Effectiveness of a desensitizing agent before in-office tooth bleaching in restored teeth

Objectives

The aim of this clinical trial was to evaluate the effectiveness and tooth sensitivity associated with bleaching in patients with composite restorations in anterior teeth after the application of a desensitizing agent.

Material and methods

Bleaching was performed with 35 % hydrogen peroxide gel in 30 patients with composite restorations in anterior teeth, divided according to the prior application of a desensitizing agent (De), or a placebo (Pl), on maxillary superior teeth. Color was recorded at baseline, 1 week after each session and 6 months after treatment. The experience of tooth sensitivity (TS) was recorded on an NRS (0–4) during bleaching and 24 h after each session. Bleaching effectiveness was evaluated by one-way ANOVA and Tukey's tests (α?=?0.05). The percentage of TS was evaluated by Fisher's exact test. For each treatment, periods were compared using the Wilcoxon signed-rank test (α?=?0.05), and at each period, treatments were compared using Mann–Whitney U test.

Results

Both groups showed similar tooth color enhancement and color stability after 6 months (p?<?0.05). No significant difference in prevalence of sensitivity was detected between groups (p?<?0.001). Higher TS intensity (median [first/third quartiles]) was observed for Pl (1.5 [1/1.75]) compared with De (0.5 [0/1]) during treatment (p?<?0.05).

Conclusions

The use of a desensitizing gel (5 % potassium nitrate, 2 % sodium fluoride) before tooth bleaching in patients with composite restorations did not reduce the prevalence of tooth sensitivity, but reduced the intensity of TS during bleaching.

Clinical relevance

Although the use of a desensitizing agent before bleaching, in patients with composite resin restorations, did not reduce the prevalence of TS, a reduction of the TS intensity during the protocol was observed without jeopardizing the whitening outcome.     

Three-year randomized clinical evaluation of a low-shrinkage silorane-based resin composite in non-carious cervical lesions

Objective

The clinical suitability of low-shrinkage resin composites for class V cavities has not been investigated in vivo. The purpose of this double-blind randomized clinical trial was to compare the clinical performances of low-shrinkage resin composite Filtek silorane and nanoceramic resin composite Ceram X mono in non-carious cervical lesions (NCCLs) over 36 months.

Materials and methods

Two calibrated operators restored 144 NCCLs in 24 patients by using Filtek silorane with silorane system adhesive (FS/SSA) and Ceram X mono with Clearfil SE (CXM/CSE) or XP bond (CXM/XPB). Then, two blinded, calibrated evaluators assessed the restorations at the baseline and 6, 12, 24, and 36 months thereafter by using the modified US Public Health Service criteria. Data were analyzed with the Freidman and Wilcoxon signed-rank tests at a significance level of 5 % (P?<?0.05).

Results

No restoration was associated with postoperative sensitivity or secondary caries. Further, no group showed significant changes until 12 months. The retention rates of the FS/SSA (97.5 %), CXM/CSE (97.5 %), and CXM/XPB (92.31 %) restorations did not differ significantly (P?>?0.05). Six (4 CXM/XPB, 1 FS/SSA, and 1 CXM/CSE) of the 121 restorations evaluated at 36 months were completely lost. However, no significant intergroup differences were observed in the other evaluation criteria.

Conclusion

The 3-year clinical performances of the restorative materials in NCCLs were not significantly different.

Clinical relevance

Filtek silorane is suitable for restoring NCCLs.     

Fluoride release and mechanical properties after 1-year water storage of recent restorative glass ionomer cements

Objectives

The objective of this study was to evaluate the relationships between fluoride release and mechanical properties after 1-year water storage of five recent restorative glass ionomer cements (GICs).

Materials and methods

Five GICs, FujiIX GP EXTRA (FEX), FujiIX GP (FIX), GlasIonomer FX-II (GFX), Ketac Molar Easymix (KME), and Riva Self Cure (RSC), were examined. Cumulative fluoride release, compressive strength, and surface hardness were measured up to 1-year storage (n?=?5), and analyzed with one-way or two-way ANOVA and Tukey HSD test (α?=?0.05). Elemental compositions before and after 1-year storage were also examined (n?=?3).

