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Gingivitis and periodontitis are associated with a negative impact on Oral Health Related Quality of Life (OHRQoL), exerting a significant influence on aspects related to the patients' function and esthetics. Periodontitis has been associated with several systemic conditions, including adverse pregnancy outcomes, cardiovascular diseases, type 2 diabetes mellitus (DM), respiratory disorders, fatal pneumonia in hemodialysis patients, chronic renal disease and metabolic syndrome. The aim of this paper was to review the results of different periodontal treatments and their impacts on patients' OHRQoL and systemic health. Non-surgical and surgical periodontal treatments are predictable procedures in terms of controlling infection, reducing probing pocket depth and gaining clinical attachment. In addition, the treatment of periodontitis may significantly improve OHRQoL and promote a reduction in the levels of systemic markers of inflammation, including some cytokines associated with cardiovascular diseases. Studies have also suggested that periodontal treatment may improve glycemic control in patients with DM. Strategies and actions for preventing the onset and recurrence of periodontitis, and the challenges facing the field of periodontology in the XXI century are presented in this review. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of adjunct systemic antibiotic treatment with metronidazole (MTZ) and amoxicillin (AMX) in patients receiving non-surgical subgingival debridement (NSD) for peri-implantitis. Forty subjects presenting with at least one implant with severe peri-implantitis were randomized into an experimental group [treated with NSD plus MTZ (400 mg) and AMX (500 mg) three times a day for 14 days] and a control group treated with NSD plus placebo. Clinical parameters and submucosal biofilm profiles were evaluated up to 1 year post-treatment. Overall, both treatments improved clinical parameters over time. At 1 year, mean probing depth (PD), mean clinical attachment (CA) level and proportions of red complex pathogens did not differ significantly between the two groups. In addition, mean PD and CA changes to 1-year posttreatment did not differ significantly between the two groups between baseline and 1-year post-treatment. These results suggest that the addition of MTZ and AMX to the treatment protocol of patients undergoing NSD for with severe peri-implantitis does not improve the clinical and microbiological outcomes of NSD. The fact that half of the implants in both groups did not achieve clinical success (PD < 5 mm, no BoP, no bone loss) suggest that neither of the tested protocols were effective for treating severe peri-implantitis. [ABSTRACT FROM AUTHOR]

The aim of this review is to summarize the evidence on associations between diabetes mellitus (DM) and complications around dental implants. Electronic database searches of MEDLINE, EMBASE, JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews and the PROSPERO register were performed from 1990 up to and including May 2018, using MeSH terms and other keywords. Systematic reviews and meta-analyses investigating the associations of DM and implant complications (failure, survival, bone loss, peri-implant diseases, and post-surgery infection) were eligible. The quality of the included reviews was determined using the Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2). Twelve systematic reviews were included. Implant survival rates ranged from 83.5% to 100%, while implant failure rates varied from 0% to 14.3% for subjects with DM. The three meta-analyses performed for event "implant failure" reported no statistically significant differences between diabetic and non-diabetic subjects. An apparently increased risk of peri-implantitis is reported in patients with DM. According to the AMSTAR 2 classification, 50% of the reviews were classified as being of "critically low", 25% as of "low" and 25% as of "moderate" quality. Evidence indicates high levels of survival and low levels of failure of implants inserted in patients with DM. However, DM was assessed as a whole in the majority of studies and, the actual influence of hyperglycemia on implant survival/failure is still uncertain. DM/hyperglycemia seems to be associated with a high risk of peri-implantitis. However, this conclusion is based on a limited number of systematic reviews. [ABSTRACT FROM AUTHOR]

Additive manufacturing (AM) is an emerging process for biomaterials and medical devices. Direct Laser Metal Sintering (DLMS) is an AM technique used to fabricate Ti-6Al-4V implant materials with enhanced surface-related properties compared with wrought samples; thus, this technique could influence microbial adsorption and colonization. Therefore, this in vitro study was conducted to evaluate the impact of different implant production processes on microbial adhesion of periodontal pathogens. Titanium discs produced using two different processes--conventional and AM--were divided into three groups: conventional titanium discs with machined surface (G1), AM titanium discs with chemical treatment (G2) and AM titanium discs without chemical treatment (G3). Subgingival biofilm composed of 32 species was formed on the titanium discs, and positioned vertically in 96-well plates, for 7 days. The proportions of microbial complexes and the microbial profiles were analyzed using a DNA-DNA hybridization technique, and data were evaluated using Kruskal-Wallis and Dunnett tests (p < 0.05). Lower proportions of the red complex species were observed in the biofilm formed in G2 compared with that in G1 (p < 0.05). Moreover, the proportions of the microbial complexes were similar between G2 and G3 (p > 0.05). Compared with G1, G2 showed reduced levels of Porphyromonas gingvalis, Actinomyces gerencseriae, and Streptococcus intermedius, and increased levels of Parvimonas micra, Actinomyces odontolyticus, and Eikenella corrodens (p < 0.05). The microbial profile of G3 did not differ from G1 and G2 (p > 0.05). The results of this in vitro study showed that titanium discs produced via AM could alter the microbial profile of the biofilm formed around them. Further clinical studies should be conducted to confirm these findings. [ABSTRACT FROM AUTHOR]

