean values in both the groups at 3 months. Microbiological analysis showed substantial reduction in detection frequency of the bacteria assessed at 3 months in both the groups. Conclusion: Within the limits of the study, ICG-based aPDT did not show additional advantage over SRP alone at 3 months, though it could be a promising treatment modality in maintenance patients in terms of patient comfort and the treatment time taken. More randomised clinical trials should be employed to understand the exact mode of action of ICG based aPDT and its role in treatment of periodontal disease.

Comparative evaluation of the clinical and radiographic efficacy of 0.05% zoledronate gel as local drug delivery system in treating intrabony defects in stage III grade B periodontitis patients with and without type-2 diabetes mellitus-A randomized split-mouth clinical trial.

This 6-month randomized split-mouth and placebo-controlled clinical trial aimed to evaluate the clinical and radiographic efficacy of adjunctive use of 0.05% zoledronate (ZLN) gel as local drug delivery to scaling and root planing (SRP) in stage III, grade B periodontitis patients with and without controlled type-2 diabetes mellitus (DM). A total of 120 infrabony sites were divided into two groups: Group-1 (non-diabetic periodontitis) and Group-2 (periodontitis +DM). A total of 60 sites in each group were randomized to receive treatment with SRP+placebo gel (control) or SRP+0.05% ZLN gel (test). Plaque index (PI), modified sulcus bleeding index (mSBI), pocket probing depth (PPD), and relative attachment levels (RAL) were assessed at baseline, 3 and 6 months, and digital intraoral periapical and cone-beam computed tomography imaging were used to measure the linear and percentage reduction of intrabony defect depth (DD, DDR%) after 6 months. Group-1 showed significant reduction in PI (0.56±0.15 and 0.52±0.19 from 0.67±0.17), mSBI (0.7± 0.60 and 0.47± 0.57 from 0.9±0.48), PPD (4.6± 0.85 and 3.43 ± 0.63 from 6.5±1.04) and gain in RAL (7.03±0.85 and 5.93 ± 0.69 from 8.9±1.09) in the ZLN-treated sites than the placebo sites and also from Group-2 sites after 3 and 6 months, respectively. A significant reduction in DD of 28.79% in Group-1 and 22.20% in Group-2 at ZLN sites was seen compared to placebo sites of both groups. ZLN gel applied subgingivally in infrabony pockets resulted in significant clinical improvements evident by probing depth reduction and gain in attachment levels along with radiographic evidence of more bone fill seen in non-diabetic patients compared to diabetic periodontitis patients.

Star-shaped incision technique for gingiva patients treated with implant-supported fixed prosthesis.

To evaluate the modified star-shaped incision on gingival sulcus for reducing horizontal food impaction around implant-supported restoration. Total 24 patients receiving bone-level implant placement were enrolled, a star-shaped incision was made on the gingiva sulcus before the placement of zirconia crown. Follow-up examination was carried out 3 and 6 months after final restoration, respectively. Assessment of soft tissue includes papilla height, modified plaque index, modified sulcus bleeding index, periodontal depth, gingival biotype and gingival margin level. Marginal bone level was measured on periapical radiographs. Only 1 patient complained about the horizontal food impaction. Both the mesial and distal papilla almost filled the entire proximal space, in good harmony with the adjacent papillae. No recession of the gingival margin was found around the crown even in the patients with thin gingival biotype. Other parameters of soft tissue including modified plaque index, modified sulcus bleeding index and periodontal depth remained low during the whole follow-up visit. The resorption of marginal crestal bone was less than 0.6 mm during the first 6 month, and there was no significant difference among baseline, 3-month and 6-month visit. The modified star-shaped incision on the gingiva sulcus maintained the gingival papilla height and reduced the occurrence of horizontal food impaction, and no recession of the gingiva margin was found around implant-supported restoration.

The Effect of Topical Application of Hyaluronic Acid on the Stability of Immediate Loaded Dental Implants in the Posterior Maxilla: Clinical and Animal Study.

