Search

Objective: To assess methods, quality and outcomes of systematic reviews (SRs) conducted to evaluate the effectiveness of root coverage (RC) procedures in the treatment of recession-type defects (RTD). Methods: MEDLINE and EMBASE were searched up to and including April 2010 to identify SRs investigating the effectiveness/efficacy of surgical interventions for the treatment of patients with RTD. Searching was conducted independently by two reviewers, and data extraction was based on the methodological criteria applied and on the effects of interventions reported by each SR. The checklist proposed by Glenny and colleagues, the Overview Quality Assessment Questionnaire and the "Assessment of Multiple systematic Reviews", instrument were used to assess the quality of SRs. Additionally, the methodological criteria applied by included reviews were compared with those proposed by the Cochrane Collaboration. Results: Search strategy identified 716 potentially eligible articles, of which 12 papers regarding 10 SRs were included in the study. Results from different SRs showed that subepithelial connective tissue grafts associated or not to coronally advanced flaps can be used to reduce recession depth and improve the width of keratinized tissue. All quality assessment tools showed that most of the SRs were of good methodological quality, but they also highlighted key points that could be improved in future reviews. Only two SRs followed in full the guidelines proposed by the Cochrane Collaboration. Conclusions: All SRs agree that RC may be anticipated by different surgical procedures. However, differences in the methodological quality between reviews were quite evident, and thus making a clear indication that there is a need of standardization of the methods that will be applied by future SRs. As a result, a standardized checklist for reporting SRs was proposed by the authors. [ABSTRACT FROM AUTHOR]

Aims To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. Material and Methods Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth ( PPD) and clinical attachment level ( CAL) and most in plaque index (PlI) and/or bleeding on probing ( BOP). Meta-analyses were performed with the data retrieved from the studies fulfilling the inclusion criteria. Results The overall effect of the subgingival application of antimicrobials was statistically significant ( p = 0.000) for both changes in PPD and CAL with a weighted mean difference ( WMD) of −0.407 and −0.310 mm respectively. No significant differences occurred for changes in BOP and PlI. Subgingival application of tetracycline fibres, sustained released doxycycline and minocycline demonstrated a significant benefit in PPD reduction ( WMD between 0.5 and 0.7 mm). The rest of the tested outcomes demonstrated a high heterogeneity. The local application of chlorhexidine and metronidazole showed a minimal effect when compared with placebo ( WMD between 0.1 and 0.4 mm). Conclusions The scientific evidence supports the adjunctive use of local antimicrobials to debridement in deep or recurrent periodontal sites, mostly when using vehicles with proven sustained release of the antimicrobial. [ABSTRACT FROM AUTHOR]

Aims: To analyse the histological structure and histomorphometric characteristics of human hard palatal mucosa in order to determine the donor site of choice for connective tissue grafts from a histological point of view. Materials and Methods: Palatal mucosa samples from six cadaver heads were harvested at four sites: incisal, premolar, molar and tuberosity. Histological and immunohistochemical techniques were performed, as was histomorphometric analysis. Results: In the current study, we found that the density and size of cells were higher in the superficial papillary layer, whereas the thickness of the collagen bundles increased in the reticular layer. Excluding the epithelium, the mean percentage of lamina propria (LP) and submucosa (SM) was 37% and 63%, respectively (p <.001). LP thickness showed similar values in the incisal, premolar and molar regions, and a significantly greater thickness in tuberosity (p <.001). The thickness of SM increased from incisal to premolar and molar, disappearing in the tuberosity (p <.001). Conclusions: As dense connective tissue of LP is the tissue of choice for connective tissue grafts, the best donor site from a histological point of view is tuberosity because it is composed only of a thick LP without the presence of a loose submucosal layer. [ABSTRACT FROM AUTHOR]

Objectives (1) To assess the risk of bias of studies in which animal models were used for investigating regenerative therapies for periodontal and peri-implant defects. (2) To investigate changes in risk of bias by comparing samples drawn from two different publication periods. Material & Methods We searched the PubMed and LILACS electronic databases, independently and in duplicate, for randomized and controlled trials published from 1998 to 2000 and from 2008 to 2010. Hand searching included search of 10 dental journals, in the issues published between August 2008 and August 2010. Studies on non-human primates and canines were included. We assessed independently and in triplicate the risk of bias with reference to a six-item checklist based on the Cochrane Collaboration's tool for assessing the risk of bias and information about formal sample size calculation. Results One hundred and seven studies were included in the review. Checklist items were poorly reported in the studies selected, and therefore for most of the studies, the risk of bias was unclear. Conclusion As a result of the unclear risk of bias of animal studies in periodontal and peri-implant treatments, it is difficult to determine the accuracy of treatment effect estimates. There is a need for standardization of reporting procedures on animal experiments. [ABSTRACT FROM AUTHOR]

The article presents a study on immediate single-tooth implants in the anterior maxilla. The study aims to asses the overall outcome of the implant treatment, observing hard and soft tissue response and aesthetics. The results show a fairly low peri-implant plaque and bleeding and significant mesial papillae re-growth between the first and three year assessment. The proposed strategy shows promise as a useful and predictable mid to long term treatment option for well-selected patients.

This article discusses a study which described the microbiota associated with peri-implant disease. Results of the study showed that peri-implant disease may be considered as a mixed anaerobic infection. The study also found a possible link between peri-implant infections and a different microbiota. Another finding is the involvement of microorganisms in the disease process even if they are not the origin of the condition.

Aim: To evaluate the efficacy of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse, as an adjunct to professionally and patient‐administered mechanical plaque removal, in the treatment of peri‐implant mucositis (PiM). Material and Methods: Patients displaying PiM in, at least, one implant were included in this randomized, double‐blinded, clinical trial. Subjects received professional prophylaxis (baseline and 6 months) and were instructed to regular oral hygiene practices and to rinse, twice daily, with the test or placebo mouth rinses, during one year. Clinical, radiographic and microbiological outcomes were evaluated at baseline, 6 and 12 months. Disease resolution was defined as absence of bleeding on probing (BOP). Data were analysed by repeated measures ANOVA, Student's t and chi‐square tests. Results: Fifty‐four patients were included and 46 attended the final visit (22 in control and 24 in test group). In the test group, there was a 24.49% greater reduction in BOP at the buccal sites (95% confidence interval [3.65–45.34%]; p = 0.002) than in controls. About 58.3% of test implants and 50% controls showed healthy peri‐implant tissues at final visit (p > 0.05). Conclusions: The use of the test mouth rinse demonstrated some adjunctive benefits in the treatment of PiM. Complete disease resolution could not be achieved in every case. [ABSTRACT FROM AUTHOR]

Aim The objective of this case-control study was to compare the inflammatory response of peripheral blood from localized aggressive periodontitis ( LAP) patients when stimulated with healthy or diseased plaque samples. Materials and Methods Whole blood and subgingival plaque samples were collected from 13 LAP subjects, 14 siblings of LAP subjects and six periodontally healthy individuals. Whole blood was stimulated for 24 h with plaque samples generated from healthy or diseased sites. The levels of 14 cyto/chemokines were detected using multiplex technology. Results Localized aggressive periodontitis-derived cultures displayed higher levels of G-CSF, INF γ, IL10, IL12p40, IL1 β, IL-6, IL-8, MCP-1, MIP-1 α, and TNF α, than control cultures regardless of stimulus used. Whole blood from healthy siblings displayed higher levels of IL-6 compared to control subjects, but lower levels than those observed in cultures from LAP participants. Conclusions This study suggests that although bacteria is an important factor in eliciting the hyper-inflammatory response observed in LAP patients, the predisposition of host's response to bacterial presence may play a more significant role than the components of the stimulatory plaque. [ABSTRACT FROM AUTHOR]

