Showing papers in "Journal of Periodontology in 2011"
TL;DR: Significant improvement with autologous PRF implies its role as a regenerative material in the treatment of furcation defects, and all clinical and radiographic parameters showed statistically significant improvement at the sites treated with PRF and OFD compared to those with OFD alone.
Abstract: Background: Platelet-rich fibrin (PRF), an intimate assembly of cytokines, glycan chains, and structural glycoproteins enmeshed within a slowly polymerized fibrin network, has the potential to accelerate soft and hard tissue healing. This double-masked randomized study is designed to evaluate the effectiveness of autologous PRF in the treatment of mandibular degree II furcation defects compared with open flap debridement (OFD).Methods: Using a split-mouth design, 18 patients with 36 mandibular degree II furcation defects were randomly allotted and treated either with autologous PRF and OFD or OFD. Plaque index, sulcus bleeding index, probing depth, relative vertical and horizontal clinical attachment level, gingival marginal level, and radiographic bone defect were recorded at baseline and 9 months postoperatively. Comparison between indices between the test and control groups was performed using the paired t test except for plaque index and sulcus bleeding index data, which used the χ2 test.Results: All ...
192 citations
TL;DR: Within the limits of the present study, there was greater PD reduction, PAL gain, and bone fill at sites treated with PRF with conventional open-flap debridement compared to conventionalOpen-Flap debridgeement alone.
Abstract: Background: Platelet-rich fibrin (PRF) is considered a second-generation platelet concentrate that is widely used in osseous regeneration. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF in the treatment of intrabony defects in patients with chronic periodontitis.Methods: Fifty-six intrabony defects were treated with either autologous PRF with open-flap debridement or open-flap debridement alone. Clinical parameters such as the probing depth (PD) and periodontal attachment level (PAL) were recorded at baseline and 9 months postoperatively. The defect fill at baseline and 9 months was calculated on standardized radiographs by using image-analysis software.Results: The mean PD reduction was greater in the test group (4.55 ± 1.87 mm) than in the control group (3.21 ± 1.64 mm), whereas the mean PAL gain was also greater in the test group (3.31 ± 1.76) compared to the control group (2.77 ± 1.44 mm). Furthermore, a significantly greater percentage of mean bone fil...
180 citations
TL;DR: Within the limitations of this study, the presence of DNA from periodontitis-associated bacteria in carotid artery atheromatous plaque retrieved by endarterectomy is confirmed.
Abstract: Background: In recent years, increasing evidence regarding the potential association between periodontal diseases and cardiovascular diseases has been identified. The available evidence underlines the importance of detecting periodontal pathogens on atheromatous plaque as the first step in demonstrating the causal relationship between the two conditions. The main aim of this investigation is to detect periodontitis-associated bacteria from carotid artery atheromatous plaque from patients who received an endarterectomy using strict sample procurement and laboratory procedures.Methods: Atheromatous plaque from endarterectomies from carotid arteries were scraped and homogenized, and bacterial DNA was extracted. To obtain a representative concentration of amplicons, two amplifications of the bacterial 16S ribosomal-RNA gene were carried out for each sample with universal eubacteria primers by a polymerase chain reaction (PCR). A nested PCR with specific primers for the target bacteria was performed next. Stat...
164 citations
TL;DR: The findings support the possibility that vitamin D may positively impact periodontal health and confirm the need for randomized clinical trials on the effects of vitamin D on periodontitis.
Abstract: Background: A previous study reported by this group found that patients in periodontal maintenance programs taking vitamin D and calcium supplementation had a trend for better periodontal health compared to patients not taking supplementation. The objective of the present study is to determine, for the same cohort of subjects, whether such differences persist over a 1-year period.Methods: Fifty-one patients enrolled in maintenance programs from two dental clinics were recruited. Of these, 23 were taking vitamin D (≥400 IU/day) and calcium (≥1,000 mg/day) supplementation, and 28 were not. All subjects had at least two interproximal sites with ≥3 mm clinical attachment loss. For mandibular-posterior teeth, gingival index, plaque index, probing depth, attachment loss, bleeding on probing, calculus index, and furcation involvement were evaluated. Photostimulable-phosphor, posterior bitewing radiographs were taken to assess alveolar bone. Daily vitamin D and calcium intakes were estimated by nutritional analys...
