Different modalities for treatment of recurrent aphthous stomatitis. A Randomized clinical trial

The underlying etiology of recurrent aphthous stomatitis (RAS) is unclear and treatment aims to provide symptomatic and faster relief. This study compared the efficacy of diode laser, a herbal combination of Acacia nilotica and Licorice (A and L) and Amlexanox in the management of RAS. Sixty patients with minor aphthae were selected and randomly divided into four groups of 15 each. Group I and II received adhesive preparations of a herbal mixture of A and L and a 2 mg Amlexanox paste respectively, group III received diode laser and the fourth group (control) used a placebo. Ulcer size, pain score were recorded on days 1, 2 and 5. Laser group showed the statistically highest mean percentage (%) of reduction in pain scores and ulcer size than the other groups. The mean % of reduction in pain scores was 43.3+20.0 at day 2 and 67.8+21.5 % at day 5 in the laser group while Amlexanox group demonstrated a 29.8 +11.3 and 61.9+24.5 mean % of reduction in pain scores at day 2 and 5 respectively. A and L group showed a lower mean % of reduction in pain scores than laser and Amlexanox groups with a 22.2+10.5 and 43.4+15.8 mean % reduction in pain scores at day 2 and day 5 respectively. Similarly the highest mean % of reduction in ulcer size was seen in the laser group being 52.7+19.8 at day 2 and 85.1+22.0 at day 5, while it was 48.1+16.5 at day 2 and 77.8+28.7 at day 5 in the Amlexanox group and 42.0+11.5 at day 2 and 63.0+20.5 at day 5 in the A and L group. All treatment modalities reduced pain and ulcer size than placebo group. Laser therapy demonstrated the highest percentage of reduction of pain score and ulcer size

Characterization and Cytotoxicity Analysis of a Ciprofloxacin Loaded Chitosan/Bioglass Scaffold on Cultured Human Periodontal Ligament Stem Cells: a Preliminary Report

AIM: The aim of this study was to analyze the cytotoxicity of ciprofloxacin (CIP) loaded on chitosan bioactive glass scaffold on human periodontal ligament stem cells (PLSCs) in vitro.MATERIALS AND METHODS: PLSCs obtained from human third molars, cultures treated with medium containing 15 x 15 mm chitosan/bioactive glass scaffolds without/with different concentration 0, 5, 10, and 20 % of CIP. A total of 15 x 10^3 cells were plated in 6 well plates. The attached cells of each group were harvested from the plates after 1, 4 and 8 days of culture to detect the viability of cells. The cell number was determined using a hemocytometer and the trypan blue dye-exclusion assay. Data was analyzed using normality using Shapiro-Wilk test. Comparisons between groups were made using One-way ANOVA complemented by Tukey's test.RESULTS: When comparing the proliferation rate of cells in the four groups, no statistically significant difference was found (P = 0.633). With regards to cell viability, no statistical difference was found between the 0, 5, and 10 % CIP concentrations, while the 20 % CIP concentration demonstrated the least viability with a high statistically significant difference (P = 0.003).CONCLUSION: Twenty percentages CIP demonstrated the least proliferation rate and viability

The Effect of Strontium Ranelate Gel on Bone Formation in Calvarial Critical Size Defects

AIM: The current study was designed to investigate the effectiveness of locally applied Strontium ranelate to induce bone formation.MATERIALS AND METHODS: Forty-eight female rats were divided into six groups (eight rats in each group): The three test groups included Strontium (SR) 2.5 mg, 5 mg and 10 mg that was dissolved in methylcellulose gel. The control groups included methylcellulose, simvastatin 5 mg and a negative control where the defect was left to heal without any intervention. At 44 days the groups were sacrificed, and the bone defects were assessed histomorphometically to assess bone formation. The data was statistically analysed.RESULTS: There was a statistically significant difference in the amount of new bone formation between all groups, where the 2.5 mg SR group showed the highest median bone percentage, is 41.95 %, followed by the 5, and 10 mg SR demonstrating a median bone are a percentage of 39.89%, and 30.19% respectively. Simvastatin showed a median bone percentage of 36.07 %, while the methylcellulose and the negative control groups demonstrated the lowest median area percentage of 23.12 and 20.70 % respectively.CONCLUSIONS: The study showed that the local application of an SR could up-regulate the bone formation and may prove to be a cost-effective method of bone regeneration

Maxillary Sinus Augmentation Using a Titanium Mesh: A Randomized Clinical Trial

BACKGROUND: Various attempts have been implemented using different materials and techniques to augment the maxillary sinus floor for prospect dental implant positioning.AIM: This contemplate was conducted to assess the osteogenic capability of the maxillary sinus in a two-step sinus membrane elevation using titanium mesh to keep the formed space to place dental implants in atrophic ridges.MATERIALS AND METHODS: Titanium micromesh was customized and positioned into the sinus on one side to preserve the elevated membrane in position. On the other side xenograft was applied. Instant and 6-months postoperative cone beam computed tomography (CBCT) was done to assess the gained bone height and density. Bone core biopsies were obtained during implant placement for histological and histomorphometric evaluation.RESULTS: The average bone height values increased in both groups. Meanwhile the average bone density value was higher at the graft group than the titanium mesh group. Histological and histomorphometric evaluation presented the average bone volume of the newly formed bone in the graft group which is superior to that of the titanium mesh group.CONCLUSION: The use of the titanium micromesh as a space-maintaining device after Schneiderian membrane elevation is a trustworthy technique to elevate the floor of the sinus without grafting

