Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study

BACKGROUND

Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation.

METHODS

This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance.

RESULTS

The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding.

CONCLUSION

The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

Importance of periodontal phenotype in periodontics and restorative dentistry: a systematic review

BACKGROUND

Periodontal phenotype is regarded to be one of the key factors influencing the efficacy of restorative therapies in dental practice. The objective of the systematic review was to explore the importance of thin and thick periodontal phenotypes and how they affect the outcome of periodontal and restorative therapies by looking at a number of academic publications from various online databases.

METHODS

Following the PRISMA guidelines (Preferred Reporting Items for Systematic Review standards), relevant data will be searched and retrieved from three significant scientific databases, including PubMed, EBSCO, and Scopus. The articles with full texts that matched the keywords and published in English between 2018 and 2023 were taken into consideration.

RESULTS

The majorities of these articles were based on the type of periodontal phenotype and their impact on periodontal and restorative treatment outcomes were selected. The initial search yielded a total of 530 articles. Only 273 were relevant to the review's objectives, and these were considered for determining eligibility. Only 20 publications were eligible for analysis.

CONCLUSION

Understanding these anatomical aspects of periodontal phenotype is crucial to both periodontology and restorative dentistry. The clinical outcome of restorative, prosthetic, orthodontic, surgical, and periodontal therapies is determined in large part by the periodontal phenotype, which also plays a significant role in clinical failure or success in dental treatments.

TRIAL REGISTRATION

This study protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO) dated 16th June 2023 with the registration ID CRD42023432568.

Variations of Serum CRP Levels in Periodontal Health and Diseases: A Clinico-Biochemical Study

This study aimed to quantify serum C-reactive protein (CRP) values in periodontally healthy people and explore the relationship between serum CRP levels and chronic periodontitis, and the influence of scaling as well as root planing (SRP) on serum CRP levels. The study included 100 systemically healthy adults (n = 100; 50 males and 50 females) who were separated into two groups: Group A (control) n = 50; periodontally healthy subjects and Group B (test) n = 50; subjects with chronic periodontitis. The test group (group B) was further separated randomly into two groups: B1 (n = 25) and B2 (n = 25). The clinical parameters and serum CRP levels were measured only once in Group A and before SRP in Group B1 subjects. In Group B2 subjects the clinical parameters and serum CRP levels were measured only after two months following SRP. For group A, B1, and B2 (the readings recorded after SRP) the mean gingival index scores were 0.146, 2.437, and 1.052, respectively, while the plaque index was 0.414, 2.499, and 0.954, respectively. Probing pocket depth (PPD) and clinical attachment loss (CAL) showed statistically significant differences between three groups, with higher values in patients with periodontitis before intervention (2.196 ± 0.49; 1.490 ± 0.23), respectively. Healthy controls (Group A) had a C-reactive protein level of 0.04820 mg/dL, while group B1 (test) had 1.678 mg/dL and 0.8892 mg/dL (group B2). C-reactive protein levels were observed to be greater in the test group (groups B1 and B2), and these differences were statistically significant (p < 0.001). Chronic periodontitis enhances blood levels of systemic inflammatory markers like CRP, which has been reduced by periodontal treatment with SRP.

Role of jargon in the patient-doctor communication in the dental healthcare sector-A systematic review and meta-analysis

Medical terminology is useful for better communication between medical and dental professionals. Overzealous use of this terminology and use of medical terms during patient interaction hamper the complete understanding of the doctor's explanation about their health status. Nowadays, the usage of abbreviations or short terminology in health sectors has become common during all stages like the patient's initial visit, during the diagnosis, and even during the treatment plan stage. The objective was to know the commonly used jargon in the dental profession and to know the effect of the commonly used jargon on patient-doctor communication and treatment outcomes. Three major scientific databases were used as search engines PubMed, Web of Science, and Scopus by following three main search criteria, the common use of jargon in the dental profession, effect of jargon on patient-doctor communication, and treatment outcomes. An approach to meta-synthesis was used in the qualitative research methodology. With the Sandelowski and Barroso approach, meta-synthesis was carried out. Following database searches, during the years 2001 to 2022, 424 studies were gathered. Ten sources were then chosen and used in the analysis stage. Usage of jargon in dental professions has an effect on patient-doctor communication, and to an extent, it also has an effect on the treatment plan which further has its effect on treatment outcome.The correlation ratio (COR) of frequency of jargon is 0.46 (0.34; 0.57), with P value <0.0001, which indicates the presence of these issues in dental healthcare sector. The cautious use of jargon within the health profession will be beneficial in terms of professional communication with the patients and also helps in rendering better treatment to the patients.