Results

The amounts of fluoride release were significantly different among the products. The highest amount of fluoride release occurred during the first day. Then, the amount of fluoride release rapidly decreased and still continued until 1-year storage. Compressive strengths indicated that two main factors were significant (GFX?<?FEX?=?RSC?<?FIX?<?KME; 1 day?<?1 week?=?1 month?=?3 months?=?6 months?=?1 year), but surface hardness showed a slightly different tendency (GFX?=?RSC?<?FEX?=?FIX?=?KME; 1 year?<?1 day?<?1 week?=?1 month?=?3 months?=?6 months). Significant correlation was found between decrease of silicon and decrease rate of the surface hardness.

Conclusions

Fluoride releases were detected up to 1-year storage, but the mechanical properties slightly decreased due to decrease of Si after 1-year storage. Elution of Si instead of fluoride release was considered more critical to deteriorate the mechanical properties of GICs.

Clinical relevance

Fluoride released for 1-year water storage will contribute to secondary caries prevention. The amount of fluoride release did not affect these mechanical properties. These results indicate the usefulness of these GICs.     

Prognostic and predictive value of serum vascular endothelial growth factor (VEGF) in squamous cell carcinoma of the head and neck

Introduction

This study aimed to investigate the prognostic and predictive value of serum vascular endothelial growth factor (VEGF) in head and neck squamous cell carcinoma (HNSCC).

Method

Preoperative and 6-month postoperative serum VEGF levels were measured using a quantitative sandwich enzyme immunoassay technique in 55 consecutive patients with HNSCC and two control groups. The first control group included normal, healthy, age- and sex-matched individuals (n?=?20), while the second control group included the patients who had history of HNSCC and were free of disease for at least 5 years (n?=?25).

Results

The mean baseline serum VEGF concentrations of the 55 patients with HNSCC and the first and the second control groups were 437.86, 42.56, and 48.03 pg/ml, respectively (P?<?0.001). After a median follow-up of 75 months, 15 patients of the study group developed recurrent disease and 40 patients remained free of disease. The mean preoperative and 6-month postoperative serum VEGF levels for the 40 patients who did not have recurrent disease were respectively 327.69 and 153.50 pg/ml compared to 731.72 and 692.96 pg/ml for the 15 patients with recurrent disease (P?<?0.001). High (≥540 pg/ml) serum VEGF level was associated with poor overall survival (P?<?0.001). Moreover, multivariate analysis showed node stage (P?<?0.001) and preoperative serum VEGF level (P?=?0.020) as significant, independent prognostic factors for overall survival.

Conclusion

Preoperative or postoperative elevated serum levels of VEGF are highly predictive for disease recurrence and are associated with poor disease-free and overall survival of patients with HNSCC.     

Clinical and microbiological changes after minimally invasive therapeutic approaches in intrabony defects: a 12-month follow-up

Objectives

This 12-month randomized, controlled trial evaluated the clinical effects and microbiological changes of minimally invasive nonsurgical and surgical approaches for the therapy of intrabony defects.

Materials and methods

Twenty-nine subjects with intrabony defects in single-rooted tooth were randomly assigned to; (1) minimally invasive nonsurgical technique (MINST) or (2) minimally invasive surgical technique (MIST). Quantities of Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Porphyromonas gingivalis, determined by using real-time PCR, were evaluated at baseline, 3, 6, and 12 months after the treatments. Clinical recordings—probing depth (PD), position of the gingival margin (PGM), and relative clinical attachment level (RCAL)—were obtained at baseline and 12 months post-therapy. The primary outcome variable of the study was RCAL.

Results

Both treatment modalities resulted in an improvement in all clinical recordings, with significant PD reductions (p?<?0.05), RCAL gains (p?<?0.05), and no change in the PGM (p?>?0.05) after 12 months in both MINST and MIST groups. No clinical differences were observed between groups (p?>?0.05). Regarding the microbiological outcomes, at the re-examinations, a significant decrease was observed for T. forsythia and P. gingivalis when compared with baseline (p?<?0.05) for both treatments. The amount of A. actinomycetemcomitans did not reduced decrease throughout the study (p?>?0.05). Intergroup differences in the microbiological assay were not found at any time point (p?>?0.05).

Conclusions

Both MINST and MIST provided comparable clinical results and microbiological changes in the treatment of intrabony defects over 12 months follow-up.

Clinical relevance

This randomized, controlled, parallel trial revealed that both therapeutic modalities may promote clinical and microbiological benefits at 12 months post-therapy.     

