Search

Introduction: Scaling and root planning (SRP) is still the gold standard of nonsurgical periodontal therapy, and it has been accompanied by several supportive therapies in recent years. One of the most studied methods is the diode laser, thanks to its thermal and bactericidal properties. Our trial intended to verify whether it could influence the chemical bond between calculus and the root surface., Objectives: The aim of the study was to assess the efficacy of the diode laser prior the mechanical removal of calculus in an in vitro application. The reduction in time and the number of strokes required to clean the untreated root surfaces were evaluated as primary outcomes. The pressure was considered as a secondary outcome., Methods: A total of 75 extracted human teeth with subgingival calculus were assigned equally among three treatment groups (n = 25) according to the size of the occupied areas, which were classified by evaluating the pixel numbers. The groups were assigned to either no pretreatment application (A), Laser Diode Fox III (Sweden & Martina) (B) or Wiser Laser Evolution (Doctor Smile) (C). The weight for instrumentation was calibrated for an After Five curette (Hu-Friedy, Chicago). A new set of tools was used for each group, and the curettes were sharpened after each use with the Sidekick sharpener (Hu-Friedy, Chicago)., Results: A Kruskal-Wallis test was used to assess the significance for each considered parameter. The results were statistically significant for each parameter for the two groups where the laser was used compared to the control group., Conclusions: Despite the limitations of an in vitro study, data showed that the diode laser had an overall positive effect on root debridement, facilitating SRP in terms of stroke count, time, and pressure., (© 2023 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Purpose: Various methods have been proposed to achieve the nearly complete decontamination of the surface of implants affected by peri-implantitis. We investigated the in vitro debridement efficiency of multiple decontamination methods (Gracey curettes [GC], glycine air-polishing [G-Air], erythritol air-polishing [E-Air] and titanium brushes [TiB]) using a novel spectrophotometric ink-model in 3 different bone defect settings (30°, 60°, and 90°)., Methods: Forty-five dental implants were stained with indelible ink and mounted in resin models, which simulated standardised peri-implantitis defects with different bone defect angulations (30°, 60°, and 90°). After each run of instrumentation, the implants were removed from the resin model, and the ink was dissolved in ethanol (97%). A spectrophotometric analysis was performed to detect colour remnants in order to measure the cumulative uncleaned surface area of the implants. Scanning electron microscopy images were taken to assess micromorphological surface changes., Results: Generally, the 60° bone defects were the easiest to debride, and the 30° defects were the most difficult (ink absorption peak: 0.26±0.04 for 60° defects; 0.32±0.06 for 30° defects; 0.27±0.04 for 90° defects). The most effective debridement method was TiB, independently of the bone defect type (TiB vs. GC: P <0.0001; TiB vs. G-Air: P =0.0017; TiB vs. GE-Air: P= 0.0007). GE-Air appeared to be the least efficient method for biofilm debridement., Conclusions: T-brushes seem to be a promising decontamination method compared to the other techniques, whereas G-Air was less aggressive on the implant surface. The use of a spectrophotometric model was shown to be a novel but promising assessment method for in vitro ink studies., Competing Interests: No potential conflict of interest relevant to this article was reported. Only Enrico Marchetti had a collaborative relationship with the Sweden & Martina company from 2017 until 2019 in a different field from that of the study., (Copyright © 2023. Korean Academy of Periodontology.)

