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Aim: To investigate the dynamic changes of peri‐implant microbiome in patients with a history of periodontitis and to construct a microbial prediction model. Materials and methods: The prospective study was performed at one month (T1), one year (T2) and two years (T3) after restoration. Clinical examinations [probing depth (PD), bleeding on probing (BOP), suppuration (SUP)], radiographic examinations and sample collection were conducted at three timepoints. Peri‐implant sulcular fluid (PISF) was collected and analysed by 16S rRNA gene sequencing. Generalized linear mixed model (GLMM) was used to identify differences. Results: Totally, 168 subjects were assessed for eligibility. Twenty‐two patients were recruited in the longitudinal study. Eventually, 67 PISF samples from 24 implants of 12 patients were collected and analysed. Peri‐implant microbiome showed increasing diversity and complexity over time. Disease‐associated genera Porphyromonas, Tannerella, Treponema and Prevotella dramatically increased from T1 to T3. The prediction model for clinical suppuration at T1 showed a high accuracy of 90%. Conclusion: The dysbiosis of peri‐implant microbiome increased with time during the two‐year observation in patients with a history of periodontitis. Genera of Porphyromonas, Tannerella, Treponema and Prevotella were biomarkers of peri‐implant mucositis. Microbiota at the early stage could predict subsequent microbial dysbiosis and clinical suppuration. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of Deoxyribonuclease I (DNase I) coating on initial adhesion and biofilm formation of peri-implant bacteria. Titanium (Ti), Ti-polydopamine (Ti-PDOP), Ti-PDOP-DNase I and Ti-PDOP-inactivated DNase I samples were studied. The FE-SEM, EDS and XPS were used to confirm that DNase I was coated onto Ti. The initial adhesion and biofilm formation of Aggregatibacter actinomycetemcomitans (A.a) and Fusobacterium nucleatum (F.n) were observed by CLSM. The osteogenic induction of Ti-PDOP-DNase I on MC3T3-E1 cells was investigated by ALP activity and RT-PCR. The adhesion clearance rate of viable bacteria on the surfaces of Ti-PDOP-DNase I was 91.95% for A.a, and 96.37% for F.n, and the 24 h biofilm formation of the bacteria was significantly inhibited. In addition, on DNase I coating, the mRNA level of osteogenic marker genes (alp, opn, bsp, sp7) and the activity of ALP were both up-regulated. Therefore, DNase I coating could be an alternative approach for preventing implant-related infection. [ABSTRACT FROM AUTHOR]

The aim of this systematic review and meta-analysis was to determine the efficacy of chlorhexidine (CHX) as an adjunctive therapy to mechanical debridement in the treatment of peri-implant diseases. Five databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trails, Web of Science, and ClinicalTrials.gov) were searched. Randomized controlled trials (RCTs) comparing mechanical debridement combined with CHX to mechanical debridement alone for patients with peri-implant disease were identified. The trial investigators evaluated factors indicating inflammatory levels, including bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). Six RCTs with 207 patients were ultimately included in this review. Low- to moderate-quality evidence demonstrated that the adjunctive CHX therapy had no significant effect on BOP reduction within 1 month (mean difference [MD], 0.10; 95% confidence interval [CI], −0.06 to 0.25), 3–4 months (MD, 0.06; 95% CI, −0.03 to 0.15), and 6–8 months (MD, 0.06; 95% CI, −0.03 to 0.14) of follow-up. Significant differences in PD reduction and CAL gain were also not found. Although 1 subgroup analysis revealed a significant result (MD, 009; 95% CI, 0.01–0.18) for the use of CHX solution, this could be interpreted as clinically slight. Based on available evidence, adding CHX to mechanical debridement, compared with mechanical debridement alone, did not significantly enhance the clinical results. Therefore, clinicians should consider the negligible effect of adjunctive CHX. [ABSTRACT FROM AUTHOR]

This article presents a study on the identification and characterization of the predominant anaerobic bacterial flora in the sulcus around progressive peri-implantitis. The predominant bacterial species in the peri-implantitis sites include Eubacterium nodatum, Filifactor alocis and Slackia exigua. While the predominant bacteria in healthy implant sites include Pseudoramibacter alactolyticus, Veillonella species and Actinomyces israelii.

