Search

Objective: It has been suggested that periodontal disease may be a risk factor for a number of multifactorial systemic conditions such as preterm deliveries. The aim of the present study was to examine the relationship between maternal periodontal disease and body size of newborns. Methods: After controlling traditional risk factors for premature child birth and low birth weight. One-hundred eighty mothers were selected: 17 were periodontally healthy, 77 had gingivitis, 72 had initial periodontitis and 14 suffered from established periodontitis. These mothers and their newborns formed the study population. The body size consisting of weight, height, and head and chest circumference, were taken from newborns' hospital files. Findings: A decrease in the newborns' body size was observed as the mothers' periodontal disease severity increased. Birth weight, height, and head and chest circumference of babies born of mothers with established periodontal disease were significantly lower than those who were born of mothers with healthy periodontal condition, gingivitis and initial periodontal disease (P=0.006, P=0.016, P<0.001 and P<0.001, respectively). Conclusion: The data suggest that there is a considerable association between periodontal disease in pregnant women and body size of their newborns, this preliminary finding needs to be confirmed in more extensive studies. [ABSTRACT FROM AUTHOR]

Background: Coverage of gingival recession defects has been considered as a subject of interest for dental practitioners. Aim: The present study was aimed to compare the clinical outcomes of root coverage (RC) procedures, using coronally advanced flap (CAF) in combination with acellular dermal matrix (ADM) with or without enamel matrix derivatives (EMD). Materials and Methods: A total of 36 Miller class I or II recession defects in 15 eligible patients were selected. The defects were randomly allocated to test (CAF+ADM+EMD) and control (CAF+ADM) groups. Recession depth (RD), recession width (RW), width of keratinized tissue (WKT), clinical attachment level (CAL), and the position of mucogingival junction (MGJ) were measured at baseline, two and six months after treatment. Statistical Analysis: Data were analyzed using repeated measures ANOVA and paired sample t-test with the patients as statistical unit. Results: At two-month follow-up, the mean RC for CAF+ADM+EMD and CAF+ADM was 82.75 ± 22 and 88.89 ± 22 percent, respectively. However, these values did not change significantly after six months. Both treatments led to significant RC (P < 0.001), whereas no significant differences were observed in WKT, CAL, and MGJ between the study groups. Conclusion: The application of EMD does not improve the clinical efficacy of ADM in combination with CAF in RC procedures.

Background: Studies have suggested a correlation between periodontitis and reduced male fertility. Inflammation has been described as the link between these ailments. Oral inflammatory load (OIL) can be measured through oral polymorphonuclear neutrophil (oPMN) count, which is associated with periodontal diseases. This cross-sectional study assessed the possible correlation between OIL and the functional parameters of sperm cells., Methods: In 229 volunteers, oral rinse and semen samples were assessed for oPMN, semen polymorphonuclears (sPMNs), sperm concentration, total sperm count, motility, morphology, and sperm DNA fragmentation index (SDFi). A multiple linear regression model was conducted to evaluate the relationships between oPMN and semen parameters., Results: The effect of elevated oPMN counts on total motility rate, progressive rate, and percentage of sperm cells with normal morphology was significant ( P <0.001), with an inverse relationship, i.e., with every unit increase in oPMN count, the mentioned parameters would decline by 0.573, 0.367, and 0.407 units, respectively. oPMN counts also correlated positively with sPMN counts and SDFi ( P <0.001), i.e., with every unit increase in the oPMN measures, sPMN counts would increase by 0.126 million/mL, with an 0.733% increase in SDFi. However, there was no significant association between oPMN counts and sperm concentration., Conclusion: OIL, as represented by oPMN counts, might affect male fertility as there is a positive correlation between the levels of these inflammatory cells and decreased sperm motility, abnormal morphological changes, increased sPMN counts, and increased SDFi., Competing Interests: The authors declare no competing interests., (©2023 The Author(s).)

