Smoking Cessation on Periodontal and Peri-Implant Health Status: A Systematic Review

Peri-Implantitis-Associated Microbiota before and after Peri-Implantitis Treatment, the Biofilm "Competitive Balancing" Effect: A Systematic Review of Randomized Controlled Trials

This systematic review of RCTs aimed to characterize short- and long-term changes in peri-implantitis-associated microbiota (total biofilm microbial load and predominant pathogens' counts) following (any) peri-implantitis treatment in systemically healthy, non-smoking, partially/totally edentulous adults. The study protocol, compliant with the PRISMA statement, was registered on PROSPERO (CRD42024514521) before the literature search. Data from 11 RCTs, assessed through the ROBINS-2 tool, were qualitatively synthesized. No data were retrieved on total edentulism, healthy peri-implant/periodontal sites, treated mucositis, gingivitis, and periodontitis sites. Shortly after treatment, Prevotella intermedia, Fusobacterium nucleatum, and Peptostreptococcus micros prevailed, indicating early colonization, as after implant placement. After both surgical and non-surgical approaches, although not eradicated, the peri-implant total biofilm load, red- and orange-complex species, and Aggregatibacter actinomycetemcomitans counts generally decreased for up to about three months. However, one month after treatment, red-complex species and Prevotella intermedia increased, likely due to persistent tissue-invasive bacteria, unresolved pathological conditions (high probing depth values) favoring anaerobiosis and dysbiosis, and a qualitatively and quantitatively decreased biofilm community, competing and balancing the predominant pathogens (biofilm "competitive balancing" effect), thus allowing recolonization by more virulent bacteria. Red-complex bacteria gradually leveled off to baseline at the six- and twelve-month follow-ups. Fusobacterium nucleatum remained almost unchanged after treatment.

Evidence-Based Critical Assessment of the Success Rate of Dental Implants in Smokers: An Umbrella Systematic Review

The aim of this umbrella systematic review is to evaluate the success rate and osseointegration of dental implants in patients with a smoking habit. Electronic database searches of PubMed/Medline, Google Scholar, ScienceDirect, Cochrane Library, and EBSCOhost were done from 2006 until August 2024, using medical subject headings (MeSH) terms. Systematic reviews and meta-analyses (SRMAs) investigating the association between smoking and the rate of success of dental implants based on dental implant failure, marginal bone loss, survival, and peri-implant parameters were deemed eligible. The Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2) was used to assess the quality of the included SRMAs. Seventeen systematic reviews have been included. In the reviews, 10 studies included meta-analyses (MAs) that evaluated implant failure rate and marginal bone loss. According to the AMSTAR 2 checklist, one review was scored "high," seven reviews were scored "moderate," seven reviews were scored "low," and two reviews were scored "critically low" quality. The strength of evidence suggests a low level of success and high rate of failure of osseointegration of dental implants in smokers. However, the influence of smoking on the rate of dental implant failure seems to be associated with various factors such as peri-implant inflammatory markers, post-operative infections, etc. Inherently, the conclusion of this review is based on a limited number of systematic reviews.

Bidirectional Association between Periodontitis and Thyroid Disease: A Scoping Review

Periodontitis is a chronic inflammatory disease of the tissues surrounding and supporting the teeth. Due to the development of chronic inflammation, periodontitis can contribute to the development of several systemic diseases, including thyroid disease. Thyroid pathology includes benign, malignant, and autoimmune conditions leading to hypothyroidism, hyperthyroidism, or euthyroidism. Alterations in thyroid hormones, especially hypothyroidism, can reveal significant oral manifestations, including periodontitis. This scoping review aims to explore the probable causal relationship between periodontitis and thyroid disease, in terms of epidemiology, pathogenesis, and treatment. The search strategy follows the PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, and Cochrane were searched from January 2014 to January 2024, entering the MESH terms "periodontitis" and "thyroid". Of 153 initial records, 20 articles were selected and discussed. There is a high prevalence of periodontitis among patients with thyroid disease, including thyroid cancer. The causes at the basis of this association are genetic factors, the oral microbiome, and proinflammatory cytokines. Periodontal treatment, specifically scaling and root planning, can ameliorate thyroid parameters. Although there are a few randomized controlled studies in the literature, this review lays the foundation for a bidirectional relationship between periodontitis and thyroid disease, the link to which is, once again, systemic inflammation.