Evaluation of Propolis Hydrogel for the Treatment of Dentinal Sensitivity: A Clinical Study

BACKGROUND

Propolis is a natural resinous substance collected by honeybees, chiefly from buds and the leaves, branches, and bark of trees. Its role as a wound-healing gel has been studied, but the use of a propolis hydrogel in the treatment of dentinal hypersensitivity has not been evaluated. Dentin hypersensitivity (DH) is commonly treated via iontophoresis using fluoridated desensitizers. The aim of the present study was to compare and evaluate the effects of a 10% propolis hydrogel, 2% sodium fluoride (NaF), and 1.23% acidulated phosphate fluoride (APF) when used in conjunction with iontophoresis for the treatment of cervical dentin hypersensitivity (DH).

METHODS

Systemically healthy patients complaining of DH were selected for this single-centre, parallel, double-blind randomized clinical trial. Three substances were selected as desensitizers for study in the present trial: a 10% propolis hydrogel, 2% sodium fluoride, and 1.23% acidulated phosphate fluoride, all in conjunction with iontophoresis. Any decrease in DH following the application of specific stimuli was assessed at baseline, before and after application, on the 14th day following use, and on the 28th day following the intervention.

RESULTS

Intra-group comparisons show diminished values of DH at maximum post-op follow-up intervals which were significantly trimmed down from the baseline (p < 0.05). The 2% NaF demonstrated a significant reduction in DH over 1.23% APF and the 10% propolis hydrogel (p < 0.05). However, there was no statistically significant difference in the mean difference between the APF and propolis hydrogel groups assessed via tactile, cold, and air tests (p > 0.05).

CONCLUSION

All three desensitizers have proved to be useful when used in conjugation with iontophoresis. Within the limitations of this study, a 10% propolis hydrogel can be used as a naturally occurring alternative to commercially available fluoridated desensitizers.

Assessment and Correlation of Salivary Ca, Mg, and pH in Smokers and Non-Smokers with Generalized Chronic Periodontitis

Background and Objectives: Diagnostic evaluation with the aid of biomarkers has reached newer heights to assess disease activity. Salivary calcium, magnesium, and pH are one of the biochemical parameters which can be helpful in assessing the progression of periodontal disease. Smokers are at topnotch threat for having oral diseases, predominantly periodontal diseases. The aim of this study was to assess the salivary calcium, magnesium, and pH levels in smokers compared with non-smokers with chronic periodontitis. Materials and Methods: The current study was conducted on 210 individuals affected with generalized chronic periodontitis, with the age group between 25 and 55 years. Based on their smoking habit, an equal number of patients were categorized into two groups; namely, group I consisted of non-smokers and group II consisted of smokers. The clinical parameters that were measured included Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Loss (CAL). The biochemical variables that were evaluated in the current study included salivary calcium, magnesium, and pH using an AVL9180 electrolyte analyzer (Roche, Germany). The gathered data were analyzed with an unpaired t test was using SPSS 20.0. Results: A statistically significant higher PPD (p < 0.01), CAL (p < 0.05), and salivary calcium levels (p < 0.001) were observed in the smokers' compared with their non-smoking counterparts. Among the biochemical parameters, calcium showed a significantly (p < 0.001) higher level in smokers (5.79 ± 1.76) in contrast to non-smokers (3.87 ± 1.03). Additionally, a significant negative correlation (p < 0.05) between calcium and PPD was observed in non-smokers, whereas a non-significant inverse relation (p > 0.05) was seen in smokers. Conclusions: The present study indicates that the salivary calcium level can be a potential biochemical parameter to assess the progression of periodontal disease in smokers and non-smokers. Within the limitations of the current study, the salivary biomarkers appear to have an essential role in the identification and indication of the status of periodontal diseases.