Background: The use of photodynamic therapy (PDT) has been evaluated as an adjunctive technique for bacterial decontamination of implants with peri-implantitis. Given the controversies over the efficacy of the application of PDT to treat peri-implant diseases, the present clinical study aimed to evaluate the posttherapeutic clinical parameters and cytokine levels in peri-implant crevicular fluid in patients with peri-implant mucosal inflammation, receiving mechanical debridement (MD) alone or in association with PDT., Materials and Methods: In this double-blinded randomized clinical trial, 52 patients with peri-implant mucosal inflammation were selected and they were randomly assigned to 2 treatment groups: a MD group and an MD + PDT group using an 805 nm laser and indocyanine green (ICG). Although the decrease in bleeding on probing was the primary outcome, pocket depth, PUS, pain on probing, clinical attachment level, gingival recession, tumor necrosis factor-α, interleukin (IL)-1β, IL-6 and matrix metalloproteinase-8 were also evaluated at baseline, 2-week, and 3-month postintervention. Repeated measure analysis of variance was used to analyze inter-group differences and a P ≤ 0.05 was considered for significant differences between tested parameters., Results: Statistically significant improvements ( P < 0.001) were detected for all variables after comparison of baseline data with those collected at each time interval of the study. Nevertheless, the inter-group comparisons of these variables between the baseline, 2-week, and 3-month intervals did not reveal any significant decrease in sites treated with either MD alone or MD + PDT., Conclusion: The application of PDT using 805-nm laser and ICG as an adjunct therapy to MD did not provide any additional improvements in the clinical or biologic parameters of peri-implant mucosal inflammation., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article., (Copyright: © 2023 Dental Research Journal.)

Introduction: Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis are the two main bacteria that cause periodontitis which is an inflammatory disease of periodontal tissues. Numerous antibacterial agents have been introduced to fight against these periodontal pathogens, but the antibacterial efficacy of concentrated growth factor has not been studied yet. Therefore, this study is aimed to investigate the antibacterial impact of concentrated growth factor on the growth of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis ., Methods: In this study, concentrated growth factor was obtained from blood samples of healthy people with no systemic disease and no antibiotics used for at least 3 months before the experiments. The concentrated growth factor from each blood sample was divided into two parts, i.e., three samples in P. gingivalis group and three samples in A. actinomycetemcomitans group, and a positive control group to verify the accuracy of the procedure and a negative group to rule out any contamination. The minimum inhibitory concentration and minimum bactericidal concentration of CGF against A. actinomycetemcomitans and P. gingivalis were determined by the broth microdilution method. Statistical analysis was performed using SPSS 22 software, and P value significance was set to 0.05., Results: The antibacterial property of CGF on the studied bacteria in concentrations of MIC and ¼ MIC is the same for both bacteria, but in ½ MIC, its impact on A. actinomycetemcomitans is significantly higher than P. gingivalis . Examining the MBC showed that no MBC dose was obtained. Results of the disk diffusion test indicated the lack of the zones of bacterial growth inhibition., Conclusions: Considering the limitations of our study, it can be concluded that CGF has antibacterial effectiveness against A. actinomycetemcomitans and P. gingivalis with no significant difference between two bacteria., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Family Medicine and Primary Care.)

Background. After periodontal surgery, in most cases, the surgical area is covered with a surgical pack. It has been suggested that these packs might minimize complications. This study aimed to compare the effects of Diplen LX membrane and Coe-Pak on pain, wound healing, and patient preference after a periodontal flap surgery in patients with moderate to severe chronic periodontitis. Methods. In this randomized clinical trial, 26 patients were evaluated. Pain scores were assessed using visual analog scale (VAS) on the 3rd and 7th days postoperatively and compared between the two dressings. On the 7th and 14th days after both flap surgeries, surgical site healing was evaluated using the wound healing index (WHI). Results. The mean age of the patients was 31. It was observed that the severity of pain in the studied patients on the 3rd and 7th days postoperatively was significantly lower in the intervention group than in the control group. It was also observed that the value of WHI in the studied patients on the 7th and 14th days postoperatively was significantly higher in the intervention group than in the control group. Conclusion. The pain was less severe in both groups using periodontal dressing and also lower in the Diplen LX membrane group. In addition, based on WHI, wound healing score in patients was also higher and more favorable in the Diplex LX membrane group. Due to the above factors, the majority of patients preferred the use of the Diplen LX membrane., (©2022 The Author(s).)