Therapeutic Strategies and Genetic Implications for Periodontal Disease Management: A Systematic Review

The objective of this review is to identify the microbiological alterations caused by various therapy modalities by critically analyzing the current findings. We limited our search to English-language papers published between 1 January 2004 and 7 May 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "microbio*" AND "periodontitis" were used. A total of 5152 papers were obtained from the databases Web of Science (2205), PubMed (1793), and Scopus (1154). This resulted in 3266 articles after eliminating duplicates (1886), and 1411 entries were eliminated after their titles and abstracts were examined. The qualitative analysis of the 22 final articles is included in this study. Research on periodontal disease shows that periodontitis alters the oral microbiome and increases antibiotic resistance. Treatments like scaling and root planing (SRP), especially when combined with minocycline, improve clinical outcomes by reducing harmful bacteria. Comprehensive mechanical debridement with antibiotics, probiotics, EMD with bone grafts, and other adjunctive therapies enhances periodontal health. Personalized treatment strategies and advanced microbial analyses are crucial for effective periodontal management and antibiotic resistance control.

Longitudinal Observation of Micromotion upon Loading of Implant-Abutment Connection

While technological advances have made implants a good treatment option with a good long-term prognosis, peri-implantitis, which results in alveolar bone resorption around implants, has been observed in some cases. Micromotion at the implant abutment connection can cause peri-implantitis. However, the temporal progression of micromotion upon loading remains unclear. Therefore, we aimed to longitudinally measure micromotion upon loading application on an implant. Implants with Morse-tapered connections were prepared. Custom titanium abutments were fabricated and tightened onto implant bodies at 35 N. A 100 N vertical load was applied for 200,000 cycles. Micromotion was measured when the load was applied, as was the total implant length and removal torque before and after loading. The micromotion was measured from the position data of the jig of the testing machine during loading. The average removal torque was 30.67 N after 10 min of tightening and 27.95 N after loading, indicating a decrease due to loading. The implant length reduced by 3.6 μm under the load. The average micromotion was 0.018 mm at 2 cycles, 0.016 mm at 100,000 cycles, and 0.0157 mm at 200,000 cycles, indicating implant length reduction under the load but not reaching 0. The micromotion between the implant and abutment under a cyclic load decreased over time but did not completely cease. These results highlight the relationship between micromotion and loading, underscoring the importance of careful monitoring and management to mitigate potential complications, such as peri-implantitis, and ensure optimal performance and durability of the implant.

Microbiota of Peri-Implant Healthy Tissues, Peri-Implant Mucositis, and Peri-Implantitis: A Comprehensive Review

Understanding the microbiological profiles of peri-implant conditions is crucial for developing effective preventive and therapeutic strategies. This narrative review analyzes the microbial profiles associated with healthy peri-implant sites, peri-implant mucositis, and peri-implantitis, along with related microbiological sampling and analyses. Healthy peri-implant sites are predominantly colonized by Streptococcus, Rothia, Neisseria, and Corynebacterium species, in addition to Gram-positive cocci and facultatively anaerobic rods, forming a stable community that prevents pathogenic colonization and maintains microbial balance. In contrast, peri-implant mucositis shows increased microbial diversity, including both health-associated and pathogenic bacteria such as red and orange complex bacteria, contributing to early tissue inflammation. Peri-implantitis is characterized by even greater microbial diversity and a complex pathogenic biofilm. Predominant pathogens include Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, and unique species like Filifactor alocis and Fretibacterium fastidiosum. Additionally, less common species such as Staphylococcus and Enterobacteriaceae, contributing to disease progression through biofilm formation and increased inflammatory response, along with EBV and human cytomegalovirus with a still not defined role, and Candida albicans contribute to disease progression through biofilm formation, immune modulation, and synergistic inter-kingdom interactions. Future research should standardize diagnostic criteria, employ advanced molecular techniques, integrate microbial data with clinical factors, and highlight inter-kingdom interactions.

