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Aalizadeh Y, Khamisi N, Asghari P, Safari A, Mottaghi M, Taherkhani MH, Alemi A, Ghaderi M, Rahmanian M. The Mediterranean diet and periodontitis: A systematic review and meta-analysis. Heliyon 2024; 10:e35633. [PMID: 39170303 PMCID: PMC11336861 DOI: 10.1016/j.heliyon.2024.e35633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/23/2024] Open
Abstract
Periodontitis is a severe oral health condition that affects the soft tissue and bone supporting the teeth. The Mediterranean diet has been proposed as a potential contributor to reducing the risk of periodontitis. This systematic review and meta-analysis aims to explore the association between adherence to the Mediterranean diet and periodontitis. A comprehensive literature search from 1992 to January 2024 was conducted across multiple databases, including PubMed, Scopus, Web of Science, and Google Scholar. The included studies were clinical trials, randomized controlled trials, and observational studies that evaluated the impact of the Mediterranean diet on periodontitis. Data extraction and quality assessment of the included studies were performed using standardized protocols. A meta-analysis was conducted to combine effect sizes from multiple studies. This review included seven studies, comprising one cohort study, five cross-sectional studies, and one randomized controlled trial. While some studies reported a potential link between Mediterranean diet adherence and periodontitis, the overall analysis did not demonstrate a significant association. The meta-analysis revealed an Odds Ratio (95 % Confidence Interval) of 0.77 (0.58, 1.03) for the association between adherence to the Mediterranean diet and periodontitis (p = 0.08). This systematic review and meta-analysis found no statistically significant association between periodontitis and Mediterranean diet adherence. Future research should prioritize the implementation of rigorous clinical studies with longer follow-up periods to better understand the causal association between the Mediterranean diet and periodontitis. Observational studies with larger sample sizes are needed to establish more conclusive evidence regarding the impact of dietary patterns on periodontal health.
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Affiliation(s)
- Yasmina Aalizadeh
- Department of Pediatric Dentistry, School of Dentistry, Islamic Azad University (khorasgan Branch), IAU (Khorasgan Branch), University Blvd, Jey St, Arqavanieh, Isfahan, 81551-39998, Iran
| | - Nima Khamisi
- School of Dentistry, Islamic Azad University (Khorasgan Branch), IAU (Khorasgan Branch), University Blvd, Jey St, Arqavanieh, Isfahan, 81551-39998, Iran
| | - Parastoo Asghari
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Knowledge and Health City, At the End of Shahid Fakouri Blvd (In Front of Fakouri 94), Mashhad, 99191-91778, Iran
| | - Amirhossein Safari
- School of Dentistry, Tehran Islamic Azad University of Medical Sciences, No. 4 9th Neystan Pasdaran St, Tehran, 1946853314, Iran
| | - Mahtab Mottaghi
- School of Dentistry, Mashhad University of Medical Sciences, At the Beginning of Vakil Abad Blvd., in Front of Mellat Park, Mashhad, 9177948959, Iran
| | - Mohamad Hosein Taherkhani
- School of Dentistry, Tehran University of Medical Sciences, TUMS, North Kargar Ave, Amirabad, Tehran, 1439955934, Iran
| | - Anahita Alemi
- School of Dentistry, Tehran Islamic Azad University of Medical Sciences, No. 4 9th Neystan Pasdaran St, Tehran, 1946853314, Iran
| | - Masoume Ghaderi
- Student Research Committee, School of Dentistry, Zanjan University of Medical Sciences, Dr.Sobouti Blvd, Zanjan, 4513956184, Iran
| | - Mohammad Rahmanian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, SBUMS, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, 1983963113, Iran
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García-González S, Aboul-Hosn Centenero S, Baumann P, Fita-Esteban I, Hernández-Alfaro F, Weyer N. Prospective, multi-centric, international, single-arm, cohort study to assess a synthetic polyamide suture material in oral surgery to close the mucosa - MUCODA study. J Dent 2024; 145:104922. [PMID: 38490322 DOI: 10.1016/j.jdent.2024.104922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES The aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery. METHODS The study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions. Main objective was the incidence of combined postoperative complications until suture removal. The 95 % Confidence Interval (Agresti-Coull method) was used to prove the non-inferiority with a pre-specified upper margin of 21.9 %. Secondary variables were intraoperative suture handling, patient pain and satisfaction, wound healing, aesthetic appearance, and bacterial contamination. RESULTS 105 patients were enrolled. Complication rate was low (1.9 %), 2 swellings occurred. Pain was present for 1.61 days ± 1.42 after various dental interventions with an average pain level of 20.98 ± 22.60 (VAS). Patients with impacted third molar extraction showed the longest pain duration (6 days) combined with the highest mean pain level of 35.33 ± 30.45 (VAS). Intraoperative suture handling was very good to excellent. Suture removal was done after an average duration of 7.56 ± 2.09 days. Patient's satisfaction was high, and an excellent wound healing was reported by the dentists. Aesthetic appearance only performed in implant patients was rated by oral surgeons with an average of 96.19 ± 3.79 points [min. 80 - max. 100] at 5 months postoperatively. Thread bacterial analysis showed that F. nucleatum was the most present species. CONCLUSIONS Our findings indicate that the non-absorbable, nylon-based monofilament suture used is safe and quite suitable for oral mucosal closure after various dental surgical interventions such as tooth extraction, implant placement and impacted third molar extraction. CLINICAL SIGNIFICANCE This study showed the safe use of a non-absorbable, nylon-based monofilament suture for different oral surgical interventions under daily routine clinical practice.
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Affiliation(s)
- S García-González
- Department of Oral Surgery, International University of Catalonia, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain.
| | - S Aboul-Hosn Centenero
- Department of Oral Surgery, International University of Catalonia, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - P Baumann
- Department of Medical Scientific Affairs, Aesculap AG, Am Aesculap Platz 78532 Tuttlingen, Germany
| | - I Fita-Esteban
- Department of Medical Scientific Affairs, B. Braun Surgical, S.A.U., Carretera de Terrassa 121 08191 Rubí, Barcelona, Spain
| | - F Hernández-Alfaro
- Department of Oral Surgery, International University of Catalonia, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - N Weyer
- Praxisklinik für MKG, Ästhetische und Plastische Chirurgie, Schwerpunkt Implantologie, Fabrikstraße 10/1, 73728 Esslingen am Neckar, Germany
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Boeriu S, Steigmann L, Di Gianfilippo R. Acellular dermal matrix for the treatment of multiple gingival recession defects associated with carious and previously restored cervical lesions: A case report with 10 years of follow-up. Clin Adv Periodontics 2024; 14:77-82. [PMID: 37116504 DOI: 10.1002/cap.10245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/23/2023] [Accepted: 04/26/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Limited evidence exists on the outcome of the modified coronally advanced tunnel (MCAT) with acellular dermal matrix (ADM) for the treatment of gingival recession defects (GRD) especially when complicated by restored cervical lesions. Therefore, the aim of this case report was to assess the short- and long-term clinical outcomes of maxillary Type 1 recession defects (RT1) associated with restored cervical lesions treated with MCAT with ADM. METHODS AND RESULTS A 43-year-old female patient, presented with multiple adjacent RT1 recessions in the left maxilla, previously treated with overhanging cervical resin restorations. The case was approached with a careful evaluation of the diagnostic determinants of root coverage, removal of the aberrant resin restorations, treatment with MCAT with ADM, and periodical evaluation over a follow-up of 10 years. The treatment was followed by complete root coverage, improvement of gingival phenotype, and perfect root coverage esthetic score. Outcomes were periodically assessed and were maintained over 10 years of follow-up. CONCLUSION MCAT with ADM is an effective technique for the treatment of multiple GRD complicated by cervical restorations. Complete root coverage and excellent esthetic outcomes were obtained and maintained in the long term.
