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Objectives: This study aimed to compare the effect of four decontamination methods on the level of residual contaminants in the re-usage of dental healing abutments. Materials and methods: In this experimental study, 50 used healing abutments were divided into five groups of ten as follows: 1. Control group: healing abutments were submerged in the ultrasonic device then autoclaved at 121 °C for 15 min; 2. Hypochlorite group: Same procedure as the control group, but the healing abutments were additionally immersed in 3 % hypochlorite for 20 min; 3. Chlorhexidine group: Same procedure as the control group, but the healing abutments were additionally treated with 12 % chlorhexidine; 4. Air polishing group: Same procedure as the control group, but the healing abutments were subjected to air polishing; 5. Hydrogen peroxide group: Same procedure as the control group, but the healing abutments were additionally exposed to 3 % hydrogen peroxide. Then, all healing abutments were stained with a protein-specific stain, Phloxine B. Five photographs were taken of each healing abutment, with four capturing the body (shank)and one capturing the top. All images were analysed, to measure the stained (contaminated) areas of each sample. The obtained data were analysed using statistical software (significance set at p

Background: This systematic review and meta-analysis aimed to assess the efficacy of autologous platelet concentrate (APCs) in comparison with coronally-advanced flap alone or in combination with connective tissue graft or other biomaterials or bioactive agents for root coverage (RC) of Miller’s Class I and II gingival recession defects by measuring the keratinized mucosa width (KMW). Materials and Methods: This systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines. An electronic search of the literature was conducted in PubMed, EMBASE, Scopus, Cochrane, Web of Science, Magiran, Scientific Information Database, and Irandoc for randomized clinical trials (RCTs) that used APCs for RC in their intervention group. Eligible articles were retrieved by assessment of titles and abstracts and then the full texts. The risk of bias was assessed by the Cochrane Library Risk of Bias Assessment Tool. Meta-analysis was carried out by RevMan 5.3 software. In the case of homogeneity, variables were reported as weighted mean difference (WMD) with 95% confidence interval (CI) for each group. Results: The search yielded 689 articles; out of which, 32 were eligible for study inclusion. Meta-analysis did not show any additional effect for RC and KMW with APCs. Clinical parameters were as follows: RC: WMD = −1.57 mm (95% CI: −2.49, −0.659; P = 0.001) and KMW: −0.106 mm (95% CI: −0.3222, 0.110; P = 0.337). Conclusion: The application of APCs for RC of Miller’s Class I and II gingival recession defects does not seem to improve the clinical parameters.

Background. Recently, the use of leukocyte- and platelet-rich fibrin (L-PRF) has been recommended due to the presence of various growth factors to increase the success of free gingival grafts (FGG). This study evaluated the effect of using L-PRF in the healing of FGG in rabbits. Methods. Twenty rabbits were randomly divided into two groups. In each group, FGG was performed in two separate sites with or without L-PRF. One of these groups was sacrificed on the 7th day and the other on the 28th day and analyzed in terms of clinical indices, including wound healing, gingi­val thickness (GT), and keratinized tissue width (KTW). Then histologic sections were obtained and stained for type and degree of inflammation and rate of vascular formation analysis. SPSS 22 was used for statistical analysis. Results. The extent of changes in GT, KTW, wound healing index, and vascular formation between the test and control groups was not statistically significant. The difference in the type of inflammation was significant only between the -7day and -28day control groups (P=0.003). The degree of inflammation between the -7day test group and the -28day control group, as well as the -7day and -28day control groups, were statistically significant (P=0.011 and P=0.002, respectively). Conclusion. Using L-PRF with FGG could improve FGG healing compared to using FGG alone, but the results were not statistically significant.

