Periodontally accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time. This study compared the effectiveness of a bovine-derived xenograft with that of bioactive glass when combined with PAOO for the treatment of adult patients with moderate crowding of the teeth. In this prospective, single-masked clinical trial, 33 orthodontic patients (20 women, 13 men; mean age 21.2 ± 1.43 [18 − 27] years), were randomly allocated to one of three groups. Group 1 underwent a modified corticotomy technique on the labial side only, whereas group 2 was treated with the same technique combined with PAOO using a bovine-derived xenograft and group 3 was treated in the same way but combining PAOO with bioactive glass. The total treatment duration was recorded from the start of active orthodontic treatment, immediately after corticotomy, and at the time of debonding. Probing depth was evaluated clinically and bone density and root length were evaluated radiographically on the day of surgery (baseline, T1), post-treatment at debonding (T2), and 9 months post-treatment (T3). The duration of orthodontic treatment was markedly reduced to an average of 11.4 ± 0.14 weeks in all groups. All probing depths were < 3 mm, the interdental papillae were well preserved, there was no loss of tooth vitality, and there was no evidence of significant apical root resorption at any time interval. All groups showed a decrease in mean bone density at T2 followed by an increase at T3. The net percentage change that occurred between baseline and 9 months post-treatment was significantly different between the three groups. Groups 2 and 3, where grafts were incorporated, demonstrated a statistically significant greater increase in bone density than group 1 at T3. Combination of orthodontic treatment and periodontal surgery is an effective treatment for adult patients that decreases the duration of active treatment and reduces the risk of root resorption. Use of a bovine-derived xenograft with modified corticotomy provided superior benefits in terms of increased bone density than did the use of bioactive glass. The study was retrospectively registered at ClinicalTrials.gov under Clinical Trial Registration Number: NCT02796911 .
1 January 2021 in Saudi Journal of Biological Sciences
The study aims to assess the concentration of vascular endothelial growth factors (VEGF) with platelet rich fibrin (PRF) biomaterial, while using it separately or in combination with nanohydroxyapatite (nano-HA) for treating intra-bony defects (IBDs) using radiographic evaluation (DBS-Win software). Sixty patients with IBD (one site/patient) and chronic periodontitis were recruited randomly to test either autologous PRF platelet concentrate, nano-HA bone graft, a combination of PRF platelet concentrate and nano-HA, or alone conventional open flap debridement (OFD). Recordings of clinical parameters including probing depth (PD), gingival index (GI), and clinical attachment level (CAL) were obtained at baseline and 6 months, post-operatively. One-way analysis of variance (ANOVA) was used to compare four groups; whereas, multiple comparisons were done through Tukey’s post hoc test. The results showed that CAL at baseline changed from 6.67 ± 1.23 to 4.5 ± 1.42 in group I, 6.6 ± 2.51 to 4.9 ± 1.48 in group II, 5.2 ± 2.17 to 3.1 ± 1.27 in group III, and 4.7 ± 2.22 to 3.7 ± 2.35 in group IV after 6 months. The most significant increase in bone density and fill was observed for IBD depth in group III that was recorded as 62.82 ± 24.6 and 2.31 ± 0.75 mm, respectively. VEGF concentrations were significantly increased at 3, 7, and 14 days in all groups. The use of PRF with nano-HA was successful regenerative periodontal therapy to manage periodontal IBDs, unlike using PRF alone. Increase in VEGF concentrations in all group confirmed its role in angiogenesis and osteogenesis in the early stages of bone defect healing.
Background: Postoperative pain is a potential adverse side effect of oral surgeries, and attempts should be made to prevent or minimize it. This study compares efficacy of preemptive ibuprofen and dexamethasone protocols for pain prevention or control after surgical implant placement.Methods: This prospective, double‐masked, parallel‐group, placebo‐controlled, randomized clinical trial included 117 patients with planned dental implant placement. Patients were assigned to receive one of three different protocols: 1) 600 mg ibuprofen 1 hour before surgery and another 600 mg 6 hours after the first dose; 2) 4 mg dexamethasone 1 hour before surgery and another 4 mg 6 hours after the first dose; or 3) placebo. Rescue medication (1,000 mg acetaminophen) was made available to each patient, and they were instructed to take it as necessary. Pain intensity was evaluated via a 101‐point numeric rating scale and a visual analog scale, and discomfort was evaluated using a four‐point verbal rating scale hourly for the first 8 hours after surgery and three times daily for the following 3 days.Results: Ibuprofen and dexamethasone significantly reduced pain (Kruskal–Wallis; P <0.05) up to 3 days after surgery and discomfort (P <0.05) up to 2 days after surgery compared with placebo treatment. Both treatments reduced the number of painkillers taken and increased time before the first painkiller was taken (P <0.01).Conclusion: Steroidal dexamethasone is as effective as non‐steroidal ibuprofen for preventing or controlling postoperative pain and discomfort after surgical implant placement.
Purpose. The objective of this study is to explore the relationship between the levels of interleukin- (IL-) 6, tumor necrosis factor- (TNF-) α, and visfatin and simvastatin usage, in the gingival crevicular fluids (GCFs) of diabetic patients afflicted with chronic periodontitis. Methods. Eighty outpatients at the Periodontology Department, Faculty of Dentistry, University Dental Hospital (King Abdulaziz University), were categorized into 4 groups (20 patients per group), on the basis of radiological evaluation of bone loss, clinical attachment levels (CAL), probing depth (PD), and gingival indices: group 1 (healthy periodontium), group 2 (chronic periodontitis + type 2 diabetes), group 3 (chronic periodontitis), and group 4 (type 2 diabetes + chronic periodontitis + simvastatin). Enzyme-linked immunosorbent assays were used to measure IL-6, TNF-α, and visfatin levels. Results. Significantly elevated levels of IL-6, TNF-α, and visfatin were seen in group 2 in comparison to groups 1 and 3. Reduced levels were seen in group 4 due to simvastatin usage. Positive association was seen between periodontal variables and the levels of IL-6, TNF-α, and visfatin. Conclusion. Periodontal destruction and diabetes have a synergistic effect on the elevation of inflammatory cytokine levels. Simvastatin may be beneficial in improving periodontal health among diabetic patients.