The aim of the study was to evaluate the clinical efficacy and safety of a new method (Carisolv™) for chemo–mechanical removal of caries. At four centres, 137 consecutive patients (64 females and 73 males aged 3–85 years, mean 35) entered a prospective, controlled, randomised open study. One primary caries lesion with distinct dentine involvement was selected per patient. A total of 116 lesions in permanent and 21 in deciduous teeth were selected. Caries was removed with traditional drilling or the new method. Gel was applied onto the carious dentine and the softened caries gently removed with specially designed hand instruments. New gel was applied and the procedure was repeated until no more debris could be removed and the surface was hard as judged by clinical criteria (probing and visual inspection). An independent examiner judged the cavity being caries–free or not, using clinical criteria. One hundred and thirteen patients were randomised for gel treatment and 24 for drilling. Three patients selected for drilling did not complete the treatment. Total caries removal was achieved in 106 cases with gel and in 19 with drilling. The reasons for incomplete caries removal were step–by–step excavation in 5 cases, unsuccessful caries removal in 1 case for each treatment, while 2 cases refused inspection. Mean (± SD) time for caries removal was 10.4 (±6.1) min with the gel method and 4.4 (±2.2) min with drilling. Mean volume of gel used was 0.4 (±0.2) ml. Eighty–two of 107 patients perceived that the new method caused less discomfort compared to drilling. Dentine caries was effectively removed using the Carisolv method without any adverse reactions.
The prevalence of MRONJ in Sweden is low. Periodontitis is the most common initiating factor. The outcome of treatment of MRONJ is healing in most patients treated surgically.
Pilocarpine induces a profuse flow of saliva when administered orally, but effects on drug-induced oral dryness have not been examined. The aim of this trial was to investigate if pilocarpine increases production of saliva in individuals suffering from dry mouth due to treatment with opioids. Sixty-five individuals were enrolled in a randomized, double-blind, placebo-controlled trial. The subjects received tramadol (50 mg t.d.s.) to induce oral dryness, and were thereafter assigned to one of three groups. Secretion rate of saliva was measured before and after tramadol, and after the oral administration of pilocarpine (5 mg), placebo, or no treatment. Baseline characteristics did not differ among the groups (mean +/- SEM: 0.37 +/- 0.06 mL/min), and tramadol lowered the secretion at the same level in all groups (0.15 +/- 0.02 mL/min). Pilocarpine increased the flow above that observed with placebo (0.66 +/- 0.19 vs. 0.15 +/- 0.02 mL/min). Thus, pilocarpine re-establishes the flow of saliva in the state of tramadol-induced oral dryness.
Background
The growing resistance of bacteria to antimicrobial medicines is a global issue and a direct threat to human health. Despite this, antibiotic prophylaxis is often still routinely used in dental implant surgery to prevent bacterial infection and early implant failure, despite unclear benefits. There is a lack of sufficient evidence to formulate clear clinical guidelines and therefore there is a need for well‐designed, large‐scale randomized controlled trials to determine the effect of antibiotic prophylaxis.
Purpose
To compare the effect of a presurgical antibiotic regimen with an identical placebo regimen in healthy or relatively healthy patients receiving dental implants.
Materials and Methods
The 474 patients participating in the study were recruited from seven clinics in southern Sweden. We randomized the patients into a test and a placebo group; the study was conducted double‐blinded. Preoperatively, the test group received 2 g of amoxicillin and the control group, identical placebo tablets. The primary outcome was implant failure; secondary outcomes were postoperative infections and adverse events. Patients were evaluated at two follow‐ups: at 7–14 days and at 3–6 months.
Results
Postoperative evaluations of the antibiotic (n = 238) and the placebo (n = 235) groups noted implant failures (antibiotic group: six patients, 2.5% and placebo group: seven patients, 3.0%) and postoperative infections (antibiotic group: two patients, 0.8% and placebo group: five patients, 2.1%). No patient reported any adverse events. Between‐group differences in implant failures and postoperative infections were nonsignificant.
Conclusion
Antibiotic prophylaxis in conjunction with implant placement is likely of small benefit and should thus be avoided in most cases, especially given the unabated growth in antibiotic‐resistant bacteria. Clinical trial registration number: NCT03412305.
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