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Santamaria P, Sari A, Nibali L. Molecular profiling of gingival crevicular fluid fails to distinguish between infrabony and suprabony periodontal defects. J Clin Periodontol 2023; 50:1315-1325. [PMID: 37438680 DOI: 10.1111/jcpe.13849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/08/2023] [Accepted: 06/25/2023] [Indexed: 07/14/2023]
Abstract
AIM To assess the differential molecular profiling of gingival crevicular fluid (GCF) from infrabony and suprabony periodontal defects compared with healthy sites. MATERIALS AND METHODS Seventy-five samples from 25 patients with untreated periodontitis stage III-IV were included. Clinical and radiological parameters as well as GCF samples were collected from an infrabony defect, a suprabony defect and a periodontally healthy site per patient. A multiplex bead immunoassay was performed to assess the level of 18 biomarkers associated with inflammation, connective tissue degradation and regeneration/repair. RESULTS GCF volume was higher in periodontal sites compared with healthy sites, with no significant difference between infrabony and suprabony defects. Fourteen biomarkers were elevated in infrabony and suprabony sites compared with healthy sites (p < .05). Only interleukin-1α levels were increased in infrabony compared with suprabony sites, whereas there was no difference in probing pocket depth. CONCLUSIONS Although the GCF molecular profile clearly differentiates periodontally affected sites from healthy sites, the different architecture between infrabony and suprabony defects is not reflected in GCF biomarker changes.
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Affiliation(s)
- Pasquale Santamaria
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Aysegul Sari
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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2
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Baruwa AO, Martins JNR, Pires MD, Pereira B, Cruz PM, Ginjeira A. Management of Apico-marginal Defects With Endodontic Microsurgery and Guided Tissue Regeneration: A Report of Thirteen Cases. J Endod 2023; 49:1207-1215. [PMID: 37468061 DOI: 10.1016/j.joen.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/06/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
The loss of periodontal tissue support and vertical buccal bone loss in apico-marginal defects can often be mistaken for features indicative of vertical root fractures and this study reports thirteen cases with persistent symptomatic apical periodontitis, apico-marginal defects, and large periapical lesions that were managed with endodontic microsurgery in conjunction with bone grafts and barrier placements with a follow-up period of up to 9 years. At the recall sessions, all cases were asymptomatic with radiographical success with only 2 cases exhibiting residual apical radiolucency, but with evident reduction in the lesion size, indicative of healing. This study highlights the potential of utilizing endodontic microsurgery combined with guided tissue regeneration that proved effective in stimulating the regeneration of periodontal tissue in cases of apico-marginal defects that can lead to favourable long-term outcomes.
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Affiliation(s)
- Abayomi O Baruwa
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Mariana D Pires
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Beatriz Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro May Cruz
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
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3
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Al-Hamoudi N, Ahmed Y, Al Rifaiy MQ, Alwithanani N, Vohra F, Abduljabbar T. Efficacy of surgical periodontal treatment with and without photobiomodulation in the treatment of severe periodontitis: An evaluation of periodontal, microbiological, and cytokine levels. Photodiagnosis Photodyn Ther 2023; 42:103494. [PMID: 36871808 DOI: 10.1016/j.pdpdt.2023.103494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
AIM To compare the efficacy of surgical periodontal treatment (SPT) alone and PDT-assisted surgery in participants with severe periodontitis MATERIAL AND METHODS: The present clinical trial was completed by 64 participants (n=32 each). The selection was made according to predefined inclusion and exclusion criteria. Patients in group A were treated with SPT only and participants in group B were treated with SPT adjunct to PDT. Microbiological assessment of P.Gingivalis; T. Forsythia and T.Denticola were evaluated using cultural analysis and periodontal parameters plaque score (PSc), bleeding on probing (BoP) periodontal depth (PD), and clinical attachment loss (CAL) at baseline and post-treatment at 6 months and 12 months were performed. The gingival crevicular fluid (GCF) was collected for the estimation of IL-1β and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay (ELISA). For intra-group comparison and post hoc correction, Student's t-test along with Bonferroni was used. For the difference between follow-ups, an analysis of variance (ANOVA) multiple rank tests were incorporated. RESULTS The mean age of participants in the SPT group was 55.25±4.6yrs. Whereas, participants treated with PDT adjunct to SPT were 54.88±3.6yrs. Periodontal parameters (BoP, PD, PSc, CAL) showed no significant difference at baseline. At 6 months and 12 months follow-up, a significant difference in all parameters (BoP, PD, PSc, and CAL) was found in participants treated with SPT alone and PDT adjunct to SPT (p<0.05). Inflammatory biomarkers at 6-month and 12-month follow-ups, a statistically significant difference in the level of biomarkers (IL-1β and TNF-α) were observed in both groups from baseline (p<0.05). However, at baseline, no significant difference was noted in both groups (p> 0.05). The microbiological assessment showed a significant drop in the bacterial count in participants treated with both regimes i.e., SPT alone and PDT adjunct to SPT. CONCLUSION Photodynamic therapy (PDT) adjunct to surgical periodontal treatment (SPT) in severe periodontitis improves microbiological and periodontal parameters and lowers the level of proinflammatory cytokines.
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Affiliation(s)
- Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Yassir Ahmed
- Department of General Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Q Al Rifaiy
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Naif Alwithanani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Taif University, Taif, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
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4
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Tumer H, Orhan K, Aksoy S, Berberoglu A. Cone-beam-computed tomography evaluation of mandibular nutrient canals in patients with periodontal diseases. Niger J Clin Pract 2023; 26:59-64. [PMID: 36751825 DOI: 10.4103/njcp.njcp_210_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background and Aim The aim of this study was to evaluate radiographically the prevalence of mandibular nutrient canals (NCs) in patients with/without periodontal bone loss with aging and to correlate the number of NCs with the severity of bone loss using cone-beam-computed tomography (CBCT). Patients and Methods CBCT examinations of 208 patients were evaluated retrospectively of all patients, 114 had periodontal bone loss, whereas 94 patients were control subjects. Alveolar bone loss investigations were performed according to the Progressive Rate Index. Results NCs were observed in 55% of the control group and 86% of the periodontitis patients. NCs were more prevalent in the elderly age group with periodontal bone loss. In the study group, the NCs were statistically more frequent than in the control subjects (P > 0.05). Conclusion Statistical analysis showed a significant difference between the age groups and the prevalence of NCs increased in patients with periodontal alveolar bone loss with aging (P < 0.05).