Aim To investigate the clinical and microbiological effects of local disinfection with 0.5% sodium hypochlorite (NaOCl) with or without systemic antimicrobials (amoxicillin and metronidazole, AM) during basic periodontal therapy (BPT). Material and Methods In a randomized clinical trial (four groups), 110 chronic periodontitis patients received BPT plus local irrigation with saline (BPT + S), local disinfection with NaOCl (BPT + DIS), BPT + DIS + AM or BPT + S + AM. The outcome was analysed at baseline, 3, 6 and 12 months. Results There was no difference in clinical attachment level gain at 12 months between the four groups. BPT + DIS showed no additional improvement compared to BPT + S; BPT + DIS + AM showed fewer sites with probing pocket depth (PPD) ≥7 mm versus BPT + S only up to 6 months ( p = 0.037). In factorial analyses, additional clinical reduction for PPD ( p = 0.023) and number of sites with PPD ≥5 ( p = 0.007), ≥6 ( p = 0.002) and ≥7 mm ( p < 0.001) were found when AM was added to BPT, but not when DIS was applied. In all groups, a comparable decrease in targeted bacteria was found. AM caused adverse events in 22% of the patients. Conclusion Local disinfection with NaOCl, also in combination with AM, showed, after 1-year follow-up, no additional clinical and microbiological effects compared to BPT alone. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to investigate the levels of 11 oral species in plaque samples and cytokine levels in biofluid samples of patients with idiopathic uveitis ( IU) and systemically healthy individuals (H) with or without gingival inflammation. Material & Methods Twenty-one patients with IU ( n = 21), and 22 systemically healthy individuals ( n = 22) were enrolled in the study. Clinical periodontal measurements were recorded. Cytokine levels in the biofluid samples were determined by ELISA. Bacterial gene copy numbers were determined by qPCR on plaque microbial DNA preparations. Results According to two-step cluster analysis, anova and t-test: GCF, serum and salivary TNF- α, IL-17A, IL-17A/E; GCF and serum IL-6; salivary IL-17F, and salivary and serum IL-17A/F levels were higher in the IU group than the H group ( p < 0.05). However, serum IL-10 and IL-17E levels were higher in the H group than the IU group ( p < 0.05). A. actinomycetemcomitans, F. nucleatum, S. oralis, A. naeslundii, and V. dispar counts were higher in IU group compared to H group ( p < 0.05). Conclusion Altered local and systemic cytokine profiles are associated with differences in the microbial plaque composition in IU. Anti-inflammatory cytokines; IL-10, IL-17E are reduced in patients with IU and Th-1 and Th-17 driven inflammatory responses in biofluids are altered. [ABSTRACT FROM AUTHOR]

Objective The aim of the present study was to evaluate the effect of a titanium brush and chemical agents following surgical treatment of experimental peri-implantitis. Material and Methods Six implants were installed in the mandible of eight beagle dogs (unit of analysis) 3 months after tooth extraction. Experimental peri-implantitis was induced 3 months later. The defects were randomly allocated in three treatment groups: (a) TiBrush™ + sodium hypochlorite + chlorhexidine ( TBH), (b) TiBrush™ + chlorhexidine ( TB), (c) an ultrasonic device + chlorhexidine ( US). The distal implant in each hemimandible was used as control, and no treatment was done. Clinical and histological measurements were performed after 3 months of healing. Results All treatment procedures resulted in statistically significant improvements of all clinical parameters. Histomorphometrical analysis revealed no statistically significant differences between treatment groups in terms of woven bone height (primary outcome). However, there were differences between test and control groups in terms of inflammation, bone defect depth and bone refill without differences between TBH and TB groups. Conclusions Resolution of peri-implantitis after access surgery and decontamination of peri-implant surfaces with TiBrush™ with or without sodium hypochlorite is possible. However, the concomitant use of sodium hypochlorite has minor effect on treatment outcomes. [ABSTRACT FROM AUTHOR]

Objectives To compare the use of sonic powered or manual toothbrush in patients with intellectual disability ( ID) in terms of plaque (PlI) and gingival ( GI) indices and adverse effects. Material and Methods Subjects with ID were recruited for this cluster-randomized, single blinded (examiner), 6-month clinical trial, comparing powered versus manual toothbrushing. Outcome variables included PlI and GI, evaluated at baseline and 3 months after supervised toothbrushing and after 3 additional months of unsupervised used. Clinical outcome variables were analysed by repeated measures ANCOVA considering time and group as factors and respective baseline values as covariates (generalized linear model). Results Sixty-four patients (34 male, mean age 34.5) in six clusters were included in the study. No statistically significant effect of toothbrushing group was observed for PlI or GI. A significant effect of time was identified ( p < 0.001) with mean reductions ranging 0.44-0.45 for PlI and 0.30-0.36 for GI from baseline to 3-6 months. No relevant adverse effect or technical problems were observed. Conclusion The tested sonic powered toothbrush was as effective and safe as the manual toothbrush. The use of powered or manual toothbrushes, together with fluoride toothpaste, may improve plaque and gingivitis levels, in patients with mild to limit ID. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to assess the accuracy of periapical radiography in measuring peri-implant bone levels. Materials and Methods Twenty-five subjects with 46 implants in need of surgical treatment for peri-implantitis were included in this cross-sectional study. Prior to surgery, periapical radiographs were taken, a prediction of type of defect was made and radiographic peri-implant bone levels ( Rx BL) were determined at the mesial and distal aspects. Intra-operatively, the peri-implant bone level ( Surg BL) was assessed mesially, distally, buccally and orally and the type of defect was recorded. A paired t-test was applied to detect differences between inter-proximal Rx BL and Surg BL. ANOVA was used to compare Surg BL at different circumferential positions. Results The mean inter-proximal Rx BL was 4.0 ± 2.2 mm and the mean inter-proximal Surg BL was 5.3 ± 2.3 mm. The difference between Rx BL and Surg BL was statistically significant ( p = 0.014). There were no significant differences in Surg BL at the mesial, distal, buccal and oral aspects ( p > 0.05). Conclusions The intra-operatively measured peri-implant bone levels were more apical than the radiographic bone levels. The intra-operatively assessed peri-implant bone levels ( Surg BL) were similar at all the circumferential positions around the implant. [ABSTRACT FROM AUTHOR]

Objective To assess in a periodontally diseased rural population deprived from regular dental care and having poor dietary conditions, the effect of vitamin C/calcium threonate/citrus flavonoids (VitC/Ca/Fl) supplementation on subgingival microbiota and plasma levels of vitamin C, HbA1c and hs CRP. Material & Methods The study population consisted of 98 subjects who previously participated in a prospective study on the natural history of periodontitis. Participants were instructed to consume one tablet/day containing 200 mg Ester C® calcium ascorbate, 25 mg calcium threonate and 100 mg citrus flavonoids for 90 days. Following parameters were evaluated: prevalence/amount of seven traditional periodontal pathogens, cytomegalovirus, Epstein-Barr virus ( EBV); and plasma levels of vitamin C, HbA1c and hs CRP. Results After VitC/Ca/Fl supplementation, 100% of subjects showed normal plasma vitamin C values compared to 55% before. At baseline, 48% of subjects harboured Aggregatibacter actinomycetemcomitans, >97% the other periodontal pathogens and 73% EBV. Supplementation with VitC/Ca/F reduced the subgingival load of all studied bacteria ( p-values: 0.014-0.0001) and EBV ( p < 0.0001) substantially in all initially positive subjects. Plasma levels of HbA1c and hs CRP dropped in all subjects ( p < 0.0001). Conclusion This uncontrolled study suggested that supplemental VitC/Ca/Fl may be helpful in reducing subgingival numbers of periodontal pathogens and EBV, and promoting systemic health. [ABSTRACT FROM AUTHOR]

