Search

ABSTRACT Aim Materials and Methods Results Conclusion To evaluate the clinical outcomes of moderate intrabony defects treated with minimally invasive non‐surgical technique (MINST) with or without adjunctive delivery of cross‐linked hyaluronic acid (xHyA) gel.Forty‐two patients with 42 interdental intrabony defects were randomly assigned to test (MINST + xHyA) or control procedures (MINST alone). Probing depth (PD), clinical attachment level (CAL), gingival recession (GR) and bleeding on probing (BOP) at the treated sites were assessed at baseline and at 3 and 6 months. Full‐mouth plaque score (FMPS) and full‐mouth bleeding score (FMBS) were recorded at baseline and after 6 months. Radiographic evaluation was performed at baseline and after 6 months, assessing the defect fill (DF) and radiographic defect angle (RDA). The primary outcome variable was PD change.Thirty‐eight patients completed the trial without any adverse events. At 6 months, a statistically significant improvement (p < 0.05) was measured in all clinical parameters except GR (p > 0.05). However, no statistically significant differences were found between the experimental and control procedures (p > 0.05). Statistically significant differences between the test and control sites were observed at 3 months for PD and CAL changes (p < 0.05). The DF change was statistically significant when comparing experimental and control procedures at 6 months (p < 0.05). Both procedures failed to show statistically significant differences in terms of RDA changes at 6 months (p > 0.05).Within their limitations, the present results indicate that (a) treatment of intrabony defects with MINST, with or without application of xHyA gel, resulted in statistically significant improvements in the investigated clinical parameters at 3 and 6 months after therapy, and (b) although the adjunctive use of xHyA gel to MINST improved the clinical outcomes compared with MINST alone up to 3 months, statistically significant differences were not observed at 6 months. The study protocol was registered in ClinicalTrial.gov (NCT05188898). [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to explore knowledge, practice, and attitude on oral cancer (OC) among a cohort of Italian dental hygienists, in consideration of their role in the field of early diagnosis. Materials and Methods: A cross‐sectional study of 150 Italian dental hygienists was performed to assess the participant's knowledge, practice, and attitude on OC. Data were collected using a structured self‐administered questionnaire (through Google Forms). The questionnaire included four sections: sociodemographic information, disease knowledge, answers related to attitudes toward OC, and a questionnaire assessing the practice of dental hygienists on oral screening. Results: Responses were received from 137 participants (83 women and 54 men). Overall, there is a good knowledge of the real risk factors among the participants (98.5%, 98.5%, and 94.2% regard smoking, alcohol, and HPV, respectively). The analysis related to the knowledge of non‐risk factors, oral potentially malignant disorders, and clinical features of OC showed more heterogeneous results. Only 60% considered university education to be adequate. The totality of dental hygienists considered continuing education necessary, but despite this, only half took updating courses. Finally, 90% performed intraoral screening visits, and 95% and 69% investigated smoking and alcohol consumption, respectively. Conclusions: Our data showed the need to implement OC training courses by re‐evaluating pre‐ and post‐graduate training programs. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to compare resolution of inflammation of naturally occurring peri‐implant mucositis (PM) at tissue‐level (TL) and bone‐level (BL) implants after non‐surgical mechanical debridement. Materials and Methods: Fifty‐four patients with 74 Implants with PM were allocated in two groups (39 TL and 35 BL implants) and treated by means of subgingival debridement using a sonic scaler with a plastic tip without adjunctive measures. At baseline and at 1, 3, 6 months, the full‐mouth plaque score (FMPS), full‐mouth bleeding score (FMBS), probing depth (PD), bleeding on probing (BOP), and modified plaque index (mPlI) were recorded. The primary outcome was BOP change. Results: After 6 months, the FMPS, FMBS, PD, and number of implants with plaque decreased statistically significantly in each group (p <.05); however, no statistically significant differences were found between TL and BL implants (p >.05). After 6 months, 17 (43.6%) TL and 14 (40%) BL implants showed a BOP change in (17.9%) and (11.4%), respectively. No statistical difference was recorded between groups. Conclusions: Within the limitations of present study, the findings showed no statistically significant differences in terms of changes in clinical parameters following non‐surgical mechanical treatment of PM at TL and BL implants. A complete resolution of PM (i.e., no BOP at all implant sites) was not achieved in both groups. [ABSTRACT FROM AUTHOR]

