Twenty different macrolide and ketolide antibiotics were analyzed by reversed phase high performance liquid chromatography on an ODS-2 cartridge column. Each of these compounds was uniquely separated and purified by varying the flow rate. Retention times of the individual drugs were proportional to the flow rate of the mobile phase. Recovery of antimicrobial activity for most of the drugs was greater than 90% based on a microbiological assay of material recovered from the column. Retention times were related to structural differences between these antimicrobial agents.

BACKGROUND:The aim of this study was to examine osseous changes following lateral bone augmentation using a novel scaffold (OV) alone and compare it to combination therapy using freeze-dried bone allograft (FDBA) and resorbable collagen membrane (FDBA/CM). METHODS:Thirty patients completed this 9-months prospective two-center cohort clinical trial. Before surgery and 9-months re-entry, linear measurements were performed, and impressions taken. Cone-beam computed tomography (CBCT) were done at baseline and 9 months. DICOM slice data were converted into volumetric images using 3D Slicer. Following 3D volumetric image construction, pre- and post-op Standard Triangle Language files were superimposed and volumetric data were extracted for a 10-mm region of interest. Linear measurements were compared similarly. RESULTS:Baseline clinical parameters were similar in both groups (4.22 and 4.53 mm for OV and FDBA/CM at -2 mm, respectively). Following treatment, vertical distance from the stent had changed minimally (-0.36 and -0.12 mm, respectively). Similarly, lateral bone gain ranged from 0 to 0.4 mm, for both groups. To the contrary, the CBCT measurements showed a significantly greater increase in horizontal width in the control at -2 mm (0.95 ± 0.2 mm) compared with -0.62 mm for the OV (P = 0.000). Similar changes were observed at -5 mm (0.63 and -0.41 mm, respectively, P = 0.01). Sites volume had increased from 266 ± 149 mm3 to 360 ± 138 mm3 (P = 0.001) for FDBA/CM with negligible changes for OV (from 334 to 335 mm3 , P = 0.952). these between-group changes being statistically significant (P = 0.023). CONCLUSION:FDBA/CM yielded better albeit moderate increase in the volume of the edentulous ridge, while OV scaffolds failed to produce similar results.

Objectives: The aim of this investigation was to evaluate the epidemiological data on dental injuries in permanent teeth among seventh and tenth grade schoolchildren in the Republic of Moldova. Study design: The pathfinder study model was chosen to evaluate the prevalence of Traumatic Dental Injuries (TDI). Schoolchildren ages 12 and 15 years old were examined: In the capital city (four schools), in two other major cities-(two schools each city), and in four villages (one per each village) in accordance with the WHO's recommendations. Results: A total of 720 seventh and tenth grade schoolchildren were examined. The overall prevalence of TDI was found to be 16.4% (total of 118 children). The prevalence of TDI was greater in the older age cohort (p<0.05). Children from rural areas presented with greater prevalence of TDI compared to children who live in urban region (p<0.03). The maxillary central incisors were found to be the most common teeth affected by trauma constituting 57.1% of the evaluated TDI cases. Enamel fracture was the main type of TDI (83%). Conclusions: The TDI mainly involved enamel fractures. Urban schoolchildren show lower rates of TDI compared to rural schoolchildren.