Effectiveness of a Single Chair Side Application of NovaMin® [Calcium Sodium Phosphosilicate] in the Treatment of Dentine Hypersensitivity following Ultrasonic Scaling-A Randomized Controlled Trial

Dentinal hypersensitivity or cervical dentinal sensitivity is one of the commonest clinical problems. The aim of this randomized controlled trial was to evaluate the effectiveness of a single chair side application of 100% pure calcium sodium phosphosilicate (NovaMin^®) in reducing dentin hypersensitivity following ultrasonic scaling as evaluated on a visual analogue scale (VAS). The study included 50 subjects who were selected based on an evaluation of dentinal hypersensitivity on a VAS carried out using a metered air blast from a three-way syringe and divided into two groups (n = 25/group); i.e., the test group (Group A) received the NovaMin^® paste and the control group (Group B) received a placebo paste made from pumice. All the 50 subjects included in the study were had VAS scores of 3 or more. The NovaMin^® powder mixed with distilled water was applied. Dentinal hypersensitivity was reassessed immediately and after 1, 2 and 4 weeks after the procedure. Results showed that the percentage reduction of dentinal hypersensitivity following a single application of NovaMin^® in powder form was about 76.38% immediately, 67.72% one week postoperatively, 52.76% two weeks postoperatively and 26.78% four weeks postoperatively. It can be concluded from the results of the current clinical study demonstrated that a single chair side application of NovaMin^® in powder form has a significant and immediate reduction in dentinal hypersensitivity, which lasted nearly for four weeks.

Dental implants in growing patients: A systematic review and meta-analysis

BACKGROUND: Dental implants provide a suitable and reliable treatment for the replacement of missing teeth. Very few studies have been reported in the literature regarding the application of dental implants in growing and developing patients. OBJECTIVE: This systematic review with meta-analysis aimed to systematically review the available literature regarding the application of dental implants in growing and developing patients. METHODS: A detailed search in the literature was performed with the help of keywords such as dental implants, treatment planning, children, adolescents, growing patients, and developing jaws. PubMed, Scopus, Web of Sciences, and Ovidsp databases were searched for papers published between 1980 and 2021. The papers focused on children, adolescents, developing jaws, and implants. In this systemic review, the dataset concerned with the type of study, aim, number of patients and specimens included, age of patients, total number of implants placed, total number of implants evaluated, medical history of developmental disorders of teeth such as ectodermal dysplasia, congenital absence of teeth, were evaluated. RESULTS: Out of the total literature searched, 33.45% of studies and case reports documented no complications in any implant treatment. In 47.21% of studies and case reports, there was both success and failure of implants while in 13.21% of studies and case reports there was a complete failure of implants. The most common cause for loss of permanent teeth in growing children and adolescent patients was dental trauma (73.13%) followed by congenital developmental disturbance of teeth (18.19%). CONCLUSION: It can be concluded from this systematic review that the use of implants in edentulous growing patients is determined by several parameters, including the patient’s overall health, the stage of jaw growth, the number of teeth to be replaced, and soft and hard tissue anatomic features. Still, the use of a conservative treatment strategy for missing teeth management in patients with developing jaws is common and recommended until the patient’s growth is completed, as there are chances of changes in the position of dental implants placed in the developing and growing jaws due to the continuous changes taking place in their body. However, placement of implants can be done in these patients successfully with proper treatment planning and taking into account the phase of growth with proper follow-up.

Effect of Injectable Platelet-Rich Fibrin with a Nano-Hydroxyapatite Bone Graft on the Treatment of a Grade II Furcation Defect

Background: Periodontal diseases lead to bone loss, crestal defects and even loss of the tooth, which also further makes it difficult to replace the tooth. Autogenous bone grafts are considered the gold standard in bone regenerative procedures. This study aimed to compare and evaluate the bone regenerative effects of i-PRF (Injectable- Platelet-rich fibrin) with a bone graft and a bone graft alone in mandibular grade II furcation defects over a period of 9 months. Method: This was a comparative study of 12 participants, who were randomly selected and grouped into two groups: test and control. Following phase I therapy, both groups were subjected to open flap debridement. In the test group, after debridement, a nano-hydroxyapatite bone graft mixed with i-PRF was inserted, whereas in the control group only a nano-hydroxyapatite bone graft was inserted. The clinical parameters such as plaque index (PI), gingival index (GI), pocket probing depth (PPD), clinical attachment level (CAL), horizontal probing depth (HPD) and vertical probing depth (VPD) were recorded at baseline, 3 months, 6 months and 9 months following the surgery. The bone area fill (BAF) was assessed using intraoral periapical radiographs (IOPARs) taken at baseline and 9 months after surgery. Results: At the baseline, there was no statistically significant difference between the tested parameters. After 9 months all the clinical parameters, PI, GI, PPD, CAL, HPD and VPD as well as radiographic bone fill showed a significant increase in both the groups (p < 0.05) (PI-TGr; CGr−VPD—3.5 ± 0.54 to 0.66 ± 0.51; 3.3 ± 0.81 to 2 ± 0.63/BAF—2.9 ± 0.88 to 5.6 ± 1.10; 3.4 ± 1.39 to 3.9 ± 1.4). On comparison the test group showed better results for each clinical parameter. Conclusion: The results showed increased improvement in clinical conditions in both groups, although better results were seen in the group where i-PRF with a nano-HA bone graft was used in the furcation defect.