Evaluation of horizontal ridge augmentation using beta tricalcium phosphate and demineralized bone matrix: A comparative study

Objectives: To evaluate the effectiveness of beta tricalcium phosphate (Beta-TCP) alone compared to Beta-TCP and Demineralized Bone Matrix (DBM) in regenerating localized horizontal maxillary alveolar ridge deficiencies prior to implant placement. Study Design: The study included 20 patients with horizontal maxillary ridge deficiencies limited to one or more neighbouring teeth and initial ridge width of . 5mmm. Patients were divided equally into two equal groups. Ridge augmentation was performed using Guided Bone Regeneration (GBR) principals. In group I GBR was performed using Beta-TCP only, while in group II both Beta-TCP and DBM were used. Following a 6 months healing period, bone cores from both groups were retrieved and implants were inserted. Specimens were examined histologically to calculate percentage of mineralized bone. Apical and crestal changes in ridge dimensions were calculated by digital subtraction using Cone Beam Computed Tomography (CBCT) immediately after graft placement and six months later. Results: There was a statistically significant difference between the mean area percentage of mineralized bone between both groups where it was 40.1 % (range: 27.76-% 66.29 %) for group I and 68.96 % (range: 60.07 % - 87.33 %) for group II. Radiograpically, the mean ridge width in group I increased crestally to 4.66 mm (range:3.5-5mm) and apically to 6.12 mm (range: 4.1-6.7 mm). In group II the mean ridge width increased crestally to 5.2 mm (range 4.9-5.4mm) and apically to 6.9 mm (range 6.0-7.8 mm). Group II showed more bone gain with a mean of 1.37 mm crestally and 2.44 mm apically. This difference however was not statistically significant Conclusion: Within the limitations of this study the combination of DBM and Beta-TCP can be used effectively in cases exhibiting minimal alveolar ridge defects

Treatment of Gingival Hyperpigmentation by Diode Laser for Esthetical Purposes

BACKGROUND: Gingival hyperpigmentation is a common esthetical concern in patients with gummy smile or excessive gingival display. Laser ablation has been recognized recently as the most effective, pleasant and reliable technique. It has the advantage of easy handling, short treatment time, hemostasis, decontamination, and sterilization effect.AIM: In the present study we wanted to explore the efficacy of a 980 nm wavelength diode laser in gingival depigmentation clinically by using both VAS and digital imaging method as means of assessment.METHODS: Diode laser ablation was done for 15 patients who requested cosmetic therapy for melanin pigmented gums. The laser beam delivered by fiberoptic with a diameter of 320 µm, the diode laser system has 980 nm wave lengths and 3 W irradiation powers, in a continuous contact mode in all cases, the entire surface of each pigmented maxillary and mandibular gingiva that required treatment was irradiated in a single session. Clinical examination and digital image analysis were done and the patients were followed up for 3 successive months.RESULTS: There was a statistically significant change in prevalence of bleeding after treatment, as none of the cases showed any signs of bleeding 1 week, 1 month and 3 months after ablation. No statistically significant change was observed in the prevalence of swelling after treatment The VAS evaluation demonstrated that only 4 patients complained of mild pain immediately after the procedure. No pain was perceived from the patients in the rest of the follow up period. There was no statistically significant change in prevalence of pain immediately after treatment compared to pain during treatment. There was a decrease in cases with mild pain after 1 week, 1 month as well as 3 months compared to pain during treatment and immediately after treatment.CONCLUSION: Within the limitations of this study, the use of diode laser was shown to be a safe and effective treatment modality that provides optimal aesthetics with minimal discomfort in patients with gingival hyperpigmentation

Effect of Laser Therapy on the Osseointegration of Immediately Loaded Dental Implants in Patients under Vitamin C, Omega-3 and Calcium Therapy