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Affiliation(s)
- Sorin Boeriu
- Private Practice, Toledo-Findlay-Maumee, Ohio, USA
| | - Larissa Steigmann
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Blyleven GM, Johnson TM, Inouye KA, Stancoven BW, Lincicum AR. Factors influencing intraoperative and postoperative complication occurrence: A series of 1135 periodontal and implant-related surgeries. Clin Exp Dent Res 2024; 10:e849. [PMID: 38345517 PMCID: PMC10847704 DOI: 10.1002/cre2.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES In periodontology, it is widely recognized that evidence characterizing the incidence and effect of treatment complications is lacking. The objective of this study was to assess the influence of operator-, procedure-, patient-, and site-associated factors on intraoperative and postoperative complication occurrence. MATERIAL AND METHODS A single investigator reviewed records of patients treated by eight periodontics residents from July 2018 through June 2022. For each procedure, the investigator recorded each intraoperative and postoperative complication or indicated that no complication had occurred. These outcomes were analyzed against a panel of explanatory covariates. In addition, the severity of each postoperative complication was assessed using a standardized grading system. RESULTS A total of 1135 procedures were included in the analysis. Intraoperative and postoperative complications were identified in 2.8% and 15.2% of procedures, respectively. The most common intraoperative complications were Schneiderian membrane perforation (1.3%) and gingival flap perforation/tear (1%), and the most common postoperative complications were dentin hypersensitivity (2.6%), excessive pain (2.5%), and infection (2.2%). Subepithelial connective tissue graft (odds ratio [OR]: 3.2, 95% confidence interval [CI]: 1.6, 6.1; p < .001), guided bone regeneration (OR: 3.0, 95% CI: 1.4, 6.5; p = .004), and guided bone regeneration with implant placement (OR: 3.1, 95% CI: 1.3, 7.6; p = .011) were associated with higher odds of postoperative complication, whereas lateral sinus elevation (OR: 102.5, 95% CI: 12.3, 852.9; p < .001), transalveolar sinus elevation (OR: 22.4, 95% CI: 2.2, 224.5; p = .008), open flap debridement (OR: 36.4, 95% CI: 3.0, 440.7; p = .005), and surgically facilitated orthodontic therapy (OR: 20.5, 95% CI: 1.2, 358.4; p = .039) were associated with higher odds of intraoperative complication occurrence. CONCLUSIONS Consistent with previous reports, procedure type appears to be the predominant factor driving complication occurrence. As analyses of treatment complications increase, individualized risk-benefit assessments will become progressively meaningful for patients.
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Affiliation(s)
- Gary M. Blyleven
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Thomas M. Johnson
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Kimberly Ann Inouye
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Brian W. Stancoven
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Adam R. Lincicum
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
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Wu J, Wang P, Yin Y, Liang J, Fan Y, Zhang X, Han X, Sun Y. Cationic Biopolymeric Scaffold of Chelating Nanohydroxyapatite Self-Regulates Intraoral Microenvironment for Periodontal Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2023; 15:55409-55422. [PMID: 37942935 DOI: 10.1021/acsami.3c13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Periodontal bone defect is a common but longstanding healthcare issue since traditional bone grafts have limited functionalities in regulating complex intraoral microenvironments. Here, a porous cationic biopolymeric scaffold (CSC-g-nHAp) with microenvironment self-regulating ability was synthesized by chitosan-catechol chelating the Ca2+ of nanohydroxyapatite and bonding type I collagen. Chitosan-catechol's inherent antibacterial and antioxidant abilities endowed this scaffold with desirable abilities to eliminate periodontal pathogen infection and maintain homeostatic balances between free radical generation and elimination. Meanwhile, this scaffold promoted rat bone marrow stromal cells' osteogenic differentiation and achieved significant ectopic mineralization after 4 weeks of subcutaneous implantation in nude mice. Moreover, after 8 weeks of implantation in the rat critical-sized periodontal bone defect model, CSC-g-nHAp conferred 5.5-fold greater alveolar bone regeneration than the untreated group. This cationic biopolymeric scaffold could regulate the local microenvironment through the synergistic effects of its antibacterial, antioxidant, and osteoconductive activities to promote solid periodontal bone regeneration.
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Affiliation(s)
- Jingwen Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Peilei Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Yijia Yin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jie Liang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
- Sichuan Testing Center for Biomaterials and Medical Devices, Sichuan University, 29 Wangjiang Road, Chengdu 610064, P. R. China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Xianglong Han
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yong Sun
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
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Silva ALM, de Souza JAC, Nogueira TE. Postoperative local interventions for the palate as a gingival graft donor area: a scoping review. Clin Oral Investig 2023; 27:6971-7006. [PMID: 37851129 DOI: 10.1007/s00784-023-05296-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE This scoping review aimed to systematically identify evidence-based interventions to stimulate healing or protect the harvested palate of patients undergoing gingival grafting. MATERIAL AND METHODS The study followed guidelines from the Joanna Briggs Institute and PRISMA-ScR (protocol available at osf.io/zhafn). PubMed, Embase, and seven other databases were searched on November 2022, with additional monitoring until April 2023. The inclusion criteria focused on studies evaluating outcomes related to the donor area (palate) and interventions for healing or protecting it, regardless of publication year and language. Data from the included publications was extracted and presented through narrative text, tables, and figures. RESULTS Eighty-one studies (including 64 clinical trials, four case series, five theses, and eight systematic reviews) and 37 clinical trial records were included. The number of studies on this topic has significantly increased, reflecting a growing interest in the field. Thirty-six interventions with published results and 12 interventions with unpublished results from clinical trial registers were identified. Some promising interventions that showed potential for improving patient-reported outcomes include cyanoacrylate adhesive, platelet-rich fibrin (PRF), and the combination of palatal stents and healing agents. CONCLUSIONS Thirty-six interventions with published results were identified for postoperative use on the harvested palate, showing varying levels of evidence and conflicting effectiveness for specific outcomes. CLINICAL RELEVANCE Postoperative discomfort and pain in the palate are commonly experienced by patients undergoing grafting procedures using this region as the donor area. Awareness of the available options and their levels of evidence is crucial for informed decision-making.
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Affiliation(s)
- Ana Luiza Mustafé Silva
- Faculty of Dentistry, Postgraduate Program in Dentistry, Universidade Federal de Goiás, CEP, Goiânia, Goiás, 74605-220, Brazil
| | - João Antônio Chaves de Souza
- Faculty of Dentistry, Postgraduate Program in Dentistry, Universidade Federal de Goiás, CEP, Goiânia, Goiás, 74605-220, Brazil
| | - Túlio Eduardo Nogueira
- Faculty of Dentistry, Postgraduate Program in Dentistry, Universidade Federal de Goiás, CEP, Goiânia, Goiás, 74605-220, Brazil.
