Modified Sulcus Bleeding Index Research Articles

Soft tissue healing around platform-switching and platform-matching single implants: A randomized clinical trial.

Implants with platform-switching (PS) design have been demonstrated to reduce marginal bone loss. However, the influence on peri-implant soft tissue healing is unclear. This study was designed to investigate its effect on peri-implant soft tissue healing after implant uncovery. Non-smokers needing two implants in different quadrants were recruited in this study. For each individual, one PS and one platform-matching (PM) implants were placed using two-stage protocol. Following 2 to 8 months of healing, all implants were uncovered and connected to the corresponding healing abutments. Clinical measurements and peri-implant crevicular fluid (PICF) were taken at 1-, 2-, 4-, and 6-week after 2nd stage surgery. The cytokine concentrations in PICF were analyzed. Peri-implant mucosa (1 × 2 × 2mm) was harvested around the healing abutment for the analysis of gene expression at uncovery and 6-week post-uncovery. Eighteen participants (nine males; 51.7 ± 14.9 years) were recruited. Compared to PM, PS showed significantly lower probing depth (PD) at 1- and 2-week as well as modified sulcus bleeding index (mSBI) at 1-, 4-, and 6-week (P<0.05). Over time, a decrease in osteoprotegerin and interleukin-1β concentrations in PICF along with an increase in receptor activator of unclear factor kappa-B ligand, periostin, and peroxidasin gene expressions in peri-implant mucosa were noted within both groups (P<0.05) without significant intergroup differences. Within the limits, implants with PS design rendered significant benefits over PM design in PD and mSBI reduction during a 6-week healing. However, molecular changes within PICF and peri-implant mucosa as a response to PM and PS appear negligible.

Efficacy of clarithromycin in the adjuvant treatment of chronic periodontitis: a Meta-analysis

To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use. Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies. Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group. CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.

Clinical and radiographic changes at tissue level implants with either a machined or a modified transmucosal neck surface: A 3-year multicentre randomized controlled proof-of-concept study.

Surface modification may yield enhanced soft tissue adhesion to transmucosal titanium implant necks. To evaluate and compare changes in soft tissues around implants with a modified hydrophilic sandblasted and acid-etched neck (mSLA; test) to those with a machined neck (M; control). Implants with a diameter of 4.1mm and a neck height of 1.8mm were randomly inserted in healed sites with pristine bone of the posterior maxilla or mandible. The modified Sulcus Bleeding Index (mSBI) (primary outcome) was assessed at baseline (BL) and 6, 12 and 36months. Secondary outcomes included the assessment of pocket probing depth (PPD), mucosal recession (REC) and clinical attachment level (CAL). Standardized radiographs were taken at time of implant placement, at BL and after 12 and 36months. Of the 43 randomized subjects, 38 (19 test and 19 controls) completed the 36-month follow-up. Implant survival rates amounted to 95.5% (test) and 100% (control) (p>.05). At 36months, 77.6% of test implants and 78.9% of control implants were without any bleeding sites (mSBI=0; p>.05). The 36-month success rate was 86.4% in the test and 85.7% in the control group, respectively (p>.05). At 36months, the mean radiographic bone level change from BL was 0.33±0.69mm at test implants and 0.12±0.3mm at control implants (p>.05). Tissue level implants with a hydrophilic mSLA transmucosal neck failed to yield clinical and radiographic benefits compared with implants with a machined neck up to 3years.

Dental caries and periodontal status in children with type 1 diabetes mellitus.

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease that strongly affects the health of individuals. Some studies have sug-gested that it affects oral health, thus indicating a higher-than-average predisposition of patients with diabetes to caries and periodontal diseases. We aimed at investigating the association between caries, periodontal diseases, and diabetes among children using dental indices. The study included 50 children (aged 10-18 years) who had type 1 diabetes for at least years. The participants were divided into well controlled (WC), (HBA1c < 7.5%) and poorly controlled (PC) (HBA1c ≥ 7.5%) groups (25 diabetic children each). The control group (GC) included non-diabetic children. The following clinical parameters were measured: DMFT index, plaque index (PI), approximal plaque index (API), gingival index (GI), and modified sulcus bleeding index (mSBI). The WC group had the lowest average value - 3.44 of the DMFT index with values of 5.80 and 3.88 in the PC and GC groups, respec-tively. A statistically significant difference was found in the DMFT value between PC and WC groups (p = 0.04). No statistically signif-icant differences in the values of other indices were found between the groups. Children with poorly controlled type 1 diabetes were characterised by a significantly higher intensity of caries. In contrast, no statistical-ly significant differences were observed in the periodontal status between the study groups.

