Relationship of Anxiety and Depression in Patients with Chronic Periodontitis

Objectives Many researchers have attempted to link the current concepts of anxiety and depression to periodontal disease. This study aimed to compare the level of anxiety and depression in Iranian patients with chronic periodontitis (CP) and periodontally healthy controls.Methods Fifty CP patients and 50 periodontally healthy controls participated in this study according to our eligibility criteria. Periodontal clinical examination was performed using a Williams probe. The clinical attachment loss (CAL), pocket probing depth (PPD) and bleeding on probing (BOP) were recorded for all teeth except for third molars. In order to psychologically assess the individuals, the Beck’s Depression Inventory (BDI) and the Beck’s Anxiety Inventory (BAI) were used. The mean scores of BAI and BDI were compared between the two groups using the Student t-test.Results The mean age of participants was 44.86±8.07 years. The mean score of BDI was 13.58±8.35 in periodontally healthy controls and 25.62±13.01 in CP patients. The mean score of BAI was 9.9±5.65 in the control and 21.02±13.63 in the test group. The Student t-test revealed a significant difference between the two groups in total score of BDI and BAI (P<0.000). A significant correlation was noted between the BDI and age (P=0.027) but BAI had no significant correlation with age (P=0.245).Conclusion According to the results of this study, the level of anxiety and depression in CP patients was higher than that in periodontally healthy controls in our study populatio

Comparison of Marginal Bone Loss in Simultaneous Versus Delayed Implant Placement Following Horizontal Ridge Augmentation with Autogenous Lateral Ramus Bone Block

Statement of the Problem: Alveolar ridge resorption after tooth extraction may interfere with optimal dental implant placement.Purpose: This study aimed to compare the marginal bone loss (MBL) and thickness of the buccal aspect of the augmented site in simultaneous versus delayed implant placement following lateral ramus horizontal ridge augmentation in the posterior mandible.Materials and Method: This prospective cohort study was conducted on patients who required horizontal bone augmentation of the posterior mandible using lateral ramus autogenous bone graft. Patients were divided into two groups of simultaneous implant placement (group 1) and delayed implant placement (group 2). Cone-beam computed tomography (CBCT) images were obtained before augmentation, at the time of implant placement, and 10 months later (6 months after implant loading). MBL and thickness of the buccal aspect were evaluated over time.Results: There were 18 patients in the group 1 and 16 patients in the group 2. Analysis of the CBCT scans demonstrated that the mean MBL was 1.21±0.35mm in the group 1 and 1.08±0.19mm in the group 2, with no significant difference between the two groups (p= 0.19). Thickness of the buccal aspect of the augmented site at the time of implant placement was 1.85±0.20mm in the group 1 and 2.16±0.29 mm in the group 2, with a significant difference (p< 0.001). However, data analysis regarding changes in the buccal plate thickness showed no significant difference between the two groups (p= 0.36).Conclusion: According to the results of this study, there was no significant difference in M-BL and post-operative changes in the thickness of the buccal aspect of the augmented sites with onlay lateral ramus bone blocks between simultaneous and delayed implant placement

A Case Report of Ruptured Superficial Femoral Artery Aneurysm

Single superficial femoral artery (SFA) aneurysm is rare and occurs in approximately 5 per 100,000 patients. Rupture is a rare complication in this aneurysm. In this case report, we present the diagnostic and therapeutic work up of a ruptured SFA aneurysm of the right lower limb in a 75-year-old diabetic man with ischemic heart disease. Pre-surgical diagnosis was through physical examination findings and color Doppler flow imaging. The defective part of the artery was resected and then reconstructed through autologous saphenous vein grafting harvested from the opposite limb. No early post-surgical complication was observed. If a pulsatile mass is found in the thigh, the SFA aneurysm should be considered as a differential diagnosis to prevent premature death and lower limb amputation by timely surgery

Reconstruction of a Severe Mandibular Atrophic Ridge with Autogenous Iliac and Rib Bone Grafts

Introduction: Prosthetic rehabilitation requires sufficient hard and soft tissues. In this article, a case of severe mandibular atrophic ridge is presented, which has been treated with autogenous iliac and rib bone grafts and simultaneous nerve transposition with an extraoral approach.Case Report: The patient was a 56-year old female with severe mandibuar atrophic ridge. The prosthetic rehabilitation for this patient was performed in four stages: 1) reconstruction of mandibular atrophic ridge using autogenous iliac and rib bone graft with simultaneous inferior nerve transposition through an extraoral approach, 2) insertion of four implant fixtures in reconstructed mandibular ridge after six months, 3) buccal and lingual vestibuloplsty and free gingival graft and loading of healing abutments, three months later, and 4) prosthetic rehabilitation after two months. Following stage four, a mandibular hybrid prosthesis on four implants with a maxillary removable complete denture were delivered to the patient. Results: Following four stages of surgical and prosthetic procedures, rehabilitation of a severe mandibular atrophic ridge was done with autogenous iliac and rib bone grafts, simultaneous inferior alveolar nerve transposition and a mandibular hybrid prosthesis on four implants. Further follow up of the patient will reveal the outcomes of this procedure. Conclusion:  This procedure can be suggested in the case of severe mandibular atrophic ridges which need inferior border augmentation and superior border vertical and horizontal augmentation at the same time

