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The aim of this study was to use intra-oral radiographs to evaluate changes in marginal bone levels around three different implant designs after 1 year.Three implant designs; two with a straight and one with a conical design, were placed adjacent to each other in the partially edentulous areas of 25 patients. The patients received 46 implants with a straight design (All fit SSO and SPI-element) and 29 implants with a conical design (SPI-contact). Two-way repeated analysis of variance (ANOVA) was used to evaluate the marginal bone changes in each group at 12 months follow-up (p0.05).None of the implants had failed by the end of this study. After 12 months, significant differences were noted in the amount of alveolar bone loss recorded between the All fit SSO and SPI implants (p0.05). Mean crestal bone loss was 0.88 ± 0.43 mm for the All fit, 0.61 ± 0.34 mm for the SPI contact and 0.54 ± 0.27 mm for the SPI element implants.The results of this study demonstrate that straight (cylindrical) implants with shorter high polish surface displayed less bone resorption.

AIMS The present study aimed at evaluating the acceptability of the Implant Success Index (ISI) in comparison with the conventional classification system. MATERIALS AND METHODS A comparative questionnaire was designed to evaluate 10 criteria that were reported to be important for acceptance of a new classification system. We asked 20 experts who had at least 5 years of clinical experience in implant dentistry to complete a questionnaire based on a visual analog scale. Data were analyzed by a blinded statistician using a Wilcoxon non-parametric rank test. RESULTS Measuring all 10 criteria, the acceptability level of ISI was significantly higher than that of the Misch classification (70.90 and 54.90, respectively; P < 0.05). The most significant differences were found in the system's ability to detect early lesions, its lack of overestimation, its quantitative base, and its comprehensiveness. The simplicity and compatibility of the two understudy classification systems were not significantly different. CONCLUSIONS ISI seems to be a proper scoring system with a high level of acceptability for determining the success rate of dental implants and for selection of procedures used for improving the status of peri-implant tissue.

Cigarette smoking and tobacco consumption are serious hazards threatening the health of human beings. Several strategies have been proposed for smoking cessation in patients presenting to medical centers to seek treatment. Some believe that the dental profession plays a key role in quit smoking programs due to its extensive and long-term relationship with patients. Use of known strategies to create motivation for quitting smoking among patients has yielded relatively optimal results. However, it seems that patients' attitudes toward smoking can be changed if we enhance their knowledge about the hazards of tobacco consumption and its adverse effects on dental and oral health and especially the health of dental implants' surrounding structures. This study reports smoking cessation in two patients requiring dental implant treatment. Twenty-eight months after loading of implants, treatment success was confirmed by use of clinical and radiographic indices. No sign of peri-implant disease was detected and the patients were eagerly following the smoking cessation program. It seems that contemporary dental treatments, especially dental implant therapy, can provide a good opportunity to create the motivation required for lifestyle changes in patients.

Objectives This study aimed to optimize the thread depth and pitch of a recently designed dental implant to provide uniform stress distribution by means of a response surface optimization method available in finite element (FE) software. The sensitivity of simulation to different mechanical parameters was also evaluated. Materials and Methods A three-dimensional model of a tapered dental implant with micro-threads in the upper area and V-shaped threads in the rest of the body was modeled and analyzed using finite element analysis (FEA). An axial load of 100 N was applied to the top of the implants. The model was optimized for thread depth and pitch to determine the optimal stress distribution. In this analysis, micro-threads had 0.25 to 0.3 mm depth and 0.27 to 0.33 mm pitch, and V-shaped threads had 0.405 to 0.495 mm depth and 0.66 to 0.8 mm pitch. Results The optimized depth and pitch were 0.307 and 0.286 mm for micro-threads and 0.405 and 0.808 mm for V-shaped threads, respectively. In this design, the most effective parameters on stress distribution were the depth and pitch of the micro-threads based on sensitivity analysis results. Conclusion Based on the results of this study, the optimal implant design has micro-threads with 0.307 and 0.286 mm depth and pitch, respectively, in the upper area and V-shaped threads with 0.405 and 0.808 mm depth and pitch in the rest of the body. These results indicate that micro-thread parameters have a greater effect on stress and strain values.