164 citations
TL;DR: This prospective study evaluates the concept of early implant placement and demonstrated successful tissue integration for all 20 implants and stable bone-crest levels around implant-abutment interfaces according to the platform-switching concept.
Abstract: Background: Early implant placement is one of the treatment options after tooth extraction. Implant surgery is performed after a healing period of 4 to 8 weeks and combined with a simultaneous contour augmentation using the guided bone regeneration technique to rebuild stable esthetic facial hard- and soft-tissue contours.Methods: In this prospective study, 20 patients were treated with an implant-born single crown and followed for 3 years. Clinical, radiologic, and esthetic parameters were recorded to assess treatment outcomes.Results: At the 3-year examination, all 20 implants were successfully integrated, demonstrating ankylotic stability and healthy peri-implant soft tissues as documented by standard clinical parameters. Esthetic outcomes were assessed by the pink esthetic score (PES) and white esthetic score (WES) and confirmed pleasing results overall. WES values were slightly superior to PES values. Periapical radiographs showed minimal crestal bone loss around used bone-level implants with a mean ...
163 citations
TL;DR: PRP may exert a positive adjunctive effect when used in combination with graft materials, but not with GTR, for the treatment of intrabony defects and no significant benefit of platelet concentrates was found for thetreatment of gingival recession.
Abstract: Background: The aim of the present review is to systematically evaluate the effects of autogenous platelet concentrates on clinical outcomes of the surgical treatment of periodontal diseases.Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched using a combination of specific search terms. Furthermore, a hand search of relevant journals and bibliographies of reviews was performed. Only randomized clinical trials were included. For periodontal intrabony defects, the primary outcome variable was the clinical attachment level. For gingival recession, outcome variables were root coverage and keratinized tissue increase. Data were adjusted for baseline values. The methodologic quality of the included studies was assessed. The results of studies in which the only difference between test and control groups was the adjunct of platelet concentrates were aggregated using a meta-analysis. For intrabony defects, the influences of guided tissue regeneration (GTR) and study type...
143 citations
TL;DR: If a survey uses a partial-mouth examination it is recommended that the amount of underestimation be assessed in the same sample and inflation factors should be calculated and used to adjust for the underestimation in disease prevalence because of the use of partial examination.
Abstract: The study design of national surveys of periodontal disease often uses partial-mouth examination protocols to rationalize the need for resources so that the collection of data from a large number of subjects can be achieved within the available means without significantly sacrificing precision and validity. Studies show that surveys that use partial examination protocols underestimate the prevalence of periodontitis, and the amount of underestimation varies depending on the number and type of sites examined, the case-definition of periodontal disease, tooth loss, and prevalence and severity of the disease. If a survey uses a partial-mouth examination it is recommended that the amount of underestimation be assessed in the same sample. This could be achieved by performing a full-mouth examination on a randomly selected subsample. Inflation factors should be calculated and used to adjust for the underestimation in disease prevalence because of the use of partial examination. Based on the NHANES III (1988 to 1994) data and adjusting for the bias caused by the examination protocol, it is estimated that approximately half of the United States population aged ≥30 years has periodontitis.
138 citations
TL;DR: In long-term use, the standardized formulation of EOMW appeared to be a reliable alternative to chlorhexidine mouthwash with respect to parameters of gingival inflammation.
