Walter Dukić

Clinical Effectiveness of Diode Laser Therapy as an Adjunct to Non-Surgical Periodontal Treatment: A Randomized Clinical Study

BACKGROUND The aim of this randomized clinical study is to evaluate the effect of a 980-nm diode laser as an adjunct to scaling and root planing (SRP) treatment. METHODS Thirty-five patients with chronic periodontitis were selected for the split-mouth clinical study. SRP was performed using a sonic device and hand instruments. Quadrants were equally divided between the right and left sides. Teeth were treated with SRP in two control quadrants (control groups [CG]), and the diode laser was used adjunctively with SRP in contralateral quadrants (laser groups [LG]). Diode laser therapy was applied to periodontal pockets on days 1, 3, and 7 after SRP. Baseline data, including approximal plaque index (API), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), were recorded before the treatment and 6 and 18 weeks after treatment. Changes in PD and CAL were analyzed separately for initially moderate (4 to 6 mm) and deep (7 to 10 mm) pockets. RESULTS The results were similar for both groups in terms of API, BOP, PD in deep pockets, and CAL. The laser group showed only significant PD gain in moderate pockets during the baseline to 18-week (P <0.05) and 6- to 18- week (P <0.05) periods, whereas no difference was found between LG and CG in the remaining clinical parameters (P >0.05). CONCLUSION The present study indicates that, compared to SRP alone, multiple adjunctive applications of a 980-nm diode laser with SRP showed PD improvements only in moderate periodontal pockets (4 to 6 mm).

Clinical Evaluation of Indirect Composite Restorations at Baseline and 36 Months After Placement

This study determined the differences in clinical performance between materials for indirect composite restorations based on Ormocer (Admira) and nano-hybrid resin composite (Grandio), both at baseline and 36 months after placement. Modified USPHS criteria were used to analyze the degree of quality. Marginal integrity was assessed 36 months after placement, whereupon, the restorations fabricated from Grandio achieved an Alpha 1 score of 70.7% and an Alpha 2 score of 29.3%. The Wilcoxon test revealed a statistically significant difference in the evaluation of marginal integrity (p = 0.003), anatomic form of the marginal step (p = 0.025) and discoloration of the margins (p = 0.014) at baseline and after 36 months. For Admira, the Wilcoxon test showed statistically significant differences in the evaluation of surface texture (p = 0.025), anatomic form of the complete surface (p = 0.034), anatomic form of the marginal step (p = 0.008), marginal integrity (p = 0.002) and discoloration of the margins (p = 0.008) at baseline and after 36 months. According to the number of restorations awarded the Alpha 1 score (excellent), the overall success rates for marginal integrity were 70.7% for Grandio and 71.8% for Admira; both were evaluated 36 months after placement. The results have shown that the indirect restorations were acceptable after 36 months, which indicates a 100% success rate. Over 36 months, no statistically significant differences were noted between the two materials. Indirect resin composite restorations represent a good therapy choice for severely damaged teeth.

Clinical evaluation of three fissure sealants: 24 month follow-up

Aim: This was to compare 3 different materials for fissure sealing (FS) after a clinical use during a 24 month period and to assess the use of flowable composite resins in combination with dentine adhesives as sealing materials. Study Design: There were 41 patients aged from 7–17 years, for whom 100 permanent molars were sealed with 3 different sealing materials. Methods: Group A, 33 teeth were sealed material Helioseal Clear Chroma (Vivadent, Schaan, Liechtenstein); Group B, 33 teeth were sealed with Teethmate F1 (Kuraray, Kurashiki, Japan), and in Group C, 34 teeth were sealed with the flowable composite Tetric Flow (Vivadent, Schaan, Liechtenstein). For the analysis of the degree of retention, the criteria used were: 0-complete retention, 1-loss of 1/3 of material, 2-loss of 2/3 of material, 3-complete loss of material. Clinical criteria for appearance of a new caries lesion included following values: Caries present (+) or caries absent (−). Statistics: Chi-Square test was used for statistical analysis of retention rates between groups. Results: After the 24 month period, the highest retention rate of complete retention was established for the material Tetric Flow of 76.5%, Helioseal Clear Croma 66.7%, and Teethmate F1 60.6%. The incidence of caries with Helioseal Clear Croma was 6.1%, for Teethmate F1 3%, with no statistically significant difference after the 24 months period (p=0.656). In the group of teeth sealed with Tetric Flow, there was not a single case of caries noted. Conclusions: The use of flowable composite resins as sealing materials is equal to other materials for fissure sealing.

Radiopacity of Flowable Composite by a Digital Technique

The aim of this in vitro study was to evaluate the radiopacity of 19 current dental flowable composite materials by a digital technique. Digital radiographs were obtained with a CCD sensor using an aluminum step wedge, a 1-mm-thick tooth slice, and a 1-mm-thick flowable composite specimen using five different combinations of exposure and voltage. The radiopacity in pixels was determined using Digora 2.6. software. The equivalent thickness of aluminum for each material was then calculated based on the calibration curve. All of the tested flowable composite materials had higher radiopacities than that of dentin, but in almost every combination of exposure and voltage, there were some composite materials that exhibited radiopacities equal to or slightly greater than enamel p>α; α=0.01). Of the flowable composite materials tested, 37% showed lower radiopacities than enamel, and 21% of the tested materials had higher radiopacities than the 3-mm aluminum equivalent. The highest radiopacity at all exposure values was produced by the Majesty Flow and Charisma Opal Flow materials, which had radiopacities almost twice that of enamel. Flowable composite materials should have radiopacities greater than that of enamel (ISO 4049), an important consideration for the introduction of new materials to the market. The digital radiopacity analysis techniques used in this study provide an easy, reliable, rapid, and precise method to characterize radiopacity of dental flowable composite materials.