Anna Avetisyan

Bio: Anna Avetisyan is an academic researcher from Yerevan State Medical University. The author has contributed to research in topics: Resorption & Dental prosthesis. The author has an hindex of 1, co-authored 5 publications receiving 6 citations.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses

Abstract: The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Occurrence of Recurrent Aphthous Stomatitis (RAS) as a Rare Oral Manifestation in a Patient with Gilbert's Syndrome.

Abstract: Recurrent aphthous stomatitis is an ulcerative disease of the oral cavity and can occur in isolation or as a manifestation of many systemic diseases. It is a quite common entity and may hence often be overlooked as an isolated lesion. Gilbert's syndrome is a genetic disorder where a deficiency of an enzyme associated with the conjugation of bilirubin results in unconjugated hyperbilirubinemia. The disease is generally asymptomatic and is aggravated by certain trigger factors. No associated oral manifestations are known. In this case report, we discuss the concomitant presence of recurrent aphthous stomatitis in a patient of Gilbert's syndrome. The presence of such recurrent stomatitis may represent as an oral manifestation of Gilbert's syndrome. Early identification of these entities may improve the overall quality of life of the patient.

Cement Selection in Dental Practice

Abstract: The cementation procedure is considered to be the most important stage of fixed prosthodontics, while the correct selection of cement is the guarantee of successful restoration which is conditioned by the its durability. Over the recent years, numerous cementing substances have been introduced to the dental practice that differ greatly from conventional cements with their properties and application methods and that is why even experienced dentists often have certain difficulties in the variety of cements to choose the one that is right for each clinical case. The selection of cement depends on a number of factors, such as the type of resorption substance, the shape of prepared tooth, the possibility to isolate the area, subject to cementation in the oral cavity as well as the patient’s aesthetic requirements. Thus, the objective of the article is to analyze currently used dental cements in order to help the dentists make the right selection of cement for different clinical cases.

Clinical Case of Root Resorption Due to Improper Orthodontic Treatment

Abstract: The article presents a case of tooth root resorption due to improper orthodontic treatment. Before the orthodontic treatment, it is necessary to diagnose the anomaly precisely, to plan and correspondingly carry out a proper treatment, considering the direction, magnitude and duration of the orthodontic forces, individual peculiarities and risk factors in every clinical case to avoid complications and achieve a successful outcome. All above-mentioned, if not taken into consideration, leads to various complications such as root resorption. The peculiarity of the presented clinical case is that X-ray examination was neglected both at the stage of diagnosis and treatment planning and during treatment. The treatment lasted more than three years. As a result, the patient developed certain complaints and presented to our clinic with loose teeth and toothache. After appropriate examinations, root resorption was diagnosed in a number of teeth. Moreover, the root resorption was severely pronounced in maxillary central incisors which made it impossible to preserve the teeth. After the orthodontic treatment was completed, restoration of the teeth with implants was suggested. Root resorption conditioned by orthodontic treatment is diagnosed mostly at early stages and is possible to be prevented. However, this case is unique in its nature since multiple teeth are affected and the roots of some teeth are almost completely resorbed in one person. The objective of this paper is to emphasize the importance of orthodontic treatment planning, following conventional treatment protocols and proper application of orthodontic forces to prevent root resorption and achieve successful outcome.

Comparative assessment of periodontal complex by experimental method and elaboration of new protocols for corresponding treatment of external and perforating internal resorption resulted many years after trauma

Abstract: Objective The objective of the study is to assess the condition of periodontal complex by cone beam computed tomography and objective data of gingival crevicular fluid in young with different types of tooth root resorption as a result of a maxillofacial trauma, and to use the obtained results to develop new treatment strategy. Material and Methods This clinical, experimental, non-randomized study included cone beam computed tomography as well as determination of gingival crevicular fluid volume and pH in 4 patients who were divided in two groups. Both groups consisted of the patients with tooth root external and perforating internal resorption. In the first group (G1) antibiotics was administered along with conventional endodontic treatment, while in the second group (G2) endodontic treatment was carried out without antibiotics. Results in the G1 the volume of gingival crevicular fluid was 6 mm2 and more, while pH was 6.5. No pain or edema were observed during the postoperative period. In the G2, the volume of gingival crevicular fluid was 6 mm2 and more, while pH was 7,0 and 6,5 in external and perforating internal resorption, respectively. Postoperative period was accompanied by pain, while edema was observed in perforating internal resorption. Conclusions According to the results obtained within the frames of this experimental study it can be concluded that the change in objective data of gingival crevicular fluid occurs in external and perforating internal root resorptions, while the use of antibiotics during the postoperative period prevents the occurrence of tenderness and complications such as edema.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses

Abstract: The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Bacteriological Evaluation of Gingival Crevicular Fluid in Teeth Restored Using Fixed Dental Prostheses: An In Vivo Study

