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Background: Peri‐implantitis is a frequent finding. Initial treatment involves non‐surgical debridement of the implant surface. Recent studies have found a correlation between titanium (Ti) particle release and peri‐implantitis, yet there is a dearth of information regarding the effect of various non‐surgical instrumentation on particle release or peri‐implantitis resolution. Methods: Patients with peri‐implantitis were recruited for a randomized, blinded, parallel‐group clinical trial. The implants were randomized to treatment composed of Ti curettes ("Mech" group) or implant‐specific treatment composed of rotary polymer microbrushes ("Imp" group). Ti release in submucosal peri‐implant plaque pre‐ and 8 weeks posttreatment was assessed as the primary outcome. Peri‐implant probing depth, bleeding on probing, and suppuration on probing were evaluated and compared between groups. Results: Thirty‐four participants completed treatment; 18 were randomized to the Mech group and 16 to the Imp group. The groups were comparable for Ti levels and probing depths at baseline. A trend was noted for 10‐fold greater Ti dissolution in the Mech group posttreatment compared to the Imp group (p = 0.069). The Imp group had a significant reduction in probing depth posttreatment (p = 0.006), while the Mech group reduction was not significant. Conclusion: Peri‐implantitis treated non‐surgically with implant‐specific instruments (Imp group) had a significantly greater decrease in probing depth versus the Mech treatment group. This improvement was linked with a trend for less Ti release to the peri‐implant plaque by the non‐abrasive treatment. [ABSTRACT FROM AUTHOR]

Background: Gingivitis is a non‐specific inflammatory lesion in response to the accumulation of oral biofilm and is a necessary precursor to periodontitis. Enhanced oral hygiene practices, including utilization of a dentifrice that could significantly improve plaque accumulation and gingival inflammation, is desirable to prevent and treat gingivitis and potentially prevent progression to periodontitis. This clinical study aimed to investigate the effect of a new stannous fluoride‐containing dentifrice with 2.6% ethylenediamine tetra acetic acid (EDTA) as an anti‐tartar agent to reduce plaque index and gingival index over a 3‐month study period compared to other commercially‐available fluoride‐containing dentifrices. Methods: This double‐blind, randomized controlled clinical study evaluated plaque, gingival inflammation, and sulcular bleeding in patients using one of five commercially available fluoride‐containing dentifrices The dentifrices tested contained: 0.454% stannous fluoride and 2.6% EDTA (D1), 0.24% sodium fluoride (C), and 0.454% stannous fluoride (D2‐D4). One hundred fifty subjects participated over a 3‐month period. Co‐primary endpoints were improvements in plaque index (PI) and modified gingival index (mGI) from baseline values. No professional cleaning was performed during the study period. Results: All subjects in the study demonstrated statistically significant improvements in all measures of oral hygiene over the 3‐month study period. Subjects using dentifrice 1 (D1) showed statistically significantly greater reductions in PI, mGI, and modified sulcular bleeding index (mSBI) compared with all other commercially‐available dentifrices tested (p < 0.00001). Conclusions: A new dentifrice with 0.454% stannous fluoride and 2.6% EDTA demonstrated significant improvements in clinical parameters associated with gingivitis compared to other sodium and stannous fluoride containing dentifrices. [ABSTRACT FROM AUTHOR]