Objectives: Evidence on the awareness and knowledge level of oral cancer and its associated risk factors among dental hygienists is scarce; this systematic review aimed to synthesize their available evidence of the level of knowledge, attitude and practice. Methods: PubMed and Scopus were searched for publications from any year up to January 2021. Studies about knowledge and/or attitudes and/or practices of dental hygienists have been taken into account. Overall, 14 studies have been selected for the systematic review. Results: Excluding tobacco use (99.8%–100%), considerable variability were found among dental hygienists about important oral cancer risk factors such as alcohol consumption (30.0%–90.0%), human papilloma virus (23.0%–90.0%), oldness (37.7%–69.3%), diet (30.0%–42.2%) and betel quid chewing (5.0% and 98.0%). There was a good level of awareness among dental hygienists regarding leukoplakia (86.5%), instead less than half recognized erythroplakia as a precancerous lesion. Moderate knowledge was recorded about frequent sites of oral cancer development. Most of dental hygienists reported to perform intraoral screening (85.2%–100%). To regard attitude, a great variability was found about adequacy of undergraduate training (15.7%–75.0%) and most of dental hygienists expressed the need for continuing education (92.7%–99.0%). Conclusions: Dental hygienists play a key role in oral cancer detection. Low knowledge of oral cancer among dental hygienists is strongly associated with the low levels of early detection. These findings provide useful information to improve continuing education programmes pre‐ and post‐graduation targeted at the prevention of oral cancer in order to reduce oral cancer morbidity and mortality. [ABSTRACT FROM AUTHOR]

This study assessed the pulp tissue dissolution from isthmus of a two‐rooted maxillary premolar using different final irrigation protocols. After root canal preparation, the surface of the tooth was reduced to an extent that the isthmus could be observed, and 1 mg of pulp tissue was introduced into the isthmus which was covered with a glass slide. Following six groups were tested: syringe and needle; subsonic activation; sonic activation; ultrasonic activation; heating followed by sonic activation; and heating followed by ultrasonic activation. Before and after each experiment a photograph of the isthmus was taken at 30× to register the area of the pulp tissue. Statistical analysis was performed with Kruskal–Wallis and Mann–Whitney tests (P < 0.05). Syringe and needle group showed the lower value of pulp tissue dissolution followed by subsonic irrigation procedures. Pulp tissue dissolution was significantly higher when heating was followed by sonic or ultrasonic activation. [ABSTRACT FROM AUTHOR]

This study investigated the effect of ultrasonic activation of intracanal‐heated sodium hypochlorite (NaOCl) on its dentinal tubular penetration and root canal cleanliness in vitro. In experiment 1, mandibular premolars were randomly allocated to three groups (n = 8): group A, ultrasonic activation; group B, ultrasonic activation of intracanal‐heated NaOCl and group C, syringe‐and‐needle irrigation. Penetration of the fluorescent‐labelled NaOCl was investigated using light microscopy. In experiment 2, mandibular premolars were randomly allocated to group B or C (n = 10), for histological analysis of the remaining pulp tissue and debris. Data were statistically analysed using Kruskal–Wallis and Mann–Whitney tests (P = 0.05). The highest penetration of NaOCl was observed in group B, followed by group A (P < 0.05). Group B showed significantly less amount of debris than group C (P < 0.05). Dentinal tubule penetration of NaOCl and root canal cleanliness were significantly improved by ultrasonic activation of intracanal‐heated NaOCl. [ABSTRACT FROM AUTHOR]

Aim To evaluate surface roughness alterations at the smooth neck of dental implants after the use of eight different prophylactic procedures. Materials and methods 50 tissue level implants (Institut Straumann AG, Basel, Switzerland) were used for the present investigation. The smooth collar of each implant was divided into two segments, each treated with one of eight cleaning procedures: use of a rubber cup ( RCZ) or a brush ( BZ) combined with an abrasive paste containing zirconium or a paste derived from perlite ( RCP, BP); use of 2 composite resin burs reinforced by zirconium glass fibers (F1, F2); and use of an air-polishing system with glycine powder and two power settings ( AP1, AP2). The qualitative alterations were recorded by means of a laser profilometer and the mean roughness ( Ra) and mean roughness profile depth ( Rz) were reported. Twenty untreated surfaces were used as controls. Results