Objective: To retrospectively assess the interproximal bone loss (CBL) in external hexagon implants (EHI), with different surface micro‐topography, placed in the posterior mandible in patients with a history of periodontitis undergoing supportive periodontal care. Material and methods: 268 consecutive patients received 755 EHI implants in the mandibular molar region between 2007 and 2015 with the following surface characteristics: 72 turned, 145 hybrids (double acid‐etched/turned), and 538 anodized. CBL was yearly evaluated by analysing calibrated digital periapical radiographs, with a follow‐up of 1–6 years. Data on implant survival were also calculated. Results: At 6 years (53 patients), the mean CBL was 1.34/1.42 mm at patient/implant level, respectively (range: 0–5.2 mm). Significantly higher CBL was detected in anodized implants than in turned and hybrid implants (1.92/1.46/1.02 mm) (p <.01). The maximum CBL values were found in 2 anodized implants at 4 years (6.3 and 8.1 mm). CBL ≥2 mm was detected in 18% of implants at 3 years and 35% at 6 (p < 2.2 × 10−16), this prevalence being 2.6 times higher in the anodized than in the hybrid and turned group (40%/15.6%, p <.0094). At 6 years, 25 anodized implants presented CBL ≥3 mm (18%). 6 anodized implants (5 patients) were removed between 4 and 5 years. Conclusion: A significant higher CBL was observed in anodized, compared to hybrid and turned implants, when placed in the mandibular molar region of periodontal patients, with a follow‐up of 1 to 6 years. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to report 10‐year results of osteotome sinus floor elevation (OSFE) without grafting severely atrophic maxilla (residual bone height ≤4 mm). Materials and Methods: Patients undergoing OSFE without grafting and implant placement were included for 10‐year examinations. Implant survival, complication‐free survival, modified bleeding index (mBI), modified plaque index (mPI), pocket probing depth (PPD), peri‐implant marginal bone loss (MBL), endo‐sinus bone gain (ESBG) and mean cost of recurrence were evaluated. Results: Overall, 23 patients with 35 implants attended 10‐year examination. Cemented implant crowns or implant‐supported fixed dental prostheses were delivered to the patients. Kaplan–Meier implant survival was 89.2% at implant level and 84.1% at patient level. Complication‐free survival was 26.0% at patient level and 37.0% at implant level. The average complication‐free survival time was 74.6 months (95% CI: 63.2–86.0 months) at implant level and 69.1 months (95% CI: 54.8–83.4 months) at patient level. The mBI, mPI, PPD, MBL and ESBG at 10‐year follow‐up were 0.91 ± 0.58, 0.48 ± 0.51, 2.94 ± 0.79 mm, 1.63 ± 0.83 mm and 2.72 ± 0.51 mm, respectively. The cost of managing recurrence was 43.6% of the initial cost of treatment. Conclusion: The results of the present study indicate that OSFE without grafting is a reliable treatment option in severely atrophic maxilla. Acceptable survival rate, stable MBL and ESBG could be achieved within 10 years. Low complication‐free survival and high costs of recurrence management need to be considered. [ABSTRACT FROM AUTHOR]

Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it. [ABSTRACT FROM AUTHOR]

Background: The aims of the present study were to compare the microbial differences between peri-implant mucositis sites with or without suppuration, and to construct a classification model with microbiota.Methods: Twenty-four implants with peri-implant mucositis were divided into suppuration (SUP) group and non-suppuration (Non-SUP) group. Clinical assessments of bleeding index, probing depth, suppuration following probing (SUP) were recorded. Submucosal samples were collected from mesiobuccal sites and distobuccal sites, and analyzed by 16S rRNA gene sequencing. Generalized linear mixed model was used to adjust age, gender, location of implants, and intraindividual correlation.Results: It was demonstrated that the microbial richness was lower in SUP group. The relative abundance of some pathogenic taxa, such as genera of Fusobacterium, Tannerella, and Peptostreptococcus, were significantly higher in SUP group than Non-SUP group. In addition, SUP group had less Gram-positive bacteria, aerobic bacteria, and more metabolic pathway related to life activity. The classification model constructed with 12 genera got a 100% accuracy in identifying sites with or without suppuration.Conclusions: The results from this study demonstrate a higher pathogenicity of microbiome at peri-implant mucositis sites with suppuration than without suppuration, which supports suppuration as a clinical indicator for higher microbial risk. [ABSTRACT FROM AUTHOR]

