Search

Abstract Background Research investigating the potential link between gingival microvascular blood flow and inflammatory status is scarce. This study aims to assess color doppler flow imaging (CDFI) and micro-flow imaging (MFI) as tools for the assessment of gingival papilla blood flow (GPBF) and to examine their diagnostic utility as a noninvasive means of detecting gingival bleeding. Methods CDFI and MFI were used to assess the GPBF grade (0–4) of 140 anterior gingival papilla sites in advanced periodontitis patients. Correlations between GPBF grades and periodontal characteristics were examined, and diagnostic performance as a means of predicting bleeding on probing (BOP) was examined using receiver operating characteristic curves. Results GPBF grades 0 and 1 assessed by the MFI were 14.29% and 15.71% respectively, lower than the 28.57% and 24.29% assessed by the CDFI. In contrast, MFI detected a higher frequency of GPBF grade 2 sites (40.71%) relative to CDFI (22.14%). The CDFI and MFI provided consistent results in 62.14% of the sites, while the MFI demonstrated higher ratings in rest 37.86% of the sites. A significant positive correlation was detected between GPBF grade and the modified gingival index (MGI), bleeding index (BI), BOP, and probing depth (PD). It showed high accuracy for CDFI or MFI to diagnosing BOP with a sensitivity of 80.51% and 96.43% and a specificity of 77.27% and 57.14%, respectively. Area under the receiver operator characteristic curve values when predicting BOP based on the GPBF grade determined using CDFI and MFI approaches 0.887 (95% CI 0.833–0.942) and 0.917 (95% CI 0.862–0.972), respectively, and there were no significant differences between these values (Z = − 1.502, p = 0.133). Conclusions Both MFI and CDFI can be employed for the evaluation of GPBF, and MFI is better suited to detecting mild inflammation. Trial registration ChiCTR2200066021 (Date of registration: 22/11/2022).

Background/purpose: The success of transcrestal sinus floor elevation (TSFE) is primarily reliant upon the experience of the surgeon owing to the limited operative visibility. To evaluate the accuracy associated with the use of a dynamic navigation system when conducting posterior maxilla implant surgery with TSFE. Materials and methods: Twenty-eight implants were placed in 28 patients requiring implantation in the posterior maxilla via a TSFE approach. The drills were used to access the planned position (within 1 mm of the bottom of the maxillary sinus floor) under dynamic navigation system. TSFE was then accomplished using osteotomes and a piezoelectric device. Lastly, the implant was inserted under the dynamic navigation. Three effective deviations between planned and actual implant placement were then measured including angular deviation (AD, degrees), entry point horizontal deviation (EPHD, mm), and apical point horizontal deviation (APHD, mm). Results: The AD, EPHD, and APHD between the planned and actual implant placement were 3.656 ± 1.665°, 1.073 ± 0.686 mm, and 1.086 ± 0.667 mm, respectively. Premolar site AD values were less than those for molar sites (P = 0.004). No significant differences in these outcomes were observed in different surgeons. Obvious sinus perforation was not detected by immediate postoperative cone beam computed tomography imaging. Conclusion: The accuracy associated with using a dynamic navigation system when conducting posterior maxilla implant surgery via a TSFE approach using piezoelectric devices was comparable. This technique thus achieved appropriate interventional precision and safety while decreasing the morbidity associated with the TSFE approach.

Background/purpose: Gingival tissue firmness cannot be objectively assessed or monitored in real-time in existing examinations. This study was designed to examine the potential utility of shear wave elastography (SWE) as a means of evaluating and monitoring gingival inflammation in an effort to assess the effects of initial periodontal therapy in patients with advanced periodontitis. Materials and methods: This pilot study included analyses of 66 sites in 6 advanced periodontitis patients. Patients underwent the SWE examination of the gingiva at the mid-labial and interdental papillae at baseline and at 2, 4, and 6 weeks following initial periodontal therapy. Measured periodontal parameters in these patients include Plaque index (PI), Gingival bleeding index (GBI), Probing depth (PD), and Clinical attachment loss (CAL). Results: Respective baseline SWE values at the mid-labial gingiva and interdental papilla 25.68 ± 6.82 kPa and 26.78 ± 6.20 kPa, with no significant differences between these two measures. A significant negative correlation between SWE and both PI (r = −0.350, P = 0.004) and GBI (r = −0.287, P = 0.020) was observed at baseline. Initial periodontal therapy contributed to significantly higher SWE values and tougher gingiva, particularly during the first two weeks. Postoperative changes in SWE were negatively correlated with SWE values at baseline (r = −0.710, P

The deviations between the preoperative (planned) and postoperative (actual) positions of dental implants have always been of a major concern in dental implant surgery. Dynamic computer-aided implant surgery (dCAIS) systems have been used to achieve optimal implant positioning. The method of registration is indeed an important factor that affects the implanting accuracy. Here, we propose a fast and concise registration method using a registration-and-fixation device as well as an adjustable handpiece for dynamic navigation in dental implant surgery. To the best of our knowledge, our work is the first study of such a registration method for dynamic navigation in a dental implant system.