Background Initial implant stability during placement is important for implant survival. It depends mainly on the amount and quality of the bone. Xenograft has become a popular grafting material for socket preservation aimed at reducing volumetric changes of the bone following tooth extraction. Aim/Hypothesis To compare bone quantity and primary implant stability 2 months following treatment of surgically created bone defects using two different types of xenografts. Material and Methods Eighteen artificial bone defects were prepared in the mandible of four sheep using conventional drilling burs (Ø4 mm and 8 mm length) under saline irrigation. Defects were randomly grafted with xenografts- Bio-Oss (BO) or Bioactive Bone (BB) or left for spontaneous healing (control) (6 defects in each group). Following 8 weeks, bone biopsy was harvested using a trephine drill of (add diameter) following by the installation of NEO dental implants. During installation, the peak insertion torque (IT) was measured by calibrated hand ratchet and primary stability was measured using Osstell system. Results Histomorphometric analysis showed higher percentage of new bone formation in the natural healing defects compared to sites with xenograft (68.66 ± 4.5%, 48.75 ± 4.34%, 50.33 ± 4.0% control, BB, BO respectively). Connective tissue portion was higher in the BO and BB groups compared to control (44.25 ± 2.98%, 41 ± 6% and 31.33 ± 4.5, P < 0.05). Residual grafting material was similar in BO and BB (7 ± 2.44%, 8.66 ± 2.1%). The mean IT (C 36.6 ± 13.7, BO 40.8 ± 16.9, BB 37.5 ± 10.7 P > 0.05) and ISQ (C 60.8 ± 10.6, BO 64.3 ± 15.6, BB 62.3 ± 12.6) values were statistically similar between 3 groups of the study. A positive correlation was found between IT and ISQ (r = 0.65, P = 0.00) Conclusion and Clinical Implications Implant's primary stability, was not influenced by the type of the xenograft used in the study at delayed implant placement approach. These results may be attributed to a relatively high bone fill of the defect (˜50%) 2 months after grafting.

BACKGROUND Cells, scaffolds, and growth factors are the key components in bone tissue engineering. Scaffold composition, topography, and architecture influence the amount of regenerated bone in the implantation site. The aims of the study were to compare viability and proliferation of mesenchymal stem cells (MSCs) seeded onto two commercial xenografts: Bio-Oss (BO) and bioactive bone bovine (BB). Next, these materials were compared for histomorphometric bone formation in a socket preservation model in rats. MATERIALS AND METHODS MSCs were seeded onto monolayers of BO or BB granules. Cell viability and proliferation were evaluated after incubation of 0, 2, 20, and 48 h. A total of 24 Sprague Dawley rats underwent unilateral extraction of maxillary molars. Rats were randomly divided into three groups: natural healing (nongrafted socket) or socket preservation with either BO or BB. Rats were sacrificed after 8 weeks, and histomorphometric analysis was done to evaluate bone formation and residual scaffold at the extraction site. RESULTS Differences in the metabolic activity of MSCs that were seeded onto BO or BB was observed at 2 h after seeding: the metabolic activity was elevated compared to baseline in the BB (P = .046) and not changed in the BO wells (P = .84). After 20 h, the metabolic activity of MSCs seeded onto BO was decreasing (P = .005), while cell viability was not changed in the BB group (P = .356). Intergroup comparison revealed higher metabolic activity of MSCs seeded on BB after 48 h compared with BO (P = .016). The in vivo results demonstrated differences in socket healing between the groups: percentage of new bone was higher in the BB compared to BO group (39.1 ± 14.3 vs. 23.7 ± 10.8%, respectively, P = .096). Connective tissue portion was higher in the BO group compared with BB (73.7 ± 11.1 vs. 49.6 ± 13.7%, respectively, P = .018). Residual grafting martial was higher in the BB (11.34 ± 4.18 vs. 2.62 ± 1.23%, P = .011). CONCLUSIONS The results of this study demonstrating higher vitality and proliferation of MSCs seeded onto BB. Furthermore, following ridge preservation, higher percentage of new bone and lower residual scaffold were found in the BB compared with BO. This enhanced regenerative response might be the result of an enhancement of metabolic activity in cells attached to it. Further research will be needed to understand the precise mechanism.

PURPOSE:To compare dimensional changes and bone quality of two different grafting materials used for socket preservation.MATERIALS AND METHODS:Thirty-three patients requiring extraction were recruited and randomly assigned to receive: biphasic calcium sulfate/ hydroxyapatite (BCS/HA); bovine derived xenograft (BDX) or no grafting (Control). Ridge width (at -3 and -6 mm) and vertical distance from a stent were measured at the time of extraction/grafting. Measurements were repeated at reentry and core biopsies were harvested.RESULTS:Baseline vertical distance for the BDX, C and BCS/HA groups were 7.45 ± 3.1, 7.69 ± 4.2, and 6.75 ± 3.5 mm, respectively (P = .830). Post-op, C group had greater vertical loss (1.71 ± 0.4 mm) compared to BCS/HA (0.65 ± 0.5) and BDX (0.25 ± 0.2 mm), P = .059. Mean baseline width at -3 mm was 8.69 ± 1.1 mm, 8.31 ± 1.4 mm, and 9.0 ± 1.1 mm, respectively (P = .509). Post-op, this width was reduced by 2.96 ± 0.3 mm (C), 1.56 ± 0.4 mm (BDX), and 0.5 ± 0.4 mm (BCS/HA), P = .001. Mean ridge width at -6 mm for the C (6.5 ± 1.7 mm) was significantly smaller than BCS/HA (7.95 ± 2.8 mm) and BDX (8.85 ± 1.9 mm), P = .043. Histologically, the BDX group had greater residual scaffold material and less vital bone compared to the BCS/HA group. Pain scores were relatively low for all groups.CONCLUSIONS:BCS/HA may be used for socket preservation with similar or better results compared to BDX. The significance of greater residual scaffold found in the BDX group is yet to be determined.

