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Aim: To assess the beneficial and adverse effects on the dental and periodontal issues of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis. Materials and methods: Nine databases were searched in April 2020 for randomized/non-randomized clinical studies. After duplicate study selection, data extraction, and risk-of-bias assessment, random-effect meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression analyses. Results: A total of 30 randomized and non-randomized clinical studies including 914 patients (29.7% male; mean age 43.4 years) were identified. Orthodontic treatment of pathologically migrated teeth was associated with clinical attachment gain (-0.24 mm; seven studies), pocket probing depth reduction (-0.23 mm; seven studies), marginal bone gain (-0.36 mm; seven studies), and papilla height gain (-1.42 mm; two studies) without considerable adverse effects, while patient sex, gingival phenotype, baseline disease severity, interval between periodontal and orthodontic treatment, and orthodontic treatment duration affected the results. Greater marginal bone level gains were seen by additional circumferential fiberotomy (two studies; MD = -0.98 mm; 95% CI = -1.87 to -0.10 mm; p = .03), but the quality of evidence was low. Conclusions: Limited evidence of poor quality indicates that orthodontic treatment might be associated with small improvements of periodontal parameters, which do not seem to affect prognosis, but more research is needed. [ABSTRACT FROM AUTHOR]

Aims: We aimed to update a previous network meta‐analysis comparing the efficacy of periodontal regenerative therapies on the treatment of infrabony lesions. Materials and Methods: Seven clinical trials were added after literature research for studies published between January 2011 and September 2019. We conducted network meta‐analysis (NMA) to compare the effects of guided tissue regeneration (GTR), enamel matrix derivatives (EMD) and their combination therapies on probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain. Sequential network meta‐analysis (SNMA) was also used to control the type‐I error rate due to multiple testing. Results: A total of 60 studies were included. For both PPD reduction and CAL gain, the flap operation (FO) was the least effective treatment. Although the differences between periodontal regenerative therapies were small, GTR attained the greatest reduction in PPD, and EMD with bone graft the greatest CAL gain compared to other therapies. SNMA used stricter efficacy criteria, yielding slightly different results from NMA. Conclusions: EMD, GTR, and their combined therapies were more effective than flap operation, although the differences between regenerative therapies remain small in this updated study. SNMA reduces the risk of false‐positive findings, thereby providing more robust evidence on the superiority of treatments. [ABSTRACT FROM AUTHOR]

Aim: The aim of the current systematic review was to critically appraise evidence from randomized and prospective non‐randomized comparative clinical trials about the efficacy of lateral bone augmentation prior to implant placement and their outcome regarding bone width gain. Materials and Methods: Eight databases were searched until May 2018 for randomized and prospective non‐randomized comparative trials on lateral bone augmentation prior to implant placement. After elimination of duplicate studies, data extraction and risk‐of‐bias assessment according to the Cochrane guidelines, random‐effects meta‐analyses of mean differences (MD) or relative risks (RR) and their 95% CIs were performed, followed by subgroup, meta‐regression and sensitivity analyses. Results: Overall, 25 trials (16 randomized/9 non‐randomized) were identified, which included a total of 553 patients (42.2% male; mean age of 43.9 years). In these included studies and populations, various modalities for primary lateral bone augmentation rendered implant placement feasible. Small discrepancies were found between overall clinical and radiographic gain (pooled gains of 3.45 ± 1.18 mm versus 2.90 ± 0.83 mm, respectively), but were not statistically significant. Bone width gain was significantly inversely associated with baseline bone width (pooled effect: −0.35 mm/mm; 95% CI: −0.63 to −0.07 mm; p = 0.01). Additionally, % graft resorption was associated with patient age (36%/year, 95% CI: −0.62 to −0.11 mm; p = 0.01). The presence of xenograft added to autologous graft led to less resorption compared to autologous graft alone (MD: 1.06 mm; 95% CI: 0.21 to 1.92 mm; p = 0.01). Barrier membrane did not yield significant difference in terms of bone width gain (MD: −0.33 mm; 95% CI: −2.24 to 1.58 mm; p > 0.05) and graft resorption (MD: 0.84 mm; 95% CI: −1.42 to 3.09 mm; p > 0.05). However, the quality of evidence ranged from very low to moderate due to bias and imprecision. Conclusions: Initially smaller bone dimensions are associated with favours larger bone width gain, which indicates that a severe lateral bone deficiency can be effectively augmented applying primary lateral bone augmentation. Both Patients' age and recipient site (maxilla or mandible) seem to influence graft resorption. The addition of a xenograft can be helpful in reducing graft resorption. Existing evidence from randomized and prospective non‐randomized trials on humans indicates that lateral bone augmentation prior to implant placement can successfully increase bone width. There are some indications that patient‐related, site‐related, and technique‐related characteristics might influence the amount of gained bone width, but the quality of evidence is for the most part hampered by the small number of existing studies and methodological limitations that might lead to bias. [ABSTRACT FROM AUTHOR]

