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Aims: The use of natural plant extracts in pharmacology, medicine and dental hygiene has found a growing interest in modern scientific research. Salvadora persica is a natural tree whose fibrous branches have been approved by the World Health Organization for oral hygiene. Periodontitis is a highly prevalent adult gingival disease that leads to bone destruction and connective tissue attachment loss. The aim of this research was assessment the antimicrobial activities of methanolic extract of Salvadora persica (miswak) on isolated strains from the oral fluid. Methods: In practical section, 50 female university students (21.4 ± 1 year) participated in the study. Based on examination by a periodontist, they were grouped into (Group I, n = 21) and (Group II, n = 29) i.e. with and without periodontitis respectively. Their un-stimulated saliva samples were obtained in sterile tubes. While three bacterial genera, Staphylococcus, Streptococcus and Lactobacillus were identified in all subjects, Enterococcus and Escherichia were only detected in Group I. Results: A statistically significant difference in colonization levels between the two groups was observed. The effect of methanolic extract of S. persica against oral bacterial strains isolated from saliva was investigated using agar disc diffusion and microdilution methods. Although methanolic extract of S. persica was effective on growth inhibition of all strains, it was significantly more effective on Gram positive bacteria than Gram negative ones. Conclusions: Effective substances present in S. persica extracts, exhibit a broad range of antibacterial activity and affect almost all bacterial species regardless of the Gram-staining nature.

Appropriate regeneration of periodontal tissues is the primary purpose of periodontal disease treatment. The present study assessed the impact of three key regenerative elements-platelet-rich plasma (PRP), canine bone marrow mesenchymal stem cells (cBM-MSCs), and fibrin glue-on periodontal regeneration. In each of the study's five dogs, Class II furcation defects were established on the buccal surface of five teeth. One tooth (five total) from each dog was placed into one of five groups: (1) PRP + fibrin glue, (2) PRP + fibrin glue + cBM-MSCs, (3) fibrin glue, (4) cBM-MSCs + fibrin glue, and (5) control (no treatment). Histologic and histometric evaluations were performed to assess the formation of new bone, cementum, and the periodontal ligament. Different types of new bone and cementum, the maximum thickness of new cementum and the periodontal ligament (PDL), the vitality of bone, and the presence of inflammation or foreign-body reactions were also elucidated. The histologic and histometric evaluations revealed substantial differences in all groups between the observed maximum thickness of newly formed cementum and PDL. The percentage of bone and cement formation drastically increased with the combined presence of stem cells, fibrin glue, and PRP. The results showed that the inherent regenerative capacity of periodontal tissues can be sufficient if their latent self-repair mechanisms are stimulated. [ABSTRACT FROM AUTHOR]

Periodontal disease is chronic but not life threatening. Therefore, adherence to periodontal maintenance (PM) is often not ideal. However, this service is frequently needed for the remainder of one's life in order to prevent disease progression and recurrence. This study evaluates the degree of compliance with PM in a private periodontal practice in Tehran, Iran. Data were collected and analyzed for degree of compliance from 519 patients who had completed active periodontal treatment up to 7 years earlier and who had begun PM. The patients were classified according to age, sex, diagnosis, prognosis, procedures performed, and compliance with prescribed maintenance intervals. In total, the overall rate of complete compliance was 3.3%, while 57.6% were erratic compliers, and 39.1% never returned for therapy. Female patients complied better than males. Patients who had received surgery complied better with PM than patients who had received scaling and root planing. These results confirmed that the degree of compliance following periodontal therapy is far from ideal. Although universal findings of poor compliance have been found, there may not be a universal solution to resolve the problem. (Quintessence Int 2003;34: 215-219) [ABSTRACT FROM AUTHOR]