Changes in mastication after an immediate loading implantation with complete fixed rehabilitation

Objective

This study aimed to measure modifications of mastication after immediate loading full-arch prosthesis (ILFAP) rehabilitation.

Materials and method

Fourteen patients were observed before and 6 months after ILFAP rehabilitation when masticating two natural, standardized foods (peanut and carrot) and three model foods with increasing hardness. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Chewing time (CT), number of chewing cycles (CC), and chewing frequency (CF) were video recorded. A self-assessment questionnaire for oral health-related quality of life [Geriatric Oral Health Assessment Index (GOHAI)] was also used.

Results

After ILFAP rehabilitation, the mean D50 values for carrot and peanuts were smaller [Repeated Model Procedures (RMP), F?=?41, p?<?0.001]. Mean CT and CC values recorded with the three model foods decreased, while CF increased regardless of the model food hardness (RMP, F?=?14, F?=?10, and F?=?11, respectively, p?<?0.001). The GOHAI score increased from 43?±?9 to 56?±?3 (t test, p?<?0.001).

Conclusion

ILFAP rehabilitation improves the ability to reduce the bolus particle size and the ability to discriminate between different food hardnesses in the 6 months post-surgery period.

Clinical relevance

This study encourages the clinical development of immediate loading implantation with a fixed full-arch prosthesis protocol.     

Volume reduction of cystic lesions after surgical decompression: a computerised three-dimensional computed tomographic evaluation

Objectives

This study was performed to evaluate the three-dimensional radiographic variation in mandibular odontogenic cystic lesions after decompression.

Materials and methods

Pre- and post-decompression computed tomography (CT) evaluations in 20 patients affected by keratocysts (n?=?10), dentigerous cysts (n?=?9) and ameloblastoma (n?=?1) were analysed using software designed for three-dimensional measurement of volumes; the results were correlated with treatment duration, age, sex and histological type.

Results

The mean (range) decompression time was 5.70 (3–12)?months. The mean (SD) pre- and post-decompression volumes were 9.50 (7.74) and 4.65 (4.34)?cm³, respectively (P?<?0.001), with a mean (SD) reduction of 49.86 % (19.34 %). The volume reduction was positively correlated with the duration of decompression (P?<?0.001), whereas no correlations with other variables were found (P?=?0.2357). The median monthly reduction in cyst volume was 11.34 % (mean, 13.52 %; range, 4.45–30.43 %) (P?<?0.001).

Conclusions

This three-dimensional CT investigation demonstrated the effectiveness of decompression in the treatment of mandibular odontogenic cystic lesions and showed a positive correlation between the duration of treatment and volume reduction.

Clinical relevance

Decompression treatment, which is simple to perform and generally well-accepted by patients, is a reliable method to considerably reduce the volume of mandibular odontogenic cystic lesions before surgical removal. Extended decompression time seems to improve results of the reduction process.     

Do chlorhexidine and ethanol improve bond strength and durability of adhesion of fiber posts inside the root canal?

Objectives

The aim was to investigate the effects of chlorhexidine and ethanol pretreatment of the root canal on push-out bond strengths and durability of adhesion of fiber posts luted with two different adhesive strategies.

Materials and methods

One hundred twenty human anterior teeth were endodontically treated. After post space preparation, the root canals were irrigated using 1 % sodium hypochlorite (NaOCl) applied with passive ultrasonic irrigation followed by distilled water (control). In pretreatment (PT) group, chlorhexidine (CHX) root canals were irrigated using 2 % chlorhexidine; and in the PT group, 99 % ethanol was used prior application of the luting agent. Two different post-and-luting systems with an etch-and-rinse (CX) adhesive approach (n?=?60) and a self-adhesive resin cement (RX; n?=?60) were inserted into the root canals. Bond strengths were evaluated initially and after thermocycling and storage for 6 months using push-out tests.

Results

Bond strength was significantly affected by the adhesive strategy (p?<?0.0005), the pretreatment (p?<?0.0005) and the location inside the root canal (p?<?0.0005; repeated measurement ANOVA). Ethanol significantly increased bond strengths irrespective of the luting agent used compared to the control and CHX group (p?<?0.05; Tukey's B).

