Matrix Metalloproteinase 9 (MMP-9) and Interleukin-8 (IL-8) in Gingival Crevicular Fluid after Regenerative Therapy in Periodontal Intrabony Defects with and without Systemic Antibiotics-Randomized Clinical Trial.

The aim of our study was to assess changes in the levels of IL-8 and MMP-9 in gingival crevicular fluid (GCF) collected from the periodontal pocket before and after regenerative surgery with deproteinized bovine bone mineral (DBBM) and collagen membrane (GTR) either independently (DBBM/GTR) or with the postoperative administration of antibiotic (DBBM/GTR+AB). The study involved 41 patients, each with one intrabony defect. IL-8 and MMP-9 were determined before therapy and after 2 weeks, 4 weeks and 6 months following the surgical procedure by means of dedicated ELISA kits. No statistical differences were observed in the levels of IL-8 and MMP-9 after 2 weeks, 4 weeks and 6 months between the groups. The changes in the level of MMP-9 over time were not statistically significant in any group. The changes in the level of IL-8 were significant for the group given antibiotic but not in the nonantibiotic group in the follow-up period. IL-8 and MMP-9 were found to correlate positively but not after 4 weeks in the test group. Current assessment of IL-8 and MMP-9 obtained from GCF samples provides evidence that collagen matrix turnover occurs actively during the early healing phase in the periodontium after regenerative procedures. We observed positive correlations of MMP-9 and IL-8 throughout the study. However, we failed to reveal any differences regard parameters studied between the two groups

Clinical assessment of the efficacy of photodynamic therapy in the treatment of oral lichen planus

The study objective was clinical assessment of the efficacy of photodynamic therapy (PDT) in the treatment of oral lichen planus (OLP). There were 23 patients aged 31–82 included in the study with oral lichen planus diagnosed clinically and histopathologically. In all patients photodynamic therapy was performed with the use of chlorin e6 (Photolon(®)), containing 20 % chlorin e6 and 10 % dimethyl sulfoxide as a photosensitizer. PDT was performed using a semiconductor laser, with power up to 300 mW and a wavelength of 660 nm. A series of illumination sessions was conducted with the use of superficial light energy density of 90 J/cm(2). Changes of lesion size were monitored at one, two, five, and ten PDT appointments from the series of ten according to the authors' own method. The sizes of clinical OLP lesions exposed to PDT were reduced significantly (on average by 55 %). The best effects were observed for the lesions on the lining mucosa (57.6 %). The therapy was statistically significantly less effective when masticatory mucosa was affected (reduction, 30.0 %). Due to substantial efficacy and noninvasiveness, PDT can be useful in the treatment of OLP lesions