Background. Evaluation of salivary biomarkers is a non-invasive, convenient, and economical method for diagnosing many diseases. Evidence shows that salivary biomarkers and periodontal disease might be correlated. This study was conducted to evaluate phase I periodontal therapy’s effect on salivary concentrations of calcium, phosphorous, and alkaline phosphatase (ALP). Methods. In this descriptive, analytical study, 16 patients were selected from those referred to the Department of Oral Medicine, Faculty of Dentistry, Isfahan University of Medical Sciences, using convenience sampling. Salivary samples were collected using the drooling method. The salivary concentrations of calcium, phosphorous, and ALP were measured immediately after saliva collection, before the first phase of periodontal therapy and one month later, using a colorimetric assay. The data were analyzed with SPSS using paired t-test. P0.05). Conclusion. This study revealed that the salivary concentrations of calcium, phosphorous, and ALP remained relatively unchanged after phase I periodontal therapy.

Background: The aim of the present study is to determine the possibility of isolation and characterization of the human periodontal ligament stem cells (hPDLSCs) using limited harvested periodontal ligament (PDL) tissue of only one patient's wisdom teeth (2–4 teeth) under the more compatible terms of use in clinical application without using the fetal bovine serum (FBS). Materials and Methods: In this pilot study, hPDLSCs were isolated from the impacted third molar, and tissue was scraped from the roots of the impacted third molar of 10 volunteers to enzymatically digest using collagenase. The cells were sub-cultured. The samples of the first seven patients and half of the eighth patient's sample were cultured in alpha modified of Eagle's medium (α-MEM) (−FBS) medium and the other part of the eighth patient's sample was cultured with prior medium supplemented with +FBS 15% as a control of the cultivation protocol. While for the past two patients (9th and 10th the α-MEM medium was supplemented with L-Glutamine, anti/anti 2X, and 20% knock-out serum replacement (KSR). Two more nutritious supplements (N2 and B27) were added to the medium of the tenth sample. Flow-cytometric analysis for the mesenchymal stem cell surface markers CD105, CD45, CD90, and CD73 was performed. Subsequent polymerase chain reaction was undertaken on three samples cultured with two growth media. Results: Cultivation failed in some of the samples because of the lack of cell adhesion to the culturing dish bottom (floating cells), but it was successful for the 9th and 10th patients, which were cultured in the α-MEM serum supplemented with KSR 20%. Flow cytometry analysis was positive for CD105, CD90, and CD73 and negative for CD45. The PDL stem cells (PDLSCs) expressed CD105, CD45, and CD90 but were poor for CD73. Conclusion: According to the limited number of sample tests in this study, isolation and characterization of PDLSCs from collected PDL tissue of one patient's wisdom teeth (2–4) may be possible by the proper setup in synthetic FBS-free serum.

Background: Chronic periodontitis (CP) is one of the most prevalent diseases of the oral cavity with various biological and behavioral risk factors. We aimed to evaluate the association between the salivary cortisol level (SCL) of unstimulated saliva and CP in patients referred to Isfahan Dental Faculty. Materials and Methods: In this analytic cross-sectional study, 90 patients were selected based on the presence of periodontitis and were divided into two groups: with periodontitis and without periodontitis (n = 45). First, by evaluating the level of anxiety with Spielberger State-Trait Anxiety Inventory questionnaire, each group was divided into three subgroups, each containing 15 persons. To measure the SCL in all subgroups by the enzyme-linked immunosorbent assay method, saliva samples were collected with unstimulated spitting method between 9 and 11 AM. Periodontal evaluation was done using the mean probing depth (PD), plaque index, and bleeding on probing. The obtained data were analyzed using SPSS software (version 20, IBM Corp., Armonk, N.Y., USA) and analysis of variance, independent t-test, Chi-square, Mann–Whitney, Spearman correlation, and Pearson correlation coefficient tests (α = 0.05). Results: The mean level of salivary cortisol (P = 0.048) and PD (P = 0.009) in patients with periodontitis was significantly higher than those without periodontitis. There was a direct and meaningful correlation between PD and SCL (P < 0.001, r = 0.363). In both groups of participants with (P < 0.001) and without periodontitis (P < 0.001), the mean SCL in patients with high anxiety was significantly more than patients with medium and low anxiety. Conclusion: Our results showed that there is an increased level of salivary cortisol (as anxiety index) in patients with CP. Therefore, it seems that the probability of the occurrence of periodontitis is higher in those with increased cortisol level.

