2023

Jump to: 2022, 2021

19 pages, 8787 KiB

Open AccessArticle

Electromyographic Evaluation of Muscle Activity in Patients Rehabilitated with Full Arch Fixed Implant-Supported Prostheses

by Mihail Mostovei, Oleg Solomon, Nicolae Chele, Cosmin Sinescu, Virgil-Florin Duma and Andrei Mostovei

Medicina 2023, 59(2), 299; https://doi.org/10.3390/medicina59020299 - 06 Feb 2023

Cited by 1 | Viewed by 1547

Abstract

Background and Objectives: Implant rehabilitation of complete edentulous arches has become more and more popular because of the increased access of the population to this type of treatment. Furthermore, the development of new rehabilitation procedures can be applied in most clinical cases, [...] Read more.

Background and Objectives: Implant rehabilitation of complete edentulous arches has become more and more popular because of the increased access of the population to this type of treatment. Furthermore, the development of new rehabilitation procedures can be applied in most clinical cases, including in those with severe atrophy. Hence, this study aimed to assess the functional changes that can occur in the stomatognathic system after implant rehabilitation procedures. Materials and Methods: A total of 63 patients were accepted in the study. They were divided into a first control (dentate) group (CG) and a second study group (edentulous, SG). For the latter, 30 patients received 204 two-stage implants immediately loaded with provisional prostheses. Surface electromyography (EMG) was assessed at the time of prostheses fixation, while for some patients it was applied six months after the fixation of the fixed prostheses, as well. These supplemental investigated patients formed a third, follow-up study group (FSG). All assessments were performed during the processes of clenching and mastication. The obtained data of the two study groups, SG and FSG, were compared with those of the control group, CG. Results: No statistical differences were found in the electrical muscular activity between the study and control groups during both clenching and mastication (p > 0.05). In addition, there were no differences within the same study group, both initially and after 6 months. The only changes were noticed between static and dynamic values for the right masseter muscle in the follow-up group FSG (p = 0.008). Deviations of the overlapping coefficients were similar for all groups (p = 0.086): for CG, 20.5%, median 11.1 (min. 0, max. 104); for SG, 21.4%, median 12.2 (min. 0, max. 103); for FSG, 36.1%, median 26.9 (min. 0, max. 160). This revealed no neuromuscular adaption to the prostheses. Conclusions: Implant-prosthetic rehabilitation led to an EMG activity that was similar to that of dentate patients immediately after the placement of the fixed implant-supported prostheses. Moreover, the measured values did not change after six months of functioning for all evaluated parameters. This may point to an immediate restoration of the muscle contraction capacity, without the necessity of adaptation over time. The study serves as an argument for the application and reliability of the immediate fixed implant-supported prostheses from the perspective of muscle adaptation and functioning. Full article

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14 pages, 7423 KiB

Open AccessArticle

Influence of the Operator`s Experience, Working Time, and Working Position on the Quality of the Margin Width: In Vitro Study

by Kinga Mária Jánosi, Diana Cerghizan, Zsigmond Rétyi, Alpár Kovács, Andrea Szász, Izabella Mureșan, Aurița Ioana Albu and Liana Georgiana Hănțoiu

Medicina 2023, 59(2), 244; https://doi.org/10.3390/medicina59020244 - 27 Jan 2023

Cited by 1 | Viewed by 1543

Abstract

Background and Objectives: Appropriate tooth preparation is mandatory to obtain a perfect marginal fit of fixed restorations. The heavy chamfer is the most commonly used finish line, especially for minimally invasive tooth preparation. The aim of the study was to compare the [...] Read more.

Background and Objectives: Appropriate tooth preparation is mandatory to obtain a perfect marginal fit of fixed restorations. The heavy chamfer is the most commonly used finish line, especially for minimally invasive tooth preparation. The aim of the study was to compare the width of the finish line obtained during tooth preparation performed by experienced (university lecturers) and inexperienced persons (dental students) in different working times and positions. Materials and Methods: Forty left upper-second molars were prepared on the simulator by each participant, totalizing 160 prepared teeth. A new round-end tapered diamond was used to obtain the 0.5 mm width of the heavy chamfer. The prepared teeth were photographed using a Canon D5300 camera with a macro lens attached to a tripod. The measurements were made with the Image-Pro Insight software selecting the same eight reference points. From these points, perpendicular lines were drawn above the finish line to the axial walls and the distance between the chamfer’s outer edge and the axial wall’s inner edge was measured. GraphPad Instat and NCSS Dowson Edition software were used. The statistical significance was set at p < 0.05. The mean (M) and standard deviation (SD) were calculated. The used tests: one sample t-test, ANOVA test, and Tukey–Kramer Multiple Comparisons Test. Results: Statistically significant differences were obtained according to the experience of the participant, preparation time, patient’s position, and the chamfer width on the prepared tooth different surfaces. Conclusions: Daytime or weeklong tiredness and patient position do not affect the width of the heavy chamfer prepared by experienced and inexperienced persons. The experience and the operator’s working position influence the width of the prepared finish line. Full article

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23 pages, 12168 KiB

Open AccessArticle

The Biological Activity of Fragmented Computer-Aided Design/Manufacturing Dental Materials before and after Exposure to Acidic Environment

by Codruța Eliza Ille, Elena-Alina Moacă, Maria Suciu, Lucian Barbu-Tudoran, Meda-Lavinia Negruțiu and Anca Jivănescu

Medicina 2023, 59(1), 104; https://doi.org/10.3390/medicina59010104 - 03 Jan 2023

Cited by 3 | Viewed by 1793

Abstract

Three ceramic and composite computer-aided design/computer-aided manufacturing (CAD/CAM) materials from different manufacturers (Cerasmart (CS)—nanoceramic resin; Straumann Nice (SN)—glass ceramic and Tetric CAD (TC)—composite resin) were tested to investigate the biocompatibility and sustainability on human fibroblasts and keratinocytes cells. Each type of CAD/CAM blocks [...] Read more.