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Mounssif I, Bentivogli V, Rendón A, Gissi DB, Maiani F, Mazzotti C, Mele M, Sangiorgi M, Zucchelli G, Stefanini M. Patient-reported outcome measures after periodontal surgery. Clin Oral Investig 2023; 27:7715-7724. [PMID: 37940683 PMCID: PMC10713745 DOI: 10.1007/s00784-023-05362-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES The present study aimed to explore the impact of different periodontal surgical treatments on the quality of life and postoperative morbidity. MATERIALS AND METHODS The present study is a single-center, prospective, observational cohort trial. One hundred fifty-five patients, referred to the Periodontal Department of Bologna University who needed periodontal surgical treatment, were recruited. The self-reported perception of the postoperative course was assessed using the following anonymous questionnaires: Italian oral health impact profile (I-OHIP-14), visual analog scale (VAS) to evaluate the intensity of the pain, and 5-point Likert scale. RESULTS Patients reported a mean OHIP-14 total score of 9.87±8.5 (range 0-42), significantly influenced by the female sex, flap extension, and periodontal dressing. A mean VAS score of 2.96±2.39 (range 0-9) was calculated, and was found to be influenced by the presence of vertical releasing incisions and palatal flap extension. Of the 155 subjects, 40 (25.8%) patients reported bleeding as a post-surgical complication, 96 (61.9%) swelling, 105 (67.7%) eating discomfort, and 44 (28.4%) reported speech discomfort. CONCLUSIONS Within the limitations of the nature of the present study, periodontal surgical procedures have a low impact on patients' quality of life evaluated through the OHIP-14 and VAS pain questionnaires. CLINICAL RELEVANCE Periodontal surgical procedures are safe procedures, with a limited duration of postoperative discomfort as well as the incidence of complications.
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Affiliation(s)
- Ilham Mounssif
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Valentina Bentivogli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Alexandra Rendón
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Davide B Gissi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Francesco Maiani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Claudio Mazzotti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Monica Mele
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Matteo Sangiorgi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Abad-Coronel C, Vélez Chimbo D, Lupú B, Pacurucu M, Fárez MV, Fajardo JI. Comparative Analysis of the Structural Weights of Fixed Prostheses of Zirconium Dioxide, Metal Ceramic, PMMA and 3DPP Printing Resin-Mechanical Implications. Dent J (Basel) 2023; 11:249. [PMID: 37999013 PMCID: PMC10670660 DOI: 10.3390/dj11110249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/11/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023] Open
Abstract
The aim of this study was to determine the mechanical implications of four-unit fixed dental prostheses (FDPs) made of (1) monolithic zirconium dioxide (ZR O2), (2) polymethylmethacrylate (PMMA), (3) metal ceramic (PFM) and (4) impression resin (3DPP). METHODS Four groups were studied with eight samples for each material (n: 32). Each structure was weighed, subjected to compressive tests and analyzed using 3D FEA. RESULTS PMMA presented the lowest structural weight (1.33 g), followed by 3DPP (1.98 g), ZR O2 (6.34 g) and PFM (6.44 g). In fracture tests, PMMA presented a compressive strength of 2104.73 N and a tension of 351.752 MPa; followed by PFM, with a strength of 1361.48 N and a tension of 227.521 MPa; ZR O2, with a strength of 1107.63 N and a tension of 185.098 MPa; and 3DPP, with a strength of 1000.88 N and a tension of 143.916 MPa. According to 3D FEA, 3DPP presented the lowest degree of deformation (0.001 mm), followed by PFM (0.011 mm), ZR O2 (0.168 mm) and PMMA (1.035 mm). CONCLUSIONS The weights of the materials did not have a direct influence on the mean values obtained for strength, stress or strain. Since the performance was related to the tension and forces supported by the structures in critical zones, the importance of considering design factors is clear. In vitro and 3D FEA assays allowed us to simulate different scenarios for the mechanical properties of certain materials before evaluating them clinically. Thus, they can generate predictions that would allow for the design of a better research methodology in future clinical trials.
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Affiliation(s)
- Cristian Abad-Coronel
- Research Group on CAD/CAM Materials and Digital Dentistry, Faculty of Dentistry, University of Cuenca, Cuenca 10107, Ecuador
| | - David Vélez Chimbo
- Facultad de Odontología, Universidad de Cuenca, Cuenca 10107, Ecuador; (D.V.C.); (B.L.); (M.P.)
| | - Billy Lupú
- Facultad de Odontología, Universidad de Cuenca, Cuenca 10107, Ecuador; (D.V.C.); (B.L.); (M.P.)
| | - Miguel Pacurucu
- Facultad de Odontología, Universidad de Cuenca, Cuenca 10107, Ecuador; (D.V.C.); (B.L.); (M.P.)
| | - Marco V. Fárez
- New Materials and Transformation Processes Research Group GiMaT, Universidad Politécnica Salesiana, Cuenca 010105, Ecuador (J.I.F.)
| | - Jorge I. Fajardo
- New Materials and Transformation Processes Research Group GiMaT, Universidad Politécnica Salesiana, Cuenca 010105, Ecuador (J.I.F.)
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Bourgoin A, Agossa K, Seror R, Fumery M, Radoi L, Gosset M. Management of dental care of patients on immunosuppressive drugs for chronic immune-related inflammatory diseases: a survey of French dentists' practices. BMC Oral Health 2023; 23:545. [PMID: 37559031 PMCID: PMC10411020 DOI: 10.1186/s12903-023-03258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES The aim of the study was to provide an overview of the practices of French general dentists (GDs) and specialists (SDs) concerning the management of patients with inflammatory bowel diseases (IBDs), rheumatic inflammatory diseases (IRDs), and vasculitis on biologic disease-modifying antirheumatic drugs (bDMARDs), conventional DMARDs, or immunosuppressants (ISs). MATERIALS AND METHODS An online national cross-sectional survey with 53 questions was developed by a multidisciplinary team including rheumatologists, gastroenterologists and dentists based on their clinical experience. It was refined following a test with nine dentists in private practice and in hospital before being disseminated to the members of French scientific societies and colleges of dentistry teachers over 3 months. Responses of general dentists versus specialists were compared with respect to their experience in managing patients with IRDs or IBDs, knowledge/training, type of invasive procedure performed, management of medical treatment, perioperative oral-care protocols, and frequency of postoperative complications after invasive dental care procedures. RESULT In total, 105 practitioners fully completed the survey (participation rate 11.1%). SDs more frequently performed invasive surgical procedures and were more aware of the recommendations of learned societies than GDs. They encountered more post-operative complications for patients on bDMARDs. For both SDs and GDs, most patients were managed without stopping treatment and pre- and postoperative antibiotics were prescribed to more than 75% of patients. When medical treatment was stopped, the decision was made by the prescribing physician. CONCLUSION Complications were reported more frequently by SDs when highly invasive procedures were performed on patients under active drug therapy. Certain common procedures, such as scaling and root planing, appear to be safe, regardless of treatment management. However, adapted guidelines for the practice of dentistry are needed to standardize the management of patients on bDMARDS, conventional DMARDs, or ISs. CLINICAL RELEVANCE French dentists perform a wide range of oral procedures on patients on bDMARDS, conventional DMARDs, or ISs under antibiotic coverage and antiseptic mouthwashes. SDs reported more postoperative complications after extensive invasive procedures for patients under active drug therapy, despite their greater knowledge of recommendations on how to manage such patients.
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Affiliation(s)
- Alice Bourgoin
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, Ivry/Seine, F-94200, France
| | - Kevimy Agossa
- Université de Lille, Inserm, CHU Lille, U1008, Lille, F-59000, France
- Department of Periodontology, Faculty of Dentistry, University of Lille, Place De Verdun, Lille, France
| | - Raphaele Seror
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - Mathurin Fumery
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
- Department of GastroenterologyPériTox Laboratory, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France
| | - Loredana Radoi
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Louis Mourier, Colombes, F-92700, France
- CESP, INSERM, Exposome and Heredity Group, Université Paris-Saclay, Villejuif, France
| | - Marjolaine Gosset
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, Ivry/Seine, F-94200, France.
- Laboratoire d'Excellence INFLAMEX, Paris, France.