Background: MicroRNAs are a class of small noncoding ribonucleic acids that perform a critical role in adjustment of gene expression. miRNAs-155 (miR-155) participates in controlling inflammation. Periodontitis is defined as inflammatory disorder of tissues surrounding the teeth. In this study, the expression levels of miR-155 and its target genes, tumor necrotizing factor alpha (TNF-α), and interleukin-6 (IL-6) were evaluated in a group of Iranian patients. Materials and Methods: This sectional study was performed on 10 healthy controls and 10 individuals with chronic periodontitis by means of polymerase chain reaction (PCR) test. For each individual, clinical parameters including probing depth and clinical attachment loss and blood samples were measured. Levels of miR-155, TNF-α, and IL-6 were quantified using real-time PCR (α=0/05) and the results were analyzed by Mann–Whitney U test. Results: The level of miR-155 was significantly higher in patients with chronic periodontitis (P < 0.001). A positive correlation was observed between the level of miR-155 and clinical parameters (P < 0.05). Level of miR-155 in tissue samples was correlated with blood samples although the expression level was higher in blood samples. Conclusion: As the expression level of miR-155, TNF-α, and IL-6 genes was higher in subjects with chronic periodontitis than healthy individuals, it might suggest a role for miR-155 in patients with chronic periodontitis.

Background: Dental implants are widely accepted substitutes for replacing missing teeth. Many factors, including the use of specific drugs such as proton-pump inhibitors (PPIs) (omeprazole), can affect the success of dental implantations. The aim of this study was to investigate the relationship between the use of omeprazole and osseointegration of dental implants. Materials and Methods: This experimental animal study was performed on eight native male dogs weighted 11–13 kg and aged 16–20 months. The dogs were divided into two groups (receivers and nonreceivers of omeprazole). After extraction of mandibular teeth, treatment was started randomly with the administration of omeprazole and saline. After a 2-month recovery period, six titanium implants were placed in the jaws of all dogs and the administration of omeprazole was continued for 2 weeks. After 4 and 12 weeks, the dogs were anesthetized and dental implants with their bone marrow were removed. The samples were examined histomorphometrically to determine osseointegration. Data were analyzed with two-way ANOVA test for 95% confidence interval. The P value was set at 0.05. Results: In the microscopic examination of the samples in week 4, the levels of bone–implant contact (BIC) in the study group were significantly lower than the control group (46.37 vs. 64.37%). In 12 weeks, BIC was significantly lower than that of the control group (67.33 vs. 82.00%). The type of bone formed in week 4 in both the groups was more woven, and in the 12th week, it was mostly lamellar. Conclusion: Systemic administration of PPIs may interfere with osseointegration of dental implants.

Introduction: Chlorhexidine mouthrinses have widely been recognized for their contribution in maintaining plaque control. Most of them contain alcohol that makes them impractical for many patients. Alcohol-free mouthwashes may have fewer side effects but may be less efficient. The current study was aimed to compare the effectiveness and side effects of chlorhexidine mouthrinses with and without alcohol. Materials and Methods: In this double-blind clinical trial, 32 patients with moderate and severe gingivitis were recruited. For all patients, full prophylactic procedures, such as removal of plaque, calculus, and stains on the teeth, were performed. Each patient was asked to use 15 mL of the mouthrinse for 60 s twice daily. The patients were divided into two groups, one group used Hexidine (0.12% chlorhexidine and 10% ethanol) mouthwash and the other group used Epimax (0.12% chlorhexidine and 0.05% sodium fluoride) mouthwash. After 14 days, plaque (PI), gingival (GI), and stain indices were analyzed. The obtained data were analyzed by using SPSS 16 using covariance [Analysis of covariance (ANCOVA)] and t-test. Results: Both mouthwashes significantly reduced the mean scores of plaque (P < 0.0001) and gingival (P < 0.032) indices after 2 weeks; however, Hexidine mouthrinse was shown to be more effective. The extent of stain was the comparable in both groups. While Epimax mouthrinse caused severe stains on the teeth, Hexidine mouthrinse caused burning mouth. Conclusion: Although Epimax mouthwash did not show any side effects, it was less suitable and caused more dental stain. Ethanol-free Hexidine mouthwash seems to be more proper for gingivitis, but its side effects are required to be taken into consideration.