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Affiliation(s)
- H Tumer
- Department of Periodontology, Final International University, Faculty of Dentistry, Mersin 10, Turkey
| | - K Orhan
- Department of Dentomaxillofacial Radiology, University of Ankara, Faculty of Dentistry, Ankara, Turkey
| | - S Aksoy
- Department of Dentomaxillofacial Radiology, Near East University, Faculty of Dentistry, Mersin 10, Turkey
| | - A Berberoglu
- Department of Periodontology, Ada Kent University, Faculty of Dentistry, Mersin 10, Turkey
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Seshima F, Bizenjima T, Aoki H, Imamura K, Kita D, Irokawa D, Matsugami D, Kitamura Y, Yamashita K, Sugito H, Tomita S, Saito A. Periodontal Regenerative Therapy Using rhFGF-2 and Deproteinized Bovine Bone Mineral versus rhFGF-2 Alone: 4-Year Extended Follow-Up of a Randomized Controlled Trial. Biomolecules 2022; 12:1682. [PMID: 36421696 PMCID: PMC9688011 DOI: 10.3390/biom12111682] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 08/06/2023] Open
Abstract
The aim of this study was to evaluate longitudinal outcomes of recombinant human fibroblast growth factor (rhFGF)-2 plus deproteinized bovine bone mineral (DBBM) therapy in comparison with rhFGF-2 alone for treating periodontal intrabony defects. This study describes 4-year follow-up outcomes of the original randomized controlled trial. Intrabony defects in periodontitis patients were treated with rhFGF-2 (control) or rhFGF-2 plus DBBM (test). Clinical, radiographic, and patient-reported outcome (PRO) measures were used to evaluate the outcomes. Thirty-two sites were able to be followed up. At 4 years postoperatively, clinical attachment level (CAL) gains in the test and control groups were 3.5 ± 1.4 mm and 2.7 ± 1.4 mm, respectively, showing significant improvement from preoperative values but no difference between groups. Both groups showed an increase in radiographic bone fill (RBF) over time. At 4 years, the mean value for RBF in the test group (62%) was significantly greater than that in the control group (42%). In 1-2-wall defects, the test treatment yielded significantly greater RBF than the control treatment. No significant difference in PRO scores was noted between the groups. Although no significant difference in CAL gain was found between the groups at the 4-year follow-up, the combination treatment significantly enhanced RBF. Favorable clinical, radiographic outcomes, and PRO in both groups can be maintained for at least 4 years.
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Affiliation(s)
- Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | | | - Hideto Aoki
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo 1010061, Japan
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo 1010061, Japan
| | - Daichi Kita
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Daisuke Irokawa
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Daisuke Matsugami
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Yurie Kitamura
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Keiko Yamashita
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Hiroki Sugito
- Department of Dental Hygiene, Tokyo Dental Junior College, Tokyo 1010061, Japan
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Sachiyo Tomita
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo 1010061, Japan
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Han X, Ren J, Lohner H, Yakoumatos L, Liang R, Wang H. SGK1 negatively regulates inflammatory immune responses and protects against alveolar bone loss through modulation of TRAF3 activity. J Biol Chem 2022; 298:102036. [PMID: 35588785 PMCID: PMC9190018 DOI: 10.1016/j.jbc.2022.102036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 12/05/2022] Open
Abstract
Serum- and glucocorticoid-regulated kinase 1 (SGK1) is a serine/threonine kinase that plays important roles in the cellular stress response. While SGK1 has been reported to restrain inflammatory immune responses, the molecular mechanisms involved remain elusive, especially in oral bacteria-induced inflammatory milieu. Here, we found that SGK1 curtails Porphyromonas gingivalis-induced inflammatory responses through maintaining levels of tumor necrosis factor receptor-associated factor (TRAF) 3, thereby suppressing NF-κB signaling. Specifically, SGK1 inhibition significantly enhances production of proinflammatory cytokines, including tumor necrosis factor α, interleukin (IL)-6, IL-1β, and IL-8 in P. gingivalis-stimulated innate immune cells. The results were confirmed with siRNA and LysM-Cre-mediated SGK1 KO mice. Moreover, SGK1 deletion robustly increased NF-κB activity and c-Jun expression but failed to alter the activation of mitogen-activated protein kinase signaling pathways. Further mechanistic data revealed that SGK1 deletion elevates TRAF2 phosphorylation, leading to TRAF3 degradation in a proteasome-dependent manner. Importantly, siRNA-mediated traf3 silencing or c-Jun overexpression mimics the effect of SGK1 inhibition on P. gingivalis-induced inflammatory cytokines and NF-κB activation. In addition, using a P. gingivalis infection-induced periodontal bone loss model, we found that SGK1 inhibition modulates TRAF3 and c-Jun expression, aggravates inflammatory responses in gingival tissues, and exacerbates alveolar bone loss. Altogether, we demonstrated for the first time that SGK1 acts as a rheostat to limit P. gingivalis-induced inflammatory immune responses and mapped out a novel SGK1-TRAF2/3-c-Jun-NF-κB signaling axis. These findings provide novel insights into the anti-inflammatory molecular mechanisms of SGK1 and suggest novel interventional targets to inflammatory diseases relevant beyond the oral cavity.
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Affiliation(s)
- Xiao Han
- Department of Oral and Craniofacial Molecular Biology, VCU Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Junling Ren
- Department of Oral and Craniofacial Molecular Biology, VCU Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hannah Lohner
- Department of Oral and Craniofacial Molecular Biology, VCU Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Lan Yakoumatos
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
| | - Ruqiang Liang
- Department of Biochemistry and Molecular Medicine, University of California, Davis, Davis, California, USA
| | - Huizhi Wang
- Department of Oral and Craniofacial Molecular Biology, VCU Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, Virginia, USA.
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Walia KD, Belludi SA, Pradhan N, Jain V, Shaik S. Evaluation of Platelet-Rich Fibrin Matrix as a Regenerative Material in the Surgical Management of Human Periodontal Intraosseous Defects - A Randomized Controlled Trial. Contemp Clin Dent 2022; 13:9-17. [PMID: 35466289 PMCID: PMC9030306 DOI: 10.4103/ccd.ccd_832_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/26/2020] [Accepted: 04/03/2021] [Indexed: 11/07/2022] Open
Abstract
Background Platelet-rich fibrin matrix (PRFM) has not been extensively studied as other platelet concentrates such as Choukron's platelet-rich fibrin (PRF). This randomized controlled trial aimed to evaluate PRFM regenerative ability in human periodontal intrabony defects. Materials and Methods Fifteen patients (age: 30-55 years) having probing pocket depth (PPD) ≥6 mm, and radiographic evidence of bilateral vertical intrabony defects were recruited. A split-mouth design was used in each patient; one quadrant of the arch was treated with open flap debridement (OFD) alone (control group) and the other quadrant with OFD + PRFM (test group). The PRFM was prepared by dual-spin technology using a patented thixotropic separator gel. Outcome measures comprising plaque index, gingival index (GI), PPD, clinical attachment level (CAL), depth of the defect, defect fill (DF), and percentage of DF (PDF) were recorded at baseline, after 3 months and 6 months. The parameters were applicably analyzed using the Friedman test, Fisher's exact test, t-test, paired t-test, repeated measures ANOVA, and Post Hoc-Bonferroni correction. Results The GI, a net reduction in CAL, and PPD of the test group were significantly better than the control group at 3 months and 6 months (P < 0.05), while DF and PDF showed significant results at 6 months (P < 0.05). A consistent early wound healing index of 1 at 1 week was displayed in the test group (66.7%) in comparison to the control group (33.7%). Conclusion PRFM can be a clinically significant periodontal regenerative material in the treatment of vertical intraosseous defects.