Objective: To assess the effect of topically applied hyaluronic acid (HA) on the stability of immediately loaded implants in the posterior maxilla. Materials and Methods: For the clinical study, a total of 20 implants were placed in 14 patients seeking the replacement of missing single or multiple posterior maxillary teeth. The patients were randomly divided into two groups. In the clinical control group (CC group), 10 implants were placed and immediately loaded, while in the clinical study group (CS group), 10 implants were coated with HA immediately before placement and immediately loaded. All patients had implant stability clinically evaluated at implant placement time (T0) and 1 (T1), 3 (T3), and 6 (T6) months after loading. Peri-implant pocket depth and modified sulcus bleeding index were evaluated clinically at 6 months in all patients. Bone density was evaluated radiographically after 3 months. All the clinical and radiographic data were subjected to statistical analysis. For the animal study, a total of 12 implants were placed in the tibiae of six rabbits. For each rabbit, 1 implant without any applied HA was placed in the left tibia (AC group), and 1 implant coated with HA was placed in the right tibia (AS group). The rabbits were euthanized at 21 and 45 days after implant insertion. Results: There were no significant statistical differences between the two groups regarding implant stability, peri-implant pocket depth, modified sulcus bleeding index, or bone density from the palatal and apical aspects. However, there was a significant statistical difference in the bone density from the buccal aspect in favor of the study group. The animal study showed that the newly formed bone in the right tibiae showed improved quantity and quality of bone, as it had denser bone trabeculae and smaller marrow spaces compared to the left tibiae. Conclusion: In the clinical study, the application of hyaluronic acid had a superior effect on the buccal bone density around immediately loaded implants. In the animal study, hyaluronic acid had a synergistic effect on the quality and quantity of bone formation around dental implants.

Mucosal bleeding correlates with submucosal microbial dysbiosis in peri-implant mucositis of patients with periodontitis.

This study aimed to investigate the relationship between microbial communities and the severity of peri-implant mucosal bleeding in peri-implant mucositis. Submucosal plaque samples were collected from 54 implants divided into the healthy implant (HI) group, peri-implant mucositis (PM) group, and peri-implantitis (PI) group. Sequencing of 16S rRNA was performed using the Illumina MiSeq platform. Alpha diversity (i.e., Shannon and Chao index) and beta diversity were used to measure microbial diversity within and between microbial communities, respectively. Differences in microbial taxa between groups were assessed via linear discriminate analysis effect size. Correlation between the modified sulcus bleeding index (mSBI) and microbial dysbiosis index (MDI) was examined using Spearman correlation analysis and linear models. The submucosal bacterial richness (Chao index) was positively correlated with the mean mSBI in the PM group. As the mean mSBI increased in the PM group, the beta diversity became closer to that of the PI group. In the PM group, the abundances of 47 genera were significantly correlated with the mean mSBI, and the MDI was positively associated with the mean mSBI. Fourteen of the forty-seven genera were discriminative taxa between the HI and PI groups, and the abundances of these biomarkers became closer to those in the PI group in the progression of peri-implant disease. A higher mSBI value corresponded to a higher risk of microbial dysbiosis in peri-implant mucositis. The biomarkers identified may be useful for monitoring the progression of peri-implant disease.

Association of stress, depression and anxiety with periodontal health indicators: A clinical study in adult population of Rishikesh

: Chronic periodontitis is a condition that causes inflammation in the tissues that support teeth, gradual attachment loss, and bone loss. Stress is the body's feedback towards detrimental forces, diseases, and additional atypical circumstances that are determined to distress its routine physiological equilibrium. On the other hand, the most prevalent psychological problems connected to periodontitis are anxiety and sadness.: This study intends to assess the relationship between stress, depression, and anxiety with indices of periodontal health.: A total of 171 patients were assessed &amp; divided into 2 groups. Gingival index, modified sulcus bleeding index, community periodontal index for treatment needs, probing pocket depth, and clinical attachment level were evaluated. The Depression Anxiety Stress Scale–21 questionnaire used as the basis for the psychometric evaluation.: The statistical analysis made use of the student 't' test and Pearson's correlation coefficient. When compared between the two groups, Group A had significantly higher values for each metric. The psychometric parameters and the periodontal parameters had a weakly positive connection (p&amp;#60;0.0001).: According to the current study, people who are stressed, depressed, or anxious are more likely to develop periodontal disease. Therefore, stress, depression &amp; anxiety could be viewed as a significant periodontal disease risk factor.

Application of Implant Healing Abutment Supporting Vertical Bone Augments in the Posterior Mandibular Area.

To address the problem of insufficient bone mass in the implant area, we focused on the vertical increment of the posterior mandibular area to increase bone mass with the aid of a healing abutment. Data of patients with insufficient vertical bone height in the posterior mandibular area were collected, and vertical increment of alveolar bone operations was performed with the aid of a healing abutment. Preoperative residual alveolar bone height, immediate postoperative alveolar bone height, and 6-month postoperative alveolar bone height were recorded, with peri-implant soft tissue results 6 months after surgery using the modified plaque index and sulcus bleeding index. Twelve patients, aged 42-73 years, with an average age of 55.91 ± 11.58 years, received vertical bone augmentation in the posterior mandibular region supported by implant healing abutments. Fifteen SLA TSIII OSSTEM implants were utilized in the 12 patients; one patient failed in vertical bone augmentation at one site (H0 = 0 mm). The vertical bone augmentation effect of two patients at two sites was 0 mm < H0 < 1 mm, and the vertical bone augmentation effect of 12 sites in nine patients was H0 ≥ 1 mm. The implant success rate was 93.3%, and the mean vertical bone gain was 2.91 mm. Peri-implant soft tissue parameters are as follows: mean modified plaque index, 1.92; mean modified sulcus bleeding index, 1.21; and mean probing depth, 3.18. No clinically observable complications occurred. Bone augmentation supported by the implant healing abutment showed the characteristics of "platform transfer", with good formation of the implant-bone interface. The bone augmentation surgery was completed at the same time as the implant placement, which reduced the pain of multiple operations and shortened waiting times. We provide a novel idea to solve the problem of insufficient vertical bone height in the posterior mandibular region.