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Jia S, Wang G, Zhao Y, Wang X. Accuracy of an autonomous dental implant robotic system versus static guide-assisted implant surgery: A retrospective clinical study. J Prosthet Dent 2023:S0022-3913(23)00284-6. [PMID: 37291043 DOI: 10.1016/j.prosdent.2023.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 06/10/2023]
Abstract
STATEMENT OF PROBLEM The accuracy of implant placement is a prerequisite for prosthetically driven implant surgery and is necessary to ensure the long-term stability of dental implants. Imprecise implant position may bring difficulties for restoration, damage anatomic structures, affect peri-implant tissues, and lead to ultimate implant failure. PURPOSE The purpose of this retrospective clinical study was to compare the accuracy of implants placed with an autonomous dental implant robotic (ADIR) system with those placed with static computer assisted implant surgery (sCAIS). MATERIAL AND METHODS Thirty-nine participants were enrolled in this retrospective study: 20 participants had received implant surgery with the ADIR system and 19 participants had implants placed with sCAIS. The preoperative plans and postoperative cone beam computed tomography (CBCT) scans after implant placement were matched during the study. The coronal, apical, and angular deviations were measured and analyzed. A linear regression model was established to analyze the source of deviation. MANOVA was used to compare differences in the major outcome variables (α=.05). RESULTS A total of 60 implants were placed in 39 participants (30 in each of the 2 groups). The mean ±standard deviation coronal, apical, and angular deviation of the ADIR system group and sCAIS group were 0.43 ±0.18 mm versus 1.31 ±0.62 mm (P<.001), 0.56 ±0.18 mm versus 1.47 ±0.65 mm (P<.001), and 1.48 ±0.59 degrees versus 2.42 ±1.55 degrees (P=.003), respectively. In addition, there was no significant difference in accuracy in the different implant regions (anterior, premolar, molar, maxilla, mandible) (P>.05). No complications were observed. CONCLUSIONS The accuracy of the implant position using the ADIR system was significantly higher than with sCAIS, suggesting that the ADIR system can achieve minimally invasive and excellent accuracy. In addition, implant regions had no significant influence on the accuracy of implant placement. (Keywords: Robotic system, Implant surgery, Static guide, Autonomous, Accuracy).
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Affiliation(s)
- Shasha Jia
- Post-Graduate, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, PR China; Post-Graduate, Oral and Maxillofacial Surgery Teaching and Research Section, School of Stomatology, Qingdao University, Qingdao, PR China
| | - Guowei Wang
- Associate Professor, Department of Stomatology, No. 971 Hospital of the Chinese Navy, Qingdao, Shandong, PR China
| | - Yimin Zhao
- Professor, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Dentistry, Center, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Xiaojing Wang
- Associate Professor, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, PR China; Associate Professor, Oral and Maxillofacial Surgery Teaching and Research Section, School of Stomatology, Qingdao University, Qingdao, PR China.
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11
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Chambrone L, Zucchelli G. Why is there a lack of evidence regarding errors and complications in periodontal and implant therapy? Periodontol 2000 2023; 92:13-20. [PMID: 35916780 DOI: 10.1111/prd.12445] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 01/09/2023]
Abstract
The occurrence of errors, complications, and adverse effects may occur as a consequence of single or multiple events related to the clinician and/or patient. Apparently, the amount of dental literature on these undesirable outcomes has not been as prolific as that obtained for conventional primary periodontal outcome measures. This review explores the potential reasons for the lack of studies reporting on errors and complications in periodontal and implant therapy, as well as other noteworthy methodological aspects, to enlighten their impact on the selection of the best (or most appropriate) "gold standard" periodontal/implant-related treatment options, and on the overall decision-making process. The following points were addressed: (a) the importance of reporting errors and complications in clinical research; (b) the adequate reporting of errors and complications in periodontology and dental implantology; and (c) efficacy trials vs effectiveness studies and their impact on the assessment and report of periodontal and implant treatment-related risks and complications.
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Affiliation(s)
- Leandro Chambrone
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Bogota, Colombia
- Department of Periodontics, School of Dentistry, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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12
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Leira Y, Cho H, Marletta D, Orlandi M, Diz P, Kumar N, D'Aiuto F. Complications and treatment errors in periodontal therapy in medically compromised patients. Periodontol 2000 2023; 92:197-219. [PMID: 36166645 DOI: 10.1111/prd.12444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Abstract
Patients who are medically compromised may be at an increased risk of complications and treatment errors following periodontal therapy. A review of the evidence on the topic is presented, in relation to the type of complication reported, of periodontal treatment, and of patients' medical status. Further, a framework for risk assessment and appropriate treatment modifications is introduced, with the aim of facilitating the management of patients with existing comorbidities and reducing the incidence of treatment complications.
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Affiliation(s)
- Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Hana Cho
- Special Care Dentistry Unit, ENT & Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
| | | | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
| | - Pedro Diz
- Special Care Dentistry Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Navdeep Kumar
- Special Care Dentistry Unit, ENT & Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
| | - Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
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13
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Barootchi S, Tavelli L, Majzoub J, Stefanini M, Wang HL, Avila-Ortiz G. Alveolar ridge preservation: Complications and cost-effectiveness. Periodontol 2000 2023; 92:235-262. [PMID: 36580417 DOI: 10.1111/prd.12469] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/30/2022]
Abstract
Alveolar ridge preservation is routinely indicated in clinical practice with the purpose of attenuating postextraction ridge atrophy. Over the past two decades numerous clinical studies and reviews on this topic have populated the literature. In recent years the focus has primarily been on analyzing efficacy outcomes pertaining to postextraction dimensional changes, whereas other relevant facets of alveolar ridge preservation therapy have remained unexplored. With this premise, we carried out a comprehensive evidence-based assessment of the complications associated with different modalities of alveolar ridge preservation and modeled the cost-effectiveness of different therapeutic modalities as a function of changes in ridge width and height. We conclude that, among allogeneic and xenogeneic bone graft materials, increased expenditure does not translate into increased effectiveness of alveolar ridge preservation therapy. On the other hand, a significant association between expenditure on a barrier membrane and reduced horizontal and vertical ridge resorption was observed, though only to a certain degree, beyond which the return on investment was significantly diminished.
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Affiliation(s)
- Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa, College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
- Private Practice, Atelier Dental Madrid, Madrid, Spain
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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14
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Mazzotti C, Mounssif I, Rendón A, Mele M, Sangiorgi M, Stefanini M, Zucchelli G. Complications and treatment errors in root coverage procedures. Periodontol 2000 2023; 92:62-89. [PMID: 36594482 DOI: 10.1111/prd.12468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/08/2022] [Accepted: 07/26/2022] [Indexed: 01/04/2023]
Abstract
Root coverage procedures have become very common in clinical dental practice. Even though these techniques are considered safe, the clinician may face several issues during the therapy due to their surgical nature. Some of these issues can be defined strictly as complications inherent to the procedure, whereas others are medical errors or treatment errors. This review will focus on describing treatment errors and complications that may arise during different phases of the root coverage therapeutic process and on how to prevent and manage them.