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Affiliation(s)
| | - Sphoorthi Anup Belludi
- Department of Periodontics, K.L.E Society's Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Neha Pradhan
- Department of Periodontics, K.L.E Society's Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Vipin Jain
- Department of Public Health Dentistry, K.L.E Society's Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Sharaz Shaik
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Han P, Liu T, Vaquette C, Frazer D, Anderson G, Ivanovski S. Iron accumulation is associated with periodontal destruction in a mouse model of HFE-related haemochromatosis. J Periodontal Res 2021; 57:294-304. [PMID: 34855211 DOI: 10.1111/jre.12959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/03/2021] [Accepted: 11/17/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the effect of Hfe gene mutation on the distribution of iron and periodontal bone loss in periodontal tissues. BACKGROUND DATA It remains unclear how tissue iron loading affects the periodontium architectures in a genetic animal model of hereditary haemochromatosis (HH). METHODS Male C57BL/6 Hfe-/- (8 weeks old) and wild-type (WT) mice were utilized to examine the iron distribution in periodontal tissues, as well as periodontal tissues changes using micro-computed tomography and histomorphometric analysis. Furthermore, tissue inflammatory mediators, bone markers and periodontal pathogens were carried out in PFA-fixed paraffin-embedded tissues using ELISA, RT-qPCR and genomic DNA qPCR, respectively. RESULTS Excessive iron deposition was found in the periodontal ligament, gingiva and alveolar bone in Hfe-/- mice relative to their WT counterparts. This, in turn, was associated with significant periodontal bone loss, increased cemento-enamel junction-alveolar bone crest distance and decreased expression of molecules involved in bone development and turnover. Furthermore, the pro-inflammatory cytokine - interleukin 6 and periodontal bacteria - Campylobacter rectus were significantly increased in Hfe-/- mice compared with WT controls. CONCLUSION Our results suggest that the iron loading in a mouse model of HH decreases alveolar bone formation and leads to alterations in the inflammatory state in the periodontium. Periodontal health should be assessed during the clinical assessment of HFE-HH patients.
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Affiliation(s)
- Pingping Han
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Epigenetics Nanodiagnostics and therapeutics Group, The University of Queensland, Herston, QLD, Australia.,School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Tianqing Liu
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Cedryck Vaquette
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - David Frazer
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gregory Anderson
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sašo Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Epigenetics Nanodiagnostics and therapeutics Group, The University of Queensland, Herston, QLD, Australia.,School of Dentistry, The University of Queensland, Herston, QLD, Australia
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Machado V, Proença L, Morgado M, Mendes JJ, Botelho J. Accuracy of Panoramic Radiograph for Diagnosing Periodontitis Comparing to Clinical Examination. J Clin Med 2020; 9:jcm9072313. [PMID: 32708230 PMCID: PMC7408796 DOI: 10.3390/jcm9072313] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
In this study, we explore the diagnostic accuracy of a Radiographic-based Periodontal Bone Loss (R-PBL) method as a screening tool for periodontitis, in the form of radiographic bone loss, under the 2018 case definition in comparison to the 2012 case definition. The analysis was based on 456 patients (253 females and 203 males), screened for periodontal status in the Study of Periodontal Health in Almada-Seixal (SoPHiAS) project and subjected to a panoramic dental X-ray. Patients were diagnosed for the presence of periodontitis following the 2018 and 2012 case definition. R-PBL classification was defined by alveolar bone loss and diagnosed as no periodontitis (≥80% remaining alveolar bone), mild to moderate periodontitis (66% to 79%), or severe periodontitis (<66%). We appraise the X-ray quality to look for the influence on the performance of R-PBL. Sensitivity, specificity, accuracy, and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass Receiver operating characteristic/are under the curve (ROC/AUC) analyses. Our results show that the tested R-PBL method under the 2018 case definition is a reliable tool in periodontitis cases screening. This method does not replace clinical periodontal evaluation, but rather, it screens patients towards a definitive periodontitis diagnosis. These results will contribute to support the development of automated prediction systems towards periodontitis surveillance.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
- Correspondence:
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - Mariana Morgado
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
| | - José João Mendes
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
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Sakir M, Ercalik Yalcinkaya S. Associations between Periapical Health of Maxillary Molars and Mucosal Thickening of Maxillary Sinuses in Cone-beam Computed Tomographic Images: A Retrospective Study. J Endod 2020; 46:397-403. [PMID: 31983459 DOI: 10.1016/j.joen.2019.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/23/2019] [Accepted: 12/12/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION This retrospective study aimed to assess the radiologic characteristics of the possible associations between mucosal thickening of the maxillary sinuses (MSs) and periodontal and anatomic conditions of healthy and diseased maxillary teeth. METHODS The periapical health of the maxillary molars in cone-beam computed tomographic (CBCT) images from 50 patients (mean age = 40.60±14.59 years) was evaluated using the CBCT-periapical index. Anatomic associations between maxillary molars and the inferior wall of the MSs and periodontal bone loss and its relation to MS pathology were assessed. The possible effects of these conditions on mucosal thickening of MSs were analyzed. Kruskal-Wallis, Mann-Whitney U, chi-square, and logistic regression (for relative risk) tests were used for statistical analysis. RESULTS CBCT-periapical index 4 was the most frequently encountered apical periodontitis (AP) lesion. The risk for pathologic changes in the MSs was significantly higher in the presence of AP (P < .001). This risk was 62.364 times greater than that in areas of MSs adjacent to healthy teeth of the same patient (95% confidence interval, 7.968-488.14). Thicker MS mucosae were detected when the molar roots with AP were closer to the MSs (P < .004). No statistically significant difference was found between periodontal status and MS pathology. CONCLUSIONS The findings of this study showed that MSs were affected by the endodontic health of adjacent molar teeth. Dental and medical practitioners should take into consideration the possible odontogenic causes while examining pathologic changes in the MS.
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Affiliation(s)
- Merve Sakir
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey.
| | - Sebnem Ercalik Yalcinkaya
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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11
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Lin HK, Pan YH, Salamanca E, Lin YT, Chang WJ. Prevention of Bone Resorption by HA/β-TCP + Collagen Composite after Tooth Extraction: A Case Series. Int J Environ Res Public Health 2019; 16:E4616. [PMID: 31766327 PMCID: PMC6926561 DOI: 10.3390/ijerph16234616] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/08/2019] [Accepted: 11/17/2019] [Indexed: 01/27/2023]
Abstract
After tooth extraction, alveolar ridge loss due to resorption is almost inevitable. Most of this bone loss occurs during the first six months after the extraction procedure. Many studies have indicated that applying socket-filling biomaterials after extraction can effectively reduce the resorption rate of the alveolar ridge. The purpose of this study was to investigate the clinical efficacy of the application of a hydroxyapatite/β-tricalcium plus collagen (HA/β-TCP + collagen) dental bone graft in dental sockets immediately after tooth extraction, so as to prevent socket resorption. The study was conducted on 57 extraction sockets located in the mandible and maxilla posterior regions in 51 patients. HA/β-TCP + collagen was inserted into all of the dental sockets immediately after extraction, and was covered with a flap. Follow-up was performed for three months after extraction, using radiographs and stents for the vertical and horizontal alveolar ridge measurements. A minimal alveolar bone width reduction of 1.03 ± 2.43 mm (p < 0.05) was observed. The height reduction showed a slight decrease to 0.62 ± 1.46 mm (p < 0.05). Radiographically, the bone height was maintained after three months, indicating a good HA/β-TCP + collagen graft performance in preserving alveolar bone. In conclusion, the HA/β-TCP + collagen graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction.