Low level laser therapy (LLLT) also known as photobiomodulation, is a treatment that uses low-level lasers or light-emitting diodes (LEDs) to change cellular function and is a clinically well accepted tool in regenerative medicine and dentistry. Considering the variety of laser, exposure, cells and study types, the exact effects of low level laser therapy seems to be unclear. The aim of this study was to review the data published in the field of the effects of low level laser therapy on proliferation and differentiation of the cells contributing in bone regeneration.To access relevant articles, an electronic search in PubMed was conducted from 2001 to April 2014. English language published papers on low level laser therapy were found using the selected keywords .The full texts of potentially suitable articles were obtained for final assessment according to the exclusion and inclusion criteria.240 articles were found from 2001 to April 2014. Following the initial screening of titles and abstracts as well as the final screening of full texts, 22 articles completely fulfilled the inclusion criteria of this study. Wavelength used in LLLT irradiation varied between 600 to 1000 nm with an energy density of 0.04-60J/cm(2) . Although almost all studies agreed on getting positive effects from LLLT, some had opposing results.Low level laser with low-energy density range appears to exert a biostimulatory effect on bone tissue, enhance osteoblastic proliferation and differentiation on cell lines used in in vitro studies. Despite the fact that many researches have been recently done on the effects of LLLT on different cell lines, without knowing the precise mechanism and effects, we are not able to offer a clinical treatment protocol. This paper is a beginning to help further progress and extend practical use of LLLT in future.

OBJECTIVES: Dentin is composed of many minerals and growth factors. Based on this composition, we studied its effect as a possible regenerative material for alveolar healing. MATERIALS AND METHODS: This study was conducted using four 2.5-year-old mongrel dogs (male; weight, 25 to 30 kg). The third mandibular premolars were carefully mobilized with a dental elevator and then removed using forceps. The crown portions of the extracted teeth were removed with cutters, and the root portions of the remaining teeth were collectively trimmed as closely as possible to 350 to 500 µm. Dentin and cementum (DC) chips harvested from the extracted teeth were soaked in blood and packed into the fresh sockets (autograft). Biopsies were performed at the ends of day 14 and day 56 following implantation. Data were expressed as mean±standard deviation and compared with t-test results. RESULTS: The ratio of SA(bone) to total area of each probe was determined and was 170±16 µm(2) for the control group and 71±14 µm(2) for the DC group, a significant difference (P

Objectives: The aim of this study was to investigate the effects of implant design on the apex area and on stress and stress patterns within surrounding bone. Methods: Three commercially available implants with the same diameter (3.5 mm), same length (10-11 mm), and same complement abutment were selected for modeling as follows: (1) flat apical design with light tapering degree, (2) dome-shaped apical design with light tapering, and (3) flat apical design with intense tapering in one-third of the apical area. According to human cone-beam computed tomography (CBCT), the bone was modeled using a cortical thickness of 2 mm and cancellous bone. Forces of 100 N and 300 N in the vertical and 15° angle directions were applied to the entire abutment surface, and the equivalent stress and strain were calculated using finite element analysis (FEA) methods. Results: In all models, stress was concentrated on the cortical bone around the implant neck; in non-axial loads, stress was concentrated on the buccal side. The maximum strain recorded was a microstrain of 7200 μm μm-1 around the apex of sample C, which also showed the highest level of stress detected in cancellous bone (4.4 MPa). We observed the pathologic overload in the apical area of sample B (with a dome-shaped apex); however, the strain value was less than that of sample C. Conclusion: FEA revealed that great sudden changes in diameter along the fixture increases stress and strain in peri-implant bone. Therefore, uniform tapering should be considered as a standard feature for most clinical situations, and a flat apical design, which creates a better stress and strain distribution in surrounding bone than dome-shaped bone, should also be used. © 2014 by Begell House, Inc.