Sub-gingival delivery of simvastatin and rosuvastatin for treatment of chronic periodontitis with diabetes mellitus: A randomized controlled clinical-radiographic pilot study.

Statins are lipid-lowering medications that work by blocking rate-limiting enzyme in cholesterol formation. In patients with Chronic periodontitis (CP) and Diabetes mellitus (DM), subgingival delivery of simvastatin (SMV) and rosuvastatin (RSV) have demonstrated to have bone-stimulatory and anti-inflammatory properties. The current study intended to assess and compare the efficacy of sub-gingivally delivered SMV gel and RSV gel as an adjunctive medication to scaling and root planing (SRP) in the management of intrabony defects in CP patients with type 2 DM. 30 patients with CP and type 2 DM were classified into three treatment groups - SRP+placebo, SRP +1.2% SMV and SRP +1.2% RSV. Clinical parameters: site-specific plaque index, modified sulcus bleeding index (mSBI), pocket probing depth (PPD), and relative attachment level (RAL) were documented at baseline, 3 and 6 months and radiographic parameter: intrabony defect depth (IBD) at baseline and 6 months post-treatment. - LDD of 1.2% SMV and 1.2% RSV demonstrated greater clinical and radiographic improvement than placebo, the improvement being statistically significant for PI, mSBI, and PPD for 1.2% SMV and statistically significant for all clinical and radiological parameters for the 1.2% RSV. 1.2% RSV demonstrated greater IBD fill and RAL gain than 1.2% SMV. - Localized sub-gingival delivery of statins was beneficial in the treatment intrabony defects in patients with CP and well-controlled type 2 DM. IBD fill and RAL gain were higher with 1.2% RSV than with 1.2% SMV.

Three-year observations on the effect of different cusp inclinations on the restoration of short maxillary first molar implants: A randomized controlled trial.

Objective: To investigate the effect of different cusp inclination on short implant prosthesis of maxillary first molar after 3years of weight-bearing in biology and mechanics. Methods: The clinical patients were randomly selected from the database and divided into four groups A, B, C, and D according to the cusp inclination of the maxillary first molar short implant restoration (4.8mm × 8mm, Dentium). 20 cases in each group. The cusp inclination was 10 degrees-15 degrees, 15 degrees-20 degrees, 20 degrees-25 degrees, 25 degrees-30 degrees. After 3years of weight-bearing, cone beam computed tomography (CBCT) and Florida probe were used to measure and observe the height of alveolar bone (H), periodontal probing depth (PD) and modified sulcus bleeding index (MBI). Visual analogue scale (VAS) was used to evaluate the overall satisfaction of patients, and the mechanical complications of each group within 3 years of implant weight-bearing were counted. Results: The H and PD of group D were 1.09 ± 0.23 and 2.19 ± 0.11 respectively, which were significantly higher than those of group A, B and C (p < 0.05). There was no significant difference in MBI between groups A-D (p > 0.05). The VAS scores of group B and group C were 88.36 ± 5.12 and 88.70 ± 4.52 respectively, which were higher than those of group A and group D (p < 0.05). The incidence of food impaction, porcelain collapse and abutment loosening in group D were 40.0%, 25.0% and 15.0% respectively, which were higher than those in group B and C (p < 0.05). Conclusion: The risk of biological and mechanical complications increases after long-term weight-bearing of maxillary first molar short implant prostheses with high cusp inclination. The cusp inclination of short implant prostheses should be designed as low as 25 degrees.

A prospective multicenter clinical study on the efficiency of detachable ball- and spring-retained implant prosthesis.