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Affiliation(s)
- Hsi Kuei Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
- Dental Department, Taipei Medical University, Shuang-Ho hospital, Taipei 235, Taiwan
| | - Yu Hwa Pan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
- Department of General Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- Graduate Institute of Dental & Craniofacial Science, Chang Gung University, Taoyuan 333, Taiwan
| | - Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
| | - Yu Te Lin
- Sunmax Biotech Co. Ltd., Tainan 744, Taiwan;
| | - Wei Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; (H.K.L.); (Y.H.P.); (E.S.)
- Dental Department, Taipei Medical University, Shuang-Ho hospital, Taipei 235, Taiwan
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12
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Wazzan T, Kashtwari D, Almaden WF, Gong Y, Chen Y, Moreb J, Katz J. Radiographic bone loss and the risk of medication-related osteonecrosis of the jaw (MRONJ) in multiple myeloma patients-A retrospective case control study. Spec Care Dentist 2018; 38:356-361. [PMID: 30194738 DOI: 10.1111/scd.12318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 02/06/2023]
Abstract
Risk factors for medication-related osteonecrosis of the jaws (MRONJ) include type and duration of antiresorptive drugs, dental trauma, local anatomy, systemic underlying conditions and therapy, smoking, and the presence of periodontal disease. However, there is a lack of studies elucidating the role of periodontal disease as risk predictor. In the present study, the dental charts of 100 multiple myeloma (MM) patients and 16 MM patients who developed MRONJ were studied. Information about age, gender, smoking history, diabetes, steroid drug intake, type and duration of bisphosphonate (BP) treatments, MRONJ status, missing teeth, periapical lesions, widening of the periodontal ligament, and periodontal status was collected. The periodontal status was determined as a percentage of missing bone at the mesial and distal surfaces of each tooth. Multivariable logistic regression was performed to identify risk factors associated with MRONJ. In the selected model, using the COX analysis, categorical bone loss percentage is significantly associated with MRONJ (P = 0.009), with hazard ratio 0.042 (high vs low) and 95% CI 0.004 to 0.453. Gender, steroid, Aredia BP type, and periapical are also significant in selected model. In conclusion, advanced alveolar bone loss and missing teeth were strongly related to the occurrence of MRONJ in MM patients.
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Affiliation(s)
- Taggreed Wazzan
- Department of Oral Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.,Department of Pharmacotherapy and Translational Research, Gainesville, FL, USA
| | - Deeba Kashtwari
- Department of Oral Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Wejood F Almaden
- Department of Oral Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research, Gainesville, FL, USA
| | - Yiqing Chen
- Department of Pharmacotherapy and Translational Research, Gainesville, FL, USA
| | - Jan Moreb
- Department of Medicine University of Florida College of Medicine, Gainesville, FL, USA
| | - Joseph Katz
- Department of Oral Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
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13
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Wang X, Jia Z, Almoshari Y, Lele SM, Reinhardt RA, Wang D. Local Application of Pyrophosphorylated Simvastatin Prevents Experimental Periodontitis. Pharm Res 2018; 35:164. [PMID: 29943090 PMCID: PMC7424626 DOI: 10.1007/s11095-018-2444-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/08/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Simvastatin (SIM), a HMG-CoA reductase inhibitor widely prescribed for hypercholesterolemia, has been reported to ameliorate inflammation and promote osteogenesis. Its clinical applications on these potential secondary indications, however, have been hampered by its lack of osteotropicity and poor water solubility. To address this challenge, we propose to design and evaluate the therapeutic efficacy of a novel simvastatin prodrug with better water solubility and bone affinity. METHOD The prodrug (SIM-PPi) was synthesized by directly conjugating a SIM trimer to a pyrophosphate (PPi). It was characterized and evaluated in vitro for its water solubility, osteotropicity, toxicity, anti-inflammatory and osteoinductive properties. It was then tested for anti-inflammatory and osteoinductive properties in vivo by three weekly injections into gingiva of a ligature-induced experimental periodontitis rat model. RESULTS In vitro studies showed that SIM-PPi has greatly improved water-solubility of SIM and shows strong binding to hydroxyapatite (HA). In macrophage culture, SIM-PPi inhibited LPS-induced pro-inflammatory cytokines (IL-1β, IL-6). In osteoblast culture, it was found to significantly increase alkaline phosphatase (ALP) activity with accelerated mineral deposition, confirming the osteogenic potential of SIM-PPi. When tested in vivo on an experimental periodontal bone-loss model, SIM-PPi exhibited a superior prophylactic effect compared to dose equivalent SIM in reducing inflammatory cells and in preserving alveolar bone structure, as shown in the histological and micro-CT data. CONCLUSION SIM-PPi may have the potential to be further developed for better clinical management of bone loss associated with periodontitis.
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Affiliation(s)
- Xiaobei Wang
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA
| | - Zhenshan Jia
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA
| | - Yosif Almoshari
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA
- The Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Subodh M Lele
- The Department of Pathology & Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, 6819-3135, USA
| | - Richard A Reinhardt
- The Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, Nebraska, 68583-0740, USA
| | - Dong Wang
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA.
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14
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Ishii T, Ruiz-Torruella M, Ikeda A, Shindo S, Movila A, Mawardi H, Albassam A, Kayal RA, Al-Dharrab AA, Egashira K, Wisitrasameewong W, Yamamoto K, Mira AI, Sueishi K, Han X, Taubman MA, Miyamoto T, Kawai T. OC-STAMP promotes osteoclast fusion for pathogenic bone resorption in periodontitis via up-regulation of permissive fusogen CD9. FASEB J 2018. [PMID: 29533736 DOI: 10.1096/fj.201701424r] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cell fusion-mediated formation of multinuclear osteoclasts (OCs) plays a key role in bone resorption. It is reported that 2 unique OC-specific fusogens [ i.e., OC-stimulatory transmembrane protein (OC-STAMP) and dendritic cell-specific transmembrane protein (DC-STAMP)], and permissive fusogen CD9, are involved in OC fusion. In contrast to DC-STAMP-knockout (KO) mice, which show the osteopetrotic phenotype, OC-STAMP-KO mice show no difference in systemic bone mineral density. Nonetheless, according to the ligature-induced periodontitis model, significantly lower level of bone resorption was found in OC-STAMP-KO mice compared to WT mice. Anti-OC-STAMP-neutralizing mAb down-modulated in vitro: 1) the emergence of large multinuclear tartrate-resistant acid phosphatase-positive cells, 2) pit formation, and 3) mRNA and protein expression of CD9, but not DC-STAMP, in receptor activator of NF-κB ligand (RANKL)-stimulated OC precursor cells (OCps). While anti-DC-STAMP-mAb also down-regulated RANKL-induced osteoclastogenesis in vitro, it had no effect on CD9 expression. In our mouse model, systemic administration of anti-OC-STAMP-mAb suppressed the expression of CD9 mRNA, but not DC-STAMP mRNA, in periodontal tissue, along with diminished alveolar bone loss and reduced emergence of CD9+ OCps and tartrate-resistant acid phosphatase-positive multinuclear OCs. The present study demonstrated that OC-STAMP partners CD9 to promote periodontal bone destruction by up-regulation of fusion during osteoclastogenesis, suggesting that anti-OC-STAMP-mAb may lead to the development of a novel therapeutic regimen for periodontitis.-Ishii, T., Ruiz-Torruella, M., Ikeda, A., Shindo, S., Movila, A., Mawardi, H., Albassam, A., Kayal, R. A., Al-Dharrab, A. A., Egashira, K., Wisitrasameewong, W., Yamamoto, K., Mira, A. I., Sueishi, K., Han, X., Taubman, M. A., Miyamoto, T., Kawai, T. OC-STAMP promotes osteoclast fusion for pathogenic bone resorption in periodontitis via up-regulation of permissive fusogen CD9.