The Role of Sulfhydryl (Thiols) Groups in Oral and Periodontal Diseases

AIM

The sulfhydryl (thiols) group of glutathione plays an important role in the neutralization of foreign organic compounds and the reduction in peroxides. The purpose of the study is to evaluate the concentration of sulfhydryl groups in the gingival tissue of healthy individuals and those with gingivitis or periodontitis, and to examine the differences between these groups.

MATERIAL AND METHODS

To assess the concentration of sulfhydryl groups (thiols) in the gingival tissue of healthy individuals and those with gingivitis or periodontitis, we used spectrophotometric analysis using dithionitrobenzoate (DTNB) as a reagent to measure the accessible sulfhydryl groups present in gingival tissue proteins. The sample was divided into three distinct groups: individuals with periodontal health, gingivitis, and periodontitis, and different indices were used to assess the periodontal status of the participants. Next, a statistical analysis was conducted to compare the concentrations of sulfhydryl groups among the different groups of patients.

CONCLUSIONS

The results of this study showed significantly decreased levels of sulfhydryl (thiols) groups in gingival tissue from patients with gingivitis and periodontitis, compared with healthy people (control group). These results confirm the role of sulfhydryl (thiols) groups in defense against free radicals. They share a significant role in detoxification, signal transduction, apoptosis, and various other functions at the molecular level.

Association between life's essential 8 and periodontitis: a study based on NHANES 2009-2014

Background

This research aims to investigate the relationship between Life's Essentials 8 (LE8), the American Heart Association's latest indicator, and periodontitis. The purpose is to provide guidance on preventative measures.

Methods

Data for our investigation were obtained from the National Health and Nutrition Examination Survey (NHANES) 2009-2014, with a total of 8,784 participants eligible. LE8 scores were compiled from 8 index scores (the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure). Periodontitis was classified by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC/AAP). The study utilized multivariable logistic analyses to investigate the potential correlation.

Results

After controlling for all covariates, LE8 was discovered to have a significant negative correlation with periodontitis prevalence [0.91 (0.88, 0.94)]. This trend continued to hold statistical significance even after converting LE8 into a categorical variable. Furthermore, a noteworthy adverse correlation was discovered across both genders, specifically males [0.35 (0.22, 0.55)] and females [0.39 (0.25, 0.60)], as well as for the majority of categorical classifications, namely ethnicity, age, education level, and marital status. However, only the age subgroups displayed some degree of significant difference from each other.

Conclusion

Life's essential 8 was negatively associated with periodontitis, but more prospective trails are needed to confirm our findings.

Periodontal and Peri-Implant Diagnosis: Current Evidence and Future Directions

Dentistry and periodontology in particular are constantly evolving in terms of both diagnostic and therapeutic tools [...].

Do Systemic Diseases and Medications Influence Dental Implant Osseointegration and Dental Implant Health? An Umbrella Review

The aim of this umbrella review is to evaluate what are the most common medications and systemic diseases that can affect bone-implant integration, the success rate and survival rate of dental implants, peri-implant tissue health, and implant loss. Systematic reviews, with meta-analysis or not, about how systemic diseases and medications influence dental implant osseointegration, survival rate, success rate, and peri-implant diseases, published only in the English language, are electronically searched across the most important scientific databases. The present umbrella review includes eight systematic reviews, and osteoporosis and diabetes are the most investigated pathologies. Systemic diseases, such as neurologic disorders, HIV, hypothyroidism, cardiovascular diseases, and drugs, such as beta blockers, anti-hypertensives, or diuretics do not show a decreased rate of implant osseointegration. It seems that drugs, such as proton-pump inhibitors (PPIs) or serotonin reuptake inhibitors (SSRIs), negatively affect implant osseointegration. Few studies compare the effects of drugs and systemic diseases on the parameters considered in this overview. It is important to underline how the results of this review need to be validated with subsequent and more reviews.

