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This study aimed to evaluate the accuracy of cone beam computed tomography (CBCT) and ridge mapping for linear measurement of alveolar ridge width. In this cross-sectional study, 25 implant placement sites in 25 patients were selected and an acrylic stent was fabricated for each one. Three buccal–lingual point pairs were located on the stent at 4-, 7-, and 10-mm distances from the soft tissue summit of the alveolar ridge. The measurements were recorded by three examiners (two periodontists and one radiologist). Both techniques (CBCT and ridge mapping) overestimated alveolar ridge width compared to direct measurements, but mean differences compared to direct measurements (gold standard) were not statistically significant. The lowest mean difference compared to direct measurements was related to the ridge mapping technique, and CBCT measurements were less accurate to measure the alveolar ridge width. In determining alveolar ridge width, ridge mapping and CBCT are both valid and useful. Ridge mapping provides high accuracy, simplicity, and lack of radiation exposure.

Background: Regarding retained cement acts as an idiopathic cause for early implant loss, cement selection with the least toxicity in the peri-implant hard and soft tissues is important. The present study aimed to evaluate the cytotoxicity of three different types of temporary cements and titanium cemented with each cement after direct exposure to human gingival fibroblasts (HGF) and MG-63 osteoblast-like cells.Methods: In this in vitro study, zinc oxide-eugenol (ZOE), eugenol-free zinc oxide (ZONE), and resin (R) cements prepared in cylindrical forms with a similar dimension were used. Each cement was placed on titanium disks to prepare cemented titanium samples. MTT assay was applied at 24- and 72-hour, and 7-day intervals to evaluate cytotoxicity.Results: All the cements decreased cell viability in both cell lines significantly. None of the cements exhibited cellular viability percentages higher than the minimum percentage (70%) required for biocompatibility. The cemented titanium disks’ cytotoxicity was not significantly different from the cement-only samples (P>0.05). There were no significant differences in the sensitivity of MG-63 osteoblast-like cells and HGF to the cements evaluated. Conclusions: The composition of the cement had a significant role in the host cell response. This study showed that dental cements could cause tissue toxicity in the gingiva and bones, finally affecting implant survival.

The recent global health problem, COVID-19, has had far-reaching impacts on lifestyles. Although many effective WHO-approved vaccines have been produced that have reduced the spread and severity of the disease, it appears to persist in humans for a long time and possibly forever as everyday it turns out to have new mutations. COVID-19 involves the lungs and other organs primarily through cytokine storms, which have been implicated in many other inflammatory disorders, including periodontal diseases. COVID-19 is in a close association with dental and periodontal practice from two respects: first, repeated mandatory lockdowns have reduced patient referrals to dentists and limited the dental and periodontal procedures to emergency treatments, whereas it is important to recognize the oral manifestations of COVID-19 as well as the influence of oral and periodontal disease on the severity of COVID-19. Second, dentistry is one of the high-risk professions in terms of close contact with unmasked individuals, necessitating redefining the principles of infection control. The pressures of the economic recession on patients as well as dentists add to the difficulty of resuming elective dental services. Therefore, this study is divided into two parts corresponding to what mentioned above: the first part examines the clinical and immunological associations between COVID-19 and periodontal and oral diseases, and the second part delineates the measures needed to control the disease transmission in dental clinics as well as the economic impact of the pandemic era on dental services.

