Turned versus anodised dental implants: a meta‐analysis

The aim of this meta‐analysis was to test the null hypothesis of no difference in the implant failure rates, marginal bone loss (MBL)and post‐operative infection for patients being rehabilitated by turned versus anodised‐surface implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in November 2015. Eligibility criteria included clinical human studies, either randomised or not. Thirty‐eight publications were included. The results suggest a risk ratio of 2·82 (95% CI 1·95–4·06, P < 0·00001) for failure of turned implants, when compared to anodised‐surface implants. Sensitivity analyses showed similar results when only the studies inserting implants in maxillae or mandibles were pooled. There were no statistically significant effects of turned implants on the MBL (mean difference‐MD 0·02, 95%CI ?0·16–0·20; P = 0·82) in comparison to anodised implants. The results of a meta‐regression considering the follow‐up period as a covariate suggested an increase of the MD with the increase in the follow‐up time (MD increase 0·012 mm year^?1), however, without a statistical significance (P = 0·813). Due to lack of satisfactory information, meta‐analysis for the outcome ‘post‐operative infection’ was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.     

Efficacy of low‐level laser therapy in the treatment of TMDs: a meta‐analysis of 14 randomised controlled trials

This study was designed to evaluate the efficacy of low‐level laser therapy (LLLT) in the treatment of temporomandibular disorders (TMDs). We searched electronic databases and references lists of relevant articles, retrieved all of the published randomised controlled trials in regard to these issues and then performed a meta‐analysis. Fourteen highly qualified RCTs reporting on a total of 454 patients, which evaluated the effectiveness of LLLT for patients suffering from TMDs were retrieved. The results indicated that LLLT was not better than placebo in reducing chronic TMD pain (weighted mean difference = ?19·39; 95% confidence interval = ?40·80–2·03; P < 0·00001; I² = 99%). However, the LLLT provided significant better functional outcomes in terms of maximum active vertical opening (MAVO) (weighted mean difference = 4·18; 95% confidence interval = 0·73–7·63; P = 0·006; I² = 73%), maximum passive vertical opening (MPVO) (weighted mean difference = 6·73; 95% confidence interval = 01·34–12·13; P = 0·06; I² = 73%), protrusion excursion (PE) (weighted mean difference = 1·81; 95% confidence interval = 0·79–2·83; P = 0·59; I² = 0%) and right lateral excursion (RLE) (weighted mean difference = 2·86; 95% confidence interval = 1·27–4·45; P = 0·01; I² = 73%). The results of our meta‐analysis have provided the best evidence on the efficacy of LLLT in the treatment of TMDs. This study indicates that using LLLT has limited efficacy in reducing pain in patients with TMDs. However, LLLT can significantly improve the functional outcomes of patients with TMDs.     

Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue integration: I. Instrument positioning,bone structure,implant length

Aim: To monitor longitudinally the development of implant stability of SLA Straumann^® tissue‐level implants using resonance frequency analysis (RFA) and to determine the influence of instrument positioning, bone structure and implant length on the assessment of RFA. Material and methods: Thirty‐two healthy adult patients received either 8 mm, ?4.1 mm Straumann^® Standard Plus tissue‐level implants (n=16: Group A) or 10 mm, ?4.1 mm Straumann^® Standard Plus tissue‐level implants (n=16: Group B). During healing, RFA was performed on Weeks 0,1, 2, 3, 4, 5, 6, 8 and 12. The implants were restored after 10 weeks (impression taking) and 12 weeks. In addition, probing depth, presence of plaque and bleeding on probing were assessed. Implant stability quotient (ISQ) values of Groups A and B were compared using unpaired t‐tests and longitudinally applying paired t‐tests between Week 0 and the subsequent time points. Results: Positioning of the Osstell^?mentor device did not affect the ISQ values. Generally, ISQ values increased continuously during healing from a mean of 65.1 (SD 16.97) to 74.7 (SD 5.17) (significantly from Week 0 to Weeks 6, 8 and 12). Lower bone density (Type III or IV) resulted in significantly lower ISQ values up to Week 8. Implant length affected the increase in ISQ values over time. While no significant increase was observed with 10 mm implants, ISQ values of 8 mm implants increased significantly from Week 0 to Weeks 6, 8 and 12. Conclusions: Using Osstell^?mentor, ISQ values are reproducible irrespective of instrument positioning. ISQ values are affected by the bone structure and implant length. Hence, no predictive values can be attributed to implant stability. To cite this article:
Sim CPC, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell^?mentor during implant tissue integration: I. Instrument positioning, bone structure, implant length.
Clin. Oral Impl. Res. 21 , 2010; 598–604.
doi: 10.1111/j.1600‐0501.2009.01878.x     

Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised‐controlled trial

To evaluate the effect of adding transcranial direct current stimulation (tDCS) to exercises for chronic pain, dysfunction and quality of life in subjects with temporomandibular disorders (TMD). Participants were selected based on the RDC/TMD criteria and assessed for pain intensity, pressure pain threshold over temporomandibular joint and cervical muscles and quality of life. After initial assessment, all individuals underwent a 4‐week protocol of exercises and manual therapy, together with active or sham primary motor cortex tDCS. Stimulation was delivered through sponge electrodes, with 2 mA amplitude, for 20 min daily, over the first 5 days of the trial. A total of 32 subjects (mean age 24·7 ± 6·8 years) participated in the evaluations and treatment protocol. Mean pain intensity pre‐treatment was 5·5 ± 1·4 for active tDCS group, and 6·3 ± 1·2 for sham tDCS. Both groups showed a decrease in pain intensity scores during the trial period (time factor – F_4·5,137·5 = 28·7, P < 0·001; group factor – F_1·0,30·0 = 7·7, P < 0·05). However, there were no differences between the groups regarding change in pain intensity (time*group interaction – F_4·5,137·5 = 1·5, P = 0·137). This result remained the same after 5 months (t‐test t = 0·29, P > 0·05). Pressure pain thresholds decrease and improvement in quality of life were also noticeable in both groups, but again without significant differences between them. Absolute benefit increase was 37·5% (CI 95%: ?15·9% to 90·9%), and number needed to treat was 2·66. This study suggests that there is no additional benefit in adding tDCS to exercises for the treatment of chronic TMD in young adults.     

Occlusal tooth wear in Chinese adults with shortened dental arches

To assess associations between occlusal tooth wear and shortened dental arches (SDA) in Chinese 40 years and older subjects. From a sample of 1462 urban and rural adults, those presenting with SDA (n = 150) were compared with a control group of 65 randomly selected subjects with complete dentitions (CDA). Occlusal wear was assessed using a modified Smith and Knight index – the occlusal tooth wear index (OWTI) – and analysed using multivariate (logistic) regression. There was no significant effect from SDA on severe occlusal wear (OTWI score 3 or 4: OR = 2·016; 95% CI = 0·960–4·231; P = 0·064). Higher age was associated with severe occlusal wear (P values ≤0·007) and with higher mean OTWI scores; urban had less often severe occlusal wear than rural residents (OR = 0·519; P = 0·008). Higher mean OTWI scores were associated with rural residents, except for anterior teeth. Females had lower mean OTWI score for anterior teeth (effect = ?0·153; P = 0·030). Premolars in SDA had higher mean OTWI scores compared with those in CDA (effect = +0·213; P = 0·006). In SDA, more posterior occluding pairs (POPs) were associated with lower mean OTWI sores for anterior teeth (effect: ?0·158; P = 0·008) and higher scores for molars (effect: +0·249, P = 0·003). Subjects with SDA or CDA presented comparable occlusal wear, but premolars in SDA tend to have higher probability for having occlusal wear. Fewer numbers of POPs were associated with more wear in anterior teeth.     