Background: Selective alveolar corticotomy is defined as an intentional injury to cortical bone. This technique is an effective means of accelerating orthodontic tooth movement. The aim of this study is to evaluate the effect of buccal corticotomy in accelerating maxillary canine retraction. Materials and Methods: The sample in this clinical trial study consisted of 15 adult female patients with therapeutic need for extraction of maxillary first premolars and maximum canine retraction. By use of split-mouth design, at the time of premolars extraction, buccal corticotomy was performed around the maxillary first premolar, randomly on one side of maxilla, and the other side was reserved as the control side. Canine retraction was performed by use of friction – less mechanic with simple vertical loop. Every 2 weeks, distance between canines and second premolars was measured until complete space closure. The velocity of space closure was calculated to evaluate the effect of this technique in accelerating orthodontic tooth movement. The obtained data were statistically analyzed using independent t-test, and the significance was set at 0.05. Results: The rate of canine retraction was significantly higher on the corticotomy side than the control side by an average of 1.8 mm/month versus 1.1 mm/month in the corticotomy side and control side, respectively (P < 0.001). Conclusion: Based on result of this study, corticotomy can accelerates the rate of orthodontic tooth movement about two times faster than conventional orthodontics and it is significant in early stages after surgical porsedure. Therefore Buccal corticotomy is a useful adjunct technique for accelerating orthodontic tooth movement.

Background: The accelerating effect of plasma rich in growth factors (PRGFs) in the healing of extraction sockets has been demonstrated by some studies. The aim of the present study was to histologically and histomorphometrically evaluate whether bone formation would increase by the combined use of PRGF and demineralized freeze-dried bone allograft (DFDBA). Materials and Methods: In four female dogs, the distal root of the second, third and fourth lower premolars were extracted bilaterally and the mesial roots were preserved. The extraction sockets were randomly divided into DFDBA + PRGF, DFDBA + saline or control groups. Two dogs were sacrificed after 2 weeks and two dogs were sacrificed after 6 weeks. The extraction sockets were evaluated from both histological and histomorphometrical aspects. The data were analyzed by Mann-Whitney followed by Kruskal-Wallis tests using the Statistical Package for the Social Sciences version 20 (SPSS Inc., Chicago, IL, USA). Significant levels were set at 0.05. Results: The least decrease in socket height was observed in the DFDBA + PRGF group (0.73 ± 0.42 mm). The least decrease in the coronal portion was observed in the DFDBA + PRGF group (1.38 ± 1.35 mm²). The least decrease in the middle surface was observed in the DFDBA group (0.61 ± 0.80 mm²). The least decrease in the apical portion was observed in the DFDBA group (0.34 ± 0.39 mm²). Conclusion: The present study showed better socket preservation subsequent to the application of DFDBA and PRGF combination in comparison with the two other groups. However, the difference was not statistically significant.