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Affiliation(s)
- Claudio Mazzotti
- Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Ilham Mounssif
- Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Alexandra Rendón
- Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Monica Mele
- Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Matteo Sangiorgi
- Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Martina Stefanini
- Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Giovanni Zucchelli
- Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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15
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Xue H, Wen J, Liu C, Shuai X, Zhang X, Kang N. Modified transcrestal sinus floor elevation with concomitant implant placement in edentulous posterior maxillae with residual bone height of 5 mm or less: a non-controlled prospective study. Int J Oral Maxillofac Surg 2023; 52:495-502. [PMID: 36058822 DOI: 10.1016/j.ijom.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022]
Abstract
The aim of this study was to describe a modified transcrestal sinus floor elevation (mTSFE) technique and to evaluate its clinical effectiveness and reliability when residual bone height is severely reduced. Forty-three maxillary edentulous patients who met the inclusion criteria were enrolled. All patients underwent the mTSFE technique; 66 dental implants were inserted simultaneously. Patient-reported outcomes were assessed 2 weeks after surgery. Prosthetic crowns were placed 6 months after surgery. Radiographic analyses and clinical analyses were conducted to assess the clinical effectiveness and feasibility of mTSFE during a follow-up period of 2-8 years. The mean vertical bone increase after surgery was 8.09 mm, and it decreased to 6.56 mm at 6 months after surgery. Two cases of membrane perforation occurred during surgery and one implant was lost in the third year after surgery; the survival rate at the implant level was 98.48%. No severe postoperative complication was reported and the subjective feeling of patients was acceptable. This mTSFE technique could simplify the operative procedure and might be helpful to reduce intraoperative trauma, as well as to alleviate postoperative discomfort.
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Affiliation(s)
- H Xue
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - J Wen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - C Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Shuai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - N Kang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China; Department of Oral Implantology (National Key Clinical Department), West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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16
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Carosi P, Lorenzi C, Di Gianfilippo R, Papi P, Laureti A, Wang HL, Arcuri C. Immediate vs. Delayed Placement of Immediately Provisionalized Self-Tapping Implants: A Non-Randomized Controlled Clinical Trial with 1 Year of Follow-Up. J Clin Med 2023; 12:jcm12020489. [PMID: 36675417 PMCID: PMC9861545 DOI: 10.3390/jcm12020489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) and immediate provisionalization. The implant stability quotient (ISQ) and insertion torque were recorded intraoperatively. After one year in function, the implant and prosthesis survival rate, pink esthetic score (PES), white esthetic score (WES), and marginal bone levels (MBL) were assessed. Sixty patients received 60 self-tapping implants. A total of 37 implants were placed in extraction sockets and 23 in edentulous ridges, and then all implants were immediately provisionalized. All implants achieved a high implant stability with a mean insertion torque and ISQ value of 58.1 ± 14.1 Ncm and 73.6 ± 8.1 Ncm, respectively. No significant differences were found between healed vs. post-extractive sockets (p = 0.716 and p = 0.875), or between flap vs. flapless approaches (p = 0.862 and p = 0.228) with regards to the insertion torque and ISQ value. Nonetheless, higher insertion torque values and ISQs were recorded for mandibular implants (maxilla vs. mandible, insertion torque: 55.30 + 11.25 Ncm vs. 62.41 + 17.01 Ncm, p = 0.057; ISQ: 72.05 + 8.27 vs. 76.08 + 7.37, p = 0.058). One implant did not osseointegrate, resulting in an implant survival rate of 98.3%. All implants achieved PES and WES scores higher than 12 at the 1-year follow-up. The clinical use of newly designed self-tapping implants with immediate temporization was safe and predictable. The implants achieved a good primary stability, high implant survival rate, and favorable radiographic and esthetic outcomes, regardless of the immediate or delayed placement protocols.
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Affiliation(s)
- Paolo Carosi
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Claudia Lorenzi
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Piero Papi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Laureti
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Claudio Arcuri
- Department of Clinical Sciences and Translational Medicine, School of Dentistry, University of Tor Vergata, 00133 Rome, Italy
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17
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Stacchi C, Bernardello F, Spinato S, Mura R, Perelli M, Lombardi T, Troiano G, Canullo L. Intraoperative complications and early implant failure after transcrestal sinus floor elevation with residual bone height ≤5 mm: A retrospective multicenter study. Clin Oral Implants Res 2022; 33:783-791. [PMID: 35578774 PMCID: PMC9543216 DOI: 10.1111/clr.13959] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 04/06/2022] [Accepted: 05/02/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Clinical indications for maxillary sinus floor elevation with transcrestal techniques have increased in recent years even in sites with minimal residual bone height (RBH). Nevertheless, limited information is currently available on incidence of intraoperative complications and early implant failure in these cases. MATERIAL AND METHODS This retrospective multicenter study was performed on anonymized clinical and radiographic records of patients who underwent transcrestal sinus floor elevation in seven clinical centers. Influence of different factors related to patient, and sinus anatomy and surgical technique on the incidence of intraoperative complications and early implant failure rate after transcrestal sinus lift were investigated. RESULTS A total of 430 patients treated with transcrestal sinus floor elevation for single-implant insertion in sites with RBH ≤5 mm were included in the final analysis. After 1 year of loading, 418 implants of 430 were satisfactorily in function. Early implant failure was recorded in 12 cases (2.8%); results were significantly associated with the presence of large sinus cavities and with the occurrence of membrane perforation. The following adverse events were recorded: membrane perforation (7.2%), acute sinusitis (0.9%), implant displacement into the sinus cavity (0.7%), oro-antral fistula (0.2%), and benign paroxysmal positional vertigo (0.5% of osteotome cases). A strong direct correlation between sinus membrane perforation and bucco-palatal sinus width (p = .000) was demonstrated. CONCLUSIONS Early implant failure after transcrestal sinus elevation showed significant direct correlation with bucco-palatal maxillary sinus width and the presence of membrane perforation. Sinus membrane perforation was strongly associated with bucco-palatal sinus width (extremely low perforation rate in narrow and much higher incidence in wide sinuses).
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health SciencesUniversity of TriesteTriesteItaly
| | | | | | | | | | - Teresa Lombardi
- Department of Health SciencesUniversity “Magna Græcia”CatanzaroItaly
| | - Giuseppe Troiano
- Department of Clinical and Experimental MedicineUniversity of FoggiaFoggiaItaly
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Periodontal tissue regeneration by transplantation of autologous adipose tissue-derived multi-lineage progenitor cells. Sci Rep 2022; 12:8126. [PMID: 35581234 PMCID: PMC9114023 DOI: 10.1038/s41598-022-11986-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/12/2022] [Indexed: 12/04/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease that destroys tooth-supporting periodontal tissue. Current periodontal regenerative therapies have unsatisfactory efficacy; therefore, periodontal tissue engineering might be established by developing new cell-based therapies. In this study, we evaluated the safety and efficacy of adipose tissue-derived multi-lineage progenitor cells (ADMPC) autologous transplantation for periodontal tissue regeneration in humans. We conducted an open-label, single-arm exploratory phase I clinical study in which 12 periodontitis patients were transplanted with autologous ADMPCs isolated from subcutaneous adipose tissue. Each patient underwent flap surgery during which autologous ADMPCs were transplanted into the bone defect with a fibrin carrier material. Up to 36 weeks after transplantation, we performed a variety of clinical examinations including periodontal tissue inspection and standardized dental radiographic analysis. A 36-week follow-up demonstrated no severe transplantation-related adverse events in any cases. ADMPC transplantation reduced the probing pocket depth, improved the clinical attachment level, and induced neogenesis of alveolar bone. Therapeutic efficiency was observed in 2- or 3-walled vertical bone defects as well as more severe periodontal bone defects. These results suggest that autologous ADMPC transplantation might be an applicable therapy for severe periodontitis by inducing periodontal regeneration.
