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Hasan F, Magan-Fernandez A, Akcalı A, Sun C, Donos N, Nibali L. Tooth loss during supportive periodontal care: A prospective study. J Clin Periodontol 2024; 51:583-595. [PMID: 38409875 DOI: 10.1111/jcpe.13943] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 12/07/2023] [Accepted: 12/23/2023] [Indexed: 02/28/2024]
Abstract
AIM To assess periodontal stability and the association between tooth- and patient-related factors and tooth loss during supportive periodontal care (SPC). MATERIALS AND METHODS A prospective observational study was carried out on previously treated periodontitis patients followed up for 5 years in SPC. The risk profile (low, moderate, high) of each patient based on periodontal risk assessment (PRA) scoring at baseline was evaluated, and tooth loss rates were analysed. RESULTS Two hundred patients were included in the study, and 143 had 5-year follow-up data available for analysis. The overall annual tooth loss per patient was 0.07 ± 0.14 teeth/patient/year. Older age, smoking, staging and grading were associated with increased tooth loss rates. Most patients whose teeth were extracted belonged to the PRA high-risk group. Both PRA and a tooth prognosis system used at baseline showed high negative predictive value but low positive predictive value for tooth loss during SPC. CONCLUSIONS Overall, the tooth loss rate of periodontitis patients in this prospective cohort study under SPC in private practice was low. Both tooth-based and patient-based prognostic systems can identify high-risk cases, but their positive predictive value should be improved.
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Affiliation(s)
- Fatemah Hasan
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Antonio Magan-Fernandez
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
- Periodontology Unit, Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - Aliye Akcalı
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, İzmir, Turkey
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London, School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Chuanming Sun
- Department of Periodontology, Faculty of Dentistry, Suzhou Health College, Suzhou, China
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London, School of Medicine and Dentistry, Queen Mary University of 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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West N, Chapple I, Culshaw S, Donos N, Needleman I, Suvan J, Nibali L, Patel A, Preshaw PM, Kebschull M. BSP Implementation of Prevention and Treatment of Peri-implant Diseases - The EFP S3 Level Clinical Practice Guideline. J Dent 2024:104980. [PMID: 38697506 DOI: 10.1016/j.jdent.2024.104980] [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: 03/11/2024] [Accepted: 03/28/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES to adapt the supranational European Federation of Periodontology (EFP) Prevention and Treatment of Peri-implant Diseases - The EFP S3 Level Clinical Practice Guideline for UK healthcare environment, taking into account a broad range of views from stakeholders and patients. SOURCES This UK version, based on the supranational EFP guideline [1] published in the Journal of Clinical Periodontology, was developed using S3-level methodology, combining assessment of formal evidence from 13 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 55 clinical recommendations for the Prevention and Treatment of Peri-implant Diseases, based on the classification for periodontal and peri-implant diseases and conditions [2]. METHODOLOGY The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework, following the S3-process, the underlying evidence was updated and a representative guideline group of 111 delegates from 26 stakeholder organisations was assembled into four working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly. RESULTS AND CONCLUSION Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline for the Prevention and Treatment of Peri-implant Diseases was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the UK healthcare community including the public. CLINICAL SIGNIFICANCE The S3-level-guidelines combine evaluation of formal evidence, grading of recommendations and synthesis with clinical expertise of a broad range of stakeholders. The international S3-level-guideline was implemented for direct clinical applicability in the UK healthcare system, facilitating a consistent, interdisciplinary, evidence-based approach with public involvement for the prevention and treatment of peri-implant diseases.
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Affiliation(s)
- Nicola West
- Restorative Dentistry, Bristol Dental School, University of Bristol, Bristol BS1 2LY, UK; Restorative Dentistry, Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Marlborough Street, Bristol, BS1 3NU, Secretary General of the European Federation of Periodontology.
| | - Iain Chapple
- Birmingham NIHR Biomedical Research Centre in Inflammation. The University of Birmingham, Birmingham, United Kingdom; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, United Kingdom
| | - Shauna Culshaw
- University of Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (AMUL), Turner Street, London, E1 2AD
| | - Ian Needleman
- Unit of Periodontology, UCL Eastman Dental Institute, Bloomsbury Campus, Rockefeller Building, 21 University Street, London, WC1E 6DE
| | - Jeanie Suvan
- Unit of Periodontology, UCL Eastman Dental Institute, Bloomsbury Campus, Rockefeller Building, 21 University Street, London, WC1E 6DE
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guys Hospital, Great Maze Pond, London, SE1 9RT
| | - Amit Patel
- Birmingham Dental Specialists, Associate Professor, University of Birmingham, Birmingham, UK, President of the Association of Dental Implantology
| | - Philip M Preshaw
- School of Dentistry, University of Dundee, Dundee UK; School of Dental Sciences, University of Newcastle, Newcastle upon Tyne, UK
| | - Moritz Kebschull
- Birmingham NIHR Biomedical Research Centre in Inflammation. The University of Birmingham, Birmingham, United Kingdom; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, United Kingdom; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA; School of Dentistry, University of Birmingham, Birmingham B5 7EG, UK, President-Elect of the European Federation of Periodontology.
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Valentini P, Calciolari E, Monlezun S, Akcalı A, Donos N, Quirynen M. APCs in sinus floor augmentation. Periodontol 2000 2024. [PMID: 38363055 DOI: 10.1111/prd.12554] [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: 09/23/2023] [Revised: 12/18/2023] [Accepted: 01/21/2024] [Indexed: 02/17/2024]
Abstract
After tooth loss in the posterior area of the maxilla, sinus floor elevation is often required to compensate the vertical bone loss due to sinus pneumatization. This narrative review reports on the potential benefits of autologous platelet concentrates (APCs) during this procedure. As for transcrestal approach, APCs have been used as "sole" substitute/graft. However, because of the low number of clinical trials available with PRGF, and even none for PRP, no definitive conclusions can be made regarding their efficacy. The number of studies on the use of L-PRF were outnumbered indicating good feasibility for vertical bone gain, with a high implant survival rate and a low degree of complications. PRP and PRGF have not been studied as a "single/sole" substitute for a one-stage lateral window approach, probably because of the weak physical characteristics of the membranes. L-PRF alone appears to be a predictable grafting material for lateral maxillary sinus grafting and a reduced RBH should not be considered as a risk factor. Compared to a "standard" bone substitute L-PRF shows slightly less vertical bone gain (consider enough membrane application and use of bony window as new sinus floor roof over the implant apices), enhanced early resorption (first 6 months after application), but a similar stable bone gain afterward. For a two-stage lateral window approach, APCs "alone" cannot be recommended, due to their weak withstand to the sinus pneumatization forces. APCs combined with bone substitutes seem to accelerate bone formation, without any additional benefits on the long-term new bone gain. The use of L-PRF membranes for the treatment of perforations appears to be an effective treatment option, but further clinical studies are needed to confirm this. Even though the abovementioned statements are based on large numbers of studies, additional RCTs comparing APCs with different types of grafting procedures for sinus elevation are needed.
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Affiliation(s)
- Pascal Valentini
- Department of Implant Surgery Tattone Hospital, University of Corsica Pasquale Paoli, Institute of Health, Corte, France
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
- Dental school, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sebastien Monlezun
- Department of Implant Surgery Tattone Hospital, University of Corsica Pasquale Paoli, Institute of Health, Corte, France
| | - Aliye Akcalı
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
- Department of Periodontology, Dental Faculty, University of Dokuz Eylul, Izmir, Turkey
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
| | - Marc Quirynen
- Department of Oral Health Sciences, Katholieke Universiteit Leuven & University Hospitals Leuven, (section Periodontology), Leuven, Belgium
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Padhye NM, Calciolari E, Zuercher AN, Tagliaferri S, Donos N. Survival and success of zirconia compared with titanium implants: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:6279-6290. [PMID: 37740825 PMCID: PMC10630218 DOI: 10.1007/s00784-023-05242-5] [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: 11/11/2022] [Accepted: 09/05/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic and clinical parameters, as well as biological and mechanical complications, were considered. MATERIALS AND METHODS A systematic search was performed up to March 2022 to identify CCTs/RCTs comparing zirconia and titanium implants with a minimum of 12 months of follow-up. Meta-analysis was performed when ≥ 2 articles with similar characteristics were retrieved. RESULTS Four published articles with two RCTs (2 different patient populations) with 100 zirconia and 99 titanium implants that were followed up over 12-80 months were selected out of the 6040 articles. A non-statistically significant difference between zirconia and titanium implant survival at 12 months was suggested (P = 0.0938). The success rates were 57.5-93.3% and 57.1-100% for zirconia and titanium implants, respectively. The pink aesthetic score (PES) was higher for zirconia (10.33 ± 2.06 to 11.38 ± 0.92) compared to titanium implants (8.14 ± 3.58 to 11.56 ± 1.0). CONCLUSION Based on the 2 RCTs retrieved in the literature, similar survival rates were reported for zirconia and titanium implants in the short term (12 months of follow-up). Future RCTs are warranted to evaluate the long-term outcomes of zirconia implants. CLINICAL RELEVANCE Zirconia implants may be the procedure of choice, particularly in the aesthetic zone, since they show a similar survival and success rate as titanium implants on a short-term follow-up. TRIAL REGISTRATION Systematic review registration number-CRD42021288704 (PROSPERO).
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Affiliation(s)
- Ninad Milind Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Department of Medicine and Surgery, Centre of Dentistry, University of Parma, Parma, Italy
| | - Anina Nives Zuercher
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Clinic of Reconstructive Dentistry, Centre of Dental Medicine, Zurich, Switzerland
| | - Sara Tagliaferri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Center of Excellence for Toxicological Research, CERT, University of Parma, Parma, Italy
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.
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Krajewski A, Perussolo J, Gkranias N, Donos N. Influence of periodontal surgery on the subgingival microbiome-A systematic review and meta-analysis. J Periodontal Res 2023; 58:308-324. [PMID: 36597817 DOI: 10.1111/jre.13092] [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: 06/20/2022] [Revised: 10/10/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to evaluate the effect of periodontal surgery on the subgingival microbiome. BACKGROUND Periodontitis is a chronic inflammation of the tooth supporting tissues caused by the dysbiosis of the subgingival biofilm. It is managed through different non-surgical and surgical treatment modalities. Recent EFP S3 guidelines recommended performing periodontal surgery as part of Step 3 periodontitis treatment after Step 1 and Step 2 periodontal therapy, with the aim to achieve pocket closure of persisting sites. Changes in the sub-gingival microbiome may explain the treatment outcomes observed at different time points. Various microbiological detection techniques for disease-associated pathogens have been evolved over time and have been described in the literature. However, the impact of different types of periodontal surgery on the subgingival microbiome remains unclear. METHODS A systematic literature search was conducted in Medline, Embase, LILACS and Cochrane Library supplemented by manual search (23DEC2019, updated 21APR2022). RESULTS From an initial search of 3046 studies, 28 were included according to our specific inclusion criteria. Seven microbiological detection techniques were used to analyse disease-associated species in subgingival plaque samples: optical microscope, culture, polymerase chain reaction (PCR), checkerboard, enzymatic reactions, immunofluorescence and 16S gene sequencing. The included studies exhibited differences in various aspects of their methodologies such as subgingival plaque sample collection or treatment modalities. Clinical data showed a significant decrease in probing pocket depths (PPD) and clinical attachment loss (CAL) after periodontal surgery. Microbiological findings were overall heterogeneous. Meta-analysis was performed on a sub-cohort of studies all using checkerboard as a microbiological detection technique. Random effect models for Treponema denticola (T. denticola), Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia (T. forsythia) did not show a significant effect on mean counts 3 months after periodontal surgery. Notably, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) showed a significant increase 3 months after periodontal surgery. 16S gene sequencing was used in one included study and reported a decrease in disease-associated species with an increase in health-associated species after periodontal surgery at 3 and 6 months. CONCLUSION This systematic review has shown that the effect of periodontal surgery on the changes in subgingival microbiome is heterogeneous and may not always be associated with a decrease in disease-associated species. The variability could be attributed to the microbiological techniques employed for the analysis. Therefore, there is a need for well-designed and adequately powered studies to understand how periodontal surgery influences the subgingival microbiome and how the individual's microbiome affects treatment outcomes after periodontal surgery.