Three ceramic and composite computer-aided design/computer-aided manufacturing (CAD/CAM) materials from different manufacturers (Cerasmart (CS)—nanoceramic resin; Straumann Nice (SN)—glass ceramic and Tetric CAD (TC)—composite resin) were tested to investigate the biocompatibility and sustainability on human fibroblasts and keratinocytes cells. Each type of CAD/CAM blocks restorative materials with fine and rough surfaces was exposed to an acidic environment for one month. After that, various powders were obtained by milling. In parallel, powders were also prepared from each restorative material, which were not exposed to the acidic environment. The cytotoxic effects were investigated by means of MTT and LDH assays, as well as nitric oxide production on two human normal cell lines, namely, fibroblasts (BJ) and keratinocytes (HaCaT). In addition, the degree of adhesion of fibroblast cells to each CAD/CAM material was evaluated by scanning electron microscopy (SEM). The results showed that the two samples that were exposed to an acidic environment (CS and SN) induced a reduction of mitochondrial activity and plasma membrane damage as regards the fibroblast cells. A similar effect was observed in TC_fine-exposed material, which seemed to induce necrosis at the tested concentration of 1 mg/mL. No oxidative stress was observed in fibroblasts and keratinocytes treated with the CAD/CAM materials. Regarding the adhesion degree, it was found that the fibroblasts adhere to all the occlusal veneers tested, with the mention that the CS and SN materials have a weaker adhesion with fewer cytoplasmic extensions than TC material. With all of this considered, the CAD/CAM restorative materials tested are biocompatible and represent support for the attachment and dispersion of cells. Full article

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2022

Jump to: 2023, 2021

10 pages, 2306 KiB

Open AccessArticle

Surface Characterization, Antimicrobial Activity of Nonthermal Atmospheric-Pressure Plasma Jet on Polyvinyl Siloxane Impression Materials

by Yu-Ri Choi, Eun-Mi Yoo, Hye-Yeon Seo and Min-Kyung Kang

Medicina 2022, 58(11), 1556; https://doi.org/10.3390/medicina58111556 - 29 Oct 2022

Cited by 1 | Viewed by 1379

Abstract

Background and Objectives The antimicrobial efficacy of a nonthermal atmospheric-pressure plasma jet (NAPPJ) on dental impression materials was investigated. Materials and Methods Type 3 polyvinyl siloxane was used as the impression material, and air and nitrogen NAPPJ were applied. The antibacterial effect of [...] Read more.

Background and Objectives The antimicrobial efficacy of a nonthermal atmospheric-pressure plasma jet (NAPPJ) on dental impression materials was investigated. Materials and Methods Type 3 polyvinyl siloxane was used as the impression material, and air and nitrogen NAPPJ were applied. The antibacterial effect of the NAPPJ was measured using the number of colony-forming units (CFUs) and scanning electron microscopy (SEM) images of Streptococcus mutans. Surface chemical characteristics of the impression material were examined using X-ray photoelectron spectroscopy (XPS) and contact angle measurement. Additionally, physical properties were analyzed through surface roughness measurement, detail reproduction, and strain-in-compression test. Results Compared with the control group, the plasma treatment group showed ruptured bacteria membranes, destroyed bacteria structures, a significant reduction in the number of CFUs, and a significantly reduced contact angle. Further, XPS analysis showed that their surface was significantly richer in hydroxyl groups. The surface roughness, detail reproduction, and strain-in-compression results indicated no significant differences between the plasma treatment and control groups. NAPPJ treatment could remove bacteria from polyvinyl siloxane dental impression materials without changing the surface's physical properties. Conclusion Therefore, it is considered a promising method for disinfection. Full article

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8 pages, 1343 KiB

Open AccessArticle

Osteogenic Differentiation of Periodontal Ligament Stem Cells Seeded on Equine-Derived Xenograft in Osteogenic Growth Media

by Montaser N. Alqutub, Areej H. Mukhtar, Yasser Alali, Fahim Vohra and Tariq Abduljabbar

Medicina 2022, 58(11), 1518; https://doi.org/10.3390/medicina58111518 - 25 Oct 2022

Cited by 1 | Viewed by 1335

Abstract

Background and Objectives: The duration of bone turnover is critical, and different time points help in identifying the optimal endpoint of treatment duration. However, investigating the combination of xenograft and stem cells to allow tissue regeneration within an ideal time duration remains [...] Read more.

Background and Objectives: The duration of bone turnover is critical, and different time points help in identifying the optimal endpoint of treatment duration. However, investigating the combination of xenograft and stem cells to allow tissue regeneration within an ideal time duration remains an under-investigated topic. The current study aimed to assess the impact of equine-derived xenograft bone blocks in assisting the human periodontal ligament stem cells (PDLSCs) to demonstrate osteogenic differentiation (collagen type 1 expression and calcium deposition) within an osteogenic growth media. Materials and Methods: Human PDLSCs were acquired commercially and seeded onto xenograft bone blocks. After the 14th and 21st day of culture, enzyme-linked immunoassay (ELISA) was utilized for the detection and quantification of levels of collagen type I, while the mineralization assessment (deposition of calcium) was conducted by staining the PDLSCs with Alizarin Red S (ARS). The statistical comparison between the means and standard deviations of study groups were evaluated using analysis of variance (ANOVA). Results: ELISA assessment revealed an upsurge in the expression of collagen type I for PDLSCs cultured with xenograft after 14 and 21 days compared to the controls (intergroup comparisons significant at p < 0.05). Similar findings were obtained for mineralization assessment and on ARS staining. PDLSCs cultured with xenograft bone blocks presented an increased deposition of calcium compared to their control counterparts (intergroup comparisons significant at p < 0.05). Conclusions: PDLSCs embedded in xenograft bone blocks inside an osteogenic growth medium demonstrated greater osteogenic differentiation potential after 14 and 21 days. This superior osteogenic differentiation capability was evident by increased collagen type I expression and more significant calcium deposition at the 14th and 21st days after culture. Full article

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11 pages, 10002 KiB

Open AccessArticle

Effect of 9% Hydrofluoric Acid Gel Hot-Etching Surface Treatment on Shear Bond Strength of Resin Cements to Zirconia Ceramics

by So-Hyun Kim, Sung-Chan Cho, Myung-Hyun Lee, Hyo-Jung Kim and Nam-Sik Oh

Medicina 2022, 58(10), 1469; https://doi.org/10.3390/medicina58101469 - 17 Oct 2022

Cited by 4 | Viewed by 2789

Abstract

Background and Objectives: There is no consensus regarding the surface treatment method for achieving optimal bonding strength between zirconia and resin cements. We evaluated the effect of hot-etching with 9% hydrofluoric acid (HF) gel using the Zirconia Etchant Cloud System on zirconia [...] Read more.