Background Free gingival graft (FGG) is a highly predictable method to increase the width of keratinized gingiva. Various materials have been reported to accelerate the wound healing process. Considering the positive effect of EPO on dermal wound healing this study aimed to investigate the effects of EPO on the rate of healing and degree of inflammation in free gingival grafts. Methods Seventeen patients with bilateral lack of keratinized gingiva in mandible were selected for this clinical trial. The surgical intervention was performed after phase I periodontal therapy. Recipient site was prepared apical to the mucogingival line, and FGG was harvested from the palate. Before graft placement, the test side and control side were treated with 1 ml of EPO 4000 IU/ml and distilled water, respectively, for 2 min. On days 7, 14, 21, 28, 60, and 90 after surgery, the grafted sites were examined by blinded observers to compare the healing and inflammation of the areas. Results All the 17 patients completed the surgeries and follow-up examinations. Direct examination revealed significantly better healing in EPO group only on the 28th day. Assessment of the photographs showed a significant value in favor of the test group at some other time points as well. The EPO group demonstrated less inflammation, which was statistically significant in many time points. The graft area was 80.88 ± 30.21 mm2 and 71.35 ± 15.62 mm2 in the EPO and control groups, respectively. The difference was not significant, though. Conclusions Topical application of erythropoietin can accelerate the healing of gingival grafts and reduce the inflammation during healing period. The final graft outcome, nevertheless, does not seem to be influenced by EPO. Trial registration This was a split-mouth randomized controlled clinical trial (IRCT201201278830N1). The first registration date: 2016-10-22

Background The purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors. One of the drugs that has been tested in many areas and shown good anti-inflammatory properties is erythropoietin (EPO). We evaluated the effect of this drug on the improvement of periodontitis after the phase I treatment. Methods This study was conducted on 30 patients with stage III periodontitis who had at least two bilateral teeth with CAL of ≥ 5 mm and PPD ≥ 6 mm at ≥ 2 non‐adjacent teeth and bleeding on probing. After oral hygiene instruction and scaling and root planning (SRP), EPO gel containing a solution of 4000 units was applied deeply in the test group and placebo gel was deeply administered in the control pockets (5 times, every other day). The clinical parameters of the plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing depth (PD) and bleeding index (BI) were measured at baseline and after three months of follow up. The P-value was set at 0.05. Results All clinical variables improved after treatment in both groups. The BI and GI scores (which reflects the degree of gingival inflammation) showed statistically more reduction in test group. The CAL decreased from 5.1 ± 4.1 to 3.40 ± 2.71 mm; and 5.67 ± 4.32 to 4.33 ± 3.19 mm in test and control group, respectively (P P Conclusion Local application of EPO gel in adjunct to SRP can improve clinical inflammation and CAL gain in periodontitis. Trial registration: This study was registered at 2017-11-06 in IRCT. All procedures performed in this study were approved with ID number of IR.TUMS.DENTISTRY.REC.1396.3139 in Tehran University of medical science.

Purpose. This study is aimed at synthesizing the available evidence regarding effectiveness of various modalities (combinations of LRS tasks) and comparison between each two modalities in terms of gingival display reduction, success rate, stability of the results, patient’s satisfaction, and postoperative morbidity. Materials and Methods. The electronic databases including PubMed, Scopus, Web of Science Cochrane Library, Google Scholar databases, ClinicalTrials.gov, and WHO International Clinical Trial Registry Platform were searched up to 27th June 2020 regarding lip repositioning surgery. The modalities were defined as the combinations of the following tasks: frenectomy (yes/no), flap thickness (full/partial), and myotomy (yes/no). Meta-analyses were performed on gingival display change from baseline to months 3, 6, and 12 in each modalities using Stata (v.16). Results. 38 studies (including three clinical trials, two quasiexperimental studies, seven case series, and 26 case reports) met the criteria for final inclusion. The mean gingival display reduced from baseline to 6 months (WMD=−2.90, 95% CI: -4.85 to -0.95) in the patients undergoing the “frenectomy + full-thickness flap + myotomy” modality. This parameter decreased from baseline to 6 and 12 months, respectively (WMD=−2.68, 95% CI: -3.49 to -1.86;WMD=−2.52, 95% CI: -4.40 to -0.64), in patients undergoing the “frenectomy + partial-thickness flap + without myotomy” modality. In patients who undergone the “without frenectomy + partial-thickness flap + without myotomy” modality, gingival display reduced from baseline to 6 months (WMD=−3.22, 95% CI: -5.61 to -0.84). Almost 83% of patients with modality 1 had satisfaction. Conclusions. Gingival display within the 6 months after LRS could be reduced with all modalities. Descriptively, the greatest reduction was observed in patients with the modality not including the frenulum.