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Schneider B, Pfaffeneder-Mantai F, Grün P, Meller O, Dobbertin K, Turhani D. Melolabial interpolated island flap for reconstruction of an anterior oronasal fistula after horseshoe Le Fort I osteotomy with iliac bone grafts interposition - A case report. Int J Surg Case Rep 2022; 93:106939. [PMID: 35303603 PMCID: PMC8928081 DOI: 10.1016/j.ijscr.2022.106939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Horseshoe Le Fort I osteotomy (HLFO) in combination with iliac bone grafts interposition is an established and very effective procedure for reconstructing the severely atrophic maxilla. However potential complications connected to this method, such as oronasal fistula (ONF), have not been described in the literature to date. CASE PRESENTATION We report the case of a female patient with severe atrophy of the edentulous maxillary alveolar ridge with type 2 diabetes (T2D). Initially, a sinus floor augmentation was performed, followed by a failed placement of dental implants. Afterwards, HLFO with simultaneous interposition of iliac bone grafts was conducted. Subsequently, an oronasal communication occurred in the antral maxilla. As several local flaps had not achieved sufficient results, a melolabial interpolated island flap was carried out, yielding satisfactory results. DISCUSSION Failed implant treatment or bone augmentation procedures in combination with T2D may have resulted in significant tissue irritation and subsequent wound healing complications in the antral maxilla, leading to an ONF. CONCLUSION In this case, an ONF occurring after HLFO was described for the first time. The melolabial interpolated island flap proved to be an outstanding long-term solution for the management of an anterior ONF occurring after HLFO over a period of 10 years. Less invasive treatment options including zygomatic implants should be taken into consideration for the treatment of such patients.
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Affiliation(s)
- Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; Division for Chemistry and Physics of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria
| | - Pascal Grün
- Center for Oral and Maxillofacial Surgery, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria
| | - Oliver Meller
- Center for Oral and Maxillofacial Surgery, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria
| | - Katharina Dobbertin
- Center for Oral and Maxillofacial Surgery, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria.
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20
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Huang X, Liu F, Guan H, Jiang Z, Wei P, Luo Y, Jia Q. Effects of endoscopic submucosal dissection on post-operative early treatment effectiveness and serum TAT-2 and GP73 expression levels in patients with early gastric cancer. Exp Ther Med 2021; 22:806. [PMID: 34093762 PMCID: PMC8170670 DOI: 10.3892/etm.2021.10238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/06/2020] [Indexed: 12/24/2022] Open
Abstract
The present study aimed to explore the effectiveness of endoscopic submucosal dissection (ESD) in the treatment of early gastric cancer (EGC) and its effect on serum tumor-associated trypsin-2 (TAT-2) and Golgi protein 73 (GP73) expression levels to provide a reference for the treatment of EGC. TAT-2 is a proteolytic target enzyme for tumor-associated trypsin inhibitor that has been previously reported to enhance invasion by promoting extracellular matrix degradation. GP73 is a novel type II Golgi membrane protein of unknown function that is expressed in the hepatocytes of patients with adult giant-cell hepatitis. A total of 161 patients with EGC treated at our hospital from April 2013 to February 2014 were selected as the study subjects. Among these, 86 patients underwent ESD (group A) and the remaining 75 underwent endoscopic mucosal resection (group B). Treatment effectiveness, incidence of complications and adverse reactions, operation time, intraoperative blood loss and length of hospital stay, as well as serum TAT-2 and GP73 expression levels, were compared between the two groups. The treatment effectiveness was significantly higher in group A than in group B (P<0.05). However, there was no significant inter-group difference in terms of incidence of complications/adverse reactions (P>0.05). After treatment, serum TAT-2 expression levels decreased in both groups (P<0.05) and serum TAT-2 expression levels were lower in group A than in group B (P<0.05). Furthermore, serum GP73 expression levels were significantly elevated in both groups (P<0.05). Kaplan-Meier survival analysis indicated no significant inter-group difference in the 5-year survival rate (P>0.05). In conclusion, ESD had a good therapeutic effect on EGC and is able to decrease serum TAT-2 expression levels and increase serum GP73 expression levels. The present study was registered into the Chinese Trials Registry (registration no. NCT02157534).
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Affiliation(s)
- Xue Huang
- Department of Gastroenterology, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi 537100, P.R. China
| | - Fujian Liu
- Department of Gastroenterology, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi 537100, P.R. China
| | - Hang Guan
- Department of Gastroenterology, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi 537100, P.R. China
| | - Zhiyong Jiang
- Department of Gastroenterology, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi 537100, P.R. China
| | - Peng Wei
- Department of Respiratory and Critical Care Medicine, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi 537100, P.R. China
| | - Yifeng Luo
- Department of Intensive Care Unit, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi 537100, P.R. China
| | - Qiuhong Jia
- Department of Gastroenterology, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang, Guangxi 537100, P.R. China
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Wagner JC, Johnson TM, Gilbert WA. Should periodontists prescribe postoperative oral corticosteroids to control pain and swelling? A systematic review. Clin Adv Periodontics 2021; 12:134-142. [PMID: 33988318 DOI: 10.1002/cap.10169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/08/2021] [Indexed: 11/05/2022]
Abstract
FOCUSED CLINICAL QUESTION In generally healthy patients receiving third molar, periodontal, or dental implant surgery, do postoperative oral corticosteroids effectively limit pain and swelling compared with placebo or alternative medications?
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Affiliation(s)
- Jennah C Wagner
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia
| | - William A Gilbert
- Department of Periodontics, US Army Dental Health Activity, Joint Base Lewis McChord, Tacoma, Washington
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Di Gianfilippo R, Wang IC, Steigmann L, Velasquez D, Wang HL, Chan HL. Efficacy of microsurgery and comparison to macrosurgery for gingival recession treatment: a systematic review with meta-analysis. Clin Oral Investig 2021; 25:4269-4280. [PMID: 33928441 DOI: 10.1007/s00784-021-03954-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Microsurgical principles, techniques, and armamentarium have made significant contributions to the periodontal plastic surgery. The present meta-analysis aimed to investigate the overall efficacy of microsurgery on root coverage, and its clinical outcomes when compared to traditional macrosurgery. MATERIAL AND METHODS Electronic searches on PubMed, Embase, and CINAHL were used to retrieve prospective clinical trials. Primary outcomes were the mean root coverage (mRC) and probability of achieving complete root coverage (cRC), with secondary outcomes as other periodontal parameters and patient-reported outcome measures (PROMs). RESULTS Nineteen studies were included in the quantitative analysis. Microsurgery was estimated to achieve 83.3% mRC and 69.3% cRC. From a subgroup of 9 comparative studies, it was estimated microsurgery increased mRC by 6.6% (p<0.001) and cRC by 27.9% (p<0.01) compared to macrosurgical control treatments. Operating microscope (OM) yielded a significantly 6.7% higher mRC than the control group (p=0.002), while using loupes showed 6.16% increase in mRC with a borderline significance (p=0.09). OM and loupes-only had a 31.05% (p=0.001) and 25.54% (p=0.001) increases in achieving cRC compared to control, respectively. As for PROMs, microsurgery reduced postoperative pain (p<0.001) and enhanced esthetics (p= 0.05). CONCLUSIONS Microsurgery significantly improved mean root coverage, probability of achieving complete root coverage, esthetics, and post-surgical recovery. Microsurgery enhances not only subclinical healing but also clinical outcomes, possibly owing to its minimally invasive approach and surgical precision. CLINICAL RELEVANCE Periodontal plastic microsurgery is minimally invasive, inducing less surgical trauma and ultimately resulting in improved clinical outcomes, patient's satisfaction, and quality of life.
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Affiliation(s)
- Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, University of Michigan - School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA
| | - I-Ching Wang
- Department of Periodontics and Oral Medicine, University of Michigan - School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA
| | - Larissa Steigmann
- Department of Periodontics and Oral Medicine, University of Michigan - School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA
| | - Diego Velasquez
- Department of Periodontics and Oral Medicine, University of Michigan - School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA.,Private Practice, 415 North Alloy Drive, Fenton, MI, 48430, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan - School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan - School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA.
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An Unusual Complication in Plastic Periodontal Surgery. Case Rep Dent 2020; 2020:8824246. [PMID: 33312741 PMCID: PMC7719491 DOI: 10.1155/2020/8824246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/05/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Oroantral communications may arise as a result of pathological processes or iatrogenic situations, particularly in oral surgery and implantology, but are uncommon in periodontal plastic surgery. Case Presentation. A healthy 37-year-old female patient with 5 mm Miller Class II recession on the maxillary left second molar was referred for a root coverage procedure. While preparing the recipient bed for the graft, an oroantral communication was created. Schneiderian membrane was sutured to reduce the dimension of the communication and covered with a connective tissue graft. Finally, the flap was laterally and coronally moved, and the patient instructed about postoperative precautions. This procedure allowed to achieve a complete closure of the oroantral communication and good root coverage after an 8-month follow-up. Conclusions Different authors described different techniques that can be used to close oroantral communications. Nevertheless, in this clinical case, it was shown that the oroantral communication may be closed without having to postpone the periodontal plastic surgery.
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Al-Bayati O, Font K, Soldatos N, Carlson E, Parsons J, Powell CA. Evaluation of the need to prescribe opioid medication to control post-surgical pain of different periodontal/oral surgeries. J Periodontol 2020; 92:1030-1035. [PMID: 33155320 DOI: 10.1002/jper.20-0315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/16/2020] [Accepted: 10/20/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND To determine the level of perceived pain after different types of periodontal/oral surgical procedures, and the differences in patients' selection of pain management, over the counter (OTC) versus opioid, based on procedure type. METHODS Patients undergoing surgical procedures were asked to complete a pain questionnaire at four time points: 1) before surgery 2) first dose of analgesic at home, 3) 24 hours postoperatively, and 4) 72 hours postoperatively. The questionnaire consisted of numerical and descriptive scales to describe the perceived pain. RESULTS A total of 198 patients completed the questionnaire. All surgical procedures were grouped into five major categories: bone augmentation procedures (11% BAP), teeth extractions (26% EXT), surgical implant placement (25% IP), mucogingival surgeries (21% MGS), and pocket elimination procedures (17%). IP surgery was associated with significantly less pain compared with MGS and EXT (P <0.05). There was a statistically significant difference for taking any medication based on type of surgical procedure at 24 hours (P <0.05). CONCLUSIONS IP is associated with significantly lower perceived pain compared with EXT and MGS surgery. Analgesic consumption was generally parallel to pain perception. A considerable number of patients elected to control the post-surgical pain using OTC medication up to 72 hours. Periodontal/oral surgery procedures vary in the amount of perceived postoperative pain. Tailoring postoperative medications to the type of periodontal/oral surgery performed will help prevent overprescribing of opioids.
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Affiliation(s)
- Omar Al-Bayati
- Division of Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Kerri Font
- Division of Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Nikolaos Soldatos
- Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, TX
| | - Emanouela Carlson
- Division of Endodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Joseph Parsons
- Division of Endodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Charles A Powell
- Department of Surgical Dentistry, Division of Periodontics, Director of Postdoctoral Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO.,Department of Periodontics, UT Health San Antonio, San Antonio, TX
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25
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Majzoub J, Chen Z, Saleh I, Askar H, Wang HL. Influence of restorative design on the progression of peri-implant bone loss: A retrospective study. J Periodontol 2020; 92:536-546. [PMID: 32902855 DOI: 10.1002/jper.20-0327] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Clinical data on the restorative designs affecting the early progression of peri-implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g., restoration emergence angle, and internal screw length/diameter) on the marginal bone loss around implants with peri-implantitis. METHODS Implants diagnosed with peri-implantitis having 1- (T1) and 2-year (T2) follow-ups were included. In addition, within 6 months pre-diagnosis (Tb), all cases required to have full documentation in which no evidence of peri-implantitis was not indicated. Changes in marginal bone levels (MBLs) from Tb to T1 and from T1 to T2 were evaluated. The effect of several variables on MBLs changes was assessed via univariate and multivariate generalized estimating equations. RESULTS Eighty-three bone-level implants from 65 patients were selected. The mean follow-up before peri-implantitis diagnosis was 99.47 ± 47.93 months. The radiographic mean marginal bone loss was 1.52 ± 1.33 mm (Tb to T1) and 0.58 ± 0.52 mm (T1 to T2). Restoration emergence angle and frequency of maintenance visits significantly affected MBLs from Tb to T1. Besides, 66.3% of the included implants' bone levels were in a zone within 1 mm of the apical end of the internal screw at T1 and remained in this zone during the second follow-up year. CONCLUSIONS Significant marginal bone loss occurred in the early post-diagnosis period of peri-implantitis, which could be affected by the restoration emergence angle. Peri-implant MBLs were frequently located in a zone within 1 mm of the apical end of the internal screw.
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Affiliation(s)
- Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Islam Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Houssam Askar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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26
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Font K, Johnson L, Powell C. Five different solutions to mitigate overprescribing opioid medications. J Dent Educ 2020; 85:31-36. [PMID: 32929746 DOI: 10.1002/jdd.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE The University of Colorado School of Dental Medicine took 5 distinct actions to mitigate the amount of opioids prescribed at the dental school between the years 2016-2020. METHODS This retrospective study evaluated a comprehensive 5-step quality improvement strategy which was implemented to decrease opioid prescribing. a) development of a Dental Pain Management Protocol, b) implementation of the protocol with pre-doctoral students, c) incorporating the results of a Master's project that determined the actual postoperative pain after periodontal/oral surgical procedures, d) development of a favorite electronic prescription list, and e) creation of patient instructions to allow for information on nonopioid analgesic use after dental procedures to be disseminated to the patient. RESULTS There was a significant decrease (P = 0.05) in the opioid prescribing trend with the implementation of these 5 actions, resulting in an overall 68.8% decrease for prescription writing of opioids and a 78.6% decrease of opioid pills over this 3 year period. CONCLUSION Simple guidelines and protocols resulted in a drastic decrease in opioid prescribing, with limited negative feedback from faculty and patients.
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Affiliation(s)
- Kerri Font
- Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado, USA
| | - Lonnie Johnson
- Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado, USA
| | - Charles Powell
- Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado, USA
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The effect of low-level laser therapy as an adjunct to periodontal surgery in the management of postoperative pain and wound healing: a systematic review and meta-analysis. Lasers Med Sci 2020; 36:175-187. [PMID: 32613416 DOI: 10.1007/s10103-020-03072-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 06/11/2020] [Indexed: 01/14/2023]
Abstract
The meta-analysis and systematic review aimed to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to periodontal surgery in the management of postoperative pain and wound healing. An electronic search in 4 databases (PubMed, Embase, Cochrane, and OpenGrey) was conducted for randomized clinical trials reporting the effectiveness of LLLT used as an adjunct to periodontal surgery to alleviate pain and accelerate wound healing compared with surgery alone. Finally, 13 studies were eligible and included. The results showed a significant difference of pain relief between groups at day 3 post-surgery, whereas no difference was found at day 7. Moreover, a significant reduction was observed in the mean analgesic intake during the first week in the LLLT group. On day 14, the adjunctive use of LLLT showed significantly faster re-epithelialization and better wound healing in palatal donor sites following free gingival graft procedures. Based on the results, LLLT used as an adjunct to periodontal surgery positively influenced postsurgical pain control. Low power (≤ 500 mW) combined with energy density ≥ 5 J/cm2 might be more appropriate for postoperative pain relief. Moreover, adjunctive LLLT to free gingival grafts could significantly accelerate wound healing of palate sites at early healing phase. Multicenter studies using different LLL parameters without postsurgical analgesics are needed to determine optimal laser settings.