Abstract: Background: The purpose of this review is to systematically evaluate the effects of an essential-oil mouthwash (EOMW) compared to a chlorhexidine mouthwash with respect to plaque and parameters of gingival inflammation.Methods: PubMed/MEDLINE and Cochrane CENTRAL databases were searched for studies up to and including September 2010 to identify appropriate articles. A comprehensive search was designed, and the articles were independently screened for eligibility by two reviewers. Articles that evaluated the effects of the EOMW compared to chlorhexidine mouthwash were included. Where appropriate, a meta-analysis was performed, and weighted mean differences (WMDs) were calculated.Results: A total of 390 unique articles were found, of which 19 articles met the eligibility criteria. A meta-analysis of long-term studies (duration ≥4 weeks) showed that the chlorhexidine mouthwash provided significantly better effects regarding plaque control than EOMW (WMD: 0.19; P = 0.0009). No significant difference with resp...
122 citations
TL;DR: LLLT as an adjunctive therapy to non-surgicalperiodontal treatment improves periodontal healing and investigates the effect of smoking on treatment.
Abstract: Background: The aim of this study is to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal therapy of smoking and non-smoking patients with moderate to advanced chronic periodontitis.Methods: All 36 systemically healthy patients who were included in the study initially received non-surgical periodontal therapy. The LLLT group (n = 18) received GaAlAs diode laser therapy as an adjunct to non-surgical periodontal therapy. A diode laser with a wavelength of 808 nm was used for the LLLT. Energy density of 4 J/cm2 was applied to the gingival surface after periodontal treatment on the first, second, and seventh days. Each of the LLLT and control groups was divided into two groups as smoking and non-smoking patients to investigate the effect of smoking on treatment. Gingival crevicular fluid samples were collected from all patients and clinical parameters were recorded on baseline, the first, third, and sixth months after treatment. Matrix metalloproteinase-1, tissue ...
121 citations
TL;DR: Both treatments of the non-surgical treatment of peri-implantitis lesions using either an erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser or an air-abrasive subgingival polishing method failed to reduce bacterial counts at 6 months.
Abstract: Background: The purpose of this study is to assess clinical and microbiologic effects of the non-surgical treatment of peri-implantitis lesions using either an erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser or an air-abrasive subgingival polishing method.Methods: In a 6-month clinical trial, 42 patients with peri-implantitis were treated at one time with an Er:YAG laser or an air-abrasive device. Routine clinical methods were used to monitor clinical conditions. Baseline and 6-month intraoral radiographs were assessed with a software program. The checkerboard DNA–DNA hybridization method was used to assess 74 bacterial species from the site with the deepest probing depth (PD) at the implant. Non-parametric tests were applied to microbiology data.Results: PD reductions (mean ± SD) were 0.9 ± 0.8 mm and 0.8 ± 0.5 mm in the laser and air-abrasive groups, respectively (not significant). No baseline differences in bacterial counts between groups were found. In the air-abrasive group, Pseudomonas aer...
118 citations
TL;DR: Sex-based differences in gingivitis in young people can be explained by oral health behaviors and hygiene status, which are influenced by lifestyle, knowledge, and attitude.
Abstract: Background: Although many epidemiologic surveys have shown that gingivitis is more prevalent in males than in females, few studies have clearly explained what causes this difference. The objective of the present study is to explain the sex difference in gingivitis based on the interaction between oral health behaviors and related factors, such as knowledge, attitude, and lifestyle, in young people.Methods: The study was comprised of 838 subjects (440 males and 398 females), aged 18 and 19 years. Gingivitis was assessed by the percentage of bleeding on probing (%BOP). Additional information was collected regarding oral hygiene status, oral health behaviors, and related factors. Structural equation modeling was used to test pathways from these factors to %BOP. Multiple-group modeling was also conducted to test for sex differences.Results: Females had greater knowledge, a more positive attitude, a healthier lifestyle, and higher level of oral health behaviors than males. There were significant differences in...
TL;DR: Cell and gene delivery technologies have the potential to overcome limitations associated with existing periodontal therapies, and may provide a new direction in sustainable inflammation control and more predictable tissue regeneration of supporting alveolar bone,periodontal ligament, and cementum.
