Background. This study was undertaken to assess the pathological and spatial associations between periapical and periodontal diseases of the maxillary first molars and thickening of maxillary sinus mucosa with cone-beam computed tomography. Methods. A total of 132 CBCT images of subjects 20‒60 years of age were evaluated retrospectively. The patients' sex and age and demographic and pathologic findings of the maxillary sinus in the first molar area were recorded, graded and analyzed. Results. Approximately 59% of patients were male and 41% were female, with no significant difference in the thickness of schneiderian membrane between males and females. Based on the periapical index scoring, the highest frequency was detected in group 1. Based on the results of ANOVA, there were no significant differences in the frequencies of endodontic‒periodontal lesions and an increase in schneiderian membrane thickness. There were significant relationships between periapical and periodontal infections (P<0.001) and schneiderian membrane thickness. Furthermore, a significant relationship was detected between the thickness of the schneiderian membrane and the distance between the sinus floor and the root apices (P=0.38). Conclusion. A retrospective inspection of CBCT imaging revealed that periapical lesions and periodontal infections in the posterior area of the maxilla were associated with thickening of the schneiderian membrane. In addition, there was a significant relationship between the location of maxillary posterior teeth, i.e. the thickness of bone from the root apex to the maxillary sinus floor, and schneiderian membrane thickness.

Background. Incorporation of antifungal and antimicrobial agents into tissue conditioners might inhibit the formation of microbial plaque and prevent complications such as denture stomatitis. The present study was carried out to evaluate the antibacterial and antifungal properties of a tissue conditioner after incorporation of ZnO‒Ag nanoparticles into their structure. Methods. In this in vitro study, 4 microorganisms were evaluated at 6 concentrations of ZnO‒Ag nanoparticles at 24- and 48-hour intervals, using 168 samples. The nanoparticles were mixed at a ratio of 50% Ag and 50% ZnO and were homogenized with the tissue conditioner at 0.625, 1.25, 2.5, 5, 10 and 20 wt% according to the MIC technique principles. After culturing the microorganisms, a spectrophotometer was used for determining proliferation of microorganisms with the use of turbidity after 24 and 48 hours of incubation at 37ºC. Results. Complete inhibition of the proliferation of Candida albicans, Enterococcus faecalis and Pseudomonas aeruginosa was observed at 24- and 48-hour intervals at a concentration of 10%; such inhibition was observed at 20% concentration of nanoparticles with Streptococcus mutans. In addition, the most effective concentration of ZnO‒Ag nanoparticles at both 24- and 48-hour intervals was 5% with C. albicans and 2.5% with E. faecalis. In addition, the most effective concentration at 24- hour interval with S. mutans was 10% and with P. aeruginosa they were 5% at 24-hour and 2.5% at 48-hour intervals. Conclusion. Incorporation of ZnO‒Ag nanoparticles into tissue conditioners resulted in the inhibition of bacterial proliferation.

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Background. Using antibacterial agents to remove the foul odor of the implant cavity and prevent peri-implantitis can affect the detorque values and lead to the loosening of the abutment screw. This study investigated the effects of tetracycline and chlorhexidine gel on detorque values. Methods. This in vitro study was carried out on three groups of five implants. Group G1 was the control group, and no material was applied to the implant cavity. In group G2, the implant cavity was first filled with artificial saliva and then with chlorhexidine gel. In group G3, the implant cavity was first filled with artificial saliva and then with tetracycline. The abutments were tightened with 25 N/cm2 and then loosened. Finally, the detorque values were calculated. Results. The highest detorque values were recorded in group G1. Group G3 showed the lowest detorque values. ANOVA showed significant differences in mean detorque values (P<0.05) between the three groups. Conclusion. According to this study, applying antibacterial agents decreased the detorque values and increased the risk of screw loosening. The reduction of detorque values was more pronounced with the oil-based antibacterial agent (tetracycline).