Additional file 1. Ethics-informed consent.

Background. This study aims to analyze the effect of Semelil, an herbal selenium-based medicine, on osteogenesis in rabbit calvarium defects. Methods. Four identical bony defects (8 mm) were created in the calvarium of 16 New Zealand male rabbits and filled randomly with xenogenic bone substitute material (Bio-Oss®) and semelil herbal drug (ANGIPARS™). One site was filled with Bio-Oss (B); the second site was treated with ANGIPARS (A); the third site was treated with ANGIPARS + Bio-Oss (AB); and the fourth site was left as untreated control (C) and defects were left unfilled. Rabbits were randomly divided into two groups (n=8) and sacrificed at four and eight weeks. Percentage of new bone formation, type of the newly formed bone, percentage of the remaining xenograft biomaterial, and foreign body reaction (FBR) were evaluated via histological and histomorphometric analyses. Results. The percentage of new bone formation was significantly different among four groups. The highest effect was observed in AB, followed by A, B, and C groups, respectively. The difference in the mean percentage of new bone formation between four and eight weeks was significant for all four groups (P<0.001). Regarding bone formation, the interaction effect of A and B was significant at four (P<0.001) and eight weeks (P=0.002). ANGIPARS alone and in presence of Bio-Oss enhanced new bone formation at both four and eight weeks (P<0.001). The mean amount of new bone formation was significantly different at four and eight weeks in groups C (P=0.008), A (P<0.001), B (P<0.001), and AB (P=0.003). FBR was not observed in any group. Conclusion. Semelil may be useful as an adjunct to conventional osteoconductive materials in order to enhance osteogenesis.

Background. This study aimed to assess Aggregatibacter actinomycetemcomitans (Aa) and Prevotella intermedia (PI) counts in gingival crevicular fluid (GCF) around healthy implants, diseased implants and sound teeth. Methods. Eight patients (four males and four females), who had healthy implants, implants with peri-implantitis and sound teeth, were selected. Samples (GCF) were analyzed using real-time polymerase chain reaction (RT-PCR). The above-mentioned bacteria were detected and counted. Data analysis in RT-PCR was carried out based on the standard curve using Prism software to compare Pi and Aa counts between the three areas (GCF around sound teeth, healthy implants and implants with peri-implantitis). Results. Pi counts were significantly higher in GCF around implants with peri-implantitis (8 implants) than around healthy implants (8 implants) (P

Purpose The purpose of the present study was to evaluate the efficacy of simvastatin administration as an osteoinductive agent combined with bovine bone material (BBM) for augmentation of human maxillary sinuses. Materials and Methods In the present randomized clinical trial with a split-mouth design, 24 maxillary sinuses in 12 patients were augmented using BBM alone or BBM combined with simvastatin. Biopsy samples were taken 9 months after maxillary sinus floor augmentation for histologic and histomorphometric analyses. A total of 44 implants were placed in the augmented bone. Results The results of the microscopic assessment of most samples revealed no inflammation or only mild chronic inflammation. Lamellation was detectable in old bone trabeculae under polarized light microscopy but was not observed in newly formed bone. Osteocytes were found with a lower frequency in the lacunae of newly formed bone compared with normal bone. No significant differences were found in the amount of newly formed bone and the amount of residual particles between the 2 groups. Conclusions Despite the greater mean percentage of newly formed bone in the test group, the histomorphometric analysis results did not show a significant positive effect for the use of simvastatin in maxillary sinus augmentation.

