Michele Vano

Effects of non‐surgical periodontal therapy on the glomerular filtration rate of the kidney: an exploratory trial

OBJECTIVE To determine whether non-surgical periodontal treatment (PT) would exert, in subjects with generalized chronic periodontitis (GCP), some beneficial effect on renal function as indicated by surrogate measures of the glomerular filtration rate (GFR). MATERIAL AND METHODS Twenty GCP systemically healthy subjects were treated with PT. Serum samples were collected at baseline and 1 day, 7, 30, 90 and 180 days after treatment. GFR was evaluated using cystatin C, a serum marker and modification of diet in renal disease (MDRD), an equation involving creatinine, urea and albumin. Serum markers of systemic inflammation such as C-reactive protein (CRP), D-dimer, serum amyloid A (SAA) and fibrinogen were also assessed. RESULTS The cystatin C level decreased significantly from baseline to the end of the trial (p<0.01). Conversely, MDRD did not vary. A significant inflammatory reaction was produced by PT in the short term. Greater increases were noted for CRP and SAA within 24 h (p<0.001 versus baseline), while D-dimer (p<0.05) and fibrinogen (p<0.01) showed mild variations. The values of inflammatory markers were normalized after 30 days. CONCLUSIONS GFR, as assessed by cystatin C levels, may be positively affected by PT. Because of the exploratory nature of this trial, further research is needed to investigate this preliminary finding.

Tooth bleaching with hydrogen peroxide and nano-hydroxyapatite: a 9-month follow-up randomized clinical trial.

OBJECTIVES The aim of this study was to compare the amount of tooth colour change, rebound rate and tooth sensitivity in patients submitted to a bleaching technique with 6% hydrogen peroxide (HP) with or without 2% nano-hydroxyapatite (n-HA). METHODS Sixty subjects were included in this examiner-blinded, randomized clinical trial using a 6% HP gel with or without 2% n-HA. Tooth colour and tooth sensitivity were analysed before and after treatment. All data were analysed statistically. RESULTS After bleaching, both treatments demonstrated significant improvements in tooth shade (P < 0.05 for both groups). At the 9-month recall, tooth shade remained significantly lighter than at baseline (P < 0.05 for both groups). However, a relapse of the tooth shade was observed compared with the immediate post-bleaching result (P < 0.05). 6% HP with 2% n-HA produced significantly lower sensitivity (P < 0.05) than the bleaching product without n-HA. Colour change evaluation resulted in no difference between the two groups. CONCLUSION Both treatments demonstrated significant improvements in tooth shade. The bleaching effectiveness of the tested products was comparable. The use of 6% HP with 2% n-HA reduced the incidence of sensitivity during the bleaching treatment compared to a bleaching agent that did not contain n-HA.

Effectiveness of nano-hydroxyapatite toothpaste in reducing dentin hypersensitivity: A double-blind randomized controlled trial

OBJECTIVE The present double-blind randomized clinical trial aimed to compare the efficacy in reducing dentin hypersensitivity of a dentifrice formulation containing nano-hydroxyapatite with a fluoride dentifrice and a placebo. METHOD AND MATERIALS 105 subjects were recruited to participate in the study. A computer-generated random table with blocking to one of the three study treatments was used in order to have 35 subjects per group: 1) nano-hydroxyapatite 15% toothpaste, fluoride-free; 2) fluoride toothpaste; 3) placebo. Groups 1, 2, and 3 were instructed to brush their teeth for 2 minutes twice a day with the provided toothpaste. The participants dentin hypersensitivity was evaluated at baseline and after 2 and 4 weeks using airblast and tactile tests. In addition, a subjective evaluation using a visual analog scale (VAS) was used. RESULTS Significantly lower values of cold air sensitivity and tactile sensitivity (P<.001) were found for the test group at 2 weeks and 4 weeks. In addition, statistically significantly (P<.001) lower values of sensitivity were reported for group 1 compared to groups 2 and 3, at 2 and 4 weeks respectively. The VAS scores were significantly lower (P<.001) in the test group at 2 and 4 weeks compared to baseline and to the control groups. CONCLUSION The findings of the present study encourage the application of nano-hydroxyapatite in fluoride-free toothpaste as an effective desensitizing agent providing quick relief from symptoms after 2 and 4 weeks.

Retention of fiber posts cemented at different time intervals in canals obturated using an epoxy resin sealer.

