Reza Pourabbas

Background. Studies have suggested a correlation between periodontitis and reduced male fertility. Inflammation has been described as the link between these ailments. Oral inflammatory load (OIL) can be measured through oral polymorphonuclear neutrophil (oPMN) count, which is associated with periodontal diseases. This cross-sectional study assessed the possible correlation between OIL and the functional parameters of sperm cells. Methods. In 229 volunteers, oral rinse and semen samples were assessed for oPMN, semen polymorphonuclears (sPMNs), sperm concentration, total sperm count, motility, morphology, and sperm DNA fragmentation index (SDFi). A multiple linear regression model was conducted to evaluate the relationships between oPMN and semen parameters. Results. The effect of elevated oPMN counts on total motility rate, progressive rate, and percentage of sperm cells with normal morphology was significant (P<0.001), with an inverse relationship, i.e., with every unit increase in oPMN count, the mentioned parameters would decline by 0.573, 0.367, and 0.407 units, respectively. oPMN counts also correlated positively with sPMN counts and SDFi (P<0.001), i.e., with every unit increase in the oPMN measures, sPMN counts would increase by 0.126 million/mL, with an 0.733% increase in SDFi. However, there was no significant association between oPMN counts and sperm concentration. Conclusion. OIL, as represented by oPMN counts, might affect male fertility as there is a positive correlation between the levels of these inflammatory cells and decreased sperm motility, abnormal morphological changes, increased sPMN counts, and increased SDFi.

Background. After periodontal surgery, in most cases, the surgical area is covered with a surgical pack. It has been suggested that these packs might minimize complications. This study aimed to compare the effects of Diplen LX membrane and Coe-Pak on pain, wound healing, and patient preference after a periodontal flap surgery in patients with moderate to severe chronic periodontitis. Methods. In this randomized clinical trial, 26 patients were evaluated. Pain scores were assessed using visual analog scale (VAS) on the 3rd and 7th days postoperatively and compared between the two dressings. On the 7th and 14th days after both flap surgeries, surgical site healing was evaluated using the wound healing index (WHI). Results. The mean age of the patients was 31. It was observed that the severity of pain in the studied patients on the 3rd and 7th days postoperatively was significantly lower in the intervention group than in the control group. It was also observed that the value of WHI in the studied patients on the 7th and 14th days postoperatively was significantly higher in the intervention group than in the control group. Conclusion. The pain was less severe in both groups using periodontal dressing and also lower in the Diplen LX membrane group. In addition, based on WHI, wound healing score in patients was also higher and more favorable in the Diplex LX membrane group. Due to the above factors, the majority of patients preferred the use of the Diplen LX membrane.

Demand for dental implants has increased in recent years and the use of conscious sedation for this type of surgery can be of great benefit. Therefore, the aim of this systematic review was to evaluate the scientific literature related to the effect of conscious sedation on the reduction of anxiety, and patient and surgeon satisfaction. The Embase, PubMed, ProQuest, Scopus, Ovid, and Cochrane databases were searched without limitations. According to the inclusion and exclusion criteria determined for the study, 10 articles were selected for the final review during several screening stages. These studies were reviewed in their full-text form by the research team and the intended data was extracted. The risk of bias was assessed for each of the selected articles. Five studies were ultimately included. Two of the them compared local anesthesia and conscious sedation, while another 2 compared the consequences of different types of conscious sedation. The anxiety reduction and patient and surgeon satisfaction data was collated. Midazolam was the most frequently used agent. After a thorough review of the final articles extracted based on the study protocol, it was concluded that the use of conscious sedation during implant surgery reduces patient anxiety, and also increases the satisfaction of the patient and surgeon.

Background. The main objective of thissystematic review wasto identify the hemodynamic effects of intravenous sedatives used in dental implant surgeries. Methods. Embase, PubMed, ProQuest, Scopus, Ovid, and Cochrane databases were searched with no limitations. Of 59 studies obtained, 50 studies were excluded due to incompatibility with the subject. The remaining studies were reviewed in full text and assessed for the risk of bias individually. The included studies were reviewed by the research team, and the necessary data were extracted. Results. Four studies were finally included. Two of the studies compared local anesthesia and intravenous sedation, while the other two compared the consequences of different types of intravenous sedation. By comparing the hemodynamic effects, the systolic and diastolic blood pressure and the heart rate data were collated. Midazolam was the most frequently used intravenous sedative, and Dexmedetomidine affected hemodynamics the most. Conclusion. Intravenous sedation leads to decreased heart rate and blood pressure. Better hemodynamic outcomes improve the patients’ cooperation by decreasing stress and anxiety. Dexmedetomidine seems to be the first choice for intravenous sedation.