Minocycline hydrochloride-loaded graphene oxide films on implant abutments for peri-implantitis treatment in beagle dogs.

Dental implant failures still occur because of peri-implant diseases such as peri-implantitis. The objective of this study was to treat peri-implantitis in beagle dogs by fabricating minocycline hydrochloride (MH)-loaded graphene oxide (GO) films on implant abutment surfaces. Beagle dogs with silk ligature were used to establish the peri-implantitis model. Modified sulcus bleeding index, peri-implant probing pocket depth, radiographic evaluation, micro-CT tomography analysis, and histological evaluation were determined to evaluate the therapeutic effect of MH-loaded GO films on abutment surfaces for peri-implantitis. Radiographic and micro-CT analysis showed that lots of marginal bone loss could be found on Ti and MH/Ti groups, especially for Ti group. Little bone less could be seen on GO/Ti group while bone less on MH/GO/Ti group was negligible. Results of the histological analysis presented that lots of neutrophils could be found on Ti and MH/Ti groups. However, almost none of the neutrophils could be observed on GO/Ti and MH/GO/Ti while lots of osteocytes could be found. MH-loaded GO films on implant abutment surfaces could prevent the further development of peri-implantitis and exhibit good therapeutic effect for peri-implantitis in beagle dogs.

Comparing conventional flap-less immediate implantation and socket-shield technique for esthetic and clinical outcomes: A randomized clinical study.

The aim of this study was to assess the esthetic and clinical outcomes of immediate implantation using the conventional flap-less approach and the socket-shield technique (SST). This study included 30 adult patients who underwent anterior teeth replacement and fulfilled the pre-defined criteria. Patients were randomly allocated to the SST (n=15) and conventional flap-less (control, n=15) groups. The esthetic outcomes were evaluated by assessing the degree of soft-tissue recession and the pink esthetic scores (PESs). Clinical parameters, including the modified plaque index, modified sulcus bleeding index (mSBI), probing depth (PD), and implant stability quotient (ISQ), were assessed. The buccal plate width (BPW) and height (BPH) were also measured. Implantation was clinically successful for all subjects in both groups. With a similar baseline, the SST group exhibited less reduction in the midfacial mucosal margins and the height of the mesial and distal papillae as well as higher BPW and BPH values compared with the control group (p<.001). The ISQ values were 76.01±1.31 for the SST group and 75.56±1.07 for the control group (p>.05), suggesting sufficient initial stability in both groups. At the 24-month follow-up, SST group patients had statistically significant lower values of PD, mSBI, and mPLI compared with the control group. There were no significant differences in the overall and individual PES values for both groups. SST may improve functional and esthetic outcomes by maintaining alveolar bone volume and peri-implant tissues. SST seems to be a promising treatment approach for implants in the esthetic zone.

Effects of a Dental Gel Over 6 Months on Periodontal Health in Subjects with Stage II and III (Mild and Moderate) Periodontitis

Objective:Overall aim of this prospective, randomized, positive controlled, double-blind in vivo study was to identify the effects of a test dental gel containing 2.6% edathamil with an added carrier and permeability enhancer vs. a positive control dentifrice on periodontal health measures in patients with Stage II and III periodontitis.Methods:In this prospective double-blinded, randomized study, 33 subjects were randomly assigned in a 1:1 ratio to brushing their teeth with either the test gel (LivFresh®, Livionex Dental Gel, Los Gatos, CA 95030) or the positive control toothpaste (Crest ProHealth®, P&G, Cincinnati, OH 45202).Full-mouth gingival index, modified sulcus bleeding index, and periodontal pocket probing depths were recorded for all teeth at baseline, and on days 90 and 180.Subjects brushed with the study material twice a day.Results:The test dental gel reduced gingival inflammation and bleeding, as well as periodontal pocket probing depths significantly more than a control dentifrice.Conclusions:In this pilot study in subjects with Stage II and III periodontitis, a test dental gel was found to improve gingival inflammation and bleeding, as well as periodontal pocket depths significantly better than a control dentifrice.