The implant collars treated with RCZ ( Ra = 0.33 μm, Rz = 2.43 μm) or BZ ( Ra = 0.30 μm, Rz = 3.70 μm) yielded the highest roughness values, followed by the surfaces treated with RCP ( Ra = 0.28 μm, Rz = 2.02 μm), with BP ( Ra = 0.25 μm, Rz = 2.16 μm) and by the use of F1 ( Ra = 0.27 μm, Rz = 2.22 μm) and F2 ( Ra = 0.27 μm, Rz = 2.04 μm). The lowest roughness values were observed in the AP1 ( Ra = 0.23 μm, Rz = 1.60 μm) and AP2 ( Ra = 0.16 μm, Rz = 1.06 μm) group, respectively. Implant collars treated with AP2 yielded statistically significantly lower ( P = 0.01) Rz values compared with untreated surfaces. Conclusion All tested procedures did not increase implant surface roughness significantly. Treatment with an air-powder abrasive system at high-pressure setting resulted in a smoothening of the implant collar surface. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to compare the efficacy of different instruments on biofilm removal from implant supported restorations. Materials and methods The study was designed as comparative multicenter clinical study including patients proceeding from the Milan, Naples, and Buenos Aires, with a peri-implant mucositis. Implants enrolled for the study were allocated in 4 groups and treated with ultrasonic scalers with plastic tips, with titanium curettes, with airflow with glycine powder, and with rubber cup and polishing paste, respectively. m PI was assessed at baseline, immediately after therapy, at 1, 3, and 6 months. m BI, PD, and REC were assessed at baseline, 1, 3, and 6 months. All parameters were recorded on six sites per implant. Kruskal-Wallis and Mann-Whitney tests were used to compare groups and centers. A generalized linear model for repeated measures was chosen for inter-group comparison. An intra-group comparison was performed with repeated measure ANOVA test to assess differences between baseline and recalls. Results A total of 89 patients (39 males, 50 females) were enrolled in the study, and 141 implants were available for the analysis. 55 implants were enrolled in University of Buenos Aires, 32 in University of Milan, and 54 in University of Naples. There were no significant differences between the four groups in inflammatory status reduction of peri-implant mucosa. Conclusions Non-surgical therapy is effective in reducing peri-implant mucositis. Sonic scaler with plastic tip and rubber cup with polishing paste showed higher efficacy when compared with titanium curettes or airflow with glycine powder. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to compare clinical outcomes in the treatment of deep non-contained intrabony defects (i.e., with ≥70% 1-wall component and a residual 2- to 3-wall component in the most apical part) using deproteinized bovine bone mineral (DBBM) combined with either enamel matrix protein derivative (EMD) or collagen membrane (CM). Methods: Forty patients with multiple intrabony defects were enrolled. Only one non-contained defect per patient with an intrabony depth ≥3 mm located in the interproximal area of single- and multirooted teeth was randomly assigned to the treatment with either EMD + DBBM (test: n = 20) or CM + DBBM (control: n = 20). At baseline and after 12 months, clinical parameters including probing depth (PD) and clinical attachment level (CAL) were recorded. The primary outcome variable was the change in CAL between baseline and 12 months. Results: At baseline, the intrabony component of the defects amounted to 6.1 ± 1.9 mm for EMD + DBBM and 6.0 ± 1.9 mm for CM + DBBM sites (P= 0.81). The mean CAL gain at sites treated with EMD + DBBM was not statistically significantly different (P = 0.82) compared with CM + DBBM (3.8 + 1.5 versus 3.7 ± 1.2 mm). No statistically significant difference (P = 0.62) was observed comparing the frequency of CAL gain ≥4 mm between EMD + DBBM (60%) and CM + DBBM (50%) or comparing the frequency of residual PD ≥6 mm between EMD + DBBM (5%) and CM + DBBM (15%) (P= 0.21). Conclusion: Within the limitations of the present study, regenerative therapy using either EMD + DBBM or CM + DBBM yielded comparable clinical outcomes in deep non-contained intrabony defects after 12 months. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the clinical and radiographic changes at implants in posterior maxillary and mandibular areas supporting single-unit crowns ( SCs) and fixed dental prostheses ( FDPs) with one mesial or distal cantilever extension after an observation period of at least 3 years. Material and methods Seventeen subjects with 19 implant-supported SCs and 21 subjects with 21 implant-supported FDPs fulfilled the inclusion criteria. All FDPs were supported by two implants and had a span of 3-4 units. All reconstructions were incorporated in the posterior maxilla or mandible. The mesial and distal radiographic marginal bone loss from baseline (i.e. delivery of the reconstruction) to the follow-up examination was