Clinics and Practice: Consolidating Best Practices in Periodontal Management

Periodontitis is a multifactorial inflammatory disease [...].

Human Papillomavirus: Oral Lesions and Vaccination

Human papillomavirus (HPV) is associated with benign and malignant lesions in various locations, such as the skin and oral and genital mucosa [...]

Usage Pattern and Nicotine Delivery during Ad Libitum Consumption of Pod E-Cigarettes and Heated Tobacco Products

Many different nicotine delivery products, such as e-cigarettes (e-cigs) or heated tobacco products (HTPs), are available on the market. To better understand these products, it is crucial to learn how consumers use them and how much nicotine they deliver. Therefore, a pod e-cig, an HTP, and a conventional cigarette (CC) were each used by 15 experienced users of the respective product category for 90 min without special use instructions ("ad libitum"). Sessions were video recorded to analyze usage patterns and puff topography. At defined time points, blood was sampled to determine nicotine concentrations, and subjective effects were inquired about using questionnaires. During the study period, the CC and HTP groups averaged the same number of consumption units (both 4.2 units). In the pod e-cig group, the highest number of puffs was taken (pod e-cig 71.9; HTP: 52.2; CC: 42.3 puffs) with the most extended mean puff duration (pod e-cig: 2.8 s; HTP: 1.9 s; CC: 1.8 s). Pod e-cigs were predominantly used with single puffs or in short clusters of 2-5 puffs. The maximum plasma nicotine concentration was highest for CCs, followed by HTPs, and then pod e-cigs with 24.0, 17.7, and 8.0 ng/mL, respectively. Craving was reduced by all products. The results suggest that the high nicotine delivery known for tobacco-containing products (CCs and HTPs) may not be needed for non-tobacco-containing products (pod e-cigs) to satisfy cravings in experienced users.

Characterization of the Oral Microbiome in Wearers of Fixed and Removable Implant or Non-Implant-Supported Prostheses in Healthy and Pathological Oral Conditions: A Narrative Review

Oral commensal microorganisms perform very important functions such as contributing to the health of the host. However, the oral microbiota also plays an important role in the pathogenesis and development of various oral and systemic diseases. The oral microbiome may be characterized by a higher prevalence of some microorganisms than others in subjects with removable or fixed prostheses, depending on oral health conditions, the prosthetic materials used, and any pathological conditions brought about by inadequate prosthetic manufacturing or poor oral hygiene. Both biotic and abiotic surfaces of removable and fixed prostheses can be easily colonized by bacteria, fungi, and viruses, which can become potential pathogens. The oral hygiene of denture wearers is often inadequate, and this can promote oral dysbiosis and the switch of microorganisms from commensal to pathogens. In light of what emerged from this review, fixed and removable dental prostheses on teeth and on implants are subject to bacterial colonization and can contribute to the formation of bacterial plaque. It is of fundamental importance to carry out the daily hygiene procedures of prosthetic products, to design the prosthesis to facilitate the patient's home oral hygiene practices, and to use products against plaque accumulation or capable of reducing oral dysbiosis to improve patients' home oral practices. Therefore, this review primarily aimed to analyze the oral microbiome composition in fixed and removable implant or non-implant-supported prostheses wearers in healthy and pathological oral conditions. Secondly, this review aims to point out related periodontal self-care recommendations for oral dysbiosis prevention and periodontal health maintenance in fixed and removable implant or non-implant-supported prostheses wearers.