In Vitro Assessment of Primary Stability of Straumann® Implant Designs

Background: Primary implant stability (PS) is one of the main factors influencing implant survival rate. Several methods to determine the PS have been used, such as Periotest values (PVs) and resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. Purpose: The aim of this study was to compare different implant designs in regard to PS assessed by Periotest and RFA in vitro. Materials and Methods: A total of 90 implants were placed in freshly slaughtered cow ribs. The implants (Straumann®, Institute Straumann AG, Basel, Switzerland; length 10 mm, ø3.3 mm) had the following three designs: Bone Level (BL, 30 implants), Standard Plus (SP, 30 implants), and Tapered Effect (TE, 30 implants). Before implant placement, the investigator was calibrated for every design according to the manufacturer's instructions. An independent observer, blinded to the study, assessed the accuracy of placement. RFA based on the Osstell device and PVs were performed after abutment connection. One‐way analysis of variance and Tukey's post hoc test were used for statistical evaluation. Results: All implants were mechanically stable. The mean PV for BL was ?4.67(± 1.18), for SP, ?6.07(± 0.94), and for TE, ?6.57(± 0.57). The mean ISQ values were 75.02(± 3.65), 75.98(± 3.00), and 79.83(± 1.85), respectively. The one‐way ANOVA showed significant difference among three implant designs in PV (p < .0001) and for the ISQ between BL/TE or SP/TE implants (p < .0001). In addition, the Tukey's (pair‐wise comparison) test showed significant differences in PV and RFA between the BL/TE (p < .0001). Conclusion: Within the limitations of this study, higher implant stability was found for tapered designed implants.     

Oral health and caries related microflora in children during the first three months following renal transplantation

There is little information on the oral health of children undergoing renal transplantation during the early transplant period. Methods. Twenty‐four children undergoing renal transplantation aged 4–13·2 years and their matched controls were recruited. The dmfs, dmft, DMFS and DMFT, plaque, gingivitis and gingival enlargement scores were recorded. The oral microflora was sampled and cultured for S. mutans, Lactobacllus species and Candida species. Results. There was a significantly lower mean dmfs (0·3 ± 0·9; P = 0·03), dmft (0·3 ± 0·9; P = 0·03), DMFS (2·3 ± 5·3; P = 0·01) and DMFT (1·5 ± 2·6; P = 0·02), respectively, in the transplant group. There was a significantly greater mean plaque score (14·7 ± 11) for the permanent dentition, at baseline only, compared with 90 days post‐transplantation (9·4 ± 10·4; P = 0·02). There was a significantly greater gingival enlargement score (1·8 ± 1·4; P = 0·04) 90 days post‐transplantation compared with baseline. The S. mutans and Lactobacillus counts were significantly lower both at baseline (P = 0·0001 and P = 0·004) and 90 days post‐transplantation (P = 0·02; and P = 0·05), respectively, compared with the controls. Conclusions. The transplant children had less active dental disease than the controls although gingival enlargement needs careful monitoring.     

Diagnosis of implant stability and its impact on implant survival: a prospective case series study

Objectives: To assess the predictability of implant stability assessment either clinically or by resonance frequency analysis (RFA). Material and methods: This prospective case series study evaluated 4114 consecutive SLA Straumann^® implants in two private clinics. Primary stability was classified in four categories, depending on the degree of implant rotation when tightening the healing cap: A (no rotation at all), B (light rotation with a feeling of resistance), C (rotation without resistance) and D (rotation and lateral oscillation). In one clinic (n=542 implants), RFA method was also used the day of the surgery (Osstell 1) and at restoration placement (Osstell 2). Survival rates were stratified according to the clinical classification categories using life table analysis. The association between Osstell 1 and 2 and the clinical classification was tested with ANOVA. Results: 3899 implants were classified as stable (A) and 213 as unstable (B–D). Their survival rates were 99.1% and 97.2%, respectively. The unstable implants were further classified in B (158), C (51) and D (4), with survivals of 98.1%, 94.1% and 100%, respectively, being these differences statistically significant (P<0.009). Using Osstell^®, implants were stratified in two groups according to a predefined threshold of implant stability quotient (≥60). At the Osstell 1 measurement there was no significant association between primary stability and implant survival (P<0.753). In Osstell 2, however, the association was significant (P<0.001). Conclusions: Only secondary stability RFA values were able to significantly predict implant outcomes, but not primary stability values. There was a good correlation between RFA and the proposed clinical classification of primary stability. To cite this article:
Rodrigo D, Aracil L, Martin C, Sanz M. Diagnosis of implant stability and its impact on implant survival: a prospective case series study.
Clin. Oral Impl. Res. 21 , 2010; 255–261.
doi: 10.1111/j.1600‐0501.2009.01820.x     