The aim of this prospective cohort observational field trial was to examine 1-year survival and success rates of a recently introduced tapered implant system with switched platform conical abutments and to evaluate patient related outcomes of therapy. Partially edentulous patients aged between 18 and 75 years, with available bone height for dental implants ≥10 mm desiring to restore the missing tooth/teeth with implant supported restoration, were recruited by 7 periodontists in their respective private practices. Dental implants were installed according to standard implant therapy protocol. Three to 6 months postoperatively, after evaluating interim implant success, implants were restored by the referring dentists. Patient, Ramfjord teeth, and implant data, including baseline and 1-year postoperative, were collected. A total of 60 patients were recruited and received 117 implants. Complete 1-year clinical and radiographic data were available for 83 and 65 implants, respectively. Two implants failed during the first year, resulting in a 1-year survival rate of 98.3%. Mean implant probing pocket depth was 2.29 ± 0.84 mm. Mean radiographic bone distance from implant's shoulder at the mesial and distal sites at 1 year was 0.66 ± 0.5 and 0.79 ± 0.64mm, respectively, resulting in a success rate of 95.4%. Patient subjective evaluation of therapy exhibited a median pain experience of 1 and median esthetics, function, and general satisfaction evaluation of 10 on a scale of 1 to 10. The tapered conical connection dental implant system, used in private dental practices, shows good 1-year survival and success rates that are similar to other implant systems on the market.

OBJECTIVE:A randomized trial to assess clinical and radiographic outcomes of short versus standard dental implants placed with concomitant vertical bone augmentation.METHOD AND MATERIALS:Patients requiring dental implants were randomized to receive either 6-mm implants (experimental) or 10-mm implants with vertical augmentation (control). Custom load-bearing healing abutments were connected to allow for indirect resonance frequency analysis measurements. Standardized radiographs were taken at implant placement (baseline), and at 3 and 12 months. Implants were restored at 3 to 6 months, and final measurements were taken at 12 months.RESULTS:Fifty patients with 25 implants per group were included. Five implants failed, four experimental and one control (84% and 96% cumulative survival rate, respectively). Short implants required significantly less surgical time (51.6 ± 23 versus 68.5 ± 35 minutes, P = .05). Implant stability quotients at baseline (67.9 ± 8.3 experimental and 70.8 ± 7.6 control, P = .215) and 12 weeks (70.17 ± 7.4 and 72.03 ± 5.9, respectively, P = .513) were similar and unchanged. Positive correlation was found between the two measurement methods (r2 = .6, P = .025). One-year average marginal bone loss was slightly lower for the experimental group (0.6 ± 0.16 mm) compared to the control group (0.86 ± 0.19 mm); however, this was not statistically significant (P = .287).CONCLUSION:Short dental implants may offer an alternative for implant placement in an atrophic jaw; however, they are associated with reduced first-year survival rate. Short dental implants should be used judiciously in light of this potential predicament, and alternatives assessed.