Background and Objectives: There is no consensus regarding the surface treatment method for achieving optimal bonding strength between zirconia and resin cements. We evaluated the effect of hot-etching with 9% hydrofluoric acid (HF) gel using the Zirconia Etchant Cloud System on zirconia surfaces and the consequent shear bond strength (SBS) of different resin cements to such surface-treated zirconia ceramics. Materials and Methods: Forty-five zirconia specimens were randomly assigned to surface-treatment groups (n = 15/group): no treatment (control, CT); sandblasting with 110-μm Al₂O₃ at an air pressure of 1 bar for 10 s (SB); hot-etching with 9% HF gel (HE). Post-treatment, specimens were examined using scanning electron microscopy (SEM) and surface roughness (SR) analysis. After treatment, self-adhesive resin cements (Maxcem Elite, MAZIC Cem, RelyX U200, 3M ESPE: Maplewood, MN, USA) were bonded to zirconia specimens, which were stored in distilled water at 37 °C for 24 h. All specimens were then subjected to SBS testing, using a universal testing machine, until failure. Data were analyzed using one-way analysis of variance and Tukey’s post hoc test (α = 0.05). Results: In the SEM images, roughness was greater in SB than in HE specimens. Ra and Rt values were highest in SB, followed by HE, and CT specimens. HE specimens showed significantly higher SBS values than CT or SB specimens (p < 0.05). MAZIC Cem cement, with 10-methacryloyloxydcyl dihydrogen phosphate yielded the highest SBS values. Conclusions: Hot-etching with 9% HF gel in a safe shell formed uniformly small, defined holes on the zirconia surface and achieved significantly higher SBS values than sandblasting (p < 0.05). Zirconia prostheses can be bonded micromechanically with resin cement, without the deterioration of properties due to t-m transformation, using chemical acid etching with the Zirconia Etchant Cloud System. Full article

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9 pages, 2920 KiB

Open AccessArticle

Interdental Papillary Reconstruction by Microtunnelling Technique Using Autologous Biomatrices—A Randomised Controlled Clinical Trial

by Sindhura Gadi, Sangeetha Subramanian, P. S. G. Prakash, Devapriya Appukuttan, Abirami Thanigaimalai, Maha A. Bahammam, Khalid J. Alzahrani, Khalaf F. Alsharif, Ibrahim F. Halawani, Mrim M. Alnfiai, Thodur Madapusi Balaji and Shankargouda Patil

Medicina 2022, 58(10), 1326; https://doi.org/10.3390/medicina58101326 - 22 Sep 2022

Cited by 2 | Viewed by 2608

Abstract

Background and objectives: The study aimed to evaluate and compare the amount of papillary gain and black triangle height reduction after intervention with a microtunnelling technique with either Connective tissue graft (CTG) or Platelet-rich fibrin (PRF) as a biomatrix at 6 months [...] Read more.

Background and objectives: The study aimed to evaluate and compare the amount of papillary gain and black triangle height reduction after intervention with a microtunnelling technique with either Connective tissue graft (CTG) or Platelet-rich fibrin (PRF) as a biomatrix at 6 months using a microsurgical approach. Materials and Methods: Twenty-six patients with interdental papillary loss were included in the study. The patients were selected randomly for the study groups with thirteen patients in each group: a control group where CTG was utilised as a matrix, and a test group where PRF was utilised as a matrix, for interdental papillary reconstruction. A microtunnelling technique was performed for both the study groups under a surgical microscope. The primary parameters assessed were interdental Papillary height (PH) and Black triangle height (BTH) at baseline, with secondary parameters Visual analogue score by dentist (VAS-D) and patient (VAS-P) assessed at 6 months. Results: Both the control and test groups showed a significant reduction in BTH within their respective group at six months (p < 0.05). The gain in papillary height significantly improved only in the CTG group at 6 months. However, significant differences could not be demonstrated for any of the variables such as BTH (p value = 0.582) and PH (p-value = 0.892) between the study groups at 6 months. Conclusions: IDP reconstruction utilising a microtunnelling approach with CTG or PRF was successful without any significant differences between the groups for the parameters assessed at 6 months. Full article

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12 pages, 8207 KiB

Open AccessArticle

Marginal Misfit of 3D-Printed (Selective Laser Sintered), CAD-CAM and Lost Wax Technique Cobalt Chromium Copings with Shoulder and Chamfer Finish Lines: An In-Vitro Study

by Samar Al-Saleh, Fahim Vohra, Shabab M. Albogami, Nawaf M. Alkhammash, Mohammed A. Alnashwan, Naif S. Almutairi, Khalid A. Aali, Mohammed Alrabiah and Tariq Abduljabbar

Medicina 2022, 58(10), 1313; https://doi.org/10.3390/medicina58101313 - 20 Sep 2022

Cited by 3 | Viewed by 1878

Abstract

Background and Objectives: The aim was to compare the Misfit of 3D-Printed, Selective laser melting (SLM), milled (Computer aided design-Computer aided manufacture CAD-CAM) and Lost wax technique (LWT) fabricated Cobalt chromium (CoCr) alloy copings on shoulder (SH), radial shoulder (R-SH) and chamfer (CH) [...] Read more.

Background and Objectives: The aim was to compare the Misfit of 3D-Printed, Selective laser melting (SLM), milled (Computer aided design-Computer aided manufacture CAD-CAM) and Lost wax technique (LWT) fabricated Cobalt chromium (CoCr) alloy copings on shoulder (SH), radial shoulder (R-SH) and chamfer (CH) finish line configuration. Materials and Methods: Ninety resin, second maxillary premolar teeth were prepared for metal-ceramic crowns, equally divided into (n = 30) SH, R-SH and CH margin preparations. For each preparation design (SH, R-SH and CH), CoCr copings were prepared using SLM, CAD-CAM and LWT. This resulted in nine study groups with 10 CoCr copings each. The marginal misfit of specimens was assessed with a high-resolution digital microscope. Misfit was evaluated in vertical and horizontal dimensions in μm. Data were analyzed using ANOVA and a post hoc multiple comparisons test. Results: For vertical misfit, the highest was observed in SLM samples with chamfer margin (167.96 ± 24.1), and the least was shown by CAD-CAM samples with radial shoulder (58.8 ± 12.53). CAD-CAM and shoulder margins showed the least vertical misfit. For horizontal misfit, the maximum was observed in SLM samples with shoulder margin (137.94 ± 37.85) and the least by LWT samples with chamfer (89.38 ± 14.81). Chamfer margins and LWT samples showed the least horizontal misfit among the group samples. Fabrication technique and finish line design play a critical role in reducing the marginal misfit of CoCr copings. Conclusions: For vertical misfit, SLM copings showed poor outcomes compared to CAD-CAM specimens, however comparable outcomes to Cast specimens. SLM copings showed comparable horizontal misfit outcomes to CAD-CAM specimens and low misfit compared to Cast copings, respectively. Vertical misfit was low with shoulder margins, and horizontal misfit was better with chamfer marginal configuration. Full article

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10 pages, 1107 KiB

Open AccessArticle

A Comparative Evaluation of Dentogingival Tissue Using Transgingival Probing and Cone-Beam Computed Tomography

by Gotam Das, Abdul Razzaq Ahmed, Ghazala Suleman, Abhishek Lal, Muhammad Haseeb Rana, Naseer Ahmed and Suraj Arora

Medicina 2022, 58(9), 1312; https://doi.org/10.3390/medicina58091312 - 19 Sep 2022

Cited by 1 | Viewed by 2815

Abstract

Background and Objective: Gingival biotype can be assessed using a variety of invasive and non-invasive procedures, such as direct probing, transgingival probing, ultrasound-guided approaches, and, for the more sophisticated, cone-beam computed tomography. The aim of this study was to evaluate gingival biotype [...] Read more.