Objectives: The aim of this study was to compare the efficacy of bovine bone substitute (Compact Bone B. ®) alone versus bovine bone substitute and simvastatin for human maxillary sinus augmentation. Materials and Methods: This study was conducted on 16 sinuses in eight patients. Radiographic assessments were done preoperatively (T0), immediately (T1) and at nine months after sinus grafting (T2). Alveolar bone height and density were assessed on cone beam computed tomography (CBCT) scans using Planmeca Romexis™ Imaging Software 2.2. Results: The change in alveolar bone height and density between T0, T1 and T2 was significant in both groups. Alveolar bone height (h0, h1, h2) and vertical height of the grafted bone (g1, g2) in three lines (anterior, middle and posterior) were not significantly different between groups. The grafted bone height shrinkage (%) in the anterior, middle and posterior limits of the augmented area were not significantly different between groups. The existing alveolar and grafted bone density increased significantly in both groups between T1 and T2, except for the existing alveolar bone density in the control group. There were no statistically significant differences between the alveolar bone density values obtained in TI and T2 between groups, except for the existing alveolar bone density at T1. Conclusions: This study did not show any significant positive effect for simvastatin in maxillary sinus augmentation based on radiographic examination.

Corrosion of implant components, including that of cover screws, has been reported as a possible etiological factor for implant failure. This study evaluated the presence of metallic particles in the soft tissues overlying two-stage implants after placing cover screws, by using a histological technique and energy-dispersive X-ray spectroscopy. The results showed large and small titanium particles in different layers of the soft tissue overlying the implant and cover screws in the majority of samples, with more particles near the cover screws. These particles might have contributed to the various degrees of inflammatory reactions detected in the different layers of the overlying soft tissues. Further studies on the corrosion of implants' metallic components are recommended, so that the implant failure rates could be minimized.

Chronic periodontal diseases, which mainly include gingivitis and periodontitis, have been described as the inflammation of the supporting tissues of the teeth. The main cause of periodontal diseases is the accumulation of the microbial dental plaque. If dental plaque is not eliminated by mechanical or chemical plaque control methods, mineralized dental plaque (calculus) occurs. The mineralization process and mechanisms of the dental calculus formation are similar to that of other pathologic calcifications. The presence of a certain type of microorganism is discovered in various pathological calcifications, such as kidney stones and arterial plaques. This microorganism is the nanobacterium. Thus, it may be considered as a potential risk factor for the chronic periodontal diseases. Nanobacterium is one of the most controversial issues in today's biological studies. Nanobacteria, as the smallest known self-replicating bacteria, are classified as Gram-negative organisms. Although their growth is slow, they g...

Free gingival grafting, the most predictable technique to increase the keratinized gingiva, leaves an open wound on the palate and the resulting discomfort during the healing phase is a significant concern. This study was intended to evaluate the effect of topical erythropoietin on healing of the donor site. Twelve patients lacking an attached gingiva at two sites in the mandible were included. In the test group, 1 mL of gel containing erythropoietin at a concentration of 4,000 IU mL-1 was applied to the donor site, whereas the control group was treated with 2 mL of the gel alone. On the second day after surgery, the same procedure was repeated. H2O2 was used to evaluate the amount of epithelialization. Clinical healing was compared using photographs and direct examination. The EPO group showed significantly better keratinization only on day 21. Comparison of clinical healing based on direct examination revealed significantly better healing in the test group on day 28. Furthermore, inflammation in the test group was lower than in the control group on the same day. Topical application of EPO improves palatal wound healing during the third and fourth weeks after free gingival graft procedures.

Background and Aims: Several studies have shown that there is greater number of viruses in deep periodontal pockets than in normal gingival sulcus. We also know that virus may have an important role in induction of Il-1β secretion by different human cells. In this study we intended to determine the capacity of Herpes simplex virus type 1 to stimulate Il-1β secretion in human gingival keratinocytes. Materials and Methods: primary gingival keratinocytes were obtained from samples extracted during crown lengthening surgical procedure. The cells were cultured in 24 well flasks and stimulated by one of these stimulants: LPS, HSV1, LPS+HSV1 and LPS+ATP. After incubation and collecting the supernatants, the amount of secreted Il-1β was measured by ELISA technique. Results: none of the stimulants were able to cause significant amount of Il-1β secretion in any of the incubation times. Conclusion: It seems that HSV1 does not have the capacity to induct IL-1β secretion as a single factor alone or in combination with bacterial LPS.

