Zahi Badran

Er:YAG Laser in the Clinical Management of Severe Peri-implantitis: A Case Report

Peri-implantitis is bacterial infections of peri-implant supporting tissues, involving the peri-implant bone. Several treatment protocols have been tested in clinical practice with variable efficacy. The clinical management of peri-implantitis aims for elimination of plaque and calculus, decontamination of the failing implant surface, and regeneration of lost bone tissue. Surface decontamination is an important part of all suggested treatments. This can be accomplished with the use of chemical agents (eg, chlorhexidine) or mechanical (eg, ultrasonic) or photonic (eg, laser) devices. In this report, we present a case of severe peri-implantitis that was successfully managed with a combined nonsurgical and surgical approach. Implant surface debridement/decontamination of the implant surface was achieved with an erbium-doped yttrium aluminium garnet (Er:YAG) laser device.

Tooth desensitization with an Er:YAG laser: in vitro microscopical observation and a case report

Tooth hypersensitivity is a frequent condition that causes discomfort and sometimes severe pain. It is caused by exposure of spots of dentinal tubules to the oral environment. Conventional desensitizing agents (professional pastes, toothpastes, mouthwashes) aim to obliterate the exposed dentinal tubules. Laser desensitization was introduced as an alternative efficient tool for the immediate treatment of tooth hypersensitivity. We explored in vitro the microscopical occluding effects of the Er:YAG laser on exposed dentinal tubules. The clinical application of this technique is also described.

Periodontitis as a risk factor for systemic disease: Are microparticles the missing link?

Periodontitis is an oral inflammatory disease affecting the teeth supportive tissue. Its bacterial infectious etiology is well established. Periodontitis has been associated with increased prevalence of systemic diseases such as cardiovascular diseases, diabetes, rheumatoid arthritis, preeclampsia, preterm birth and inflammatory bowel disease. The rational of considering periodontitis as risk factor for systemic disease is the passage of inflammatory cytokines and/or bacteria in the bloodstream, thus affecting distant organs. Membrane microparticles are released by multiple cells in inflammatory environment. Recent data suggested the role of these microparticles in the pathogenic process of many systemic diseases, that can be also associated to periodontitis. We hypothesized that periodontitis could be a chronic reservoir of microparticles, hence elucidating partially the interaction with systemic diseases initiation or progression.

Laser-Induced Fluorescence for Subgingival Calculus Detection: Scientific Rational and Clinical Application in Periodontology

OBJECTIVE To review the data available on the laser-induced calculus fluorescence phenomenon and the calculus detection devices as well as to determine the clinical relevance of using commercialized calculus detection devices in periodontal treatment. METHODS In vitro or in vivo English publications found on Medline. RESULTS In vitro and in vivo studies showed that the devices on the market had a satisfactory detection capacity. Very few studies demonstrated that the erbium:yttrium-aluminium-garnet (Er:YAG) laser debridement, when performed with automatic calculus detection, could lead to improvements at the clinical level, and the outcome was similar to that obtained with conventional treatments. CONCLUSIONS Although preliminary data were encouraging, there was a lack of scientific data concerning the calculus detection devices. Therefore, future studies are crucial for determining the clinical relevance of such equipment.

Clinical Outcomes After Nonsurgical Periodontal Therapy with an Er:YAG Laser Device: A Randomized Controlled Pilot Study

OBJECTIVE The purpose of this study was to compare the short-term effects of nonsurgical periodontal treatment with the short-term effects of Er:YAG laser debridement (ERL) and manual scaling and root planning (SRP) in nonsmoking patients with chronic periodontitis. METHODS Nineteen nonsmoking patients (mean age 60.7) with chronic generalized periodontitis were randomly treated with ERL or SRP in a split-mouth design. Clinical attachment level (CAL), periodontal pocket depth (PPD), and bleeding on probing (BOP) were recorded. Immediately after completion of the treatment procedure, patients used a visual analogue scale (VAS) to grade the degree of discomfort experienced during treatment. RESULTS Both groups showed significant reductions in their PPD, CAL, and BOP values 2 months after treatment. The sites treated with Er:YAG laser demonstrated mean PPD changes that varied from 5.00 ± 0.63 to 3.54 ± 0.83 mm, mean CAL changes that varied from 5.19 ± 0.69 to 3.86 ± 0.94 mm, and BOP changes that varied from 26.57 ± 12.54 to 13.17 ± 7.52 mm. Sites treated with manual SRP demonstrated mean PPD changes that varied from 4.91 ± 0.55 to 3.51 ± 0.98 mm, mean CAL changes that varied from 5.08 ± 0.59 to 3.95 ± 1.16 mm, and BOP values that varied from 24.81 ± 7.65 to 15.41 ± 6.32 mm. Comparison of the two techniques demonstrated the statistically significant superiority of Er:YAG only for the CAL scores (p<0.05). CONCLUSIONS Within the limits of this study, ERL may be posited as an alternative to mechanical treatment in the management of chronic periodontitis. In addition, ERL may be performed on patients who are sensitive to the use of injectable anesthetics. Future studies, with larger samples, are needed to determine the long-term clinical outcomes of ERL.

Silicon Nitride (Si3N4) Implants: The Future of Dental Implantology?

&NA; For decades titanium has been the preferred material for dental implant fabrication, with mechanical and biological performance resulting in high clinical success rates. These have been further enhanced by incremental development of surface modifications aimed at improving speed and degree of osseointegration and resulting in enhanced clinical treatment options and outcomes. However, increasing demand for metal‐free dental restorations has also led to the development of ceramic‐based dental implants, such as zirconia. In orthopedics, alternative biomaterials, such as polyetheretherketone or silicon nitride, have been used for implant applications. The latter is potentially of particular interest for oral use as it has been shown to have antibacterial properties. In this article we aim to shed light on this particular biomaterial as a future promising candidate for dental implantology applications, addressing basic specifications required for any dental implant material. In view of available preclinical data, silicon nitride seems to have the essential characteristics to be a candidate for dental implants material. This novel ceramic has a surface with potentially antimicrobial properties, and if this is confirmed in future research, it could be of great interest for oral use.

Potential relationship between periodontal diseases and eye diseases

Periodontal diseases are inflammatory lesions initiated by oral bacteria and lead to the destruction of the supporting structures of the teeth (gingiva, periodontal ligament and alveolar bone) in susceptible patient. Via several biological mechanisms, periodontal diseases have been associated with multiple systemic diseases, such as rheumatoid arthritis, diabetes, cardiovascular diseases, Alzheimers disease and adverse pregnancy outcomes. Similarly certain eye diseases have been associated with systemic diseases of the inflammatory pathway. We hypothesized that periodontal diseases are associated with eye diseases. Thus using literature data we find that several studies have reported that eye disorders are associated with the presence of periodontal diseases. But the mechanisms of this relationship are not clear. However the innate immune response involvement, the sharing of similar risk factors in pathogenesis and the changes of eye choroid thickness may be suggested as several hypotheses to explain this potential association.

Clinical management of an atypical dental invagination

Dental invagination (DI) is a tooth malformation that usually affects permanent teeth. Its precise etiology is still controversial and represents a clinical challenge as it can favor the development of carious lesion or periodontal inflammation. This paper presents a case of a 23-year-old Caucasian male, where an atypical buccal DI could not be completely diagnosed in the dens invaginatus category. Furthermore, other differential diagnoses could not be confirmed. The dental malformation was seen on a permanent maxillary first incisor and was associated with periodontal inflammation and attachment loss. Successful clinical management of this case consisted of surgical restorative treatment and regular follow-up, accompanied by thorough oral hygiene procedures.

Relationship between removable prosthesis and some systemics disorders.

This article reviews the dental literature concerning the potential impact of the removable prosthesis (RP) on the health status of patients with certain systemic diseases. Literature was surveyed using Medline/PubMed database resources, as well as a manual search, up to 2015 to identify appropriate articles that addressed the aim of this review. The research used keywords about associations between RP and six pathologies: Human immunodeficiency virus infection, diabetes mellitus, pulmonary diseases, gastric-Helicobacter pylori, cancer, and cardiovascular diseases. Analysis of literature showed that in patients with dentures having one or more of the six general conditions listed, Candida albicans organism is more frequently found in the oral flora compared to healthy denture wearer. Although causality has not been established and pending further research on this topic, the hygienic practices necessary to minimize the risk of numerous pathologies should be strengthened in the case of these patients, all the more in the presence of physical or psychological disability. The relationship between the general diseases and increasing of oral candidiasis denture patients is not explained. Therefore, attention to oral hygiene and professional care for removing C. albicans may be beneficial in these medically compromised patients.