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Affiliation(s)
- Takenobu Ishii
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA.,Orthodontics, Tokyo Dental College, Tokyo, Japan
| | - Montserrat Ruiz-Torruella
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Atsushi Ikeda
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Satoru Shindo
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Alexandru Movila
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Hani Mawardi
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah Albassam
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rayyan A Kayal
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Kenji Egashira
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA.,Research and Development Headquarters, Lion Corporation, Odawara, Japan
| | | | - Kenta Yamamoto
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Abdulghani I Mira
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Xiaozhe Han
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA.,Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Martin A Taubman
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA.,Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Takeshi Miyamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan; and
| | - Toshihisa Kawai
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
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15
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Chan M, Dadul T, Langlais R, Russell D, Ahmad M. Accuracy of extraoral bite-wing radiography in detecting proximal caries and crestal bone loss. J Am Dent Assoc 2017; 149:51-58. [PMID: 29096875 DOI: 10.1016/j.adaj.2017.08.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Extraoral bite-wing (EB) radiography is an imaging technology used in dentistry. The authors conducted an in vivo study comparing the accuracy of intraoral bitewing (IB) radiographs and EB radiographs for proximal caries and bone loss diagnosis. METHODS The authors recruited 116 patients who received IB radiographs to receive EB radiographs. The 5 calibrated authors made a consensus radiographic diagnosis of proximal caries and crestal bone loss. For this study, they assumed IB radiographs as the criterion standard. Next, they obtained EB radiographs for the 116 patients and calculated sensitivity, specificity, and false-positive rates against each patient's IB radiograph. RESULTS The patients' EB radiographs revealed a significantly greater number of caries and crestal bone loss findings compared with their IB radiographs. The EB radiographs had a high to excellent sensitivity and moderate to low specificity of caries and crestal bone loss findings, respectively. Considering IB radiographs to be the criterion standard, the false-positive rate for EB radiographs was moderate for caries and high for bone loss diagnosis. CONCLUSIONS The EB radiographs, which generate fewer images of overlapping proximal surfaces, have the advantage of detecting more carious lesions and bone loss findings than the IB radiographs do, but with the disadvantage of more false-positive diagnoses. Further research is needed to evaluate if the false-positive findings represent true carious lesions and bone loss. PRACTICAL IMPLICATIONS EB radiography is a promising technology, which has several advantages over traditional IB radiography. Clinicians should be aware of false-positive diagnosis of caries and bone loss with EB radiography.
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16
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Haas LF, Zimmermann GS, De Luca Canto G, Flores-Mir C, Corrêa M. Precision of cone beam CT to assess periodontal bone defects: a systematic review and meta-analysis. Dentomaxillofac Radiol 2017; 47:20170084. [PMID: 28869397 DOI: 10.1259/dmfr.20170084] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard (in situ measurement). METHODS Studies in which the main objective was to evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard were selected. Four databases were searched. The studies were selected by two independent reviewers. The methodology of selected studies was assessed using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. The quality of evidence and strength of recommendation was assessed by The Grading of Recommendations Assessment Tool, Development and Evaluation. RESULTS Using a selection process in two phases, 16 studies were identified and, in seven articles meta-analysis was performed. The results from these meta-analyses showed that no difference between the measurements of CBCT and in situ for alveolar bone loss, and demonstrated a concordance of 82.82% between CBCT and in situ for the classification of the degree of furcation involvement. CONCLUSIONS Based on a moderate level of evidence, CBCT could be useful for furcation involvement periodontal cases, but it should only be used in cases where clinical evaluation and conventional radiographic imaging do not provide the information necessary for an adequate diagnosis and proper periodontal treatment planning.
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Affiliation(s)
- Letícia Fernanda Haas
- 1 Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - G De Luca Canto
- 2 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil.,3 Department of Dentistry, Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada
| | - Carlos Flores-Mir
- 3 Department of Dentistry, Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada
| | - Márcio Corrêa
- 2 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
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17
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Saberi BV, Nemati S, Malekzadeh M, Javanmard A. Assessment of digital panoramic radiography's diagnostic value in angular bony lesions with 5 mm or deeper pocket depth in mandibular molars. Dent Res J (Isfahan) 2017; 14:32-36. [PMID: 28348615 PMCID: PMC5356386 DOI: 10.4103/1735-3327.201133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Assessment of alveolar bone level in periodontitis is very important in determining prognosis and treatment plan. Panoramic radiography is a diagnostic tool used to screen patients. The aim of the present study was to assess the diagnostic value of digital panoramic radiography in angular bony defects with 5 mm or deeper pocket depth in mandibular molars. MATERIALS AND METHODS In this cross-sectional study, ninety angular bony defects in mandibular molars teeth with 5 mm or deeper pocket depth were selected in sixty patients with the diagnosis of chronic periodontitis. Before surgery, bone probing was performed. During the surgery, the vertical distance from cementoenamel junction to the most apical part of bony defect was measured using a Williams probe and this measurements were employed as gold standard. This distance was measured on the panoramic radiographs by a Digital Calliper and Digital Ruler. All data were compare dusing independent samples t-test and Pearson's correlation coefficient. RESULTS No significant difference was found between the results of bone probing and intra-surgical measurements (P = 0.377). The mean defect depth determined by Digital Caliper and Digital Ruler on panoramic radiographs was significantly less than surgical measurements (P < 0.001). The correlation between bone probing and surgical measurements in determining the defect depth was strong (r = 0.98, P < 0.001). Radiographic measurements made by Digital Ruler (r = 0.86), comparing to Digital Caliper (r = 0.79), showed a higher degree of correlation with surgical measurements. CONCLUSION Based on this study, bone probing is a reliable method in vertical alveolar bone defect measurements. While the information obtained from digital panoramic radiographs should be used with caution and the ability of digital panoramic radiography in the determination of defect depth is limited.