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Affiliation(s)
- Anna Krajewski
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jeniffer Perussolo
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nikolaos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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6
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Donos N, Calciolari E, Ghuman M, Baccini M, Sousa V, Nibali L. The efficacy of bone reconstructive therapies in the management of peri-implantitis. A systematic review and meta-analysis. J Clin Periodontol 2023. [PMID: 36635029 DOI: 10.1111/jcpe.13775] [Citation(s) in RCA: 4] [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] [Received: 08/27/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023]
Abstract
AIM To evaluate the efficacy of bone reconstructive procedures for the reduction of probing pocket depth (PPD), bleeding on probing (BOP), and suppuration in peri-implantitis-related bone defects at ≥12-month follow-up. MATERIALS AND METHODS Three databases were searched for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared bone reconstructive therapies to access flap surgery (AFS) (Focused Question-FQ 1), and RCTs, CCTs, and prospective case series that assessed the efficacy of reconstructive therapies (FQ 2). Meta-analysis was performed for FQ1 when more than three studies were identified, while for FQ2 a network was drawn based on RCTs with common treatment arms. RESULTS Seven RCTs were identified for FQ1 while five RCTs and six prospective case series for FQ2. There was no significant difference in PPD change between AFS and reconstructive surgery (-0.387; p = .325) at 12 months. Furthermore, no clear differences in terms of PPD and BOP changes resulted from the different reconstructive therapies included in the network. Only a small percentage of treated cases with any modality achieved peri-implantitis resolution, as defined by different composite outcomes. CONCLUSIONS Reconstructive surgery does not offer significant improvements in peri-implant clinical parameters as compared to AFS at 12 months. It was not possible to establish a hierarchy of efficacy among the different biomaterials employed for reconstructive surgery.
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Affiliation(s)
- Nikos Donos
- Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Mandeep Ghuman
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
| | - Michela Baccini
- Dipartimento di Statistica, Informatica, Applicazioni 'G. Parenti' (DiSIA), University of Florence, Florence, Italy
| | - Vanessa Sousa
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
| | - Luigi Nibali
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
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Aristodemou E, Retzepi M, Calciolari E, Donos N. The effect of experimental diabetes and membrane occlusiveness on guided bone regeneration: A proof of principle study. Clin Oral Investig 2022; 26:5223-5235. [PMID: 35688955 DOI: 10.1007/s00784-022-04491-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the effect of membrane occlusiveness and experimental diabetes on early and late healing following guided bone regeneration. MATERIAL AND METHODS A total of 30 Wistar rats were randomly allocated to three groups: healthy (H), uncontrolled diabetic (UD) and controlled diabetic (CD). A critical size calvarial defect (CSD) was created at the mid-portion of one parietal bone, and it was treated with a double layer of e-PTFE membrane presenting 0.5 mm perforations. The animals were killed at 7 and 30 days of healing, and qualitative and quantitative histological evaluations were performed. Data were compared with the ones previously obtained from other 30 animals (10H, 10UD, 10 CD), where two CSDs were randomly treated with a double-layer e-PTFE occlusive membrane or left empty. RESULTS Following application of cell occlusive or cell permeable membranes, significant regeneration can be observed. However, at 30 days in the H group occlusive compared to cell permeable membranes promoted enhanced bone regeneration (83.9 ± 7.3% vs. 52.5 ± 8.6%), while no significant differences were observed within the CD and UD groups. UD led to reduced regeneration compared to H when an occlusive barrier was applied, whereas comparable outcomes to H and CD were observed when placing perforated membranes. CONCLUSION The application of cell permeable membranes may have masked the potentially adverse effect of experimental UD on bone regeneration. CLINICAL RELEVANCE Membrane porosity might contribute to modulate the bone regenerative response in UD conditions. Future studies are needed to establish the degree of porosity associated with the best regenerative outcomes as well as the underlying molecular mechanisms.
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Affiliation(s)
| | - M Retzepi
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Dental School, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - N Donos
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.
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Saydzai S, Buontempo Z, Patel P, Hasan F, Sun C, Akcalı A, Lin GH, Donos N, Nibali L. Comparison of the efficacy of periodontal prognostic systems in predicting tooth loss. J Clin Periodontol 2022; 49:740-748. [PMID: 35702014 PMCID: PMC9543611 DOI: 10.1111/jcpe.13672] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 12/14/2022]
Abstract
Aim The aim of this analysis was to assess how different tooth‐prognosis systems could predict tooth loss in a cohort of periodontitis patients followed up prospectively during supportive periodontal care (SPC). Materials and Methods Clinical and radiographic data of 97 patients undergoing regular SPC for 5 years were used to assign tooth prognosis using four different systems (McGuire & Nunn, 1996; Kwok & Caton, 2007; Graetz et al., 2011; Nibali et al., 2017). Three independent examiners assigned tooth prognosis using all four systems, following a calibration exercise. The association between prognostic categories and tooth loss was tested for each prognostic system separately and across prognostic systems. Results All four systems showed good reproducibility and could identify teeth at higher risk of being lost during 5 years of SPC; the risk of tooth loss increased with the worsening of tooth‐prognosis category (p < .0001). Although specificity and negative predictive values were good, low sensitivity and positive predictive values were detected for all systems. Conclusions Previously published periodontal prognostic systems exhibited good reproducibility and predictive ability for tooth retention. However, low sensitivity was detected, with several teeth in the worst prognosis category being retained at 5 years. Some modifications in the number of categories and their definitions are suggested.
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Affiliation(s)
- Selai Saydzai
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King's College London, London, UK
| | - Zoe Buontempo
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King's College London, London, UK
| | - Pankti Patel
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King's College London, London, UK
| | - Fatemah Hasan
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King's College London, London, UK
| | - Chuanming Sun
- Department of Periodontology, Faculty of Dentistry, Suzhou Health College, Suzhou, China
| | - Aliye Akcalı
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey.,Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Guo-Hao Lin
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Nikos Donos
- Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King's College London, London, UK
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Jung RE, Becker K, Bienz SP, Dahlin C, Donos N, Hammächer C, Iglhaut G, Liñares A, Ortiz-Vigón A, Sanchez N, Sanz-Sánchez I, Thoma DS, Valles C, Weng D, Nart J. Effect of peri-implant mucosal thickness on esthetic outcomes and the efficacy of soft tissue augmentation procedures: Consensus report of group 2 of the SEPA/DGI/OF workshop. Clin Oral Implants Res 2022; 33 Suppl 23:100-108. [PMID: 35763020 PMCID: PMC9543632 DOI: 10.1111/clr.13955] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to comprehensively assess the literature in terms of the effect of peri-implant mucosal thickness on esthetic outcomes and the efficacy of soft tissue augmentation procedures to increase the mucosal thickness with autogenous grafts or soft tissue substitutes. MATERIAL AND METHODS Two systematic reviews (SR) were performed prior to the consensus meeting to assess the following questions. Review 1, focused question: In systemically healthy patients with an implant-supported fixed prosthesis, what is the influence of thin as compared to thick peri-implant mucosa on esthetic outcomes? Review 2, focused question 1: In systemically healthy humans with at least one dental implant (immediate or staged implant), what is the efficacy of connective tissue graft (CTG), as compared to absence of a soft tissue grafting procedure, in terms of gain in peri-implant soft tissue thickness (STT) reported by randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs)? Review 2, focused question 2: In systemically healthy humans with at least one dental implant (immediate or staged implant), what is the efficacy of CTG, as compared to soft tissue substitutes, in terms of gain in peri-implant STT reported by RCTs or CCTs? The outcomes of the two SRs, the consensus statements, the clinical implications, and the research recommendations were discussed and subsequently approved at the consensus meeting during the group and plenary sessions. CONCLUSIONS There was a tendency of superior esthetic outcomes in the presence of a thick mucosa. The connective tissue graft remains the standard of care in terms of increasing mucosa thickness.
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Affiliation(s)
- Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Stefan P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christer Dahlin
- Department of Biomaterials, Institute for Surgical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nikos Donos
- Centre for Oral Clinical Research, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | | | - Gerhard Iglhaut
- Department of Oral and Craniomaxillofacial Surgery, Translational Implantology, Center for Dental Medicine, University Medical Center of Freiburg, Freiburg, Germany.,Private Center of Oral Surgery, Memmingen, Germany
| | - Antonio Liñares
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Nerea Sanchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, Madrid, Spain
| | - Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, School of Dentistry, University Complutense, Madrid, Spain
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Dietmar Weng
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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10
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Nibali L, Sousa V, Davrandi M, Liu LS, Spratt D, Donos N. Patterns of subgingival microbiota in different periodontal phenotypes. J Dent 2021; 117:103912. [PMID: 34890714 DOI: 10.1016/j.jdent.2021.103912] [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: 07/05/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To compare the subgingival microbiota of patients with aggressive (AgP) or chronic periodontitis (CP) to healthy (H), non-periodontitis patients as well as to explore their relevant associations to different host genetic variants. METHODS Following clinical examination, blood and subgingival plaque sampling of 471 study participants (125 AgP, 121 CP, 225 H), subgingival community analysis was performed by next generation sequencing of the 16S rRNA. Microbial data from 266 participants (75 AgP, 95 CP, 98 H) were available for analysis. SNPs in the IL6, IL6R and FTO gene were selected for genetic marker analyses. RESULTS Combined periodontitis patients (AgP + CP), particularly those classified with AgP, exhibited lower alpha- and beta- diversity. Several genera (including Peptostreptococcaceae, Filifactor, Desulfobulbus, Tannerella and Lachnospiracee) and species were over-abundant in combined periodontitis vs. healthy individuals, while other genera such as Prevotella or Dialister were found to be more abundant in healthy cases. The only genus with difference in abundance between AgP and CP was Granulicatella. No associations between IL6, IL6RA and FTO genetic variants and microbial findings were detected. CONCLUSION This study suggests that limited microbial differences existed between AgP and CP and challenges the current notion that periodontitis is associated with increased subgingival microbial diversity compared with periodontal health. CLINICAL SIGNIFICANCE The findings of this study cast some doubts on the notion that the dysbiosis characteristic of periodontal disease is expressed as increased microbial diversity.