OBJECTIVES:The aim of the present research was to evaluate the current caries experience of schoolchildren in the Republic of Moldova.METHODS:A pathfinder study was planned and executed according to the World Health Organization (WHO) recommendations. Caries experience was recorded in three large cities (the capital city and two other large cities) and four villages throughout the country. Within each site and age group, school clusters were randomly chosen. Three different age groups (6, 12 and 15 years) of schoolchildren were assessed.RESULTS:Overall, 1,100 children were examined: 724 from cities and 376 from the villages. Among the study population, 408 (37.1%) were female and 692 (62.9%) were male, 380 were 6 years of age, 365 were 12 years and 355 were 15 years. The prevalence of caries experience [decayed, missing and filled scores of > 1 for primary (dmft) and secondary (DMFT) teeth] was 87.4% (dmft score = 3.9 ± 3.0) for 6-year-old participants, 77.53% (DMFT score = 2.7 ± 2.3) for 12-year-old participants and 86.2% (DMFT score = 3.7 ± 2.9) for 15-year-old participants. For the 12-year group, a higher proportion of caries-free children were detected in urban areas than in rural areas (25.5% vs. 15.5%, P = 0.003). We found more caries-free participants among 12-year-olds than among 15-year-olds (22.5% vs. 13.8%, P = 0.004).CONCLUSIONS:These WHO key index age groups may be inserted into the global oral health databank and provide a 'pathfinder' baseline for formulating and conducting future public oral health programmes in the Republic of Moldova, with an emphasis on children in rural locations.

BACKGROUND:The effect of different surgical techniques for ridge preservation on soft tissue parameters has seldom been investigated. The objective of this study was to compare the effect of two different ridge preservation techniques on soft and hard tissue dimensions.METHODS:Thirty patients requiring tooth extraction were randomly allocated to either control group C (allograft covered with a non-crosslinked collagen membrane with primary closure) or experimental group E (allograft covered with cross-linked collagen membrane left exposed). Sites were surgically re-entered at 6 months. Soft and hard tissue measurements, cone beam computed tomography (CBCT), and cast measurements were taken at baseline and 6 months.RESULTS:Twenty-eight patients were included in this analysis. When the two treatment groups were compared, the width of the buccal keratinized tissue in the E group showed an increase of 0.43 ± 0.42 mm compared to net loss of 1.57 ± 0.51 mm for the C (P = 0.006). Similarly, buccal tissue thickness has increased in the E group 0.46 ± 0.22 mm compared to a loss of 0.15 ± 0.23 mm in the C group (P = 0.068). Volumetric assessment of the changes in the alveolar ridge for the E group showed a slight decrease (68.3 ± 17 mm3) whereas the C group has experienced almost double this loss (107.5 ± 11 mm3; P = 0.07). Crestal width, measured on the CBCT scan, has shown significant reduction in the C group (4.18 ± 0.56 mm) compared to only 1.74 ± 0.4 mm in the E group (P = 0.003).CONCLUSION:Crosslinked collagen membrane with allograft placed intentionally non-submerged resulted in better preservation of the keratinized tissues (width and thickness) with similar and at times better osseous preservation following extraction.

Background Tooth extraction is associated with remodeling of the alveolar process. A horizontal bone loss of 29–63% and a vertical bone loss of 11–22% is expected. An assortment of materials for socket preservation are available. More recently, the combination of calcium sulfate HA particles has been shown effective for bone formation in canines and human studies, still, bovine derived xenografts are considered by many as the gold standard. Comparative studies of calcium sulfate HA alloplasts and bovril. Aim/Hypothesis The purpose of the present randomized control clinical trial was to examine the dimensional changes and the composition of the newly formed bone using different grafting materials for socket preservation immediately following tooth extraction Material and Methods Healthy patients in need for non-molar tooth extraction were recruited for this prospective randomized clinical trial. Thirty-three patients were recruited of which 32 completed the study. At the time of extraction, subjects were randomly assigned into one of the following treatment group- socket preservation using bi-phasic calcium sulfate with hydroxyapatite (CS HA)+ socket preservation using bovine derived xenograft (BDX)+ spontaneous natural healing (Control). Using a custom-made stent, ridge width was measured at crest, −3 and −6 mm. Vertical distance (from the bottom of the stent to bone crest) was also measured. These measurements were repeated at 4–6 months reentry, at which time, core biopsies were taken for histology and histomorphometrical analyses. Results Age ranged from 45 to 80 years (mean 63.9 ± 8.1 years). Mean vertical distance at baseline was 7.45 ± 3.1, 7.69 ± 4.2 & 6.75 ± 3.5 mm. for BDX, C & CS HA groups respectively (P = 0.830). Following tooth extraction, the C group had greater vertical bone loss (1.71 ± .4 mm.) compared to the CS HA (0.65 ± .5 mm.) and BDX (0.25 ± .2 mm.) groups (P = 0.059). Mean baseline horizontal width at −3 mm. was similar- 8.69 ± 1.1, 8.31 ± 1.4 & 9.0 ± 1.1 mm. for the 3 groups respectively (P = 0.509). Following tooth extraction, the C group had 2.96 ± 0.3 mm horizontal bone loss compared to 1.56 ± 0.4 mm. (BDX) and 0.5 ± 0.4 mm. (CS HA), P = 0.001 At reentry, the mean ridge width at −6 mm for the C group (6.5 ± 1.7 mm.) was significantly smaller than the CS HA (7.95 ± 2.8 mm.) and the BDX (8.85 ± 1.9 mm.) groups (P = 0.043). Histological, the BDX group had greater proportions of residual scaffold material while lesser vital bone compared with the CS HA group. Pain scores were relatively low for all groups. Conclusions and Clinical Implications Both grafting materials has similar favorable beneficial effect in reducing dimensional shrinkage of alveolar ridges compared to non-grafted controls, while greater residual scaffolds were found in the BDX group.