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Affiliation(s)
| | - Somayeh Nemati
- Department of Radiology, Guilan University of Medical Sciences, Rasht, Iran
| | - Meisam Malekzadeh
- Department of Periodontology and Dental Sciences Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Afrooz Javanmard
- Department of General Practitioner, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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18
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Ge J, Yang C, Zheng J, Hu Y. Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction: A randomized controlled trial. Clin Implant Dent Relat Res 2016; 19:572-580. [PMID: 27933720 DOI: 10.1111/cid.12466] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 09/17/2016] [Accepted: 10/06/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Extraction of impacted mandibular third molar (M3) has been cited as causing osseous defect at the distal aspect of the adjacent second molar (M2). PURPOSE This randomized controlled trial was aimed to evaluate the effect of autogenous bone grafting in situ for regeneration of periodontal osseous defect distal to the M2 compared with non-grafting after impacted M3 removal. MATERIALS AND METHODS A total of 60 sites in 51 adult patients were enrolled and randomly assigned to the control group or the test group. In both groups, the M3 was extracted using a piezosurgical device, and the distal root surface of M2 was scaled and root planned. In addition, the removed alveolar bone was grinded to particles and grafted to the distal osseous defect of M2 in the test group. The primary outcome variable was the osseous defect depth (ODD), the secondary outcome variables were probing pocket depth (PD) and clinical attachment level (CAL) on the disto-buccal aspect of the M2 during a 12-month follow-up period. Postoperative symptom at 7-day postoperatively and adverse events were also recorded and analyzed. RESULTS The patient characteristics were homogeneous between the 2 groups. Six and 12 months after surgery, there were statistically significant bone fill in both groups (P < .01). Moreover, the ODD and CAL in the test group were significantly lower than the control group at every postoperative re-entry (P < .01). The postoperative symptom was more severe in the test group than the control group, but the difference was not significant (P > .05). CONCLUSIONS The result of this study demonstrated that scaling and root planning was beneficial to periodontal healing of M2 after impacted M3 extraction. Addition of autogenous bone grafting for the treatment of osseous defects distal to M2 was safe and more effective than periodontal treatment alone. (Registry Number: ChiCTR-IOC-15006561).
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Affiliation(s)
- Jing Ge
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical; Shanghai Key Laboratory of Stomatology, Shanghai, PRC
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical; Shanghai Key Laboratory of Stomatology, Shanghai, PRC
| | - Jiawei Zheng
- Department of Oral-maxillofacial Head and Neck Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical; Shanghai Key Laboratory of Stomatology, Shanghai, PRC
| | - Yingkai Hu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical; Shanghai Key Laboratory of Stomatology, Shanghai, PRC
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19
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Martande SS, Kumari M, Pradeep AR, Singh SP, Suke DK, Guruprasad CN. Platelet-Rich Fibrin Combined With 1.2% Atorvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol 2016; 87:1039-46. [PMID: 27294433 DOI: 10.1902/jop.2016.150306] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF), a second-generation platelet concentrate, and atorvastatin (ATV), a potent member of the statin group, are known to promote tissue regeneration. The current study is designed to evaluate combined efficacy of PRF and 1.2% ATV gel with open flap debridement (OFD) in treatment of intrabony defects (IBDs) in individuals with chronic periodontitis (CP). METHODS Ninety-six individuals with single defects were categorized into three groups: 1) OFD with PRF; 2) OFD with PRF + 1.2% ATV; and 3) OFD alone. Clinical parameters: 1) site-specific plaque index; 2) modified sulcus bleeding index; 3) probing depth (PD); 4) relative clinical attachment level (rCAL); and 5) gingival marginal level were recorded at baseline before surgery and 9 months postoperatively. Percentage radiographic IBD depth reduction was evaluated at baseline and 9 months. RESULTS PRF + 1.2% ATV and PRF alone showed significantly greater PD reduction and rCAL gain compared with OFD alone at 9 months. Furthermore, PRF + 1.2% ATV showed a similar percentage radiographic defect depth reduction (50.96% ± 4.88%) compared with PRF alone (47.91% ± 4.79%), and a greater reduction compared with OFD alone (5.54% ± 1.71%) at 9 months. CONCLUSIONS PRF + 1.2% ATV showed similar improvements in clinical parameters with a greater percentage radiographic defect depth reduction compared with PRF alone in treatment of IBDs in individuals with CP. Thus, 1.2% ATV failed to augment the regenerative potential of PRF alone in periodontal IBDs.
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Affiliation(s)
- Santosh S Martande
- Department of Periodontics, Dr. D.Y. Patil Dental College and Hospital, Pimpri, Pune, Maharashtra, India
| | - Minal Kumari
- Department of Periodontics, Vydehi Institute of Dental Sciences and Research Center, Bangalore, India
| | - A R Pradeep
- Department of Periodontics, Government Dental College & Research Institute, Bangalore, India
| | - Sonender Pal Singh
- Department of Periodontics, Government Dental College & Research Institute, Bangalore, India
| | - Deepak Kumar Suke
- Department of Periodontics, Government Dental College & Research Institute, Bangalore, India
| | - C N Guruprasad
- Department of Periodontics, Government Dental College & Research Institute, Bangalore, India
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20
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Mahajan A, Kedige S. Periodontal bone regeneration in intrabony defects using osteoconductive bone graft versus combination of osteoconductive and osteostimulative bone graft: A comparative study. Dent Res J (Isfahan) 2015; 12:25-30. [PMID: 25709671 PMCID: PMC4336968 DOI: 10.4103/1735-3327.150307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Bone loss is one of the hallmarks of periodontitis. Hence, a major focus of research into periodontal regeneration has concentrated on the initiation of Osteogenesis. Osteoinduction requires the differentiation of mesenchymal cells into osteoblasts with subsequent formation of new bone. The present study has been carried out to evaluate periodontal bone regeneration in intrabony defects using osteostimulative oleaginous calcium hydroxide suspension Osteora(®) (Metacura, Germany) in combination with osteoconductive bone graft Ossifi™ (Equinox Medical Technologies, Holland). MATERIALS AND METHODS A total of 22 sites in patients within the age range of 25-50 years, with intrabony defects were selected and divided into two groups (Group A and Group B) by using the split-mouth design technique. All the selected sites were assessed with the clinical parameters such as - Plaque Index, Gingival Index, Sulcus Bleeding Index, Periodontal Probing Depth, Clinical Attachment Level, Gingival Recession and radiographic parameter to assess the amount of Defect Fill. Mann-Whitey U-test and Wilcoxon Signed Rank Test has been used to find the significance of study parameters on continuous scale for the comparison between the mesial and distal bone levels. P < 0.05 was considered to be statistically significant. RESULTS Osteora(®) in combination with osteoconductive Ossifi™ showed better regenerative potential and more significant amount of bone fill in periodontal intrabony defects than when Ossifi™ was used alone (P = 0.039). CONCLUSION Osteora(®) can be used as an adjunct to osteoconductive bone grafts, as an osteo-stimulating agent in the treatment of periodontal intrabony defects.
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Affiliation(s)
- Anushi Mahajan
- Department of Periodontology and Oral Implantology, Christian Dental College, Ludhiana, Punjab, India
| | - Suresh Kedige
- Department of Periodontology and Oral Implantology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
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21
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Sam G, Shivashankar VY. Management of a pathologically migrated upper anterior tooth using platelet-rich fibrin and a modified crown preparation technique. J Indian Soc Periodontol 2015; 18:786-8. [PMID: 25624639 PMCID: PMC4296467 DOI: 10.4103/0972-124x.147439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/13/2014] [Indexed: 11/21/2022] Open
Abstract
In adult periodontal patients, pathologic tooth migration can create serious functional and aesthetic problems. In such situations, a combined orthodontic and periodontal treatment is often indicated. However, the lengthy treatment time and the demanding nature of orthodontic therapy for such periodontally compromised teeth is often a challenge. In this case report, an approach combining platelet-rich fibrin for the treatment of osseous defect and a modified crown preparation technique to reposition the crown was done on a pathologically migrated right lateral incisor.