Conclusion

Ethanol significantly increased bond strength of the CX and the RX system inside the root canal and could be recommended as a final rinse for luting fiber posts using an ethanol-based etch-and-rinse adhesive system or self-adhesive resin cement.

Clinical relevance

PT of the root canal using ethanol seems to facilitate adhesive luting of fiber posts with the tested adhesive system and luting cements.     

The influence of parotid gland sparing on radiation damages of dental hard tissues

Objective

The aim of the present study was to evaluate whether radiation damage on dental hard tissue depends on the mean irradiation dose the spared parotid gland is subjected to or on stimulated whole salivary flow rate.

Material and methods

Between June 2002 and October 2008, 70 patients with neck and cancer curatively irradiated were included in this study. All patients underwent dental treatment referring to the guidelines and recommendations of the German Society of Dental, Oral and Craniomandibular Sciences prior, during, and after radiotherapy (RT). During the follow-up period of 24 months, damages on dental hard tissues were classified according to the RTOG/EORTC guidelines. The mean doses (D _mean) during spared parotid gland RT were determined. Stimulated whole saliva secretion flow rates (SFR) were measured before RT and 1, 6, 12, 24 months after RT.

Results

Thirty patients showed no carious lesions (group A), 18 patients developed sporadic carious lesions (group B), and 22 patients developed general carious lesions (group C). Group A patients received a D _mean of 21.2?±?11.04 Gy. Group B patients received a D _mean of 26.5?±?11.59 Gy and group C patients received a D _mean of 33.9?±?9.93 Gy, respectively. The D _mean of group A was significantly lower than the D _mean of group C (p?<?0.001). Additionally, the mean SFR 6 months after RT of group A was significantly higher than the mean SFR of group C (p?<?0.01).

Conclusions

Irradiation damage on dental hard tissue correlates with increased mean irradiation doses as well as decreased salivary flow rates.

Clinical relevance

Parotid gland sparing resulting in a dose below 20 Gy reduces radiation damage on dental hard tissues, and therefore, the dose may act as a predictor for the damage to be expected.     

Postoperative tooth sensitivity with a new self-adhesive resin cement—a randomized clinical trial

Objectives

This study evaluated and compared sensitivity of teeth after cementation of full-coverage crowns with a new self-adhesive resin cement (SARC). A resin-modified glass ionomer cement (RMGIC) served as control.

Materials and methods

Eighty-eight full-coverage crowns were cemented to vital teeth with either the self-adhesive cement iCem (Heraeus Kulzer; n?=?44) or the RMGIC GC Fuji PLUS (GC, n?=?44). Before preparations, patients were questioned for sensitivity (patient sensitivity, PS). In addition, air was blown for 2 s onto the buccal cementoenamel junction (air sensitivity, AS), and ice spray was applied in the cementoenamel junction area (ice sensitivity, IS). Patient responses were recorded with a visual analog scale. After cementation of the crowns, patients were recalled for follow-up (f/u) visits at 1 day, 1 week, and 3 weeks. PS, AS, and IS were recorded during each visit. Data were analyzed with Mann–Whitney U tests.

Results

The two groups revealed comparable sensitivity scores at baseline. SARC showed significantly lower PS sensitivity scores at 1 day (p?=?0.02) and significantly lower AS scores at 1-week follow-up (p?=?0.01). IS generally produced the highest sensitivity scores with SARC revealing significantly lower scores at all follow-up visits.

Conclusion

Cementation of crowns with the SARC tested in this study resulted in overall lower postoperative sensitivity than with the RMGIC.

Clinical relevance

Among other clinical advantages, some self-adhesive resin cements seem to lower postoperative sensitivity of crowned teeth.     

Two-year clinical evaluation of composite resins in non-carious cervical lesions

Objective

The purpose of this double-blind, randomised trial was to compare the clinical performance of a hybrid composite (Clearfil AP-X, Kuraray, Tokyo) and a nanocomposite (Filtek Z350, 3M ESPE, St. Paul, MN) over a period of 2 years in non-carious class V lesions using a modified US Public Health Service (USPHS) system.

Methods

Forty-six patients with at least one pair of equivalent non-carious cervical lesions under occlusion and a mean age of 44.1 years (range 27–66 years; median 45 years) were enrolled in this study. A total of 116 restorations (58 with each material) were placed according to manufacturer's instructions by two calibrated operators. The restorations were evaluated at baseline and at 6, 12 and 24 months after placement using the USPHS criteria for retention, colour match, marginal discolouration, marginal adaptation, anatomic form, surface texture and secondary caries. Statistical analysis was conducted using the Cochran and the McNemar tests at a significance level of 5 % (P?<?0.05).

