1,721,030 research outputs found
Effectiveness of Photobiomodulation as an Adjunct to Nonsurgical Periodontal Therapy in the Management of Periodontitis- A Systematic Review of in vivo Human Studies
No full textPhotobiomodulation therapy (PBMT) has anti-inflammatory, analgesic and regenerative properties. This systematic review aimed to critically appraise the published data of in vivo human randomized clinical trials (RCTs), and present a comprehensive overview of the efficacy of PBMT, as an adjunct to the nonsurgical periodontal therapy (NSPT) in the management of periodontitis. The systematic review protocol is registered in the Prospective Register Of Systematic Reviews (PROSPERO) (www.crd.york.ac.uk/PROSPERO/; ref CRD 42020169108). With the help of the appropriate key words, structured electronic and manual search strategies were applied to gather the relevant published data on in vivo human RCTs based on this topic. Seventeen papers that met the eligibility criteria were included in this review and subjected to a qualitative assessment. Current evidence lacks adequate information regarding the photobiomodulation (PBM) dosimetry, which is fundamental in establishing a standardized and replicable protocol for future researches. Furthermore, substantial discrepancies in the study methodology and a high risk of bias, arising from the majority of the included papers, abet to the inferior quality of these studies. Ultimately, there is an urgent necessity to conduct further well-designed RCTs in order to determine the effectiveness of PBMT, if any, by taking into consideration the abovementioned confounding factors
Photobiomodulation Affects Key Cellular Pathways of all Life-Forms: Considerations on Old and New Laser Light Targets and the Calcium Issue
No full textAfter 50 years of studies on photobiomodulation (PBM), there is still so much to investigate to understand the laser light-nonplant cells interactions. The current scientific knowledge allows to say that the phenomena induced by PBM are based on cellular pathways that are the key points of cell life. The mitochondria chromophores, also present on the bacterial membrane, the calcium channels, ion that regulates the life-and-death cellular processes, as well as the TRP family, whose genes have been found in protozoa and suggest that its basic mechanism evolved long before the appearance of animals, seem to be elective targets in photobiomodulatory events by wavelengths from 600 up to 980 nm. The ambiguous resulting cellular communication way, mediated by ATP, ROS and/or calcium, leads to cell manipulation, which modifies its metabolism and whose response connects all life-forms from bacteria to vertebrates. Because of the Giano-Bifronte features of ROS and calcium, as well as the fine balance of energetic mitochondrial processes, whose alteration is responsible for several diseases, the PBM can show unpredictable results and it requires scrupulous approach to avoid cellular damages. However, when carefully applied, PBM is able to improve nonhealthy cell's responses and represents a reliable support in human and veterinary medicine
Is antimicrobial photodynamic therapy an effective treatment modality for aggressive periodontitis? A systematic review of in vivo human randomized controlled clinical trials
No full textBackground: Limitations of scaling and root planing (SRP) have directed research to utilize additional therapies to enhance conventional techniques. The present systematic review was conducted to evaluate and present a comprehensive overview on effectiveness of antimicrobial photodynamic therapy (aPDT) in the management of aggressive periodontitis (AgP). Methodology: The PRISMA statement guidelines and Cochrane Collaboration recommendations were followed to conduct this systematic review. The review protocol is registered in PROSPERO (CRD 42019143316). A structured electronic and manual search strategy was implied to gather the relevant published data on in vivo human RCTs from their earliest records until 31st October 2019. Relevant data was extracted from the eligible studies, analysed and impartially appraised for its quality. Results: Eleven papers met the eligibility criteria and included in this review. The data on standardized study protocol, ideal photosensitizer (PS) dye-wavelength combination, optimal parameters was inconclusive and a high risk of bias in majority of the studies noted, which are fundamental in establishing a standardized and replicable protocol. Conclusion: Ultimately researchers should conduct well-designed and robust RCTs performed by trained clinicians in order to determine the effectiveness of aPDT, if any, after acknowledging the drawbacks highlighted in this systematic review