Cytological picture of the oral mucosa in patients with gastric and colon cancer

The incidence of malignant gastrointestinal cancers in Poland has been constantly growing, which hasled to an intensification of the search for new markers of the early clinical stage of this disease. The oral cavity,as the first part of the gastrointestinal tract, has a very important role. The oral cavity presents symptoms of bothtypically stomatological and systemic diseases. Oral cancers, benign or malignant, may originate and grow in anyof the tissues of the mouth, and within this small area they may be of varied clinical, histological and biologicalfeatures. These can be lesions typically observed in the oral cavity, but also characteristic of cases where thesymptoms occur both in the mouth and in other body parts. The aim of this study was to present a cytologicalpicture of the oral mucosa in patients with gastric and colon cancer and to compare the cytological picture withthat obtained from a group of patients with no cancer, using the Papanicolaou classification and the Bethesdasystem. The study was conducted in 126 patients treated surgically in the II General and GastroenterologicalSurgery Clinic between 2006 and 2008. All patients were divided into two groups based on the type of lesions. Inboth of the studied groups, more than half of the patients did not present any abnormalities in the mucosa of themouth, lips and cheeks in the physical examination. None of the patients had erosion, ulceration or lesionstypical of leukoplakia or lichen planus. No malignant cells were detected in either of the studied groups, andthere were no well-defined lesions found in the oral cavity that would distinguish the patients with gastrointestinalcancer. (The incidence of malignant gastrointestinal cancers in Poland has been constantly growing, which hasled to an intensification of the search for new markers of the early clinical stage of this disease. The oral cavity,as the first part of the gastrointestinal tract, has a very important role. The oral cavity presents symptoms of bothtypically stomatological and systemic diseases. Oral cancers, benign or malignant, may originate and grow in anyof the tissues of the mouth, and within this small area they may be of varied clinical, histological and biologicalfeatures. These can be lesions typically observed in the oral cavity, but also characteristic of cases where thesymptoms occur both in the mouth and in other body parts. The aim of this study was to present a cytologicalpicture of the oral mucosa in patients with gastric and colon cancer and to compare the cytological picture withthat obtained from a group of patients with no cancer, using the Papanicolaou classification and the Bethesdasystem. The study was conducted in 126 patients treated surgically in the II General and GastroenterologicalSurgery Clinic between 2006 and 2008. All patients were divided into two groups based on the type of lesions. Inboth of the studied groups, more than half of the patients did not present any abnormalities in the mucosa of themouth, lips and cheeks in the physical examination. None of the patients had erosion, ulceration or lesionstypical of leukoplakia or lichen planus. No malignant cells were detected in either of the studied groups, andthere were no well-defined lesions found in the oral cavity that would distinguish the patients with gastrointestinalcancer.

Effect of systemic antibiotics on the outcomes of regenerative periodontal surgery in intrabony defects: a randomized, controlled, clinical study.

OBJECTIVES To assess the potential influence of systemic antibiotic administration on the healing of periodontal intrabony defects treated with deproteinized bovine bone mineral (DBBM) and collagen membrane. MATERIALS AND METHODS Forty-one intrabony defects were treated by means of DBBM and collagen membrane (GTR). Postoperatively, the patients received either systemic antibiotics (i.e., 1 g of amoxicillin, twice daily for 7 days) (test) or no antibiotics (control). Clinical attachment level (CAL), probing depth (PD), and gingival recession (GR) were measured at baseline and at 1 year following regenerative surgery. The depth of the intrabony component (INTRA DD) and its width (INTRA DW) were measured during surgery and after 1 year at reentry. The depth (RxD) and width (RxW) of the intrabony defects were evaluated radiographically at baseline and at 1 year. RESULTS No adverse events were observed in any of the two groups throughout the entire study period. In the test group, mean CAL changed from 8.7 ± 1.4 mm at baseline to 5.0 ± 1.7 mm at 1 year (p < 0.0001), while PD decreased from 7.8 ± 1.5 mm at baseline to 4.0 ± 0.9 mm at 1 year (p < 0.0001). In the control group, mean CAL changed from 8.6 ± 1.9 mm to 5.9 ± 1.6 mm (p < 0.001) and mean PD improved from 7.4 ± 1.3 mm to 4.1 ± 1.3 mm (p < 0.001). Mean CAL gain measured 3.6 ± 1.6 mm in the test and 2.7 ± 1.6 mm in the control group, respectively. Defect fill (i.e., INTRA DD gain) at re-entry measured 3.7 ± 1.8 mm in the test and 2.7 ± 2.1 mm in the control group. A CAL gain of ≥ 3 mm was measured in 76% of the defects in the test group and in 40% of the defects in the control group, respectively. In both groups, all evaluated clinical and radiographic parameters improved statistically significantly compared with baseline, but no statistically significant differences were found between the two groups. CONCLUSIONS Within their limits, the present study has failed to show any substantial added clinical benefits following the postoperative administration of amoxicillin in conjunction with regenerative periodontal surgery using DBBM and GTR. CLINICAL RELEVANCE The post-surgically administration of systemic antibiotics does not seem to be necessary following regenerative periodontal surgery

Advancement of Marginal Bone and Soft Tissue Aesthetics for Slope-Configured Implants

