Paul A. Levi

Anterior maxillary and mandibular biotype: relationship between gingival thickness and width with respect to underlying bone thickness.

Purpose:Periodontal biotype is considered to be a significant factor related to successful dental treatments. The purpose of this study was to determine the relationship between gingival thickness (GT) and width with respect to the underlying bone thickness in the maxillary and mandibular anterior sextant. Materials and Methods:Overall, 180 anterior teeth within healthy patients were assessed. GT and buccal bone thickness (BT) were measured at 3 locations: crestal/gingival margin, tooth apex, and a midpoint between the 2. In addition, the apicoincisal gingival width (GW) was recorded. Clinical and cone beam CT measurements were compared and correlated. Results:No statistically significant relations were observed between GT and BT measures at any of the 3 positions. The mean GT at crestal mid and apical position for the maxillary teeth was 1.01 (±0.58) mm, 1.06 (±0.48) mm, and 0.83 (±0.47) mm, respectively, and the corresponding mean BT was 1.24 (±0.90) mm, 0.81 (±0.33) mm, and 2.78 (±1.62) mm, respectively. The GW is directly related (R = 0.007; P < 0.05) to the crestal BT. Conclusion:In this study, the GT is not linked to the BT. However, the GW seems to be associated with the crestal BT.

Comparison of the efficacy of different types of lasers for the treatment of peri-implantitis: a systematic review.

PURPOSE To evaluate the efficacy of various types of lasers (neodymium-doped yttrium-aluminum-garnet [Nd:YAG], carbon dioxide [CO2], diode, erbium/chromium-doped yttrium-scandium-gallium-garnet [Er,Cr:YSGG], and erbium-doped yttrium-aluminum-garnet [Er:YAG]) in the treatment of peri-implantitis and their use in surgical and nonsurgical procedures. MATERIALS AND METHODS Human studies for the treatment of peri-implantitis with laser therapy, published between 2002 and January 2014, were collected utilizing the electronic databases PubMed, Ovid, MEDLINE, Cochrane, and Google Scholar. Two reviewers conducted the study selection, data collection, and validity assessment. RESULTS Eight hundred twelve studies were selected in the initial title search; 13 studies were then chosen for this review. No human studies evaluated the effect of the Nd:YAG laser on peri-implantitis. The CO2 laser is reported to be safe and able to enhance bone regeneration. The diode laser (980 nm) seems to be effective in its bactericidal effect without changing the implant surface pattern. The Er,Cr:YSGG laser was reported to obtain bone regeneration around a failing implant in one case, while the Er:YAG laser exhibits a strong bactericidal effect against periodontopathic bacteria at a low energy level. CONCLUSION Although lasers have shown promising results in reducing clinical signs of peri-implantitis, because of the limited sample sizes and short follow-up periods, no firm conclusion can be drawn at this moment. Hence, there is a need for more well-designed, longitudinal, randomized controlled clinical trials.

Histomorphometric Results in Ridge Preservation Procedures Comparing Various Graft Materials in Extraction Sockets With Nongrafted Sockets in Humans: A Systematic Review

Introduction: The aim of this systematic review was to evaluate, from a histological point of view, the amount of newly formed bone in ridge preservation procedures using various graft materials in comparison with natural healing (NH) and to determine which is the ideal type of graft to be used. Materials and Methods: A search strategy was developed to find articles in a human model published between 1990 and January 2013 in English language using MEDLINE database. Results: Thirty-four articles were included in this systematic review. When comparing the percentage of newly formed bone using various grafting materials with NH, calcium sulfate, magnesium enriched hydroxyapatite, and porcine-derived bone grafts offered the best outcomes. However, due to the heterogeneity of the included studies, the search was extended to determine which type of graft resulted in greatest bone formation. Conclusion: When comparing ridge preservation with NH, only 3 studies encountered a greater amount of newly formed bone in the ridge preservation group, whereas the rest did not find statistically significant differences or even observed a greater percentage of newly formed bone in the control group. Therefore, more studies are needed to determine whether the use of graft materials enhances new bone formation in contrast to NH alone and to determine the most effective bone grafting material.

Self-reported Oral Hygiene Habits in Smokers and Nonsmokers Diagnosed with Periodontal Disease.

PURPOSE To determine whether smokers report having less adequate oral hygiene habits than nonsmokers. MATERIALS AND METHODS Using a 24-item questionnaire addressing both smoking and oral hygiene habits, patients from three periodontal practices in Spain were evaluated. In order to assess the periodontal status of all patients, immediately following the survey, the patients were examined clinically and categorised according to the American Dental Association (ADA) classification for periodontal diseases. RESULTS 762 patients with ADA type I gingivitis (4.1%), type II early periodontitis (31.2%), type III moderate periodontitis (39.2%) and type IV advanced periodontitis (25.5%) were surveyed. A total of 289 smokers (38.0%) and 402 (52.8%) nonsmokers participated in the study: 77 (10.1%) participants were identified as heavy smokers (>20 cigarettes/day), along with 122 (16.0%) moderate smokers (10-20 cigarettes/day) and 90 (11.8%) light smokers (<20 cigarettes/day). A greater proportion of nonsmokers brushed their teeth two (37.8%) or more (22.9%) times a day compared with moderate smokers (twice: 32.0%, more: 15.6%) and heavy smokers (twice: 32.5%, more: 15.6%), respectively (p < 0.05). Heavy smokers used dental floss statistically significantly less frequently (10.4%) than nonsmokers (21.6%) (p < 0.05). No statistically significant differences were found between smokers and nonsmokers regarding the use of mouthwashes (p > 0.05). CONCLUSIONS This study revealed comparable oral hygiene habits in nonsmokers and light smokers. However, heavy smokers were found to have worse oral hygiene habits than nonsmokers.

Comparison of Periodontal Biotypes Between Maxillary and Mandibular Anterior Teeth: A Clinical and Radiographic Study.

Periodontal biotype is a key element influencing esthetic treatment outcomes in clinical practice. However, while the soft and hard tissue thicknesses of maxillary anterior teeth have been widely studied, information regarding mandibular anterior teeth is scarce. Therefore, the aim of this study was to determine whether there is a relationship in terms of hard and soft tissue thickness between maxillary and mandibular anterior teeth. The present study included 90 maxillary and 90 mandibular anterior teeth in 15 healthy patients. Clinical and cone beam computed tomography measurements were taken to determine gingival and buccal bone thickness, respectively, and a correlation was made between maxillary and mandibular anterior teeth. No statistically significant differences were found when comparing gingival and buccal bone thickness at the crestal third and midpoint of maxillary and mandibular teeth (P > .05). However, some differences were observed at the apical third between the two groups. The results suggest that soft and hard tissue dimensions of maxillary and mandibular anterior teeth are comparable, especially in the coronal third. However, more studies are necessary to confirm that maxillary anterior teeth can be used as a reference when dealing with mandibular incisors and canines.