Purpose This study aimed to assess the interdental bone level in premolar bitewing radiographs while retracting the cheeks. Methods Seventy-two horizontal bone defects were created on dried mandibles and maxillae. The distance from the bone level to the cement-enamel junction of premolars was detected by a modified digital caliper (considered the gold standard). The reliability of all radiographs was assessed by intraclass correlation coefficient (ICC), and the validity was compared to the gold standard using the analysis of variance test. P-values less than 0.05 were considered statistically significant. Results This study showed that the reliability of radiographs without a cheek simulator and with 0.16 second exposure time was significantly higher than that of the two other groups (ICC=0.96 compared to 0.93 and 0.88, respectively). The results from the radiographs without a cheek simulator and with 0.16 second exposure time were more similar to the gold standard measures than those of the two other groups, although the difference was not statistically significant. Conclusions Retracting the buccal soft tissue plays an important role in increasing the accuracy of radiographs in detecting the interdental alveolar bone level and produces more accurate results than increasing the exposure time, although it does not have a significant role in reliability of results. Graphical Abstract

J Korean Assoc Oral Maxillofac Surg 2014;40:220-224) Objectives: This study aimed to assess and compare the levels of interleukin-1beta (IL-1β ) and interleukin-6 (IL-6) in the crevicular fluid around healthy implants, implants with peri-implantitis, and healthy teeth. Materials and Methods: This study evaluated 16 dental implants in 8 patients (4 males and 4 females). These patients had at least one healthy im- plant and one implant with peri-implantitis next to healthy teeth. The crevicular fluid was collected using absorbent cones and transferred to the labora - tory. Specimens were evaluated by ELISA for interleukin levels. Data were analyzed using repeated measures ANOVA and Bonferroni tests (P

BACKGROUND This study aimed at comparing the colonization and passage of Streptococcus mutans and Aggregatibacter actinomycetemcomitans (Aa) through polytetrafluoroethylene (PTFE) and acellular dermal matrix (ADM) membranes loaded with tetracycline, amoxicillin, and chlorhexidine. METHODS In this in vitro study, PTFE and ADM membranes were loaded with tetracycline, amoxicillin, and chlorhexidine. The colonization and crossing of S. mutans and Aa through these membranes were evaluated using vials containing culture medium. Three-way analysis of variance and Tukey's honestly significant difference test were used for the statistical analyses (p

Aim To explore the relationship between primary implant stability and cortical bone thickness. Materials and methods Twenty-three implants were inserted into fresh sheep bone. The cortical width of implant recipient sites was determined using cone-beam computed tomography (CBCT). The maximum insertion torque value of each implant was recorded. Implant stability was measured using an Osstell system. Spearman's correlation coefficient was used to evaluate the correlations among variables. Results The cortical width and Hounsfield unit mean values were 3.3 ± 1.0 (mm) and 1468.5 ± 272.3, respectively. The correlation between cortical bone thickness and Osstell value was not statistically significant (p > 0.01). Conclusion The cortical bone thickness evaluated using CBCT had no correlation with the primary stability of dental implants.

Among the factors that may impede success in dental treatments, gingival biotype is the greatest cause of concern, particularly affecting the outcomes of periodontal therapy, root coverage procedures, and implant placement. Different tissue biotypes respond differently to inflammation and to surgical and restorative treatment; consequently, it is crucial to identify tissue biotype before treatment. Special care must be taken when treatment planning for cases with a thin gingival biotype. This article reviews the characteristics of various gingival biotypes and the many ways to determine them.

Aplastic anemia (AA) is a rare but extremely serious disorder that results from an unexplained failure of the bone marrow to produce blood cells. Patients with AA are at high risk for infections, including periodontitis. Treatment modalities are complicated by bleeding disorders. This is a case report of the successful periodontal and prosthesis treatment in a patient with AA, chronic diffuse gingivitis, excessive tooth caries that interfered with mastication, painful oral lesions, and limited mouth opening. Physiotherapy was performed to improve the mouth opening, and the patient was examined for HBsAg, HBsAb, and HIV; white blood cell and platelet count and coagulation tests were given before every periodontal treatment. Caries removal and root canal therapy were done, hopeless teeth were extracted, and full-mouth crown lengthening was performed. Free gingival grafts were placed in areas of inadequate keratinized tissue, and full-mouth rehabilitation with fixed prosthesis was completed.The mouth opening was improved to 31 mm, inflammation was significantly controlled especially after comprehensive periodontal treatment, the redness significantly decreased, and an acceptable condition for prosthesis reconstruction was obtained.The treatment modalities used in this case provide a new ray of hope for patients who are severely medically compromised.