Objective Tumour necrosis factor α ( TNF- α) is considered a key signalling modulator in the pathogenesis of both periodontitis ( PD) and type 2 diabetes mellitus ( DM2). This study aims at elucidating the effect of TNF- α blocking on the interplay between PD and DM2. Methods Obese diabetic Zucker rats and their lean littermates were divided into five treatment groups with or without periodontitis. Anti- TNF- α treatment was provided with Etanercept injections. Diabetic state was evaluated by oral glucose tolerance test, the homeostatic model assessment, free fatty acids and blood glucose. Systemic inflammation was assessed by measurement of interleukin ( IL)-1 β, IL-6 and TNF- α in plasma. Kidney complications were evaluated by real-time rt PCR, creatinine clearance rate, urinary albumin excretion and increase in weight. PD was evaluated by registration of alveolar bone level. Results After 4 weeks the diabetic state was modified by Etanercept treatment with lower insulin levels and lower homeostatic model assessment. Furthermore, while kidney complications were reduced by Etanercept treatment, PD had no effect. PD was influenced by diabetic state, but the impact was attenuated by Etanercept treatment. Conclusion In this study anti- TNF- α treatment improved glucose tolerance and compensated for the increased periodontal disease in obese diabetic Zucker. PD did not influence diabetic parameters assessed including complications of the rats kidneys. [ABSTRACT FROM AUTHOR]

Aim A randomized controlled clinical trial was designed to evaluate the efficacy of the photodynamic therapy ( PDT) in the treatment of residual pockets of chronic periodontitis patients. Material and Methods Thirty-four patients with at least four residual periodontal pockets undergoing maintenance care were included and randomly assigned to test group ( PDT, n = 18) or control group (sham procedure, n = 16). The intervention was performed at baseline, 3, 6 and 12 months. Clinical parameters such as pocket probing depth ( PPD), clinical attachment level ( CAL), bleeding on probing (BoP) and plaque index ( PI) were measured before intervention and after 3, 6 and 12 months. Subgingival samples were obtained at baseline, and after 7 days, 3, 6 and 12 months to quantify Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia by real-time polimerase chain reaction ( PCR). Results All clinical variables showed significant improvement during the study, but there was no significant difference between test and control groups. The microbiological analyses showed no differences between groups at any time during the study. Conclusion Within the limits of this clinical trial and considering the laser and photosensitizer protocol used, PDT failed to demonstrate additional clinical and bacteriological benefits in residual pockets treatment. [ABSTRACT FROM AUTHOR]

Aim This study evaluated the effects of scaling and root planing ( SRP) on gingival crevicular fluid ( GCF) and serum levels of adipokines in patients with chronic periodontitis ( CP) with or without obesity. Methods Twenty patients with obesity and 20 patients without obesity, all with CP, received SRP. Serum and GCF levels of resistin, adiponectin, leptin, tumour necrosis factor [ TNF]- α and interleukin [ IL]-6 were evaluated by enzyme-linked immunosorbent assay at baseline, 3, 6 and 12 months post-therapy. Results SRP reduced the amounts of TNF- α in deep sites and increased the concentration of adiponectin in shallow sites of non-obese patients ( p < 0.05). SRP increased the concentrations of TNF- α and leptin in patients with obesity ( p < 0.05). GCF levels of TNF- α were higher in patients with obesity than in patients without obesity at all time-points ( p < 0.05). There were no changes in serum levels of any adipokines for any group after therapy ( p > 0.05). Patients with obesity exhibited higher serum levels of leptin at all time-points and IL-6 at 3 months post-therapy ( p < 0.05). Conclusions Obesity may modulate systemic and periodontal levels of adipokines in favour of pro-inflammation, independently of periodontal therapy. SRP did not affect the circulating levels of adipokines in patients with or without obesity. [ABSTRACT FROM AUTHOR]

Aim This study evaluated the effects of a topical herbal patch (PerioPatch®) for gingival wound healing in a rat model. Materials and Methods A mid-crestal incision was performed on each side of the edentulous anterior maxilla in 48, 6-month-old, Wistar rats. Full-thickness flaps were raised, repositioned and sutured. Four experimental groups were established: herbal patch, placebo patch, no patch and no patch and no surgery. Patches were placed immediately after surgery and replaced every 12 h for the following 3 days. Half of the animals were killed after 5 and the remaining ones after 12 days. Tissue blocks were retrieved and processed for histological and immunohistochemical evaluation. Epithelial gap, collagen contents, amount of macrophages, cellular proliferation and vascular contents were evaluated in the central incision area. Statistical analysis consisted of two-way anova. Results The herbal patch group presented the smallest epithelial gap at 12 days, the highest collagen content both at 5 and 12 days, a larger number of proliferating cells at day 5 and more numerous blood vessels at day 12. Macrophage number was similar in all groups. Conclusion Herbal patch improved wound healing in this animal model. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to evaluate the clinical and microbiological efficacy of moxifloxacin ( MOX) in one-stage scaling and root planing ( SRP) in treating generalized aggressive periodontitis ( GAgP). Materials and Methods Forty subjects were randomly allocated to two treatment groups. The two treatment groups consisted of SRP combined with systemically admi-nistered MOX at the dosage of 400 mg once daily for 7 days or SRP + placebo once daily for 7 days. Subgingival plaque samples were analysed for cultivable bacteria. Results Both groups resulted in significant reduction of probing depth (PD) and clinical attachment level (CAL) compared with baseline ( p < 0.0001), and this difference was maintained at 6 months from baseline in both groups. However, subjects receiving MOX showed the greatest improvements CAL, and PD. Subjects in both groups at 6 months displayed the greatest reduction from baseline in frequency of sites with PD ≥6 mm ( p < 0.001), favouring the MOX group. Adjunctive antibiotic protocol reduced subgingival Aggregatibacter actinomycetemcomitans to undetectable levels, after 3 and 6 months, and there was a significant reduction in the levels of Porphyromonas gingivalis and Tannerella forsythia in the MOX group compared to the placebo group. Conclusions The results from this study suggest that moxifloxacin as and adjunct to one-stage full-mouth SRP leads to a better clinical and microbiological advantages compared to mechanical treatment. [ABSTRACT FROM AUTHOR]

Aim To evaluate the effect of surgical treatment of experimental peri-implantitis at implants with different surface characteristics using different anti-infective procedures. Material and methods Four implants with different surface characteristics (A: TiOblast, B: OsseoSpeed, C: AT-I, D: TiUnite) were installed in a randomized order in each side of the mandible in 6 labrador dogs 3 months after tooth extraction. Experimental peri-implantitis was induced 3 months later. Surgical treatment of peri-implantitis was performed. The implants were cleaned with gauze soaked in either saline (control) or chlorhexidine (test). Clinical and radiographical examinations were performed and microbiological samples were taken during a 6-month period after surgery. Biopsies were obtained and prepared for histological analysis. Results Clinical signs of soft tissue inflammation were reduced after surgical therapy in most test and control sites. While the analysis of bone level alterations in radiographs together with histological and microbiological assessments of resolution of peri-implantitis lesions failed to demonstrate statistically significant differences between test and control procedures, the evaluations disclosed significant differences between implant D and implants A, B and C on treatment outcome. Conclusion It is suggested that (i) the local use of chlorhexidine has minor influence on treatment outcome, (ii) resolution of peri-implantitis following surgical treatment without the adjunctive use of local and systemic antimicrobial agents is possible and (iii) the results are influenced by implant surface characteristics. [ABSTRACT FROM AUTHOR]