OBJECTIVES To evaluate the effect of immediate versus delayed post space preparation and cementation on the retention of different types of fiber posts in canals obturated with an epoxy resin sealer. METHODS Sixty-eight single-rooted human teeth were decoronated and the root canals were shaped with rotary instruments and obturated with gutta-percha and an epoxy resin sealer. The teeth were divided into four experimental groups according to the different times of post space preparation and cementation: immediate (group 1), 24h (group 2) and 1 week (group 3) after root canal filling. Control group (group 4) with no root canal obturation was included. Two teeth were randomly selected from each group for SEM examination. Each group was further divided into three subgroups of five teeth each (n=5), according to the type of post and the materials used for luting the posts. A push-out test was performed and differences among experimental groups were analyzed with two-way ANOVA and Tukey test (alpha=0.05). RESULTS Interfacial strength values achieved in group 1, where an immediate cementation was performed, were significantly lower (p<0.05) than those in group 2 and group 3 in which post cementation was performed 24h or 1 week after the root canal filling. Post type affected post retention, FRC Postec and DT Light Post posts achieved higher interfacial strengths than ENA Post (p<0.05). SEM examination revealed a more conspicuous presence of sealer remnants on the walls of immediately prepared post spaces. CONCLUSIONS Delayed cementation of fiber post resulted in higher retentive strengths irrespective of the post type.

Jaw clenching effects in relation to two extreme occlusal features: patterns of diagnoses in a TMD patient population

Abstract Objective: The aim of this investigation was to compare the pattern of temporomandibular disorder (TMD) diagnoses in clenching patients with different occlusal features, the null hypothesis being that no between-group differences exist. Materials and methods: Two groups of subjects receiving a jaw clenching diagnosis and having large overjet or anterior open bite (Group A; N = 45, 75·5% females, mean age: 38·1±15·9 years) or normal occlusion (Group B; N = 69, 71% females, mean age: 34·6±13·8 years) were recruited among a TMD patient population and were given Research Diagnostic Criteria for TMD (RDC/TMD) axis I diagnoses, namely, group I muscle disorders, group II disc displacements, and group III arthralgia/osteoarthritis/osteoarthrosis. Major findings: The distribution of RDC/TMD single and combined group diagnoses was significantly different between the two groups (P<0·05), with Group A subjects showing a higher prevalence of multiple diagnoses (60% versus 43·3%), as well as a higher prevalence of combined RDC/TMD axis I group II and III diagnoses (37·8% versus 20·2%). All TMD signs and symptoms were more frequent in the patients with large overjet or anterior open bite with respect to the patients with normal occlusion. Conclusion: In a TMD patient population, jaw clenching may have different consequences in subjects with large overjet or anterior open bite with respect to subjects featuring normal occlusion.

Lack of short‐term adjunctive effect of systemic neridronate in non‐surgical periodontal therapy of advanced generalized chronic periodontitis: an open label‐randomized clinical trial

AIM To determine if the adjunctive use of intra-muscular neridronate (NE) during non-surgical periodontal treatment (PT) provides, in patients with generalized chronic periodontitis (GCP), adjunctive benefits as compared with PT alone 3 months after the completion of a 3-month NE therapy. MATERIAL AND METHODS Sixty GCP healthy patients were randomly assigned to control (CG) or test group (TG). CG patients received PT only. Thirty subjects in TG also received adjunctive NE (12.5 mg in an i.m. injection/week for 3 months). Clinical parameters were evaluated at baseline, at the end of NE treatment (3 months after PT) and 3 months after the completion of NE treatment (6 months after the beginning of PT). RESULTS Groups were balanced at baseline and all clinical parameters showed improvement between baseline and follow-ups. At 6 months improvements from baseline at sites with deep pocket depth (>or=7 mm) were 3.2 mm [95% confidence interval (CI): 2.7-3.9] in CG and 3.0 mm (95% CI: 2.3-3.8) in TG with a non-significant difference of 0.2 mm (95% CI: -1.0-0.5; ANCOVA; p=0.549) between groups. Secondary outcomes did not show significant differences between groups. No major adverse events were reported. CONCLUSIONS The adjunctive use of NE during PT did not result in additional short-term improvements in periodontal conditions of GCP patients when compared with PT.