Is Ozone a Valid Adjuvant Therapy for Periodontitis and Peri-Implantitis? A Systematic Review

INTRODUCTION

Ozone is a naturally occurring unstable compound with three oxygen atoms that generally transforms into an oxygen molecule, releasing one oxygen atom. This feature has been exploited in dentistry for numerous applications, including for periodontal diseases and peri-implantitis.

METHODS

This review was performed in relation to the PRISMA flow chart and was annotated in the PROSPERO register. PICO questions were used as research questions. The risk of bias in the non-randomized clinical trials was appraised using the ROBINS-I tool.

RESULTS

An electronic search found a total of 1073 records, in particular, 842 from MEDLINE/PubMed, 13 from Bio Med Central, 160 from Scopus, 1 from the Cochrane library databases, and 57 from the PROSPERO register. A total of 17 studies were included in the present systematic review. Information regarding the characteristics of the periodontal clinical and radiographic parameters for gaseous ozone, ozonate water, ozonate oil, and ozone gel, including clinical attachment loss (CAL) probing depth (PPD), bleeding on probing (BoP), plaque index (PI), gingival index (GI), and marginal bone levels (MBL), were obtained.

CONCLUSIONS

The studies included in this systematic review show different results regarding the ozone in periodontal treatment in association with or without SRP.

Microbial Air Contamination in a Dental Setting Environment and Ultrasonic Scaling in Periodontally Healthy Subjects: An Observational Study

The risk of microbial air contamination in a dental setting, especially during aerosol-generating dental procedures (AGDPs), has long been recognized, becoming even more relevant during the COVID-19 pandemic. However, individual pathogens were rarely studied, and microbial loads were measured heterogeneously, often using low-sensitivity methods. Therefore, the present study aimed to assess microbial air contamination in the dental environment, identify the microorganisms involved, and determine their count by active air sampling at the beginning (T0), during (T1), and at the end (T2) of ultrasonic scaling in systemically and periodontally healthy subjects. Air microbial contamination was detected at T0 in all samples, regardless of whether the sample was collected from patients treated first or later; predominantly Gram-positive bacteria, including Staphylococcus and Bacillus spp. and a minority of fungi, were identified. The number of bacterial colonies at T1 was higher, although the species found were similar to that found during the T0 sampling, whereby Gram-positive bacteria, mainly Streptococcus spp., were identified. Air samples collected at T2 showed a decrease in bacterial load compared to the previous sampling. Further research should investigate the levels and patterns of the microbial contamination of air, people, and the environment in dental settings via ultrasonic scaling and other AGDPs and identify the microorganisms involved to perform the procedure- and patient-related risk assessment and provide appropriate recommendations for aerosol infection control.

Impact of Smoking Habit on Peri-Implant Indicators following Different Therapies: A Systematic Review

Peri-implant disease and its treatment is becoming a major concern for clinicians as the number of implants placed each year is rising. Smoking is a common habit, and it is associated with an increased risk of developing peri-implant disease. The role of smoking in the response to peri-implant treatment has never been investigated. Searches were conducted in electronic databases to screen articles published until August 2021. The included studies had at least two groups of patients: peri-implant disease only or peri-implant disease and smoking status. Outcomes of interest included plaque index (PI), probing depth (PD), bleeding on probing (BoP), radiographic crestal bone loss (CBL), and analysis of peri-implant sulcular fluid. Seven hundred and forty-nine articles were found in the databases, only 71 articles potentially qualified. A total of seven studies with a minimum follow-up of six months were included. There is no homogeneity in the diagnosis, smoker definition and treatment proposed. All surgical and non-surgical treatment have statistically significantly different outcomes in smokers and nonsmokers. Recognizing this study’s limitations, we conclude that smoking might play a significant role on the outcome of peri-implant disease treatment. None of the proposed treatments appear to be significantly more effective.