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Affiliation(s)
- L Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Centre for Oral, London, United Kingdom; Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom.
| | - V Sousa
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Centre for Oral, London, United Kingdom; Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom
| | - M Davrandi
- Microbiology Department, University College London Eastman Dental Institute, London, UK
| | - L S Liu
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
| | - D Spratt
- Microbiology Department, University College London Eastman Dental Institute, London, UK
| | - N Donos
- Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom
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11
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Donos N, Asche NV, Akbar AN, Francisco H, Gonzales O, Gotfredsen K, Haas R, Happe A, Leow N, Navarro JM, Ornekol T, Payer M, Renouard F, Schliephake H. Impact of timing of dental implant placement and loading: Summary and consensus statements of group 1-The 6th EAO Consensus Conference 2021. Clin Oral Implants Res 2021; 32 Suppl 21:85-92. [PMID: 34642977 DOI: 10.1111/clr.13809] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This publication reports on the EAO workshop group 1 summaries, discussions and consensus statements based on four systematic reviews evaluating the impact of timing of dental implant placement and loading. MATERIALS AND METHODS The first of the systematic reviews was on the influence of the timing of implant placement and loading in the biological outcomes of implant-supported fixed partial dentures. The second systematic review evaluated the influence of the timing of implant placement and loading on the aesthetic outcomes in single-tooth implants. The third systematic review was on the long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading and the fourth on patient's perception of timing concepts in implant dentistry. The group evaluated these systematic reviews, provided comments and additions as required and agreed on the relevant consensus statements as well as on clinical and research recommendations. RESULTS Different timings of implant placement/loading presented with high implant survival rates. The systematic reviews evaluated from this working group provided a number of conclusions based on the available/current literature. However, the specific topic of timing is an area that further research is required in order to provide detailed guidelines for the different protocols to be employed.
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Affiliation(s)
- Nikos Donos
- Centre for Oral Clinical Research, Barts and The London, School of Medicine and Dentistry, Queen Mary University of London (QMUL, London, UK
| | - Nele Van Asche
- Centre for Periodontology and Oral Implants, KULeuven, Leuven, Belgium
| | - Aron Naim Akbar
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
| | - Helena Francisco
- Departamento de Cirurgia Oral e Implantologia, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Oscar Gonzales
- Department of Periodontology, Complutense University of Madrid, Madrid, Spain.,Department of Periodontology and Periodontal-Prosthesis, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Klaus Gotfredsen
- Oral Rehabilitation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Robert Haas
- Academy for Oral Implantology, Vienna, Austria
| | - Arndt Happe
- Department of Prosthetic Dentistry, University Ulm Center of Dentistry, Germany and Private Practice, Münster, Germany
| | - Natalie Leow
- Periodontology Unit, UCL-Eastman Dental Institute, London, UK
| | | | - Turker Ornekol
- Cosmodent Center for Dentistry and Dental Implants, Istanbul, Turkey
| | - Michael Payer
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University of Graz, Graz, Austria
| | | | - Henning Schliephake
- Department of Oral & Maxillofacial Surgery, University Medicine-Augusta-University, Göttingen, Germany
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12
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West N, Chapple I, Claydon N, D'Aiuto F, Donos N, Ide M, Needleman I, Kebschull M. BSP implementation of European S3 - level evidence-based treatment guidelines for stage I-III periodontitis in UK clinical practice. J Dent 2021; 106:103562. [PMID: 33573801 DOI: 10.1016/j.jdent.2020.103562] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To adapt the supranational European Federation for Periodontology (EFP) S3-Level Clinical Practice Guideline for treatment of periodontitis (stage I-III) to a UK healthcare environment, taking into account the views of a broad range of stakeholders, and patients. SOURCES This UK version is based on the supranational EFP guideline (Sanz et al., 2020) published in the Journal of Clinical Periodontology. The source guideline was developed using the S3-level methodology, which combined the assessment of formal evidence from 15 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 62 clinical recommendations for the treatment of stage I-III periodontitis, based on a step-wise process mapped to the 2017 classification system. METHODOLOGY The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for the adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework and following the S3-process, the underlying systematic reviews were updated and a representative guideline group of 75 delegates from 17 stakeholder organisations was assembled into three working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly. RESULTS AND CONCLUSION Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the dental community in the UK. CLINICAL SIGNIFICANCE The aim of S3-level guidelines is to combine the evaluation of formal evidence, grading and synthesis with the clinical expertise of a broad range of stakeholders to form clinical recommendations. Herein, the first major international S3-level guideline in dentistry, the EFP guideline, was implemented for direct clinical applicability in the UK healthcare system.
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Affiliation(s)
- Nicola West
- Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Trust, Birmingham, UK.
| | - Nick Claydon
- Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Francesco D'Aiuto
- Periodontology, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Nikos Donos
- Periodontology, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University, Turner Street, London E1 2AD, UK.
| | - Mark Ide
- Periodontology, Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London SE1 9RT, UK.
| | - Ian Needleman
- Periodontology, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Moritz Kebschull
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
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13
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Machtei EE, Romanos G, Kang P, Travan S, Schmidt S, Papathanasiou E, Tatarakis N, Tandlich M, Liberman LH, Horwitz J, Bassir SH, Myneni S, Shiau HJ, Shapira L, Donos N, Papas A, Meyle J, Giannobile WV, Papapanou PN, Kim DM. Repeated delivery of chlorhexidine chips for the treatment of peri-implantitis: A multicenter, randomized, comparative clinical trial. J Periodontol 2020; 92:11-20. [PMID: 33111988 DOI: 10.1002/jper.20-0353] [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: 05/21/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Peri-implantitis is a challenging condition to manage and is frequently treated using non-surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri-implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5 mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri-implantitis. METHODS A multicenter, randomized, single-blind, two-arm, parallel Phase-3 study was conducted. Peri-implantitis patients with implant pocket depths (IPD) of 5-8 mm underwent subgingival implant surface debridement followed by repeated bi-weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12 weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24 weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24 week. RESULTS A total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24 weeks, a significant reduction in IPD (P = 0.01) was measured in the ChxC group (1.76 ± 1.13 mm) compared with the control group (1.54 ± 1.13 mm). IPD reduction of ≥2 mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (P = 0.03). Changes in gingival recession (0.29 ± 0.68 mm versus 0.15 ± 0.55 mm, P = 0.015) and relative attachment gain (1.47 ± 1.32 mm and 1.39 ± 1.27 mm, P = 0.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were < 65 years exhibited significantly better responses (P < 0.02); likewise, non-smokers had similarly better response (P < 0.02). Both protocols were well tolerated, and no severe treatment-related adverse events were recorded throughout the study. CONCLUSIONS Patients with peri-implantitis that were treated with an intensive treatment protocol of bi-weekly supragingival plaque removal and local application of chlorhexidine chips had greater mean IPD reduction and greater percentile of sites with IPD reduction of ≥2 mm as compared with bi-weekly supra-gingival plaque removal.
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Affiliation(s)
- Eli E Machtei
- Department of Periodontology, School of Graduate Dentistry, Faculty of Medicine, Technion (I.I.T.), Rambam health care campus, Haifa, Israel.,Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook, New York, USA
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, USA
| | - Suncica Travan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Stephan Schmidt
- Department of Periodontics, Justus-Liebig University, Giessen & Avadent, Bad Homburg, Germany
| | - Evangelos Papathanasiou
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Nikolaos Tatarakis
- Center for Oral Clinical Research, Barts & The Royal London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Moshik Tandlich
- Department of Periodontology, the Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | | | - Jacob Horwitz
- Department of Periodontology, School of Graduate Dentistry, Faculty of Medicine, Technion (I.I.T.), Rambam health care campus, Haifa, Israel
| | - Seyed Hossein Bassir
- Department of Periodontology, School of Dental Medicine, Stony Brook, New York, USA
| | - Srinivas Myneni
- Department of Periodontology, School of Dental Medicine, Stony Brook, New York, USA
| | - Harlan J Shiau
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Maryland, USA
| | - Lior Shapira
- Department of Periodontology, the Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Nikos Donos
- Center for Oral Clinical Research, Barts & The Royal London School of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Athena Papas
- Division of Oral Medicine, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Joerg Meyle
- Department of Periodontics, Justus-Liebig University, Giessen & Avadent, Bad Homburg, Germany
| | - William V Giannobile
- Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, USA
| | - David M Kim
- Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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14
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Nibali L, Sousa V, Davrandi M, Spratt D, Alyahya Q, Dopico J, Donos N. Differences in the periodontal microbiome of successfully treated and persistent aggressive periodontitis. J Clin Periodontol 2020; 47:980-990. [PMID: 32557763 DOI: 10.1111/jcpe.13330] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 09/16/2019] [Revised: 05/23/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022]
Abstract
AIMS The primary aim of this investigation was to analyse the periodontal microbiome in patients with aggressive periodontitis (AgP) following treatment. METHODS Sixty-six AgP patients were recalled on average 7 years after completion of active periodontal treatment and had subgingival plaque samples collected and processed for 16S rRNA gene sequencing analyses. RESULTS Of 66 participants, 52 showed persistent periodontal disease, while 13 participants were considered as "successfully treated AgP" (no probing pocket depths >4 mm) and 1 was fully edentulous. Genera associated with persistent generalized disease included Actinomyces, Alloprevotella, Capnocytophaga, Filifactor, Fretibacterium, Fusobacterium, Leptotrichia, Mogibacterium, Saccharibacteria [G-1], Selenomonas and Treponema. "Successfully treated" patients harboured higher proportions of Haemophilus, Rothia, and Lautropia and of Corynebacterium, Streptococcus and Peptidiphaga genera. Overall, patients with persistent generalized AgP (GAgP) revealed higher alpha diversity compared to persistent localized AgP (LAgP) and stable patients (p < .001). Beta diversity analyses revealed significant differences only between stable and persistent GAgP groups (p = .004). CONCLUSION Patients with persistent AgP showed a more dysbiotic subgingival biofilm than those who have been successfully treated. It remains to be established whether such differences were predisposing to disease activity or were a result of a dysbiotic change associated with disease recurrence in the presence of sub-standard supportive periodontal therapy or other patient-related factors.
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Affiliation(s)
- Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London, UK
| | - Vanessa Sousa
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London, UK
| | - Mehmet Davrandi
- Microbial Diseases Department, University College London Eastman Dental Institute, London, UK
| | - David Spratt
- Microbial Diseases Department, University College London Eastman Dental Institute, London, UK
| | - Qumasha Alyahya
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
| | - Jose Dopico
- Periodontics Department, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London, UK
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15
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Fuller J, Donos N, Suvan J, Tsakos G, Nibali L. Association of oral health-related quality of life measures with aggressive and chronic periodontitis. J Periodontal Res 2020; 55:574-580. [PMID: 32232983 DOI: 10.1111/jre.12745] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 11/06/2019] [Revised: 02/09/2020] [Accepted: 02/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Evidence suggests that periodontitis has a negative effect on the quality of life of an individual, with increased impacts by greater disease severity. The aim of this study was to assess the association between quality of life and the presence of different severity and forms of periodontitis (aggressive and chronic), compared to a disease-free control group. MATERIALS AND METHODS Four hundred and seventy one study participants were classified according to periodontal diagnosis using the 1999 Consensus Classification into chronic periodontitis (CP), aggressive periodontitis (AgP) and periodontally healthy. Oral health-related quality of life was assessed using the OHIP-14 questionnaire. Outcomes consisted of the prevalence of oral impacts reported occasionally, fairly often or very often (OFOVO) as well as fairly often or very often (FOVO), OHIP-14 total and domain scores. Logistic and linear regression analyses were carried out to test associations between periodontal diagnosis and quality of life outcomes, adjusted for smoking, age, ethnicity and body mass index. RESULTS Over 90% of periodontitis patients reported at least one oral impact experienced occasionally, fairly often or very often (OFOVO) compared with 53.8% of periodontally healthy controls (P < .001). After adjustment for covariates, significant differences were found between the periodontitis groups and healthy controls for OHIP-14 outcome scores (P < .001) and across all of the OHIP-14 domains (P < .005). These differences were clinically meaningful as they were higher than the measurement errors. No significant differences were identified between AgP and CP in adjusted analysis when comparing OHIP-14 scores. CONCLUSION Patients with periodontitis have worse quality of life than periodontally healthy individuals, with differences being clinically meaningful. AgP patients reported worse OHRQoL overall compared to CP patients, but these moderate and meaningful differences were explained through the adjustment process.