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]

Dimou NL, Nikolopoulos GK, Hamodrakas SJ, Bagos PG. Fc γ receptor polymorphisms and their association with periodontal disease: a meta-analysis. J Clin Periodontol 2010. 37: 255–265 doi: 10.1111/j.1600-051X.2009.01530.x. Aim: A systematic review and a meta-analysis were conducted in order to investigate the potential association of Fc γ receptor (Fc γR) polymorphisms with susceptibility to aggressive and chronic periodontal disease. Materials and Methods: A database search yielded a total of 17 studies involving 1685 cases and 1570 controls. Three polymorphisms were included in the meta-analysis: Fc γRIIA H131R (rs1801274), Fc γRIIIA F158V (rs396991) and Fc γRIIIB NA1/NA2. Random-effect models were used in the analysis. Odds ratios (ORs) along with their 95% confidence intervals (CIs) were computed to compare the distribution of alleles and genotypes between cases and controls. Results and Conclusions: The Fc γRIIIB NA1/NA2 polymorphism was associated with both aggressive (per-allele OR 2.005, 95% CI: 1.044, 3.851) and chronic periodontitis (recessive contrast NA2NA2 versus NA1NA1+NA1NA2 OR 1.397, 95% CI: 1.039, 1.878). The analysis showed weak evidence for association between the Fc γRIIA H131R polymorphism and aggressive periodontitis in Asians (R versus H allele OR 1.579, 95% CI: 1.025, 2.432). On the contrary, no relationship was identified between Fc γRIIIA F158V and periodontal disease. Accumulating evidence from basic research makes the suggested association between Fc γRIIIB NA1/NA2 polymorphism and periodontitis biologically plausible. Further research, however, is needed in order to assess possible gene–gene or gene–environment interactions (i.e. with smoking). [ABSTRACT FROM AUTHOR]

Objectives: The aim of this prospective comparative study was to evaluate the survival rate, condition of peri-implant tissues, patient satisfaction and surgical and prosthetic aftercare of the IMZ-implant system (two-stage cylinder type), the Brånemark-implant system (two-stage screw type) and the ITI-implant system (one-stage screw type) supporting a mandibular overdenture during a 10-year follow-up period. Materials and Methods: Three groups of 30 edentulous patients were treated with two endosseous implants in the interforaminal region of the mandible. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment and after 1, 5 and 10 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period, as well as patient satisfaction. Results: The 10-year survival rate was 93% for the IMZ group, 98% for the Brånemark group and 100% for the ITI group (IMZ

Aim: To investigate potential effect of bias on magnitude of outcomes. Material and Methods: Randomized-controlled trials (RCTs) from the Cochrane Database of Systematic Reviews were searched. Methodological quality of RCTs was assessed in terms of allocation concealment and examiner masking. Meta-regression analyses were used to determine associations between the quality assessments and magnitude of treatment outcomes on probing depth and attachment level. Results: Thirty-five RCTs were identified from five systematic reviews. Adequate allocation concealment and examiner masking were found in 24% and 64% of trials respectively. There were no statistically significant differences in the magnitude of treatment outcomes comparing adequate versus inadequate or unclear allocation concealment, nor comparing adequate and inadequately examiner masked trials. However, a retrospective power calculation indicated 265 RCTs would be needed to demonstrate a statistically significant effect for the impact of bias on CAL as an outcome measure for a 0.5 mm exaggeration of mean difference between test and control. Conclusions: There is insufficient evidence to support or refute the theory that the bias from improper methods of allocation concealment and examiner masking affect the magnitude of clinical outcomes in periodontology trials. The pilot data provide a baseline for sample size calculations in future research. [ABSTRACT FROM AUTHOR]