To analyze and compare the stress distribution around tapered and cylindrical implants and investigate how different abutment diameters influence crestal bone stress levels.Six finite element models of an abutment (5 mm, 4.3 mm, and 3.5 mm in diameter) and supporting implants (tapered and cylindrical) were designed. A vertical force of 100 N and a 15-degree oblique force of 100 N were applied separately on the occlusal surface, and von Misses stresses were evaluated in the cortical and cancellous bone.Higher stress was observed under oblique loading than under vertical loading of both tapered and cylindrical implants. Tapered implants demonstrated more stress under both vertical and oblique loading. Platform switching reduced peri-implant crestal bone stress in all models under vertical and oblique forces. The peri-implant crestal bone around tapered implants experienced 4.8% more stress under vertical loading and 35% more stress under oblique loading in comparison to bone around cylindrical implants (2.62 MPa with vertical loading, 8.11 MPa under oblique loading). Oblique loads resulted in much higher stress concentrations in the peri-implant crestal bone than vertical loads (238% in cylindrical and 308% in tapered implants). When the abutment diameter decreased, both models showed reductions of stress in the crestal bone under both types of loading.In this finite element analysis, tapered implants increased crestal bone stress upon loading, and platform switching minimized the stress transmitted to the crestal bone in both tapered and parallel wall implants.

The biologic width (BW) includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD) as well as the distance between free gingival margin and the bone crest (FB) of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm) was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002). BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments.

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

BACKGROUND: The aim of this study was to investigate knowledge, attitude and practice (KAP) of cardiovascular disease (CVD) patients about their oral health status. METHODS: In this cross-sectional study, we analyzed the data of 150 CVD patients that collected by a self-administered questionnaire consists of demographic characteristics and KAP. Oral health indicators calculated based on the results of oral examination by an expert dentist. RESULTS: CVD patients had an overall moderate level of knowledge and attitude, but their practice was lower than moderate. There were important associations between knowledge scores with gender, education, residential area and financial status, between attitude scores with education and residential area, and between practice scores with education and financial status. There were no associations between KAP and age, marital status or job. Significant positive correlations were found between KAP components. Significant negative correlations were found between oral hygiene index with knowledge and practice. CONCLUSION: The practice of heart disease patients about their oral health was poor, and declares that increasing awareness and attitude may not promote practice. Efficient programs are needed to promote oral health practice of adult populations in special groups.

Objective: Reconstruction methods are an essential prerequisite for functional rehabilitation of the stomatognathic system. Plasma rich in growth factors (PRGF) offers a new and potentially useful adjunct to bone substitute materials in bone reconstructive surgery. This study was carried out to investigate the influ-ence of PRGF and fibrin membrane on regeneration of bony defects with and without deproteinized bovine bone mineral (DBBM) on rabbit calvaria. Materials and Methods: Twelve New Zealand white rabbits were included in this randomized, blinded, prospective study. Four equal 3.3×6.6 mm cranial bone defects were created and immediately grafted with DBBM, PRGF+DBBM, PRGF+fibrin membrane and no treatment as control. The defects were evaluated with histologic and histomorphometric analysis performed 4 and 8 weeks later. Results: Adding PRGF to DBBM led to increased bone formation as compared with the control group in 4- and 8-week intervals. In DBBM and PRGF+fibrin membrane samples, no significant increase was seen compared to the control group. There was also a significant increase in the rate of biodegradation of DBBM particles with the addition of PRGF in the 8-week interval. Neither noti-ceable foreign body reaction nor any severe inflammation was seen in each of the specimens evaluated. Conclusion: Under the limitation of this study, adding PRGF to DBBM enhanced osteogenesis in rabbit calvarias. Applying autologous fibrin membrane in the de-fects was not helpful.