BACKGROUND: The use of laser therapy in the biostimulation of bone repair has been growing steadily.AIM: This study aimed to evaluate the radio-densitometric effect of low-intensity laser therapy on the osseointegration of immediately loaded dental implants in patients under vitamin C, omega-3 and calcium therapy.PATIENTS AND METHODS:  A single implant was placed in the mandibular first molar region of twenty patients which were equally divided into two groups. In the non-laser group, the healing phase was left to progress spontaneously without any intervention, while in the laser group it was augmented with low-level laser therapy of wavelength 904 nm in contact mode, continuous wave, 20 mW output power and exposure time 30 sec with a dose 4.7 J/cm2. Patients in both groups were given vitamin C, calcium and omega-3 starting one month preoperatively. Postoperative digital panoramas were taken immediately after surgery, 1.5 months and 6 months postoperatively. Changes in bone density along the bone-implant interface at the mesial, distal and apical sides were assessed using the Digora software.RESULTS: Independent student t-test was used to compare means of variables between the laser and the non-laser group while repeated measures ANOVA was used to compare bone densities at different times for the same group. Significant increased differences were observed at the mesial, distal and apical sides surrounding the implants of both groups per time. However, the rate of increase was significantly higher in the laser group.  The mean difference at the mesial side after 6 months was 21.99 ± 5.48 in the laser group and 14.21 ± 4.95 in the non-laser group, while it read 21.74 ± 3.56 in the laser group and 10.78 ± 3.90 in non-laser group at the distal side and was 18.90 ± 5.91 in the laser group and 10.39 ± 3.49 in non-laser group at the apical side. Significance was recorded at P = 0.004, P = 0.0001, and 0.001 at the mesial, distal and apical sides respectively.CONCLUSION: The low-intensity laser irradiation significantly promoted bone healing and speeded up the osseointegration process emphasising the laser’s biostimulatory effect

Management of pain in oral lichen planus patients: a comparative pilot study

Abstract Background Treating oral lichen planus (OLP) is a big challenge for clinicians. Despite numerous existing remedies, to date, no effective cure has been found, which is mainly attributed to the lack of understanding of the pathogenesis of the disease. Our aim was to compare the effectiveness of topical steroids and diode laser in treating OLP patients. Twenty-four patients with OLP were allocated into two groups of 12 patients each. One group was treated with a 970-nm diode laser applied twice weekly and the other group was treated with topical steroids applied four times per day. Patients were followed up for 2 months. Pain was recorded using the visual analog scale (VAS) and the clinical signs and symptoms were recorded using the reticular, atrophic, erosive (RAE) sores. Pain and RAE records were taken before treatment, after treatment, and after 2 months. Results When pain and RAE scores were compared before and after treatment, a significant lower pain score (P = 0.020) and RAE scores (P = 0.025) were observed in the steroid group than the laser group. No significant differences in pain (P = 0.333) and RAE (P = 0.06) scores were observed between both groups in the follow-up. No significant difference was seen between the improvement parameters in the two groups (P = 0.117%), although better scores were seen in the steroid group. Conclusions Topical steroids reduce pain and RAE scores in OLP patients more than laser treatment. Trial registration NCT03572959, Registration date: 30th June 2018, retrospectively registere

A simple method to debond a cement-retained implant-supported fixed partial denture from its abutment screw connection: a case report

Abstract Background Screw loosening of a cement-retained, implant-supported fixed partial denture causes the abutment and restoration to be completely separated as one unit from the implant body. In such circumstances, drilling of an access hole through the restoration is made to retrieve the abutment screw connection, and a new restoration is then fabricated. Method This clinical case presents a patient whose implant-supported fixed partial denture was completely detached from the implants, and it was retrieved from the abutment’s screw connection using acetic acid (vinegar). Results The cement was dissolved and the fixed partial denture was easily separated from the abutment screw connections thus avoiding damage of the restoration. Conclusion A new and simple technique was described to retrieve the FPD restoration from the abutments’ screw connections using undiluted acetic acid (vinegar)

The Influence of Small, Midi, Medium and Large Fields of View on Accuracy of Linear Measurements in CBCT Imaging: Diagnostic Accuracy Study

AIM: This study aimed to assess the effect of changing the field of view on the dimensional accuracy of CBCT imaging. METHODS: The implant-bone models were randomly numbered from 1 to 13 by the principal researcher, and then on each model at the incisors region three positions were selected and marked on the model with a permanent blue marker. Then at each marked position three radio-opaque ‘RO’ markers “gutta-percha pieces†were glued on the model surfaces as following; two pieces on the facial surface one occlusally (at the alveolar crest) and one apically (at the inferior border of the model) both were on the same vertical line and perpendicular to the horizontal plane, while the third one was placed on the lingual surface opposing the occlusally placed buccal piece. CBCT examinations of each bone model were performed using Cranex3Dx CBCT (Helsinki, Finland) machine. Each model was scanned four times with standardised tube current and voltage of 12.5 mA and 90 kVp respectively at four different FOVs. The FOVs used were as following: Small FOV: 50 x 50 mm with voxel size 200 µm, Midi FOV: 61 x 78 mm with voxel size 300 µm, Medium FOV: 78 x 78 mm with voxel size 300 µm, Large FOV: 78 x 150 mm with voxel size 350 µm. The reference standard in this study was the real linear measurements that were obtained directly on the implant-bone models using high precision sliding electronic digital calliper with 0-150 mm internal and external measuring range and 0.01 mm resolution accuracy. The index test in the current study was the CBCT linear measurements obtained from CBCT images of implant-bone models using small, midi, medium and large FOVs. RESULTS: The results of this study showed that both medium and large FOVs showed a statistically significant difference, which could be translated into clinical relevance only in thickness measurements. CONCLUSION: The interpretation of these results leads to the assumption that increasing the FOV size together with voxel size could adversely affect the accuracy of CBCT linear measurements, especially when small distances are to be assessed