Objectives: This study sought to evaluate the accuracy and errors of linear measurements of mesiodistal dimensions of Kennedy Class III edentulous space using cone beam computed tomography (CBCT) in comparison with clinical measurements. Materials and Methods: Nineteen Kennedy Class III dental arches were evaluated. An impression was made of each dental arch and poured with dental stone. The distance was measured on dental cast using a digital Vernier caliper with an accuracy of 0.1mm and on CBCT scans. Finally, the linear mesiodistal measurements were compared and the accuracy of CBCT technique was evaluated by calculating absolute value of errors, intra-class correlation coefficient and simple linear regression model. Results: In comparison with the cast method, estimation of size on CBCT scans had an error of -8.46% (underestimation) to 5.21% (overestimation). In 26.5% of the cases, an accepted error of ±1% was found. The absolute value of errors was found to be in the range of 0.21-8.46mm with an average value of 2.86 ±2.30mm. Conclusions: Although the measurements revealed statistically significant differences, this does not indicate a lower accuracy for the CBCT technique. In fact, CBCT can provide some information as a paraclinical tool and the clinician can combine these data with clinical data and achieve greater accuracy. Undoubtedly, calibration of data collected by clinical and paraclinical techniques and the clinician's expertise in use of CBCT software programs can increase the accuracy of implant placement. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to histologically compare the regenerative properties of two allografts manufactured by two Iranian companies. Materials and Methods: In this study, four 8-mm defects were produced in the calvaria of 12 rabbits. In three defects, three types of allografts namely ITB, CenoBone and Grafton were placed and one defect served as control. Samples were prepared and histomorphometric evaluations were carried out after healing periods of four weeks (interval 1) and eight weeks (interval 2). Qualitative and quantities variables were compared and analyzed with SPSS software. Results: Mild inflammation was observed in 45% and 12.5% of the samples in the first and second intervals, respectively. Foreign body reaction was observed in only 5% of the samples. The quality of regenerated bone was immature, mixed and lamellar in 54.5%, 15.9% and 4.5% of the samples, respectively. The rate of allograft resorption was the highest and lowest in the CenoBone and Grafton samples, respectively. The mean amount of regenerated bone was higher in areas containing Grafton; however, the differences were not statistically significant. Conclusion: Despite the differences in the numerical values of bone regeneration, there were no statistically significant differences in bone generation among the material groups, and allografts manufactured in Iran can be suitable alternatives to Grafton with the same good properties. Further studies are necessary to clarify the efficacy of these allografts. [ABSTRACT FROM AUTHOR]

Objectives: Implant primary stability is one of the important factors in achieving implant success. The osteotome technique may improve primary stability in patients with poor bone quality. The aim of this study was to compare implant stability using two different techniques namely osteotome versus conventional drilling in the posterior maxilla. Materials and Methods: In this controlled randomized clinical trial, 54 dental implants were placed in 32 patients; 29 implants were placed in the osteotome group and 25 in the conventional drilling group. Implant stability was assessed at four time intervals namely at baseline, one, two and three months after implant placement using resonance frequency analysis (RFA). Results: Primary stability based on implant stability quotient (ISQ) units was 71.4±7 for the osteotome group and 67.4±10 for the control group. There was no statistically significant difference between the two groups in implant stability at any of the measurement times. In each group, changes in implant stability from baseline to one month and also from two months to three months post-operatively were not significant but from one month to two months after implant placement, implant stability showed a significant increase in both groups. Conclusion: The results of this study revealed that in both techniques, good implant stability was achieved and osteotome technique did not have any advantage compared to conventional drilling in this regard. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the efficacy of two types of bone substitutes, Bio-Oss and NuOss, for repair of bone defects. Materials and Methods: This study was performed on the calvaria of 14 New Zealand rabbits. The 6mm critical size defect (CSD) models of bone regeneration were used. Three CSDs were created in each surgical site. The first defect was filled with NuOss, the second one with Bio-Oss and the third one remained unfilled as the control. After healing periods of one and two months (seven animal for each time point), histological and histomorphometric analyses were carried out to assess the amount of new bone formation, presence of inflammation, foreign body reaction and type of new bone. Qualitative variables were analyzed by multiple comparisons, Wilcoxon, Friedman and Mann Whitney tests. Quantitative variables were analyzed using the Mann-Whitney and Wilcoxon tests. Level of statistical significance was set at 0.05. Results: The level of inflammation was not significantly different at four and eight weeks in the Bio-Oss (P=0.944), NuOss (P=1.000) and control groups (P=0.71). At four weeks, foreign body reaction was not observed in Bio-Oss, NuOss and control groups. There was no significant difference in the type of the newly formed bone at four and eight weeks in any group (P=0.141 for Bio-Oss, P=0.06 for NuOss and P=0.389 for the control group). Conclusion: Deproteinized bovine bone mineral can be used as a scaffold in bone defects to induce bone regeneration. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cardiovascular diseases are the most common cause of death in Iran. Moreover, periodontal diseases are very common in our country. In this study, we have designed a standardized questionnaire for evaluating knowledge, attitude, and practice (KAP) of Iranian adult patients with cardiovascular diseases about oral health. METHODS: For designing and standardizing a self-administered questionnaire, we performed a cross-sectional pilot study on 51 cases with periodontal complaints. A dentist carried out the physical examination to determine oral health indicators. Twelve experts and ten lay people of the target population answered questions about validity. Cronbach's alpha, factor analysis, and Pearson correlation coefficients were used in the analysis. RESULTS: The cases of this pilot study were middle aged, with moderate financial and health status, but low oral health and educational level. Debris score was correlated with all other physical exam findings except decay, missing, and filled (DMF). Reliability was 0.826 according to Cronbach's alpha score. Face validity was higher than 80%. Content validities of the whole of the questionnaire were 85.98% for clarity, 78.05% for relevancy, 85.16% for simplicity, and 82.32% for consistency of each question with the question set. Factor analysis showed that 15 components explain 74% of the total variance. CONCLUSION: This questionnaire is culturally adjusted and appropriate for our community, valid and reliable, and sufficiently estimates the variance of the oral health status. It can be used as a standard tool in further studies in adult population of the Iranian middle aged patients with low level of education and moderate socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: Recent studies have shown that lactoferrin promotes the proliferation and differentiation of osteoblasts and inhibits osteoclast‑mediated bone resorption. Anorganic bovine bone (ABB) graft has been extensively used as an osteoconductive material in the bone reconstructive surgeries. The purpose of this study was to examine whether the combination of lactoferrin with Bio‑Oss would improve ossification in experimentally induced bone defects in rabbit calvaria. Materials and Methods: In this randomized, prospective animal study, a total of 32 bone defects with the diameter of 6 mm were created on the calvaria of 8 male New Zealand rabbits (4 defects in each animal). One defect was filled with ABB + Lactoferrin + Vehicle (BLV), the second one with ABB + Lactoferrin (BL), the third defect with ABB + V (BV), and the fourth defect was filled with ABB (B) alone. After 4 weeks, histologic sections were prepared and evaluated histologically and histomorphometrically. The type, percentage and vitality of newly formed bone, inflammation, percentage of residual material, and foreign body reaction were assessed for each specimen. Data were analyzed using Friedman tests. Results: All groups were similar in terms of inflammation and vitality, type, percentage of new bone formation, and residual material. The percentage of new bone formation in BLV, BL, BV, and B groups were 14.73 ± 3.14%, 15.02 ± 1.51%, 15.95 ± 2.24% and 13.44 ± 2.89% (P = 0.1) and the amount of residual biomaterial were 11.85 ± 1.50%, 13.73 ± 1.80%, 13.02 ± 1.86%, and 15.41 ± 2.05%, respectively (P = 0.392). Conclusion: Based on results of this study, the combination of lactoferrin and ABB did not show any significant improvement in bone regeneration compared with ABB alone in surgically induced bony defects in rabbit calvaria. [ABSTRACT FROM AUTHOR]