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Affiliation(s)
- Jennifer Fuller
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK
| | - Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK
| | - Jeanie Suvan
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
| | - George Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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16
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Suvan J, Harrington Z, Petrie A, Patel K, Darbar U, Donos N, D'Aiuto F. Obesity as predictive factor of periodontal therapy clinical outcomes: A cohort study. J Clin Periodontol 2020; 47:594-601. [DOI: 10.1111/jcpe.13261] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/29/2019] [Accepted: 01/04/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Jean Suvan
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | | | - Aviva Petrie
- Unit of Biostatistics UCL Eastman Dental Institute London UK
| | - Kalpesh Patel
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | - Ulpee Darbar
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | - Nikos Donos
- Centre for Oral Clinical Research Barts and The London School of Medicine and Dentistry QMUL London UK
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17
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Sanz M, Dahlin C, Apatzidou D, Artzi Z, Bozic D, Calciolari E, De Bruyn H, Dommisch H, Donos N, Eickholz P, Ellingsen JE, Haugen HJ, Herrera D, Lambert F, Layrolle P, Montero E, Mustafa K, Omar O, Schliephake H. Biomaterials and regenerative technologies used in bone regeneration in the craniomaxillofacial region: Consensus report of group 2 of the 15th European Workshop on Periodontology on Bone Regeneration. J Clin Periodontol 2019; 46 Suppl 21:82-91. [PMID: 31215114 DOI: 10.1111/jcpe.13123] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [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: 11/27/2018] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS To review the regenerative technologies used in bone regeneration: bone grafts, barrier membranes, bioactive factors and cell therapies. MATERIAL AND METHODS Four background review publications served to elaborate this consensus report. RESULTS AND CONCLUSIONS Biomaterials used as bone grafts must meet specific requirements: biocompatibility, porosity, osteoconductivity, osteoinductivity, surface properties, biodegradability, mechanical properties, angiogenicity, handling and manufacturing processes. Currently used biomaterials have demonstrated advantages and limitations based on the fulfilment of these requirements. Similarly, membranes for guided bone regeneration (GBR) must fulfil specific properties and potential biological mechanisms to improve their clinical applicability. Pre-clinical and clinical studies have evaluated the added effect of bone morphogenetic proteins (mainly BMP-2) and autologous platelet concentrates (APCs) when used as bioactive agents to enhance bone regeneration. Three main approaches using cell therapies to enhance bone regeneration have been evaluated: (a) "minimally manipulated" whole tissue fractions; (b) ex vivo expanded "uncommitted" stem/progenitor cells; and (c) ex vivo expanded "committed" bone-/periosteum-derived cells. Based on the evidence from clinical trials, transplantation of cells, most commonly whole bone marrow aspirates (BMA) or bone marrow aspirate concentrations (BMAC), in combination with biomaterial scaffolds has demonstrated an additional effect in sinus augmentation and horizontal ridge augmentation, and comparable bone regeneration to autogenous bone in alveolar cleft repair.
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Affiliation(s)
- Mariano Sanz
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Danae Apatzidou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zvi Artzi
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Darko Bozic
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Elena Calciolari
- Centre for Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Hugo De Bruyn
- Department Periodontology & Implantology, College of Dental Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nikos Donos
- Centre for Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Jan E Ellingsen
- Department of Prosthetics an Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Håvard J Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - David Herrera
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - France Lambert
- Dental Biomaterials Research Unit (d-BRU), Department of Periodontology and Oral Surgery, University of Liège (ULiège), ULiège, Belgium
| | - Pierre Layrolle
- Inserm, U791, Laboratory for Osteoarticular and Dental Tissue Engineering, Faculty of Dental Surgery, University of Nantes, Nantes Cedex 1, France
| | - Eduardo Montero
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Kamal Mustafa
- Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Bergen, Norway
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Gottingen, Germany
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Arias-Bujanda N, Regueira-Iglesias A, Balsa-Castro C, Nibali L, Donos N, Tomás I. Accuracy of single molecular biomarkers in saliva for the diagnosis of periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2019; 47:2-18. [PMID: 31560804 DOI: 10.1111/jcpe.13202] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [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: 04/24/2019] [Revised: 07/25/2019] [Accepted: 09/13/2019] [Indexed: 12/20/2022]
Abstract
AIM To analyse, using a meta-analytical approach, the diagnostic accuracy of single molecular biomarkers in saliva for the detection of periodontitis in systemically healthy subjects. MATERIALS AND METHODS Articles on molecular biomarkers in saliva providing a binary contingency table (or sensitivity and specificity values and group sample sizes) in individuals with clinically diagnosed periodontitis were considered eligible. Searches for candidate articles were conducted in six electronic databases. The methodological quality was assessed through the tool Quality Assessment of Diagnostic Studies. Meta-analyses were performed using the Hierarchical Summary Receiver Operating Characteristic model. RESULTS Meta-analysis was possible for 5 of the 32 biomarkers studied. The highest values of sensitivity for the diagnosis of periodontitis were obtained for IL1beta (78.7%), followed by MMP8 (72.5%), IL6 and haemoglobin (72.0% for both molecules); the lowest sensitivity value was for MMP9 (70.3%). In terms of specificity estimates, MMP9 had the best result (81.5%), followed by IL1beta (78.0%) and haemoglobin (75.2%); MMP8 had the lowest specificity (70.5%). CONCLUSIONS MMP8, MMP9, IL1beta, IL6 and Hb were salivary biomarkers with good capability to detect periodontitis in systemically healthy subjects. MMP8 and IL1beta are the most researched biomarkers in the field, both showing clinically fair effectiveness for the diagnosis of periodontitis.
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Affiliation(s)
- Nora Arias-Bujanda
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Alba Regueira-Iglesias
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Balsa-Castro
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Nikos Donos
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Queen Mary University of London, London, UK
| | - Inmaculada Tomás
- Oral Sciences Research Group, Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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19
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Arias‐Bujanda N, Regueira‐Iglesias A, Balsa‐Castro C, Nibali L, Donos N, Tomás I. Accuracy of single molecular biomarkers in gingival crevicular fluid for the diagnosis of periodontitis: A systematic review and meta‐analysis. J Clin Periodontol 2019; 46:1166-1182. [DOI: 10.1111/jcpe.13188] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/20/2019] [Accepted: 08/21/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Nora Arias‐Bujanda
- Oral Sciences Research Group Department of Surgery and Medical Surgical Specialties School of Medicine and Dentistry Health Research Institute Foundation of Santiago (FIDIS) Universidade de Santiago de Compostela Santiago de Compostela Spain
| | - Alba Regueira‐Iglesias
- Oral Sciences Research Group Department of Surgery and Medical Surgical Specialties School of Medicine and Dentistry Health Research Institute Foundation of Santiago (FIDIS) Universidade de Santiago de Compostela Santiago de Compostela Spain
| | - Carlos Balsa‐Castro
- Oral Sciences Research Group Department of Surgery and Medical Surgical Specialties School of Medicine and Dentistry Health Research Institute Foundation of Santiago (FIDIS) Universidade de Santiago de Compostela Santiago de Compostela Spain
| | - Luigi Nibali
- Periodontology Unit Centre for Host Microbiome Interactions Faculty of Dentistry, Oral and Craniofacial Sciences King’s College London London UK
| | - Nikos Donos
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research Queen Mary University of London London UK
| | - Inmaculada Tomás
- Oral Sciences Research Group Department of Surgery and Medical Surgical Specialties School of Medicine and Dentistry Health Research Institute Foundation of Santiago (FIDIS) Universidade de Santiago de Compostela Santiago de Compostela Spain
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20
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Nibali L, Koidou VP, Hamborg T, Donos N. Empirical or microbiologically guided systemic antimicrobials as adjuncts to non‐surgical periodontal therapy? A systematic review. J Clin Periodontol 2019; 46:999-1012. [DOI: 10.1111/jcpe.13164] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/20/2019] [Accepted: 06/23/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Luigi Nibali
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry Queen Mary University London (QMUL) London UK
- Periodontology Unit Centre for Host-Microbiome Interactions, Faculty of Dentistry Oral & Craniofacial Sciences, King's College London London UK
| | - Vasiliki P. Koidou
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry Queen Mary University London (QMUL) London UK
| | - Thomas Hamborg
- Pragmatic Clinical Trials Unit Queen Mary University London (QMUL) London UK
| | - Nikos Donos
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry Queen Mary University London (QMUL) London UK
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21
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Nibali L, Koidou V, Salomone S, Hamborg T, Allaker R, Ezra R, Zou L, Tsakos G, Gkranias N, Donos N. Minimally invasive non-surgical vs. surgical approach for periodontal intrabony defects: a randomised controlled trial. Trials 2019; 20:461. [PMID: 31351492 PMCID: PMC6660941 DOI: 10.1186/s13063-019-3544-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/18/2019] [Accepted: 06/29/2019] [Indexed: 12/03/2022] Open
Abstract
Background Periodontal intrabony defects are usually treated surgically with the aim of increasing attachment and bone levels and reducing risk of progression. However, recent studies have suggested that a minimally invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. The aim of this study is to compare the efficacy of a modified MINST approach with a surgical approach (modified minimally invasive surgical therapy, M-MIST) for the treatment of intrabony defects. Methods This is a parallel-group, single-centre, examiner-blind non-inferiority randomised controlled trial with a sample size of 66 patients. Inclusion criteria are age 25–70, diagnosis of periodontitis stage III or IV (grades A to C), presence of ≥ 1 ‘intrabony defect’ with probing pocket depth (PPD) > 5 mm and intrabony defect depth ≥ 3 mm. Smokers and patients who received previous periodontal treatment to the study site within the last 12 months will be excluded. Patients will be randomly assigned to either the modified MINST or the M-MIST protocol and will be assessed up to 15 months following initial therapy. The primary outcome of the study is radiographic intrabony defect depth change at 15 months follow-up. Secondary outcomes are PPD and clinical attachment level change, inflammatory markers and growth factors in gingival crevicular fluid, bacterial detection, gingival inflammation and healing (as measured by geometric thermal camera imaging in a subset of 10 test and 10 control patients) and patient-reported outcomes. Discussion This study will produce evidence about the clinical efficacy and potential applicability of a modified MINST protocol for the treatment of periodontal intrabony defects, as a less invasive alternative to the use of surgical procedures. Trial registration ClinicalTrials.gov, NCT03797807. Registered on 9 January 2019.