UNLABELLED: This study sought to determine TANK (rs1921310, rs3820998) gene polymorphism in patients suffering from chronic periodontitis and peri-implantitis among an Iranian population. MATERIALS AND METHODS: In this cross-sectional study, 77 chronic periodontitis and 40 peri-implantitis patients, along with 89 periodontally healthy subjects, were evaluated. A 5 cc venous blood sample was obtained from subjects. DNA was extracted using Miller's salting-out method and polymorphisms were determined by the use of KBioscience's Competitive Allele-Specific PCR (CASP) genotyping system. Data were analyzed using SPSS version 11.5 software. Differences in allele and genotype frequencies among patients and controls were evaluated with Kruskal-Wallis test. P

AIM In the present study, we sought to assess the correlation of IKKi gene polymorphisms (rs1539243 and rs12728136) with chronic periodontitis and peri-implantitis in an Iranian population for the first time in dentistry. MATERIALS AND METHODS This cross-sectional study was conducted on 75 patients with chronic periodontitis, 38 patients with peri-implantitis, and 84 periodontally healthy subjects. Blood samples were taken from all subjects (5 cc venous) and transferred into Falcon tubes containing EDTA. Extracted DNA samples were evaluated with a spectrophotometer (75 ng), transferred into a 96-well plate, and sent to KBioscience Institute in the United Kingdom for analysis. Assessment of IKKi gene polymorphisms was performed at the KBioscience Institute. Data were analyzed using SPSS v19 software. Differences in genotype frequencies and allele among patients and controls were evaluated using the chi-squared test (P

Background: The present study was carried out to test the antibacterial effect of the body wall of the sea cucumber Holothuria leucospilota Brandt on Streptococcus mutans and Streptococcus salivarius. Methods: After sampling sea cucumbers from the Persian Gulf, different extractions were prepared. Then, aqueous, phosphate-buffered saline (PBS, pH 7.8), chloroform, hexane and methanolic extracts from sea cucumber body wall were screened for antibacterial activity against pathogenic bacteria S. mutans and S. salivarius using the disk diffusion method. Results: The PBS extract did not show any antibacterial or inhibitory activity; the chloroform extract, however, demonstrated high levels of antibacterial activity against S. salivarius while exhibiting low levels of activity against S. mutans. The hexane and methanolic extracts were found to show no antibacterial activity against S. mutans, but exhibited antibacterial activity against S. salivarius. Conclusions: In conclusion, the results demonstrated the possibility of utilizing sea cucumbers as a cheap source of potential antibacterial agents and for treating odontogenic diseases.

Periodontal disease (PD) and peri-implantitis (PI) are characterized by an immune response leading to destructive inflammation. The prominent impact of genetic factors on periodontitis has been previously evaluated and IL-17 has found to play a critical role in this process. This cytokine has a controversial behavior. This study aimed at finding out whether the polymorphism of this cytokine plays a significant role in chronic periodontitis (CP) and PI or it is just a pro-inflammatory regulatory cytokine. Fresh human blood samples were obtained and three main genotypes were traced carefully. The samples were transferred into 96-well plates and sent to KBioscience Institute in the United Kingdom for genotyping the polymorphism using Competitive Allele Specific PCR (KASP) technique. SPSS version19 software and chi-square and Kruskal-Wallis tests were used for statistical differences considering p-value less than 0.05. A significant difference was detected between the three groups in terms of specific SNP studied in this experiment (P = 0.00). The CC genotype of IL17 polymorphism (rs10484879) may contribute to the pathogenesis of peri-implantitis and periodontitis. The association of IL-17 polymorphism with PI and CP is a promising finding that may help in future similar studies on other ethnicities and larger study populations.