Aim The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy ( NSPT) in adult subjects with chronic periodontitis. Materials and Methods Relative to a previous 12-month follow-up study, recruitment and follow-up period were extended, resulting in 116 eligible among the 286 screened subjects. They received NSPT and concurrent smoking cessation interventions. Periodontal maintenance was performed every 3 months. A calibrated examiner, blinded to smoking status, performed full-mouth periodontal examination in six sites per tooth at baseline, 3, 12 and 24 months of follow-up. Expired air carbon monoxide concentration measurements and interviews were performed to gather demographic and behavioural information. Results From the 116 enrolled subjects, 61 remained up to 24 months of follow-up. Of these, 18 quit smoking (Q), 32 continued smoking ( NQ) and 11 oscillated (O) at 24 months of follow-up. Thereby, Q showed significantly higher mean CAL gain in diseased sites and higher reduction in the proportion of sites with CAL ≥ 3 mm, when compared to NQ. In addition, Q presented significantly higher mean probing depth reduction relative to NQ( p ≤ 0.05). Conclusion Smoking cessation promoted additional benefits on NSPT in chronic periodontitis subjects. [ABSTRACT FROM AUTHOR]

Aims Dysbiotic microbial communities underlie the aetiology of several oral diseases, especially in smokers. The ability of an ecosystem to rebound from the dysbiotic state and re-establish a health-compatible community, a characteristic known as resilience, plays an important role in susceptibility to future disease. The present investigation was undertaken to examine the effects of smoking on colonization dynamics and resilience in marginal and subgingival biofilms. Materials and methods Marginal and subgingival plaque and gingival crevicular fluid samples were collected from 25 current and 25 never smokers with pre-existing gingivitis at baseline, following resolution, after 1, 2 4, 7, 14 and 21 days of undisturbed plaque formation and following resolution. 16S cloning and sequencing was used for bacterial identification and multiplexed bead-based flow cytometry was used to quantify the levels of 27 immune mediators. Results Smokers demonstrated an early pathogenic colonization that led to sustained pathogen enrichment with periodontal and respiratory pathogens, eliciting a florid immune response. Smokers also demonstrated greater abundance of pathogenic species, poor compositional correlation between marginal and subgingival ecosystems, and significantly greater pro-inflammatory responses following resolution of the second episode of disease. Conclusions The ability of the subgingival microbiome to 'reset' itself following episodes of disease is decreased in smokers, thereby lowering the resilience of the ecosystem and decreasing its resistance to future disease. [ABSTRACT FROM AUTHOR]

Aim The aim of the study was to evaluate the effect of full-mouth tooth extraction on the oral microflora, with emphasis on the presence and load of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Material and methods Adult patients ( n = 30), with moderate to advanced periodontitis and scheduled for full-mouth tooth extraction, were consecutively selected. Prior to and 1 and 3 months after full-mouth tooth extraction saliva, tongue, buccal and gingival mucosa and subgingival plaque/prosthesis samples were obtained. Aerobic and anaerobic culture techniques and quantitative real-time polymerase chain reaction ( qPCR) were employed for the detection of oral pathogens. Results Full-mouth tooth extraction resulted in reduction below detection level of A. actinomycetemcomitans and P. gingivalis in 15 of 16 and 8 of 16 previously positive patients using culture techniques and qPCR, respectively. Those patients remaining qPCR positive showed a significant reduction in load of these bacteria. Conclusion Full-mouth tooth extraction significantly changes the oral microflora. These changes include reduction of A. actinomycetemcomitans and P. gingivalis, frequently to levels below detection threshold. In some patients, A. actinomycetemcomitans and P. gingivalis can persist in the edentulous oral cavity up to 3 months after full-mouth tooth extraction. [ABSTRACT FROM AUTHOR]

Aim To evaluate the direct effects of periodontal therapy in Chronic Obstructive Pulmonary Disease ( COPD) patients with chronic periodontitis ( CP). Materials and Methods In a pilot randomized controlled trial, 60 COPD patients with CP were randomly assigned to receive scaling and root planing ( SRP) treatment, supragingival scaling treatment, or oral hygiene instructions only with no periodontal treatment. We evaluated their periodontal indexes, respiratory function, and COPD exacerbations at baseline, 6 months, 1, and 2 years. Results Compared with the control group, measurements of periodontal indexes were significantly improved in patients in two treatment groups at 6-month, 1-year, and 2-year follow-up (all p < 0.05). Overall, the means of forced expiratory volume in the first second/forced vital capacity ( FEV1/ FVC) and FEV1 were significantly higher in the two therapy groups compared with the control group during the follow-up ( p < 0.05). In addition, the frequencies of COPD exacerbation were significantly lower in the two therapy groups than in the control group at 2-year follow-up ( p < 0.05). Conclusions Our preliminary results from this pilot trial suggest that periodontal therapy in COPD patients with CP may improve lung function and decrease the frequency of COPD exacerbation. [ABSTRACT FROM AUTHOR]

Objective The purpose of this ongoing randomized study was to assess differences in bone level changes and success rates using implants supporting single crowns in the posterior mandible either with platform matched or platform switched abutments. Material and Methods Patients aged 18 and above, missing at least two teeth in the posterior mandible and with a natural tooth mesial to the most proximal implant site were enrolled. Randomization followed implant placement. Definitive restorations were placed after a minimum transgingival healing period of 8 weeks. Changes in crestal bone level from surgery and loading (baseline) to 12-month post-loading were radiographically measured. Implant survival and success were determined. Results Sixty-eight patients received 74 implants in the platform switching group and 72 in the other one. The difference of mean marginal bone level change from surgery to 12 months was significant between groups ( p < 0.004). Radiographical mean bone gain or no bone loss from loading was noted for 67.1% of the platform switching and 49.2% of the platform matching implants. Implant success rates were 97.3% and 100%, respectively. Conclusions Within the same implant system the platform switching concept showed a positive effect on marginal bone levels when compared with restorations with platform matching. [ABSTRACT FROM AUTHOR]

Objectives To histologically and immunologically assess experimental peri-implant mucositis at surface enhanced modified (mod) hydrophilic titanium implants. Materials and Methods In a split-mouth design ( n = 6 foxhounds), four different implants were inserted on each side of the maxilla: three titanium-zirconium alloy implants (TiZr) with either modSLA (sand-blasted, acid etched and chemically mod), modMA (machined, acid etched and chemically mod), or M (machined) surfaces in the transmucosal portion, and one titanium implant with a machined transmucosal portion (TiM). Experimental mucositis was induced at one randomly assigned side (NPC), whereas the contra-lateral maxillary side received mechanical plaque removal three times per week (PC). At 16 weeks, tissue biopsies were processed for histological (primary outcome: apical extension of the inflammatory cell infiltrate measured from the mucosal margin - PM- aICT) and immunohistochemical (CD68 antigen reactivity) analyses. Peri-implant sulcus fluid was analysed for interleukin (IL)-1β, IL-8, matrix metalloproteinase (MMP)-8 and myeloperoxidase (MPO). Results Mean PM- aICT values varied between 1.86 (TiZrmodSLA) and 3.40 mm (TiM) in the UPC group, and between 0.88 (TiZrmodSLA) and 2.08 mm (TiZrM) in the PC group. Mean CD68, IL-1β, IL-8, MMP-8 and MPO values were equally distributed between mod- and control implants in both NPC and PC groups. Conclusions The progression of experimental mucositis was comparable at all implant surfaces investigated. [ABSTRACT FROM AUTHOR]