averaged and compared between SCs supporting one cantilever extension with that of implants supporting FDPs adjacent to or distant from the cantilever extension. Changes in mean pocket probing depth ( PPD) were calculated and compared between the three groups. Results The mean observation period was 78.2 ± 34.5 months for SCs supported by one implant and 67.8 ± 29.8 months for FDPs supported by two implants. No implant loss occurred, yielding a 100% survival rate. At baseline, the mean radiographic bone levels ± SD were 2.6 ± 0.3 mm for implants supporting SCs, 2.6 ± 0.3 mm for implants of FDPs adjacent to the cantilever extension, and 2.4 ± 0.5 mm for implants of FDPs distant from the cantilever extension. At follow-up, the corresponding mean bone levels ± SD were 2.7 ± 0.4, 2.7 ± 0.5, and 2.8 ± 0.5 mm, respectively. No statistically significant differences ( P > 0.05) were observed comparing the mean marginal bone loss between the three groups. Moreover, mean changes in PPD between baseline and follow-up were not statistically significantly different ( P > 0.05) between the three groups. Conclusion The presence of one mesial or distal cantilever extension in the posterior maxilla or mandible does not jeopardize the marginal bone levels of implants supporting SCs or short-span FDPs after a mean observation period of at least 5 years. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to compare the healing of deep, non-contained intrabony defects (i.e., with a ≥80% 1-wall component and a residual 2- to 3-wall component in the most apical part) treated with either an enamel matrix derivative (EMD) or guided tissue regeneration (GTR) after 12 months. Methods: In this randomized, controlled clinical trial, 40 subjects with 40 defects affecting single-rooted teeth were treated. The defects were treated with EMD alone or with a non-resorbable titanium-reinforced membrane. No grafting materials were used. At baseline and after 12 months, clinical parameters including probing depths (PDs) and clinical attachment levels (CAL) were recorded. The difference in CAL gain was the primary outcome. Results: At baseline, the intrabony component of the defects amounted to 8.5 ± 2.2 mm at EMD-treated sites and 8.6 ± 1.7 mm at GTR-treated sites (P = 0.47). The mean CAL gain at sites treated with GTR was significantly greater (P<0.001) than that at sites treated with EMD (4.1 ± 1.4 mm versus 2.4 ± 2.2 mm, respectively). GTR therapy, compared to EMD application alone, significantly (P= 0.01) increased the probability of CAL gain ≥4 mm (79.2% versus 11.3%, respectively) and significantly (P=0.01 ) decreased the probability of residual PDs ≥6 mm (3% versus 79.3%, respectively). Conclusion: Although the outcomes of open-flap debridement alone were not investigated, the application of EMD alone appeared to yield less PD reduction and CAL gain compared to GTR therapy in the treatment of deep, non-contained intrabony defects. [ABSTRACT FROM AUTHOR]

Background: Limited data exist on the longitudinal crestal bone changes around teeth compared with implants in partially edentulous patients. This study sought to compare the 10-year radiographic crestal bone changes (bone level [BL]) around teeth and implants in periodontally compromised (PCPs) and periodontally healthy (PHPs) patients. Methods: A total of 120 patients were evaluated for the radiographic crestal BL around dental implants and adjacent teeth at time of implant crown insertion and at the 10-year follow-up. Sixty patients had a previous history of periodontitis (PCPs), and the remaining 60 were PHPs. In each category (PCP and PHP), two different implant systems were used. The mean BL change at the implant and at the adjacent tooth at the interproximal area was calculated by subtracting the radiographic crestal BL at the time of crown cementation from the radiographic crestal BL at the 10-year follow-up. Results: At 10 years after therapy, the survival rate ranged from 80% to 95% for subgroups for implants, whereas it was 100% for the adjacent teeth. In all eight different patient categories evaluated, teeth demonstrated a significantly more stable radiographic BL compared with adjacent dental implants (teeth BL, 0.44 ± 0.23 mm; implant BL, 2.28 ± 0.72 mm; P <0.05). Radiographic BL changes around teeth seemed not to be influenced by the presence or absence of advanced bone loss (≥3 mm) at the adjacent implants. Conclusions: Natural teeth yielded better long-term results with respect to survival rate and marginal BL changes compared with dental implants. Moreover, these findings also extend to teeth with an initial reduced periodontal attachment level, provided adequate periodontal treatment and maintenance are performed. As a consequence, the decision of tooth extraction attributable to periodontal reasons in favor of a dental implant should be carefully considered in partially edentulous patients. [ABSTRACT FROM AUTHOR]