Abstract: Inflammatory periodontal diseases are a leading cause of tooth loss and are linked to multiple systemic conditions, such as cardiovascular disease and stroke. Reconstruction of the support and function of affected tooth-supporting tissues represents an important therapeutic endpoint for periodontal regenerative medicine. An improved understanding of periodontal biology coupled with current advances in scaffolding matrices has introduced novel treatments that use cell and gene therapy to enhance periodontal tissue reconstruction and its biomechanical integration. Cell and gene delivery technologies have the potential to overcome limitations associated with existing periodontal therapies, and may provide a new direction in sustainable inflammation control and more predictable tissue regeneration of supporting alveolar bone, periodontal ligament, and cementum. This review provides clinicians with the current status of these early-stage and emerging cell- and gene-based therapeutics in periodontal regenerative medicine, and introduces their future application in clinical periodontal treatment. The paper concludes with prospects on the application of cell and gene tissue engineering technologies for reconstructive periodontology.
TL;DR: Increased levels of proinflammatory cytokines and RANKL were observed in the GCF of patients with type 2 diabetes with CP, compared to patients without diabetes, and poor or good glycemic status seems to modulate osteo-immunoinflammatory mediators in a different manner.
Abstract: Background: This study compares the levels of cytokines and bone-related factors in the gingival crevicular fluid (GCF) of systemically healthy patients with chronic periodontitis (CP); and better-controlled, and poorly controlled patients with type 2 diabetes and CP.Methods: Thirty-seven patients with type 2 diabetes and CP and 20 systemically healthy patients with CP were enrolled in this study. The patients with diabetes mellitus were categorized as better-controlled (n = 17; HbA1c levels ≤8%) or poorly controlled (n = 20; glycated hemoglobin values >8%). Levels of tumor necrosis factor-α, interleukin (IL)-4, interferon (IFN)-γ, IL-23, IL-17, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), and osteoprotegerin (OPG) in GCF of diseased sites were analyzed by enzyme-linked immunosorbent assay.Results: Type 2 diabetes mellitus, as a whole, upregulates the levels of OPG, sRANKL, IFN-γ, IL-17, and IL-23 and downregulates the production of IL-4 in sites with CP (P <0.05). Better-controll...
TL;DR: The use of paper strips was suitable for the simultaneous determination of microbial and immunologic parameters in periodontal pockets and indicated that most of the substrates of these proteases by in vitro assays identified until now can be easily degraded in P. gingivalis-infected sites.
Abstract: Background: The analysis of samplings from periodontal pockets is important in the diagnosis and therapy of periodontitis. In this study, three different sampling techniques were compared to determine whether one method yielded samples suitable for the reproducible and simultaneous determination of bacterial load, cytokines, neutrophil elastase, and arginine-specific gingipains (Rgps). Rgps are an important virulence factor of Porphyromonas gingivalis, the exact concentration of which in gingival crevicular fluid (GCF) has not been quantified.Methods: GCF was sampled from four sites per patient (one sample per quadrant using two samples per method) in 36 patients with chronic periodontitis. One week later, the procedure was repeated with alternative methods. Variables determined were loads of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) and P. gingivalis, levels of interleukin-6 and -8, activity of neutrophil elastase, and level of Rgps.Results: The detected cyto...
TL;DR: Differences in implant design may affect the potential risk for invasion of oral microorganisms into the fixture-abutment interface microgap under dynamic-loading conditions, as indicated by the results of this study.
Abstract: Background: Previously, we demonstrated that the geometry of the fixture–abutment interface influences the risk of bacterial invasion into the internal part of the implant, although the contribution of loading on this invasion was not evaluated. The aim of the present study is to use an in vitro dynamic-loading model to assess the potential risk for invasion of oral microorganisms into the fixture–abutment interface microgap of dental implants with different fixture–abutment connection characteristics.Methods: Twenty-eight implants were divided into two groups (n = 14 per group) based on their microgap dynamics. Group 1 was comprised of fixtures with internal Morse-taper connection that connected to standard abutments. Group 2 was comprised of implants with a four-groove conical internal connection that connected to multibase abutments. The specimens were immersed in a bacterial solution of Escherichia coli and loaded with 500,000 cycles of 15 N in a wear simulator. After disconnection of fixtures and abu...