Aim To identify the diagnostic accuracy of gingival crevicular fluid ( GCF) candidate biomarkers to discriminate periodontitis from the inflamed and healthy sites, and to compare the performance of two independent matrix metalloproteinase ( MMP)-8 immunoassays. Materials and Methods Cross sectional study. GCF ( N = 58 sites) was collected from healthy, gingivitis and chronic periodontitis volunteers and analysed for levels of azurocidin, chemokine ligand 5, MPO, TIMP-1 MMP-13 and MMP-14 by ELISA or activity assays. MMP-8 was assayed by immunofluorometric assay ( IFMA) and ELISA. Statistical analysis was performed using linear mixed-effects models and Bayesian statistics in R and Stata V11. Results MMP-8, MPO, azurocidin and total MMP-13 and MMP-14 were higher in periodontitis compared to gingivitis and healthy sites ( p < 0.05). A very high correlation between MPO and MMP-8 was evident in the periodontitis group ( r = 0.95, p < 0.0001). MPO, azurocidin and total levels of MMP-8, MMP-13 and MMP-14 showed high diagnostic accuracy (≥0.90), but only MMP-8 and MPO were significantly higher in the periodontitis versus gingivitis sites. MMP-8 determined by IFMA correlated more strongly with periodontal status and showed higher diagnostic accuracy than ELISA. Conclusions MPO and collagenolytic MMPs are highly discriminatory biomarkers for site-specific diagnosis of periodontitis. The comparison of two quantitative MMP-8 methods demonstrated IFMA to be more accurate than ELISA. [ABSTRACT FROM AUTHOR]

Background We have recently developed a periodontal diagnostic tool that was validated in non-smokers with periodontitis. Tobacco smoking is a recognized risk factor for periodontal diseases that can mask gingival bleeding and lead to a false negative diagnosis. Therefore, the purpose of current study is to further validate this instrument in smokers with periodontal diseases. Methods Using a portable optical near-infrared spectrometer, optical spectra were obtained, processed and evaluated from healthy ( n = 108), gingivitis ( n = 100), and periodontitis ( n = 79) sites of 54 systemically healthy smokers. A modified Beer-Lambert unmixing model that incorporates a non-parametric scattering loss function was used to determine the relative contribution of deoxygenated haemoglobin (Hb) and oxygenated haemoglobin (HbO2) to the overall spectrum. The balance between tissue oxygen delivery and utilization in periodontal tissues was then assessed. Results Tissue oxygen saturation was significantly decreased in the gingivitis ( p = 0.016) and periodontitis ( p = 0.007) sites, compared to the healthy sites. There was a trend towards increased concentration of Hb and decreased concentration of HbO2 from healthy to diseased sites, without statistical significance ( p > 0.05). Conclusions Optical spectroscopy can determine tissue oxygenation profiles of healthy and diseased sites in smokers. The spectral profile of periodontal sites in smokers generally resembles those from non-smoking patients. [ABSTRACT FROM AUTHOR]

Aim To measure the levels of hCAP18/LL-37 in gingival crevicular fluid from patients with periodontal diseases compared with healthy controls and to determine the correlation between hCAP18/LL-37 and chondroitin sulphate (CS) levels in patients with periodontitis. Material and Methods Gingival crevicular fluid samples from 51 patients and 25 healthy volunteers were analysed for the hCAP18/LL-37 levels by immunoblotting and were determined for the CS levels by the competitive enzyme-linked immunosorbent assay. Results Tris buffer pH 9.85 was selected to recover hCAP18/LL-37 from Periopaper strips, in which the percentages of recovery were around 70%. The median levels of hCAP18/LL-37 in the aggressive and the chronic periodontitis (CP) groups were significantly greater than those in the gingivitis and the healthy groups ( p < 0.05). Significant correlations between the unprocessed 18- kDa fragment and CS levels ( r = 0.650; p < 0.001) and between the mature 4.6- kDa fragment and CS levels ( r = 0.502; p < 0.001) were observed only in the CP group. Conclusion The significant correlations between the hCAP18/LL-37 and the CS levels were found in CP, but not in aggressive periodontitis. The presence versus absence of such correlations may be clinically applicable to help clinicians distinguish between two distinct types of periodontitis. [ABSTRACT FROM AUTHOR]

Objectives Psychosocial variables have received increased attention in periodontology. Attachment theory adds to known risk factors by linking early interactional experiences with adult tendencies of stress-regulation, health behaviour, symptom reporting, and healthcare utilization. The study investigates associations between attachment patterns and periodontal parameters. Methods Within the context of a longitudinal study on periodontal diseases, 310 patients with aggressive (AgP) and chronic periodontitis (CP) filled out questionnaires on psychological attachment patterns. The influence of attachment style on health behaviour, treatment attendance and utilization, and periodontal variables was tested. Results We found associations between psychological attachment anxiety on smoking and higher number of session use, independent of disease severity, which was more pronounced for women. Patients with higher attachment avoidance attended periodontal treatment later when diagnosed with CP and earlier with AgP. For men, we found differential associations for attachment avoidance and anxiety and number of teeth at beginning of treatment. Conclusion Psychological attachment patterns are a promising target for understanding periodontal disease in addition to known psychosocial risk factors. [ABSTRACT FROM AUTHOR]

Aim To examine microbiological and immunological alterations following two periodontal surgical techniques, over a 6-month period. Materials and methods A total of 30 chronic periodontitis patients participated in the present randomized controlled clinical trial and were randomized in two groups. Modified Widman flap (MWF) was applied in the control group and apically positioned flap (APF), without intervention to the bone, in the experimental group. Gingival crevicular fluid samples and subgingival plaque samples from the operated sites were collected at baseline, 6th, 12th and 24th post-operative week. Results No major differences were noticed in immunological and microbiological profile of patients receiving either modified MWF or APF, for a period of 6 months. Conclusions The choice of the periodontal surgical procedure does not seem to affect the immunological and the microbiological profile of patients with chronic periodontitis. [ABSTRACT FROM AUTHOR]

Aim To assess the efficacy of a 0.07% cetylpyridinium chloride ( CPC) mouth rinse in the control of plaque and gingival inflammation during a 6-month period. Material and Methods Adult subjects with moderate gingivitis were selected [≥40% bleeding on marginal probing ( BOMP)]. After retrieving microbiological samples and evaluating the clinical parameters (plaque, BOMP and stain indexes), a professional prophylaxis was performed and subjects were randomly assigned to the test ( CPC mouth rinse) or to the placebo group. Subjects were re-assessed after 3 and 6 months. Results A total of 67 patients (35 test, 32 placebo) were included in the analysis. At 6 months, intra-group significant plaque reductions were observed in the test group (0.691, p < 0.001), but not in the placebo (0.181, p = 0.653). At 6 months, the mean BOMP values were lower in the test group ( p = 0.052). Changes between baseline and 6 months were significantly higher in the test group both for plaque ( p = 0.002) and BOMP ( p = 0.037) when compared with the placebo. A microbiological impact was observed in the test group, especially for Prevotella intermedia. Conclusion The evaluated 0.07% CPC-based mouth rinse, used three times per day adjunctively to mechanical tooth cleaning, prevents plaque accumulation and gingival inflammation, as compared to the placebo, for at least 6 months. [ABSTRACT FROM AUTHOR]