Background and Objective: Gingival biotype can be assessed using a variety of invasive and non-invasive procedures, such as direct probing, transgingival probing, ultrasound-guided approaches, and, for the more sophisticated, cone-beam computed tomography. The aim of this study was to evaluate gingival biotype in relation to transgingival probing and cone-beam computed tomography (CBCT). Materials and Methods: This study included a total of two hundred healthy individuals. Gingival thickness was assessed and measured from the right and left maxillary central incisor teeth using CBCT and transgingival probing of the attached gingiva. The measurements were analyzed with regard to tooth type (central incisor). Linear measurements for gingival biotype were measured using both methods. Correlations and differences between measurement methods were assessed. Results: The mean age of study participants was 32.49 ± 8.61 years. The radiographic measurements on CBCT were 1.34 ± 0.17 mm for the right central and 1.28 ± 0.21mm for the left central. The transgingival probing measurements were 1.31 ± 0.18 for the right central and 1.22 ± 0.21mm for the left central. Conclusion: As per the results of this study, there is a significant positive correlation between transgingival probing and CBCT measurements of gingival biotypes. Full article

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14 pages, 7502 KiB

Open AccessArticle

Influence of the Text Neck Posture on the Static Dental Occlusion

by Eniko Tunde Stoica, Corina Marcauteanu, Anca Tudor, Virgil-Florin Duma, Elena Constanta Amaricai, Roxana Onofrei, Oana Suciu, Meda Lavinia Negrutiu and Cosmin Sinescu

Medicina 2022, 58(9), 1303; https://doi.org/10.3390/medicina58091303 - 18 Sep 2022

Cited by 3 | Viewed by 2639

Abstract

Background and Objectives: The excessive use of smartphones for various tasks led to a new adverse postural phenomenon called text neck. The aim of this study was to investigate the effect of the text neck posture (TNP) on static occlusion by using the [...] Read more.

Background and Objectives: The excessive use of smartphones for various tasks led to a new adverse postural phenomenon called text neck. The aim of this study was to investigate the effect of the text neck posture (TNP) on static occlusion by using the T-Scan III occlusal diagnostic system. Materials and Methods: Nineteen subjects (aged 20 to 24 years) were considered for this research. They had normal values for anterior overbite and overjet, Angle Class I occlusion, no posterior crossbite, and no signs or symptoms of cervical or temporo-mandibular disorders. Occlusal registrations were performed with the T-Scan III system in a normal, neutral head posture (NHP), as well as in the TNP. The investigated parameters were: occlusion time (OT), asymmetry index of the occlusal force (AOF), percent of the maximum movie force (%MMF), and the time elapsed from the last occlusal contact until the maximum intercuspation (MAT-OTB). The last three parameters were analyzed in the maximum area frame (MA) of the registrations. For the statistical analysis of the recorded data, the Wilcoxon Signed Ranks test and the Spearman’s correlation coefficient were used. Results: The following values were obtained in NHP and in TNP: for AOF, 14.88 ± 10.39% and 18.04 ± 12.83%, respectively; for OT, 1.34 ± 1.84 s and 1.32 ± 1.8 s, respectively; for the %MMF, 97.5 ± 2.83% and 96.31 ± 3.17%, respectively; for MAT-OTB, 2.08 ± 1.82 s and 1.45 ± 2.3 s, respectively. There were no statistically significant differences between the static occlusal parameters measured in NHP and those in TNP. However, the high values of the AOF and OT in NHP revealed an imbalance of the occlusal force distribution between the right and left side in maximum intercuspation (MI), as well as a lack of simultaneity of static occlusal contacts. Furthermore, there was a significant, direct, and strong correlation between OT and AOF in NHP. Conclusions: The NHP should not be used as the starting position in TNP simulations in T-Scan studies, so as to avoid statistically insignificant differences between static occlusion in NHP and TNP. The healthy standing subjects, with normal occlusal relationships from the clinical point of view, revealed an occlusal instability in NHP when examined with the T-Scan. Full article

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9 pages, 3028 KiB

Open AccessArticle

Evaluation of Cytotoxic and Antibacterial Effect of Methanolic Extract of Paeonia lactiflora

by Yu-Ri Choi and Min-Kyung Kang

Medicina 2022, 58(9), 1272; https://doi.org/10.3390/medicina58091272 - 14 Sep 2022

Cited by 1 | Viewed by 1707

Abstract

Background and objectives: Bacterial antibiotics have had several side effects. Therefore, interest in natural substances with less side effects is increasing these days. Paeonia lactiflora, the root of Paeonia lactiflora, is used as a raw material for medicines. In this study, [...] Read more.

Background and objectives: Bacterial antibiotics have had several side effects. Therefore, interest in natural substances with less side effects is increasing these days. Paeonia lactiflora, the root of Paeonia lactiflora, is used as a raw material for medicines. In this study, we investigated the antibacterial effect and the cytotoxicity of Paeonia lactiflora extract. Materials and Methods: For cytotoxicity, MTT analysis according to ISO 10993-5 was performed. The antibacterial test of the Paeonia lactiflora was determined from bacterial viability, Inhibition zone test, CFU (colony forming unit) and SEM (scanning electron microscope). To confirm the antibacterial component of Paeonia lactiflora, the content of flavonoids and polyphenols was analyzed. Results: Our results showed that Paeonia lactiflora extract contained flavonoids and polyphenols, which exhibited antimicrobial activity against Streptococcus mutans (S. mutans) and Candida albicans (C. ablicans). Further, the cytotoxicity of Paeonia lactiflora extract was low. Conclusions: We believe that our study makes a significant contribution to the literature because it demonstrates that Paeonia lactiflora extract can be used as an antibiotic. Full article

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12 pages, 2165 KiB

Open AccessSystematic Review

Effectiveness and Clinical Performance of Erythritol Air-Polishing in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials

by Florin Onisor, Alexandru Mester, Leonardo Mancini and Andrada Voina-Tonea

Medicina 2022, 58(7), 866; https://doi.org/10.3390/medicina58070866 - 28 Jun 2022

Cited by 6 | Viewed by 2584

Abstract

Background and objectives: The purpose of the present systematic review was to analyze the effectiveness of erythritol-based air-polishing in non-surgical periodontal therapy. Materials and methods: The protocol details were registered in the PROSPERO database (CRD42021267261). This review was conducted under the [...] Read more.