Background: Effectiveness of scaling and root planing (SRP) with/without adjunct probiotic (Lactobacillus reuteri) treatment towards the reduction in periodontal inflammatory parameters (clinical attachment loss [AL], marginal bone loss [MBL], plaque index [PI], and bleeding on probing [BOP] in shamma users and non-users [controls] with chronic periodontitis [CP]) remains uninvestigated. The aim of the present randomized controlled trial was to compare the efficacy of SRP with and without adjunct probiotic therapy (PT) in the treatment of CP among shamma users and controls (individuals not using tobacco in any form).Methods: The study was conducted in accordance with the Consolidated Standards of Reporting Trials guidelines. Patient demographics were recorded using a questionnaire. Therapeutically, patients were allotted into four groups as follows: 1) group 1: Shamma chewers that underwent SRP alone; 2) group 2: Shamma-chewers that underwent SRP + PT; 3) group 3: Non-chewers that underwent SRP alone; and 4) group 4: Non-chewers that underwent SRP + PT. Periodontal parameters (PI, BOP, PD, clinical AL and mesial and distal MBL) were measured on all teeth except third molars at baseline and at 3- and 6-month follow-ups. Level of significance was set at P < 0.05.Results: In total, 31, 32, 31, and 33 individuals were included in groups 1, 2, 3, and 4, respectively. Among shamma users, there was no significant difference in the scores of PI, BOP, PD, clinical AL and MBL when SRP was performed with/without adjunct PT. Amongst controls, SRP with adjunct PT was more effective in reducing PI (P < 0.05), BOP (P < 0.05) and PD (P < 0.05) at 3-month follow-up. There was no significant difference in periodontal parameters at 3- and 6-month follow-ups in patients that underwent SRP with and without adjunct PT.Conclusions: Habitual shamma use compromises the outcome of SRP in patients with CP. Among patients that do not use any form of ST product, SRP is an effective treatment modality for the treatment of CP, and this relationship is independent of use of adjunct PT. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to conduct a systematic review and meta-analysis on the efficacy of growth factors (GF) on clinical outcomes after treatment (surgical/non-surgical) of peri-implant diseases (peri-implant mucositis and peri-implantitis). Materials and methods: A protocol was developed to answer the following focused question: Is there any difference for the use of GF for treatment of peri-implant diseases versus comparative GF treatment or without GF? Electronic database and manual searches were independently conducted to identify randomized controlled trials (RCTs). Publications were selected based on eligibility criteria and then assessed for risk-of-bias using the Cochrane Handbook. The primary outcome was probing depth (PD) and bleeding on probing (BOP) reduction along with changes in vertical defect depth (VDD). Changes in clinical attachment level, gingival recession, and plaque index, among others, were studied as secondary outcomes. Based on primary outcomes, random-effects meta-analysis was conducted. Results: A total of five RCTs were included. GF enhance the reduction of PD (standardized mean difference (SMD) = − 1.28; 95% confidence interval (CI) − 1.75, − 0.79; p = < 0.0001) and BOP (SMD = − 1.23; 95% CI − 1.70, − 0.76; p = < 0.0001) in the management of peri-implant mucositis. For the treatment of peri-implantitis, the use of GF yielded to significantly greater improvement in VDD (SMD = 0.68; 95% CI 0.22, 1.14; p = 0.004); however, there were no significant differences in terms of PD (SMD = 0.08; 95% CI − 1.08, 1.26; p = 0.887) and BOP (SMD = 0.211; 95% CI − 0.20, 0.63; p = 0.317). The overall risk of bias of the included studies was low to unclear. Conclusion: The results of the present systematic review suggest that the addition of GF might enhance the outcomes in the treatment of peri-implant mucositis. However, there is a lack of evidence for supporting additional benefit of GF managing peri-implantitis. Clinical relevance: Within the limitations of the current systematic review and based on the meta-analyses, (1) the addition of GF for the treatment peri-implant mucositis might be associated with better outcomes in terms of PD and BOP, and (2) an additional benefit of GF for the treatment peri-implantitis could not be determined on the basis of the selected evidence. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the changes in alveolar contour after guided bone regeneration (GBR) with two different combinations of biomaterials in dehiscence defects around implants. Material and methods: Chronic alveolar ridge defects were created bilaterally in the mandible of eight Beagle dogs. Once implants were placed, three treatment groups were randomly allocated to each peri-implant dehiscence defect: (i) test group received a bone substitute composed of hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) covered by a cross-linked collagen membrane, (ii) positive control group with placement of deproteinized bovine bone mineral (DBBM) plus a porcine natural collagen membrane, and (iii) a negative control with no treatment. Two healing periods (8 and 16 weeks) were evaluated. Dental casts were optically scanned, the obtained files were uploaded into an image analysis software and superimposed to evaluate the linear changes. Results: In both healing periods, the gains in linear contours were higher in the test group and at the intermediate level (3 mm below the gingival margin). While at 8 weeks, no significant differences were found between the groups; at 16 weeks, the test and positive control groups demonstrated significant gains in contour compared with negative control. Conclusions: GBR using different biomaterials significantly increased the buccal contours of the alveolar crest when used at dehiscence defects around dental implants. Clinical relevance: Particulate highly porous synthetic bone substitute and a cross-linked collagen membrane demonstrated similar outcomes in terms of contour augmentation when compared to bovine xenograft (DBBM) and a collagen membrane. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain (PFP) is defined biomechanically, but is characterized by features that fit poorly within nociceptive pain. Mechanisms associated with central sensitization may explain why, for some, symptoms appear nociplastic. This study compares psychological and somatosensory characteristics between those with persistent PFP and controls.Methods: A total of 150 adults with PFP were compared to 61 controls. All participants completed a survey evaluating participant characteristics, PFP-related constructs and psychological factors: anxiety, depression, pain catastrophizing, kinesiophobia, pain self-efficacy. Participants also attended a session of somatosensory testing, which included knee and elbow thermal and mechanical detection and pain thresholds, conditioned pain modulation (CPM), and temporal summation of pain (TSP). Differences were evaluated using analysis of covariance (sex as covariate). Multivariate backward stepwise linear regression examined how psychological and somatosensory variables relate to PFP (knee injury and osteoarthritis outcome score-patellofemoral [KOOS-PF]).Results: The PFP group had multimodal reduced pain thresholds at the knee and elbow (standardized mean difference [SMD], p: 0.86-1.2, <.001), reduced mechanical detection at the elbow (0.43, .01) and higher TSP (0.41, .01). CPM was not different. Psychological features demonstrated small effects (0.47-0.59, 0.01-0.04). The PFP group had a 55% (95% CI: 0.47-0.62) risk of kinesiophobia and an 11% (0.06-0.15) reduced pain self-efficacy risk. Kinesiophobia, knee pressure pain threshold, pain self-efficacy and pain catastrophizing explained 40% of KOOS-PF variance (p = <.001).Conclusions: Widespread hyperalgesia and evidence of symptom amplification may reflect nociplastic pain. Clinicians should be aware that kinesiophobia and the nociplastic pain may characterize the condition.Significance: (a) Individuals with PFP have widespread reduced pain thresholds to pressure and thermal stimuli. (b) Mechanically induced pain is likely amplified in those with PFP. (c) Pain-related fear is highly prevalent and helps explain PFP-related disability. [ABSTRACT FROM AUTHOR]

Objectives: Conventional guided bone regeneration (GBR) limits the amount of bone graft due to limited soft tissue expansion. We hypothesize that the use of tissue expander will successfully augment soft tissue prior to bone graft, allowing for sufficient amount of grafting which will lead to a more stable and effective vertical bone graft. The authors aimed to evaluate effectiveness of the novel self‐inflating tissue expander for vertical augmentation in terms of soft tissue expansion, clinical outcomes, and related complications. Material and methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring vertical augmentation. For experimental group patients, the tissue expander was subperiosteally implanted and followed by a tunneling bone graft without full flap reflection. Control patients underwent conventional vertical GBR. Primary objectives were to evaluate the dimensional changes of soft tissue and radiographic vertical bone gain and retention. As a secondary outcome, clinical complications and thickness changes of expanded overlying tissue were assessed and analyzed. Results: Twenty‐three patients in each group were included. During a 4‐week expansion, two of the experimental group showed over‐expansion and one showed mucosal perforation associated with previous severe scars. The other patients showed uneventful expansion and mean tissue augmentation was 6.88 ± 1.64 mm vertically. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p >.05). Significantly higher vertical bone gain was shown in the experimental group (5.12 ± 1.25 mm) compared with that in the control patients (4.22 ± 1.15 mm; p <.05). After a 6‐month retention period, the mean vertical bone measurement of the controls had decreased to 1.90 mm (55.0% reduction), which was a significantly greater decrease than that in the experimental group (mean 3.55 mm, 30.7% reduction; p <.05). Conclusion: Our results demonstrated the effectiveness of tissue expanders followed by tunneling bone graft for vertical augmentation; however, studies comparing the two techniques without tissue expanders are needed to elucidate the net effect of tissue expansion. [ABSTRACT FROM AUTHOR]