Receptor activator for nuclear factor kappa B ligand (RANKL)/RANK/OPG pathway plays a redundant role in osteoclastogenesis, osteoclast activation and regulation of bone resorption. Recently, single nucleotide polymorphisms (SNP) have been reported as a co-factor in pathogenesis of inflammatory diseases. The aim of this study was to investigate the relationship between osteoprotegerin (OPG) gene polymorphisms and chronic periodontitis and peri-implantitis in an Iranian population.77 patients with chronic periodontitis (CP), 40 patients with peri-implantitis (PI) and 89 periodontally healthy subjects were enrolled in this study. A total of 5 ml of blood was obtained from the arm vein of participants. DNA was extracted based on the salting out method. Two functional SNPs (T950C and G1181C) were analysed by using polymerase chain reaction and restriction fragment length polymorphism (PCR_RFLP). The prevalence differences in three batches were evaluated by chi-square test.An evaluation of the T950C genotype found that there was no statistical difference between groups. A comparison of the G1181C genotype distribution between peri-implantitis and chronic periodontitis groups, and between peri-implantitis and normal groups found that the frequency of the CC genotype was significantly higher in patients with peri-implantitis (P = 0.005).Our results indicate that a SNP at G1181C is associated with the presence of PI.

BACKGROUND Chronic periodontitis (CP) and peri-implantitis (PI) are inflammatory diseases that affect supporting tissues of teeth or implants. The involvement of hyperpolarization-activated cyclic nucleotide-gated 2 (HCN2) in neuronal excitability, hyperalgesia, allodynia, spontaneous pain, synaptic plasticity, and rebound activity was previously determined. Recently, scientists found that HCN2 plays an important role in chronic inflammatory pain. This study aimed to evaluate the relationship between gene polymorphisms of HCN2 and CP/PI. METHODS A total of 74 patients with CP, 37 patients with PI, and 80 healthy controls presenting to the Periodontology Department of Shahid Beheshti University of Medical Sciences were enrolled. DNA was extracted from fresh blood samples of the arm vein of participants and transferred to KBioscience Institute (UK) for genotyping. χ2-test was performed with SPSS software v.19 for statistical analyses. A p value

The aim of this study was to use finite element analysis (FEA) to assess the influence of microthread design at the implant neck on stress distribution in the surrounding bone. A commercially available implant with 3.5 mm diameter and 10.5 mm length was selected and used as a model. For the purpose of designing the microthread implant model, microthreads were added to the implant neck in a computerized model. A force measuring 100 N was then applied to the entire surface of the abutment in the vertical direction. The results showed that in both models, stress was mainly concentrated at the cortical bone adjacent to the neck of the implant. Maximum stress values in the cortical bone surrounding the implant surface periphery were 12 and 6.25 MPa for the microthread and conventional models, respectively. In this study, we conclude that adding a microthread design at the implant neck decreased stress values in the adjacent bone.

Aim: The purpose of this study was to investigate the cytotoxicity of nanohybrid mineral trioxide aggregate (MTA) in comparison with calcium-enriched mixture (CEM) cement and MTA-Angelus, using human gingival fibroblasts (HGFs). Materials and Methods: Nine disc-shaped specimens of each material (in 2 set stat: A, set for 24 h; B, set for 30 min; and C, fresh stat) were prepared. HGFs were exposed to tested materials’ extracts or control media. Cytotoxicity testing was performed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide assay in two time intervals. Statistical Analysis: Results were evaluated by one-way ANOVA and t-test. Statistical significance was set at P < 0.05. Results: CEM cement demonstrated favorable cell viability values when completely set (24 h set MTA = 24 h set CEM) at both time intervals. Interestingly, 24 h after incubation, CEM in Groups B and C demonstrated higher cell viability values than MTA (P < 0.05). However, after 72 h of incubation, these groups of CEM and MTA showed equal cell viability. All samples of nanohybrid MTA had slight cytotoxic effects after 24 h of incubation, and moderate cytotoxic effects after 72 h of incubation. Conclusion: Set CEM and set MTA-Angelus exerted similar, favorable effects on cell viability. However, within the limitations of this in vitro study, the results suggest that nanohybrid MTA could not be recommended as a material of choice for cervical root resorption.