Background and objectives: The purpose of the present systematic review was to analyze the effectiveness of erythritol-based air-polishing in non-surgical periodontal therapy. Materials and methods: The protocol details were registered in the PROSPERO database (CRD42021267261). This review was conducted under the PRISMA guidelines. The electronic search was performed in PubMed, Scopus, and Web of Science databases to find relevant clinical trials published until January 2022. The inclusion criteria consisted of human clinical trials which reported the use of non-surgical periodontal treatment and erythritol air-polishing compared to non-surgical periodontal treatment alone in patients with good systemic health requiring treatment for periodontal disease. Results: 810 studies were imported into the Covidence Platform. Of these, seven clinical trials met the inclusion criteria. In active periodontal therapy, for PD (probing depth), CAL (clinical attachment level), and BOP (bleeding on probing), no statistical significance was achieved at 6 months follow-up. In supportive periodontal therapy for PD, CAL, and BOP, no statistical significance was achieved at 3 months follow-up. Conclusions: The findings suggest that erythritol air-polishing powder did not determine superior improvements of periodontal parameters compared to other non-surgical periodontal therapies. Future randomized clinical trials (RCTs) with calibrated protocols for diagnosis, therapeutic approaches, and longer follow-up are needed to draw a clear conclusion about the efficiency of erythritol air-polishing powder. Full article

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15 pages, 6335 KiB

Open AccessReview

A Bibliometric Analysis (2010–2020) of the Dental Scientific Literature on Chemo-Mechanical Methods of Caries Removal Using Carisolv and BRIX3000

by Dana Cristina Bratu, Nicoleta Nikolajevic-Stoican, George Popa, Silvia Izabella Pop, Bianca Dragoș and Magda-Mihaela Luca

Medicina 2022, 58(6), 788; https://doi.org/10.3390/medicina58060788 - 11 Jun 2022

Cited by 3 | Viewed by 2398

Abstract

Reports in the literature have proposed and analyzed several minimally invasive techniques for caries removal in recent decades. In light of recent events surrounding the ongoing epidemiological context, concerns have been raised regarding the generation of aerosols during dental procedures. The aim of [...] Read more.

Reports in the literature have proposed and analyzed several minimally invasive techniques for caries removal in recent decades. In light of recent events surrounding the ongoing epidemiological context, concerns have been raised regarding the generation of aerosols during dental procedures. The aim of our research was to provide an overview of the scientific literature on the topic of chemo-mechanical caries removal (CMCR) methods, focusing on two products (Carisolv, BRIX3000), commercially available in Europe. A bibliometric analysis was used to investigate the scientific articles included in Web of Science (WoS) Core Collection database, published from January 2010 to December 2020. We analyzed the co-occurrence of all keywords (Author Keywords and the KeyWords Plus section), co-authorship and co-citation, using the free software VOSviewer. Our bibliometric analysis revealed a worldwide interest in the subject of chemo-mechanical methods of caries removal, which has transcended the area of pediatric dentistry. The analyzed studies have been conducted mainly in high-income countries that have developed sanitary policies regarding prevention and early treatment of carious lesions as a health priority. Full article

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18 pages, 3935 KiB

Open AccessArticle

Comparative Evaluation of Influence of Nd:YAG Laser (1064 nm) and 980 nm Diode Laser on Enamel around Orthodontic Brackets: An In Vitro Study

by Daliana-Emanuela Mocuta(Bojoga), Oana Grad(Buriac), Marius Mateas, Ruxandra Luca and Darinca Carmen Todea

Medicina 2022, 58(5), 633; https://doi.org/10.3390/medicina58050633 - 01 May 2022

Cited by 4 | Viewed by 3170

Abstract

(1) Background: The prevention of demineralizing lesions at the enamel structure level continues to represent a challenge in daily dental practice. When bacteria influence the pH level, this will decrease below the threshold for remineralization and the dissociation of hydroxyapatite will occur with [...] Read more.

(1) Background: The prevention of demineralizing lesions at the enamel structure level continues to represent a challenge in daily dental practice. When bacteria influence the pH level, this will decrease below the threshold for remineralization and the dissociation of hydroxyapatite will occur with a high percentage of phosphate and calcium loss. These elements continue to be studied by many authors in order to obtain a working protocol that will lead to their stabilization at the level of the enamel structure, thus preventing the demineralization process. The aim of this study is to evaluate and compare the influence of two types of laser wavelengths on the surface morphology and mineral components of the enamel through an examination with scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDX). (2) Methods: Thirty permanent human incisors extracted for periodontal reasons from patients aged 25–40 years old were selected for this study. Metallic brackets (SS Standard 022 Slot, OC Orthodontics, McMinnville, OR, 97128, USA) were bonded onto each tooth. The buccal surface was randomly assigned three sections: Section A—negative control (no treatment), section B—treated with 980 nm Gallium–Aluminum–Arsenide diode laser (a 300 µm optic fiber was used with 0.8 W output power, energy density of 5.33 J/mm², in continuous mode, for 30 s, oriented perpendicularly to the enamel surface in contact mode) (KaVo GENTLEray 980 Diode Laser, Kaltenbach & Voigt GmbH, Biberach, Germany), and section C—treated with Nd:YAG laser (a 300 µm fiber was carried out at a 1 mm distance from the enamel surface with 0.75 W power, 75 mJ pulse energy, pulse repetition rate of 10 Hz, 5 J/mm² fluency, average exposure time of 30 s, and water cooling assisted) (LIGHTWALKER AT S, M021-5AF/1 S, Fotona d.o.o, Ljubljana, Slovenia). The elements evaluated in this study were calcium (Ca), phosphate (P), oxygen (O), and carbon (C). A one-way analysis of variance, paired t-tests, and independent t-tests were carried out to evaluate the results using the SPSS 19 IBM Statistical package software for Microsoft. (3) Results: The evaluation of the data indicated that both wavelengths produced an increase in Ca wt% (for diode laser the mean of Ca wt% before irradiation was 21.06, while that after treatment reached 28.24; and for Nd:YAG laser, the mean of Ca wt% before irradiation was 21.31, while that after treatment reached 33.88); as well, the 980 nm diode laser decreased P wt% (from 17.20 before irradiation to 16.92 after irradiation) and the Nd:YAG laser increased P wt% (from 17.46 before irradiation to 18.28 after irradiation). These results showed a statistically significant difference at the p < 0.05 level. (4) Conclusions: It can be concluded that the best improvement of enamel chemical composition was obtained with Nd:YAG irradiation. Full article

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9 pages, 2009 KiB

Open AccessSystematic Review

Efficiency of Hyaluronic Acid in Infrabony Defects: A Systematic Review of Human Clinical Trials

by Florin Onisor, Simion Bran, Alexandru Mester and Andrada Voina-Tonea

Medicina 2022, 58(5), 580; https://doi.org/10.3390/medicina58050580 - 23 Apr 2022

Cited by 4 | Viewed by 2409

Abstract

Background and objectives: The aim of this systematic review was to assess the electronic literature about the benefits of using hyaluronic acid (HA) in the surgical periodontal treatment of infrabony defects. Materials and methods: This review was conducted under the PRISMA guidelines. The [...] Read more.