Objective: Morning breath is a temporary and unpleasant malodour sourced from the mouth, which occurs upon awakening. This double-blind, crossover, randomized clinical trial aimed to evaluate the bad-breath suppression of three commercially available mouthwashes: Mentadent Professional® Chlorhexidine 0.05% with vitamin C (ChxC), Meridol Alito Sicuro® (SnF 2 ) and CB12® (ZnChx) compared to a placebo (PbO) on morning halitosis., Methods: Thirty-two subjects refraining from oral hygiene practices for 12 h before the evaluation, performed a 30-s rinse with 15 ml of mouthwash, followed by a 5-s gargle, in the evening before bedtime. In order to assess morning halitosis, visual inspection (Winkel Tongue Coating Index), organoleptic (Rosenberg index) and chromatographic measurements were used. Gas chromatography was carried out by means of a dedicated device, the Oral Chroma. The recorded measurements have to be considered solely after the rinse since no data about the pre-exposure were available. A washout period of 1 week passed between one administration and the next., Results: The mean value of the organoleptic indices after administration of ChxC mouthwash is similar to ZnChx, SnF 2 and PbO values. Thus, no statistically significant differences were recorded among the mouthwashes and PbO. Nevertheless, ChxC seems to be more efficient in comparison with the PbO regarding VSCs levels analysed with Oral Chroma, (CH 3 SH; p = 0.0081) and [(CH 3 ) 2  S; p = 0.0003]., Conclusion: Considering our limited sample, instrumental examination demonstrated that the use of the analysed mouthwashes can result in low VSCs levels after 12 h from a single rinse. Furthermore, the highest number of patients (n = 14) were proved to be free from bad smell after using a single administration of ChxC with respect to the other commercial products. The other tested mouthwashes did not show better performances with respect to the placebo after a single rinse., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim of this review was to give an overview of the outcomes of the use of different regenerative materials to treat molars with class II furcation defects in patients with periodontitis in comparison with open flap debridement (OFD). A search of five databases (PubMed-Medline, Embase, Cochrane, Scopus and Web of Science) was conducted up to and including January 2022. According to the PICOS guidelines, only randomized control trials (S) considering periodontal patients with at least one molar with a class II furcation involvement (P) treated with regenerative materials (I) in comparison to OFD as control treatment (C) and a minimum follow-up period of 6 months were included. Vertical clinical attachment level (VCAL) was considered as the primary outcome (O), while horizontal clinical attachment level (HCAL), horizontal probing depth (HPD) and vertical probing depth (VPD) were considered as secondary outcomes. The search through the databases initially identified 1315 articles. Only 25 of them met the eligibility criteria and were included. The studies were grouped in four macro-categories according to the material used: absorbable and non-absorbable membranes, blood derivatives and a combination of different materials. The greater part of the included studies reported a statistically significant difference in using regenerative materials when compared to OFD. The blood derivatives groups reported a range of mean changes in VCAL of 0.86-4.6 mm, absorbable membrane groups reported -0.6-3.75 mm, non-absorbable membranes groups reported -2.47-4.1 mm, multiple materials groups reported -1.5-4.87 mm and enamel matrix derivatives reported a mean change in VCAL of 1.45 mm. OFD showed a range of mean VCAL changes of -1.86-2.81 mm. Although no statistical analysis was performed, the use of regenerative materials may be considered moderately beneficial in the treatment of molars with grade II furcation involvement. However, the substantial heterogeneity in the protocols' design does not allow us to draw definitive conclusions. In addition, low levels of evidence for morbidity and patient-centered outcomes were reported.

Covid-19 is an infective respiratory illness caused by a novel virus, which might present different degrees of severity: from mild or even asymptomatic carriers to severe pneumonia, requiring intubation and intensive care unit (ICU) management. SARS-CoV-2 may cause also central nervous system involvement, including psychiatric manifestations. Some cases of psychosis apparently covid-related have been reported since the start of the pandemic; we will briefly review some of them here, then we will report a case concerning a patient with emerging psychosis during the disease caused by the virus. Our case describes a man with no prior personal or familiar psychiatric history, who developed delusion and a post-traumatic stress symptoms (PTSS) which required hospitalization in a psychiatric unit. The patient was treated with antipsychotic medications and underwent a brief follow-up.

Aims: The present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019., Methods: We obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1-June 30, 2018 and 2019; (b) March 1-April 30, 2020 (i.e., lockdown); and (c) May 1-June 30, 2020 (i.e., post-lockdown)., Results: During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45-0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44-0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54-0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32-2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49-0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01-1.79)., Conclusion: The COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background and Objectives : The aim of the present systematic review and meta-analysis was to investigate the efficacy of leukocyte-platelet-rich fibrin (L-PRF) in addition to coronally advanced flap (CAF) for the treatment of both single and multiple gingival recessions (GRs) compared to the CAF alone and to the adjunct of connective tissue graft (CTG). Root coverage outcomes using platelet concentrates have gained increased interest. In particular, it has been suggested that adding L-PRF to CAF may provide further benefits in the treatment of GRs. Materials and Methods : An electronic and manual literature search was conducted to identify randomized controlled trials (RTCs) investigating root coverage outcomes with CAF + L-PRF. The outcomes of interest included mean root coverage (mRC), recession reduction, keratinized tissue width (KTW) gain, gingival thickness (GT) gain, and patient-reported outcome measures (PROms) such as pain perception and discomfort. Results : A total of 275 patients and 611 surgical sites were analyzed. L-PRF in adjunct to single CAF seems to show statistically significant results regarding clinical attachment level (CAL) with a weighted means (WM) 0.43 95% CI (-0.04,0.91), p < 0.0001, GT (WM 0.17 95% CI (-0.02,0.36), p < 0.0001, and mRC (WM 13.95 95% CI (-1.99,29.88) p < 0.0001, compared to single CAF alone. Interesting results were obtained from the adjunct of PRF to multiple CAF with respect to multiple CAF alone with an increase in the mRC WM 0.07 95% CI (-30.22,30.35), p = 0.0001, and PPD change WM 0.26 95% CI (-0.06,0.58), p < 00001. On the other hand, no statistically significant data were obtained when L-PRF was added to single or multiple CAF combined with CTG according to the included outcomes such as mRC ( p = 0.03 overall). Conclusions : L-PRF is a valid alternative to CAF alone. L-PRF compared to CTG in single and multiple CAF showed statistically significant results regarding pain perception and discomfort PROms ( p < 0.0001). However, CTG remains the gold standard for treating gingival recession.