BACKGROUND Peri-implantitis (PI) and chronic periodontitis (CP) are multifactorial diseases of implant/tooth supporting tissue that are caused by bacterial infection and increased host immune response. T-cell proliferation plays a pivotal role in the orchestration of host response to bacterial infection. BRAF is a positive regulator of T-cell proliferation. The aim of this study was to evaluate for the first time the role of a functional single nucleotide polymorphism (SNP) of the BRAF gene in association to PI and CP. METHODS A total of 194 individuals referred to the Periodontology Department of Shahid Beheshti Dental School, Tehran, Iran, were divided into three groups: 74 patients in the CP group (39 men and 35 women, with mean age of 48.3 years), 38 patients in the PI group (20 men and 18 women, with mean age of 50.2 years), and 82 patients in the healthy periodontium group (39 men and 43 women, with mean age of 45.4 years). DNA was extracted from fresh blood samples collected from the arm vein of participants and was transferred to KBiosience institute (United Kingdom) for genotyping. χ2 and Kruskal-Wallis tests were conducted using SPSS software v. 19 for statistical analysis (p

Aim The haptoglobin–hemoglobin (Hp–Hb) complex plays a significant role in regulating immune responses and acts as a bacteriostatic agent. Haptoglobin polymorphisms result in different Hb binding affinities. This study sought to assess whether Hp 2-2 could be a genetic determinant for increasing the risk of peri-implantitis and chronic periodontitis. Methods Of the Iranian subjects referred to the Department of Periodontics, Shahid Beheshti University, Tehran, 203 were entered into the study, including 117 patients and 86 periodontally healthy individuals. Polymerase chain reaction (PCR) was performed for genotyping. Data were analyzed by Kruskal–Wallis test using the SPSS statistics software package. Results The prevalence of Hp 2-2, 2-1, and 1-1 did not differ significantly between patients and healthy subjects (P > 0.05). The highest frequencies of Hp 1-1, 2-1, and 2-2 genotypes were seen in the control (7%), peri-implantitis (51%) and periodontitis (64%) groups, respectively. Conclusions Haptoglobin polymorphisms may not play a role in development of peri-implantitis or chronic periodontitis among Iranians but we strongly suggest researchers to evaluate this polymorphism in further studies on larger sample sizes, different populations, and other types of periodontitis.

Background One of the most recommended methods of systemic antibiotic administration in periodontics is the combination of amoxicillin and metronidazole, which has great inhibitory effect on periodontal pathogens. The aim of this study is to determine the local concentrations of these drugs in gingiva and compare its distribution in healthy and inflamed tissues. Methods The study population was selected from patients referred to our department. Fifteen subjects were referred for crown lengthening, and another 15 subjects required flap surgery because of severe periodontitis. All 30 patients received three doses of amoxicillin 500 mg plus metronidazole 250 mg before surgery. Tissue samples were gathered during surgery, and chemotherapy was continued for 7 days with 8-h intervals. After 7 days, during the second appointment, the next samples were collected. Samples were sent to the laboratory to determine the drug concentration with the use of high-performance liquid chromatography. Results Amoxicillin concentration in healthy gingival tissue was not detectable. The concentrations after 24 h and 7 days of administration were 25.9±4.1 and 124.8±18 μg/mL, respectively. The values for metronidazole were 28.86±1.7, 1.70±0.3, and 36.0±1.5 μg/mL. Conclusions The combination of systemic amoxicillin and metronidazole for 7 days has sufficient gingival connective tissue concentration much more than the minimum inhibitory concentration in healthy and inflamed tissue.

AIMS The purpose of this study was to evaluate the regenerative response of parietal bone defects in rats to bioactive ceramic and TGF-beta 1. MATERIALS AND METHODS Sixty mature adult rats with initial weights of 300 g to 324 g were used. The diameter of each defect was 3 mm. The animals were divided into four study groups consisting of 15 rats per group. Groups 1 and 3 (control groups) received 30 μg bioceramic per surgical defect site. Groups 2 and 4 (experimental groups) received 30 μg bioceramic combined with 10 μL of reconstituted TGF-beta 1 (200 ng). Animals of Groups 1 and 3 were euthanized at 18 days; Group 2 and 4 animals were terminated at 49 days after surgery. Each of the outcomes was analyzed via two-way analysis of variance model (ANOVA). RESULTS Histologic reactions to the implants were similar with no significant difference between bioceramic and bioceramic + TGF-beta 1 specimens. In the 18-day specimens, the percentage of ceramic was marginally higher than the 49-day specimens. No significant difference was noted in the percentage of bone in 18-day and 49-day specimens. CONCLUSIONS Based on the findings of this study, it was concluded that TGF-beta 1 promoted no significant increase in new bone when compared to bioactive ceramic alone.