Results

No surface texture changes or secondary caries were detected in association with any restorations. The retention rates for Clearfil AP-X (100 %) and for Filtek Z350 (91.38 %) did not differ significantly (P?>?0.05). Two Z350 restorations were completely lost after 2 years. No significant differences were observed in the colour match, marginal discolouration, marginal adaptation or anatomic form.

Conclusions

There were no significant differences in the clinical performances between the materials.

Clinical relevance

Both restorative materials exhibited acceptable clinical performance in class V non-carious lesions 2 years post-restoration.     

Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial

Objectives

This randomized split-mouth clinical trial was designed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction.

Materials and methods

A total of 36 chronic periodontitis subjects, of both genders, were selected. One pair of contralateral single-rooted teeth with pocket depth >5 mm was chosen from each subject. All patients received non-surgical periodontal treatment, after which the experimental teeth were designated to either test or control groups. Both teeth received scaling, root planing and coronal polishing (SRP) and teeth assigned to the test group (SRP + DL) were irradiated with the 808?±?5 nm diode laser, for 20 s, in two isolated appointments, 1 week apart. The laser was used in the continuous mode, with 1.5 W and power density of 1,193.7 W/cm². Clinical and microbiological data were collected at baseline, 6 weeks and 6 months after therapy.

Results

There was a significant improvement of all the clinical parameters—clinical attachment level (CAL), probing depth (PD), plaque index (PI) and Bleeding on Probing (BOP)—for both groups (P?<?0.001), with no statistical difference between them at the 6 weeks and the 6 months examinations. As for microbiological analysis, a significant reduction after 6 weeks (P?>?0.05) was observed as far as colony forming units (CFU) is concerned, for both groups. As for black-pigmented bacteria, a significant reduction was observed in both groups after 6 months. However, the difference between test and control groups was not significant. There was no association between group and presence of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study.

Conclusions

After 6 months of evaluation, the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment.

Clinical relevance

The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment. More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice.     

Six months of high-dose xylitol in high-risk caries subjects—a 2-year randomised, clinical trial

Objectives

The hypothesis was that the daily use of a high dose of a xylitol chewing gum for 6 months would reduce the increment of decayed permanent first molar surfaces (ΔD₆S) in high-risk schoolchildren after 2 years.

Methods

In this randomised, clinical trial, 204 schoolchildren with a high caries risk were assigned to two experimental groups, xylitol and non-xylitol. Caries status, salivary mutans streptococci, and lactobacilli were re-evaluated 2 years later in 74 xylitol-treated and 83 non-xylitol-treated schoolchildren. Differences in mean ?D₆S between groups registered at baseline and at follow-up were evaluated using the nonparametric Mann–Whitney U test.

Results

Outcome was the development of detectable carious lesions initial (D₁–D₂) and manifest (D₃) in the permanent first molars. In the xylitol group, the difference in proportion of children with decayed first permanent molars at baseline and follow-up was 1.43 % for manifest lesion and 2.86 % for initial lesions; while in the non-xylitol group was 10.26 % (p?<?0.01) and 16.66 % (p?<?0.01), respectively. A statistically significant difference regarding means was also observed in the non-xylitol group: the ?D₆S for manifest lesion was 0.18 (p?=?0.03) and 0.67 (p?=?0.02) for initial lesion.

Conclusion

The use of a chewing gum containing a high dose of xylitol for a period of 6 months has been shown to produce a long-term effect on caries development in high caries-risk children.

Clinical relevance

A school-based preventive programme based on 6 months’ administration of a high dose of xylitol via chewing gum proved to be efficacious in controlling caries increment in high-risk children.     

Platelet-rich fibrin in the treatment of localized gingival recessions: a split-mouth randomized clinical trial

Objectives

The aim of this study is to evaluate the clinical efficacy of platelet-rich fibrin (PRF) in combination with coronally advanced flap (CAF) in the treatment of localized gingival recessions.