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28
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Capnography monitoring in procedural intravenous sedation: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:3761-3770. [PMID: 32556657 DOI: 10.1007/s00784-020-03395-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/04/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Currently, procedural sedation in the clinical setting relies heavily on the use of pulse oximetry to monitor hypoxemia. Different studies suggest that incidence of hypoxemia and incidence of arterial oxygen desaturation are reduced by early intervention via capnography monitoring. The aim of this article was to discuss the importance of implementing capnography monitoring during procedural sedations performed in a dental setting and determine whether additional capnographic monitoring reduces the incidence of arterial oxygen desaturation and the overall complications rate. MATERIALS AND METHODS Two independent reviewers conducted electronic (PubMed and EMBASE) and manual searches up to February 2020. Randomized clinical trials (RCTs), including both patients under procedural sedation monitored by capnography and oximetry, and reporting the incidence of hypoxemia or episodes of oxygen desaturation were included. Risk ratio was used to compare the outcomes (i.e., the incidence of hypoxemia, the episodes of oxygen desaturation, the detection of apnea, the reduction of events of bradycardia, and hypotension) between patients monitored by capnography and standard approach. RESULTS Fourteen randomized clinical trials fulfilling the inclusion criteria were selected. The analysis revealed that capnography monitoring group showed the lower incidence of hypoxemia (RR 0.76, 95%CI 0.70 to 0.83, p < 0.001) and the episodes of oxygen desaturation (RR 0.79, 95%CI 0.71 to 0.87, p < 0.001) compared with the oximetry monitoring group. Apnea was detected in capnography monitoring earlier than standard monitoring (RR 2.60, 95%CI 2.30 to 2.93, p < 0.001). No significant difference was found between capnography and standard monitoring groups in terms of reduction of events of bradycardia (RR 1.17, 95%CI 0.91 to 1.50, p = 0.225) and hypotension (RR 0.96, 95%CI 0.76 to 1.21, p = 0.746). CONCLUSION Capnography monitoring reduced incidence of hypoxemia during procedural sedations. Within the limitations of this review, we suggest that the application of capnography during procedural sedation would decrease the frequency of oxygen desaturation events and incidence of hypoxemia. CLINICAL RELEVANCE Training and instructing dental providers on using capnography monitoring would help in reducing adverse events during intravenous sedation.
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Spicciarelli V, Marruganti C, Viviano M, Baldini N, Franciosi G, Tortoriello M, Ferrari M, Grandini S. A new framework to identify dental emergencies in the COVID-19 era. J Oral Sci 2020; 62:344-347. [PMID: 32493868 DOI: 10.2334/josnusd.20-0208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
In order to reduce the spread of COVID-19 (Coronavirus Disease 2019), it is crucial to take extraordinary prevention and safety measures in dental offices, and to defer all elective and non-urgent procedures. Dental emergencies are defined through oral symptoms but, the systemic and psychological conditions of each patient should be considered. The present short communication proposes a multilevel evaluation (oral, systemic and psychological) and risk assessment score for the management of dental emergencies following the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) outbreak. A comprehensive categorization and score scale assessment for dental emergencies allows a better identification of patient's treatment needs and avoids unnecessary contact between dental health care providers and patients during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Valentina Spicciarelli
- Department of Medical Biotechnologies, Unit of Endodontics and Restorative Dentistry, University of Siena
| | | | - Massimo Viviano
- Department of Medical Biotechnologies, Unit of Oral Pathology, University of Siena
| | - Nicola Baldini
- Department of Medical Biotechnologies, Unit of Oral Surgery and Implantology, University of Siena
| | - Giovanni Franciosi
- Department of Medical Biotechnologies, Clinical Professor of Endodontics and Restorative Dentistry, University of Siena
| | - Mario Tortoriello
- Department of Medical Biotechnologies, Unit of Oral Pathology, University of Siena
| | - Marco Ferrari
- Department of Medical Biotechnologies, Clinical Professor of Prosthodontics, University of Siena
| | - Simone Grandini
- Department of Medical Biotechnologies, Clinical Professor of Endodontics and Restorative Dentistry, University of Siena
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30
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Majzoub J, Barootchi S, Tavelli L, Wang C, Travan S, Wang H. Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study. J Periodontol 2020; 91:1148-1158. [DOI: 10.1002/jper.19-0529] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/02/2020] [Accepted: 01/14/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Jad Majzoub
- Department of Periodontics & Oral Medicine University of Michigan School of Dentistry Ann Arbor MI
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine University of Michigan School of Dentistry Ann Arbor MI
| | - Lorenzo Tavelli
- Department of Periodontics & Oral Medicine University of Michigan School of Dentistry Ann Arbor MI
| | - Chin‐Wei Wang
- Department of Periodontics & Oral Medicine University of Michigan School of Dentistry Ann Arbor MI
| | - Sunčica Travan
- Department of Periodontics & Oral Medicine University of Michigan School of Dentistry Ann Arbor MI
| | - Hom‐Lay Wang
- Department of Periodontics & Oral Medicine University of Michigan School of Dentistry Ann Arbor MI
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Barootchi S, Chan HL, Namazi SS, Wang HL, Kripfgans OD. Ultrasonographic characterization of lingual structures pertinent to oral, periodontal, and implant surgery. Clin Oral Implants Res 2020; 31:352-359. [PMID: 31925829 DOI: 10.1111/clr.13573] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/25/2019] [Accepted: 01/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Increased applications of ridge augmentation in the lingual posterior mandible call for an urgent need to study its anatomy. Therefore, our first aim was to validate ultrasound in measuring the mandibular lingual structures in human cadavers. Secondarily, to test its feasibility in imaging the lingual nerve in live humans. MATERIALS AND METHODS Nine fresh un-embalmed fully/partially edentulous cadaver heads were utilized for aim 1. Three areas in the lingual mandible were imaged (mandibular premolar, molar, and retromolar). Immediately after, biopsies were harvested from each site. The thickness of the mucosa, mylohyoid muscle, and lingual nerve diameter was measured via ultrasound and statistically compared to histology. Similarly, the lingual nerve in live humans was also imaged. RESULTS None of the differences between the ultrasound and histology measurements reached statistical significance (p > .05). The mean mucosal thickness via ultrasound and histology was 1.45 ± 0.49 and 1.39 ± 0.50 mm, 5 mm lingual to the mylohyoid muscle attachment. At 10 mm beyond the attachment, the ultrasound and histologic values were 1.54 ± 0.48 and 1.37 ± 0.49, respectively. The mean muscle thickness measured via ultrasound and histology was 2.31 ± 0.56 and 2.25 ± 0.47 mm, at the 5 mm distance. At the 10 mm distance, the measurements were 2.46 ± 0.56 and 2.36 ± 0.5 mm, respectively. The mean ultrasonic lingual nerve diameter was 2.38 ± 0.44 mm, versus 2.43 ± 0.42 mm, with histology. The lingual nerve diameter on 19 live humans averaged to 2.01 ± 0.35 mm (1.4-3.1 mm). CONCLUSIONS Within its limitations, ultrasound accurately measured mandibular lingual soft tissue structures on cadavers, and the lingual nerve on live humans.
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Affiliation(s)
- Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Sharon S Namazi
- Division of Anatomy, Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, Michigan.,Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan
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