The aim of the study was to examine changes within the marginal bone and soft tissue aesthetics following placement of implants with a sloped shoulder configuration. Thirty patients with a single missing tooth who showed a palatal/lingual&ndash;buccal bone height discrepancy of 2.0&ndash;3.0 mm on CBCT were enrolled in the study. The thickness of buccal and palatal/lingual bone plates 1 and 3 mm apically from the platform; Pink Aesthetic Score and Papilla Index were evaluated. After the implant insertion the mean thickness of the buccal bone plate when measured 1 mm and 3 mm from the shoulder was 1.85 &plusmn; 0.68 mm and 1.99 &plusmn; 1.05 mm. Six months after the definitive crown delivery, the value of this parameter decreased by 0.32 &plusmn; 0.53 mm and 0.15 &plusmn; 1.05 mm, respectively. After the temporary crown delivery, the median Pink Aesthetic Score was 5, and it increased to 7.75 six months after the definitive crown delivery. Likewise, the Papilla Index median improved from 1 to 2. After the use of implants with a sloped shoulder configuration, a slight decrease in buccal bone plate thickness can be expected. However, the reduction in the thickness of this bone plate does not have a negative impact on soft tissues, as evidenced by the improvement in indices assessing aesthetics

The Cone Beam Computed Tomography Evaluation of Cortical Bone Plate after Piezocision-Assisted Orthodontic Upper Arch Expansion: A Case Series

Background: The purpose of the study was to evaluate cone beam computed tomography (CBCT) after piezocision-assisted orthodontic maxillary arch expansion. Methods: Forty CBCT images of 20 patients taken before and after treatment were included in the study. The following radiographic parameters were measured: buccal/palatal bone plate thickness measured in three locations, 0.5 mm, 3.5 mm, and 5 mm from the margin of alveolar process; cemento-enamel junction-crest distance (CEJ-C) measured at buccal (CEJ-B) and palatal/lingual (CEJ-P) aspects. Results: After treatment there were insignificant changes in CEJ-C and thickness of buccal/palatal plates for all the dental groups except for incisors and premolars. CEJ-B increased by 1.43 mm on premolars and CEJ-P by 1.65 mm on incisors and by 0.31 mm on premolars. On the incisors, the buccal plate width increased significantly, by 0.2 mm and 0.44 mm at 3.5-mm and 5-mm measurement points. On premolars, the buccal plate width decreased in three measuring points by 0.27 mm, 0.37 mm, and 0.25 mm. Conclusions: Piezocision-assisted orthodontic maxillary arch expansion does not cause evident negative changes of cortical plates except for the premolar region. Therefore, premolars may be at greater risk of buccal plate loss than other teeth

Evaluation of concordance between CAD/CAM and clinical positions of abutment shoulder against mucosal margin: an observational study

Abstract Background While working on CAD/CAM-customized abutments, the use of standard impression copings with a circular diameter produces inconsistency within the emergence profile. It may begin with a collapse of the supra-implant mucosa during impression taking, then lead to a computer-generated mismatch of the position and outline of the abutment shoulder, and consequently result in a compromised outcome of anticipated treatment. The aim of the study was to compare the virtual and clinical positions of the abutment shoulder in relation to the mucosal margin after the abutment delivery. Methods Conventional open-tray impression takings followed uncovering surgery. Master casts were scanned with a desktop scanner. Clinical examinations took place after abutment’s insertion and temporization (T1) and prior to cementation of the definitive crown (T2). The distances between the abutment shoulder and marginal soft tissue were measured intraorally in four aspects and juxtaposed with those on the virtual model. Results The study evaluated 257 dental implants and CAD/CAM-customized abutments. As T1 and T2 showed, there was a positive correlation between the virtually designed abutment shoulder position and matching clinical location relative to the mucosal margin. In 42.1% of cases, the distance between the mucosal margin and the abutment shoulder did not change. It increased in 36.3% of cases while a decrease occurred in 21.6% of them. Conclusions Computer-set position of the abutment shoulder in relation to the mucosal margin can be predictably implemented in clinical practice