Effect of Acellular Dermal Matrix Placement Simultaneous with Implant Placement on Vertical Soft Tissue Thickness: A Randomized Controlled Clinical Trial

Acellular dermal matrix (ADM) is commonly used for soft tissue augmentation in root coverage, increasing the width of keratinized gingiva or vestibular depth, or filling the localized alveolar bone defects. This parallel-design randomized controlled clinical trial assessed the effect of ADM membrane placement simultaneous with implant placement on vertical soft tissue thickness. A total of 25 submerged implants were placed in 25 patients (8 men, 17 women) with vertical soft tissue thickness < 3 mm at the surgical site. Patients were randomized into two groups: The intervention group (n = 13) received ADM over the implant for soft tissue augmentation, while no augmentation was performed for the control group (n = 12). After 3 months, healing abutments were placed, and the soft tissue thickness at the surgical site was measured again with a periodontal probe in both groups. Data were analyzed using Mann-Whitney and Wilcoxon tests. All 25 patients were successfully treated. The presurgical vertical soft tissue thickness was 2 mm and 1.92 mm in the control and test groups, respectively (P > .05). These values changed to 1.83 mm and 2.69 mm, respectively, after the intervention. The mean gain in soft tissue thickness was 0.76 mm in the test group, and the difference between groups was statistically significant (P < .05). ADM membrane can be successfully used to augment vertical soft tissue thickness simultaneous with implant placement.

Tooth Discoloration and Solubility of Zinc Oxide Eugenol Combined with Different Concentrations of Nano-Curcumin: An in vitro Study

Statement of the Problem

Due to the unfavorable properties of eugenol, the eugenol content can be reduced to improve the properties of zinc oxide eugenol (ZOE) by making a new combination of nanocurcumin called curcumin pulpal paste (CPP).

Purpose

The aim of this in vitro study was to evaluate the solubility and tooth discoloration of three concentrations of CPP compared to ZOE, and Metapex.

Materials and Method

In this in vitro study for evaluating of the solubility, five groups including ZOE, Metapex, and three concentrations of CPP (5%, 10%, and 20%) were tested. For evaluating the solubility, the changes in of the weight of samples were measured at 1, 3, 7 and 30 days after initial setting. In order to evaluate the tooth discoloration, 75 bovine maxillary anterior teeth were filled with one of five pulpal pastes. The changes in tooth color were evaluated at 1 hour, 1 week, 1 and 3 months after material placement.

Results

The solubility increased by increasing the nano-curcumin percentage in CPPs. After 30 days, the solubility of the 5%CPP, and ZOE was not significantly different (p= 1.000). According to the colorimetric test, after 3 months, the highest discoloration was recorded for 20% CPP (8.45), and the smallest discoloration was registered for Metapex (4.06). The discoloration of 5% CPP, and 10% CPP was similar to ZOE's color change (p> 0.05).

Conclusion

The results of the present study showed that the solubility of pulpal paste has increased with increasing curcumin concentrations. Therefore, pulpal paste with different nanocurcumin concentrations can be used considering the patient's age and the desired time of deciduous tooth loss, and dissolution of pulpal paste. Concerning the discoloration after 3 months, Metapex was the best material and the most discoloration rate was related to 20% CPP, and there was no difference between the 5% CPP, and 10% CPP with ZOE.

Evaluating Vitality and Sensitivity of Teeth Adjacent to the Site of Closed Sinus Lift Surgery before and after Treatment

The aim of this study was to evaluate the effect of closed sinus lift surgery on dental vitality and periodontal sensitivity of teeth adjacent to the surgery area. Thirty patients undergoing closed sinus lift surgery by osteotomes were evaluated for dental vitality and periodontal sensitivity of adjacent teeth. Dental vitality and sensitivity were evaluated using the electric pulp tester (EPT) and cold spray once before surgery and one week, one month, and six months after surgery. In order to increase the validity of the study, one contralateral tooth in each patient was considered the control. In the test group, the number of teeth that did not respond to EPT and cold stimuli increased from baseline to six months after surgery and showed a significant difference between the four time intervals (P = 0.015 for EPT; P = 0.007 for cold stimuli). Thus, the vitality of teeth adjacent to the closed sinus lift area was lost over time. There was no significant difference between the two groups at any time for either stimuli. According to this research, tooth sensitivity to EPT and cold stimuli was not significantly different between test subjects and controls. For both cold and electrical stimulation, the number of teeth that did not respond was highest at one week after surgery and significantly different from baseline. However, after six months postsurgery, this number decreased, indicating recovery. However, some teeth were considered necrotic in the sixth month. It can be concluded that closed sinus lift surgery may cause necrosis in adjacent teeth, but more studies are required.