Background. Ferritin is a positive acute phase protein (APP) in inflammation and chronic infections, including chronic periodontitis. Two key factors that can regulate ferritin expression are iron and pro-inflammatory cytokines. Serum ferritin levels increase after menopause, affecting women’s health. This study aimed to evaluate serum ferritin levels in postmenopausal women upon undertaking non-surgical periodontal treatment. Methods. In this cross-sectional study, blood samples of 38 postmenopausal women with chronic periodontitis were collected before any treatment. The serum ferritin levels and periodontal parameters, probing depth (PD), clinical attachment level (CAL), and gingival index (GI) were recorded at baseline and three months after non-surgical periodontal therapy. Wilcoxon test was used to compare serum ferritin levels before and after treatment. T-test was used for comparison of periodontal parameters, with a P value of ≤0.05 considered significant. Results. A decrease was observed in the serum ferritin level (from 108.55 mcg/L to 98.28 mcg/L) after treatment compared to baseline (P<0.001). Also, significant improvements in periodontal parameters were observed compared to the baseline (P<0.001). Conclusion. Based on the results, it can be concluded that non-surgical periodontal treatment significantly reduces serum ferritin levels in postmenopausal women with chronic periodontitis.

Background. Peri-implantitis is an infectious disease that affects the tissues around dental implants, with clinical signs of inflammation and irreversible loss of supporting bone. This study aimed to compare the effect of sterile topical tetracycline ophthalmic ointment as an adjuvant to mechanical debridement with mechanical debridement alone in the treatment of peri-implantitis. Methods. In this single-blind randomized clinical trial, 32 patients (16 patients in each group) with peri-implantitis were treated topically using sterile tetracycline ophthalmic ointment. Four clinical parameters, including modified bleeding index (mBI), modified plaque index (mPI), probing depth (PD), and clinical attachment level (CAL), were measured at baseline and at 3- and 6-month follow-up intervals. Results. PD reduction was statistically significant after 3 and 6 months in the test and control groups (P=0.001). Also, mPI and mBI reduction rates were significant in the test and control groups (P=0.001) after 3 and 6 months. However, in all the samples in the two groups, the mean of CAL before and after treatment was constant, with no significant difference (P>0.05). Conclusion. Using sterile ocular tetracycline ointment could be an adjunctive treatment in improving and enhancing the therapeutic effects of mechanical debridement in the treatment of peri-implantitis. (IRCT20210909052418N1)

Introduction: Cytokines play a prominent role in the induction of periodontal diseases. Aloe vera can ameliorate periodontal disease considering its anti-inflammatory and antibacterial effects. Objectives: This study investigated the effect of topical aloe vera gel, associated with scaling and root planing (SRP), on interleukin-1 (IL-1) and interleukin-17 (IL-17) of gingival crevicular fluid (GCF) levels in chronic periodontitis patients. Patients and Methods: This study recruited 20 patients diagnosed with moderate to severe chronic periodontitis (with probing pocket depths of ≥5 mm). The control group subjects underwent only SRP; the test group subjects underwent SRP, followed by topical aloe vera gel application. Periodontal clinical parameters, including probing depth (PD), clinical attachment level (CAL) and gingival index (GI), were determined; GCF levels of IL-1 and IL-17 were determined using the enzyme-linked immunosorbent assay (ELISA) at baseline and one month postoperatively. Results: There were significant decreases in periodontal clinical parameters in both groups compared to the baseline. The test group exhibited a significant decrease in interleukin levels compared with the control group as follows; interleukin-1 beta (IL-1β) (control; 61.78±14.54, test; 43.06±10.99 ng/mL) (P<0.001), IL-17 (control; 81.33±16.66, test; 57.04±16.26 ng/mL) (P<0.001). Conclusion: Topical aloe vera gel in combination with SRP significantly improved clinical parameters of periodontitis and decreased IL-1β and IL-17 GCF levels. Trial Registration: The trial protocol of the present study was approved by the Iranian registry of Clinical Trials (identifier: IRCT20100412003690N11; https://en.irct.ir/trial/44975; ethical code #IR.TBZMED.REC.1398.1113).