Angiogenesis plays a pivotal role in tissue engineering and regenerative medicine. This study aimed to develop an electrospun fiber scaffold that supports release of recombinant human vascular endothelial growth factor (rhVEGF) to enhance angiogenesis. Scaffolds composed of core-shell fibers were fabricated using co-electrospinning. The core solution was composed of polyethylene oxide and mixed with rhVEGF. The shell solution was composed of polycarpolactone, with 0.25, 1, and 3% of polyethylene glycol (PEG) to manipulate pore size on the shell. Pore size and density increased with higher PEG concentrations. Similarly, rhVEGF release was affected by PEG concentration: initial burst release was found in all scaffolds, followed by continuous 4 h release in 3% PEG and 18 h release in the 0.25 and 1% PEG polymeric scaffolds. Endothelial cell migration toward rhVEGF-incorporated polymeric scaffold was 80-fold higher as compared to VEGF-free polymeric scaffold. In a subcutaneous mouse model, VEGF-incorporated polymeric scaffold stimulated cell migration into the scaffold within three days and significantly enhanced blood vessels formation within 14 days, whereas control scaffolds contained few vessels. In conclusion, the described novel scaffold represents a promising device for vascular tissue engineering, which may be of clinical significance in treating vascular deficient wounds. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2712-2721, 2017.

BACKGROUND:The aim of this research was to study the efficacy of endothelial progenitor cells (EPC) with ß tri-calcium phosphate (β-TCP) and barrier in the treatment of experimental peri-implantitis.METHODS:Thirty implants were placed in five American foxhounds. Following osseointegration, ligature-induced peri-implantitis was initiated. EPC were isolated from peripheral blood. Two months later, open flap debridement was performed and implants' surface was decontaminated with 24% EDTA. The sites were grafted with β-TCP and collagen membrane (β-TCP group) or β-TCP loaded with EPC and covered with membrane (EPC group) or left un-grafted (OFD group). At 3 months, animals were killed and specimens sent for histomorphometric and micro-CT analysis. Bone height and %BIC served as primary and secondary outcomes.RESULTS:EPC group showed shorter distance to first BIC (3.29 ± 0.69 mm) compared to 4.2 ± 0.92 mm (β-TCP) and 3.82 ± 0.73 mm (OFD). Mean histological BIC was 2-3 folds higher in the EPC group (17.65 ± 3.3%) compared with OFD (7.55 ± 2.24%, p = 0.01) and β-TCP (5.68 ± 2.91%, p = 0.05). BIC greater than 25% was found only in the EPC group. The distance between the implant shoulder to 1st BIC was 2.51 ± 0.7 mm (lingual sites) compared to 3.64 ± 0.8 mm for buccal sites (p < 0.0001).CONCLUSION:β-TCP loaded with EPC and covered with a membrane-enhanced bone formation around previously contaminated dental implants in an experimental peri-implantitis canine model.