Ten‐Year Retrospective Follow‐Up Study of the TiOblast™ Dental Implant

Purpose: Long‐term results in the clinical outcome of different implant systems, including high patient numbers and a long follow‐up time, are rare. This retrospective study evaluated the cumulative survival rate of a self‐tapping, cylindrical implant system with a conical implant‐abutment connection after 10 years of prosthetic loading. Materials and Methods: A total of 516 TiOblast? implants (Astra Tech AB, Mölndal, Sweden) were placed in 108 patients. The patients were treated in the Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University, Mainz, Germany, between September 1994 and May 2005. The main indications for implantation were the treatment of edentulous mandibles (74%) and partial edentulism (15%). Twenty‐three implants were placed postradiation, and a further 64 implants were irradiated after insertion. In 153 implants, a bony augmentation was conducted prior to implantation. Results: The in situ rate was 89.7% after an average implantation time of 108 months. Eighty‐three patients with 403 implants were available for investigation. Seventeen patients with 76 implants have died since 1994. Absence of osseointegration (n = 22), peri‐implantitis (n = 18), fracture of the implants (n = 9), failing of primary stability (n = 2), and implants next to tumors (n = 2) were the reasons of explantation in 26 patients. Under analysis with different implant success‐assessment criteria, the success rate showed results from 76 to 89%. Conclusion: With respect to the critical patient selection including a high number of patients with minor and major augmentations, the 10‐year clinical use of the studied implant system showed acceptable results.     

Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue integration: II. Implant surface modifications and implant diameter

Objectives: To monitor the development of the stability of Straumann^® tissue‐level implants during the early phases of healing by resonance frequency analysis (RFA) and to determine the influence of implant surface modification and diameter. Material and methods: A total of twenty‐five 10 mm length implants including 12 SLA RN ?4.1 mm implants, eight SLActive RN ?4.1 mm implants and five SLA WN ?4.8 mm implants were placed. Implant stability quotient (ISQ) values were determined with Osstell^?mentor at baseline, 4 days, 1, 2, 3, 4, 6, 8 and 12 weeks post‐surgery. ISQ values were compared between implant types using unpaired t‐tests and longitudinally within implant types using paired t‐tests. Results: During healing, ISQ decreased by 3–4 values after installation and reached the lowest values at 3 weeks. Following this, the ISQ values increased steadily for all implants and up to 12 weeks. No significant differences were noted over time. The longitudinal changes in the ISQ values showed the same patterns for SLA implants, SLActive implants and WB implants. At placement, the mean ISQ values were 72.6, 75.7 and 74.4, respectively. The mean lowest ISQ values, recorded at 3 weeks, were 69.9, 71.4 and 69.8, respectively. At 12 weeks, the mean ISQ values were 76.5, 78.8 and 77.8, respectively. The mean ISQ values at all observation periods did not differ significantly among the various types. Single ISQ values ranged from 55 to 84 during the entire healing period. Pocket probing depths of the implants ranged from 1 to 3 mm and bleeding on probing from 0 to 2 sites/implant post‐surgically. Conclusions: All ISQ values indicated the stability of Straumann^® implants over a 12‐week healing period. All implants showed a slight decrease after installation, with the lowest ISQ values being reached at 3 weeks. ISQ values were restored 8 weeks post‐surgically. It is recommended to monitor implant stability by RFA at 3 and 8 weeks post‐surgically. However, neither implant surface modifications (SLActive) nor implant diameter were revealed by RFA. To cite this article:
Han J, Lulic M, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell^?mentor during implant tissue integration: II. Implant surface modifications and implant diameter.
Clin. Oral Impl. Res. 21 , 2010; 605–611.
doi: 10.1111/j.1600‐0501.2009.01909.x     

Influence of bony defects on implant stability

Introduction: The purpose of this study was to analyze the evolution of implant mechanical stability in different types/sizes of bony defects using both Periotest and Osstell devices as “objective tools.” Materials and methods: Thirty‐two implants were randomly allocated to one of the four types of bone defects: marginal bone loss, peri‐apical bone defect, constant width dehiscence and constant length dehiscences. Periotest/Osstell measurements were completed before and during staged bone removal (to enlarge defect size). Results: Significant differences (P<0.05) with initial values were found after a 2 mm marginal bone removal (Osstell/Periotest); for a peri‐apical bone lesion, after removal of 5 mm (Osstell) or 8 mm (Periotest); for a 6‐mm‐long dehiscence, after removal up to 180° of the implant perimeter (Osstell/Periotest); for a 3‐mm‐wide dehiscence, after removal of 10 mm (Osstell) or 6 mm (Periotest). Conclusion: Periotest and Osstell are in general not very sensitive in the identification of peri‐implant bone destruction, except for marginal bone loss. To cite this article:
Merheb J, Coucke W, Jacobs R, Naert I, Quirynen M. Influence of bony defects on implant stability.
Clin. Oral Impl. Res. 21 , 2010; 919–923.
doi: 10.1111/j.1600‐0501.2010.01932.x     