Peri-implant diseases have been recognized as being among the ever-increasing complications related to dental implants. The aim of this study was to evaluate the adjunctive use of enamel matrix derivative (EMD) to mechanical debridement (MD) in patients with these conditions in terms of clinical parameters and cytokine levels of peri-implant crevicular fluid (PICF).

Faramarzi M, et al. J Korean Assoc Oral Maxillofac Surg. 2015 Aug;41(4):181-189. http://dx.doi.org/10.5125/jkaoms.2015.41.4.181

Background: There are limited clinical experiments addressing the effects of photodynamic therapy (PDT) as an adjunct to conventional scaling and root planing (SRP) on clinical and biologic features of periodontitis. This trial compares the clinical parameters and cytokine profiles in gingival crevicular fluid of patients with moderate‐to‐severe chronic periodontitis (CP) who have been treated using SRP alone or SRP + PDT.Methods: Twenty‐two patients with two contralateral teeth affected with moderate‐to‐severe CP were selected. After SRP, the participants’ teeth were randomized to receive either no further treatment or a single application of PDT using a 638‐nm laser and toluidine blue. Although the change in probing depth was the primary outcome, bleeding on probing, clinical attachment level, gingival recession, interleukin‐1β, tumor necrosis factor (TNF)‐α, and matrix metalloproteinase 8 and 9 were also evaluated at baseline and 3 months postintervention. An oral rinse assay was also performed to determine the total levels of oral polymorphonuclear cells (PMNs) before and 3 months after the treatments.Results: Within each group, significant improvements (P P Conclusion: In patients with CP, a single application of PDT (using a 638‐nm laser and toluidine blue) did not provide any additional benefit to SRP in terms of clinical parameters or inflammatory markers 3 months following the intervention.

Dental plaque is a well-documented etiologic factor for periodontal diseases. While chlorhexidine (CHX) is the gold-standard agent for treating dental plaques, undesirable side effects are often found after continuous use of the mouthwash. Therefore, this single-center, randomized, triple-blinded and clinical trial was undertaken to evaluate the efficacy of Pistacia atlantica Var. mutica extract mouthwash on de novo dental plaque bacteria and subgingival microorganisms compared to CHX on a total of 28 patients. The mean aerobic plaque bacterial count of patients at baseline was 2.17×10⁶. After 4 days of treatment, there were statistically significant decreases in the mean aerobic bacteria in the patients who received P. atlantica and/or CHX (7.25×10⁴, p=0.006) and (9.91×10³, p=0.002), respectively, compared to the patients who received the placebo (6.26×10⁵). This study showed that P. atlantica mouthwash is effective against gingival microorganisms. Because of its reduced side effects, P. atlantica mouthwash may be a good alternative choice for patients.

Persian physicians had a great role in assimilation and expansion of medical sciences during the medieval period and Islamic golden age. In fact the dominant medical figures of that period were of Persian origin such as Avicenna and Razes, but their works have been written in Arabic that was the lingua franca of the period. Undoubtedly the most substantial medical book of that period that has been written in Persian belongs to Abubakr Rabi ibn Ahmad al-Akhawayni al-Bokhari and his book, Hidayat al-Mutallimin fi-al-Tibb (Learner’s Guide to Medicine).There are two chapters related to oral and dental diseases in the Hidayat, a chapter on dental pain and a chapter on bouccal pain. Akhawayni’s views on dental diseases and treatments are mainly based on anatomical principles and less influenced by humeral theory and no mention about the charms, magic and amulets. False idea of dental worm cannot be seen among his writings. Cutting of the dental nerve for relieving the pain, using the anesthetizing fume, using the natural antiseptic and keeping the tooth extraction as the last recourse deserves high praise.