TL;DR: Certain periodontal pathogens could be associated with an increased level of proinflammatory cytokines in the peripheral blood and thus increased risk of systemic diseases.
Abstract: Background: Periodontitis is a local inflammatory disease that also has some systemic effects. We investigated the levels of interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and interleukin (IL)-2, -4, -5, and -10 in the serum of patients with periodontitis in relation to the bacterial load in the dental plaques.Methods: Serum cytokine levels in patients with generalized periodontitis and healthy control groups were determined using the cytometric bead array kit. Bacterial load in the dental plaque was determined semiquantitatively by real-time polymerase chain reaction. The proportions of different lymphocyte subsets were determined in the peripheral blood of patients with periodontitis by flow cytometry. Finally, relationships between the bacterial load in the subgingival plaques of patients with periodontitis and levels of cytokines and counts of lymphocyte subsets were established.Results: Serum levels of IFN-γ, TNF-α, and IL-10 were significantly increased, whereas those of IL-2 were significantly ...
TL;DR: It is suggested that stress might be associated with periodontal disease through physiologic and behavioral mechanisms and in making diagnoses of psychiatric patients, the association between salivary stress markers and periodontAL disease needs to be included.
Abstract: Background: Some cross-sectional and longitudinal studies attempted to link periodontitis with stress. To our knowledge, only one small study was published on the mechanism by which stress may influence periodontal diseases, suggesting behavioral and physiologic mechanisms and investigating the role of inflammation as a potential mediator. The present study is planned to explore the associations among periodontal disease, psychologic factors, and salivary markers of stress, psychoneuroimmunologic variables, and health behaviors.Methods: One hundred periodontitis patients were selected, and participants provided information on general health, chronic stress, and demographics. Stress markers (choromogranin A, cortisol, α-amylase, and β-endorphin) were measured from saliva. A dentist assessed the presence of dental plaque on lingual and buccal surfaces, the gingival index, and the number of remaining teeth with periodontal disease.Results: Stress and salivary stress markers were significantly correlated with...
TL;DR: Chronic periodontitis is associated with elevated plasma CRP levels, even after controlling for several potential confounders.
Abstract: Background: This study aims to analyze the relationship between chronic periodontitis and C-reactive protein (CRP) by considering associated variables in individuals with or without cardiovascular disease.Methods: A sample of 359 individuals of both sexes (aged ≥40 years) was assessed. Among these individuals, 144 subjects were admitted to the hospital because of a first occurrence of acute myocardial infarction; 80 subjects were in the hospital for reasons other than acute myocardial infarction; and 135 subjects were living in the community. A questionnaire was applied to obtain demographic and lifestyle characteristics. Complete clinical periodontal examinations and anthropometric assessments were performed. CRP levels, plasma glucose levels, lipid profiles, and blood tests were performed to investigate any conditions that might have suggested infection and/or inflammation. CRP evaluations were performed using nephelometry. Individuals were considered to have periodontal disease if they simultaneously p...
TL;DR: Vitamin D insufficiency (serum 25[OH]D <75 nmol/l) is associated with maternal periodontal disease during pregnancy and represents a potential therapeutic strategy to improve maternal oral health.
Abstract: Background: Maternal periodontal disease is found in ≤40% of pregnant women and is associated with adverse pregnancy outcomes. Vitamin D deficiency may play a role in periodontal disease and tooth loss, and insufficient vitamin D status is common among pregnant women. The objective of this study is to examine the relationship between maternal vitamin D status and periodontal disease.Methods: A case-control study was conducted. Cases were defined as pregnant women with clinical moderate to severe periodontal disease; controls were pregnant women who were periodontally healthy. Maternal data were chart abstracted and serum was collected between 14 and 26 weeks of gestation. Serum 25-hydroxyvitamin D (25[OH]D) levels were measured using liquid chromatography–tandem mass spectrometry. Median serum 25(OH)D levels and prevalence of vitamin D insufficiency (defined as <75 nmol/l) were compared between cases and controls. The odds ratio and 95% confidence interval for moderate to severe periodontal disease among ...