Efficacy of the lateral advanced flap in root-coverage procedures for mandibular central incisors: A 5-year clinical study
No full textThe aim of this study was to determine the efficacy of the lateral advanced flap in root-coverage procedures for mandibular incisors and to evaluate pain after treatment. A total of 15 patients who required treatment for gingival recessions were selected from the University of Genoa Laser and Restorative Dentistry Department. The inclusion criteria were the presence of at least one 3-mm gingival recession defect of a mandibular incisor and 3 mm or more of keratinized tissue width on the immediately adjacent tooth. One calibrated masked examiner performed the clinical measurements, including recession depth and width, probing depth, clinical attachment level, and keratinized tissue width. Patients were checked 7, 14, and 30 days after surgery and were included in supportive periodontal maintenance every 4 months. Further follow-ups were done at the first, third, and fifth year postsurgery when the same baseline assessment parameters were recorded according to the root-coverage esthetic score (RES). Numeric score recorded pain evaluations showed a mean of 3 at the day of the surgery, 2 in the first day after the surgery, and no significant scores were referred in the following days. Mean recession depth was 3.2 ± 1.3 mm at baseline; at 5 years, RES showed a positive increase of all scores. The laterally coronally advanced surgical technique was very effective in treating isolated gingival recessions. It combined the esthetic and root-coverage advantages of the coronally advanced flap with the increased gingival thickness and keratinized tissue associated with the lateral gingival flap
Hydro air abrasion on dental glass-ceramics: A direct 3D analysis by stylus profilometry
No full textAir abrasion is used in dentistry for cavity opening, post-endodontic cavity cleaning, and removal of hard deposits or stains. Different applications may require different settings. We aimed to gain better understanding of the effect of some operating parameters on the efficiency of air abrasion on a model dental material. We abraded lithium disilicate glass-ceramic blocks (IPS e.max CAD, Ivoclar Vivadent) with Prepstart H2O device (Danville) and 27-μm-size aluminium oxide abrasive (Danville). At 5 bar constant pressure, we varied incidence direction, treatment time, distance, powder consumption, and supporting medium, in separate experiments addressing individual aspects. The abraded surfaces were characterized by stylus profilometer XP-2 (Ambios). Laboratory condition of normal incidence at fixed direction showed threefold increased volume abrasion vs 45° incidence and oscillating direction. Working in air, 2 mm distance was more efficient than 1 and 5 mm, likely due to its influence on the abrading particles speed. Maximum vs medium powder consumption decreased the abraded volume, while increasing the treated area. Using water restricted the treated surface. To minimize the risk of dental material damage, the best conditions should be 45° direction and 5 mm distance, which both increase the treated area. To counteract this, water may be used. The most abrasive condition is instead 90°, at intermediate 2 mm distance. In most cases, abraded volume scales linearly with time. The present combination of device and abrasive can be effective even on enamel-like ceramic material. Tuning air abrasion settings to the specific dental application appears to be necessary
Correction to: Outpatient erbium:YAG (2940 nm) laser treatment for snoring: a prospective study on 40 patients (Lasers in Medical Science, (2018), 33, 2, (399-406), 10.1007/s10103-018-2436-6)
No full textIn the originally published article, the name of the first author was incorrectly labeled. Given name is Isabelle and family name is Fini Storchi
Utilization of 810 nm Diode Laser Treatment in Periodontitis as an Alternative to Surgical Debridement Approach