Background: The aim of this cross-sectional study was (1) to determine the prevalence of peri-implant mucositis and peri-implantitis and (2) to reveal the risk indicators associated with peri-implant diseases. The second point was to investigate the role of keratinized mucosa on peri-implant health. Materials and methods: Three hundred and eighty-two subjects who were treated with 1415 dental implants between 2011–2017 were clinically evaluated. Patients' medical and dental history, as well as implant details, were recorded. Peri-implant examination included probing pocket depth (PPD), bleeding on probing (BoP), plaque index (PI), gingival index (GI), and keratinized tissue width. Furthermore, the patient (sex, age, and smoking) and implant/prosthesis-related factors (surface characteristic, time in function, design of prosthesis etc.) were evaluated. Implants were classified into three groups: healthy, peri-implant mucositis, and peri-implantitis. Uni- and multi-variate regression analyses were utilized for statistics. Results: 41.1% (n = 157) and 36.9% (n = 84) of patients had mucositis and peri-implantitis, respectively. 53.6% (n = 758) of implants (95%CI 80.2–90.4) had mucositis, and 21.7% (n = 307) had peri-implantitis. Patients with a maintenance < 2/year (OR = 2.576), having periodontitis (OR = 3.342) and higher PI (OR = 3.046) had significant associations with the development of peri-implant mucositis. Significant ORs were determined for peri-implantitis with patients having maintenance < 2/year (OR = 2.048), having number of implants ≥ 4 (OR = 2.103), diagnosed with periodontitis (OR = 3.295), and higher PI (OR = 7.055). Keratinized tissue width < 2 mm (ORs = 5389/8.013), PPD (ORs = 1.570/8.338), PI (ORs = 6.726/5.205), and BoP (ORs = 3.645/4.353) independent variables were significantly associated with both peri-implant mucositis and peri-implantitis at implant level, respectively. Conclusions: Within the limits of this study, the prevalence of mucositis and peri-implantitis was shown to be high in Turkish population. Furthermore, increased risk for peri-implantitis was identified in patients having maintenance < 2/year, presence of periodontitis, poor plaque control, and having number of implants ≥ 4. Less keratinized tissue (< 2 mm), PPD, and BoP were also risk indicators for peri-implantitis development. [ABSTRACT FROM AUTHOR]

The study assessed pepper's tendency to absorb water vapour from the environment. This property depends on its fineness level, and should be regarded as the basic factor determining its storage stability. The scope of the study included the determination of the water content and activity of the analysed material; the determination of adsorption isotherms at 20°C as well as a mathematical description of sorption isotherms using the Brunauer, Emmett, Teller, Guggenheim, Anderson, De Boer, and Peleg models. Another aim of the study was to assess these models for describing surface phenomena and to evaluate selected parameters of the pepper particle surface microstructure as well as the parameters characterizing the energy phenomena accompanying adsorption as factors used to predict stability during storage. An analysis of the results demonstrated that commercial samples of black pepper of different fineness levels were characterized by a different water content and activity. Pepper with a low fineness level exhibited a higher monomolecular layer volume and a greater sorption-specific surface area. The analysed pepper samples did not differ significantly in terms of porosity or capillary capacity. The GAB and Peleg models empirically described the determined sorption isotherms of ground black pepper in the full range of water activity very well. [ABSTRACT FROM AUTHOR]

Introduction: Observational studies have shown that tea consumption has a potentially beneficial effect on bone health. However, few studies have assessed the effects of types of tea consumed on bone health. We aimed to investigate whether drinking oolong tea is associated with increased calcaneus bone mineral density (BMD) in postmenopausal women. Methods: From an epidemiological survey in Shantou, 476 postmenopausal women aged 40 to 88 years were enrolled in the study. All women were questioned about their demographic features, lifestyle, health status, types of tea consumed, habit of tea consumption, and habitual dietary intake by use of a structured questionnaire. Estimated areal BMD was measured by calcaneal quantitative ultrasound (QUS). Results: As compared with non-tea drinkers, oolong tea drinkers had higher calcaneus BMD (β 34.70 [95% CI 10.38, 59.03]). In addition, calcaneus BMD was significantly increased for those drinking 1–5 cups/day (β 27.43 [95% CI 3.70, 51.16]) but not > 5 cups/day. We observed no linear increase in calcaneus BMD with increasing years of tea consumption and local polynomial regression fitting showed a parabola-shaped association between years of tea consumption and calcaneus BMD. However, symptoms of osteoporosis did not differ by types of tea consumed. Conclusion: Long-term moderate oolong tea consumption may have beneficial effects on bone health in postmenopausal women in Shantou of southern China. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of smoking on the reduction of pockets >4 mm deep and a composite variable of residual pockets >4 mm and bleeding on probing (BoP) after treatment. Methods: Eligible after exclusion due to missing records were 3,535 individuals, referred for periodontal treatment between 1980 and 2015. The number of teeth (NT), probing pocket depth (PPD), proportion of plaque (PLI) and BoP were registered before treatment and 1 year after treatment. To analyse the impact of smoking on PPD reduction, a mixed model adjusted for age, sex, type of therapy, baseline PPD, reduction of PLI, BoP and NT was used. Depending on residual PPD and BoP, two categories were created: good and poor responders. Results: PLI was reduced by 20% in non‐smokers and by 18% in smokers, and BoP by 46% and 37%, respectively. In the adjusted mixed model, the mean reduction of PPD > 4 mm among smokers undergoing surgery was 14.4 versus 9.7 in non‐smokers (p <.001). The odds ratio for being a poor responder was 2.40 (95% CI 1.99–2.91, p <.001) for smokers. Conclusion: Although surgical treatment reduced PPD >4 mm in smokers more effectively than in non‐smokers, significantly more non‐smokers were good responders after periodontal therapy. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to establish a rodent peri‐implantitis model induced by a mixed bacterial infection characterized by bone loss and semi‐quantitative graduation of peri‐implant inflammation in histological sections. Materials and Methods: Two titanium implants were implanted in Sprague‐Dawley rats, bilaterally in each maxilla. After 3 weeks healing, the rats were randomized into three groups according to different treatments over the next 3 months: Antibiotic‐Group with oral lavage of antibiotics; Bacteria‐Group with oral lavage of Streptococcus oralis and Aggregatibacter actinomycetemcomitans; and Untreated Group with standard housing and no additional treatment. Maxillae were dissected to perform microscopic and histological analysis of bone height and peri‐implant tissues. Results: The bone level, measured at one implant site per animal, in the Bacteria‐Group (2.60 ± 0.39 mm) was significantly reduced compared to the Antibiotic‐Group (2.29 ± 0.32 mm) after 3 months. The differences of bone height in the Bacteria‐Group and the Untreated Group (2.46 ± 0.27 mm) did not reach statistical significance. The inflammatory response with respect to the number of inflammatory cells and fibrous tissue compartments of the peri‐implant tissues in the Bacteria‐Group was significantly increased compared with the Antibiotic‐Group (p <.05). S. oralis and A. actinomycetemcomitans DNAs were detected in the Bacteria‐Group. Conclusions: This rat model of peri‐implantitis used oral bacterial lavage for the induction of an inflammatory host response and bone loss. Additional bacterial treatment enhances the peri‐implant phenotype, so that significant differences to a reduced bacterial load similar to the human peri‐implantitis disease can be identified. [ABSTRACT FROM AUTHOR]

Biofilm-related infections have been a major clinical problem and include chronic infections, device-related infections and malfunction of medical devices. Since biofilms are not fully available for the human immune system and antibiotics, they are difficult to eradicate and control; therefore, imposing a global threat to human health. There have been avenues to tackle biofilms largely based on the disruption of their adhesion and maturation. Nowadays, the use of probiotics and their derivatives has gained a growing interest in battling against pathogenic biofilms. In the present review, we have a close look at probiotics with the ultimate objective of inhibiting biofilm formation and maturation. Overall, insights into the mechanisms by which probiotics and their derivatives can be used in the management of biofilm infections would be warranted. [ABSTRACT FROM AUTHOR]

Purpose: To review and discuss current literature on the use of systemically administered or locally delivered antibiotics in the treatment of peri-implantitis. Materials and methods: A literature search was conducted using MEDLINE through the PubMed database of the US National Library of Medicine using studies up to 2011. Studies on the microbiology of peri-implantitis lesions were hand selected. Results and conclusions: Two studies on the use of systemically administered antibiotics in the treatment of peri-implantitis were identified. Both studies involved a case series without controls. Five studies on locally delivered antibiotics were found. In all cases, local antibiotics were used in conjunction with mechanical debridement and chemical disinfection with antimicrobial agents such as chlorhexidine digluconate or hydrogen peroxide. The additional effects of local antibiotics were noted in all studies but were in general moderate. This may in part be due to the selection of patients with advanced deep pockets and advanced bone loss. The current available scientific information on the use of locally or systemically administered antibiotics is insufficient to allow any firm specific recommendations for the use of these drugs. Local application of minocycline or doxycycline as an adjunct to mechanical debridement and irrigation with an antimicrobial agent may be effective in moderately deep lesions. Surgical access by full-thickness flap surgery in deeper lesions is probably necessary to halt the progression of bone loss. No sound scientific basis is available for the use of systemic antibiotics. There is an urgent need for randomised clinical trials on the use of antibiotics in the treatment of peri-implantitis. Proper periodontal infection control in dentate patients before [ABSTRACT FROM AUTHOR]