This prospective clinical study was conducted to evaluate the clinical usefulness of the freely detachable zirconia ball- and spring-retained implant prosthesis (BSRP) through a comparative analysis of screw- and cement-retained implant prosthesis (SCRP). A multi-center, randomized, prospective clinical study evaluating the clinical usefulness of the detachable zirconia ball- and spring-retained implant prostheses was conducted. Sixty-four implant prostheses in 64 patients were examined. Periodic observational studies were conducted at 0, 3, 6, and 12 months after delivery of the implant prosthesis. Factors such as implant success rate, marginal bone resorption, periodontal pocket depth, plaque and bleeding index, and prosthetic complications were evaluated, respectively. During the 1-year observation period, all implants survived without functional problems and clinical mobility, showing a 100% implant success rate. Marginal bone resorption was significantly higher in the SCRP group than in the BSRP group only at the time of implant prosthesis delivery (P = .043). In all observation periods, periodontal pocket depth was slightly higher in the BSRP group than in the SCRP group, but there was no significant difference (P > .05). The modified plaque index (mPI) scores of both groups were moderate. Higher ratio of a score 2 in modified sulcus bleeding index (mBI) was observed in the BSRP group in the 6- and 12-months observation. Within the limitations of this study, the newly developed zirconia ball- and spring-retained implant prosthesis could be considered as an applicable and predictable treatment method along with the existing screw- and cement-retained prosthesis.

Oral health-related quality of life (OHRQoL) in Polish adults with periodontal diseases, oral mucosal diseases and dental caries.

With the development of medicine and extending the human lifespan, the next challenge for healthcare providers is to improve the quality of life. Oral Health Impact Profile (OHIP) is a worldwide known questionnaire that is used for assessing oral health-related quality of life (OHRQoL). The aim of the present study was to assess the impact of periodontal diseases, oral mucosal lesions and dental caries on OHRQoL among Polish adults. A cross-sectional study consisting of an intraoral clinical examination and a questionnaire was conducted among 250 adult patients seeking dental treatment at the University Dental Clinic (UDC) in Cracow, Poland. The obtained clinical data included the number of decayed, filled and missing teeth (DMFT), the presence of fixed or removable dental prostheses, the type and size of oral mucosal diseases, periodontal data based on a visual examination as well as the approximal plaque index (API) and modified sulcus bleeding index (mSBI) scores, and the patient's dental history. A modified OHIP questionnaire was used, which had been previously validated amongst patients with periodontal and oral mucosal diseases. In patients reporting problems with oral mucosa, the OHIP-14 scores in relation to oral mucosa and other soft tissues were higher, and the scores in relation to the teeth were lower than in patients who did not suffer from oral mucosal diseases (0.86 (0.25-1.81) vs. 0.29 (0-1.00); p < 0.001, and 0.39 (0.07-1.07) vs. 0.68 (0.29-1.29); p = 0.048, respectively). Among patients looking for treatment due to caries and other dental problems, the OHIP-14 scores relating to dentures were higher and the scores relating to oral mucosa were lower than in patients who did not report such problems (2.07 (0.96-2.15) vs. 0.64 (0-1.38); p = 0.043, and 0.14 (0-0.56) vs. 0.57 (0.14-1.31); p = 0.001, respectively). Among patients noticing prosthetic problems, the OHIP-14 scores relating to dentures were higher than in those who did not suffer from such issues (2.07 (1.23-2.36) vs. 0.64 (0-1.36); p = 0.004). The symptoms reported by patients with periodontal diseases, oral mucosal lesions and dental caries influenced their OHRQoL. The proper prophylaxis and treatment of these diseases are important to avoid the worsening of OHRQoL.

The Effectiveness of a Bioactive Healing Abutment as a Local Drug Delivery System to Impact Peri-Implant Mucositis: A Prospective Case Series Study.

Modern dental therapy makes use of prosthetic implant reconstructions, which are supported or retained on dental implants. The most frequent, long-term complications associated with these prosthetic implants include mucositis and peri-implantitis. Since mucositis is the initial inflammation of tissues supporting the dental implant, the management of this condition is thus crucial. The aim of the present study was to assess the effects of the placement of bioactive healing abutment for 48 h, in patients diagnosed with peri-implant mucositis. Moreover, the quantitative and qualitative shift in the bacterial profile of the biofilm present in the peri-implant pockets, was assessed by means of RT-PCR genotyping. Each patient was examined using a commercially available PET test protocol: the first sample was taken upon diagnosis (after which the bioactive healing abutment, with clindamycin at a dose of 30 mg, was used for 48 h and replaced with the prosthetic superstructure used so far by a patient); the second sample was taken two weeks after removal of the bioactive healing abutment. The effects of the intervention were clinically assessed using the PET test after the two weeks. A significant reduction in mucositis was observed following treatment, as measured by periodontal indices: modified Sulcus Bleeding Index-mBI (p &lt; 0.001), modified Plaque Index-PLI (r = 0.69, Z= -4.43; p &lt; 0.001) and probing depth-PD (Z = -4.61; p &lt; 0.001). Significant differences in the occurrence of periopathogenic bacteria were also observed: Aggregatibacter actinomycetemcomitans (p &lt; 0.014; Z = -2.45; r = 0.38), Treponema denticola (p &lt; 0.005; Z = -2.83; r = 0.44), Tannerella forsythia (p &lt; 0.001; Z = -4.47; r = 0.69) and Porphyromonas gingivalis (p &lt; 0.132; Z = -1.51).