Aim: We conducted a systematic review and a meta-analysis, in order to investigate the potential association of cytokine gene polymorphisms with either aggressive or chronic periodontal disease. Material and Methods: A comprehensive literature search was performed. We retrieved a total of 53 studies summarizing information about 4178 cases and 4590 controls. Six polymorphisms were included in our meta-analysis which are the following: IL-1A G[4845]T, IL-1A C[−889]T, IL-1B C[3953/4]T, IL-1B T[−511]C, IL-6 G[−174]C and TNFA G[−308]A. Random effect methods were used for the analysis. We calculated the specific odds ratios along with their 95% confidence intervals to compare the distribution of alleles and genotypes between cases and controls. Results and Conclusions: Using random effect methods we found statistically significant association of IL-1A C[−889]T and IL-1B C[3953/4]T polymorphisms with chronic periodontal disease without any evidence of publication bias or significant statistical heterogeneity. A weak positive association was also found concerning IL-1B T[−511]C and chronic periodontal disease. No association was found for all the cytokines examined as far as the aggressive form of the disease is concerned. Future studies may contribute to the investigation of the potential multigenetic predisposition of the disease and reinforce our findings. [ABSTRACT FROM AUTHOR]

Aim: To evaluate and compare the microbiological effects of hand instruments, Er:YAG-laser, sonic, and ultrasonic scalers in patients with chronic periodontitis. Patient perception of each treatment was documented. Material and Methods: From 72 patients, bacterial samples were collected from the deepest pocket in each quadrant (total: 288 sites). A polymerase chain reaction kit estimated the amount of Aggregatibacter ( Actinobacillus) actinomycetemcomitans ( Aa), Porphyromonas gingivalis ( Pg), Prevotella intermedia ( Pi), Tannerella forsythensis ( Tf), and Treponema denticola ( Td) at baseline as well as 3 and 6 months after therapy. One quadrant in each patient was randomly assigned to curettes (H-group), Er:YAG laser (L-group), sonic device (S-group), or ultrasonic device (U-group). Results: Three months post-operatively, the amounts of Pg, Pi, Tf, and Td were significantly reduced in all groups. Laser and sonic instrumentation failed to reduce Aa. Six months after therapy, significant differences were still detected for Pg (L- and U-group), for Pi and Tf (S-group), and for Td (L-, S- and U-group). Patients rated ultrasonic treatment as more preferable than hand and laser instrumentation. Conclusion: The various treatment methods resulted in a comparable reduction of the evaluated periodontal pathogens, and bacterial increase was only partially different 6 months post-operatively. Ultrasonic instrumentation caused less discomfort. [ABSTRACT FROM AUTHOR]

Meijer HJA, Batenburg RHK, Raghoebar GM, Vissink A: Mandibular overdentures supported by two Brånemark, IMZ or ITI implants: a 5-year prospective study. J Clin Periodontol 2004 doi: 10.1111/j.1600-051X.2004.00510.x© Blackwell Munksgaard, 2004. The aim of this prospective comparative study was to evaluate the survival rate and the condition of the peri-implant tissues of the IMZ implant system (two-stage cylindertype), the Brånemark implant system (two-stage screwtype) and the ITI implant system (one-stage screwtype) supporting a mandibular overdenture during a 5-year follow-up period. Three groups of 30 edentulous patients were treated with two endosseous implants in the interforaminal region of the mandible. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment and after 1, 2, 3, 4 and 5 years of functional loading. The five-year survival rate is 98.3% for the IMZ group, 98.3% for the Brå group and 100% for the ITI group. Mean scores on indices for plaque, calculus, gingiva and bleeding were very low at all evaluation periods. Mean marginal bone loss over a period of 5 years, was 1.4 mm for the IMZ group, 0.7 mm for the Brå group and 0.9 mm for the ITI group. It is concluded that two implants placed in the interforaminal region, connected with a bar, supply a proper base for the support of a mandibular overdenture in the edentulous patient. After 5 years no clinically relevant and statistically significant radiographic changes had developed between the three implant systems. [ABSTRACT FROM AUTHOR]