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Affiliation(s)
- L Nibali
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK. .,Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
| | - V Koidou
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - S Salomone
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - T Hamborg
- Pragmatic Clinical Trials Unit, Centre for Primary Care and Public Health, Queen Mary University of London (QMUL), London, UK
| | - R Allaker
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - R Ezra
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - L Zou
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - G Tsakos
- Department of Epidemiology and Public Health, University College London (UCL), London, UK
| | - N Gkranias
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
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22
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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23
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Nibali L, Darbar U, Rakmanee T, Donos N. Anemia of inflammation associated with periodontitis: Analysis of two clinical studies. J Periodontol 2019; 90:1252-1259. [DOI: 10.1002/jper.19-0124] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Luigi Nibali
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical ResearchInstitute of DentistryQueen Mary University London (QMUL) London United Kingdom
- Centre for Host‐Microbiome Interactions Dental InstituteKing's College London London United Kingdom
| | - Ulpee Darbar
- University College Hospitals NHS Trust (UCLH)Eastman Dental Hospital London United Kingdom
| | - Thanasak Rakmanee
- Faculty of DentistryThammasat University Pathum Thani Phra Nakhon Thailand
| | - Nikos Donos
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical ResearchInstitute of DentistryQueen Mary University London (QMUL) London United Kingdom
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24
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D'Aiuto F, Gkranias N, Bhowruth D, Khan T, Orlandi M, Suvan J, Masi S, Tsakos G, Hurel S, Hingorani AD, Donos N, Deanfield JE. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol 2018; 6:954-965. [PMID: 30472992 DOI: 10.1016/s2213-8587(18)30038-x] [Citation(s) in RCA: 219] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/26/2017] [Accepted: 10/02/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic inflammation is believed to be a major mechanism underlying the pathophysiology of type 2 diabetes. Periodontitis is a cause of systemic inflammation. We aimed to assess the effects of periodontal treatment on glycaemic control in people with type 2 diabetes. METHODS In this 12 month, single-centre, parallel-group, investigator-masked, randomised trial, we recruited patients with type 2 diabetes, moderate-to-severe periodontitis, and at least 15 teeth from four local hospitals and 15 medical or dental practices in the UK. We randomly assigned patients (1:1) using a computer-generated table to receive intensive periodontal treatment (IPT; whole mouth subgingival scaling, surgical periodontal therapy [if the participants showed good oral hygiene practice; otherwise dental cleaning again], and supportive periodontal therapy every 3 months until completion of the study) or control periodontal treatment (CPT; supra-gingival scaling and polishing at the same timepoints as in the IPT group). Treatment allocation included a process of minimisation in terms of diabetes onset, smoking status, sex, and periodontitis severity. Allocation to treatment was concealed in an opaque envelope and revealed to the clinician on the day of first treatment. With the exception of dental staff who performed the treatment and clinical examinations, all study investigators were masked to group allocation. The primary outcome was between-group difference in HbA1c at 12 months in the intention-to-treat population. This study is registered with the ISRCTN registry, number ISRCTN83229304. FINDINGS Between Oct 1, 2008, and Oct 31, 2012, we randomly assigned 264 patients to IPT (n=133) or CPT (n=131), all of whom were included in the intention-to-treat population. At baseline, mean HbA1c was 8·1% (SD 1·7) in both groups. After 12 months, unadjusted mean HbA1c was 8·3% (SE 0·2) in the CPT group and 7·8% (0·2) in the IPT group; with adjustment for baseline HbA1c, age, sex, ethnicity, smoking status, duration of diabetes, and BMI, HbA1c was 0·6% (95% CI 0·3-0·9; p<0·0001) lower in the IPT group than in the CPT group. At least one adverse event was reported in 30 (23%) of 133 patients in the IPT group and 23 (18%) of 131 patients in the CPT group. Serious adverse events were reported in 11 (8%) patients in the IPT group, including one (1%) death, and 11 (8%) patients in the CPT group, including three (2%) deaths. INTERPRETATION Compared with CPT, IPT reduced HbA1c in patients with type 2 diabetes and moderate-to-severe periodontitis after 12 months. These results suggest that routine oral health assessment and treatment of periodontitis could be important for effective management of type 2 diabetes. FUNDING Diabetes UK and UK National Institute for Health Research.
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Affiliation(s)
- Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK.
| | - Nikolaos Gkranias
- Centre for Clinical Oral Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Devina Bhowruth
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Tauseef Khan
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Jean Suvan
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Stefano Masi
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Steve Hurel
- Department of Endocrinology, University College London Hospitals, University College London, London, UK
| | - Aroon D Hingorani
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Nikos Donos
- Centre for Clinical Oral Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - John E Deanfield
- Institute of Cardiovascular Sciences, University College London, London, UK
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Dereka X, Calciolari E, Donos N, Mardas N. Osseointegration in osteoporotic-like condition: A systematic review of preclinical studies. J Periodontal Res 2018; 53:933-940. [PMID: 29845622 DOI: 10.1111/jre.12566] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
Osteoporosis is one of the most common skeletal disorders affecting a significant percentage of people worldwide. Research data suggested that systemic diseases such as osteoporosis could act as risk factors for osseointegration, jeopardizing the healing process and thus the predictability of dental implant success on compromised patients. It is well accepted that preclinical studies in animal models reproducing the osteoporotic condition are one of the most important stages in the research of new biomaterials and therapeutic modalities. The aim of this systematic review was to investigate whether osteoporosis compromises dental implant osseointegration in experimental osteoporotic-like conditions. A 3-stage systematic literature research was conducted in MEDLINE via OVID and EMBASE up to and including March 2017. Experimental studies reporting on dental implant osseointegration on different osteoporotic animal models were assessed. The studies had to report on the percentage of bone-to-implant contact (%BIC) as the primary outcome. ARRIVE guidelines for reporting on animal research were applied to evaluate the methodological quality and risk of bias of the studies. Fifty-seven studies met the inclusion criteria and were assessed qualitatively. The most adopted animal model was the rat. A variability of %BIC values was observed, ranging from 30% to 99% and from 26% to 94% for the healthy and osteoporotic group, respectively. The great majority (47) of the included studies concluded that estrogen deficiency significantly affects BIC values, 9 studies stated that it was not possible to observe statistical differences in BIC between ovariectomized and healthy groups and 1 study did not provide a comparison between the healthy and osteoporotic group. Owing to the great heterogeneity in implant surface, study design, observation time-points, site of implant placement and reported outcomes, a meta-analysis could not be performed. An overall high risk of bias was observed, owing to the limited information on animal housing and husbandry, baseline characteristics and health status, ethical statement and allocation to the experimental groups provided. Although the available studies seem to suggest a lower osseointegration in osteoporotic-like conditions, no robust conclusions can be drawn due to the great heterogeneity and overall low quality of the available studies. Future studies with emphasis on minimizing the possible sources of bias and evaluating osseointegration of dental implants placed into jawbones instead of long bones are warranted.
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Affiliation(s)
- X Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Mardas
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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Wismeijer D, Joda T, Flügge T, Fokas G, Tahmaseb A, Bechelli D, Bohner L, Bornstein M, Burgoyne A, Caram S, Carmichael R, Chen C, Coucke W, Derksen W, Donos N, El Kholy K, Evans C, Fehmer V, Fickl S, Fragola G, Gimenez Gonzales B, Gholami H, Hashim D, Hui Y, Kökat A, Vazouras K, Kühl S, Lanis A, Leesungbok R, Meer J, Liu Z, Sato T, De Souza A, Scarfe WC, Tosta M, Zyl P, Vach K, Vaughn V, Vucetic M, Wang P, Wen B, Wu V. Group 5 ITI Consensus Report: Digital technologies. Clin Oral Implants Res 2018; 29 Suppl 16:436-442. [DOI: 10.1111/clr.13309] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 05/29/2018] [Accepted: 05/31/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Daniel Wismeijer
- Academic Center for Dentistry Amsterdam Amsterdam The Netherlands
| | - Tim Joda
- Department of Dental Medicine University of Bern Bern Switzerland
| | - Tabea Flügge
- Department of Oral and Maxillofacial Surgery University of Freiburg Freiburg Germany
| | - George Fokas
- Department Implant DentistryUniversity of Hong Kong Hong Kong
| | - Ali Tahmaseb
- Academic Center for Dentistry Amsterdam Amsterdam The Netherlands
| | | | | | | | | | | | | | | | | | - Wiebe Derksen
- Academic Center for Dentistry Amsterdam Amsterdam The Netherlands
| | | | | | | | | | | | | | | | | | | | - Yu Hui
- Department of Oral SurgerySchool of Dental MedicineUniversity of Belgrade Belgrade Serbia
| | | | | | | | | | | | - Joerd Meer
- University of Groningen Groningen The Netherlands
| | - Zhonghao Liu
- School of StomatologyBinzhou Medical University Binzhou China
| | | | | | | | | | - Paul Zyl
- Private Practice Capetown South Africa
| | - Kirstin Vach
- Department of Oral and Maxillofacial Surgery University of Freiburg Freiburg Germany
| | - Vida Vaughn
- University of Louisville Louisville Kentucky
| | - Milan Vucetic
- Faculty of Dental Medicine University of Belgrade Belgrade Serbia
| | - Ping Wang
- Academic Center for Dentistry Amsterdam Amsterdam The Netherlands
| | - Bo Wen
- Peking University School of Stomatology Beijing China
| | - Vivian Wu
- Academic Center for Dentistry Amsterdam Amsterdam The Netherlands
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Schliephake H, Sicilia A, Nawas BA, Donos N, Gruber R, Jepsen S, Milinkovic I, Mombelli A, Navarro JM, Quirynen M, Rocchietta I, Schiødt M, Schou S, Stähli A, Stavropoulos A, Sánchez Suárez LM. Drugs and diseases: Summary and consensus statements of group 1. The 5th
EAO Consensus Conference 2018. Clin Oral Implants Res 2018; 29 Suppl 18:93-99. [DOI: 10.1111/clr.13270] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Henning Schliephake
- Department of Oral & Maxillofacial Surgery; University Medicine George-Augusta-University; Göttingen Germany
| | - Alberto Sicilia
- Section of Periodontology; Faculty of Medicine and Health Science; University Clinic of Dentistry; University of Oviedo; Oviedo Spain
| | - Bilal Al Nawas
- Department of Oral and Maxillofacial Surgery; University Medical Centre of the Johannes Gutenberg University; Mainz Germany
| | - Nikos Donos
- Lead Centre for Immunobiology & Regenerative Medicine QMUL; Barts and The London School of Medicine & Dentistry; London UK
| | - Reinhard Gruber
- Department of Oral Biology; Medical University of Vienna, MedUni Vienna; Vienna Austria
| | - Søren Jepsen
- Department of Periodontology; University of Bonn; Bonn Germany
| | - Iva Milinkovic
- Department of Periodontology; School of Dental Medicine; University of Belgrade; Beograd Serbia
| | - Andrea Mombelli
- Division of Periodontology; University Clinics of Dental Medicine; University of Geneva; Geneva Switzerland
| | | | - Marc Quirynen
- Department of Dentistry; Universitair Ziekenhuis Leuven; Leuven Belgium
| | - Isabella Rocchietta
- The London Centre for Implant and Aesthetic Dentistry (LCIAD) Ltd; London UK
| | - Morten Schiødt
- Department of Oral & Maxillofacial Surgery; Rigshospitalet; Copenhagen Denmark
| | - Søren Schou
- Department of Oral & Maxillofacial Surgery; School of Dentistry; University of Copenhagen; Copenhagen Denmark
| | - Alexandra Stähli
- Klinik für Parodontologie; Zahnmedizinische Kliniken Bern; Universität Bern; Bern Switzerland
| | - Andreas Stavropoulos
- Department of Periodontology; Centre of Oral Health Sciences; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Luis Miguel Sánchez Suárez
- Private Practice; Group Aula Dental Avanzada; Avd de las Salinas 49, San Pedro del Pinatar Murcia 30740 Spain
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Calciolari E, Donos N. The use of omics profiling to improve outcomes of bone regeneration and osseointegration. How far are we from personalized medicine in dentistry? J Proteomics 2018; 188:85-96. [DOI: 10.1016/j.jprot.2018.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 12/12/2022]
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Kaiser F, Donos N, Henderson B, Alagarswamy R, Pelekos G, Boniface D, Nibali L. Association between circulating levels of heat-shock protein 27 and aggressive periodontitis. Cell Stress Chaperones 2018; 23:847-856. [PMID: 29766408 PMCID: PMC6111086 DOI: 10.1007/s12192-018-0891-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/22/2018] [Revised: 03/02/2018] [Accepted: 03/09/2018] [Indexed: 01/23/2023] Open
Abstract
Heat-shock protein (Hsp) 27 is a major intracellular molecular chaperone and controller of intracellular responses to inflammatory signals. In the extracellular space, recombinant Hsp27 has been described to exert anti-inflammatory activities. The aim of this study was to assess the association between circulating levels of Hsp27 and different types of periodontitis. Pro- and anti-inflammatory cytokines and the stress proteins Hsp27 and Hsp60 with proposed anti- and pro-inflammatory properties, respectively, were measured by two-site ELISA in the serum of patients with aggressive periodontitis (AgP, n = 30), chronic periodontitis (CP, n = 29) and periodontally healthy controls (H, n = 28). Furthermore, Hsp27 and Hsp60 levels were also measured longitudinally in 12 AgP patients at 6 time points up to 3 months after treatment. AgP patients had lower levels of Hsp27 compared to CP patients and healthy subjects (adjusted one-way ANOVA, p < 0.001, followed by post hoc Tukey HSD comparisons), while no differences in levels of Hsp60 or cytokines between the three groups were detected. In CP patients and H subjects, the systemic Hsp27 levels correlated with Hsp60 (r = 0.43, p < 0.001; r = 0.59, p < 0.001, respectively) and with pro-inflammatory cytokines TNF-α (r = 0.48, p < 0.001; r = 0.55, p < 0.001, respectively) and IL-6 (r = 0.44, p < 0.01). However, no such correlations were detected in AgP cases. No consistent temporal patterns of changes of Hsp27 concentration were detected across AgP patients following periodontal treatment. This study provides the first evidence that Hsp27 may be differentially expressed and regulated in AgP patients as compared with CP patients and healthy individuals.