Background: Ozone is a molecule that plays an important role in dentistry, specially for wound healing. The aim of the present study was to clinically and immunologically evaluate the effect of ozonated oil on the healing of palatal wounds. Methods: This is a prospective, longitudinal, triple‐blind, randomized, placebo‐controlled clinical trial. The groups were divided as follows: Test group (n = 14): after removal of the free gingival graft (FGG), the palatal wound was treated with ozonized seed sunflower oil with a peroxide index between 510 and 625 meq O2/kg; Control group (n = 14): after removal of the FGG, the palatal wound was treated with non‐ozonated sunflower oil (placebo). The treatments were applied three times a day, for 7 days. Results: There were no significant differences in the measurements of wound area (mm2) between the test and control groups in the different periods evaluated (0, 3, 7, and 14 days; p > 0.05). The intra‐group analysis showed a significant decrease in wound size over the course of days (0, 3, 7, and 14 days; p < 0.05). Vascular endothelial growth factor (VEGF; pg/mL) presented a significant reduction at 7 days (p < 0.05) compared to day 3 in the test group (p < 0.05). There was a statistical difference for malondialdehyde (MDA; pg/mL) in the test group between 3 and 7 days post‐treatment (p < 0.05) and between test and control groups on the 7th day (p < 0.05). Conclusions: The application of highly ozonated sunflower oil did not improve the remaining scar area of the palate, decreasing the VEGF and increasing the oxidative stress marker MDA. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the effect of scaling and root planing (SRP) on levels of plasma C-reactive protein (CRP).Methods: A total of 30 patients with advanced periodontitis as determined by Clinical Periodontal Sum Score (CPSS) were recruited. Venous whole blood samples were drawn to obtain serum samples from all participants at baseline and 1 month after SRP (post-SRP). High-sensitivity CRP (hs-CRP) was measured by highly sensitive immunoturbidimetric assay. Wilcoxon signed-rank test was used for data analysis. Spearman rank correlation analysis was conducted to test the correlations between CPSS and hs-CRP at baseline and post-SRP.Results: There was a statistically significant reduction in the post-SRP CPSS values from the baseline values (z = 4.783, p < 0.0001). Similarly, there was a statistically significant reduction in the post-SRP hs-CRP levels from the baseline levels (z = 4.782, p < 0.0001). Moreover, there was positive association between the baseline levels of CPSS and hs-CRP (ρ = 0.5703) and the post-SRP values of CPSS and hs-CRP (ρ = 0.7507).Conclusion: The present study suggests that SRP can significantly reduce the levels of CRP. [ABSTRACT FROM AUTHOR]

Background: The aim of this randomized clinical trial was to compare a flapless technique of alveolar ridge preservation (ARP) to a flap technique to determine if preserving the periosteal blood supply would limit loss of crestal ridge width and height. Methods: Twenty‐four patients were randomly assigned to receive ARP using either a flapless or flap technique. Sockets were grafted with demineralized bone matrix and mineralized particulate allograft then covered with a barrier in both groups. Re‐entry was performed at 4 months to obtain samples for histological analysis and subsequent implant placement. Results: Ridge width of the flapless group at the crest decreased from 8.3 ± 1.3 mm to 7.0 ± 1.9 mm for a mean loss of 1.3 ± 0.9 mm (p < 0.05), whereas the flap group decreased from 8.5 ± 1.5 mm to 7.5 ± 1.5 mm for a mean loss of 1.0 ± 1.1 mm (p < 0.05). The mean midbuccal vertical change for the flap group was a loss of 0.9 ± 1.3 mm (p < 0.05) versus 0.5 ± 0.9 mm (p < 0.05) for the flapless group. There was no statistically significant difference between the groups. Histologically, flapless ARP revealed more vital mineralized tissue (44 ± 10%) compared to the flap group (p>0.05). In the flapless group, the occlusal soft tissue was significantly thicker than in the flap group at the 4‐month re‐entry (p< 0.05). Conclusions: Crestal ridge width, height, and percentage of vital mineralized bone following treatment with a flapless ARP technique, was not significantly different from a flap technique. [ABSTRACT FROM AUTHOR]

Background: Tissue regeneration within the periodontally involved furcation area is one of the most challenging aspects of periodontal surgery. The aim of this study was to evaluate the additional benefit of leukocyte and platelet-rich fibrin (L-PRF) to autogenous bone grafts (ABGs) in the treatment of mandibular molar degree II furcation involvement, comparing the clinical outcomes with those from open flap debridement (OFD)+ABG and OFD alone treatments.Methods: Fifty-four patients, exhibiting one buccal or lingual mandibular molar furcation defect, were randomly assigned to three treatment groups: OFD+ABG+L-PRF (n = 18); OFD+ABG (n = 18); and OFD (n = 18). Clinical (probing depth [PD], horizontal clinical attachment level [HCAL], vertical clinical attachment level [VCAL], gingival recession [GR]) and radiographic (vertical bone level [VBL]) parameters were evaluated at baseline and 6 months after treatment. HCAL change was the primary outcome.Results: No significant differences within each group were reported for GR changes, but statistically significant improvements in HCAL, VCAL, PD, and VBL were observed in all groups, except for VBL in the OFD group. At 6 months, the mean HCAL gain was 2.29 ± 0.18 mm in the OFD+ABG+L-PRF group, which was significantly greater than that in the OFD+ABG (1.61 ± 0.18 mm) and OFD (0.86 ± 0.18 mm) groups. Both OFD+ABG+L-PRF and OFD+ABG therapies produced a significantly greater clinical and radiographic improvement than OFD.Conclusion: The addition of L-PRF to ABG produces a significantly greater HCAL gain and PD reduction as compared with OFD+ABG treatment in mandibular degree II furcation involvements. [ABSTRACT FROM AUTHOR]