Background and objectives: The aim of this systematic review was to assess the electronic literature about the benefits of using hyaluronic acid (HA) in the surgical periodontal treatment of infrabony defects. Materials and methods: This review was conducted under the PRISMA guidelines. The electronic search was conducted on PubMed, Scopus, Web of Science, and Cochrane databases until February 2022. The inclusion criteria consisted of human clinical trials that reported the use of HA in open-flap debridement (OFD) for infrabony defects. The assessment of risk of bias was performed using the Cochrane risk of bias tool. Statistical analysis was performed using Review Manager. Results: Overall, three RCTs were found eligible for the statistical analysis. Probing depth (PD) reduction and clinical attachment level (CAL) gain in the HA test group presented WMs of −1.11 mm (95% CI −2.38 to 0.16 mm; p = 0.09) and −1.38 mm (95% CI −2.26 to −0.49 mm; p = 0.002), respectively. However, the heterogeneity of the RCTs was high, and the risk of bias, in general, was low. Conclusions: The use of hyaluronic acid seems to have beneficial effects in periodontal surgery using OFD, in terms of PD and CAL. To draw a clear conclusion, more adapted and well-designed clinical trials are needed to assess the advantage of this product in comparison with other products. Full article

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11 pages, 38604 KiB

Open AccessArticle

Extruded Nucleoli of Human Dental Pulp Cells

by Mugurel Constantin Rusu, Alexandra Diana Vrapciu, Mihnea Ioan Nicolescu, Mihai Dragomir Stoenescu, Adelina Maria Jianu, Rodica Lighezan, Roxana Oancea, Vasile Sorin Mănoiu and Sorin Hostiuc

Medicina 2022, 58(2), 260; https://doi.org/10.3390/medicina58020260 - 10 Feb 2022

Viewed by 2588

Abstract

Background and Objectives: The dental pulp stem cells are highly proliferative and can differentiate into various cell types, including endothelial cells. We aimed to evaluate the ultrastructural characteristics of the human dental pulp cells of the permanent frontal teeth. Materials and Methods [...] Read more.

Background and Objectives: The dental pulp stem cells are highly proliferative and can differentiate into various cell types, including endothelial cells. We aimed to evaluate the ultrastructural characteristics of the human dental pulp cells of the permanent frontal teeth. Materials and Methods: Human adult bioptic dental pulp was collected from n = 10 healthy frontal teeth of five adult patients, prior to prosthetic treatments for aesthetic purposes. Tissues were examined under transmission electron microscopy. Results: We identified cells with a peculiar trait: giant nucleoli resembling intranuclear endoplasmic reticulum, which mimicked extrusion towards the cytoplasm. These were either partly embedded within the nuclei, the case in which their adnuclear side was coated by marginal heterochromatin and the abnuclear side was coated by a thin rim of ribosomes, or were apparently isolated from the nuclei, while still being covered by ribosomes. Conclusions: Similar electron microscopy features were previously reported in the human endometrium, as nucleolar channel system; or R-Rings induced by Nopp140. To our knowledge, this is the first report of extruded nucleolar structure in the dental pulp. Moreover, the aspect of giant extruded nucleoli was not previously reported in any human cell type, although similar evidence was gathered in other species as well as in plants. Full article

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13 pages, 5037 KiB

Open AccessCase Report

A Novel Technique for Shortening Orthodontic Treatment: The “JET System”

by Shinichi Narita, Kiyoko Narita and Masaru Yamaguchi

Medicina 2022, 58(2), 150; https://doi.org/10.3390/medicina58020150 - 19 Jan 2022

Cited by 1 | Viewed by 5033

Abstract

We have developed a novel technique, the Jiyugaoka Enjoyable Treatment (JET) system, to complete orthodontic treatment in a short time. It entails the use of the regional acceleratory phenomenon (RAP), light continuous forces and low friction in cases involving extraction. In the JET [...] Read more.

We have developed a novel technique, the Jiyugaoka Enjoyable Treatment (JET) system, to complete orthodontic treatment in a short time. It entails the use of the regional acceleratory phenomenon (RAP), light continuous forces and low friction in cases involving extraction. In the JET system, tooth extraction not only creates space, but also triggers the RAP; thus tooth extraction accelerates orthodontic treatment. We describe for the first time how to use the JET system to shorten treatment time in a patient in whom four premolars were extracted. A 15 year old girl patient exhibited an Angle Class I bimaxillary protrusion with moderate crowding in the maxillary (−5.0 mm) and mandibular arches (−3.5 mm). Her facial appearance was slightly asymmetric, and her facial profile was convex. Immediately after the simultaneous extraction of the maxillary first premolars and mandibular second premolars, orthodontic treatment was started with a combination of passive self-ligating brackets and super-elastic nickel-titanium closed coil springs that provided orthodontic forces of less than 50 gf (1.8 ozf). The appliance was adjusted once a month. The total treatment time was 13 months. Cephalometric superimpositions showed a slight anchorage loss, and panoramic radiographs showed a slight apical root resorption but no significant reduction in the crest bone height. At the 3-year 6-month retention follow-up, stability was excellent. The JET system might shorten the orthodontic treatment period without serious anchorage loss or other adverse effects. Full article

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2021

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11 pages, 1207 KiB

Open AccessSystematic Review

The Outcomes of Enamel Matrix Derivative on Periodontal Regeneration under Diabetic Conditions

by Laura Elena Narita, Alexandru Mester, Florin Onisor, Simion Bran, Maria Ioana Onicas and Andrada Voina-Tonea

Medicina 2021, 57(10), 1071; https://doi.org/10.3390/medicina57101071 - 08 Oct 2021

Cited by 3 | Viewed by 2600

Abstract

Background and Objectives: Enamel matrix derivative (EMD) is a biomaterial used for periodontal regenerative therapy due to its properties of stimulating cementum development and bone synthesis. Diabetes is a chronic condition that affects healing and predisposes to infection. The aim of this [...] Read more.