Aim This study developed the Schiff Index into a Cumulative Hypersensitivity Index ( CHI) to measure dentine hypersensitivity ( DH) severity per subject. It validates this score by investigating if it compares to one comprising a percentage score from all tooth surfaces and as a highest score per subject. Materials and methods Overall, 350 subjects were recruited from hospital and general practice in south-east England. Buccal, occlusal and oral Schiff Index scores were collected and percentages calculated based on scores 1, 1 and above, 2 and above and 3. CHI scores and highest Schiff Index scores were also recorded per subject. Spearman correlation coefficients ( p-values) assessed the relationship between CHI scores, Schiff Index percentages and Schiff Index highest per subject. Results In subjects with a Schiff Index score of 1 or more on at least one tooth surface (indicating DH was present), correlation of the CHI score to the Schiff Index percentage score was 0.982 ( p < 0.001). Correlation of the sextant score to the highest Schiff Index score per subject was 0.963, ( p < 0.001). DH was more likely on tooth surfaces with gingival recession ( p < 0.001) and without bleeding on probing ( p < 0.01). Conclusions This study has validated a novel CHI score to indicate DH severity per subject and may help guide clinical management. [ABSTRACT FROM AUTHOR]

Aim Peri-implant gingival healing following one-stage implant placement was investigated and compared to periodontal healing. Methods Healing at surgical sites [implant (I) and adjacent teeth (T+)] was compared to non-operated tooth (T−) in non-smokers receiving one-stage implant. Periodontal Indices ( PI, GI) were recorded at surgery and up to 12 weeks post-operatively. Peri-implant ( PICF) and gingival crevicular fluids ( GCF) were analysed for cytokines, collagenases and inhibitors. Data were analysed by linear mixed model regression analysis and repeated measures anova. Results Forty patients (22 females; 21-74 years old) completed the study. Surgical site GI, increased at week 1, decreased significantly during early healing (weeks 1-3; p = 0.0003) and continually decreased during late healing (weeks 6-12) for I ( p < 0.01). PICF volume decreased threefold by week 12 ( p = 0.0003). IL-6, IL-8, MIP-1β and TIMP-1 levels significantly increased at surgical sites at week one, significantly decreasing thereafter ( p < 0.016). Week one IL-6, IL-8 and MIP-1β levels were ~threefold higher and TIMP-1 levels 63% higher, at I compared to T+ ( p = 0.001). Conclusion Peri-implant gingival healing, as determined by crevicular fluid molecular composition, differs from periodontal healing. The observed differences suggest that peri-implant tissues, compared to periodontal tissues, represent a higher pro-inflammatory state. [ABSTRACT FROM AUTHOR]

Aim To investigate the effect of photodynamic therapy (PDT) as adjunct to mechanical therapy in furcations. Materials and Methods A double-blind, parallel, randomized controlled clinical trial was conducted in subjects presenting class II furcations. The subjects were randomly allocated to a test (PDT; n = 16) or control group (non-activated laser/only photosensitizer; n = 21). At baseline, 3 and 6 months, clinical, microbiological and cytokine pattern evaluation was performed. Clinical attachment level was defined as the primary outcome variable. Results Clinical parameters improved after both therapies ( p < 0.05) with no differences between groups at any time point ( p > 0.05). At 6 months, real-time PCR evaluation showed a decrease in Porphyromonas gingivalis and Tannerella forsythia only in the PDT group ( p < 0.05) with no inter-group differences. Regarding cytokines, IL-4 and IL-10 levels increased in both groups at 6 months. GM-CSF, IL-8, IL-1β and IL-6 levels decreased only in the PDT group after 3 months ( p < 0.05). At 3 months, inter-group analyses showed that GM-CSF, IFN-γ, IL-6 and IL-8 levels were lower in the PDT group. At 6 months, lower IL-1β levels were also observed in the PDT group ( p < 0.05). Conclusion Photodynamic therapy did not promote clinical benefits for class II furcations; however, advantages in local levels of cytokines and a reduction in periodontopathogens were demonstrated. [ABSTRACT FROM AUTHOR]

Aim To compare the results of two targeted techniques to an open-ended technique in periodontitis patients, differentiated on the basis of smoking habit. Materials & Methods Thirty periodontitis patients (15 smokers and 15 non-smokers) provided subgingival plaque samples for 16S rRNA gene amplicon sequencing, culturing and quantitative polymerase chain reaction (qPCR). Results No differences were found in the composition of the subgingival microbiome between smokers and non-smokers with culture and qPCR. With pyrosequencing, operational taxonomic units (OTUs) classified to genera Fusobacterium, Prevotella and Selenomonas were more abundant in smokers, while OTUs belonging to the genera Peptococcus and Capnocytophaga were more abundant in non-smokers. Principal coordinate analysis identified two clusters; one was composed mainly of smokers (80%) and revealed significantly lower taxonomic diversity, higher attachment loss and higher proportion of the genera Fusobacterium, Paludibacter and Desulfobubus. Conclusion In periodontitis, there is a difference in the composition of the subgingival microbiome between smokers and non-smokers, as revealed by pyrosequencing. This difference was not identified by the targeted techniques. Low taxonomic diversity was associated with higher disease severity, especially in smokers. This supports the hypothesis of the ecological microbial-host interaction in the severity of periodontal disease. [ABSTRACT FROM AUTHOR]

Aim Assessment of the effect of non-surgical periodontal therapy ( SRP) on serum inflammatory parameters in patients with untreated aggressive (AgP) and chronic (ChP) periodontitis. Methods Overall, 31 ChP and 29 AgP were examined clinically prior to and 12 weeks after SRP (subgingival scaling of all pockets within 2 days) with systemic antibiotics for patients positive for Aggregatibacter actinomycetemcomitans (14 AgP, 9 ChP). Blood was sampled prior to, one day, 6, and 12 weeks after the first SRP visit. Serum elastase, C-reactive protein ( CRP), lipopolysaccharide-binding protein ( LBP), interleukin ( IL) 6, 8, and leukocyte counts were assessed. Results At baseline, serum elastase, CRP, and LBP were significantly ( p < 0.01) higher in AgP than ChP. Serum elastase, CRP, LBP, and IL-6 were significantly ( p < 0.001) elevated one day after scaling in both groups. Both groups showed significant clinical improvement ( p < 0.001). A significant difference was observed regarding change of serum elastase 12 weeks after SRP between AgP and ChP ( p = 0.015). Multiple regression analysis revealed AgP, African origin, and bleeding on probing to be associated with more pronounced elastase reduction. CRP reduction was associated with African origin, systemic antibiotics, and baseline probing pocket depth. Conclusion SRP results in serum elastase reduction in AgP but not in ChP. [ABSTRACT FROM AUTHOR]

