Assessment of the effect of the corticotomy-assisted orthodontic treatment on the maxillary periodontal tissue in patients with malocclusions with transverse maxillary deficiency: a case series

Background

The aim of the study was to assess the effect of corticotomy–assisted orthodontic treatment on soft tissue clinical parameters in patients with malocclusions with transverse maxillary deficiency.

Methods

The study included 20 generally healthy adult individuals with malocclusion, who underwent a corticotomy-assisted orthodontic treatment in maxilla. During the corticotomy performed after full-thickness flap elevation, only the buccal cortical plate was cut with the use of OTS-7, OTS7–4, OTS7-3 ultrasound tips of the piezosurgery device (Mectron s. p. a., Italy). A clinical examination was performed prior to the corticotomy procedure, then repeated – 3, 6, 9 and 12 months after the procedure. The following parameters were assessed: FMPI (full mouth plaque index), FMBOP (full mouth bleading on probing), PD (probing depth), CAL (clinical attachment level), GR (gingival recession height), RW (recession width), PH (papilla height), PW (papilla width), BS (bone sounding), biotype and KT.

Results

There was a statistically significant reduction in PD (mean difference: 0.06; 95% Cl: − 0.33, − 0.18), CAL (mean difference: 0.07; 95% Cl: − 0.33, − 0.19), PH (mean difference: 0.26; 95% Cl: − 0.47, 0.05) and BS (mean difference: 0.13; 95% Cl: − 0.41, − 0.14) after the treatment. Statistically significant changes were also noted in relation to KT (mean difference: 0.17; 95% Cl: − 0.07, 0.27) and biotype (mean difference: 0.07; 95% Cl: 0.26, 0.39), which thickness increased significantly after the treatment. No statistically significant differences were observed in GR, RW and PW.

Conclusions

The corticotomy–assisted orthodontic treatment did not jeopardize the periodontal clinical status in maxilla. There is a need for further studies on a larger number of patient to compare the clinical findings with a control group as well as in patients with conventional orthodontic treatment in a longer follow-up time to find out more about the post-treatment periodontal tissue changes and stability.

Evaluation of concordance between CAD/CAM and clinical positions of abutment shoulder against mucosal margin: an observational study

Background

While working on CAD/CAM-customized abutments, the use of standard impression copings with a circular diameter produces inconsistency within the emergence profile. It may begin with a collapse of the supra-implant mucosa during impression taking, then lead to a computer-generated mismatch of the position and outline of the abutment shoulder, and consequently result in a compromised outcome of anticipated treatment. The aim of the study was to compare the virtual and clinical positions of the abutment shoulder in relation to the mucosal margin after the abutment delivery.

Methods

Conventional open-tray impression takings followed uncovering surgery. Master casts were scanned with a desktop scanner. Clinical examinations took place after abutment’s insertion and temporization (T1) and prior to cementation of the definitive crown (T2). The distances between the abutment shoulder and marginal soft tissue were measured intraorally in four aspects and juxtaposed with those on the virtual model.

Results

The study evaluated 257 dental implants and CAD/CAM-customized abutments. As T1 and T2 showed, there was a positive correlation between the virtually designed abutment shoulder position and matching clinical location relative to the mucosal margin. In 42.1% of cases, the distance between the mucosal margin and the abutment shoulder did not change. It increased in 36.3% of cases while a decrease occurred in 21.6% of them.

Conclusions

Computer-set position of the abutment shoulder in relation to the mucosal margin can be predictably implemented in clinical practice.

Effect of nonsurgical periodontal treatment in conjunction with either systemic administration of amoxicillin and metronidazole or additional photodynamic therapy on the concentration of matrix metalloproteinases 8 and 9 in gingival crevicular fluid in patients with aggressive periodontitis

Background

To evaluate in patients with aggressive periodontitis (AgP) the effect of nonsurgical periodontal treatment in conjunction with either additional administration of systemic antibiotics (AB) or application of photodynamic therapy (PDT) on the gingival crevicular fluid (GCF) concentration of matrix metalloproteinases 8 and 9 (MMP-8 and -9).