Implant-Gingival Unit Stability Around One-Stage Implant with Laser-Microgrooved Collar: Three-Year Result of a Prospective Study.

The aim of the present prospective study was to evaluate the stability of peri-implant soft tissue and the stability of the implant-gingival unit (IGU) around one-stage titanium implants with a laser-microgrooved collar surface following 3 years of loading. Thirty one-stage titanium implants with a laser-microgrooved collar surface were placed in 30 partially edentulous patients. Clinical and radiographic examinations were carried out at implant placement, after a period of 4 to 6 months free of masticatory loading, and after 3 years of function. Plaque Index (PI), modified sulcus bleeding index (SBI), probing depth (PD), distance between the implant coronal margin and the mucosal margin (DIM), clinical attachment level (CAL), and keratinized tissue width (KTW) and thickness (KTT) were recorded. Radiographic marginal bone levels (MBL) were assessed at the mesial (MI) and distal (DI) aspects of implant sites. In addition, the influence of KTT on IGU stability was investigated. No implants failed during the follow-up period. Compared to baseline, PI, BPI, PD, DIM, CAL, KTW, MBL, and IGU showed differences that were not statistically significant (P > .05). Moreover, IGU didn't show a statistical correlation with KTT. Within the limitations of the present study, it can be concluded that around one-stage implants with laser-microgrooved collar, the peri-implant tissues and IGU remain stable over the three evaluation periods.

Evaluation of FGF-23 and 25(OH)D3 levels in peri-implant sulcus fluid in peri-implant health and diseases.

There are limited studies to date investigating vitamin D and fibroblast growth factor (FGF)-23 in different peri-implant conditions. To evaluate the peri-implant sulcus fluid (PISF) FGF-23 and 25-hydroxy-vitamin D3 (25(OH)D3 ) levels in peri-implant health and diseases. A total of 90 dental implant sites (peri-implant healthy group [n = 30], peri-implant mucositis group [n = 30], and peri-implantitis group [n = 30]) in 53 participants were included in the study. Probing depth (PD), clinical attachment level (CAL), suppuration (S), modified plaque index (mPI), gingival index (GI), modified sulcus bleeding index (mSBI), and keratinized mucosa width (KMW) were recorded as clinical parameters, and PISF samples were obtained. FGF-23 and 25(OH)D3 levels were analyzed by enzyme-linked immunosorbent assay. There were no statistically significant differences in FGF-23 concentrations among the groups (P > .05). The 25(OH)D3 concentration was significantly lower in peri-implantitis group compared with the other two groups (P < .05). The mean total amount of FGF-23 in the peri-implantitis group was significantly higher than the peri-implant healthy group whereas 25(OH)D3 total amount was significantly lower in the peri-implantitis group than the peri-implant healthy group. The 25(OH)D3 concentration was significantly negatively correlated with CAL, PD, mPI, S, GI, and mSBI and statistically significant relationship was found between FGF-23 total amount and these clinical parameters (P < .05). There was a negligible positive correlation between 25(OH)D3 and FGF-23 concentrations (τ = 0.169; P = .018). Within the limitations of this study, it can be concluded that FGF-23 and vitamin D seems to affect peri-implant bone health, and further studies are needed to explain the association between FGF-23 and 25(OH)D3 in peri-implant conditions.