Aim The microbial differences between peri-implantitis and periodontitis in the same subjects were examined using 16S rRNA gene clone library analysis and real-time polymerase chain reaction. Materials and methods Subgingival plaque samples were taken from the deepest pockets of peri-implantitis and periodontitis sites in six subjects. The prevalence of bacteria was analysed using a 16S rRNA gene clone library and real-time polymerase chain reaction. Results A total of 333 different taxa were identified from 799 sequenced clones; 231 (69%) were uncultivated phylotypes, of which 75 were novel. The numbers of bacterial taxa identified at the sites of peri-implantitis and periodontitis were 192 and 148 respectively. The microbial composition of peri-implantitis was more diverse when compared with that of periodontitis. Fusobacterium spp. and Streptococcus spp. were predominant in both peri-implantitis and periodontitis, while bacteria such as Parvimonas micra were only detected in peri-implantitis. The prevalence of periodontopathic bacteria was not high, while quantitative evaluation revealed that, in most cases, prevalence was higher at peri-implantitis sites than at periodontitis sites. Conclusions The biofilm in peri-implantitis showed a more complex microbial composition when compared with periodontitis. Common periodontopathic bacteria showed low prevalence, and several bacteria were identified as candidate pathogens in peri-implantitis. [ABSTRACT FROM AUTHOR]

Aim Adenosine receptors modulate inflammation in periodontal tissues. No data are available regarding the effects of adenosine A2A receptor stimulation in experimental periodontitis ( EPD). The aim of this study was to investigate the effects of polynucleotides (also known as polydeoxyribonucleotide, PDRN), a ligand of A2A receptor, in EPD in rats. Materials and Methods EPD was induced ligating the cervix of the lower left first molar. Sham- EPD had no ligature. After 7 days, EPD animals were randomized to a daily treatment with vehicle gel or 0.75% PDRN gel or PDRN gel with a specific A2A antagonist ( DMPX). Treatments lasted 7 days. Animals were then euthanized and the periodontium and surrounding gingival tissue were excised for histological evaluation and bio-molecular analysis of inflammatory (p- JNK, p- ERK, TNF-α, IL-6, HMGB-1) and apoptotic proteins ( BAX and Bcl-2). Results Vehicle-treated EPD rats showed severe inflammatory infiltrate in both gingival and periodontal ligament, as well as an enhanced expression of p- JNK, p- ERK, TNF-α, IL-6, HMGB-1 and BAX and a reduction in Bcl-2. PDRN gel restored the histological features, blunted inflammatory and apoptotic proteins expression and preserved Bcl-2 expression. DMPX abrogated PDRN positive effects. Conclusion Our data suggest that adenosine receptor stimulation by PDRN might represent a new therapeutic strategy for periodontitis. [ABSTRACT FROM AUTHOR]

Background Metabolic syndrome (MetS) may be associated with periodontitis. This study aimed to investigate whether the existence of periodontitis and MetS is cross-sectionally associated with matrix metalloproteinase ( MMP) in gingival crevicular fluid ( GCF) among community Koreans. Materials and Methods Medical and periodontal parameters were evaluated by physicians and dentists in 314 subjects (199 healthy, 58 only periodontitis, 34 only MetS and 23 both). The community periodontal index was used to assess periodontitis. MMP-8, 9, 13 were determined by enzyme-linked immunosorbent assay. Age, gender, monthly household income, smoking and drinking were interviewed as confounders. Analysis of covariance ( ANCOVA) was applied. Gender-stratified analyses were applied. Results After controlling for various confounders, MMP-8, MMP-9 and MMP-13 in GCF were significantly associated with periodontitis in both genders and MMP-9, MMP-13 were associated with MetS in women. MMP-8, MMP-9 and MMP-13 showed association with periodontitis-MetS coexistence non-synergistically in both genders. MMP-9 was synergistically associated with periodontitis-MetS coexistence in women. Conclusion Our results suggest that MMP-8, MMP-9, MMP-13 in GCF were independently related to coexistence of periodontitis and MetS. MMP-9 and MMP-13 could be an appropriate common indicator of periodontitis and MetS in women. Further studies might guarantee that MMPs in GCF could screen periodontitis and MetS. [ABSTRACT FROM AUTHOR]

Aim This study was undertaken to investigate the existence of a periodontopathic bacterium, Fusobacterium nucleatum, in chorionic tissues of pregnant women, and the effects of F. nucleatum on human chorion-derived cells. Materials and Methods Oral and chorionic tissue samples were collected from 24 high-risk pregnant women and 15 normal pregnant women. The presence of F. nucleatum in the samples was detected using polymerase chain reaction. Chorion-derived cells and Toll-like receptor ( TLR)-2 or TLR-4 gene-silenced chorion-derived cells were stimulated with F. nucleatum lipopolysaccharide ( LPS). Interleukin ( IL)-6 and corticotrophin-releasing hormone ( CRH) levels in the culture supernatants were measured using ELISA. Results F. nucleatum was detected in all oral samples and seven chorionic tissues from the high-risk pregnant women, but was not detected in chorionic tissues from the normal pregnant women. F. nucleatum LPS significantly increased IL-6 and CRH secretion by chorion-derived cells. The F. nucleatum LPS-induced IL-6 and CRH levels were significantly reduced in TLR-2 or TLR-4 gene-silenced chorion-derived cells. Conclusions We suggest that F. nucleatum is detected in chorionic tissues of high-risk pregnant women, but not in chorionic tissues of normal pregnant women, and that F. nucleatum induces IL-6 and CRH production via both TLR-2 and TLR-4 in chorion-derived cells. [ABSTRACT FROM AUTHOR]

Aim Although it is established that peri-implantitis is a bacterially induced disease, little is known about the bacterial profile of peri-implant communities in health and disease. The purpose of the present investigation was to examine the microbial signatures of the peri-implant microbiome in health and disease. Materials and methods Subgingival and submucosal plaque samples were collected from forty subjects with periodontitis, peri-implantitis, periodontal and peri-implant health and analysed using 16 S pyrosequencing. Results Peri-implant biofilms demonstrated significantly lower diversity than subgingival biofilms in both health and disease, however, several species, including previously unsuspected and unknown organisms, were unique to this niche. The predominant species in peri-implant communities belonged to the genera Butyrivibrio, Campylobacter, Eubacterium, Prevotella, Selenomonas, Streptococcus, Actinomyces, Leptotrichia, Propionibacterium, Peptococcus, Lactococcus and Treponema. Peri-implant disease was associated with lower levels of Prevotella and Leptotrichia and higher levels of Actinomyces, Peptococcus, Campylobacter, non-mutans Streptococcus, Butyrivibrio and Streptococcus mutans than healthy implants. These communities also demonstrated lower levels of Prevotella, non-mutans Streptococcus, Lactobacillus, Selenomonas, Leptotrichia, Actinomyces and higher levels of Peptococcus, Mycoplasma, Eubacterium, Campylobacter, Butyrivibrio, S. mutans and Treponema when compared to periodontitis-associated biofilms. Conclusion The peri-implant microbiome differs significantly from the periodontal community in both health and disease. Peri-implantitis is a microbially heterogeneous infection with predominantly gram-negative species, and is less complex than periodontitis. [ABSTRACT FROM AUTHOR]

Aim To determine the strength of association of type 2 diabetes mellitus and periodontal disease with the oral inflammatory burden, as assessed by markers of inflammation in saliva. Material and Methods Unstimulated saliva samples were collected from 192 subjects with or without type 2 diabetes. β-glucuronidase ( βG) was measured via a fluorometric array and interlukin-1β ( IL-1β) via enzyme-linked immunosorbent assay. The concentration of both mediators was evaluated in relationship to clinical parameters, severity of periodontal disease and diabetes status. Results Regression analysis demonstrated that diabetes and periodontal disease was independently and positively correlated with increased concentration of βG in saliva ( p < 0.001). Moreover, the relative association of periodontal disease with the level of βG in saliva was greater than the strength of association of the diabetic status. IL-1β concentration in saliva was primarily associated with the severity of periodontal disease ( p < 0.01), but not the presence of diabetes ( p = 0.50). Conclusions This study examined the nature of the inflammatory response in the oral cavity as assessed by inflammatory markers in saliva. Both periodontal disease and diabetes mellitus were independently associated with the oral inflammatory burden, in which the effect of periodontal disease was more pronounced. [ABSTRACT FROM AUTHOR]