Methods

Thirty-six patients with AgP were included in the study. Patients were randomly assigned to treatment with either scaling and root planing (SRP) followed by systemic administration of AB (e.g. Amoxicillin + Metronidazole) or SRP + PDT. The analysis of MMP-8 and -9 GCF concentrations was performed at baseline and at 3 and 6 months after treatment. Nonparametric U-Mann-Whitney test was used for comparison between groups. Changes from baseline to 3 and 6 months were analyzed with the Friedman’s ANOVA test with Kendall’s index of consistency.

Results

In the AB group, patients showed a statistically significant (p = 0.01) decrease of MMP-8 GCF level at both 3 and 6 months post treatment. In the PDT group, the change of MMP-8 GCF level was not statistically significant. Both groups showed at 3 and 6 months a decrease in MMP-9 levels. However, this change did not reach statistical significance.

Conclusions

Within the limits of the present study, it may be suggested that in patients with AgP, nonsurgical periodontal therapy in conjunction with adjunctive systemic administration of amoxicilin and metronidazole is more effective in reducing GCF MMP-8 levels compared to the adjunctive use of PDT.

Nonsurgical treatment of aggressive periodontitis with photodynamic therapy or systemic antibiotics. Three-month results of a randomized, prospective, controlled clinical study

The aim of this randomized, controlled clinical study was to compare the short-term effects of nonsurgical periodontal therapy with the additional administration of systemic antibiotics (AB) and the same therapy with additional photodynamic therapy (PDT) in the treatment of patients with aggressive periodontitis (AP). Thirty-six patients with AP received full-mouth nonsurgical periodontal treatment (SRP) and were then randomly divided into two groups of 18 subjects each. Group AB received amoxicillin and metronidazole three times a day for 7 days. Group PDT received two applications of PDT on the day of SRP as well as at follow-up after 7 days. The following clinical parameters were measured at baseline and 3 months after therapy: plaque index (PLI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). After 3 months, PD was significantly reduced in both groups (from 5.0±0.8 mm to 3.2±0.4 mm with AB, and 5.1±0.5 mm to 4.0±0.8 mm with PDT; both p<0.001), while AB revealed significantly lower values compared to PDT (p = 0.001). In both groups, GR was not significantly changed. CAL was significantly reduced in both groups (PDT: 5.7±0.8 mm to 4.7±1.1 mm; p=0.011; AB: 5.5±1.1 mm to 3.9±1.0 mm; p<0.001) and differed significantly between the groups (p=0.025). The number of residual pockets (PD ≥4 mm) and positive BOP was reduced by AB from 961 to 377, and by PDT from 628 to 394. Pockets with PD ≥7 mm were reduced by AB from 141 to 7, and by PDT from 137 to 61. After 3 months, both treatments led to statistically significant clinical improvements. The systemic administration of antibiotics, however, resulted in significantly higher reduction of PD and a lower number of deep pockets compared to PDT.

Retention force assessment in conical crowns in different material combinations

The puprose of this study was to evaluate retention force of conical double crowns in two material connections: gold casting alloy/gold casting alloy and gold casting alloy/gold electroforming alloy. 12 crown pairs of both material connections with the cone angles of 2°, 4° and 6° were made. Experiment of 10.000 in-and-out cycles was performed using a new device which allows the retentive force to be measured in continuous way without necessity of moving the samples to another device. It has been found that the higher the retentive force values, the lower the cone angle. Dispersion of the retention value was similar in both groups, but when cone angle was 2° or 4°, stability of retention force with the passage of time was higher in combinations with electroformed copings. The optimum solution was the cast alloy/cast alloy connection but only with cone angle 6°. However, retentive values seem to be too low to achieve proper retention of dentures.