Background: The purpose of this study was to perform a histological, histomorphometrical, and immunohistochemical evaluation of the effect of Enamel matrix derivative (EMD) on bone formation around titanium dental implant. Materials and Methods: In this animal study, 12 implants (10 × 3.8 mm) were inserted in the tibia bone of three dogs of Iranian breed. Two implants were placed in each tibia with EMD only on the left side. The dogs were sacrificed 2, 4, and 6 weeks after implantation. Following decalcification of the implants′ surrounding tissue and preparation of 4 μm thick sections, they were stained with hematoxylin and eosin (H and E) and immunohistochemical (IHC) stain for osteopontin (OPN) marker. Histomorphometric evaluation was performed via measurement of the percentage of the woven, lamellar, and total generated bone. Light microscopy osteoblastic intensity of OPN in osteoblasts and bone matrix was also evaluated Data were analyzed by Wilcoxon signed Ranks, and Mc Nemar tests. Results: In both control and EMD-applied groups, bone formation was recognized around the implants at the 4 th week postimplantation. The percentage of total generated bone in the test group was higher than the control group, although being not statistically significant (P value = 0.917). Osteoclasts exhibited significantly higher proliferation activity compared the control group when stimulated by EMD (P value = 0.027). On average, the staining intensity in osteoblasts and extracellular matrix of bone, in EMD-applied subjects was higher than those of the controls (P value = 0.167 and P value = 0.414, respectively). Conclusion: EMD enhanced bone formation around dental implants, but this increase was not significant.

Background: The differences between marginal gingiva and interdental papilla may be due to variation in the molecular composition of these two different anatomical structures. The aim of this study was to evaluate the staining intensity of fibronectin in human marginal gingiva and interdental papilla. Materials and Methods: In a prospective analytical study, 16 healthy subjects needing crown lengthening surgery were selected. All participants were medically healthy, non-smokers, with no medication intake, and a healthy periodontium. During surgery, facial/buccal marginal gingiva and interdental papilla were separately harvested. The specimens were subjected to hematoxylin and eosin, histochemical (Masson′ strichorom, reticulin, and elastic), and immunohistochemical staining for evaluation of morphology and inflammation; assessment of connective tissue fibers (collagen, reticulin, and elastic); and determination of fibronectin staining intensity. The data were analyzed by Spsssoftware, Wilcoxon, and Spearman tests. P

Introduction: Scaling and root planing is one of the most commonly used procedures during periodontal treatments. Removal of calculus using conventional hand instruments is incomplete and rather time consuming. To find more efficient and less difficult instrumentation method, investigators have proposed lasers as an alternative or adjunct to hand instruments for scaling and root planing. The aim of the present study was to compare the effectiveness of three methods of hand instruments, ultrasonic and Er:YAG laser for scaling & root planing of root surfaces with SEM method.Methods and materials: This was an experimental study and samples included 15 extracted premolars collected from patients with periodontal problem. The teeth were sectioned in two parts vertically. Therefore 30 samples were randomly divided in two groups. In the first group each surface of root from CEJ was divided in two parts. One part was scaled with manual curret and another by Er:YAG laser and third group was cleaned by ultrasonic methods. Another surface was considered as control group. The surface changes were evaluated by SEM in magnification of 50, 400 and 750 by 5 Examiners. Data was analyzed by SPSS program.Results: The findings show that surface roughness is more in control group comparing with three other groups. Besides roughness from the most to the least belong to: ultrasonic group, laser group & manual scaling group. Kruscal-wallis test & Mann-Whitney test showed that there was a significant difference in the amount of surface roughness between manual group & laser group and also between control group & other groups and between manual and ultrasonic group. But there was no significant difference between rate of surface roughness in laser and ultrasounic group.Conclusion: The efficacy of Er:YAG laser for scaling & root planing is not more than manual and ultrasonic instruments the amount of surface roughness created by Er:YAG is more than manual scaling but the difference is not significant comparing to ultrasonic scaling.Key Words: Scaling & root planing, Er:YAG laser, Surface roughness, Ultrasonic scaling, Manual scaling, SEM.

