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Stazić P, Jurić D, Turić A, Šošić A, Marušić A, Roguljić M. Reporting characteristics of nonsurgical periodontal therapy trials registered in ClinicalTrials.gov: an observational study. J Comp Eff Res 2023; 12:e230058. [PMID: 37418255 PMCID: PMC10508296 DOI: 10.57264/cer-2023-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023] Open
Abstract
Aim: To evaluate the completeness of the description of nonsurgical periodontal therapy interventions in clinical trials registered in ClinicalTrials.gov and correspondence of registered information for trial participants and outcome measures with published articles. Materials & methods: We retrieved data from ClinicalTrials.gov and corresponding publications. The completeness of intervention reporting was assessed using the Template for Intervention Description and Replication (TIDieR) checklist for oral hygiene instructions (OHI), professional mechanical plaque removal (PMPR), and subgingival instrumentation, antiseptics and antibiotics. The completeness of registration of trial protocol information was assessed according to the WHO Trial Registration DataSet for participant information (enrollment, sample size calculation, age, gender, condition) and primary/secondary outcome measures. Results: 79 included trials involved OHI (n = 38 trials, 48.1%), PMPR (n = 19, 24.1%), antiseptics (n = 11, 12.7%), or antibiotics (n = 11, 12.7%). There was a great variety in the terms used to describe these interventions. Most of the analyzed trials (93.7%) were completed and did not provide any data on study phase (74.7%). The description of intervention in the registry in ClinicalTrials.gov was inadequate for all analyzed interventions, with description inconsistencies in matching publications. There were also discrepancies in registered and published outcomes: for 39 trials with published results, 18 had different registered and reported primary outcomes, and 29 different registered and reported secondary outcomes. Conclusion: The completeness of the description of nonsurgical therapy of periodontitis in clinical trials is unsatisfactory, reducing the quality of translation of the new evidence and procedures into clinical practice. Significant discrepancy in registered and reported trial outcomes calls into question the validity of reported results and relevance for practice.
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Affiliation(s)
- Petra Stazić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Diana Jurić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Antonela Turić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Antonio Šošić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Ana Marušić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Marija Roguljić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
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Yamamoto T, Taniguchi M, Matsunaga K, Kawata Y, Kawamura M, Okubo K, Yamashiro K, Omori K, Takashiba S. Analysis of subgingival microbiota in monozygotic twins with different severity and progression risk of periodontitis. Clin Case Rep 2022; 10:e05725. [PMID: 35449775 PMCID: PMC9014707 DOI: 10.1002/ccr3.5725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 03/11/2022] [Accepted: 03/27/2022] [Indexed: 11/24/2022] Open
Abstract
The study aims to reveal the composition of subgingival bacteria in monozygotic twins with discordant in severity and progression risk of periodontitis. Microbiome analysis indicated that most bacteria were heritable but differed in their abundance and immune response. The dysbiotic bacteria can be considered as risk markers for periodontitis progression.
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Affiliation(s)
- Tadashi Yamamoto
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
| | | | - Kazuyuki Matsunaga
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
- Department of Neurology Brain Attack Center Ota Memorial Hospital Fukuyama, Hiroshima Japan
| | - Yusuke Kawata
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Mari Kawamura
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Keisuke Okubo
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Keisuke Yamashiro
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Kazuhiro Omori
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Shogo Takashiba
- Department of Pathophysiology ‐ Periodontal Science Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
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Rajendran P. Lamotrigine-Induced Gingival Enlargement: An Older Problem Due to a Newer Drug - A Rare Case Report. Clin Adv Periodontics 2020; 12:130-133. [PMID: 32852892 DOI: 10.1002/cap.10123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Gingival enlargement (GE) due to anti-epileptic drugs (AEDs) shows a high prevalence rate. However, lamotrigine, a newer AED, has not shown to induce GE. The present case report describes a rare case of GE in a patient with epilepsy under lamotrigine therapy for the past 3 years. CASE PRESENTATION In this report, successful management of lamotrigine-influenced GE in a 24-year old patient with epilepsy by gingivectomy followed by stringent oral hygiene protocol is presented. CONCLUSION The present case report suggests that, even this newer AED can cause GE and the oral hygiene status of the patients could be an important triggering factor.
