vanousheh norouzi

Oroantral Fistula (OAF) is a pathologic and epithelialized path between the oral cavity and the maxillary sinus. Various reasons can lead to its development, the most common of which is the extracion of upper molar teeth. Any condition that leads to traumatized tooth extraction or conditions that make tooth extraction more difficult, such as: improper use of an dental elevator, teeth with long roots near the sinus, dental infections, etc., increase the probability of this problem.The most common age of occurrence of OAF is between 30 & 60 years old.most studies suggest that smaller fistulas have a chance of healing spontaneously, but larger types and those that persist for a longer period of time usually do not heal without intervention. It can lead to uncomfortable side effects such as pain, sinusitis, air escaping from the mouth to the nose, and even a change in the person's voice and overall discomfort in the patient. Various surgical and non-surgical treatments have been proposed for the management of OAF. Non- surgical treatments include blocking the area by placing different materials inside defect, and surgical treatments include closing the area with local and regional flaps or in combination with Autografts and Allografts, etc. The purpose of this review article is to investigate the etiology factors of OAF, the prevalence rate and the ways of its management by various surgical and non- surgical treatments.

Periodontitis is an inflammatory disease with the production of cytokines that can lead to local and systemic inflammatory responses. On the other hand, during systemic inflammation in the body, the levels of acute phase proteins (APPs) can change. APPs include positive and negative types, which in response to inflammatory conditions, the concentration of positive types increases and negative types decreases. Therefore, examining changes in APPs can be used as a marker during periodontitis and periodontal treatment.

The purpose of this review article was to investigate the effect of periodontitis and periodontal treatment on positive APPs. The distinguishing feature of this article is the investigation of the effect of periodontal disease and its treatment on positive APPs. In addition, the introduction of new positive APPs in the future can be used to conduct new studies.

In this study, the keywords periodontitis, acute phase proteins, periodontal debridement, and inflammation mediators in English were searched in Google Scholar and PubMed and Scopus databases from 2000 to 2022. Among the found articles, finally, 65 related articles were selected and reviewed. 

Periodontal treatment can reduce the levels of positive APPs increased during periodontitis. 

Periodontitis as an inflammatory disease can lead to changes in the levels of positive APPs leading to an increase in the levels of these proteins. Periodontal treatment, which includes non-surgical treatment (the first step of periodontal treatment and the gold standard of this treatment is scaling above and below the gums and leveling the root surfaces to remove etiological factors) and, if necessary, surgical treatment can lead to the reduction of their levels.

Periodontitis is an inflammatory-infectious disease of tooth-supporting structures that results in the progressive destruction of the periodontal ligament and alveolar bone due to an imbalance between the host defense and microorganisms. Subgingival microbiota has a significant role in the initiation and progression of periodontitis, affecting the innate and acquired immune responses by the infiltration of immune cells such as monocytes and polymorphonuclear cells that are abundant under inflammatory conditions. The immune cells induce the release of proinflammatory cytokines that lead to the destruction of periodontal connective tissue and the alveolar bone. Cytokines activate hepatocytes to produce acute phase proteins as a component of the nonspecific response. These proteins are a group of proteins that increase (positive type) and decrease (negative type) under inflammatory conditions. This response is called the acute phase response (APR) that occurs after the initiation of a systemic inflammatory reaction. Nonsurgical periodontal therapy is the first stage of treatment for periodontitis. Its aim is to eliminate etiologic agents and decrease inflammation. The aim of this review article was to evaluate the effect of periodontitis as an inflammatory condition and its treatment on the concentrations of negative acute phase proteins.

This study aimed to compare dentinal micro crack formation following root canal instrumentation with ProTaper Universal (PTU) and WaveOne (WO) rotary systems in straight and curved root canals. Methods and Materials: One hundred mesiobuccal (MB) straight and curved canals of mandibular molars meeting inclusion criteria were divided into two control (n=10) and four experimental groups (n=20). After mounting the teeth and simulating the periodontal ligament, all the MB canals were coronally flared using Gates-Glidden drills #3 and 2 respectively. Then, in the experimental groups, the canals were instrumented with either PTU files (Sx, S1, S2, F1, F2), or Primary WO (25/0.08). Afterwards, roots were horizontally sectioned at 2, 4, and 6 mm from the apices, and evaluated under a microscope under 20× magnification. Data were analyzed with the Chi-Square and Kruskal-Wallis tests. The significance level was set at 0.05. The control groups showed no cracks. There was no significant difference between the two systems in the straight root canals (P>0.05). But in the curved root canals, PTU produced significantly more cracks (P<0.05) with the complete crack type which was dominant (P=0.013) compared to WO. This in vitro study showed that in curved root canals, instrumentation with reciprocal WO system may be safer than full rotational PTU instruments regarding crack formation.