Comparative Evaluation of Locally Administered 2% Gel Fabricated from Lemongrass Polymer and 10% Doxycycline Hyclate Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis-A Randomized Controlled Trial

Background: Extracts of medicinal plant like lemongrass offer a new choice for optional antimicrobial therapy against various oral microorganisms. The objective of this study was to assess, verify, and compare the antimicrobial effectiveness of locally administered 2% lemongrass gel and 10% doxycycline hyclate gel as an adjunct to scaling and root planing (SRP) in treating chronic periodontitis. Method: This is a double-blind parallel arm randomized controlled study. Forty subjects were randomly divided into Group A and B for 2% lemongrass gel and 10% doxycycline hyclate gel, respectively. The clinical assessments of Gingival Index (GI), Plaque Index (PI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) together with microbial colony counts for Porphyromonas gingivalis, Actinomyces naeslundii, and Prevotella intermedia were done at baseline, 1st month, and 3rd month follow-ups. Results: The results showed there was a significant reduction in the mean scores of GI, PPD, and CAL clinical indices from baseline to the 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Similarly, there was significant reduction in mean CFU scores for all periodontal pathogens from baseline to 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Conclusions: It could be concluded that the local delivery of 2% lemongrass gel as an adjunct to scaling and root planing is effective and comparable to 10% doxycycline gel in the treatment of chronic periodontitis.

Evaluation of locally-administered controlled-release doxycycline hyclate gel in smokers and non-smokers in the management of periodontitis: An Indian study

Purpose: To assess the clinical and biological effect of locally-administered controlled-release 10 % doxycycline hyclate gel in smokers and non-smokers for the management of periodontitis. Methods: Forty periodontitis patients were enrolled in this study from December 2012 to February 2013 at the Department of Periodontology and Implantology of the Institute of Dental Sciences and Dental Unit of Rohilkhand Medical College, Bareilly, Uttar Pradesh (UP), India. For each patient, probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and sulcular bleeding index (SBI) were recorded. Changes in microbial counts were assessed by measuring colonyforming units (CFU) of three major periodontal pathogens. Clinical and microbial parameters were recorded at baseline and one month after scaling and root planing plus controlled local drug delivery of 10 % doxycycline hyclate gel in smokers and non-smokers. Results: A statistically significant change (p < 0.01) in PPD was observed among smokers between baseline (4.26 ± 0.12mm) and re-evaluation at one month (3.20 ± 0.11) with a change of 24.88 %. A statistically significant difference was found between smokers and non-smokers in PPD at the end of a 1-month re-evaluation (p < 0.05). None of the other parameters showed improvement in smokers following treatment. Conclusion: These results indicate that 10 % doxycycline hyclate gel, when administered locally into the periodontal pocket, shows clinical and microbial improvement, among smokers and non-smokers, in the management of periodontitis. Therefore, 10 % doxycycline gel is potentially an effective therapeutic strategy in the management of periodontitis.

Comparison of the effect of sodium bicarbonate and glycine air polishing systems on tooth surface roughness: An atomic force microscopic analysis

BACKGROUND

A variety of prophylactic materials are used in the dental office for the removal of stains and calculus.

OBJECTIVE

To evaluate tooth surface changes caused by the application of air abrasive powders (sodium bicarbonate, SBAP and glycine air powder, GPAP) along with scaling and root planing (SRP), under atomic force microscope (AFM) and to analyze the histological soft tissue changes caused by these agents, using light microscopy.

METHODS

This study was conducted in two phases: in vitro and in vivo. In the in vitro phase, hard tissue analysis was done under AFM following air powder polishing. Eighteen extracted teeth were chosen. SRP and tooth sectioning were carried out. Subsequently, each section of the tooth was mounted on a glass plate with self-cure acrylic resin and air polished using SBAP and GPAP. In the vivo phase, the soft tissue was analyzed under a light microscope for surface roughness. A biopsy specimen was taken from patients who had received phase I therapy, and flap surgery was planned using a modified Widman flap technique.