Demand for dental implants has increased in recent years and the use of conscious sedation for this type of surgery can be of great benefit. Therefore, the aim of this systematic review was to evaluate the scientific literature related to the effect of conscious sedation on the reduction of anxiety, and patient and surgeon satisfaction. The Embase, PubMed, ProQuest, Scopus, Ovid, and Cochrane databases were searched without limitations. According to the inclusion and exclusion criteria determined for the study, 10 articles were selected for the final review during several screening stages. These studies were reviewed in their full-text form by the research team and the intended data was extracted. The risk of bias was assessed for each of the selected articles. Five studies were ultimately included. Two of the them compared local anesthesia and conscious sedation, while another 2 compared the consequences of different types of conscious sedation. The anxiety reduction and patient and surgeon satisfaction data was collated. Midazolam was the most frequently used agent. After a thorough review of the final articles extracted based on the study protocol, it was concluded that the use of conscious sedation during implant surgery reduces patient anxiety, and also increases the satisfaction of the patient and surgeon.

Background: The main objective of thissystematic review wasto identify the hemodynamic effects of intravenous sedatives used in dental implant surgeries., Methods: Embase, PubMed, ProQuest, Scopus, Ovid, and Cochrane databases were searched with no limitations. Of 59 studies obtained, 50 studies were excluded due to incompatibility with the subject. The remaining studies were reviewed in full text and assessed for the risk of bias individually. The included studies were reviewed by the research team, and the necessary data were extracted., Results: Four studies were finally included. Two of the studies compared local anesthesia and intravenous sedation, while the other two compared the consequences of different types of intravenous sedation. By comparing the hemodynamic effects, the systolic and diastolic blood pressure and the heart rate data were collated. Midazolam was the most frequently used intravenous sedative, and Dexmedetomidine affected hemodynamics the most., Conclusion: Intravenous sedation leads to decreased heart rate and blood pressure. Better hemodynamic outcomes improve the patients' cooperation by decreasing stress and anxiety. Dexmedetomidine seems to be the first choice for intravenous sedation., Competing Interests: The authors declare that they have no competing interests with regards to authorship and/or publication of this paper., (© 2019 The Author(s).)

Background: Peri-implant diseases have been recognized as being among the ever-increasing complications related to dental implants. The aim of this study was to evaluate the adjunctive use of enamel matrix derivative (EMD) to mechanical debridement (MD) in patients with these conditions in terms of clinical parameters and cytokine levels of peri-implant crevicular fluid (PICF)., Methods: In the present double-blind clinical trial, 46 patients with peri-implant mucositis (PM) were randomly divided into control and test groups. Two different therapeutic protocols, consisting of non-surgical MD alone (control group) and MD with the application of EMD (test group), were considered for the two groups. Clinical parameters [bleeding on probing (BOP) and probing depth (PD)] and sampling from PICF were carried out before treatment and 3 months postoperatively. The levels of IL-6 and IL-17 cytokines in PICF were evaluated by enzyme-linked immunosorbent (ELISA)., Results: Three-month post-interventional assay revealed significant improvements in BOP and PD in the test group in comparison to the control group (P < 0.0001). Relative to control, IL-6 and IL-17 levels were reduced significantly (p < 0.05) in the test group compared to the control group., Conclusion: Application of EMD can be considered an adjunct to MD in the non-surgical treatment of PM. However, complete recovery was not observed using either treatment approach showing that management of implant-associated disease is still a significant clinical problem.