Materials and methods

Twenty-two patients with localized gingival recession defects (Miller I, II) participated in this split-mouth trial. Forty-four defects received either CAF?+?PRF (test) or CAF with subepithelial connective tissue graft (SCTG) (control). Gingival recession depth (RD), gingival recession width (RW), keratinized tissue width (KTW), recession area (RA), probing depth (PD), clinical attachment level (CAL) and gingival thickness (GT) were evaluated at baseline and 6 months. RD, RW, RA and KTW were calculated on standardized photographs with a computer image analysis program.

Results

Percentage of root coverage in test group was 92.7 % and in control group was 94.2 % (p?>?0.05). Percentage of complete root coverage of the test and control groups was 72.7 and 77.3 %, respectively (p?>?0.05). KTW and GT were increased in both groups from baseline to 6 months (p?p?>?0.05).

Conclusion

Within the limits of the present study, it can be concluded that localized gingival recessions could be successfully treated with CAF?+?PRF as well as CAF?+?SCTG. The digital measuring method provided high accuracy and precision in the evaluation of treatment outcomes after both surgical procedures.

Clinical relevance

PRF might be suggested as an alternative to SCTG for the treatment of localized gingival recessions.     

Is smoking a predictor of apical periodontitis?

Objectives

To evaluate the association between cigarette smoking and the frequency of apical periodontitis in female and male patients seeking treatment at the University of Basel (KREBS Project).

Materials and methods

This cohort study included full-mouth periapical radiographs of 161 subjects, including 66 current smokers, 26 former smokers and 69 individuals who had never smoked. The periapical region of all teeth was radiographically evaluated using the Periapical Index (PAI) score. Generalised linear mixed-effects models using the logit link were performed.

Results

The frequency of apical periodontitis differed based on gender and smoking status. Current male cigarette smokers with <10 or ≥10 pack years showed frequencies of apical periodontitis of 12 % and 5.5 %, respectively, compared to 3.8 % in individuals who had never smoked. The corresponding data for female smokers were 5.7 % and 7.2 % in smokers with <10 or ≥10 pack years, respectively, versus 5.2 % in individuals who had never smoked. The factors “prevalent coronal restoration” (p?<?0.001), “prevalent root canal treatment” (p?<?0.001) and “quality of root canal filling” (p?<?0.001) were significant predictors for apical periodontitis. After adjustment for quality of root canal filling cigarette smoking was not associated with apical periodontitis in current female and male smokers with <10 or ≥10 pack years (p?>?0.05).

Conclusion

Smoking status did not predict apical periodontitis in females and males in this sample group.

Clinical relevance

With respect to quality of root canal filling, tobacco use may not be a significant predictor for apical periodontitis.     

Radiographic assessment of maxillary incisor position after rapid maxillary expansion in children with clinical signs of eruption disorder

Background and objective

In this study we assessed the influence of rapid maxillary expansion (RME) on the intraosseous vertical position and inclination of the impacted incisors diagnosed at an early developmental stage on panoramic radiographs and subsequently treated by surgical removal of the obstacle.

Materials and methods

Following surgical removal of the obstacles to incisor eruption (T1), a group of 34 subjects (mean age 8 years 11 months ±11 months) underwent RME, while a group of 28 subjects (mean age 9 years 1 month ±1 year) was monitored after surgery without further treatment. At T2 (on average 10 months after T1), the prevalence rate of subjects with erupted incisors was recorded. The measurements were taken on the panoramic radiographs at T1 and T2 to assess the vertical position and angulation of delayed unerupted incisors.

Results

At T2, impacted incisors erupted in 82.4% of the patients in the RME group versus 39.3% of those in the monitored group (χ² =8.45, p<0.001). All the patients treated with RME showed an improvement in the vertical and angular position of the unerupted teeth. Logistic regression revealed RME therapy as the only significant predictive variable (p<0.001) for successful eruption of the delayed incisors at T2.

Conclusion

RME in early mixed dentition appears to be an effective procedure to increase the prevalence rate of impacted maxillary incisor eruption.     

Effects of periodontal therapy on serum lipid profile and proinflammatory cytokines in patients with hyperlipidemia: a randomized controlled trial

Objective

The aim of this study was to evaluate whether periodontal treatment in patients with periodontitis and hyperlipidemia may have any influence on plasma lipids and pro-inflammatory cytokine levels.