Long-term follow-up of conical crown-retained dentures fabricated using different technologies

This study presents the results of a long-term clinical evaluation of conical crown-retained dentures fabricated using different technologies. Four different material connections between the outer and inner crowns were used: cast gold/cast gold, cast gold/electroforming, nonprecious alloy/electroforming, and titanium abutment/electroforming. Technical failures and retention values were assessed. The best clinical outcome was found with dentures in which both crowns were cast from gold alloy. The most frequent technical failures were observed in restorations with electroformed outer crowns. Better clinical outcomes were noted when the electroformed outer crowns were used in dentures retained by implants as compared to dentures on natural dentition.

Serum levels of interleukin-1 (IL-1), interleukin-6 (IL-6) and interleukin-8 (IL-8) in patients treated with dental implants

The aim of the present study was to evaluate the levels of proinflammatory interleukins (IL)--IL-1, IL-6 and IL-8 in the blood of patients subjected to dental implant anchorage procedures. The study involved 10 generally healthy people aged 27-52, 4 men and 6 women. The patients were characterised by normal oral hygiene and lack of clinical symptoms of oral inflammation. Surgical procedures used Italian Logos system dental implants. The blood for analysis was collected three times: prior to surgery, one day and four months after the procedure before implant exposure. Interleukin levels were assayed with the ELISA method. The results were subjected to statistical analysis using Wicoxon's test. In all the cases examined soft tissue healing following the procedure was uneventful. The three consecutive examinations revealed similar IL-1 blood levels. Mean serum concentrations of IL-6 and IL-8 increased significantly in the second examination and returned to the close-to-initial values after 4 months. Increase of blood serum levels of IL-6 and IL-8 in the first day after implantation reflects local inflammation process caused by tissue impair.

Clinical and radiographic evaluation of periodontal therapy using enamel matrix derivative (Emdogain)

The aim of the present study was to evaluate clinical and radiographic outcome following the application of enamel matrix derivative--Emdogain in the treatment of the bone defects due to periodontitis. The study included 25 generally healthy patients with advanced periodontitis. Clinical and radiographic examination was carried out twice: before the procedure and a year after treatment. The following clinical parameters were evaluated: probing pocket depth (PPD), clinical attachment level (CAL) and gingival recession (GR). Defect depth, width and bone defect fill were assessed on the radiographs. A year after surgery the follow-up examination found a significant improvement of clinical parameters. The mean depth of gingival pockets was reduced from 8.76 +/- 1.74 mm to 4.52 +/- 1.56 mm. The mean CAL value was also decreased from 10.72 +/- 1.56 mm to 7.82 +/- 1.68 mm. Analysis of radiographs showed a statistically significant reduction in depth and width of bone defects. Our results indicate a good clinical and radiographic effect following the application of Emdogain in the treatment of periodontal intrabony defects.

Evaluation of polypeptide growth factors in the process of dental implant osseointegration

The aim of the present study was to evaluate the concentration of three polypeptide growth factors: transforming growth factor beta (TGF beta), platelet-derived growth factor (PDGF) and fibroblast growth factor (FGF) in the blood of patients treated with Italian Logos system implants. The blood for analysis was collected three times: prior to the surgery, the day after and four months after the procedure before implant exposure for the prosthetic phase. The concentration of growth factors was assayed using ELISA method with R&D kits. The mean serum PDGF concentration on the first day and after 4 months following the procedure were comparable to the preliminary examination. The mean serum concentration of TGF beta in the second examination increased significantly compared to that before surgery. Four months later its mean concentration was lower than in the second examination, but still higher than in the preliminary examination. The mean serum FGF concentration in our patients remained similar throughout the study. Based on presented above data we conclude that inflammation process caused by tissue injure during implantation stimulates TGF beta release what can be detected by increase of it's concentration in blood serum.