Objectives: The purpose of this study was to compare the microbial and clinical effects of mechanical debridement (MD) alone or in combination with the application of enamel matrix derivative (EMD) and sustained-release micro-spherical minocycline (MSM) for treatment of peri-implant mucosal infl ammation (PIMI)., Materials and Methods: Subjects with at least one implant with PIMI were included and divided into control and two different test groups. In all three groups, MD was performed. In the MSM group, following MD, MSM was placed subgingivally around the implants. In the EMD group, after MD, EMD was placed in the sulcus around the implants. Sampling of peri-implant crevicular fl uid for microbial analysis with real-time polymerase chain reaction and recording of probing depth (PD) and bleeding on probing (BOP) were performed prior to as well as two weeks and three months after treatment. Median values and interquartile range were estimated for each variable during the various assessment intervals of the study., Results: In all groups, at two weeks and three months, the counts of Porphyromonas gingivalis decreased significantly compared to baseline. Levels of P. gingivalis were significantly reduced in MSM (P<0.001) and EMD (P=0.026) groups compared to the control group. Also, clinical parameters improved significantly at two weeks and three months. Reduction of PD was significant in MSM (P<0.001) and EMD (P<0.001) groups. The decrease in BOP in the MSM, EMD, and control groups was 60%, 50%, and 20%, respectively., Conclusion: The use of MSM and EMD can be an adjunctive treatment for management of PIMI and improves clinical parameters and reduces P. gingivalis burden three months after treatment.

Purpose. The aim of this study was to evaluate the efficacy of anorganic bovine bone (Bio-Oss) in comparison with nanocrystalline hydroxyapatite (Ostim) in sinus floor augmentation. Methods. Ten patients aged 40-80 were selected. All the patients needed sinus floor augmentation due to insufficient bone for simultaneous implant placement. The patients underwent panoramic radiography and cone beam computed tomography (CBCT) prior to surgical procedure. After lifting the sinus membrane, Bio-Oss and Ostim are randomly grafted at one of the two sides. Biopsies were obtained from areas identified 5 months after the surgery and before implant placement and then were prepared for histological analysis. Statistical analysis was performed with nonparametric Wilcoxon signed-rank test for comparison of histological and radiological parameters between the two groups. Results. Histological findings revealed a significant increase in percentages of new bone in the Ostim group (P = 0.015). Furthermore, new bone density was greater with Ostim compared to Bio-Oss (P = 0.038); however, the difference in height increase after surgery did not reach statistical significance (P = 0.191). Conclusion. Despite the limitations of this trial, Ostim and Bio-Oss are useful biomaterials in sinus augmentation and Ostim seems to be even more effective in new bone formation.

Background: There are limited clinical experiments addressing the effects of photodynamic therapy (PDT) as an adjunct to conventional scaling and root planing (SRP) on clinical and biologic features of periodontitis. This trial compares the clinical parameters and cytokine profiles in gingival crevicular fluid of patients with moderate-to-severe chronic periodontitis (CP) who have been treated using SRP alone or SRP + PDT., Methods: Twenty-two patients with two contralateral teeth affected with moderate-to-severe CP were selected. After SRP, the participants' teeth were randomized to receive either no further treatment or a single application of PDT using a 638-nm laser and toluidine blue. Although the change in probing depth was the primary outcome, bleeding on probing, clinical attachment level, gingival recession, interleukin-1β, tumor necrosis factor (TNF)-α, and matrix metalloproteinase 8 and 9 were also evaluated at baseline and 3 months postintervention. An oral rinse assay was also performed to determine the total levels of oral polymorphonuclear cells (PMNs) before and 3 months after the treatments., Results: Within each group, significant improvements (P <0.001) were found for all variables in 3-month follow-up compared with baseline. Only TNF-α was significantly improved in the PDT + SRP versus SRP group. Total levels of PMNs were reduced for all patients compared with baseline levels (P <0.001)., Conclusion: In patients with CP, a single application of PDT (using a 638-nm laser and toluidine blue) did not provide any additional benefit to SRP in terms of clinical parameters or inflammatory markers 3 months following the intervention.