Background and Objectives: Enamel matrix derivative (EMD) is a biomaterial used for periodontal regenerative therapy due to its properties of stimulating cementum development and bone synthesis. Diabetes is a chronic condition that affects healing and predisposes to infection. The aim of this review was to evaluate the current studies available on the application and results of EMD for periodontal regenerative therapy under diabetic conditions. Materials and Methods: Five databases (PubMed, ResearchGate, Scopus, Web of Science and Google Scholar) were searched for relevant articles, using specific keywords in different combinations. The inclusion criteria were clinical trials, case reports, case studies, and animal studies published in English, where periodontal treatment for bone defects includes EMD, and it is performed under diabetic conditions. Results: Of the 310 articles resulted in search, five studies published between 2012 and 2020 met the inclusion criteria and were selected for the current review. In human studies, the use of EMD in infrabony defects showed favorable results at follow-up. In animal studies, periodontal regeneration was reduced in diabetic rats. Conclusions: EMD might promote bone healing when used under diabetic conditions for the regenerative periodontal therapy. Due to limited number of studies, more data are required to sustain the effects of EMD therapy in diabetic settings. Full article

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13 pages, 5353 KiB

Open AccessArticle

Counterclockwise Drilling with Different Tapered Drills Condenses the Implant Bed—An Optical Coherence Tomography In Vitro Study

by Rafael Delgado-Ruiz, Mina Mahdian, Ilyasse Benezha and Georgios Romanos

Medicina 2021, 57(9), 940; https://doi.org/10.3390/medicina57090940 - 06 Sep 2021

Cited by 3 | Viewed by 2071

Abstract

Background and Objectives: To evaluate the condensation and the microarchitecture of implant bed walls of sites prepared with counterclockwise drilling with tapered implant drills using optical coherence tomography. Materials and Methods: Four drill designs with different wall and tip angles were used. [...] Read more.

Background and Objectives: To evaluate the condensation and the microarchitecture of implant bed walls of sites prepared with counterclockwise drilling with tapered implant drills using optical coherence tomography. Materials and Methods: Four drill designs with different wall and tip angles were used. Polyurethane laminas resembling type IV bone microarchitecture were superimposed and clamped with a vice to simulate the coronal, middle, and apical aspects of the implant site. Twenty implant beds were prepared at 1200 rpm in clockwise (control) and counterclockwise (test) directions (N = 160). Optical coherence tomography (OCT) was used to evaluate the condensation and microarchitecture characteristics of the implant bed walls. The relative condensation was calculated using the Image J software Bone application. The microarchitecture was evaluated in reconstructed 3D volumes in XY, XZ, and YZ sections. Statistical analysis was performed using one-way ANOVA. Dunnet test was applied to determine differences between groups. Significance was set as p < 0.05. Results: Counterclockwise drilling (Test) condensed and changed the microarchitecture of the apical regions for all the implant beds in all of the groups when compared to clockwise drilling (control). The apical region of test groups showed the highest relative bone condensation (p = 0.026) when compared to controls. Conclusions: The direction of rotation (counterclockwise drilling) and not the design of tapered drills (tip and wall angles) is responsible for the condensation at the apical area observed in polyurethane blocks. The OCT method can be used for the evaluation of changes in density and microstructure of polyurethane blocks. Full article

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15 pages, 5580 KiB

Open AccessArticle

Association between Cone-Beam Computed Tomography and Histological and Immunohistochemical Features in Periapical Lesions Correlated with Thickened Maxillary Sinus Mucosa

by Alexandra Dumitrescu, Maria-Alexandra Martu, Alexandru Nemtoi, Ana Sirghe, Liliana Chelaru, Diana Tatarciuc, Ana-Maria Dumitrescu and Danisia Haba

Medicina 2021, 57(8), 840; https://doi.org/10.3390/medicina57080840 - 19 Aug 2021

Cited by 11 | Viewed by 3310

Abstract

Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and [...] Read more.

Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and periapical lesions using cone-beam computed tomography (CBCT) imaging and histological and immunohistochemical investigations. Materials and Methods: A total of 1450 initial patients diagnosed with maxillary sinusitis in the Ear-Nose-Throat (ENT) Department, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, Romania, were treated with anti-inflammatory drugs. Of these, 629 still had unresolved symptomatology and were later referred to the Dental Medicine departments for further investigations. Only 50 subjects with periapical lesions in the premolar/molar maxillary area were included in the present study. All the periapical lesions were observed on CBCT and classified using the Periapical Status Index (PSI) and the mean maxillary sinus mucosa thicknesses (MSMT). The enrolled patients underwent surgical procedures with the excision of periapical lesions. The excised samples were submitted to the histological and immunohistochemical investigations. Results: The 50 patients presented periapical lesions of their maxillary teeth in 328 dental units. There was a higher prevalence of periapical lesions in men than in women (chi-square test). We observed a significant difference between the mean MSMT of individuals with periapical lesions compared to those without (p < 0.01). Mean MSMT was 1.23 mm for teeth without periapical lesions and 3.95 mm for teeth with periapical lesions. The histopathological study identified 50% cases with periapical granulomas, 10% cases with periapical granulomas with cystic potential, and 40% cases as periapical cysts. Immunohistochemical stainings showed that CD4+ helper and CD8+ cytotoxic T lymphocytes, along with CD20+ B lymphocytes and CD68+ macrophages, were diffusely distributed in all periapical cysts and in some periapical granulomas, but CD79α+ plasma cells characterized especially periapical granulomas. Conclusions: The current study observed a significant correlation between CBCT maxillary mucosa thickness and type of periapical lesion. Chronic inflammatory lympho-histiocytic infiltrate predominates in periapical lesions, supporting the idea that lesion progression is determined by a humoral-type (CD20+ and CD79α+ B lymphocytes) but also by a cellular-type (CD4+ and CD8+ T lymphocyte population) immune mechanism. Full article

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27 pages, 7258 KiB

Open AccessArticle

Micro-CT and Microscopy Study of Internal and Marginal Gap to Tooth Surface of Crenelated versus Conventional Dental Indirect Veneers

by Alexandra-Cristina Măroiu, Cosmin Sinescu, Virgil-Florin Duma, Florin Topală, Anca Jivănescu, Paul Mircea Popovici, Anca Tudor and Mihai Romînu

Medicina 2021, 57(8), 772; https://doi.org/10.3390/medicina57080772 - 29 Jul 2021

Cited by 12 | Viewed by 2906

Abstract

Background and Objectives: Ceramic veneers represent the most appropriate treatment option for minimally invasive aesthetic rehabilitation. For long-term clinical success, the accurate marginal and internal adaptation of dental restorations are of paramount importance. The aim of this in vitro study is to [...] Read more.

