Background: Peri-implantitis is an inflammatory disease with an increasing diffusion rate which can affect the long-term survival of a prosthetic rehabilitation. The present study focused on the decontaminating efficacy of chlorhexidine and air polishing system with sodium bicarbonate powder against Candida albicans, a microorganism which seems to have a superinfecting opportunistic role in the pathology. The aim of the authors was to investigate and compare the effectiveness of these treatments, commonly used in clinical practice. Methods: An in vitro study was conducted to analyze the effects of two widely used therapeutic aids for the disinfection of affected titanium implants: chlorhexidine (CHX) and air polishing with sodium bicarbonate powder (P). A qualitative and quantitative comparative analysis of the residual biofilm was carried out using a colorimetric assay (XTT) and scanning electron microscopy (SEM) observation. The experiment was conducted both on machined titanium surfaces and on rough sandblasted ones with the aim of bringing out differences in the therapeutic outcomes concerning the superficial texture of the implant. The null hypothesis was that no difference could be detected between the samples, regarding both the treatments performed and the nano-structural features of titanium. Results: The best results (on both types of implant surfaces) were obtained when combining the use of chlorhexidine and air polishing (C + P). A linear decrease in the optical density (OD) values recorded at three different time points (30 s, 1 min, 5 min) was also observed passing from the first to the last one. When observed under scanning electron microscope rough surfaces showed an extensive and highly structured biofilm, more complex if compared to the one encountered when analyzing machined implants. Conclusions: the present pilot study showed that rough surfaces can promote fungal adhesion and eventually hinder the outcome of a decontaminating treatment. For this purpose, the physio-chemical technique is always more efficient if compared to a single-technique approach regardless of the surface characteristics.

The purpose of this study was to compare the envelope flap and triangular flap for impacted lower third molar (M3) extraction and their effects on the periodontal health of adjacent second molars (M2). A population of 60 patients undergoing M3 extraction with the envelope flap (Group A) or triangular flap (Group B) was analyzed, comparing probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (REC) recorded at six sites (disto-lingual, mid-lingual, mesio-lingual, disto-vestibular, mid-vestibular, and mesio-vestibular) before (T⁰) and 6 months after extraction (T¹). There was a statistically significant mean difference in PPD and CAL at two sites, disto-vestibular (dv) and disto-lingual (dl), between values recorded before and 6 months after surgery for either Group A or Group B. Furthermore, for the same periodontal records, at 6 months after surgery, a statistically significant difference was recorded between younger and older patients, implying that the healing process was more beneficial for younger patients. No significant differences were found between the two groups (A and B) in PPDdl, PPDdv, CALdl, and CALdv, confirming that the mucoperiosteal flap design does not influence the periodontal healing process of second molars.

Background: The extraction of the mandibular third molar is one of the most frequent intervention in oral surgery. A common indication for wisdom tooth extraction is represented by pericoronitis, which can determine discomfort and pain in patients. The present study aimed to evaluate the impact of patients’ quality of life by comparing a surgical approach with a periodontal approach. Methods: We evaluated 82 patients diagnosed with pericoronitis that occurred at the third molar site. In total, 41 of them received a periodontal treatment and 41 were treated by extraction. The quality of life (QoL) of the patients was assessed by using the Oral Health Impact Profile-14 (OHIP-14) index. Results: A total of 82 patients were included in the study and were followed up for 6 months. Of the patients, 41 received a periodontal treatment and 41 underwent surgical extraction. At the baseline, the OHIP-14 scores of the surgical group were higher (19.71, SD 9.90) than the periodontal group (14.41, SD 8.71). At 1 week, there was a reduction in terms of OHIP-14 in both groups, but the periodontal group showed lower values (12.3, SD 8.11). Long-term follow-up showed a reduction of the OHIP-14 values, with a difference in favor of the surgical group (0.10, SD 0.45). However, there was a reduction in OHIP-14 scores in both groups. Conclusion: Although the periodontal treatment offered a rapid improvement in terms of quality of life during the first week after the treatment, after 1 month and 6 months, the extraction of the mandibular third molar extraction remained the best treatment, removing the occurrence of re-inflammation of the site.