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Affiliation(s)
- George Sam
- Department of Periodontics, Government Dental College, Kottayam, India
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Kumar A, Chandra RV, Reddy AA, Reddy BH, Reddy C, Naveen A. Evaluation of clinical, antiinflammatory and antiinfective properties of amniotic membrane used for guided tissue regeneration: A randomized controlled trial. Dent Res J (Isfahan) 2015; 12:127-35. [PMID: 25878677 PMCID: PMC4387624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the antiinflammatory, antiinfective and clinical properties of amniotic membrane (AM) when used for guided tissue regeneration (GTR) in contained interdental defects. MATERIALS AND METHODS A total of 30 subjects participated in this study. Two sites in each subject were randomly assigned into each of the following experimental groups; test group: AM with bone graft and control group: Bone graft only. Clinical parameters included recording site-specific measures of plaque, gingivitis, probing pocket depth (PPD), and clinical attachment loss (CAL). The levels of interleukin-1β (IL-1β) and human beta-defensin-2 (hBD-2) levels in gingival crevicular fluid (GCF) from the test and control sites were measured by using commercially available enzyme linked immunosorbent assay kits. The evaluation of bone fill was performed by using digital subtraction technique and morphometric area analysis. One-way analysis of variance followed by the post-hoc test was used for intragroup and intergroup comparison. A P < 0.05 was considered as statistically significant. RESULTS Combination therapy using an AM increased bone fill and reduced PPD and CAL when compared to controls. AM also resulted in a significant reduction of GCF IL-1β levels and insignificant increase in the hBD-2 levels. CONCLUSION From this trial conducted over a period of 24 weeks, AM demonstrated a marked antiinflammatory effect and its use resulted in an improvement in periodontal parameters. AM has the potential to function as a barrier for GTR and the unique properties associated with this material can augment its potential as a matrix for periodontal regeneration.
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Affiliation(s)
- Aravind Kumar
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India
| | - Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India,Address for correspondence: Dr. Rampalli Viswa Chandra, Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India. E-mail:
| | - Aileni Amarender Reddy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India
| | - Bavigadda Harish Reddy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India
| | - Chakravarthy Reddy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India
| | - Anumala Naveen
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India
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Nagahara T, Yoshimatsu S, Shiba H, Kawaguchi H, Takeda K, Iwata T, Mizuno N, Fujita T, Kurihara H. Introduction of a mixture of β-tricalcium phosphate into a complex of bone marrow mesenchymal stem cells and type I collagen can augment the volume of alveolar bone without impairing cementum regeneration. J Periodontol 2014; 86:456-64. [PMID: 25494830 DOI: 10.1902/jop.2014.140384] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study is to evaluate whether β-tricalcium phosphate (β-TCP) could be a promising modality to help augment alveolar bone in periodontal tissue regeneration by bone marrow mesenchymal stem cells (BMMSCs). METHODS Expanded BMMSCs and atelocollagen (Col) were mixed together (MSC/Col). A combination of β-TCP with MSC/Col was also prepared (MSC/Col/TCP). MSC/Col/TCP or MSC/Col was transplanted into experimental periodontal Class III furcation defects that had been exposed to inflammation in beagle dogs. Periodontal tissue regeneration was evaluated by histologic and morphometric analyses at 4 and 8 weeks after transplantation. RESULTS MSC/Col and MSC/Col/TCP enhanced periodontal tissue regeneration compared to Col and TCP/Col according to hematoxylin and eosin staining. The percentage of new cementum length in the MSC/Col/TCP group was not significantly different from that in the MSC/Col group at 4 and 8 weeks. On the other hand, the percentage of new bone area in the MSC/Col/TCP group was much higher than that in the MSC/TCP group at 4 weeks. However, at 8 weeks, no significant difference in new bone area was found between the two groups. In the MSC/Col/TCP group, β-TCP was surrounded by newly formed bone. Multinucleated cells, which were positive for osteopontin and tartrate-resistant acid phosphatase, were present in the interconnected macropores of β-TCP. CONCLUSION These findings suggest that β-TCP is applicable as a scaffold for BMMSCs transplantation and helps augment alveolar bone without impairing regeneration of cementum.
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Affiliation(s)
- Takayosi Nagahara
- Department of Periodontal Medicine, Applied Life Science, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Abstract
The aim of this systematic review and meta-analysis was to investigate whether there are any effects of diabetes mellitus on implant failure rates, postoperative infections, and marginal bone loss. An electronic search without time or language restrictions was undertaken in March 2014. The present review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligibility criteria included clinical human studies. The search strategy resulted in 14 publications. The I (2) statistic was used to express the percentage of total variation across studies due to heterogeneity. The inverse variance method was used for the random effects model when heterogeneity was detected or for the fixed effects model when heterogeneity was not detected. The estimates of an intervention for dichotomous outcomes were expressed in risk ratio and in mean difference in millimeters for continuous outcomes, both with a 95% confidence interval. There was a statistically significant difference (p = .001; mean difference = 0.20, 95% confidence interval = 0.08, 0.31) between diabetic and non-diabetic patients concerning marginal bone loss, favoring non-diabetic patients. A meta-analysis was not possible for postoperative infections. The difference between the patients (diabetic vs. non-diabetic) did not significantly affect implant failure rates (p = .65), with a risk ratio of 1.07 (95% confidence interval = 0.80, 1.44). Studies are lacking that include both patient types, with larger sample sizes, and that report the outcome data separately for each group. The results of the present meta-analysis should be interpreted with caution because of the presence of uncontrolled confounding factors in the included studies.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - T Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - A Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Mizutani K, Park K, Mima A, Katagiri S, King GL. Obesity-associated Gingival Vascular Inflammation and Insulin Resistance. J Dent Res 2014; 93:596-601. [PMID: 24744283 DOI: 10.1177/0022034514532102] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/26/2014] [Indexed: 11/15/2022] Open
Abstract
Obesity is a risk factor for periodontitis, but the pathogenic mechanism involved is unclear. We studied the effects of insulin in periodontal tissues during the state of obesity-induced insulin resistance. Gingival samples were collected from fatty (ZF) and lean (ZL, control) Zucker rats. Endothelial nitric oxide synthase (eNOS) expression was decreased, and activities of protein kinase C (PKC) α, ß2, δ, and ϵ isoforms were significantly increased in the gingiva from ZF rats compared with those from ZL rats. Expression of oxidative stress markers (mRNA) and the p65 subunit of NF-κB was significantly increased in ZF rats. Immunohistochemistry revealed that NF-κB activation was also increased in the gingival endothelial cells from transgenic mice overexpressing NF-κB-dependent enhanced green fluorescent protein (GFP) and on a high-fat vs. normal chow diet. Analysis of the gingiva showed that insulin-induced phosphorylation of IRS-1, Akt, and eNOS was significantly decreased in ZF rats, but Erk1/2 activation was not affected. General PKC inhibitor and an anti-oxidant normalized the action of insulin on Akt and eNOS activation in the gingiva from ZF rats. This provided the first documentation of obesity-induced insulin resistance in the gingiva. Analysis of our data suggested that PKC activation and oxidative stress may selectively inhibit insulin-induced Akt and eNOS activation, causing endothelial dysfunction and inflammation.