The efficacy of non‐narcotic analgesics on post‐operative endodontic pain: A systematic review and meta‐analysis

The objective of this review was to evaluate the efficacy of non‐narcotic analgesics including non‐steroidal anti‐inflammatory drugs (NSAIDs) and/or paracetamol in the treatment of post‐operative endodontic pain. Additionally, we aimed to examine the possible association of study covariates on the pain scores using meta‐regression analysis. An electronic search was performed in 2016. After data extraction and quality assessment of the included studies (n = 27, representing 2188 patients), meta‐analysis was performed using a random‐effect inverse variance method. Meta‐regression analysis was conducted to examine the associations between effect sizes and study‐level covariates (P < 0·05). The results showed that administration of non‐narcotic analgesic was more effective than placebo in the management of post‐operative pain, resulting in a lower pain scores with a standardised mean difference of ?0·50 (95% CI= ?0·70, ?0·30), ?0·76 (95%CI= ?0·95, ?0·56), ?1·15 (95% CI= ?1·52, ?0·78), ?0·65 (95% CI= ?1·05, ?0·26) for immediately after the procedure, 6?, 12? and 24 h post?operative follow‐ups (test for statistical heterogeneity: P = 0·000, P = 0·000, P = 0·000 and P = 0·001), respectively. Our meta‐regression analysis provided the evidence for association between some study covariates with treatment effect, each at different follow‐ups. We concluded that the clinicians can manage post‐operative endodontic pain by administration of NSAIDs and/or paracetamol. However, analgesic regimens should be considered as important determinants when prescribing a pharmacological adjuvant.     

上下颌后牙区单颗SLA和SLActive种植体共振频率分析比较

目的    应用共振频率分析法使用共振频率分析仪Osstell ISQ对比大颗粒喷砂酸蚀（SLA）和亲水性大颗粒喷砂酸蚀（SLActive）2种表面种植体的种植体稳定系数（ISQ）变化趋势,评价SLActive种植体临床预期性。方法    2011年1—9月就诊于广东省佛山市第二人民医院口腔修复中心的上下颌后牙区部分牙缺失患者55例,后牙区被植入33颗SLA种植体（SLA组）和34颗SLActive种植体（SLActive组）,对比测量术后即刻、2周、4周、6周、12周种植体稳定性。结果    2组对比ISQ在术后2、4、6及12周的变化差异均有统计学意义（均P＜0.05）,而术后即刻差异无统计学意义（P＞0.05）。结论      SLActive能促进骨结合,缩短愈合时间,增加临床预期性。     

Primary stability measurements of single implants in the midline of the edentulous mandible for overdentures

Objectives: To determine the primary stability of the Southern wide diameter (8 mm) implants, Neoss regular diameter (4 mm) implants, and Southern regular diameter (3.75 mm) implants placed in the midline of edentulous mandibles for single‐implant overdentures. Variables related to host site and implant characteristics were investigated to determine their influence on the primary stability of the implants. Materials and methods: A total of 36 implants were placed in the midline symphysis of the edentulous mandibles of 36 participants. Their primary stability was then measured using the magnetic Osstell mentor device. Analysis of variance (ANOVA) was used to compare the mean implant stability quotient (ISQ) scores with one‐way ANOVA for multiple comparisons. Results: The highest measurement (ISQ) of primary stability was for the Southern 8 mm wide diameter implants (84.8, SD 9.8), followed by the Neoss 4 mm regular diameter (82.3, SD 4.8) implants and the Southern 3.75 mm regular diameter implants (75.3, SD 8.4), respectively. The Southern 3.75 mm regular diameter implants had a significantly lower mean ISQ value than the same system 8 mm wide diameter (P=0.004) and the Neoss 4 mm regular diameter implants (P=0.03). No significant differences were observed between the 8 mm and the 4 mm diameter implants (P>0.05). Conclusions: Host‐site variables such as age, gender, bone volume, and quality do not appear to influence the primary stability of the implants. No clear correlation was established between ISQ values and implant diameter. To cite this article:
Alsabeeha NHM, De Silva RK, Thomson WM, Payne AGT. Primary stability measurements of single implants in the midline of the edentulous mandible for overdentures.
Clin. Oral Impl. Res. 21 , 2010; 563–566.
doi: 10.1111/j.1600‐0501.2009.01890.x     