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Affiliation(s)
- Frank Kaiser
- Department of Microbial Diseases, Eastman Dental Institute, University College London, London, UK
| | - Nikos Donos
- Centre for Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University London, Turner Street E1 2AD, London, UK
| | - Brian Henderson
- Department of Microbial Diseases, Eastman Dental Institute, University College London, London, UK
| | - Rajesh Alagarswamy
- Department of Microbial Diseases, Eastman Dental Institute, University College London, London, UK
| | - George Pelekos
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - David Boniface
- Biostatistics Unit, Eastman Dental Institute, University College London, London, UK
| | - Luigi Nibali
- Centre for Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University London, Turner Street E1 2AD, London, UK.
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Calciolari E, Hamlet S, Ivanovski S, Donos N. Pro-osteogenic properties of hydrophilic and hydrophobic titanium surfaces: Crosstalk between signalling pathways in in vivo models. J Periodontal Res 2018; 53:598-609. [DOI: 10.1111/jre.12550] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2018] [Indexed: 12/12/2022]
Affiliation(s)
- E. Calciolari
- Centre for Oral Immunobiology and Regenerative Medicine; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
- Centre for Oral Clinical Research; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
| | - S. Hamlet
- School of Dentistry and Oral Health; Gold Coast Campus; Griffith University; Southport QLD Australia
- Menzies Health Institute Queensland; Griffith University; Gold Coast QLD Australia
| | - S. Ivanovski
- School of Dentistry; University of Queensland; Brisbane QLD Australia
| | - N. Donos
- Centre for Oral Immunobiology and Regenerative Medicine; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
- Centre for Oral Clinical Research; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
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31
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Calciolari E, Ravanetti F, Strange A, Mardas N, Bozec L, Cacchioli A, Kostomitsopoulos N, Donos N. Degradation pattern of a porcine collagen membrane in an in vivo model of guided bone regeneration. J Periodontal Res 2018; 53:430-439. [PMID: 29446096 DOI: 10.1111/jre.12530] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Although collagen membranes have been clinically applied for guided tissue/bone regeneration for more than 30 years, their in vivo degradation pattern has never been fully clarified. A better understanding of the different stages of in vivo degradation of collagen membranes is extremely important, considering that the biology of bone regeneration requires the presence of a stable and cell/tissue-occlusive barrier during the healing stages in order to ensure a predictable result. Therefore, the aim of this study was to investigate the degradation pattern of a porcine non-cross-linked collagen membrane in an in vivo model of guided bone regeneration (GBR). MATERIAL AND METHODS Decalcified and paraffin-embedded specimens from calvarial defects of 18, 10-month-old Wistar rats were used. The defects were treated with a double layer of collagen membrane and a deproteinized bovine bone mineral particulate graft. At 7, 14 and 30 days of healing, qualitative evaluation with scanning electron microscopy and atomic force microscopy, and histomorphometric measurements were performed. Markers of collagenase activity and bone formation were investigated using an immunofluorescence technique. RESULTS A significant reduction of membrane thickness was observed from 7 to 30 days of healing, which was associated with progressive loss of collagen alignment, increased collagen remodeling and progressive invasion of woven bone inside the membranes. A limited inflammatory infiltrate was observed at all time points of healing. CONCLUSION The collagen membrane investigated was biocompatible and able to promote bone regeneration. However, pronounced signs of degradation were observed starting from day 30. Since successful regeneration is obtained only when cell occlusion and space maintenance exist for the healing time needed by the bone progenitor cells to repopulate the defect, the suitability of collagen membranes in cases where long-lasting barriers are needed needs to be further reviewed.
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Affiliation(s)
- E Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK
| | - F Ravanetti
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - A Strange
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, UK
| | - N Mardas
- Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK
| | - L Bozec
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, UK
| | - A Cacchioli
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - N Kostomitsopoulos
- Laboratory Animal Facilities, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK
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32
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Nibali L, Sun C, Akcalı A, Yeh YC, Tu YK, Donos N. The effect of horizontal and vertical furcation involvement on molar survival: A retrospective study. J Clin Periodontol 2018; 45:373-381. [DOI: 10.1111/jcpe.12850] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Luigi Nibali
- Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research; Institute of Dentistry, Barts and the London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
| | - Chuanming Sun
- Department of Periodontology; Faculty of Dentistry; Suzhou Health College; Suzhou China
| | - Aliye Akcalı
- Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research; Institute of Dentistry, Barts and the London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
| | - Yi-Chun Yeh
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Nikos Donos
- Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research; Institute of Dentistry, Barts and the London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
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Abstract
PURPOSE The literature surrounding necrotising ulcerative gingivitis (NUG) is extensive, yet the rare nature of this disease means that there is a lack of good quality research available. This paper aims to scrutinise the literature and provide an up-to-date summary of the available information. MATERIALS AND METHODS A literature search was performed electronically using the Cochrane Library, Ovid Medline, Embase, PubMed Clinical Queries and Google Scholar. Keyword searches were carried out, utilising MeSH terms and free text. English language articles primarily were included, with key foreign language (French and German) articles included where possible from the 1900s to the present day. RESULTS Necrotising ulcerative gingivitis is a rare disease (prevalence <1%), with an acute, painful and destructive presentation. It is an opportunistic bacterial infection which is predominantly associated with spirochetes. Treatment of NUG must be provided on a case-by-case basis, tailored to what the individual can tolerate and the extent of the infection. CONCLUSION Although there is low prevalence of NUG, its importance should not be underestimated as one of the most severe responses to the oral biofilm. Risk factors must be investigated and addressed. Treatment should consist of gentle superficial debridement, oral hygiene instruction and prescription of mouthwash and antibiotics in severe cases.
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Calciolari E, Mardas N, Dereka X, Anagnostopoulos AK, Tsangaris GT, Donos N. Protein expression during early stages of bone regeneration under hydrophobic and hydrophilic titanium domes. A pilot study. J Periodontal Res 2017; 53:174-187. [PMID: 29063586 DOI: 10.1111/jre.12498] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES There is significant evidence that, during the early stages of osseointegration, moderately rough hydrophilic (SLActive) surfaces can accelerate osteogenesis and increase bone-to-implant contact in comparison to hydrophobic (SLA) surfaces. However, very little is known regarding the molecular mechanisms behind the influence that surface chemistry modifications to increase hydrophilicity determine on bone healing. The aim of this study was to describe for the first time the proteins and related signalling pathways expressed during early osseous healing stages under SLA and SLActive titanium domes for guided bone regeneration. MATERIAL AND METHODS One SLA and 1 SLActive dome with an internal diameter of 5.0 mm and a height of 3.0 mm were secured to the parietal bones of nine 6-month-old male New Zealand rabbits. Three animals were randomly euthanized at 4, 7 and 14 days and the newly formed tissues retrieved under the domes were analysed with liquid chromatography-mass spectrometry/mass spectrometry. STRING and KEGG databases were applied for Gene Ontology and pathway analyses. RESULTS A different modulation of several pathways was detected between the 2 groups at all healing times. The main differences in the osseous healing response associated to the 2 surfaces were related to pathways involved in regulating the inflammatory response, differentiation of osteoblast precursors and skeletogenesis. At day 7, the highest number of proteins and the highest cellular activity were observed in both groups, although a more complex and articulated proteome in terms of cellular metabolism and signal transduction was observed in SLActive samples. CONCLUSION This is the first study describing the proteome expressed during early healing stages of guided bone regeneration and osseointegration. A combination of enhanced early osteogenic response and reduced inflammatory response were suggested for the hydrophilic group. Future studies are needed to corroborate these findings and explore the molecular effects of different titanium surfaces on the cascade of events taking place during bone formation.
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Affiliation(s)
- E Calciolari
- Centre for Clinical Oral Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
| | - N Mardas
- Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
| | - X Dereka
- Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece
| | - A K Anagnostopoulos
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - G T Tsangaris
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - N Donos
- Centre for Clinical Oral Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
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35
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Coelho RS, Gusmao ES, Siqueira RACD, Donos N, Vajgel BCF, Cimões R. Are there differences between partial and total periodontal examination of the mouth? Int Arch Med 2017. [DOI: 10.3823/2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Diagnosis of periodontal disease for epidemiologic survey is difficult due to complexity of periodontal exam. The aim of this study was to compare data from a full-mouth examination and a partial-mouth examination, observing the agreement between both methods of presenting the Community Periodontal Index (CPI).