Background and aims. The aim of this study was to compare the effectiveness of adjunctive photodynamic therapy (PDT) in the treatment of aggressive periodontitis. Materials and methods. A total of 24 patients with clinical diagnosis of aggressive periodontitis received scaling and root planing (SRP) for periodontal treatment. In a split-mouth design study, the teeth of one quadrant of each arch with ≥4 mm of probing depth were selected randomly for additional treatment with PDT (test group). PDT was performed with a diode laser beam with a wavelength of 670-690 nm and a power of 75 Mw. The control group consisted of selected teeth of the contralateral quadrant (SRP only). Before any treatment, subgingival plaque samples were collected by an endodontic paper cone for microbiological analysis by real-time polymerase chain reaction (PCR) for detection of Aggregatibacter actinomycetecommitans. Clinical parameters including clinical attachment loss (CAL) as primary outcome, plaque index (PI), bleeding on probing (BOP), probing depth (PD) and gingival recession (REC) were measured at baseline and after 90 days. Inter-group and intra-group statistical analyses were performed. Results. Treatment groups showed an improvement in all the clinical parameters and a significant reduction in the counts of A. actinomycetecommitans at 90 days compared to baseline (P < 0.05). None of the periodontal parameters exhibited significant differences between the two groups (P > 0.05). Conclusion. Within the limitations of this study, the results did not show additional benefits from PDT as an adjunctive treatment for patients with aggressive periodontitis.

Persian physicians had a great role in assimilation and expansion of medical sciences during the medieval period and Islamic golden age. In fact the dominant medical figures of that period were of Persian origin such as Avicenna and Razes, but their works have been written in Arabic that was the lingua franca of the period. Undoubtedly the most substantial medical book of that period that has been written in Persian belongs to Abubakr Rabi ibn Ahmad al-Akhawayni al-Bokhari and his book, Hidayat al-Mutallimin fi-al-Tibb (Learner's Guide to Medicine).There are two chapters related to oral and dental diseases in the Hidayat, a chapter on dental pain and a chapter on bouccal pain. Akhawayni's views on dental diseases and treatments are mainly based on anatomical principles and less influenced by humeral theory and no mention about the charms, magic and amulets. False idea of dental worm cannot be seen among his writings. Cutting of the dental nerve for relieving the pain, using the anesthetizing fume, using the natural antiseptic and keeping the tooth extraction as the last recourse deserves high praise.

Background and Aims: The aim of this clinical investigation was to compare clinical and microbiological effectiveness of adjunctive CHX gel in the treatment of periodontitis., Materials and Methods: Twenty-four subjects with localized or generalized moderate-to-severe chronic periodontitis underwent scaling and root planing. One tooth in each quadrant with a probing depth of >4 mm was chosen for combined gel and SRP, with contralateral tooth as control (SRP treated site). Clinical assessment was carried out at baseline and 1 and 3 months later; microbial assessment was performed by real-time PCR. Periodontal probing depth (PPD) was considered as primary outcome., Results: Twenty patients completed the study. Baseline PPDs were 4.90±0.78 and 5.05±0.79 in the SRP and gel groups, respectively (P>0.05), which decreased to 3.67±0.59 and 3.7±0.83 one month after treatment and 3.25±0.65 and 3.38±0.79 three months after treatment. Although values decreased significantly in both groups after one and three months (P=0.001 in the SRP and P=0.001 in the gel group), the inter-group difference was not significant neither at one-month (P=0.47) nor at three-month (P=0.77) intervals. The only clinical parameters exhibiting statistically significant inter-group differences was BOP in both one-month (P=0.004) and three-month (P=0.0001) intervals. All the other clinical measurements showed significant decreases after one and three months in both sites but without inter-group differences., Conclusion: Subgingival application of xanthan chlorhexidine gel combined with scaling and root planing reduced bleed-ing of periodontal pockets. Clinical trials to evaluate effectiveness of this gel in aggressive and severe periodontitis modified by systemic factors are suggested.