Background and Objectives: Ceramic veneers represent the most appropriate treatment option for minimally invasive aesthetic rehabilitation. For long-term clinical success, the accurate marginal and internal adaptation of dental restorations are of paramount importance. The aim of this in vitro study is to assess the effect of a novel (patented) design of veneers compared to conventional ones on their marginal and internal gap to the prepared tooth surface. Materials and Methods: Twenty-four lithium disilicate ceramic veneers are obtained using Computer-Aided-Design (CAD) and then milled using Computer-Aided-Manufacturing (CAM). The samples are divided into two groups: 12 conventional (CO) veneers (i.e., with a linear marginal contour) and 12 crenelated (CR) veneers, the latter with the novel sinusoidal marginal design. All samples are bonded to frontal teeth, and the adhesive interfaces are analyzed using two methods, optical microscopy and micro-Computed Tomography (CT): the former for the accuracy of the marginal gap and the latter for the internal gap (as well as for the homogeneity of the luting cement) of ceramic veneers. Results: STATA and one-way ANOVA tests reveal significant differences between CO and CR veneers: (i) the marginal gap is smaller for CR (64 μm) than for CO veneers (236 μm); (ii) the internal adaptation is better for CR veneers: for a cement width of up to 120 μm, the covered surface for the CR group is 81.5%, while for the CO group it is 64.5%; (iii) the mean of the porosities within the cement is not significantly different (3.4·10⁶ μm³ for CO and 3.9·10⁶ μm³ for CR veneers), with a higher standard deviation for the CO group. Analytical modeling is achieved for internal gaps using the micro-CT results. The characteristic functions obtained allow us to compare the volume of luting cement for the two types of veneers. Conclusion: The novel veneers design produces an improvement in the marginal and internal adaptation of the restorations to the prepared tooth surface. Thus, it provides favorable premises for better clinical performances. Full article

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9 pages, 1436 KiB

Open AccessArticle

The Effects of Prednisone/Ketoprofen Administration in Association with Amoxicillin Clavulanate Following Periodontal Surgical Therapy in Patients with Severe Chronic Periodontitis

by Lidia Sfetcu, Andreea Cristiana Didilescu, Cristian Vlădan, Octavian Dincă, Daniela Miricescu, Gabriela Băncescu, Alexandru Bucur and Laura Carina Tribus

Medicina 2021, 57(5), 447; https://doi.org/10.3390/medicina57050447 - 04 May 2021

Cited by 1 | Viewed by 2361

Abstract

Background and Objectives: The aim of this study was to evaluate and compare the effects of two different anti-inflammatory drugs (ketoprofen and prednisone) combined with an antibiotic (amoxicillin + clavulanic acid) and periodontal surgery on dental and periodontal parameters in patients with [...] Read more.

Background and Objectives: The aim of this study was to evaluate and compare the effects of two different anti-inflammatory drugs (ketoprofen and prednisone) combined with an antibiotic (amoxicillin + clavulanic acid) and periodontal surgery on dental and periodontal parameters in patients with severe chronic periodontitis. In addition, salivary stress expressed by cortisol levels was assessed. Materials and Methods: An interventional study was performed on 22 periodontal subjects and 19 clinical healthy controls. The patients were divided in four groups, depending on treatment planning, as follows: eight patients received prednisone and antibiotherapy, associated with surgical periodontal therapy; seven patients received ketoprofen and antibiotherapy, associated with surgical periodontal therapy (group II); seven patients received only prednisone. Periodontal healthy patients underwent routine scaling and polishing. Bleeding on probing (BOP), dental mobility and salivary cortisol (ng/mL) were assessed before and after treatment. The means and standard deviations for the salivary cortisol levels (SCLs), dental and periodontal parameters were calculated for all groups using each patient as a unit of analysis. Results: Data analyses showed that the two different anti-inflammatory drugs associated with or without surgical therapy were efficient on inflammation periodontal parameters (BOP, dental mobility). Prednisone treatment alone was associated with a significant decrease of SCLs between pretreatment and post-treatment. Conclusions: In the present study, the effects of either of the anti-inflammatory drugs on inflammation evolution and salivary stress were comparable in patients undergoing antibiotherapy and surgical periodontal therapy. Full article

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14 pages, 3521 KiB

Open AccessArticle

Complementarity of Photo-Biomodulation, Surgical Treatment, and Antibiotherapy for Medication-Related Osteonecrosis of the Jaws (MRONJ)

by Diana Florina Nica, Mircea Riviș, Ciprian Ioan Roi, Carmen Darinca Todea, Virgil-Florin Duma and Cosmin Sinescu

Medicina 2021, 57(2), 145; https://doi.org/10.3390/medicina57020145 - 05 Feb 2021

Cited by 12 | Viewed by 3300

Abstract

Background and Objectives: Antiresorptive or anti-angiogenic agents may induce medication-related osteonecrosis of the jaws (MRONJ), which represents a challenge for clinicians. The aim of this study is to design and apply a composed and stage-approach therapy combining antibiotherapy, surgical treatment, and photo-biomodulation [...] Read more.

Background and Objectives: Antiresorptive or anti-angiogenic agents may induce medication-related osteonecrosis of the jaws (MRONJ), which represents a challenge for clinicians. The aim of this study is to design and apply a composed and stage-approach therapy combining antibiotherapy, surgical treatment, and photo-biomodulation (PBM) for the prevention or treatment of MRONJ lesions. Materials and Methods: The proposed treatment protocol was carried out in the Department of Oral & Maxillofacial Surgery of the “Victor Babes” University of Medicine and Farmacy of Timisoara, in 2018–2020. A total of 241 patients who were previously exposed to antiresorptive or anti-angiogenic therapy, as well as patients already diagnosed with MRONJ at different stages of the disease were treated. A preventive protocol was applied for patients in an “at risk” stage. Patients in more advanced stages received a complex treatment. Results: The healing proved to be complete, with spontaneous bone coverage in all the n = 84 cases placed in an “at risk” stage. For the n = 49 patients belonging to stage 0, pain reductions and decreases of mucosal inflammations were also obtained in all cases. For the n = 108 patients proposed for surgery (i.e., in stages 1, 2, or 3 of MRONJ), a total healing rate of 91.66% was obtained after the first surgery, while considering the downscaling to stage 1 as a treatment “success”, only one “failure” was reported. This brings the overall “success” rate to 96.68% for a complete healing, and to 99.59% when downscaling to stage 1 is included in the healing rate. Conclusions: Therefore, the clinical outcome of the present study indicates that patients with MRONJ in almost all stages of the disease can benefit from such a proposed association of methods, with superior clinical results compared to classical therapies. Full article

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