Effect of Curing Time on Micro shear Bond Strength of Enamel and Dentin Bonding Agents to Enamel

Introduction: The bond strength to enamel may be simply improved by increasing the polymerization rate via prolonging the curing time. This study sought to assess the effect of increasing the curing time on microshear bond strength of enamel (Heliobond) and dentin (Excite) bonding agents to enamel. Materials and Methods: 90 extracted, sound human molar teeth randomly divided into six groups. In group 1, the enamel surfaces etched 30 seconds and were rinsed for 30 seconds. After drying, Heliobond was applied and light cured for 10 seconds, in groups 2 and 3, the curing time was 20 and 40 seconds, respectively. In group 4, specimens were prepared as in group 1 except that Excite dentin bonding agent was used.  Groups 5 and 6 were prepared as in group 4 but the curing time was 20 and 40 seconds, respectively. The microshear bond strength of specimens was measured using micro tensile tester and analyzed. The mode of failure of specimens was evaluated under a microscope. Results: Two-way ANOVA showed significant differences in bond strength of Heliobond and Excite specimens cured for different times. However, no significant difference was noted in microshear bond strength of specimens cured for 10 and 20 seconds (neither in Excite nor in Heliobond groups). Pairwise comparison of groups revealed significant differences between specimens cured for 10 and 20 seconds with 40 seconds curing times. The overall microshear bond strength of specimens in Heliobond groups was significantly higher than that of Excite groups. The mode of failure of groups bonded with Heliobond and Excite was not significantly different. Conclusion: Within the limitations of this study, prolonging the curing time up to the certain time significantly increased the micro shear bond strength of both enamel (Heliobond) and dentin (Excite) bonding agents to enamel

Knowledge and Attitude of Iranian Dental Students and Specialists about Obstructive Sleep Apnea

Objective Obstructive sleep apnea (OSA) is a relatively common sleep disorder, which leads to multiple sleep arousals and hypoxemia. We aimed to assess the knowledge and attitude of students and faculty members of ShahidBeheshti Dental School, Tehran, Iran about OSA. MethodsWe conducted a cross-sectional study on undergraduate and postgraduate students and faculty members of oral and maxillofacial (OMF) surgery, orthodontics, and oral medicine departments of ShahidBeheshti Dental School. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) questionnaire was used to obtain information. We used the Chi-square, Kruskal Wallis, and Mann-Whitney U tests for statistical analysis. The data were analyzed by SPSS 22.0 (α &lt;0.05). Results One hundred ninety-seven participants, including 43 dental students, 68 postgraduate students, and 64 faculty members filled out the questionnaire. The mean knowledge score among all participants was 10.69±3.133. Overall, OMF medicine and OMF surgeryfaculty members had significantly higher correct answer choices in the knowledge section than fifth and sixth-year dental students (P&lt;0.001). There was no significant difference among other groups (P&gt;0.05). About attitude, 91% of respondents reported that OSA is an important or extremely important disorder. However, only 10.2% and 16.9% felt confident about the ability to manage patients with OSA and identifying patients at risk of OSA, respectively. Overall, gender and educational level were correlated with the mean attitude score (P&lt;0.05). Conclusion All participants had poor knowledge but a positive attitude towards OSA. This shows the necessity of better education about OSA

Effect of Non-Surgical Therapy on Receptor Activator Level of Salivary Nuclear Factor Kappa B Ligand and Osteoprotegerin in Chronic Periodontitis: A Prospective Cohort Study

Introduction: The receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) are molecules that play a significant role in bone resorption. The aim of this study was to evaluate the effect of periodontal therapy on the salivary levels of RANKL, OPG, and their relative ratio in patients with chronic periodontitis. Materials and Methods: This prospective cohort study was conducted and twenty-five patients with chronic periodontitis and 25 volunteers with healthy periodontium were recruited in this study. All the patients received scaling and root planing (SRP) combined with oral hygiene instructions (OHI).&nbsp; Five mL unstimulated saliva sample was collected from all individuals at baseline and four weeks after periodontal therapy. Salivary RANKL and OPG concentrations were determined by enzyme -linked immunosorbent assays (ELISA). Demographic and clinical vari¬ables were compared between the groups using Fisher’s exact test. Comparisons of indices and analyses between the test and control groups were performed by independent t-test and Mann-Whitney U test. The correlations between the salivary and periodontal parameters were evaluated by Spearman correlation coefficient test. Results: SRP improved all examined clinical parameters, and the RANKL concentration and sRANKL/OPG ratio decreased significantly in the saliva after the treatment (p=0.012 and p=0.011). However, no significant change was found for OPG (p=0.840). Conclusion: Our observations indicated that non-surgical periodontal treatment significantly reduced the RANKL and sRANKL/OPG levels. Salivary levels of RANKL and sRANKL/OPG reflected the disease response to therapy, which is suitable for monitoring the results of periodontal treatment

Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis

Abstract Background This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region. Main text We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane’s CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case–control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran’s Q test and the I 2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. Conclusions Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone