Regeneration, Reconstruction & Restoration (Triple R)

Background and objectives:  To assess the efficacy of the Cutanplast reabsorbable gelatin sponge for reducing the side effects of impacted third molar surgery.

Materials and methods:  This non-randomized double-blind split-mouth study included 15 patients (30 sites) with two bilateral impacted third molars in one jaw. Following extraction, a random socket on one side was filled with a Cutanplast reabsorbable gelatin sponge with dimensions of10×50×70 mm. The sponge was inserted, however not actually used at the control site. Two independent surgeons visually examined the effect of gelatin sponge application on the occurrence of dehiscence, edema, and infection three and seven days postoperatively. Additionally, postoperative pain was quantified using a visual analog scale.

Results: At three days, there was no significant difference in the frequency of swelling between the two groups (P=0.9). At seven days, no edema was observed. By three days, no dehiscence occurred; however, at seven days, ten (66.7%) controls developed dehiscence, but no dehiscence was seen in the test group (P=0.001). The odds ratio computed for dehiscence due to the absence of gelatin was 0.67. The two groups did not differ significantly in terms of pain (P>0.05).

Conclusion: At seven days postoperatively, the use of Cutanplast resorbable gelatin prevented dehiscence, but had no effect on pain, edema, or infection.

Background and objectives: The aim of this study was to determine the epidemiological profile of patients hospitalized due to the treatment of an intraosseous lesion of the jaw.

Materials and methods: This descriptive-analytical cross-sectional study of 186 patients was conducted from January 2017 to February 2022 at Khatam al-Anbia Hospital in Zahedan. All data, including gender, age, lesion location, and participants' histopathological reports, were obtained from the medical records of all patients hospitalized for treatment of a jaw intraosseous lesion. To examine the association between the study variables, a chi-square test was performed.

Results: Among the 186 medical records, there were 76 male patients (41%) and 110 female patients (59%). 101 lesions (54.3%) were detected in individuals under 40 years of age and 85 lesions (45.7%) in individuals with age over 40 years. Bone lesions were found more frequently in the mandible (69.4%) than in the maxilla (30.6%). Primary intraosseous carcinoma (25.8%) was the most common lesion, followed by odontogenic keratocysts (18.3%) and radicular cysts (14.0%). Age and lesion location were significantly correlated with bone lesions (P < 0.05), whereas there was no significant association between gender and bone lesions (P > 0.05).

Conclusion: The prevalence of oral and maxillofacial bone lesions leading to hospitalization is therefore different from the prevalence of oral and maxillofacial bone lesions in routine practice. In particular, in this study, malignant bone lesions (primary intraosseous carcinoma) were more common than benign and inflammatory bone lesions.

Background and objectives:  Fluoride mouthwash is an over-the-counter product that has been considered effective for daily oral hygiene maintenance in orthodontic patients, particularly to inhibit enamel demineralization around orthodontic brackets. We sought to evaluate the effect of fluoride mouthwash on the force degradation of four different orthodontic elastomeric chains.

Materials and methods:  In this in-vitro study, 120 orthodontic elastomeric chains of four different trademarks were investigated. The study involved three different environments. The experimental groups used pre-stretched elastomeric chains at initial, 50%, and 100% lengths, which were then stored in either water or fluoride media (n=5 in each group). The control group's chains were stored in the air throughout the entire experimental period.  After three weeks, tensile strength measurements were performed. One-way analysis of variance (ANOVA) was used to assess the effect of the storage environment and pre-stretching extent on the tensile strength. Observed data were analyzed by means of Multifactorial ANOVA at a significance level of 0.05%.

Results: The tensile strength in fluoride storage medium was generally lower than in water for all trademarks, except for the conventional and Energy chains (RMO) at 50% pre-stretching, with no significant difference for the Super chain™ (GAC) and conventional chain (RMO) at this level. After three weeks, all samples showed increased length, with the conventional chain (GAC) having the highest and the Energy chain (RMO) having the lowest elongation percentile. The tensile force at 50% elongation was lower than at 100% elongation for all elastomeric chains.

Conclusion: The tensile strength in a fluoride storage medium was generally lower compared to that in water.

Background and objectives:  Probiotics have recently emerged as adjunctive agents to conventional periodontal treatment, aiming to improve clinical outcomes. This study systematically reviews published literature evaluating the potential clinical benefits of probiotics in treating chronic periodontitis.

Materials and methods:  A search of the MEDLINE database (via PubMed) was conducted up to November 2020. Randomized clinical trials (RCTs) in English comparing probiotics to a placebo for treating chronic periodontitis were selected. Clinical outcome variables included probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP).

Results:  Eight studies met the inclusion criteria. All were double-blind, parallel-arm, placebo-controlled RCTs. Six studies reported a statistically significant reduction in PPD, while four studies showed a beneficial reduction in BOP and PI compared to the control group.

Conclusion:   Probiotic consumption appears to moderately improve the treatment of chronic periodontitis. However, heterogeneity among studies may limit the strength of this conclusion.

The complex root canal system morphology in rare cases can complicate the root canal treatment and cautious management of the case is mandatory. The aim of this case report is to illustrate the successful endodontic management of biradicular maxillary central incisor with the aid of three-dimensional cone-beam computed tomography. A 36-year-old female was referred to the Department of Endodontics with the chief complaint of spontaneous pain in the anterior region of maxilla. Complete clinical examination revealed no tenderness to percussion and palpation and no periodontal pocket was measured. Maxillary right central incisor was sensitive to cold and other adjacent teeth responded within normal limits. Preoperative radiographs showed normal periodontal ligament spaces. By using bisecting angle technique at different angles, the presence of a second root was confirmed based on the Same Lingual Opposite Buccal (SLOB) rule. A diagnosis of irreversible pulpitis by clinical, radiographic, and CBCT examination was made. The entire procedure that has been undergone is described including pulpal and periapical examination together with adjunctive conventional radiography and CBCT, access cavity preparation, root canal shaping, and final obturation. A 1-year follow-up showed asymptomatic tooth and proved CBCT to be useful to manage endodontic anatomic variations. The dental pulp within tooth crown and root canal, also known as root canal system, is deemed to have various morphologies and has been categorized into different classes by many studies. Detecting the variations in the anatomical configuration of the root canal system by various techniques will help to improve the success rate of endodontic treatment. Previous case reports concerning maxillary incisors and their unusual anatomy were also reviewed to identify research gaps and limitations.