Two-stage closed sinus lift for severe bone deficiency in the posterior maxilla imrpoves long-term clinical outcomes

To evaluate the long-term clinical outcomes of two-stage closed sinus lift for the maxillary sinus with residual bone height (RBH) of 1-3 mm in the posterior maxillary. Seventy-eight patients with maxillary posterior tooth loss (1 mm≤RBH≤3 mm and alveolar ridge width ≥5 mm) were treated with two-stage closed sinus lift at the Dental Implantation Center of our hospital between March, 2012 and December, 2014. Coral hydroxyapatite powder and 148 implants were implanted. The superstructure was fixed within 6 months after the operation and the patients were followed up for 1-5 years for assessing the patients' satisfaction, postoperative response, stability and survival rates of the implant, soft tissue condition, bone height of maxillary sinus floor elevation and the marginal bone loss. Perforation of the maxillary sinus floor occurred in 3 (3.85%) of the cases. Twenty-three (30.67%) patients complained of mild pain, and 52 (69.33%) did not experience headache or fever or reported obvious pain or swelling after the operation. The overall response to the operation was favorable. The ISQ value was 58.39±1.39 immediately after the operation, and increased significantly to 81.88±1.22 at 6 months (P &lt; 0.05). During the healing period and the follow-up, none of the implants fell off, and the implant survival rate was 100%. The peri-implant probing depth and modified sulcus bleeding index at 1 year after sinus lifting were similar to those at 5 years after the operation (P &gt; 0.05), but the sinus floor elevation and marginal bone resorption at the two time points differed significantly (P &lt; 0.05). Compared with lateral wall lifting, two-stage close lifting of the maxillary sinus floor is associated with less trauma and less discomfort, and effectively solves the problem of severe alveolar bone height deficiency in the maxillary posterior region to achieve favorable long-term clinical outcomes.

Effect of toothpaste containing amine fluoride and stannous chloride on the reduction of dental plaque and gingival inflammation. A randomized controlled 12-week home-use study.

This single-centre, controlled, randomized, double-blinded clinical study in parallel groups was performed to assess the efficacy of an experimental toothpaste on plaque and gingivitis. In adult subjects with gingivitis, amine fluoride/stannous chloride toothpaste (test) and monofluorophosphate toothpaste (control) were applied twice daily by regular toothbrushing at home. Evaluations of plaque index (PI), gingival index (GI), modified sulcus bleeding index (mSBI) and safety took place at baseline and after 3 and 12weeks of study product use. After study completion, all subjects received a dental prophylaxis. A descriptive statistical analysis included means and standard deviations. Unpaired t tests compared index reductions between groups at a significance level of 0.05. Intention-to-treat analysis included 240 out of 241 subjects. Baseline mean PI was reduced by 0.87±0.35 in the test group and by 0.65±0.41 in the control group. Within-group differences and between-group differences in index reduction were statistically significant (P < 0.001). Mean GI and mSBI were reduced significantly over time (P<0.001) with no clinically meaningful differences between groups. Both toothpastes reduced plaque and gingivitis statistically significant and clinically meaningful over 12weeks. Compared to the control toothpaste, application of the amine fluoride/stannous chloride toothpaste led to a clinically meaningful and more pronounced plaque reduction.

All-Ceramic Zirconium Dioxide Implant Abutments for Single-Tooth Replacement in the Posterior Region: A 5-Year Outcome Report.

To assess the clinical performance of a prefabricated all-ceramic zirconium dioxide implant abutment for single-tooth replacement in the posterior region. Forty implants (Xive S plus screw type, Dentsply Sirona Implants) were inserted into the posterior region in 24 patients and were provided with zirconium dioxide abutments (Cercon abutment, Dentsply Sirona Implants). The licensed range of indications for these abutments is limited to the maxillary and mandibular anterior teeth. The following parameters were used to document the state of the soft tissue: modified Plaque Index; modified Sulcus Bleeding Index; and pocket depth. Mesial and distal bone levels were determined on radiographs during the prosthetic treatment and at the 5-year recall. A total of 34 functioning implants were followed up over a 5-year interval. Two patients wearing three abutments were lost to follow-up. In total, five abutments exhibited a rotational misfit during the observation period, causing significant gingival discoloration and damage to the implants. In the remaining restorations, the soft and hard tissue parameters were indicative of a low inflammatory status. Compared to the baseline situation, partly significant bone apposition could be observed. The observed specific type of failures after 5 years in function for full zirconia posterior implant abutments cannot be recommended, at least not in combination with the implant system used in this study.