Background: Periodontal disease has been associated with a number of systemic diseases. A high prevalence of periodontitis among individuals with chronic kidney diseases and end-stage renal disease has been reported. However, no association between periodontal diseases and glomerulonephritis has previously been investigated., Objective: The aim of this study was to assess the severity and possible role of periodontitis in a group of patients with unknown primary glomerulonephritis., Methods: Ten patients with unknown primary glomerulonephritis, and who had a renal biopsy with stable renal function and serum creatinine <1.6 mg/dL, were recruited. Severity of the periodontal disease was clinically measured with plaque index (PI), gingival index (GI), and periodontal pocket depth (PD). The subjects received appropriate dental treatments where indicated. The patients were also put on angiotensin-converting enzyme inhibitor or angiotensin receptor blockers for controlling blood pressure and proteinuria. Six months following appropriate periodontal treatment, renal function, degree of proteinuria, and level of C-reactive protein (CRP) were measured in each individual., Results: The median age of the patients was 30 (15.8) years. The median urine protein excretion was lower following the periodontal therapy (P=008). Prior to the dental and/or periodontal therapies, the median PI, PD, and GI were 57.5%, 4.3, and 1.1, respectively. The majority of the patients had advanced periodontal disease. In four patients, +2/+3 CRP turned negative after periodontal treatment., Conclusions: The present study revealed that a causative link might exist between periodontal disease and glomerulonephritis.

Background and Aims: C-reactive protein (CRP) is a well-known acute-phase reactant produced by the liver in response to inflammation caused by various stimuli. Periodontal disease is a chronic infection of tooth-supporting structures characterized by attachment loss and alveolar bone loss. The aim of this study was to assess the relationship between serum C-reactive protein levels and periodontal diseases., Materials and Methods: The study was conducted on 166 patients referring to Tabriz Faculty of Dentistry. The age range was between 35 and 59 years. 83 subjects with periodontitis according to NHANES III index as test group and 83 healthy individuals as controls participated in this study. Body mass index (BMI), waist circumference (WC), probing depth, attachment loss and CRP levels were measured in both test and control groups. Data was analyzed with Student's t-test, odds ratio (OR), Chi-square test and Spearman's correlation coefficient, using SPSS 13.0 software., Results: The results revealed a statistically significant difference between all of the analyzed variables in test and control groups (P < 0.05). Classifying the test subjects into two subgroups (subjects with CRP ≥ 3 mg/l and subjects with CRP < 3 mg/l), the highest OR in females belonged to WC (OR = 6.4; 95% CI: 1.18-35.2, P = 0.02) and in males to obesity (OR = 4.8; 95% CI: 0.65-35.19, P = 0.05). Considering the correlation between obesity, overweight, WC and CRP with probing depth and attachment loss denoted that obesity presented the highest (r = 1, P = 0.00) and overweight the lowest (r = 0.4, P = 0.07) association. In females, CRP was related to the severity of periodontitis and attachment loss (r = 0.662, P = 0.00). Excluding overweight, the association between all the variables was statistically significant (P < 0.05)., Conclusion: Our findings indicate that periodontal disease is correlated with CRP elevation and dis-eases associated with obesity.