Methods and Findings: The population comprised of male and female subjects, aged 18 years and over, attending public health centers in the city of Recife, Brazil. A total of 505 patients participated in this study. Each participant completed a form and underwent periodontal examination. Firstly, for each tooth present one of the periodontal conditions was determined: periodontal health, gingival bleeding, dental calculus, shallow periodontal pockets and deep periodontal pockets, according to CPI. Finally, partial data (10 index teeth) was recorded derived from the total version of CPI. Bivariate analysis of frequencies and means was performed. Mc Nemar test was used to calculate the level of statistical significance of the association tested. There are significant statistical differences between partial and full-mouth examination (p<0.001). According to gender, men classified as score 1 presented the same prevalence in both methods; partial recording overestimated 0.2% of women classified as score 1; percentile difference among men was higher for subjects classified as score 0. Among subjects with at least one tooth with deep periodontal pocket, percentile difference between different approaches was higher among elders (60 years and over).
Conclusions: Considering the variable age, the smaller amount of lost information refers to periodontal pockets in individuals aged 18 to 30 years of age. In older individuals classified as periodontally healthy and with gingival bleeding no loss of information was observed. Partial examination of the mouth underestimated the presence of periodontal pockets and overestimated the presence of calculus and bleeding. A high concordance between the partial and total examination was observed.
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36
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Retzepi M, Calciolari E, Wall I, Lewis MP, Donos N. The effect of experimental diabetes and glycaemic control on guided bone regeneration: histology and gene expression analyses. Clin Oral Implants Res 2017; 29:139-154. [PMID: 28719032 DOI: 10.1111/clr.13031] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To investigate the effect of experimental diabetes and metabolic control on intramembranous bone healing following guided bone regeneration (GBR). MATERIAL AND METHODS Ninety-three Wistar rats were allocated to three experimental groups, healthy (H), uncontrolled diabetes (D) and controlled diabetes (CD). Twenty one days following diabetes induction, a standardised 5-mm defect was created at the mid-portion of each parietal bone. In 75 animals (25H, 25D, 25CD), one defect was treated with an intracranial and extracranial membrane according to the GBR principle, and one defect was left empty (control); five animals per group were then randomly sacrificed at 3, 7, 15, 30 and 60 days and processed for decalcified histology. In 18 animals (6H, 6D, 6CD), both defects were treated according to the GBR principle; three animals from each group were then randomly sacrificed at 7 and 15 days of healing and employed for gene expression analysis. RESULTS Application of the GBR therapeutic principle led to significant bone regeneration even in the D group. However, at 15 and 30 days, the osteogenesis process was impaired by uncontrolled diabetes, as shown by the significant reduction in terms of defect closure (38-42%) and newly formed bone (54-61%) compared to the healthy group. The comparison of the D vs. H group at 15 days of healing yielded the largest number of genes with significantly differential expression, among which various genes associated with the ossification process (bmp4, ltbp4, thra and cd276) were identified. CONCLUSIONS Uncontrolled diabetes seems to affect early phases of the bone regeneration following GBR. A misregulation of genes and pathways related to cell division, energy production, inflammation and osteogenesis may account for the impaired regeneration process in D rats. Further studies are warranted to optimise the GBR process in this medically compromised patient population.
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Affiliation(s)
- M Retzepi
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - I Wall
- Regenerative Medicine Bioprocessing Unit, UCL Advanced Centre for Biochemical Engineering, London, UK
| | - M P Lewis
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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37
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Nibali L, Krajewski A, Donos N, Völzke H, Pink C, Kocher T, Holtfreter B. The effect of furcation involvement on tooth loss in a population without regular periodontal therapy. J Clin Periodontol 2017; 44:813-821. [DOI: 10.1111/jcpe.12756] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Luigi Nibali
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Anna Krajewski
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Nikos Donos
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Henry Völzke
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Christiane Pink
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Thomas Kocher
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
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38
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Needleman I, Ashley P, Fine P, Haddad F, Loosemore M, di Medici A, Donos N, Newton T, van Someren K, Moazzez R, Jaques R, Hunter G, Shimmin M, Brewer J, Meehan L, Mills S, Porter S. Infographic: oral health in elite athletes. Br J Sports Med 2017; 51:757. [PMID: 28223308 DOI: 10.1136/bjsports-2017-097517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ian Needleman
- Periodontology, UCL Eastman Dental Institute, London, UK
| | - Paul Ashley
- Paediatric Dentistry, UCL Eastman Dental Institute, London, UK
| | - Peter Fine
- CPD, UCL Eastman Dental Institute, London, UK
| | - Fares Haddad
- Trauma & Orthopaedic Surgery, University College Hospital, London, UK
| | - Mike Loosemore
- Institute for Sport Exercise and Health; University Collage Hospital London, London, UK
| | - Akbar di Medici
- Institute for Sport Exercise and Health; University Collage Hospital London, London, UK
| | - Nikos Donos
- Periodontology, UCL Eastman Dental Institute, London, UK
| | - Tim Newton
- Psychology as Applied to Dentistry, KCL Dental Institute, London, UK
| | | | | | - Rod Jaques
- President, Faculty of Sport and Exercise Medicine, Edinburgh, UK
| | | | | | - John Brewer
- ISPAR, Univeristy of Bedforshire, Bedford, UK
| | - Lyndon Meehan
- Restorative Dental West glamorgan, Morriston Hospital, Swansea, UK
| | - Steve Mills
- Maine, Just for Kids Pediatric Dentstry, Scarborough, Toronto, Ontario, Canada
| | - Stephen Porter
- Maxillofacial Medicine and Surgery, UCL Eastman Dental Institute, London, UK
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Salvi GE, Bosshardt DD, Lang NP, Abrahamsson I, Berglundh T, Lindhe J, Ivanovski S, Donos N. Temporal sequence of hard and soft tissue healing around titanium dental implants. Periodontol 2000 2017; 68:135-52. [PMID: 25867984 DOI: 10.1111/prd.12054] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/22/2022]
Abstract
The objective of the present review was to summarize the evidence available on the temporal sequence of hard and soft tissue healing around titanium dental implants in animal models and in humans. A search was undertaken to find animal and human studies reporting on the temporal dynamics of hard and soft tissue integration of titanium dental implants. Moreover, the influence of implant surface roughness and chemistry on the molecular mechanisms associated with osseointegration was also investigated. The findings indicated that the integration of titanium dental implants into hard and soft tissue represents the result of a complex cascade of biological events initiated by the surgical intervention. Implant placement into alveolar bone induces a cascade of healing events starting with clot formation and continuing with the maturation of bone in contact with the implant surface. From a genetic point of view, osseointegration is associated with a decrease in inflammation and an increase in osteogenesis-, angiogenesis- and neurogenesis-associated gene expression during the early stages of wound healing. The attachment and maturation of the soft tissue complex (i.e. epithelium and connective tissue) to implants becomes established 6-8 weeks following surgery. Based on the findings of the present review it can be concluded that improved understanding of the mechanisms associated with osseointegration will provide leads and targets for strategies aimed at enhancing the clinical performance of titanium dental implants.
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40
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Ramachandra SS, Dopico J, Donos N, Nibali L. Disease Staging Index for Aggressive Periodontitis. Oral Health Prev Dent 2017; 15:371-378. [PMID: 28831460 DOI: 10.3290/j.ohpd.a38746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Major advances in the knowledge about the aetiopathogenesis of aggressive periodontitis (AgP) have been achieved. An ever increasing number of scientific articles related to AgP are published every year contributing significantly to the knowledge of this unique and complex disease. AgP has been classified into localised and generalised forms based on their extent and disease progression with distinct clinical and radiological features. A classification of AgP based on severity (mild, moderate and severe) exists; however, it is not easily applicable. Therefore, studies on AgP do not categorise the disease based on severity. A disease staging index for AgP is proposed based on clinical and radiological features, as well as risk factors. Based on the presence or absence of risk factors confirmed by longitudinal studies, cases of AgP can be divided into low risk, medium risk and high risk profiles for disease progression. Clinicians can devise a broad treatment plan for their AgP cases based on this staging. More frequent recall intervals are proposed for patients at medium and high risk for disease progression. Ten cases of AgP with 10-year follow-up were used to validate the staging index by retrospectively assigning prognosis and associating it with tooth loss. The use of this staging by researchers would increase external validity of research on AgP. Long-term analysis of AgP cases are needed to validate this staging index longitudinally.
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41
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Nibali L, Sun C, Akcalı A, Meng X, Tu YK, Donos N. A retrospective study on periodontal disease progression in private practice. J Clin Periodontol 2016; 44:290-297. [DOI: 10.1111/jcpe.12653] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Luigi Nibali
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Chuanming Sun
- Department of Periodontology; Faculty of Dentistry; Suzhou Health College; Suzhou China
| | - Aliye Akcalı
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Xsuan Meng
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Nikos Donos
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
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42
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Dufty J, Gkranias N, Petrie A, McCormick R, Elmer T, Donos N. Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study. Clin Oral Investig 2016; 21:1935-1944. [PMID: 27830369 DOI: 10.1007/s00784-016-1979-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/04/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Necrotizing ulcerative gingivitis (NUG) has been seen in military populations throughout history. This study aims to determine the prevalence, treatment modality and risk factors associated with NUG in the British Armed Forces. MATERIALS AND METHODS A whole population dataset of the British Armed Forces was searched to determine cases of NUG during the period 1 January to 31 December 2012. Individual case records were identified, and a case-control study undertaken with data gathered and analysed against a randomised control group, matched for age, sex and service. RESULTS A prevalence rate for NUG of 0.11 % was determined against the whole military population. The majority of cases received (alone or in combination) the following: oral hygiene instruction (66.5 %), antibiotics (64.4 %) and a mouthwash (58.1 %). Of the cases, 48.7 % received debridement. Analgesics were only prescribed in 8.4 % of the cases, and smoking cessation advice was only given in 10.7 % of the cases. Analysis of risk factors against the control group showed an increase in odds ratios for diagnosis of NUG of 3.4 (95 % CI 2.0-5.7) for current smokers and 7.3 (95 % CI 1.9-28.0) for individuals with an overall Basic Periodontal Examination (BPE) score of 3. CONCLUSIONS Whilst NUG is a rare disease, it is evident from this study that it still occurs within the British Armed Forces. A strong association was shown between NUG and current smokers and those cases with an overall BPE score of 3. CLINICAL RELEVANCE This study provides prevalence data for NUG in the British Armed Forces and description of its treatment and associated risk factors. Oral hygiene and smoking must be addressed in patients with NUG and prescribing protocols should be carefully followed.
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Affiliation(s)
- J Dufty
- Defence Medical Services, Ministry of Defence, London, UK
| | - N Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - A Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK
| | - R McCormick
- Defence Medical Services, Ministry of Defence, London, UK
| | - T Elmer
- Defence Medical Services, Ministry of Defence, London, UK
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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43
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Cimőes R, Cavalcanti de Siqueira RRA, Crovella S, Eleutério de Souza PR, Donos N. A Fast Method for DEFB1 - 44C/G SNP Genotyping in Brazilian Patients with Periodontitis. Acta Stomatol Croat 2016; 48:208-15. [PMID: 27688368 DOI: 10.15644/asc48/3/5] [Citation(s) in RCA: 4] [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] [Indexed: 10/31/2022] Open
Abstract
AIM Defensins are cationic antimicrobial peptides expressed in epithelial cells. Such peptides exhibit antibacterial, antifungal and antiviral properties, and are a component of the innate immune response. It has been suggested that they have a protective role in the oral cavity. This study evaluated the DEFB1 polymorphism in diabetic patients with or without periodontitis in comparison to healthy controls. MATERIAL AND METHODS We used Hairpin-Shaped Primer (HP) assay to study the distribution of the -44 C/G SNP (rs1800972) in 119 human DNAs obtained from diabetic patients and healthy control patients. RESULTS The results indicate that there are no differences in distribution between groups and that in diabetic periodontitis patients the homozygous mutant could be found more frequently. CONCLUSION Further studies are necessary in order to investigate the role of DEFB1 polymorphisms in diabetic periodontitis patients and the influence of the peptide in periodontal pathogens.