Efficacy of Locally Administered 1.2% Rosuvastatin Gel in Patients with Periodontitis: A Randomized Placebo Controlled Clinical Trial

Objective Periodontitis initiation and progression are a result of host immune inflammatory response to oral pathogens. Several pharmacological agents are being delivered locally, to improve periodontal health. Hence, the present randomized placebo controlled clinical trial is designed to check the clinical and antimicrobial efficacy of locally delivered 1.2% rosuvastatin (RSV) in intrabony defects (IBD) in periodontitis patients. Materials and Methods One-hundred patients were randomly allotted into two treatment groups: group A received 1. 2% RSV gel, scaling and root debridement and group B received placebo gel, scaling and root debridement. Clinical parameters, including modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline before phase 1 and after 6 months. Radiographic assessment of IBD was done by cone beam computed tomography at baseline and after 6 months. Anaerobic colony count was done at baseline and after 180 days. Results On intragroup comparison, there is a significant improvement in periodontal parameters in both the groups. On intergroup comparison, there is significant gain in CAL in group A than group B ( p = 0.04). There is significant decrease in PD in group A, compared to group B. There is significant bone fill in group A ( p = 0.034), compared to group B. With respect to mSBI, PI, and anaerobic colony count, there is no significant difference between the two groups after 6 months. No adverse effect was noticed in any subjects. Conclusion The author concludes that 1.2% RSV gel when delivered locally into IBD improved periodontal clinical parameters such as PD and CAL and showed significant bone fill.

Evaluation of the clinical efficacy of 1.2% atorvastatin in the treatment of periodontal intraosseous defects by CBCT: A randomized controlled clinical trial.

Background. Atorvastatin (ATV), which belongs to the statin class of drugs, is the formidable inhibitor of 3-hydroxy-2- methyl-glutaryl coenzyme A reductase. This clinical trial evaluated and compared the clinical and radiographic changes in chronic periodontitis (CP) patients, obtained through 1.2% ATV as an adjunct to scaling and root planing (SRP) in the treatment of intraosseous defects. Methods. Twenty CP patients, with a minimum of one pair of bilateral intraosseous, were randomly selected for this splitmouth study. Group 1 included 20 sites treated with SRP and subgingival delivery of a placebo gel, whereas an equal number of sites in group 2 were treated by SRP along with subgingival delivery of 1.2% ATV gel. The plaque index (PI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD) and clinical attachment level (CAL) were evaluated at baseline and 3- and 6-month intervals, while the intraosseous defect was assessed at baseline and 6-month interval using cone-beam computed tomography (CBCT). Paired t-test was used to determine statistical significance. Results. A greater reduction in the mean PPD and gain in CAL was found in group 2 compared to group 1 at 3- and 6-month intervals. Furthermore, a significantly greater bone fill was obtained in group 2 (1.70±0.54 mm) compared to group 1 (0.22±0.43 mm) after six months. Conclusion. ATV, as an adjunct to SRP, enhanced periodontal regeneration, as a noninvasive way to treat periodontal intraosseous defects.

Comparative Evaluation of Boric Acid Gel versus Chlorhexidine Gel in the Treatment of Chronic Periodontitis: Randomized, Placebo-Controlled Clinical Study.

Background:Over the years, various antimicrobials have been tried and tested in the treatment of periodontitis. Chlorhexidine (CHX) has emerged as the gold standard. In recent years, trend has shifted toward the use of agents with antibacterial, anti-inflammatory, and osteoblastic activity. Boric acid (BA) is one such agent which possess all such properties and thus been evaluated in the treatment of periodontitis.Aim and Objective:The aim of the study is to compare and evaluate the efficacy of 0.75% BA gel versus 1% CHX gel as an adjunct to scaling and root planing in patients with chronic periodontitis both clinically and microbiologically.Materials and Methods:The present study was a randomized, placebo-controlled clinical trial where 45 systemically healthy patients with chronic periodontitis were included in the study. About 15 patients each were divided into three groups, that is, Group I received BA gel, Group II received CHX gel, and Group III received placebo gel as a local drug delivery agent. Clinical parameters such as gingival index, plaque index, modified sulcus bleeding index, probing pocket depth, and clinical attachment level were evaluated at baseline and 6-month follow-up. Microbiological analysis to check for mixed anaerobic flora was done using subgingival plaque samples at baseline and 3 months after treatment.Results:Significant reduction was seen in all clinical parameters in both BA and CHX gel groups as compared to control group (P < 0.05). However, on comparing BA gel group with CHX gel, the results were statistically insignificant (P > 0.05).Conclusion:BA gel and CHX gel both were equally effective in improving the clinical and microbiologic parameters in patients with chronic periodontitis when used as a local drug delivery agent.