��������������SLA��SLActive��ֲ�干��Ƶ�ʷ����Ƚ�

??Objective    The difference of implant stability quotient??ISQ??was compared between SLA and SLActive implants in the posterior mandible and maxilla by resonance frequency analysis??RFA?? in order to evaluate the clinical predictability of Straumann SLActive implants. Methods    Totally 33 SLA and 34 SLActive implants were placed in the posterior mandible and maxilla of 55 patients. Each implant was tested by Osstell ISQ for RFA after being inserted for 0??2??4??6??and 12 weeks. Results    Significant differences of ISQ were observed in the two groups ??SLA and SLActive?? after being implanted for 2??4??6??and 12 weeks. However??there was no significant difference after 0 week. Conclusion    SLActive exhibits the advantages of improving osseointegration??shortening the healing time??and increasing the clinical predictability.     

Comparison of utility weighted DMFT with patient‐reported oral well‐being

This study investigated a method of measuring oral health, as opposed to measuring disease. The objective was to compare DMF score and whole mouth utility scores to a patient‐reported outcome measure (PROM). Disutility values for lost and restored teeth were used to weight the decayed, missing and filled teeths(DMFTs) of 10 adult patients. This gave two whole mouth utility scores (WMU). These scores were then compared with a patient‐reported oral health outcome measure recorded by the use of a visual analogue scale (VAS). The anchors for the VAS were ‘my mouth could not be worse’ and ‘my mouth could not be better’. There was a positive correlation (r = 0·6457) between WMU1 and the patient‐reported outcome measure (P < 0·05) and a negative correlation (r = ?0·8383) between WMU1 and DMFT which was significant at the P < 0·01 level. There was a statistically significant positive correlation of r = 0·7926 between WMU2 and the patient‐reported outcome measure (P < 0·01) and a negative correlation (r = ?0·9393) between WMU2 and DMFT (P < 0·01). The Pearson's correlation between DMFT and the patient‐reported outcome measure was ?0·8757, which was significant at the 0·01 level. Patient reports of their perceived level of health correlate well with DMFT scores. Weighting DMFT scores according to the differential values assigned to missing, or missing and filled, teeth does not increase the degree of correlation between the measure and the patients’ personal quantification of their oral health. Decayed, missing and filled teeth therefore seems to adequately capture the patient's sense of well‐being.     

Efficacy of statin delivery as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A meta‐analysis

The action of statins in stimulating bone formation and having other pleiotropic effects, such as anti‐inflammatory and immunomodulatory effects, has justified their use as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). The aim of the present study was to evaluate the efficacy of statin delivery as an adjunct to SRP in the treatment of CP. Electronic searches were conducted using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, up until July 2017. The primary outcome was probing depth (PD), while the secondary outcomes were changes in clinical attachment level (CAL) and bone defect (BD) fill. Eleven studies were included, and all showed significant PD reduction, CAL gain, and BD fill with adjunctive statin delivery compared to SRP alone. The meta‐analysis showed significant improvement in periodontal parameters for atorvastatin (PD: weighted mean difference [WMD] = ?1.84, ?2.56 to ?1.12, P < .001; CAL: WMD = ?2.31, ?3.58 to ?1.03, P < .001; BD fill: WMD = 2.66, ?3.92 to ?1.39, P < .001), simvastatin (PD: WMD = ?1.91, ?2.27 to ?1.55, P < .001; CAL: WMD = ?1.91, ?2.27 to ?1.55, P = .001; BD: WMD = ?1.52, ?2.20 to ?0.85, P < .001), and rosuvastatin (PD: WMD = ?0.94, ?1.32 to ?0.55, P < .001; CAL: WMD = ?1.00, ?1.41 to ?0.60, P < .001; BD fill: WMD = ?1.30, ?1.80 to ?0.79, P < .001). Adjunctive statin delivery appears to be effective in reducing PD, CAL gain, and BD fill in CP, and therefore, these drugs could be a promising therapeutic option for periodontal regeneration in future.     