Presence of available and stable fluoride in a dentifrice formulation is a major requirement for an anti-caries effect. Although the available fluoride concentration in Iranian dentifrices has been reported in previous studies, there is little information on its stability; which is dependent upon dentifrice formulation. This study was done to assess the fluoride ion concentration and stability in four widely used dentifrices in Iran.In this analytical study, three samples of each brand of dentifrice (Nasim, Pooneh, Crest, and Signal) were purchased. Total fluoride (TF) and total soluble fluoride (TSF) concentrations were determined by ion specific electrodes. Data about TF were analyzed by one-way analysis of variance (ANOVA). Kruskal-Wallis and Mann-Whitney tests were used for nonparametric data (TSF).All dentifrices had more than 1000 ppm of fluoride ions. TSF in Crest was significantly higher than in other dentifrices (P

Introduction. The periodontal inflammation is one of the most common oral and dental diseases. Periodontitis is advanced periodontal bacterial infection. At present treatment of this disease is oral hygiene instructions, scaling and root planning, plaque control with different mouth washes and in some cases, periodontal surgery. In this investigation, Benzydamin was used as mouth wash which has anti pain and anesthetic properties. The purpose of this research was to study anti-inflammatory effects of using Benzydamin mouth wash 0.15 percent on moderate periodontitis.Material and Methods. This was a clinical test study, which has been done in Isfahan University (School of Dentistry). Sample included 80 patients, (52 female and 28 male) with an average age of 27 years. Patients who had moderate periodontitis were tested and divided into 40 person group (case and control). In both groups before performing the firt phase of treatment, index of gingival inflammation and bleeding index was determined. In case group, patients were given both oral hygience instructions and oral Bensydamin month wash. In control group only oral hygiene instructions were given to them. After one week, both case and control groups were recalled and once more indexes determined and then average was made. Acording to statistical formulas descriptive statistic and t-tests, curves and tables were made.Results. The mean for bleeding index before clinical test were 2.01 and 1.7 and after clinical test were 1.22 and 1.27 for both case and control groups. These differences between two groups were significant. But the mean for gingival inflamation index before and after clinical test were 2.18, 2.01 and 1.87, 2.03 which in both stages. Their differences were not significant.Discussion. Rsults indicate Benayamin month wash will decrease gingival bleeding and to lesser extend gingival inflamation. In control group, bleeding index was decreased slightly which can be due to oral hygiene instructions.Key words. Moderate periodontitis, Benzydamin hydrochloride 0.15%.

Purpose: Despite the large number of publications, there is still controversy among clinicians regarding the application of dental lasers for the treatment of chronic periodontitis. This study was therefore conducted to compare clinical and microbial results of nonsurgical periodontal therapy alone or associated with Nd:YAG laser in periodontal pocket healing. Materials and Methods: Forty-eight periodontal pockets in 6 patients suffering from generalized chronic penodontitis were selected. They were treated with nonsurgical periodontal therapy (supra- and subgingival ultrasonic scaling, hand scaling and root planing). The pockets were randomly divided into two groups. For 24 pockets, Nd:YAG laser (Fidelis plus, Fotona, 300 μm fiber, 2 W, 20 Hz, 1 min, 2 times for each site and about 8×105 J per cm²) was applied; in the control group, no laser was applied. Clinical parameters evaluated during this study were: periodontal pocket depth, modified gingival index, bleeding on probing, clinical attachment level, and gingival recession. Microbiological samples from pockets were also examined for Porphyromonas gingivalis and Prevotella intermedia. All patients were followed up for a period of two months. Results: There was significant improvement in all parameters after treatment in both groups, but after one or two months, the laser-treated group showed statistically better results than the control group. Microbial evaluation showed that the laser-treated group had a greater reduction of Prevotella intermedia. Conclusion: This clinical trial indicated that Nd:YAG laser application together with conventional methods provide better clinical and microbial results than those obtained by conventional method alone. [ABSTRACT FROM AUTHOR]