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Affiliation(s)
- Poornima Rajendran
- Department of Periodontology, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
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Gusman DJR, Ervolino E, Theodoro LH, Garcia VG, Nagata MJH, Alves BES, de Araujo NJ, Matheus HR, de Almeida JM. Antineoplastic agents exacerbate periodontal inflammation and aggravate experimental periodontitis. J Clin Periodontol 2019; 46:457-469. [PMID: 30854670 DOI: 10.1111/jcpe.13101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 12/22/2018] [Accepted: 03/02/2019] [Indexed: 12/15/2022]
Abstract
AIM This study evaluated the effects of 5-fluorouracil (5-FU) and cisplatin (CIS) in healthy periodontal tissues and in the early stages of experimental periodontitis (EP) in rats. METHODS One hundred and eighty male rats were divided into three groups, which were submitted to the following systemic treatments: physiological saline solution (PSS); CIS and 5FU. Each group was subdivided into two subgroups: without (NEP) and with (EP) induction of EP. Animals were euthanized at 3, 5 and 7 days post-treatment. Histological, histometric (percentage of bone in the furcation [PBF]) and immunohistochemical (for tumour necrosis factor-α, interleukin-1β and receptor activator of nuclear factor-κB ligand) analyses were performed. Data were statistically analysed. RESULTS CIS-NEP and 5FU-NEP showed more inflammation than PSS-NEP at 3, 5 and 7 days. CIS-EP and 5FU-EP showed more inflammation and lower PBF than PSS-EP at all periods of evaluation. 5FU-EP showed lower PBF than CIS-EP at 5 and 7 days. CONCLUSION 5-FU and CIS exacerbated periodontal inflammation and aggravated the progression of EP in its early stages.
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Affiliation(s)
- David Jonathan Rodrigues Gusman
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.,Department of Periodontics, University of Western São Paulo (UNOESTE), Presidente Prudente, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Letícia Helena Theodoro
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Valdir Gouveia Garcia
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Maria José Hitomi Nagata
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Breno Edson Sendão Alves
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.,Department of Periodontics, Maringa University Center (UNINGA), Maringá, Paraná, Brazil
| | - Nathalia Januario de Araujo
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Henrique Rinaldi Matheus
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Juliano Milanezi de Almeida
- Department of Surgery and Integrated Clinic - Division of Periodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Halpern LR. The Geriatric Syndrome and Oral Health: Navigating Oral Disease Treatment Strategies in the Elderly. Dent Clin North Am 2019; 64:209-228. [PMID: 31735227 DOI: 10.1016/j.cden.2019.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Poor oral health in the geriatric population is being framed as a potentially new geriatric syndrome; an oral and maxillofacial geriatric syndrome. As such, the treatment of oral diseases will require a comprehensive approach that considers the multimorbidity of disease, and polypharmacy that is precipitated/exacerbated by oral and maxillofacial dysfunction. This is challenging because oral diseases are not 1 discrete systemic illness but a combination of many with common causes. This article presents a roadmap approach to evaluate symptoms and apply therapeutic strategies for 5 common oral and maxillofacial dysfunctions seen in the elderly.
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Affiliation(s)
- Leslie R Halpern
- Oral and Maxillofacial Surgery, University of Utah, School of Dentistry, 530 South Wakara Way, Salt Lake City, UT 84108, USA.