Unusual asymptomatic giant sialolith of the submandibular gland: a clinical report

This report presents an unusual case of asymptomatic sialolith of the submandibular gland. A 61-year-old man was referred to our department for multiple extractions. An ortopantomographic exam revealed the existence of a large radiopacity in the right premolar mandibular region. The patient was completely asymptomatic and no episodes of pain and swelling had occurred in the previous years. Ultrasonography and clinical examination confirmed the diagnosis of sialolithiasis of the submandibular duct. The calculus was removed trans-orally in local anaesthesia. The sialolith measured 22 mm and it was mainly constituted by phosphate, calcium and smaller amounts of magnesium. The bacteriological exam revealed the presence of Streptococcus Mitis, Streptococcus Salivarius and non-pathogenic Neisserie. Postoperative course was uneventful. Even a sialolith of significant dimensions may not be symptomatic. Nevertheless, the likelihood of future complications may constitute an indication for surgical removal of abnormal asymptomatic sialoliths.

Bacterial adhesion on direct and indirect dental restorative composite resins: An in vitro study on a natural biofilm

Statement of problem. Both direct and indirect techniques are used for dental restorations. Which technique should be preferred or whether they are equivalent with respect to bacterial adhesion is unclear. Purpose. The purpose of this in vitro study was to determine the affinity of bacterial biofilm to dental restorative composite resins placed directly and indirectly. Material and methods. Five direct composite resins for restorations (Venus Diamond, Adonis, Optifil, Enamel Plus HRi, Clearfil Majesty Esthetic) and 3 indirect composite resins (Gradia, Estenia, Signum) were selected. The materials were incubated in unstimulated whole saliva for 1 day. The biofilms grown were collected and their bacterial cells counted. In parallel, the composite resin surface morphology was analyzed with atomic force microscopy. Both bacterial cell count and surface topography parameters were subjected to statistical analysis (&agr;=.05). Results. Indirect composite resins showed significantly lower levels than direct composite resins for bacterial cell adhesion, (P<.001). No significant differences were observed within the direct composite resins (P>.05). However, within the indirect composite resins a significantly lower level was found for Gradia than Estenia or Signum (P<.01). A partial correlation was observed between composite resin roughness and bacterial adhesion when the second and particularly the third‐order statistical moments of the composite resin height distributions were considered. Conclusions. Indirect dental restorative composite resins were found to be less prone to biofilm adhesion than direct composite resins. A correlation of bacterial adhesion to surface morphology exists that is described by kurtosis; thus, advanced data analysis is required to discover possible insights into the biologic effects of morphology.

Indirect composite restorations luted with two different procedures: A ten years follow up clinical trial

Objectives: The aim of this clinical trial was to evaluate posterior indirect composite resin restoration ten years after placement luted with two different procedures. Study Design: In 23 patients 22 inlays/onlays (Group A) were luted using a dual-cured resin composite cement and 26 inlays/onlays (Group B) were luted using a light cured resin composite for a total of 48 Class I and Class II indirect composite resin inlays and onlays. The restorations were evaluated at 2 time points: 1) one week after placement (baseline evaluation) and 2) ten years after placement using the modified USPHS criteria. The Mann-Whitney and the Wilcoxon tests were used to examine the difference between the results of the baseline and 10 years evaluation for each criteria. Results: Numerical but not statistically significant differences were noted on any of the recorded clinical parameters (p>0.05) between the inlay/onlays of Group A and Group B. 91% and 94 % of Group A and B respectively were rated as clinically acceptable in all the evaluated criteria ten years after clinical function. Conclusions: Within the limits of the study the results showed after ten years of function a comparable clinical performance of indirect composite resin inlays/onlays placed with a light cure or dual cure luting procedures. Key words:Light curing composite, dual curing composite, indirect composite restoration, inlays/onlays, clinical trial.

Stiffness effect of using polywave or monowave LED units for photo-curing different bulk fill composites

We investigated three bulk fill composites (Mat1, Mat2, Mat3) cured by two polywave (Poly1, Poly2) and one monowave (Mono) lamps. We used infrared spectroscopy, nanoindentation and atomic force microscopy to assess degree of conversion (DC), stiffness, and roughness after polishing, respectively. Mat2 exhibited the highest DC with Poly1 and second highest with Mono, however was the less stiff. Both Mat1 and Mat3 showed highest DC with Poly2, while Poly1 scored better than Mono. Mat3 scored better than Mat1 and was the third highest when cured with Poly2. For each composite cured by different lamps the stiffness ranked same as the DC. However, roughness did not correlate with hardness. Absolute stiffness value depends on composite formulation. Polywave lamps work better than monowave but not in all cases, as Mat2 showed higher DC with Mono than with Poly2. However, all lamps guarantee a DC≥50% but Mono for Mat1.