TL;DR: In this paper, a retrospective chart review of patients at the Harvard School of Dental Medicine (HSDM) who had one of two types of rough-surface implants (group A or B) placed by periodontology residents from 2003 to 2006 was performed.
Abstract: Background: Dental implants are a predictable treatment option for replacing missing teeth and have strong survival and success outcomes. However, previous research showed a wide array of potential risk factors that may have contributed to dental implant failures. The objectives of this study are to study if implant survival rates were affected by known risk factors and risk indicators that may have contributed to implant failures. The secondary outcome measures were whether the level of expertise of the periodontal residents affected success rates and how the rate of implant success at the Harvard School of Dental Medicine (HSDM) compared to published standards.Methods: A retrospective chart review of patients at the HSDM who had one of two types of rough-surface implants (group A or B) placed by periodontology residents from 2003 to 2006 was performed. Demographic, health, and implant data were collected and analyzed by multimodel analyses to determine failure rates and any factors that may have increas...
TL;DR: A high WC seems to be associated with periodontitis, whereas BMI does not, and a significant association between abdominal obesity andperiodontitis is found.
Abstract: Background: The present study aims to determine whether there is an association between periodontitis and obesity among Korean adults who participated in the Fourth Korean National Health and Nutrition Examination Survey (KNHANES).Methods: In 2007, 4,246 subjects, >19 years of age, who participated in the KNHANES (a cross-sectional survey conducted by the Korea Centers for Disease Control and Prevention) were selected for analysis. Participants underwent a periodontal examination and anthropometric measurements, and were asked to complete a questionnaire about their socioeconomic status and overall health status. Body mass index (BMI) and waist circumference (WC) were used as measures of overall body fat and upper body fat. Standard BMI and WC cutoff points were used, as established by the World Health Organization and the Korean Society for the Study of Obesity. Periodontal status was assessed by Community Periodontal Index and periodontitis was defined as ≥ “code 3.” Multivariate logistic regression ana...
TL;DR: Characterization of these events contributes to a better understanding of cooperative molecular dynamics in alveolar bone healing, and highlights potential pathways that could be further explored for the enhancement of osseous regenerative strategies.
Abstract: Background: Understanding the molecular features of bone repair and osseointegration may aid in the development of therapeutics to improve implant outcomes The purpose of this investigation is to determine the gene expression dynamics during alveolar bone repair and implant osseointegrationMethods: An implant osseointegration preclinical animal model was used whereby maxillary defects were created at the time of oral implant placement, while a tooth extraction socket healing model was established on the contralateral side of each animal The surrounding tissues in the zone of the healing defects were harvested during regeneration for temporal evaluation using histology, immunohistochemistry, laser capture microdissection, and quantitative reverse transcription–polymerase chain reaction for the identification of a panel of 17 putative genes associated with wound repairResults: In both models, three distinct expression patterns were displayed: 1) genes that are slowly increased during the healing process
TL;DR: Ridge preservation without flap advancement preserves more keratinized tissue and has less postoperative discomfort and swelling than either of the control or test groups.
Abstract: Background: The aim of this single-masked, randomized controlled clinical trial is to compare hard and soft tissue changes after ridge preservation performed with (control, RPc) and without (test, RPe) primary soft tissue closure in a split-mouth design.Methods: Eleven patients completed this 6-month trial. Extraction and ridge preservation were performed using a composite bone graft of inorganic bovine-derived hydroxyapatite matrix and cell binding peptide P-15 (ABM/P-15), demineralized freeze-dried bone allograft, and a copolymer bioabsorbable membrane. Primary wound closure was achieved on the control sites (RPc), whereas test sites (RPe) left the membrane exposed. Pocket probing depth on adjacent teeth, repositioning of the mucogingival junction, bone width, bone fill, and postoperative discomfort were assessed. Bone cores were obtained for histological examination.Results: Intragroup analyses for both groups demonstrated statistically significant mean reductions in probing depth (RPc: 0.42 mm, P = 0....