Polypeptide growth factors in the course of surgical periodontal treatment

The aim of the study was to evaluate the behaviour of certain polypeptide growth factors in patients with rapidly progressive periodontitis (RPP) during periodontal therapy using alloplastic grafts. Concentrations of epidermal growth factor (EGF), fibroblastic growth factor (FGF), platelet-derived growth factor (PDGF) and transforming growth factor beta (TGF beta) were assayed in blood serum and saliva. Significant differences in the behaviour of growth factors in blood referred to EGF and PDGF. Their mean concentrations in serum of RPP patients were higher both in the preliminary examination and in the final investigation after 3 months compared with control group. However, mean FGF concentrations in serum were significantly higher only in the distant examination. In saliva, the concentrations of EGF, PDGF and FGF were not significantly different compared with control group. Salivary TGF beta in patients with RPP was significantly higher than in controls and increased in the final examination. The differences observed in the concentrations of growth factors in the serum and saliva of patients with RPP indicate that these factors can be involved in inflammation, destruction and regeneration of periodontal tissues.

Interleukin 6, tumor necrosis factor alpha and their soluble receptors in the blood serum of patients with denture stomatitis and fungal infection

Determinations of the blood serum levels of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and their soluble receptors (sIL-6R, sTNFR) in denture stomatitis patients (DS) were performed. Serum levels of interleukins and their soluble receptors were measured using the ELISA method. In all examined patients mycological diagnostics were conducted using API 20C AUX stripe tests and an automatic ATB machine. Results were compared with those of healthy denture wearers (D), and controls (C). In DS patients, yeasts were isolated in 90.9%, in D in 66.7% of cases. The most often isolated species in both groups was Candida albicans. Mean concentrations of IL-6 and TNF-alpha were statistically significantly higher in DS and D groups compared to controls. Mean concentrations of sIL-6R were similar in all groups; however, concentrations of sTNFR in both DS and D groups were significantly lower compared to controls. There were no correlations found between values of IL-6 and TNF-alpha nor between examined interleukins and their soluble receptors.

An assessment of the structure of perception in people with bruxism

The aim of the study was to assess the structure of perception in people with bruxism. 50 people with a diagnosis of bruxism (B), in whom primary evidence of oclusal disharmony and temporomandibular disorders were excluded, were included in the study. The control group (C) consisted of 50 people with no evidence of parafunctional abnormalities of the chewing mechanism. Shalit's diagram was used to assess the structure of perception. The primary indices: discriminability (D), articulation (A), affective load+ (AL+) and affective load- (AL-) and secondary indices: reduction (R), emotionality (E), intensity (I) were derived from Shalit's diagram. A significant reduction in the mean value of the primary indices D and AL+ was noted, as well as in the secondary indices E and I in people with bruxism, in comparison to the control group. Assessment of the structure of perception in people with bruxism through the analysis of the primary and secondary indices, makes it possible to predict behavior which has a negative effect on the individual's own health and provides the opportunity for changing such behavior to be more pro-health oriented.

Interleukin 6 and its soluble receptor in periodontitis

The paper presents the evaluation of interleukin 6 (IL-6) and interleukin 6 soluble receptor (sIL-6R) values in the blood serum of patients with various forms of periodontitis (P), as confronted with local state. The study involved a group of 15 patients with P, including 4 patients with rapidly progressive periodontitis (RPP), 10 with adult periodontitis (AP) and 1 with juvenile periodontitis (JP). The concentration of IL-6 and its soluble receptor in blood serum were assessed using the immunoenzymatic ELISA method. The clinical state was estimated with the following periodontal indices: plaque index (PI), oral hygiene index (OHI), sulcus bleeding index (SBI), probing pocket depth and probing attachment loss. The P group showed an insignificant decrease in the IL-6 level in serum and a significant increase in sIL-6R concentration, compared with controls. A correlation was found between the level of IL-6 and PI, OHI and SBI.