Abstract Objectives: A meta-analysis technique was used to pool data from studies to assess the effectiveness of the pre-brushing rinse PLAX on existing plaque and gingivitis. Methods: Studies were identified using MEDLINE and other sources, and grouped according to whether PLAX was used in short- or long-term treatment. The quality of trials was assessed by 2 independent readers. The DerSimonian and Laird random effects model was used. Meta-analyses were performed according to duration and type of PLAX treatment. In “1-day” studies, the effect of PLAX after rinsing and after rinsing and brushing was evaluated, whereas in longitudinal studies, this was done at several follow-up times. Results: A total of 19 studies were included and mean quality scores ranged from 0.13 to 0.60, for the study protocol from 0.18 to 0.70 and for data analysis and presentation from 0.05 to 0.53. In “1-day” studies, PLAX significantly reduced plaque after rinsing (difference=0.143; 95% CI=0.02–0.27;p =0.022), whereas no significant reduction was observed in post-brushing measures. In “longitudinal” studies, plaque was significantly reduced at 1–2 (difference=0.168; 95% CI=0.09–0.24; p <0.0001), 3–4 (difference=0.179; 95% CI=0.01–0.35; p =0.043), 12 (difference=0.288; 95% CI=0.21–0.37; p <0.0001) and 24 (difference=0.377; 95% CI=0.19–0.57; p =0.0001) weeks. The meta-analysis that evaluated gingivitis showed a significant reduction in inflammation with PLAX treatment at 12 (difference=0.209; 95% CI=0.17–0.25; p <0.0001) and 24 (difference=0.257; 95% CI=0.22–0.29; p <0.0001) weeks follow-up. Conclusions: Although PLAX use appears to offer some benefit in plaque and gingivitis reduction, the clinical magnitude of the difference and the benefit on oral health are likely to be small. [ABSTRACT FROM AUTHOR]

AbstractObjective: To compare the progression of periodontal destruction in people with and without HIV. Method: Relative attachment loss on 6 index teeth was compared between 19 people with HIV and 17 people without HIV infection over 12 and 18 month follow ups. Results: The proportions of sites with 1, 2 or 3 mm of relative attachment loss were similar in the study and control groups. Mean maximum relative attachment loss was similar in both groups after 12 months but greater in the study group after 18 months. Conclusions: The data are not compelling evidence of greater periodontal destruction associated with HIV infection. Large scale cohort studies or meta-analyses would be more conclusive. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The use of systemic tetracycline in the treatment of periodontal disease has been controversial. To investigate this controversy, we performed a quality assessment and attempted to perform a meta-analysis of 13 published studies. We evaluated the quality of the study protocol and data analysis and presentation for each study, We were unable to combine data from the majority of studies due to heterogeneity of the outcomes evaluated and limitations in data reported in the individual studies. Therefore, only 2 studies were included in the quantitative meta-analysis. On a scale of 0-1. the mean score for this group of studies was 0.27 (±0.19) for study protocol and 0.31 (±0.11) for data analysis and presentation. Mean reduction in probing depth for the group treated with tetracycline plus scaling was 2.45 mm; for the group which received only scaling, 2.02 mm; for the group that received only tetracycline, 1.98 mm; and for the control group. 0.65 mm. We conclude that analysis of data from the published literature does not demonstrate that the use of systemic tetracycline is more beneficial than conventional treatment in the management of adult periodontal disease. More information is needed in order to perform an extensive meta-analysis of this subject. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The author reflects on the importance of the critical evaluation of data in determining the associations between oral and general health awareness. General health awareness appears to be an important alternative explanation for the association between flossing and obesity. The reported association between dental flossing and body mass index is not sufficiently compelling to initiate a randomized trial on whether dental flossing might help people lose weight.