Implant Osseointegration in Circumferential Bone Defects Treated with Latex‐Derived Proteins or Autogenous Bone in Dog's Mandible

Background: In sites with diminished bone volume, the osseointegration of dental implants can be compromised. Innovative biomaterials have been developed to aid successful osseointegration outcomes. Purpose: The aim of this study was to evaluate the osteogenic potential of angiogenic latex proteins for improved bone formation and osseointegration of dental implants. Materials and Methods: Ten dogs were submitted to bilateral circumferential defects (5.0 × 6.3 mm) in the mandible. Dental implant (3.3 × 10.0 mm, TiUnite MK3?, Nobel Biocare AB, Göteborg, Sweden) was installed in the center of the defects. The gap was filled either with coagulum (Cg), autogenous bone graft (BG), or latex angiogenic proteins pool (LPP). Five animals were sacrificed after 4 weeks and 12 weeks, respectively. Implant stability was evaluated using resonance frequency analysis (Osstell Mentor?, Osstell AB, Göteborg, Sweden), and bone formation was analyzed by histological and histometric analysis. Results: LPP showed bone regeneration similar to BG and Cg at 4 weeks and 12 weeks, respectively (p ≥ .05). Bone formation, osseointegration, and implant stability improved significantly from 4 to 12 weeks (p ≤ .05). Conclusion: Based on methodological limitations of this study, Cg alone delivers higher bone formation in the defect as compared with BG at 12 weeks; compared with Cg and BG, the treatment with LPP exhibits no advantage in terms of osteogenic potential in this experimental model, although overall osseointegration was not affected by the treatments employed in this study.     

A comparison between insertion torque and resonance frequency in the assessment of torque capacity and primary stability of Brånemark system implants

summary The aim of this study was to determine primary stability and insertion torque of Brånemark System implants placed in the anterior mandible, and to evaluate a possible correlation between primary stability and insertion torque. Thirty edentulous patients were treated with 60 Brånemark System implants using a one‐stage technique. The insertion torque values of all implants were recorded with the Osseocare equipment. Immediately after implant placement, each implant was connected to the transducer of an Osstell machine to measure the primary implant stability. The average insertion torque and resonance frequency values were 41·5 ± 5·8 and 74·1 ± 3·8 for 30 implants. The correlation between insertion torque and resonance frequency values indicated a statistical significance (P < 0·001). The difference between mean insertion torque values for female and male patients was statistically significant (P < 0·001). No significant difference (P > 0·05) was found between younger and older patients with mean insertion torque values of 43·1 ± 4·7 and 40·1 ± 6·5 respectively. The results of this study showed a strong correlation between the primary stability and insertion torque values of Brånemark System TiUnite MKIII implants at the time of implant placement.     

Piroxicam and laser phototherapy in the treatment of TMJ arthralgia: a double‐blind randomised controlled trial

This study aimed to evaluate the efficacy of piroxicam associated with low‐level laser therapy compared with single therapies in 32 patients presenting temporomandibular joint arthralgia in a random and double‐blind research design. The sample, divided into laser + piroxicam, laser + placebo piroxicam and placebo laser + piroxicam groups, was submitted to the treatment with infrared laser (830 nm, 100 mW, 28 s, 100 J cm^?2) at 10 temporomandibular joint and muscle points on each side during four sessions concomitant to take one capsule a day of piroxicam 20 mg during 10 days. The treatment was evaluated throughout four sessions and 30 days follow‐up through visual analogue scale (VAS), maximum mouth opening and joint and muscle (temporal and masseter) pain on palpation. The results showed that all the study groups had a significant improvement in the VAS scores (P < 0·05), and there were no significant group differences. Piroxicam was effective in the reduction of joint and muscle pain on palpation (P < 0·05) and showed the lowest temporal pain (P = 0·02) at the 30‐day follow‐up. The combination of low‐level laser therapy and piroxicam was not more effective than single therapies in the treatment of temporomandibular joint arthralgia. The use of piroxicam was more effective in the following 30 days.