In periodontitis patients, furcation defects are crucial sites to regenerate due to their complex anatomy. Various modern surgical techniques and use of biomaterials have been suggested in the literature. Among all, platelet-rich fibrin (PRF) has potential in tissue regeneration thanks to its role in the release of growth factors. Therefore, the purpose of this study was to evaluate the beneficial effect of the addition of PRF to open flap debridement (OFD) or as an adjuvant to other biomaterials such as bone grafts in the treatment of grade 2 mandibular furcation defects. Systematic research was carried out on the databases Medline, Scopus, Embase, and Cochrane Library and registered on PROSPERO (CRD42020167662). According to the PICO guidelines by Cochrane, randomized trials and prospective non-randomized trials were evaluated, with a minimum follow-up period of 6 months. The inclusion criteria were the absence of systemic diseases, non-smoking patients, and a population aged from 18 to 65 years. Vertical pocket probing depth (PPD), vertical clinical attachment level (VCAL), and gingival recession (REC) were the primary outcomes. Vertical furcation depth (VFD), and the percentage of bone defect fill (%v-BDF) were considered as secondary outcomes. A meta-analysis of the primary and secondary outcomes was performed. Publication bias was assessed through a funnel plot. Eighty-four articles were initially extracted. Eight randomized clinical trials were analyzed according to the exclusion and inclusion criteria. The Quality assessment instrument (QAI) revealed four articles at low risk of bias, one at moderate, and three at high risk of bias. The metanalysis showed significant data regarding PPD, VCAL, VFD and %v-BDF in the comparison between PRF + OFD vs. OFD alone. The adjunct of PRF to a bone graft showed a significant difference for VCAL and a not statistically significant result for the other involved parameters. In conclusion, the adjunctive use of PRF to OFD seems to enhance the periodontal regeneration in the treatment of grade 2 furcation defects. The combination of PRF and bone graft did not show better clinical results, except for VCAL, although the amount of literature with low risk of bias is scarce. Further well-designed studies to evaluate the combination of these two materials are therefore needed.

Aim: This paper aims to study, evaluate and compare the effectiveness of two group interventions within a Psychiatric Intensive Care Unit (PICU). The outcome indicators of the satisfaction of patients and their families with the ward were evaluated with a Satisfaction Questionnaire on the department, and their satisfaction with the groups were evaluated with the Satisfaction Questionnaire for the groups. The two theoretical orientations examined are the cognitive-behavioural therapy, with group cognitive-behavioural intervention in the context of SPDC, and psychoanalysis, with multifamily psychoanalysis groups, according to the model of Jorge García Badaracco., Methods: The sample is composed of 83 users (42 males and 41 females) participating in the groups; 41 users (23 males and 18 females) not participating in the groups; 54 family members participating in the groups; 41 family members not participating in the groups., Results: The results show an improvement of satisfaction with activities compared to the hospitalisation into the ward (p<.01), an improvement in the perception of the ward climate (p<.01) of the users participating in the groups, regardless of the orientation of reference, but it shows a greater effectiveness of groups with cognitive-behavioral group orientation (p<.001)., Discussion and Conclusions: The results indicate a greater effectiveness of the groups with cognitive-behavioural orientation, but confirm that psychotherapeutic groups in psychiatric contexts, even in emergency, not only seems to be well accepted and perceived positively by users and family members, but it also contributes to increasing satisfaction with the ward.

Objectives: To evaluate whether changes in the concentration of different biomarkers in the gingival crevicular fluid (GCF) can be used to detect the root resorption process in adult or adolescent patients undergoing treatment with a fixed appliance, in comparison with untreated subjects or treated patients not showing signs of root resorption., Material and Methods: The following databases were analysed in the period between June 2017 and March 2018, without any language and initial date restrictions: PubMed, EMBASE, Scopus, Web of Science and Cochrane Library. A quality assessment instrument (QAI) was developed to establish the risk of bias., Results: A total of 1127 articles were analysed. Based on the inclusion and exclusion criteria, seven studies qualified for the final review. The QAI tool revealed that five articles were at a moderate risk of bias and two articles were at a low risk of bias., Conclusion: Dentine phosphoprotein (DPP) may be considered a relatively useful marker for root resorption. Dentinal sialoprotein (DSP) could be a potential biomarker but is not highly helpful at detecting root shortening. Inflammatory cytokines (pro- and anti-resorption), osteopontin (OPN), osteoprotegerin (OPG), RANKL and alkaline phosphatase (ALP) are useful biomarkers to explain the biological mechanisms that occur during orthodontic movement but are not specific enough. Further studies are required to clarify the role of GM-CSF as a potential biomarker to distinguish subjects at a risk of severe root resorption in the early phase., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)