Abstract: The present in vivo study determined the microbiological counts of the gingival crevicular fluid (GCF) among patients with fixed dental prostheses fabricated using three different techniques. A total of 129 subjects were divided into three study groups: first, cobalt-chrome-based, metal-ceramic prostheses fabricated by the conventional method (MC, n = 35); the second group consisted of cobalt-chrome-based, metal-ceramic prostheses fabricated by the computer-aided design and computer-aided manufacturing (CAD/CAM) technique (CC-MC, n = 35); the third group comprised zirconia-based ceramic prostheses fabricated using the CAD/CAM technique (CC-Zr, n = 35). The control consisted of 24 patients using prostheses fabricated with either MC, CC-MC, or CC-Zr. The GCF was obtained from the subjects before treatment, and 6 and 12 months after the prosthetic treatment. Bacteriological and bacterioscopic analysis of the GCF was performed to analyze the patients’ GCF. The data were analyzed using SPSS V20 (IBM Company, Chicago, IL, USA). The number of microorganisms of the gingival crevicular fluid in all groups at 12 months of prosthetic treatment reduced dramatically compared with the data obtained before prosthetic treatment. Inflammatory processes in the periodontium occurred slowly in the case of zirconium oxide-based ceramic constructions due to their biocompatibility with the mucous membranes and tissues of the oral cavity as well as a reduced risk of dental biofilm formation. This should be considered by dentists and prosthodontists when choosing restoration materials for subjects with periodontal pathology.

Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review

Abstract: Periodontal health plays an important role in the longevity of prosthodontic restorations. The issues of comparative assessment of prosthetic constructions are complicated and not fully understood. The aim of this article is to review and present the current knowledge regarding the various technical, clinical, and molecular aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Articles on periodontal health and fixed dental prostheses were searched using the keywords “zirconium”, “CAD/CAM”, “dental ceramics”, “metal–ceramics”, “margin fit”, “crown”, “fixed dental prostheses”, “periodontium”, and “margin gap” in PubMed/Medline, Scopus, Google Scholar, and Science Direct. Further search criteria included being published in English, and between January 1981 and September 2021. Then, relevant articles were selected, included, and critically analyzed in this review. The margin of discrepancy results in the enhanced accumulation of dental biofilm, microleakage, hypersensitivity, margin discoloration, increased gingival crevicular fluid flow (GCF), recurrent caries, pulp infection and, lastly, periodontal lesion and bone loss, which can lead to the failure of prosthetic treatment. Before starting prosthetic treatment, the condition of the periodontal tissues should be assessed for their oral hygiene status, and gingival and periodontal conditions. Zirconium-based restorations made from computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, compared to constructions made by conventional methods, and from other alloys. Compared to subgingival margins, supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.

Wear Resistance, Color Stability and Displacement Resistance of Milled PEEK Crowns Compared to Zirconia Crowns under Stimulated Chewing and High-Performance Aging.

Abstract: Recently, polyetheretherketone (PEEK) has been introduced to the dental market as a high-performance and chemically inert biomaterial. This study aimed to compare the wear resistance, abrasiveness, color stability, and displacement resistance of zirconia and PEEK milled crowns. An ideal tooth preparation of a first maxillary molar was done and scanned by an intraoral scanner to make a digital model. Then, the prosthetic crown was digitally designed on the CAD software, and the STL file was milled in zirconia (CaroZiir S, Carol Zircolite Pvt. Ltd., Gujarat, India) and PEEK (BioHpp, Bredent GmbH, Senden, Germany) crowns using five-axis CNC milling machines. The wear resistance, color stability, and displacement resistance of the milled monolithic zirconia with unfilled PEEK crowns using a chewing simulator with thermocyclic aging (120,000 cycles) were compared. The antagonist wear, material wear, color stability, and displacement were evaluated and compared among the groups using the Wilcoxon-Mann-Whitney U-test. Zirconia was shown to be three times more abrasive than PEEK (p value < 0.05). Zirconia had twice the wear resistance of PEEK (p value < 0.05). Zirconia was more color stable than PEEK (p value < 0.05). PEEK had more displacement resistance than zirconia (p value < 0.05). PEEK offers minimal abrasion, better stress modulation through plastic deformation, and good color stability, which make it a promising alternative to zirconia crown.

Tooth root resorption: A review

Abstract: Tooth root resorption is multifactorial, leading to progressive destruction and eventual loss of tooth root dentin and cement. There are internal and external types of root resorption, each having its variety. The etiology and pathogenesis of tooth root resorption are poorly understood, and the most significant etiological factors are trauma, pulpal infection, tooth bleaching, and orthodontic treatment. Tooth root resorption is primarily asymptomatic; thus, it is revealed accidentally by radiographic examination. Progressive clinical manifestations are pain, tooth discoloration, tooth mobility, and other conditions. Awareness of the causes and risk factors allowing tooth root resorption, and regular radiographic examination, in case of necessity, make it possible to reveal resorption at an early stage and to prevent its further development. Thus, the aim of this study is to present etiopathogenesis, a clinical course, and diagnostic peculiarities of internal and external types of tooth root resorption, enabling practicing dentists to timely diagnose root resorption and take appropriate measures to avoid further complications. Within the limitation of this review, even though the etiopathogenesis of tooth root resorption is yet not fully understood, it is suggested that the etiological factors fall into two groups (endogenic and exogenic) to enhance further understanding of the possible causes and mechanisms of root resorption and allow practitioners to monitor high-risk patients and make timely diagnoses. Moreover, radiographic examination and CBCT are indispensable for the diagnosis of root resorption.