TL;DR: It was found that GCF values were higher than serum values and visfatin values were considered an inflammatory marker in periodontal disease in GCF and serum.
Abstract: Background: Visfatin is a pleiotropic mediator that acts as growth factor, cytokine, and enzyme involved in energy including nicotinamide adenine dinucleotide metabolism and was recently demonstrated to exert several proinflammatory functions. The purpose of this study is to determine the presence of visfatin in gingival crevicular fluid (GCF) and serum samples and to find out their association, if any.Methods: At the beginning of the study, 40 individuals (20 males and 20 females; age range: 23 to 53 years) were selected and divided into three groups based on the gingival index, probing depths, clinical attachment levels, and radiologic parameters (bone loss). Group 1 (10 patients with healthy periodontium; age range: 25-36 years), group 2 (15 patients with gingivitis; age range: 25-36 years), and group 3 (15 patients with chronic periodontitis; age range: 23-53 years) GCF (by microcapillary pipettes) and serum (by venipuncture) samples were collected to estimate levels of visfatin using an enzyme-linked...
TL;DR: Although the outcomes of open-flap debridement alone were not investigated, the application of EMD alone appeared to yield less PD reduction and CAL gain compared to GTR therapy in the treatment of deep, non-contained intrabony defects.
Abstract: Background: The purpose of this study is to compare the healing of deep, non-contained intrabony defects (i.e., with a ≥80% 1-wall component and a residual 2- to 3-wall component in the most apical part) treated with either an enamel matrix derivative (EMD) or guided tissue regeneration (GTR) after 12 months.Methods: In this randomized, controlled clinical trial, 40 subjects with 40 defects affecting single-rooted teeth were treated. The defects were treated with EMD alone or with a non-resorbable titanium-reinforced membrane. No grafting materials were used. At baseline and after 12 months, clinical parameters including probing depths (PDs) and clinical attachment levels (CAL) were recorded. The difference in CAL gain was the primary outcome.Results: At baseline, the intrabony component of the defects amounted to 8.5 ± 2.2 mm at EMD-treated sites and 8.6 ± 1.7 mm at GTR-treated sites (P = 0.47). The mean CAL gain at sites treated with GTR was significantly greater (P <0.001) than that at sites treated wi...
TL;DR: A decision-making process for treating non-carious cervical lesions (NCCLs) associated with gingival recessions based upon the topographic relationship between the MRC and NCCL and to assess patient and independent-periodontist esthetic evaluations is suggested.
Abstract: Background: A method to predetermine the maximum root coverage level (MRC) was recently demonstrated to be reliable in predicting the position of the soft tissue margin after root coverage surgery. The aim of the present study is to suggest a decision-making process for treating non-carious cervical lesions (NCCLs) associated with gingival recessions based upon the topographic relationship between the MRC and NCCL and to assess patient and independent-periodontist esthetic evaluations.Methods: Five treatments were performed in 94 patients with NCCLs associated with a single gingival recession: 1) coronally advanced flap (CAF); 2) bilaminar procedure; 3) coronal odontoplasty plus restoration plus root odontoplasty plus CAF; 4) restoration plus CAF; and 5) restorative therapy. Clinical and esthetic evaluations made by the patient and an independent periodontist were done 1 year after treatments.Results: The satisfaction of the patient and periodontist with esthetics was very high in all NCCL treatments and ...
TL;DR: Stress-transferring mechanism at the bone-implant interface characterized by the direction and profile of interfacial stresses, which leads to more compressive and less shear stress, may clarify the biomechanical aspect of microthread dental implants.