Background: Full-thickness mucoperiosteal flap (FTF) elevation could potentially affect the periodontium of the involved teeth; it is not clear if the periodontal phenotype of teeth involved in a FTF may influence these changes. The aim of this study was to evaluate the impact of FTF on teeth periodontium, as well as assessing the impact of periodontal phenotype on bone remodeling.Methods: In this single arm prospective clinical trial, 26 subjects and a total of 52 adjacent teeth were included. Patients receiving implant surgery in the posterior area, at the time of implant site preparation, an FTF was extended one tooth mesial and distal to the planned site, and the flap was elevated both facially and lingually. Vertical and horizontal bone linear changes were measured on both adjacent teeth, using superimposed cone-beam computerized tomography (CBCT) images taken prior to implant placement (T0) and at 12 months (T1). Baseline digital scans of models and DICOM files were superimposed to assess the periodontal phenotype.Results: Vertical bone changes from T0 to T1 were statistically significant (P = 0.013), with changes were significantly higher at the mesial (-0.31 ± 0.30 mm) and facial (P < 0.05) sites. Horizontal dimensional changes 5 mm subcrestally were similar among different locations (P = 0.086) and the bone width loss was higher closest to the crest (P = 0.001). No correlation was found between soft tissue thickness and bone changes. However, bone thickness at baseline appears to influence the extent of horizontal bone remodeling. Overall, the magnitude of bone loss either vertically or horizontally was clinically insignificant (≤0.4 mm). A preventive effect against bone loss maybe expected with bone thickness > 2 mm.Conclusion(s): Marginal bone changes in maxillary and mandibular posterior teeth following FTF at 12 months are very minimal, and mainly influenced by bone rather than soft tissue thickness. Overall, FTF does not seem to have deleterious effects on adjacent teeth periodontium. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to examine osseous changes following lateral bone augmentation using a novel scaffold (OV) alone and compare it to combination therapy using freeze-dried bone allograft (FDBA) and resorbable collagen membrane (FDBA/CM).Methods: Thirty patients completed this 9-months prospective two-center cohort clinical trial. Before surgery and 9-months re-entry, linear measurements were performed, and impressions taken. Cone-beam computed tomography (CBCT) were done at baseline and 9 months. DICOM slice data were converted into volumetric images using 3D Slicer. Following 3D volumetric image construction, pre- and post-op Standard Triangle Language files were superimposed and volumetric data were extracted for a 10-mm region of interest. Linear measurements were compared similarly.Results: Baseline clinical parameters were similar in both groups (4.22 and 4.53 mm for OV and FDBA/CM at -2 mm, respectively). Following treatment, vertical distance from the stent had changed minimally (-0.36 and -0.12 mm, respectively). Similarly, lateral bone gain ranged from 0 to 0.4 mm, for both groups. To the contrary, the CBCT measurements showed a significantly greater increase in horizontal width in the control at -2 mm (0.95 ± 0.2 mm) compared with -0.62 mm for the OV (P = 0.000). Similar changes were observed at -5 mm (0.63 and -0.41 mm, respectively, P = 0.01). Sites volume had increased from 266 ± 149 mm3 to 360 ± 138 mm3 (P = 0.001) for FDBA/CM with negligible changes for OV (from 334 to 335 mm3 , P = 0.952). these between-group changes being statistically significant (P = 0.023).Conclusion: FDBA/CM yielded better albeit moderate increase in the volume of the edentulous ridge, while OV scaffolds failed to produce similar results. [ABSTRACT FROM AUTHOR]