Material and methods

We randomly assigned 109 patients with hyperlipidemia and chronic periodontitis into group 1 (n?=?55) and group 2 (n?=?54). Patients in group 1 underwent a standard cycle of supragingival mechanical scaling and polishing. Patients in group 2 underwent the adjunctive full-mouth intensive removal of subgingival dental plaque biofilms with the use of scaling and root planning. Periodontal parameters, total cholesterol (TC), triglyceride (TRG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), tumor necrosis factor-alpha (TNF-α), interleukin(IL)-1β(IL-1β), and IL-6 were evaluated before treatment and 2 and 6 months after treatment.

Results

Two and 6 months after treatment, TRG levels were significantly lower in group 2 than in group 1 (P?<?0.05), and the levels of HDL-C were significantly higher (P?<?0.05). Two and 6 months after therapy, the levels of TNF-α were significantly lower in group 2 than in group 1 (P?<?0.05), as were the levels of IL-1β (P?<?0.001) and IL-6 (P?<?0.001).

Conclusions

Intensive periodontal treatment of participants with hyperlipidemia and chronic periodontitis improved serum lipid levels and decreased circulating pro-inflammatory cytokine levels.

Clinical relevance

This study showed that intensive treatment of periodontitis results in an improvement in serum lipid levels and a decrease in serum proinflammatory cytokine levels in patients with periodontitis and hyperlipidemia. These findings may contribute to present knowledge that periodontal therapy may be beneficial for individuals with hyperlipidemia.

     

The use of NaOCl in combination with CHX produces cytotoxic product

Objectives

The combination of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) yields a “precipitate potentially toxic” (PPT). The aim of this study was to evaluate the tissue response to implanted polyethylene tubes filled with PPT-soaked fibrin sponge.

Methods

Forty rats received four polyethylene tubes each; each tube was filled with fibrin sponge soaked by 2.5 % NaOCl, 2.0 % CHX, PPT (2.5 % NaOCl plus 2.0 % CHX), or not soaked (control). The observation time points were 7, 15, 30, 60, and 90 days. At each time point, eight animals were killed, and the tubes and surrounding tissues were removed, fixed, and prepared for light microscopic analysis by performing glycol methacrylate embedding, serial cutting into 3-μm sections, and hematoxylin–eosin staining. Qualitative and quantitative evaluations of the reactions were performed. Results were statistically analyzed by Kruskal–Wallis test (p?<?0.05).

Results

All chemical solutions caused moderate reactions at 7 days. On day 30, PPT group was more cytotoxic than the control group and the CHX group (p?<?0.05). On days 15 and 60, PPT group was more cytotoxic than the control group (p?<?0.05). On day 90, there was no statistically significant difference between the different groups.

Conclusion

PPT is more cytotoxic than NaOCl and CHX alone, particularly in the short term.

Clinical significance

Protocols which suggest the use of CHX and NaOCl must be revised because this mixture produces cytotoxic product.     

Use of ultrasonic scalpel and monopolar electrocautery for skin incisions in neck dissection: a prospective randomized trial

Purpose

Ultrasonic scalpel (UC) and monopolar electrocautery (ME) are standard equipment for soft tissue surgery. The aim of the present study was to compare intraoperative and postoperative patterns of patients using either UC or ME for skin incisions in neck dissection.

Material and methods

In a prospective randomized study of 30 patients, the thermal effects of UC (n?=?15) and ME (n?=?15) were examined using real-time infrared thermographic imaging. Additionally, tissue damage was evaluated histopathologically. The other measured variables were operation and bleeding time, postoperative pain score (only neck incision area), in-patient time, and complications.

Results

UC significantly reduces the thermal effects, compared to ME (p?<?0.001). The mean depth of tissue damage (i.e., necrosis) was 272.7 μm for UC and 284.7 μm for ME with no significant difference (p?=?0.285). From the third postoperative day, patients treated using UC had noticeably less pain in the neck incision area (t3 p?=?0.010; t4 p?<?0.001; t5 p?<?0.005). Cutting time was reduced for ME by 36.1 s (p?<?0.001) and the bleeding time was decreased by 40.9 s for UC (p?<?0.001). The total preparation time was the same (p?=?0.402). When comparing in-patient time (p?=?0.723), as well as complications, no significant differences were seen.

Conclusion

UC results in less postoperative pain and less bleeding in the neck incision area. Accordingly, UC is superior to ME for skin incisions in neck dissection.