RESULTS

This study compared surface changes in enamel and cementum, under AFM, as indicated by RA after SRP, SRP and SBAP, and SRP and GPAP; comparisons were then drawn across the three groups. The mean AFM values were 108.5 and 144.7, 102.7 and 81.7, and 95.6 and 7.4, at the crown and root, for SRP, SRP and SBAP, and SRP and GPAP interventions, respectively. GPAP was the least rough on soft tissues.

CONCLUSION

SBAP and GPAP were better than hand instrumentation as indicated by AFM and histological section analysis.

Efficacy of calcium sodium phosphosilicate containing dentifrice in reducing dentin hypersensitivity compared to other dentifrices with dentin tubule occluding molecules: A systematic review

Purpose: To assess the effectiveness of calcium sodium phosphosilicate in reducing dentin hypersensitivity compared to other dentin tubule occluding molecules. Methods: A structured research question was formulated, and an electronic search of available literature was carried out via PubMed, Google Scholar, and Scopus. A hand search as well as a gray literature search were also carried out. The search produced a total of 67 articles. Of these, only eight articles were eligible to be included in our review. Risk of bias and study quality were checked using Cochrane tool. The review was registered in The International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42018096200. Results: The results show a reduction in dentin hypersensitivity with calcium sodium phosphosilicate compared to many other molecules. However, nanohydroxyapatite showed a better desensitizing effect compared to Novamin. Conclusion: According to the available evidence, 5 % calcium sodium phosphosilicate containing toothpaste is more effective reducing dentin hypersensitivity compared to many other dentinal tubule occluding molecules.

Efficacy of Pluronic F-127 gel containing green tea catechin extract on chronic periodontitis – A clinical study

Purpose: To evaluate the efficacy of pluronic F-127 gel containing green tea catechin extract as a local drug delivery system in the treatment of chronic periodontitis. Methods: A total of 20 chronic periodontitis patients participated as per the set inclusion and exclusion criteria. Complete scaling and root planing (SRP) was done for all subjects and pluronic F-127 gel containing green tea catechin was applied on one site. The contralateral site received SRP alone. The plaque index (PI), gingival index (GI), and probing pocket depth (PPD) were recorded at baseline and on the 28th day. Results: At the 28th-day follow-up, green tea catechin tooth sites showed significantly lower mean scores (GI = 0.55, p = 0.30 and PPD = 3.35 mm) than the corresponding SRP tooth sites (GI = 1.25, PI = 1.15, and PPD = 4.40 mm) (p < 0.05). Conclusion: When compared to scaling and root planing alone, the local drug delivery gel containing green tea catechin as an adjuvant was more effective in reducing the clinical parameters of periodontitis. Keywords: Adjuvant therapy, Camellia sinensis, Local drug delivery, Periodontal pocket

A novel perspective for predicting gingival biotype via dentopapillary measurements on study models in the Saudi population: Cross-sectional study

Background/Purpose

Gingival biotype (GB) is a crucial factor in predicting the success of soft tissue periodontal and peri-implant surgical interventions. Consequently, contemplating noninvasive, less time-consuming procedure to anticipate it has become a part and parcel of the current practice. This article presents a novel algorithm to detect GB in the Saudi population based on the dentopapillary measurements taken on laboratory models. In addition, it targets to allocate a range of values for thick and thin biotypes.

Materials and Methods

Model analysis was done on 160 patients to measure eight gingival parameters, and an algorithm was developed according to the results of multiple and linear regression analyses. Applying the dentopapillary parameters to the algorithm revealed a prediction of the biotype. Finally, the resultant values and the exact thickness were reassessed directly in a sample of patients using a modified caliper.

Results

The regression analysis revealed an algorithm predicting biotypes among patients based on their measured dentopapillary values. Discriminant analysis was used to allocate the values to thin and thick biotypes to further demystify that they coincide with <0.7 mm and >1.5 mm, respectively. However, gingival thickness between 0.7 and 1.5 mm was considered intermediate biotype.

Conclusion

GB could be predicted based on the dentopapillary measurements taken on laboratory models, which may further reduce the chairside time and increase the success rate of the surgical procedures. Significant variations in the range of values of the thick and thin biotype were detected in the Saudi population compared to other races.

Clinical Significance

The escalating invasion of interventional procedures in the dental practice necessitates measuring the GB as a predictor of procedure success. This study introduces an algorithm for detecting the GB and updates the range of values for thick and thin biotypes in the Saudi population that would consequently reduce chairside time.