Objectives: Dental implants are a prominent scientific breakthrough and are frequently applied for replacement of the missing teeth. From the clinicians' point of view, long-term studies are essential to find out the predictability of dental implant systems. Materials and Methods: In this retrospective study, 1,626 patients who received 4,389 Dyna implants in a private office between 2013-2019 were evaluated. All statistical analyses were performed using SPSS 25 for Windows. P values less than 0.1 were considered significant for regression analysis. Results: Dyna implant ts (4389) placed from 2013 to 2019 were evaluated in this study. One-hundred and thirty-three (3.03%) implants failed during the healing period or recall visits. Eighty-nine implants (2.03%) failed immediately and 44 (1%) failed after 3 months. Conclusion: The present study showed that the Dyna dental implant system had high implant survival, and it had all the survival criteria similar to world-class dental implant systems., (Copyright © 2021 The Authors. Published by Tehran University of Medical Sciences.)

Objectives: Eradication of Aggregatibacter actinomycetemcomitans ( A. actionmycetemcomitans ), as an opportunistic periodontopathogen, and inhibition of its virulence factor expression require a new adjunctive therapeutic method. In this study, we accessed the expression level of rcpA gene, as a virulence factor associated with A. actinomycetemcomitans biofilm formation, following treatment by antimicrobial photodynamic therapy (aPDT) using indocyanine green (ICG) doped with chitosan nanoparticles (CS-NPs@ICG)., Materials and Methods: CS-NPs@ICG was synthesized and examined using scanning electron microscopy (SEM). A. actinomycetemcomitans ATCC 33384 strain was treated with CS-NPs@ICG, as a photosensitizer, which was excited with a diode laser at the wavelength of 810 nm with the energy density of 31.2 J/cm2. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to determine the changes in rcpA gene expression level., Results: Synthetized CS-NPs@ICG was confirmed via SEM. The results revealed that CS-NPs@ICG-mediated aPDT could significantly decrease rcpA gene expression to 13.2-fold (P<0.05). There was a remarkable difference between aPDT using CS-NPs@ICG and ICG (P<0.05). The diode laser, ICG, and CS-NPs@ICG were unable to significantly downregulate rcpA gene expression (P>0.05)., Conclusion: aPDT with CS-NPs@ICG leads to a decrease of the virulence factor of A. actinomycetemcomitans and can be used as an adjunct to routine treatments for successful periodontal therapy in vivo., Competing Interests: CONFLICT OF INTEREST STATEMENT None declared., (Copyright© Dental Research Center, Tehran University of Medical Sciences.)