Aim The influence of non-surgical periodontal therapy on oral health-related quality of life ( OHQoL) was investigated. Materials and Methods Sixty-five Chinese adults (25 men, mean 47.4 years) with moderate-to-advanced chronic periodontitis were recruited. All received oral hygiene instructions ( OHI) and non-surgical periodontal treatment in a quadrant-wise approach, followed by recalls at 1, 3, 6, 9 and 12 months post treatment, when OHI and prophylaxis were repeated. Clinical parameters were recorded, and oral health impact profile short-form ( OHIP-14 S) was administered at all time points. Results Moderate-to-deep sites (≥4 mm) decreased from 31.0% to 3.0% at 12 months post treatment ( p < 0.005) which corresponded well with reductions in plaque, 72.8% to 25.4% ( p < 0.005) and bleeding on probing, 86.3% to 32.0% ( p < 0.005). Median OHIP-14 S scores gradually reduced from 17 at baseline to 14 over the first 6 months and remained plateaued at 12-month post treatment ( p < 0.005). Improvements in subdomains of physical pain, psychological discomfort and psychological disability accounted for the changes. Conclusion This study demonstrates that OHQoL, in particular, pain and psychological subdomains, improvement was associated with non-surgical periodontal therapy responses. Clinicians could capitalize upon the positive psychological OHQoL impacts of mechanical periodontal treatment for subsequent patient-centred motivation during maintenance therapy. [ABSTRACT FROM AUTHOR]

Aim: Several studies have suggested that metabolic disorders are related to periodontitis. The objective of this study is to assess whether periodontitis is associated with the metabolic syndrome ( MetS) among Koreans. Material and Methods This case-control study was performed among 167 cases with MetS and 166 healthy controls from Shiwha- Banwol Environmental Health Cohort ( N = 1853). The community periodontal index ( CPI) was used to assess periodontitis ( CPI 3-4). MetS was an outcome variable and periodontitis was a main explanatory variable. Age-gender-matched conditional logistic regression models were applied. Monthly household income, smoking, drinking, physical activity and diabetes mellitus were factored as confounders. We also performed stratified analyses according to confounders. Results Those with periodontitis are more likely to be patients with MetS than those without periodontitis. The adjusted odds ratio of periodontitis for MetS was 1.76. There was no significant dose-effect response on the relationship between the number of sextants with periodontitis and MetS. Links became higher in adults aged 45-60 years and adults without diabetes mellitus. Conclusions These results suggest that periodontitis could be an independently related factor on MetS. Hence, dentists and physicians should be aware of the importance of periodontitis as a potential source of inflammatory burden. [ABSTRACT FROM AUTHOR]

Aim The aim of this 5-years longitudinal study was to investigate the pattern and rate of periodontal attachment loss ( PAL) progression in an urban population in South Brazil. Methods In 2001, a multistage probability sampling strategy was used to derive a representative sample of 1,465 dentate individuals from Porto Alegre, Brazil. Five years later, 697 dentate individuals (294 M/403 F, mean age: 37.9 ± 13.3) were available for follow-up. PAL was assessed by calibrated examiners using a full-mouth protocol. Estimates of proximal PAL progression and standard errors ( SE) are reported. Results Fifty-six per cent ( SE: 1.9) and 36% ( SE: 1.8) of subjects showed PAL progression ≥3 mm affecting ≥2 and ≥4 teeth respectively. PAL progression ≥3 mm was mostly localized affecting 3.8 ( SE: 0.2) teeth and 5.7 ( SE: 0.3) sites. Annual PAL progression was, on average, 0.3 mm ( SE: 0.01). Significant differences in PAL progression were observed according to age, gender, race and socioeconomic status. PAL progression increased with age reaching the highest progression rate in the 40-49 years cohort, and then decreased in older age groups. PAL progression was consistently higher among males and non-Whites than females and whites. Conclusion A large proportion of this urban Brazilian sample was affected by PAL progression underscoring the need for health promotion initiatives aiming at preventing progression of destructive periodontal disease. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to assess the role of anti-bone resorptive agents and an anti-inflammatory compound in murine Porphyromonas gingivalis ( P. gingivalis) -induced periodontitis. Material and Methods Six randomly assigned groups were administered vehicle (saline, control) ( n = 6), P. gingivalis infection only (untreated) ( n = 6), human- Fc ( n = 4), Kavain ( n = 6), OPG-Fc ( n = 6) and Receptor activator of nuclear factor-kappa B ( RANK)-Fc ( n = 6) intraperitoneally at day 0, 3 and 7. Animals were euthanized on day 10 and subjected to comprehensive histomorphometric analysis. To capture the progress of inflammation, serum samples were collected at days 0, 3, 7 and 10 for levels of pro-inflammatory cytokines. Results Compared with control group, OPG-Fc, RANK-Fc and Kavain treatment showed significant bone loss reduction with OPG-Fc performing better than RANK-Fc or Kavain. Epithelial down-growth showed significant reduction in treatment groups with OPG-Fc performing better than RANK-Fc or Kavain. Finally, Kavain, OPG-Fc and RANK-Fc-treated mice displayed reduced inflammatory cell counts and cytokine expression particularly at day 7 postinfection. Conclusions RANKL antagonists and Kavain effectively reduced alveolar bone loss in P. gingivalis-induced periodontitis in our mice model. Compared with RANK-Fc, Kavain-treated animals showed milder improvement of bone and connective tissue inflammation. Therapeutic implications in the prevention of periodontal bone loss are discussed. [ABSTRACT FROM AUTHOR]

Franchini R, Petri A, Migliario M, Rimondini L: Poor oral hygiene and gingivitis are associated with obesity and overweight status in paediatric subjects. J Clin Periodontol 2011; 38: 1021-1028. doi: 10.1111/j.1600-051X.2011.01770.x. Abstract Aim: The association between obesity and periodontitis has been extensively investigated in adults but not in young people. Our aim is to evaluate whether overweight/obese paediatric patients have a greater chance of being affected by gingivitis than those of normal weight. Subjects and Methods: Ninety-eight subjects ranging between 10 and 17 years of age were classified as obese/overweight or normal weight on the basis of body mass index. Auxological data, blood pressure, insulin resistance, psychological profile, oral hygiene habits, plaque and gingival indices were collected. Results: Anthropometric measurements and blood pressure were significantly higher in overweight/obese subjects than in the normal-weight subjects ( p<0001). The overweight/obese subjects showed a worse attitude towards oral hygiene. Two-way anova revealed a significant effect of obesity status ( p<0001) on the gingival index. Logistic and linear regression analyses identified gingivitis as dependent on insulin resistance and bad oral hygiene rather than on the overweight/obese status simply defined. Negative psychological features related to physical and academic self-concept were also risk factors for gingivitis probably because they were related to a generic poor self-awareness. Conclusion: The gingivitis observed in overweight and obese young subjects is probably due to a combination of metabolic and inflammatory profiles and neglected attitude towards oral hygiene. [ABSTRACT FROM AUTHOR]