AIM:The aim of this study was to retrospectively evaluate the association between shallow vestibular depth (VD) and peri-implant parameters.MATERIAL AND METHODS:Peri-implant parameters were evaluated in 61 periodontal patients under regular supportive periodontal therapy. Clinical parameters included gingival index (GI), plaque index (PI), bleeding on probing (BOP), peri-implant pocket depths (PPD), mucosal recession (MR), relative attachment level (RAL), width and thickness of keratinized mucosa (KMW, KMT) and VD. Radiographic bone level (RBL) was measured on peri-apical radiographs.RESULTS:Sites with shallow VD (≤ 4 mm) were associated with higher MR (0.91 mm versus 0.47 mm, p ≤ 0.009), higher RAL (4.23 mm versus 3.59 mm, p ≤ 0.0001) and higher RBL (2.18 mm versus 1.7 mm, p = 0.05) when compared with adequate vestibular depth sites (VD > 4 mm). Moreover, sites with shallow VD presented lower KMW compared with sites with adequate VD (1.24 mm versus 2.38 mm, respectively, p ≤ 0.0001). Slightly greater BOP, and GI were recorded for the shallow VD compared with adequate sites. According to multivariate analysis, factors that could predict RAL included: VD, GI, age, supporting periodontal therapy, implant type and design.CONCLUSIONS:Based on this study, inadequate vestibular depth around dental implants may be associated with increased peri-implant bone loss and mucosal recession. Further prospective and intervention studies will be required to fully understand this phenomenon.

AIM:To evaluate (clinically, histologically, and histo-morphometrically) the use of composite materials (Biphasic calcium sulphate [BCS] with β Tri-Calcium Phosphate (β-TCP) and Hydroxyapatite [HA]) in extraction socket sites and compare it to un-disturbed natural healing.MATERIAL AND METHODS:Prospective clinical trial of 36 patients (40 extraction sockets) were randomly assigned to either test or control group. Alveolar ridge horizontal dimension was measured in the middle of the socket at crest and 3 and 6 mm subcrestally. Crestal vertical height was measured at baseline surgery and at 4 month re-entry, at which time bone core biopsies were harvested from the center of the edentulous ridge. Histo-morphometric evaluation of the samples was performed using hematoxylin & eosin stains and morphometric software.RESULTS:The change in horizontal ridge width was higher in the control compared to the experimental group: 2.28 ± 2.36 mm versus 0.03 ± 2.32 mm (p = .007) at -3 mm and 2.28 ± 2.43 versus 0.035 ± 3.05 (p = .02) at -6 mm, for the experimental and control sites, respectively. The vertical distance form bone crest to neighboring horizontal line interconnecting the neighboring teeth was minimal in both groups (0.307 ± 2.01 mm versus 0.14 ± 2.03 mm [p = 0.41]). Residual scaffolds occupied 15.99 ± 11.4% of the volume in the grafted (test) sites while bone area fraction was not statistically different among the groups (47.7 ± 10.6% versus 52.6 ± 11.6%, test versus control, respectively p = .39). The percentage of connective tissue in the control group was significantly higher that test group (36.3 ± 19.4% versus 46.7 ± 10.6% test versus control, respectively, p = .013).CONCLUSION:Ridge preservation technique using a combination of two synthetic bone grafts β-TCP and HA with BCS resulted in greater stability in the horizontal dimension after 4 months.