Appropriate regeneration of periodontal tissues is the primary purpose of periodontal disease treatment. The present study assessed the impact of three key regenerative elements-platelet-rich plasma (PRP), canine bone marrow mesenchymal stem cells (cBM-MSCs), and fibrin glue-on periodontal regeneration. In each of the study's five dogs, Class II furcation defects were established on the buccal surface of five teeth. One tooth (five total) from each dog was placed into one of five groups: (1) PRP + fibrin glue, (2) PRP + fibrin glue + cBM-MSCs, (3) fibrin glue, (4) cBM-MSCs + fibrin glue, and (5) control (no treatment). Histologic and histometric evaluations were performed to assess the formation of new bone, cementum, and the periodontal ligament. Different types of new bone and cementum, the maximum thickness of new cementum and the periodontal ligament (PDL), the vitality of bone, and the presence of inflammation or foreign-body reactions were also elucidated. The histologic and histometric evaluations revealed substantial differences in all groups between the observed maximum thickness of newly formed cementum and PDL. The percentage of bone and cement formation drastically increased with the combined presence of stem cells, fibrin glue, and PRP. The results showed that the inherent regenerative capacity of periodontal tissues can be sufficient if their latent self-repair mechanisms are stimulated.

Objectives: This study sought to evaluate the accuracy and errors of linear measurements of mesiodistal dimensions of Kennedy Class III edentulous space using cone beam computed tomography (CBCT) in comparison with clinical measurements., Materials and Methods: Nineteen Kennedy Class III dental arches were evaluated. An impression was made of each dental arch and poured with dental stone. The distance was measured on dental cast using a digital Vernier caliper with an accuracy of 0.1mm and on CBCT scans. Finally, the linear mesiodistal measurements were compared and the accuracy of CBCT technique was evaluated by calculating absolute value of errors, intra-class correlation coefficient and simple linear regression model., Results: In comparison with the cast method, estimation of size on CBCT scans had an error of -8.46% (underestimation) to 5.21% (overestimation). In 26.5% of the cases, an accepted error of ±1% was found. The absolute value of errors was found to be in the range of 0.21-8.46mm with an average value of 2.86 ±2.30mm., Conclusions: Although the measurements revealed statistically significant differences, this does not indicate a lower accuracy for the CBCT technique. In fact, CBCT can provide some information as a paraclinical tool and the clinician can combine these data with clinical data and achieve greater accuracy. Undoubtedly, calibration of data collected by clinical and paraclinical techniques and the clinician's expertise in use of CBCT software programs can increase the accuracy of implant placement.

Objectives: Anterior maxilla, known as the esthetic zone, plays an important role in facial and smile esthetics. This study assessed the frequency of implant treatments in the esthetic zone of patients presenting to Dental Implant Department of Tehran University during 2002-2012., Materials and Methods: This descriptive study was conducted on dental records of patients receiving implant treatment during 2002-2012. Patient records were retrieved from the archives and patient demographics, implant characteristics, failure rate, prevalence of complications and implant systems were collected. The data were reported as frequency and percentage., Results: Of a total of 2,381 implants placed in the mentioned time period, 492 (20.8%) had been placed in the anterior maxilla and 531 (22.3%) had been placed in the anterior mandible from canine to canine. Timing of implant placement was immediate in 12.0%, early in 0.5% and late in 87.4%. Survival rate was 99.1%. Rate of failure was 0.8%. Failure rate was 0.4% in the maxillary and 1.1% in the mandibular canine to canine region. Complications were reported in 10.1% of patients. Rate of complications was 18.3% in the maxillary canine to canine, 8.9% in the mandibular canine to canine, 18.1% in the maxillary first premolar to first premolar and 9.5% in the mandibular first premolar to first premolar. The frequency of bone grafts placed in these areas was 17.6%, 33.9%, 13.6%, 32.1% and 14.3%, respectively., Conclusion: Of implants placed in our center, around 20% were in the anterior maxilla, and delayed implant placement was the most commonly adopted technique.