Objectives: The present study was conducted to determine the reproducibility of peri-implant tissue assessment using the new implant success index (ISI) in comparison with the Misch classification. Materials and Methods: In this descriptive study, 22 cases of peri-implant soft tissue with different conditions were selected, and color slides were prepared from them. The slides were shown to periodontists, maxillofacial surgeons, prosthodontists and general dentists, and these professionals were asked to score the images according to the Misch classification and ISI. The intra- and inter-observer reproducibility scores of the viewers were assessed and reported using kappa and weighted kappa (WK) tests. Results: Inter-observer reproducibility of the ISI technique between the prosthodontists-periodontists (WK=0.85), prosthodontists-maxillofacial surgeons (WK=0.86) and periodontists-maxillofacial surgeons (WK=0.9) was better than that between general dentists and other specialists. In the two groups of general dentists and maxillofacial surgeons, ISI was more reproducible than the Misch classification system (WK=0.99 versus WK noncalculable, WK=1 and WK=0.86). The intra-observer reproducibility of both methods was equally excellent among periodontists (WK=1). For prosthodontists, the WK was not calculable via any of the methods. Conclusion: The intra-observer reproducibility of both the ISI and Misch classification techniques depends on the specialty and expertise of the clinician. Although ISI has more classes, it also has higher reproducibility than simpler classifications due to its ability to provide more detail.

Purpose: Peri-implantitis and periodontitis are inflammatory and infectious diseases of im- plant and tooth-supporting tissues. Recently, the role of gene polymorphisms of immune re- sponse components in the relevant pathogenesis has been investigated. The present study was the first to evaluate the relationship between two known single nucleotide polymorphisms (SNPs) of the receptor activator of nuclear factor kappa-β (RANK) gene (rs3018362 and rs35211496) in chronic periodontitis and peri-implantitis patients in an Iranian population. Methods: Eighty-one periodontally healthy patients, 38 patients with peri-implantitis, and 74 patients with chronic periodontitis were enrolled in this study. DNA was extracted from blood arm vein samples by using Miller's salting out technique according to the manufac- turer's instructions given in the extraction kit. The concentration of DNA samples was mea- sured using a spectrophotometer. The genetic polymorphisms of the RANK gene were eval- uated using a competitive allele specific polymerase chain reaction (KBioscience allele spe- cific PCR) technique. Differences in the frequencies of genotypes and alleles in the diseased and healthy groups were analyzed using chi-squared statistical tests (P < 0.05). Results: Analysis of rs35211496 revealed statistically significant differences in the expres- sion of the TT, TC, and CC genotypes among the three groups (P = 0.00). No statistically sig- nificant difference was detected in this respect between the control group and the chronic periodontitis group. The expression of the GG, GA, and AA genotypes and allele frequencies (rs3018362) showed no statistically significant difference among the three groups (P = 0.21). Conclusions: The results of this study indicate that the CC genotype of the rs35211496 RANK gene polymorphism was significantly associated with peri-implantitis and may be considered a genetic determinant for peri-implantitis, but this needs to be confirmed by further studies in other populations.

Purpose This study aimed to assess the combined effect of dismantling before sterilization and aging on the accuracy (±10% of the target torque) of spring-style mechanical torque devices (S-S MTDs). Methods Twenty new S-SMTDs from two different manufacturers (Nobel Biocare and Straumann: 10 of each type) were selected and divided into two groups, namely, case (group A) and control (group B). For sterilization, 100 cycles of autoclaving were performed in 100 sequences. In each sequence, 10 repetitions of peak torque values were registered for aging. To measure and assess the output of each device, a Tohnichi torque gauge was used (P

Background A cursory review of the current socket preservation literatures well depicts the necessity of further esthetic considerations through the corrective procedures of the alveolar ridge upon and post extraction. A new technique has been described here is a rotational pedicle combined epithelialized and connective tissue graft (RPC graft) adjunct with immediate guided tissue regeneration (GBR) procedure. Results We reviewed this technique through a case report and discuss it’s benefit in compare to other socket preservation procedures. Conclusion The main advantages of RPC graft would be summarized as follows: stable primary closure during bone remodeling, saving or crating sufficient vestibular depth, making adequate keratinized gingiva on the buccal surface, and being esthetically pleasant.