No full textThe efficacy of surgical periodontal may be compromised by inadequate patients’ self-performed plaque control or lack of supportive periodontal therapy. This clinical case report aimed to evaluate the effectiveness of 810 nm diode laser-assisted full-mouth sulcular debridement, as a potential treatment modality in the management of chronic periodontitis along with a 12-month follow-up evaluation. Each periodontal pocket was lased within 2 mm of deepest point, using a light contact of “hot tip” of the fiber with tissue [Average power—1W, emission mode-continuous wave, in “contact”, beam diameter—400 μm, spot area at tissue—0.0013 cm2, fluence—124.9 J cm−2, power density—796 W cm−2, total energy—300 J, total treatment duration—300 s (5 min)]. The patient was followed up to 12 months and did not report any immediate or delayed complications such as any sign of photothermal damage, pain, tissue swelling and deformation, bleeding and infection. 810 nm diode laser-assisted sulcular debridement at low-power settings showed overall clinical and radiographic improvements and can be deemed as a potential alternative to surgical debridement approach, in persistent moderate periodontal pockets (4–6 mm)
Comparison between the Flapless Surgical Approach and a Novel Single Incision Access in Terms of Recovery Time and Comfort after Extraction of Impacted Inferior Third Molars: A Randomised, Blinded, Split-Mouth Controlled Clinical Trial
No full textThe recent attention to quality of life and oral health care procedures reflects a renewed ‘patient-based’ approach to dealing with non-life-threatening conditions. In the current study, we proposed a novel surgical approach to the extraction of impacted inferior third molars (iMs3) through a randomised, blinded, split-mouth controlled clinical trial following the CONSORT guidelines. The novel surgical procedure, hereinafter referred to as single incision access (SIA), will be compared with our previously described flapless surgical approach (FSA). The predictor variable was the novel SIA approach, involving access through a single incision without removal of soft tissue, on the impacted iMs3. The primary endpoint was the acceleration of the iMs3 extraction healing time. The secondary endpoints were the incidences of pain and oedema as well as gum health (pocket probing depth and attached gingiva). The study was carried out on 84 teeth of 42 patients with both iMs3 impacted. The cohort was composed of 42% Caucasian males and 58% Caucasian females, aged 23.8 ± 7.9 (17–49) years. We observed faster recovery/wound-healing on the SIA side (33.6 ± 4.3 days) than at the FSA side (42.1 ± 5.4 days; p < 0.05). The FSA approach confirmed the evidence previously detected concerning early post-surgery improvement in terms of attached gingiva and reduced oedema and pain, with respect to the traditional envelope flap. The novel SIA approach follows the early positive post-surgery FSA results
Role of photobiomodulation therapy in modulating oxidative stress in temporomandibular disorders. A systematic review and meta-analysis of human randomised controlled trials
No full textThis systematic review and meta-analysis (PROSPERO registration; ref CRD 42020198921) aimed to govern photobiomodulation therapy (PBMT) efficacy in temporomandibular disorder (TMD). PRISMA guidelines and Cochrane Collaboration recommendations were followed. Differences in pain reduction assessment by qualitative measurement with visual analogue scale pain (VAS), pressure threshold (PPT) and maximum mouth opening (MMO) were calculated with 95% confidence intervals and pooled in a random effects model with a subgroup analysis, evaluating the role of follow-up duration. Heterogeneity was analysed using Q and I2 tests. Publication bias was assessed by visual examination of funnel plot symmetry. Qualitative analysis revealed 46% of the 44 included studies showed a high risk of bias. Meta-analysis on 32 out of 44 studies revealed statistically significant intergroup differences (SSID) for VAS (SMD = −0.55; 95% CI = −0.82 to −0.27; Z = 3.90 (p < 0.001)), PPT (SMD = −0.45; 95% CI = −0.89 to 0.00; Z = 1.97 (p = 0.05)) and MMO (SMD = −0.45; 95% CI = −0.89 to 0.00; Z = 1.97 (p = 0.05)), favouring PBMT compared to control treatment strategies. Sensitivity analysis revealed SSID (SMD = −0.53; 95% CI = −0.73 to −0.32; Z = 5.02 (p < 0.0001)) with low heterogeneity (Τ2 = 0.02; χ2 = 16.03 (p = 0.31); I2 = 13%). Hence, this review, for first time, proposed suggested recommendations for PBMT protocols and methodology for future extensive TMD research
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