Objectives: The aim of this study was to histologically compare the regenerative properties of two allografts manufactured by two Iranian companies., Materials and Methods: In this study, four 8-mm defects were produced in the calvaria of 12 rabbits. In three defects, three types of allografts namely ITB, CenoBone and Grafton were placed and one defect served as control. Samples were prepared and histomorphometric evaluations were carried out after healing periods of four weeks (interval 1) and eight weeks (interval 2). Qualitative and quantities variables were compared and analyzed with SPSS software., Results: Mild inflammation was observed in 45% and 12.5% of the samples in the first and second intervals, respectively. Foreign body reaction was observed in only 5% of the samples. The quality of regenerated bone was immature, mixed and lamellar in 54.5%, 15.9% and 4.5% of the samples, respectively. The rate of allograft resorption was the highest and lowest in the CenoBone and Grafton samples, respectively. The mean amount of regenerated bone was higher in areas containing Grafton; however, the differences were not statistically significant., Conclusion: Despite the differences in the numerical values of bone regeneration, there were no statistically significant differences in bone generation among the material groups, and allografts manufactured in Iran can be suitable alternatives to Grafton with the same good properties. Further studies are necessary to clarify the efficacy of these allografts.

Objectives: Implant primary stability is one of the important factors in achieving implant success. The osteotome technique may improve primary stability in patients with poor bone quality. The aim of this study was to compare implant stability using two different techniques namely osteotome versus conventional drilling in the posterior maxilla., Materials and Methods: In this controlled randomized clinical trial, 54 dental implants were placed in 32 patients; 29 implants were placed in the osteotome group and 25 in the conventional drilling group. Implant stability was assessed at four time intervals namely at baseline, one, two and three months after implant placement using resonance frequency analysis (RFA)., Results: Primary stability based on implant stability quotient (ISQ) units was 71.4±7 for the osteotome group and 67.4±10 for the control group. There was no statistically significant difference between the two groups in implant stability at any of the measurement times. In each group, changes in implant stability from baseline to one month and also from two months to three months post-operatively were not significant but from one month to two months after implant placement, implant stability showed a significant increase in both groups., Conclusion: The results of this study revealed that in both techniques, good implant stability was achieved and osteotome technique did not have any advantage compared to conventional drilling in this regard.

Objectives: The aim of the present randomized clinical trial was to evaluate marginal bone loss around two types of implants modified at the neck area: Nobel Active and Nobel Replace Groovy, both manufactured by Nobel Biocare., Materials and Methods: A total of 25 Nobel Active and 21 Nobel Replace Groovy implants were included in the present study. The implants were placed based on the relevant protocol and patient inclusion and exclusion criteria. The amount of bone loss around implants was compared at 6 and 12-month intervals using digital periapical radiographs., Results: The mean bone loss values in the Nobel Active and Nobel Replace Groovy groups were 0.682 mm and 0.645 mm, respectively, with no statistically significant difference based on the results of independent t-test (P=0.802)., Conclusion: Use of both implant types yielded favorable results, with high durability. The two implant types exhibited no superiority over each other in terms of bone loss.

Objective: The purpose of this study was to evaluate the efficacy of two types of bone substitutes, Bio-Oss and NuOss, for repair of bone defects., Materials and Methods: This study was performed on the calvaria of 14 New Zealand rabbits. The 6mm critical size defect (CSD) models of bone regeneration were used. Three CSDs were created in each surgical site. The first defect was filled with NuOss, the second one with Bio-Oss and the third one remained unfilled as the control. After healing periods of one and two months (seven animal for each time point), histological and histomorphometric analyses were carried out to assess the amount of new bone formation, presence of inflammation, foreign body reaction and type of new bone. Qualitative variables were analyzed by multiple comparisons, Wilcoxon, Friedman and Mann Whitney tests. Quantitative variables were analyzed using the Mann-Whitney and Wilcoxon tests. Level of statistical significance was set at 0.05., Results: The level of inflammation was not significantly different at four and eight weeks in the Bio-Oss (P=0.944), NuOss (P=1.000) and control groups (P=0.71). At four weeks, foreign body reaction was not observed in Bio-Oss, NuOss and control groups. There was no significant difference in the type of the newly formed bone at four and eight weeks in any group (P=0.141 for Bio-Oss, P=0.06 for NuOss and P=0.389 for the control group)., Conclusion: Deproteinized bovine bone mineral can be used as a scaffold in bone defects to induce bone regeneration.

Pre-implant disease is an inflammatory process that affects the surrounding tissues of a functional osseointegrated implant. It is usually the result of a disequilibrium between the micro-flora and the defense system. This case reports a 57-year-old man with unusual bone loss around dental implants. This was an unusual case of peri-implantitis that occurred only in the implants on one side of the mouth although they were all unloaded implants.