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Affiliation(s)
- Renata Cimőes
- PhD, Federal University of Pernambuco, Recife, Brazil
| | | | | | | | - Nikos Donos
- PhD, Eastman Dental Institute, Unit Periodontology, London, United Kingdom
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44
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Al-Kattan R, Retzepi M, Calciolari E, Donos N. Microarray gene expression during early healing of GBR-treated calvarial critical size defects. Clin Oral Implants Res 2016; 28:1248-1257. [PMID: 27616585 DOI: 10.1111/clr.12949] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate the gene expression and molecular pathways implicated in the regulation of the osseous healing process following guided bone regeneration (GBR). MATERIAL AND METHODS Six 6-month-old Wistar male rats were used. Standardized 5-mm critical size defects were created in the parietal bones of each animal and treated with an extracranial and intracranial ePTFE membrane, according to the GBR principle. Three animals were randomly sacrificed after 7 and 15 days of healing. Total RNA was extracted from each sample and prepared for gene expression analysis. RNA quality and quantity were assessed, followed by hybridization of the cRNA to Affymetrix GeneChip Rat Genome 230 2.0 Arrays. The Affymetrix data were processed, and first-order analysis, quality control and statistical analysis were performed. Biological interpretation was performed via pathway and Gene Ontology (GO) analysis. RESULTS Between the 7- and 15-day samples, 538 genes were differently regulated. At day 7, inflammatory and immune responses were clearly upregulated. In addition, GO terms related to angiogenesis and cell cycle regulation were overexpressed. At day 15, a more complex cellular activity and cell metabolism were evident. The bone formation processes were significantly overexpressed, with several genes encoding growth factors, enzyme activity, and extracellular matrix formation found as upregulated. Remarkably, a negative regulation of Wnt signalling pathway was observed at 15 days. DISCUSSION The gene expression profile of the cells participating in osseous formation varied depending on the healing stage. A number of candidate genes that seem differentially expressed during early stages of intramembranous bone regeneration was suggested.
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Affiliation(s)
- R Al-Kattan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - E Calciolari
- Department of Periodontology, UCL Eastman Dental Institute, London, UK.,Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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45
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Calciolari E, Mardas N, Dereka X, Anagnostopoulos AK, Tsangaris GT, Donos N. The effect of experimental osteoporosis on bone regeneration: part 2, proteomics results. Clin Oral Implants Res 2016; 28:e135-e145. [PMID: 27580862 DOI: 10.1111/clr.12950] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To identify and describe protein expression in a Wistar rat calvarial critical size defect (CSD) model following treatment with guided bone regeneration in healthy and osteoporotic conditions. MATERIAL AND METHODS Thirty-six 10-month-old female Wistar rats were used. Half of them were ovariectomized (OVX) and fed with a low-calcium diet to induce an osteoporotic-like status. In each animal of both groups, two 5-mm calvarial CSDs were treated with deproteinized bovine bone mineral graft particles and a bilayer collagen membrane. Six OVX and six control rats were randomly euthanized at 7, 14, and 30 days. One defect/animal was randomly chosen for proteomic analysis. Differently expressed proteins between the two groups were identified with matrix-assisted laser desorption time-of-flight mass spectrometry and liquid chromatography-mass spectrometry/mass spectrometry. RESULTS At 7 days, 29 and 27 proteins were, respectively, identified in the healthy and OVX animals. At 14 days, 103 proteins were detected in the healthy controls and 20 proteins in the OVX rats, while at 30 days, 31 and 75 proteins were identified, respectively. Only limited proteins known to play a role in the later stages of bone formation and maturation were identified within the animals 'proteomes. DISCUSSION The osseous formation process was quite immature even at 30 days of healing. An overexpression of inflammatory and stress response pathways was detected in the OVX animals, as well as a tendency toward a delayed maturation of the osseous wound and a reduced/delayed differentiation of osteoblast cell precursors.
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Affiliation(s)
- E Calciolari
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.,Periodontology Department, UCL Eastman Dental Institute, London, UK
| | - N Mardas
- Centre for Adult Oral Health, Bart's & The London School of Dentistry & Medicine, Queen Mary University of London (QMUL), London, UK
| | - X Dereka
- Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece
| | - A K Anagnostopoulos
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - G T Tsangaris
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - N Donos
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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46
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Chapple ILC, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, Madianos P, Louropoulou A, Machtei E, Donos N, Greenwell H, Van Winkelhoff AJ, Eren Kuru B, Arweiler N, Teughels W, Aimetti M, Molina A, Montero E, Graziani F. Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 2016; 42 Suppl 16:S71-6. [PMID: 25639826 DOI: 10.1111/jcpe.12366] [Citation(s) in RCA: 326] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. AIM The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. METHODS Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. RESULTS Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.
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Affiliation(s)
- Iain L C Chapple
- Periodontal Research Group & MRC Centre for Immune Regulation Birmingham Dental School, Birmingham, UK
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47
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Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, Donos N, Lyngstadaas SP, Deschner J, Dard M, Stavropoulos A, Zhang Y, Trombelli L, Kasaj A, Shirakata Y, Cortellini P, Tonetti M, Rasperini G, Jepsen S, Bosshardt DD. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol 2016; 43:668-83. [PMID: 26987551 DOI: 10.1111/jcpe.12546] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2016] [Indexed: 12/27/2022]
Abstract
BACGROUND On June 5th, 2015 at Europerio 8, a group of leading experts were gathered to discuss what has now been 20 years of documented evidence supporting the clinical use of enamel matrix derivative (EMD). Original experiments led by Lars Hammarström demonstrated that enamel matrix proteins could serve as key regenerative proteins capable of promoting periodontal regeneration including new cementum, with functionally oriented inserting new periodontal ligament fibres, and new alveolar bone formation. This pioneering work and vision by Lars Hammarström has paved the way to an enormous amount of publications related to its biological basis and clinical use. Twenty years later, it is clear that all these studies have greatly contributed to our understanding of how biologics can act as mediators for periodontal regeneration and have provided additional clinical means to support tissue regeneration of the periodontium. AIMS This review article aims to: (1) provide the biological background necessary to understand the rational for the use of EMD for periodontal regeneration, (2) present animal and human histological evidence of periodontal regeneration following EMD application, (3) provide clinically relevant indications for the use of EMD and (4) discuss future avenues of research including key early findings leading to the development of Osteogain, a new carrier system for EMD specifically developed with better protein adsorption to bone grafting materials.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, Nova Southeastern University, Fort Lauderdale, Florida, USA.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - David L Cochran
- Department of Periodontics, Dental School, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Stuart Froum
- Department of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York, NY, USA
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Carlos Nemcovsky
- Department of Periodontology and Dental Implantology, Dental School, Tel-Aviv University, Tel-Aviv, Israel
| | - Nikos Donos
- Department of Periodontology, Queen Marry University of London, London, UK
| | | | - James Deschner
- Section of Experimental Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Michel Dard
- New York University, College of Dentistry, New York, NY, USA
| | | | - Yufeng Zhang
- Department of Oral Implantology, Wuhan University, Wuhan, China
| | - Leonardo Trombelli
- Department of Periodotology, Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | - Adrian Kasaj
- Department of Operative Dentistry and Periodontology, University Medical Center, Mainz, Germany
| | - Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Maurizio Tonetti
- European Research Group on Periodontology (ERGOPerio), Genova, Italy
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Foundation IRCCS Ca' Granda Polyclinic, Milan, Italy
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
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48
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Dopico J, Nibali L, Donos N. Disease progression in aggressive periodontitis patients. A Retrospective Study. J Clin Periodontol 2016; 43:531-7. [DOI: 10.1111/jcpe.12533] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2016] [Indexed: 01/18/2023]
Affiliation(s)
- José Dopico
- Periodontology Unit; Division of Clinical Research; UCL Eastman Dental Institute; London UK
- Periodontology Unit; Universidad de Santiago de Compostela; Santiago de Compostela Spain
| | - Luigi Nibali
- Periodontology Unit; Division of Clinical Research; UCL Eastman Dental Institute; London UK
- Clinical Oral Research Centre; Institute of Dentistry; Queen Mary University London (QMUL); London UK
| | - Nikos Donos
- Periodontology Unit; Division of Clinical Research; UCL Eastman Dental Institute; London UK
- Clinical Oral Research Centre; Institute of Dentistry; Queen Mary University London (QMUL); London UK
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49
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Moschouris P, Retzepi M, Petrie A, Donos N. Effect of Wnt3a delivery on early healing events during guided bone regeneration. Clin Oral Implants Res 2016; 28:283-290. [DOI: 10.1111/clr.12796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 12/21/2022]
Affiliation(s)
- P Moschouris
- Periodontology Unit; Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - M Retzepi
- Periodontology Unit; Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - A Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - N Donos
- Periodontology Unit; Department of Clinical Research; UCL Eastman Dental Institute; London UK
- Centre for Oral Clinical Research; Institute of Dentistry; Barts & The London School of Medicine & Dentistry; London UK
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50
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Nibali L, Novoa L, Donos N, Henderson B, Blanco J, Tomas I. Leukocyte receptor expression in chronic periodontitis. Clin Oral Investig 2016; 20:2559-2564. [PMID: 26961374 DOI: 10.1007/s00784-016-1774-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/31/2015] [Accepted: 02/29/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Microbial recognition in the periodontium through specific leukocyte receptors gives rise to the response which in susceptible individuals can lead to periodontal diseases. The aim of this study was to explore the expression of leukocyte receptors in the gingival tissues of chronic periodontitis patients and to analyse differences between diseased and control sites (sites with probing pocket depth <4 mm). MATERIAL AND METHODS Thirty-seven chronic periodontitis patients were included in the study. Gingival biopsies were harvested from diseased and control sites and processed by flow cytometry for the determination of the expression of 16 leukocyte receptors (CD4, CD8, CD11b, CD14, CD16, CD19, CD25, CD28, CD49d, CD49e, CD62, CD71, CD80, CCR7, Ly6G and HLA-DR). RESULTS Expression of all studied receptors was higher in test compared with control sites (p < 0.005). Sampled sites with less bleeding on probing exhibited higher expression of CD16 and CD14 receptors (p = 0.020 and 0.011, respectively). CONCLUSIONS This study points towards considerable differences in the expression of leukocyte receptors between diseased and control sites in the same periodontal patients.
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Affiliation(s)
- L Nibali
- Clinical Oral Research Centre, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - L Novoa
- Oral Sciences Research Group, Periodontology and Special Needs Units, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - N Donos
- Clinical Oral Research Centre, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - B Henderson
- Division of Microbial Diseases, UCL Eastman Dental Institute, London, UK
| | - J Blanco
- Oral Sciences Research Group, Periodontology and Special Needs Units, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - I Tomas
- Oral Sciences Research Group, Periodontology and Special Needs Units, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
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