The aim of this retrospective descriptive study was to describe the epidemiological and some common clinical symptoms and signs among humans stung by Hemiscorpius lepturus (H. lepturus) in the southwest province of Iran, Khuzestan. Cases were collected from hospital patients' files referred to two major Khuzestan hospitals over 5 years. Only definite stings of this species, identified by trained health-caring personnel, were included in this study. Epidemiological and clinical signs and symptoms were recorded. There were 354 scorpion victims, 43% of whom were from rural areas. Stings mainly occurred at night between 7p.m. and 5a.m. (56.1%), or from early morning 5a.m. to 12a.m. (38.6%), 41% of which occurred in the lower extremities. Eighty three percent of accidents occurred in mild/hot months of this area between April and October. The age most inflicted was between 1 month to 10 years and 11-20 years old, observed in 39.6% and 26.8% of victims, respectively. Among all the 26,397 scorpion stung files studied over the period of the study, while only 10-15% of stung cases occurred due to this not highly prevalent scorpion of Iran, it was responsible for 89% of the deaths and 92% of hospitalized scorpion-stung patients. The majority of cases were children aged less than 12 years old. Clinical signs and symptoms were both local and systemic. The local symptoms ranged from erythema to severe necrosis with no immediate sensation of pain. Renal toxicity is one of the serious systemic effects, which, if not treated early by administration of the polyvalent antivenom, can progress to severe renal and cardio-respiratory failure. Overall, the findings demonstrate that the characteristic clinical features of envenomation produced by this scorpion differ significantly from those reported for other scorpions in the world.

Background and Aims: Autogenous onlay bone grafting is a common procedure for alveolar ridge augmentation. It has been suggested that the amount of healed bone after this technique would be significantly less than the initial quantity. The aim of this study was to determine the relationship between the various parameters influencing the outcome of ridge augmentation procedures., Materials and Methods: Thirty-two patients, 17 males and 15 females (mean age 40 ± 8.66), requiring lateral ridge augmentation in the anterior maxilla were recruited. Bone grafts obtained from either the mandibular ramus or symphysis were grafted on the recipient site and the buccolingual dimensions of the edentulous ridge before and six months after the procedure were measured and the difference between them was considered as ridge augmentation (RA). Parameters including graft thickness (GT), graft area (GA) and donor site (DS) were also recorded., Results: Onlay bone grafts, taken from mandibular and symphysis areas, significantly increased the buccolingual dimension of the alveolar ridge (mean 1.98 ± 1.22 mm, p< 0.001). However, the mean RA by symphysis grafts was significantly greater than ramus grafts (2.49 mm vs. 1.48 mm). There was also a significant correlation between graft thickness, surface area and the amount of bone augmentation., Conclusion: Symphysis area provides thicker and larger grafts, which may result in a better clinical outcome in alveolar ridge augmentation.

Objectives: Gingival overgrowth is a complication of cyclosporine therapy following organ transplantation. Oral azithromycin is frequently used to treat this complication. This study examined the efficacy of local azithromycin, in the form of toothpaste, against cyclosporine-induced gingival overgrowth., Materials and Methods: Twenty stable renal transplanted patients (10 men and 10 women) with gingival hyperplasia were randomly assigned to a test group and a control group. Azithromycincontaining toothpaste had 85 mg azithromycin per gram of toothpaste. Both toothpastes were prescribed b.i.d., each time using 1.5 cm, for 1 month. All participants received scaling, root planing, polishing, and oral hygiene instructions, at least 4 weeks prior to initiation of the study. Gingival overgrowth index, bleeding on probing, blood urea nitrogen, creatinine, and serum cyclosporine levels were measured at baseline, and then again in the second and fourth weeks after tooth brushing. Patient satisfaction with the toothpastes was evaluated by a visual analogue scale. The stability of clinical responses was followed for 3 months after cessation of the toothpastes., Results: Gingival overgrowth index decreased significantly in the azithromycin-containing toothpaste group (from 1.1+/-0.56 to 0.51+/-0.47, P<.001); however, in the control group, this decrease was not significant (P=.22). Bleeding on probing also decreased significantly in patients in the azithromycin-containing toothpaste group compared with controls (P=.001). When compared with baseline levels, trough levels of cyclosporine, blood urea nitrogen, and creatinine did not change in either of the groups. Patients in the control group were more satisfied with the toothpaste than were patients in the test group (53 vs 38)., Conclusions: Azithromycin-containing toothpaste is an effective, simple, and noninvasive treatment for cyclosporine-induced gingival overgrowth.