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Abstract
Assessment of the periodontium has relied exclusively on a variety of physical measurements (e.g., attachment level, probing depth, bone loss, mobility, recession, degree of inflammation, etc.) in relation to various case definitions of periodontal disease. Periodontal health was often an afterthought and was simply defined as the absence of the signs and symptoms of a periodontal disease. Accordingly, these strict and sometimes disparate definitions of periodontal disease have resulted in an idealistic requirement of a pristine periodontium for periodontal health, which makes us all diseased in one way or another. Furthermore, the consequence of not having a realistic definition of health has resulted in potentially questionable recommendations. The aim of this manuscript was to assess the biological, environmental, sociological, economic, educational and psychological relationships that are germane to constructing a paradigm that defines periodontal health using a modified wellness model. The paradigm includes four cardinal characteristics, i.e., 1) a functional dentition, 2) the painless function of a dentition, 3) the stability of the periodontal attachment apparatus, and 4) the psychological and social well-being of the individual. Finally, strategies and policies that advocate periodontal health were appraised. I'm not sick but I'm not well, and it's a sin to live so well. Flagpole Sitta, Harvey Danger
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Fabbri C, Fuller R, Bonfá E, Guedes LKN, D'Alleva PSR, Borba EF. Periodontitis treatment improves systemic lupus erythematosus response to immunosuppressive therapy. Clin Rheumatol 2014; 33:505-9. [PMID: 24415114 DOI: 10.1007/s10067-013-2473-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 12/19/2013] [Indexed: 02/06/2023]
Abstract
Periodontal disease (POD) may affect rheumatic diseases severity, but there are no data regarding the effect of its treatment on disease activity in SLE patients under immunosuppressive therapy. Forty-nine consecutive SLE patients (SLEDAI ≥ 2) with POD and under corticosteroid and cyclophosphamide pulse therapy (IVCYC) were selected. Periodontal assessment included bleeding gingival index (BGI), probing depth (PD), and probing attachment level (PAL). At entry, POD was defined as BGI > 1 and patients were assigned to groups according to the availability of odontological intervention in TREATED (n = 32) and NOT TREATED (n = 17). SLEDAI and POD parameters were determined at entry and after 3 months. Age, female gender, and race were alike among TREATED and NOT TREATED (p > 0.05). Both groups had also comparable disease duration (10.7 ± 6.8 vs. 11.0 ± 6.6, p = 0.83), IVCYC number (5.8 ± 4.8 vs. 4.5 ± 4.8, p = 0.17), and SLEDAI (5.9 ± 4.2 vs. 6.3 ± 4.3, p = 0.73) as well as POD parameters [BGI (40.8 ± 31.0 vs. 40.7 ± 36.2 %, p = 0.89), PD (1.7 ± 1.8 vs. 1.5 ± 0.60 mm, p = 0.80), and PAL (2.5 ± 1.9 vs. 1.9 ± 1.1 mm, p = 0.18)]. At the end of the study, TREATED group had a significant improvement in SLEDAI (5.9 ± 4.2 vs. 3.4 ± 3.3, p = 0.04) with a paralleled reduction in BGI (40.8 ± 31.0 vs. 15.2 ± 17.2 %, p < 0.01), PD (1.7 ± 1.8 vs. 1.1 ± 0.3 mm, p < 0.01), and PAL (2.5 ± 1.9 vs. 1.7 ± 0.9 mm, p < 0.01). In contrast, SLEDAI (6.3 ± 4.3 vs. 6.0 ± 5.5, p = 0.40) and POD parameters [BGI (p = 0.33), PD (p = 0.91), and PAL (p = 0.39)] remained largely unchanged in NOT TREATED group. Periodontal disease treatment seems to have a beneficial effect in controlling disease activity in SLE patients under immunosuppressive therapy. Therefore, management of this modifiable risk factor is recommended.
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Affiliation(s)
- Cristiana Fabbri
- Odontology Division of São Paulo University, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Peker İ, Alkurt MT, Usalan G. Clinical evaluation of medications on oral and dental health. Int Dent J 2008; 58:218-22. [DOI: 10.1111/j.1875-595x.2008.tb00352.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gujral DM, Bhattacharyya S, Hargreaves P, Middleton GW. Periodontal disease in a patient receiving Bevacizumab: a case report. J Med Case Rep 2008; 2:47. [PMID: 18271967 PMCID: PMC2262909 DOI: 10.1186/1752-1947-2-47] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 02/13/2008] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Bevacizumab is a monoclonal antibody that inhibits the action of vascular endothelial growth factor (VEGF) thereby acting as an angiogenesis inhibitor. As a result, supply of oxygen and nutrients to tissues is impaired and tumour cell growth is reduced. Reported side effects due to bevacizumab are hypertension and increased risk of bleeding. Bowel perforation has also been reported. Periodontal disease in patients on bevacizumab therapy has not been reported before. CASE PRESENTATION We report a case of a forty-three year old woman who developed periodontitis whilst receiving bevacizumab for lung cancer. The periodontal disease remained stable on discontinuation of the drug. CONCLUSION Further investigations are needed to determine the mechanism for bevacizumab-induced periodontal disease.
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Affiliation(s)
- Dorothy M Gujral
- St Lukes Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | | | - Peter Hargreaves
- St Lukes Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - Gary W Middleton
- St Lukes Cancer Centre, Royal Surrey County Hospital, Guildford, UK
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