IL-1ß rs1143634 and rs16944 polymorphisms in patients with periodontal disease

Background: Periodontal disease (PD) is a chronic inflammatory condition caused by pathogenic microflora in a biofilm, often leading to tooth loss. The inflammatory response of periodontal tissues to infection is influenced by both environmental and genetic factors. The interleukin (IL)-1 family of proinflammatory cytokines plays a role in the tissue destruction associated with PD due to their proinflammatory and bone-resorptive properties. In addition, recent studies have indicated that polymorphisms in the genes encoding IL-1 might be associated with greater PD severity. In this study, we examined the association between IL-1ß rs1143634 and rs16944 polymorphisms and PD in non-smoking and smoking patients.Materials and methods: This study included 200 patients with PD (130 non-smokers and 70 smokers) and 156 control subjects (124 non-smokers and 32 smokers). Periodontal evaluation included approximal plaque index, modified sulcus bleeding index, probing pocket depth and clinical attachment loss.Genotyping was utilized for all samples by using allelic discrimination assays with TaqMan® probes on a 7500Fast Real-Time PCR Detection System.Results: There were no statistically significant differences in the distribution of rs1143634 and rs16944 genotypes and alleles between patients with PD and control subjects, between smoking patients with PD and smoking controls, or between non-smoking patients with PD and non-smoking controls.Conclusions: The results of this study suggest there is no association between IL-1ß rs1143634 and rs16944 polymorphisms and PD.

Comparative evaluation of subgingivally delivered 1.2% rosuvastatin and 1% metformin gel in treatment of intrabony defects in chronic periodontitis: A randomized controlled clinical trial.

The aim of this study is to explore and compare the clinical efficacy of locally delivered 1.2% Rosuvastatin (RSV) and 1% Metformin (MF) gel as an adjunct to scaling and root planning (SRP) in the treatment of intrabony defects in chronic periodontitis patients. A total of 90 volunteers were randomly assigned to three treatment groups; 1) SRP plus placebo gel; 2) SRP plus 1.2% RSV gel; 3) SRP plus 1% MF gel. Clinical parameters like modified sulcus bleeding index (mSBI), plaque index (PI), pocket probing depth (PD) and clinical attachment level (CAL) were recorded at baseline, 6 and 12 months and the radiologic assessment of bone defect fill was performed at 6 and 12 months. mSBI, BP, PD, and CAL were improved in all the groups, however mean reductions in PD, CAL gain, and percentage of bone fill was found to be higher in RSV and MF groups than placebo group at all visits. Adjunctive use of locally delivered 1.2% RSV and 1% MF gel stimulates a significant PD reduction, CAL gains and improved bone fill when compared with placebo gel. Results were significantly better with the use of 1.2% RSV gel than 1% MF gel.

Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis.