Abstract: Background: The mechanism by which the microthread implant preserves peri-implant crestal bone is not known. The objective of this research is to assess the effect of microthreads on the magnitude and direction of the stress at the bone–implant interface using finite element analysis modeling.Methods: Three-dimensional finite element models representing the microthreaded implant (microthread model) and smooth surface implant (smooth model) installed in the mandibular premolar region were created based on microscopic and computed tomography images. The mesh size was determined based on convergence tests. Average maximum bite force of adults was used with four loading angles on the occlusal surface of the prosthesis.Results: Regardless of the loading angle, principal stresses at the bone–implant interface of the microthread model were always perpendicular to the lower flank of each microthread. In the smooth model, stresses were affected by the loading angle and directed obliquely to the smooth interface, r...
TL;DR: It is suggested that serum levels of anti-Pg IgG antibodies were associated with RA, and might affect serum Levels of RF and periodontal condition in patients with RA.
Abstract: Background: Periodontopathic bacteria have been implicated as contributory to the etiology of rheumatoid arthritis (RA). Anticyclic citrullinated peptide (CCP) antibodies and rheumatoid factor (RF) were shown to be associated with RA. This study examines whether serum levels of antibodies to periodontopathic bacteria may affect clinical and laboratory profiles of RA.Methods: The study participants consisted of 80 patients with RA, and 38 age-, sex-, smoking status–, and periodontal condition–balanced healthy controls. After periodontal and rheumatologic examination, serum levels of immunoglobulin G (IgG) antibodies to Porphyromonas gingivalis (Pg), Prevotella intermedia, Aggregatibacter actinomycetemcomitans (Aa) (previously Actinobacillus actinomycetemcomitans), and Eikenella corrodens (Ec) and those of anti-CCP antibodies and RF were determined by an enzyme-linked immunosorbent assay.Results: Patients with RA showed significantly higher levels of anti–Pg and anti-CCP antibodies than controls (P = 0.04 a...
TL;DR: This computer-simulated study demonstrates a novel experimental design by which the spatial relation between implant and lingual plate in mandibular first molar region is investigated and the incidence and risk of perforation in the area of lingual concavity are investigated.
Abstract: Background: Lingual plate perforation at the time of implant placement in posterior mandible is a potential surgical complication, and presence of a lingual concavity is considered a risk factor. Little is known about the spatial relationship between implant and lingual plate. The role of lingual concavity in the risk of lingual perforation has not yet been fully studied. This computer-simulated study investigates the incidence of lingual plate perforation in edentulous mandibular first molar region and the risk of perforation in the area of lingual concavity.Methods: One hundred and three qualified cone-beam computed tomography scans were selected from the database. Implants of various dimensions were virtually placed into the area using computer software. The distance between implant tip and lingual plate was measured using a digital caliper. Incidence of lingual plate perforation and proximity of the implant tip to lingual plate were measured for three types of cross-sectional mandibular morphology.Res...
TL;DR: It is confirmed that iNOS-derived NO plays a crucial role in the pathogenesis of periodontitis, probably by stimulating OC differentiation and activity.
Abstract: Background: Inflammatory stimuli activate inducible nitric oxide synthase (iNOS) in a variety of cell types, including osteoclasts (OC) and osteoblasts, resulting in sustained NO production. In this study, we evaluate the alveolar bone loss in rats with periodontitis under long-term iNOS inhibition, and the differentiation and activity of OC from iNOS-knockout (KO) mice in vitro.Methods: Oral aminoguanidine (an iNOS inhibitor) or water treatment was started 2 weeks before induction of periodontitis. Rats were sacrificed 3, 7, or 14 days after ligature placement, and alveolar bone loss was evaluated. In vitro OC culture experiments were also performed to study the differentiation of freshly isolated bone marrow cells from both iNOS KO and wild-type C57BL/6 mice. OC were counted 6 days later after tartrate-resistant acid phosphatase staining (a marker of osteoclast identity), and bone resorption activity was assessed by counting the number of resorption pits on dentin disks.Results: Rats with ligature showe...