Chronic periodontitis (CP) and peri-implantitis (PI) are multifactorial diseases of tooth and implant supporting apparatus. Bacterial invasion and consequent host immune response seem to play a role in relevant pathogenesis. The structural differences between tooth and implant pose preferential biofilm colonization. This study was aimed to compare the prevalence of bacteria in CP and PI. Clinical and radiographic examination performed over 69 individuals referred to Shahid Beheshti Dental School (Tehran, Iran) and four groups categorized: CP (n=22), HP (n=21), PI (n=13) and HI (n=13). The mean age was 45.6 years, 55% of participants were female and 45% were male. Bacterial samples were collected by paper point method and transferred to Institute of Odontology, University of Gothenburg (Gothenburg, Sweden) for checkerboard DNA-DNA hybridization. Kruskal-Wallis and Mann-Whitney U tests were used to compare distribution of bacteria in four groups. Significant differences were observed for T. forsythia, P. intermedia, C. rectus, P. endodontic, P. gingivalis, T. denticola and P. tannerae (P

This article proposes a combined technique including bone grafting, connective tissue graft, and coronally advanced flap to create some space for simultaneous bone regrowth and root coverage. A 23 year-old female was referred to our private clinic with a severe class II Miller recession and lack of attached gingiva. The suggested treatment plan comprised of root coverage combined with xenograft bone particles. The grafted area healed well and full coverage was achieved at 12-month follow-up visit. Bone-added periodontal plastic surgery can be considered as a practical procedure for management of deep gingival recession without buccal bone plate.

Introduction There are numerous studies supporting the high success rate of dental implants used for reconstruction of missing teeth. However, complications like mucositis and peri-implantitis are increasingly reported. Placement of dental implants in partially edentulous patients is associated with the risk of peri-implant diseases, especially when an old or a new inflammatory lesion is present adjacent to the implant site. Although no consensus has been reached on the difference in prevalence of peri-implant mucositis and peri-implantitis between fully and partially edentulous patients, available data clearly show that the combination of periodontal lesion and peri-implantitis is a possible risk factor for further complications. Several classification systems have been suggested for determination of the severity of disease around dental implants. However, no classification has been proposed for combined biological complications around teeth and implants. This study reviews the possible pathologic communication routes between natural dentition and the implants installed adjacent to them. Furthermore, we introduce a new classification system for the peri-implant disease in association with natural teeth called “PIST”. This system was designed based on the origin of the defects in order to clarify the different pathological situations which can be detected around dental implant. Using this classification system can help improve diagnosis, comparison and subsequent selection of the best treatment option.

Gene polymorphism of cytokines influencing their function has been known as a contributing factor in the pathogenesis of inflammatory diseases of the tooth and implant supporting tissues. The aim of this study was to investigate the association of IL-17R gene polymorphism (rs879576) with chronic periodontitis and periimplantitis in an Iranian population. 73 patients with chronic periodontitis, 37 patients with periimplantitis and 83 periodontally healthy patients were enrolled in this study. 5cc blood was obtained from each subject's arm vein and transferred to tubes containing EDTA. Genomic DNA was extracted using Miller's Salting Out technique. The DNA was transferred into 96 division plates, transported to Kbioscience Institute in United Kingdom and analyzed using the Kbioscience Competitive Allele Specific PCR (KASP) technique. Chi-square and Kruskal Wallis tests were used to analyze differences in the expression of genotypes and frequency of alleles in disease and control groups (P-Value less than 0.05 was considered statistically significant). There were no significant differences between periodontitis, periimplantitis with AA, GG, GA genotype of IL-17R gene (P=0.8239). Also comparison of frequency of alleles in SNP rs879576 of IL-17R gene between the chronic periodontitis group and periimplantitis group did not revealed statistically significant differences (P=0.8239). The enigma of IL-17 and its polymorphism-role in periodontitis and periimplantitis is yet to be investigated more carefully throughout further research but this article demonstrates that polymorphism of IL-17R plays no significant role in incidence of chronic periodontitis and Periimplantitis.