This review aimed at evaluating the effects of chronic periodontitis (CP) treatment with local statins as adjuncts to scaling and root planing (SRP), compared with SRP alone or with placebo. Electronic and hand searches were conducted in three databases to select randomized controlled trials (RCTs) comparing SRP + statins versus SRP alone. Random effects models were conducted to determine the clinical attachment level (CAL) gain as the primary outcome variable, and probing pocket depth (PPD) reduction, modified sulcus bleeding index (mSBI), and intrabony defect depth (IBD) as the secondary outcomes. Of the 526 papers identified, 15 articles met the criteria for inclusion in this systematic review, and 13 in the meta-analysis. The meta-analysis showed a statistically significant CAL gain (mean differences [MD] = 1.84mm, 95% confidence interval [CI] = 1.45 to 2.23; p = 0.000), PPD reduction (MD = 1.69mm, 95% CI = 1.37 to 2.04; p = 0.000), mSBI change (MD = 0.70, 95% CI = 0.57 to 0.84; p = 0.000), and IBD (MD = 1.48, 95% CI = 1.30 to 1.67; p = 0.000) attributed to SRP + statin treatment (6months). Within the limitations of this study, the collective evidence emerging from this systematic review and meta-analysis may support the use of locally applied statins as adjuncts to SRP in CP treatment, based on being an easy, low-cost alternative, with lesser adverse effects on bacterial resistance. These results should be interpreted with caution. Clinicians might consider the use of SRP + statins as an adjunct over other alternative approaches, based on the results of the present review. The informed decision should be taken, considering the patient's values and preferences, and the intervention to be implemented by the clinician.

The evaluation of peri-implant sulcus fluid osteocalcin, osteopontin, and osteonectin levels in peri-implant diseases.

Peri-implant mucositis is an inflammation of the soft tissues surrounding an implant. Peri-implantitis refers to a process characterized by peri-implant bone loss along with an inflammation of the soft tissues. Osteocalcin, osteopontin, and osteonectin proteins are related to bone remodeling. The aim of the present study was to investigate peri-implant sulcus fluid (PISF) osteocalcin, osteopontin, and osteonectin levels in peri-implant mucositis and peri-implantitis. Fifty-two implants with peri-implantitis, 46 implants with peri-implant mucositis, and 47 control implants were included in the study. Clinical parameters including probing depth, modified sulcus bleeding index and modified plaque index were recorded. PISF osteocalcin, osteopontin, and osteonectin levels were analyzed by ELISA kits. There were no significant differences in PISF osteocalcin, osteopontin, and osteonectin total amounts between healthy controls, peri-implant mucositis and peri-implantitis groups (P>0.05). Probing depths were not correlated with PISF osteocalcin, osteopontin, and osteonectin levels in the study groups (P>0.05). Soft tissue inflammation around dental implants does not cause a change in osteocalcin, osteopontin, and osteonectin levels in PISF. Also, peri-implantitis does not seem to give rise to an increase in PISF levels of osteocalcin, osteopontin, and osteonectin.

The Effect of Platelet-Rich Fibrin on Soft Tissue and Crestal Bone in One-Stage Implant Placement in Fresh Extraction Sockets: A Randomized Controlled Clinical Trial

Introduction: The goal of modern dentistry is to prevent tooth loss and provide a healthy dentition with optimal functional efficiency, structural balance, and aesthetic harmony. The placement of an implant immediately after tooth extraction helps to maintain the bone crest and leads to ideal implant positioning from a prosthetic point of view and has the potential of decreasing the total treatment time for patients. Aim and Objective: To evaluate the platelet rich fibrin with or without bone ceramic on soft issue and crestal bone in one stage implant placement in fresh extraction socket. Materials and Methods: A total of 30 patients were randomly assigned into two groups—each group comprising 15 patients based on platelet-rich fibrin with and without bone ceramic and one-stage implant placement in fresh extraction socket. All patients were prospectively evaluated clinically and radiographically. All the data were analyzed using a software statistical package for social sciences (SPSS) version 11.5 (Chicago, Illinois, USA). Results: During the 6-month interval, no implant was lost; the mean bone level at the implants increased in platelet-rich fibrin (PRF) with bone ceramic group and decreased in PRF group and papillary index increased in both the groups, whereas modified sulcus bleeding index and probing pocket depth (PPD) decreased in both the groups. Conclusion: It can be concluded that mean crestal bone levels increased in PRF with bone ceramic group, whereas decrease in PRF group and both the groups are statistically significant. When the papillary levels are compared between the two groups, there was no statistical significance, but increased papillary levels were found in both the groups. The mean PPD was decreased in both the groups, but there was no statistical significance between the two groups.