PURPOSE:To evaluate changes in sinus dimensions immediately postoperatively and 1 year later using a composite of bovine-derived xenograft and autogenous bone for lateral bone augmentation of the maxillary sinus.MATERIALS AND METHODS:Patients who underwent lateral wall sinus augmentation procedures without concomitant implant placement were considered for this retrospective analysis if they had three consecutive panoramic radiographs: pretreatment (T0), immediately after lateral wall sinus augmentation (T1), and approximately 1 year postoperatively (T2). Eighteen subjects aged 47 to 69 years were included. The surgical protocol included grafting with a composite of bovine-derived xenograft and autogenous bone (9:1 ratio). Digital panoramic radiographs were transferred into measurement software, and the following measurements were performed: (1) vertical distance from the alveolar crest to the height of the augmented material, (2) sagittal area of the grafted area, and (3) vertical distance from the alveolar crest to the roof of the maxillary sinus. All measurements were performed by one examiner. Double measurements were performed in nine patients at T2, and the calculated Cronbach's alpha statistic was very high (.9658 to .9882).RESULTS:The mean overall sinus sagittal area was 1,330 ± 481 mm2 prior to the grafting procedure, when it decreased to 858.2 ± 436 mm2 (range, 380.7 to 2,134 mm2) immediately postoperatively (P = .0035) and remained stable at 1 year (mean, 882.2 ± 384 mm2, P > .05). Similarly, the overall area of the grafted material at the time of surgery was 468.3 ± 208 mm2 and was only slightly reduced at 1 year (422.2 ± 193 mm2). The midsagittal graft height at T1 (mean, 20.67 ± 4.5 mm) was insignificantly and minimally reduced at 1 year (mean, 19.35 ± 4.9 mm).CONCLUSION:The linear dimensions of composite bone-derived xenograft/autogenous bone grafts following lateral wall sinus augmentation exhibited minimal changes during the 8- to 12-month healing period.

UNLABELLEDPeriodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis.AIMThe aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches.METHODSTwo meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus.RESULTSData support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.

BACKGROUND:In our previous study, we found that a novel ultrasound (US) device may serve as a useful intraoperative tool to measure the distance from osteotomy to the inferior alveolar canal (IAC).PURPOSE:To validate our previous results in a larger group of osteotomies in the posterior mandible.METHODS:During dental implant placement surgery, osteotomies were created using a standardized 2-mm-diameter pilot drill. The distance from the bottom of the osteotome to the IAC was assessed using an ultrasonic device and compared with a standard panoramic radiograph used to measure the same residual distance. The total distance from the crestal bone to the IAC was measured on a preoperative computed tomography (CT) and compared with total US measurements by summing the drill depth with residual depth measurements.RESULTS:Mean radiographic and US residual distances were 5.19 ± 1.95 mm, 5.01 ± 1.82 mm, p = 0.79 respectively. These measurements presented strong positive correlations (r = 0.61, p = .01). Mean total CT distance was 13.48 ± 2.66 mm; mean total US calculation was 13.69 ± 2.51 mm. No significant difference was found (p > .05).CONCLUSIONS:The results support our previous pilot study and confirm that the tested US device identifies the IAC and measures the distance from the osteotomy to the roof of the mandibular canal.

BACKGROUNDSystemic sclerosis (SSc) is a chronic disease with prominent vasculopathy, inflammation, production of autoantibodies, and tissue fibrosis. Periodontitis is a chronic inflammatory oral condition manifesting as microbial infection, inflammation and destruction of the alveolar bone. In both conditions tumor necrosis factor-alpha (TNFα) and other proinflammatory cytokines play an important role in pathogenesis.OBJECTIVESTo assess the periodontal status in SSc patients and compare these parameters to TNFα level in gingival crevicular fluid (GCF) of SSc patients and healthy controls.METHODSTwenty SSc patients and 20 controls underwent periodontal examination, including probing depth (PD), plaque index (PI), gingival-index (GI), bleeding on probing (BOP), and measurement of TNFα levels in collected GCF.RESULTSSSc patients had a greater PD (3.74 ± 0.32 mm vs. 3.35 ± 0.31 mm, P > 0.003), GI (1.53 ± 0.34 vs. 1.12 ± 0.54, P > 0.049), and non-significantly higher BOP than controls. TNFα levels in GCF were higher in SSc patients (1.63 ± 0.36 vs. 1.15 ± 0.34 pg/ml, P = 0.001). Periodontitis parameters correlated with several SSc variables; PI in particular was higher in patients with longer disease duration, sclerodactyly, more severe skin involvement, and SSc activity score.CONCLUSIONSPatients with SSc have higher indices of periodontal inflammation and higher TNFα level in GCF than did healthy individuals. These changes probably reflect the complexity of factors that influence oral health in SSc. Common pathologic pathways may be responsible for the association between SSc and periodontitis, which requires further study.