The aim of this randomized, single blinded clinical trial was to evaluate the effect of a pre-procedural mouthwash containing cetylpyridinium chloride (CPC), zinc lactate (Zn) and sodium fluoride (F) in the reduction of viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler. Sixty systemically healthy volunteers receiving dental prophylaxis were randomly assigned to one of the following experimental groups (15 per group): (i) rinsing with 0.075% CPC, 0.28% Zn and 0.05% F (CPC+Zn+F), (ii) water or (iii) 0.12% chlorhexidine digluconate (CHX), and (iv) no rinsing. Viable bacteria were collected from different locations in the dental office on enriched TSA plates and anaerobically incubated for 72 hours. The colonies were counted and species were then identified by Checkerboard DNA-DNA Hybridization. The total number of colony-forming units (CFUs) detected in the aerosols from volunteers who rinsed with CPC+Zn+F or CHX was statistically significantly (p<0.05) lower than of those subjects who did not rinse or who rinsed with water. When all locations were considered together, the aerosols from the CPC+Zn+F and CHX groups showed, respectively, 70% and 77% fewer CFUs than those from the No Rinsing group and 61% and 70% than those from the Water group. The mean proportions of bacterial species from the orange complex were statistically significantly (p<0.05) lower in aerosols from the CPC+Zn+F and CHX groups compared with the others two groups. In conclusion, the mouthwash containing CPC+Zn+F, is effective in reducing viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the ability of the BANA Test to detect different levels of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia or their combinations in subgingival samples at the initial diagnosis and after periodontal therapy. Periodontal sites with probing depths between 5-7 mm and clinical attachment level between 5-10 mm, from 53 subjects with chronic periodontitis, were sampled in four periods: initial diagnosis (T0), immediately (T1), 45 (T2) and 60 days (T3) after scaling and root planing. BANA Test and Checkerboard DNA-DNA hybridization identified red complex species in the subgingival biofilm. In all experimental periods, the highest frequencies of score 2 (Checkerboard DNA-DNA hybridization) for P. gingivalis, T. denticola and T. forsythia were observed when strong enzymatic activity (BANA) was present (p < 0.01). The best agreement was observed at initial diagnosis. The BANA Test sensitivity was 95.54% (T0), 65.18% (T1), 65.22% (T2) and 50.26% (T3). The specificity values were 12.24% (T0), 57.38% (T1), 46.27% (T2) and 53.48% (T3). The BANA Test is more effective for the detection of red complex pathogens when the bacterial levels are high, i.e. in the initial diagnosis of chronic periodontitis. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to examine the relationship between the composition of the subgingival microbiota and the vitamin D receptor (VDR) gene polymorphism in Brazilian adults with chronic periodontitis. The clinical parameters of probing depth, clinical attachment level, bleeding on probing, plaque accumulation and suppuration were measured in 60 Caucasian adults who were divided into two groups: 30 healthy individuals (control) and 30 with chronic periodontitis (ChP). Subgingival plaque samples were collected from 6 sites per subject and analyzed for 38 bacterial species using the Checkerboard DNA-DNA Hybridization. DNA was obtained from the subjects' epithelial cells by scraping the buccal mucosa and using a mouthwash containing 3% of glucose. Polymorphism in the VDR gene was analyzed by the polymerase chain reaction (PCR), followed by Taql digestion (RFLP). The healthy subjects presented significantly lower levels (0.3 × 107 ± 0.7 × 107) of total microbial counts in comparison with subjects with chronic periodontitis (4.5 × 107 ± 2.9 × 107). Regarding the occurrence of VDR polymorphism, it was observed that the Tt genotype was more prevalent in the Periodontitis group (60%) than in the Healthy group (30%), while the prevalences of the TT genotype were 23.3% and 53.3%, respectively (Chi-square test, p < 0.05). No difference was found in the composition of subgingival microbiota among the VDR genotypes evaluated for the Healthy and Periodontitis groups. In conclusion, the Tt genotype was associated with periodontal disease; however, no association with the subgingival microbiota was observed. [ABSTRACT FROM AUTHOR]