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Affiliation(s)
- K Mizutani
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Park
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - A Mima
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA Department of Nephrology and Hematology, Nara Hospital, Kinki University Faculty of Medicine, Osaka, Japan
| | - S Katagiri
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - G L King
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
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Sheikhi M, Pozve NJ, Khorrami L. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus. Dent Res J (Isfahan) 2014; 11:495-501. [PMID: 25225564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Maxillary sinuses are covered by a 1 mm thick mucous membrane that when this membrane becomes inflamed, the thickness may increase 10-15 times. The common causes of odontogenic sinusitis are dental abscesses and periodontal disease. Computed tomography (CT) is considered the gold standard for sinus diagnosis. Recently, cone beam computed tomography (CBCT) has been introduced for dental and maxillofacial imaging, which has several advantages over traditional CT, including lower radiation dose and chairside process. This study aims to find the association between mucosal thickening (MT) of the sinus and periodontal bone loss (PBL) and pulpoperiapical condition. MATERIALS AND METHODS A total of 180 CBCT images were reviewed. PBL was assessed in six points under each sinus at the mesial and distal sides of the upper second premolar and first and second molars by measuring the distance from the alveolar crest to the point 2 mm under the cemento-enamel junction (CEJ). The MT was assessed at six points in the floor of the sinus precisely over the mentioned points. To assess the possible role of pulpoperiapical condition on the sinus MT, the existing teeth were classified into five groups due to the probable effect of each condition on the pulp and peri-apex. The statistical association between MT of sinus and PBL and pulpoperiapical condition was assessed using SPSS software (SPSS Inc., version 16.0, Chicago, IL, USA) and bivariate correlation and binary linear regression statistical tests (P < 0.05). RESULTS MT was observed in 39.4% of patients (mean = 4.68 ± 5.25 mm). PBL was seen in 33% of the patients (mean = 1.87 ± 1.63 mm). Linear regression test showed that there is an association between both PBL and pulpoperiapical condition and MT, but the effect of PBL was about 4 times stronger. CONCLUSION This study showed that MT of the maxillary sinus was common among patients with PBL and MT of the maxillary sinus was significantly associated with PBL.
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Abstract
Aggressive periodontitis (AgP) is thought to have a faster rate of progression than chronic periodontitis (CP). However, there is a lack of studies systematically investigating disease progression and tooth loss in AgP. A systematic search of the literature was conducted by two independent reviewers for longitudinal studies including patients with AgP (previously known as 'periodontosis', 'juvenile' or 'early-onset' periodontitis) indicating measures of disease progression. Ovid MEDLINE(®) and Embase databases were searched for at least 5-year longitudinal human studies in AgP patients. In total, 16 studies were included in the review, from an initial search of 1,601 titles. Heterogeneity was detected for disease definition and clinical data reporting; hence meta-analysis was feasible only for the objective measure 'tooth loss'. The average tooth loss for all AgP cases was 0.09 (95% C.I. = 0.06-0.16) per patient-year. The corresponding values by diagnosis were 0.05, 0.14, and 0.12 tooth loss per patient-year, respectively, for LAgP, GAgP, and un-specified AgP. For studies reporting tooth loss during the 'observational period' (excluding extractions at initial therapy), the average tooth loss for AgP was 0.09 per patient-year. High heterogeneity was detected for these analyses. In conclusion, most studies report good long-term stability of treated AgP cases.
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Affiliation(s)
- L Nibali
- Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK
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28
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Bashutski JD, Kinney JS, Benavides E, Maitra S, Braun TM, Giannobile WV, McCauley LK, Eber RM. Systemic Teriparatide Administration Promotes Osseous Regeneration of an Intrabony Defect: A Case Report. Clin Adv Periodontics 2012; 2:66-71. [PMID: 26525954 DOI: 10.1902/cap.2012.110043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 08/15/2011] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Teriparatide comprises the first 34 amino acids of parathyroid hormone and is a systemic anabolic agent that is Food and Drug Administration approved for the treatment of osteoporosis but not for periodontitis. To our knowledge, this is the first clinical case report to document the treatment of a patient with severe periodontitis using an open-flap debridement procedure in conjunction with teriparatide. CASE PRESENTATION A 45-year-old female patient was diagnosed with severe chronic periodontitis, including the presence of an intrabony defect on tooth #6. She received open-flap debridement surgery in conjunction with daily systemic administration of 20 μg teriparatide, oral vitamin D, and calcium supplements for 6 weeks. Radiographic, clinical, gingival crevicular fluid (pyridinoline cross-linked carboxy-terminal propeptide of type I procollagen, procollagen type 1 N-propeptide, and osteocalcin), and serum parameters (parathyroid hormone, bone alkaline phosphatase, calcium, and 25-hydroxyvitamin D) were assessed. Treatment outcomes were evaluated over 4 years, with successful radiographic and clinical results throughout the follow-up period. CONCLUSION Teriparatide administration in conjunction with traditional open-flap debridement surgery offers potential for the treatment of severe intrabony defects resulting from chronic periodontitis.
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Affiliation(s)
- Jill D Bashutski
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Janet S Kinney
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Samopriyo Maitra
- Department of Biostatistics, School of Public Health, University of Michigan
| | - Thomas M Braun
- Department of Biostatistics, School of Public Health, University of Michigan
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.,Biomedical Engineering, College of Engineering, University of Michigan
| | - Laurie K McCauley
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.,Department of Pathology, Medical School, University of Michigan
| | - Robert M Eber
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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Tihanyi D, Gera I, Eickholz P. Influence of individual brightness and contrast adjustment on accuracy of radiographic measurements of infrabony defects. Dentomaxillofac Radiol 2011; 40:177-83. [PMID: 21346085 PMCID: PMC3611457 DOI: 10.1259/dmfr/56018062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 02/19/2010] [Accepted: 02/19/2010] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess the accuracy of radiographic measurements of infrabony defects and to compare the accuracy with and without individual digital adjustment of brightness and contrast. METHODS In 41 periodontitis patients (19 females, 22 males; age range 23-73 years), 50 radiographs of 50 infrabony defects were obtained. All radiographs were digitized. Using a personal computer program, the linear distances between cemento-enamel junction (CEJ) and alveolar crest (AC) and between CEJ and bony defect (BD), and the depth of the infrabony defect (INFRA), were measured twice, according to the individual judgement of the radiographic examiner: (1) without digital adjustment (W) and (2) after use of contrast and brightness adjustment (A). Intrasurgical bone measurements served as the gold standard. The accuracy of measurements with or without digital adjustment was compared. RESULTS Radiographic measurements underestimated the gold standard for CEJ-BD (W: 1.1 mm ± 1.8 mm, P < 0.001; A: 1.0 mm ± 1.9 mm, P = 0.001). Both CEJ-AC (W: 0.2 mm ± 2.5 mm; A: 0.5 mm ± 2.6 mm) and INFRA (W: -0.4 mm ± 2.4 mm; A: -0.6 mm ± 2.5 mm) measurements came close to the gold standard. Statistically significant differences between W and A regarding accuracy were not observed. CONCLUSIONS The measurement tool used in this study provided high-accuracy measurements of periodontal bone loss in INFRA. Individual brightness and contrast adjustment failed to improve accuracy.
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Affiliation(s)
- D Tihanyi
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - I Gera
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - P Eickholz
- Department of Periodontology, Centre for Dental, Oral and Maxillofacial Medicine (Carolinum), Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
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