Purpose: To compare the subgingival microbiota around two differently designed implant systems that were in function for more than 12 years in a randomised split-mouth study design, and to compare the outcome with natural dentition. Materials and methods: A total of 18 partially edentulous patients received at least two TiOblast™ (Astra Tech) and two Branemark (Nobel Biocare) implants following a split mouth design. At the last follow-up visit, periodontal parameters (probing depth, bleeding on probing and plaque) were recorded and intraoral radiographs were taken to calculate bone loss. Subgingival plaque samples were collected for culture, qPCR and checkerboard DNA-DNA hybridisation analysis. These data were related to implant design and bone loss. This study setup allowed a comparison of 34 Astra Tech (Impl A) with 32 Branemark (Impl B) implants. Results: During the 12-year follow up, five patients dropped out. One Branemark implant was lost before abutment connection in a dropout patient. Mean bone loss between loading and year 12 was 0.7 mm (range: -0.8–5.8) (Impl A), and 0.4 mm (range: 1.1–4.1) (Impl B). No significant microbiological differences (qualitative and quantitative) could be observed between both implant types. Compared to teeth, subgingival plaque samples from implants did not reach the concentration of pathogens, even after 12 years of function. Conclusions: These data show that both implant systems (with differences in macro-design and surface characteristics), in patients with good oral hygiene and a stable periodontal condition, can maintain a successful treatment outcome without significant subgingival microbiological differences after 12 years of loading. The presence of periodontopathogens did not necessarily result in bone loss. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the relative accuracy of the ridge-mapping method against that of standard computed tomography (CT). Materials and Methods: Consecutive partially edentulous subjects requiring dental implants were recruited for this prospective study. Vacuumformed radiographic templates with reference points were used for the ridge-mapping procedure and CT scanning. Ridge-mapping measurements were translated onto study models, which were subjected to CT scanning with the templates in place. CT images of the study models obtained from the ridge-mapping method were compared with CT images of the subjects. The data were analyzed with the Wilcoxon signed-rank test. Differences were considered significant if P < .05. Results: Fourteen subjects were recruited and a total of 21 implant sites were evaluated. The ridge dimensions measured by the bone-mapping method and CT scanning were significantly different (P < .05). The mean difference ranged from 0.3 to 0.5 mm, and large variations were found in the sulcus region. Conclusion: Measurements of the alveolar bone dimension using the ridgemapping method are different from CT scanning, with a mean difference of about 0.4 mm. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to retrospectively analyze a cohort of patients who had implants placed in the posterior maxilla and assess and identify the predictors of implant failure. Materials and Methods: With institutional review board approval, dental records from a population of patients who had maxillary posterior implants placed were used to create a database. Independent variables were divided into continuous (age of the patient at stage-one implant surgery [S1], time between extraction and S1, time between extraction and sinus augmentation, time between sinus augmentation and S1, time between S1 and stage-two implant surgery [S2], and the time between S2 and restoration of the implant) and categorical (gender, American Society of Anesthesiologists [ASA] status, current smoking status, implant position, implant proximity, residual crestal bone height, implant length and diameter, and sinus augmentation technique and materials). The dependent variable was implant failure, which was defined as complete removal of the implant. Simple logistic regression was used to assess the influence of each of the predictors on implant failure (P < .05). Results: The final database included 504 maxillary posterior implants with an overall survival rate of 93.2% over a mean follow-up period of 35.7 months. For the continuous variables, the age of the patient at S1 was statistically associated with implant failure (P = .028), as was the time between extraction and S1 (P = .014). For the categorical variables, ASA status (P < .001), implant proximity (P = .043), residual crestal bone height (P < .001), implant diameter (P = .050), sinus augmentation technique (P = .002), and sinus graft materials (P < .001) were statistically associated with implant failure. Conclusion: Within the limitations of this retrospective study, the results suggest that there are risk factors associated with maxillary posterior implant failure. Implants placed in areas with inadequate residual crestal bone height that required sinus augmentation were statistically associated with implant failure. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this review was to determine the effect of several potential local risk factors on implant survival and success (primary outcomes) as well as on mucosal recession, bleeding on probing, and proximal marginal bone loss (secondary outcomes). Materials and Methods: A comprehensive review of the literature was conducted. The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by three reviewers. After title and abstract screening of 2,681 publications obtained from the search, 19 articles were deemed to be relevant to the topic and the search criteria. Results: Limited data show that when an implant is placed within 3 mm of the neighboring tooth, proximal bone is at risk. The data regarding the placement of implants into infected sites are still insufficient, but studies have shown that this may be possible. Soft tissue thickness has not been shown to be a risk factor in implant survival. There is also no evidence to support a relationship between the width of keratinized tissue and implant survival. No studies were found that directly related bone density to implant survival. Implant stability was also difficult to examine due to the lack of validated stability measures. Discussion and Conclusion: One critical factor that faced the group during the review of the literature and interpretation of the data was the multifactorial nature of implant therapy. This makes isolation of specific risk factors difficult. Conclusions are limited by the current lack of quality clinical trials in this area. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to analyze the demographic and prosthodontic treatment differences between patients who did and did not respond to a mailed questionnaire. Materials and Methods: All living patients who received tooth- and implant-related fixed prosthodontic treatment between January 1984 and June 2005 (n = 986) in one private prosthodontic practice were mailed a questionnaire regarding their prosthodontic treatment. Demographic data (sex, age) and treatment data (survival, type of treatment, time in situ, number of units, number of treatments) for responding and nonresponding patients were collected from patient files and analyzed. Statistical significance was set at P = .05. Results: There were 500 responding patients (50.7%) with 2,702 fixed prosthodontic units (60.02%) and 486 nonresponding patients (49.3%) with 1,800 fixed prosthodontic units (39.98%). Prostheses were in situ from 1 to 20 years, with the average time in situ for respondents of 7.47 ± 5.48 years and 6.5 ± 5.21 years for nonrespondents. Responding and nonresponding patients had similar sex distributions (P = .61), Kaplan-Meier 10-year estimated cumulative survivals (92.2 ± 1.72% and 91.5 ± 1.92%; P = .13), and received a similar distribution of treatment prostheses (implant versus tooth) (P = .24). However, responding patients were significantly older (P < .001), had their prostheses in situ for a greater length of time (P ? .01), received more prosthetic units (P < .001), and underwent more treatment episodes (P < .001) than nonresponding patients. Conclusions: Patient questionnaires provide valid and unique research information. Prosthesis outcomes for patients who did and did not respond to the questionnaire were the same. Treatment outcomes of patients who attend review appointments and those who are lost to follow-up cannot be assumed to be different. Demographic- and treatmentrelated characteristics of responding patients indicated that an enhanced providerpatient rapport was a principal motivator for responding to the questionnaire. [ABSTRACT FROM AUTHOR]

Purpose: To review the literature on the treatment of peri-implant diseases. Specific emphasis was placed on the use of antimicrobial therapy, defined as local or systemic administration of antiseptic and/or antibiotic agents. Materials and Methods: A search of MEDLINE, the Cochrane Controlled Trials Register, and The Cochrane Health Group Specialized Register was conducted, and articles published in English until July 31, 2003, were included. The results of experimental animal studies and human research are presented. Results: A variety of antimicrobial treatment regimens in combination with nonsurgical or surgical debridement with and without regenerative therapy were reported. Use of antimicrobials varied between studies with respect to type of drug, dosage, delivery system, duration, and commencement of antibiotic administration. Patient compliance and adverse effects related to the antimicrobials were mostly not mentioned. Discussion: While the majority of the case reports and studies presented showed positive outcomes following antimicrobial treatment, there were no non- medicated controls included, so the relative effect of the antimicrobial agent(s) cannot be evaluated. Conclusions: Although antimicrobials are widely used for the treatment of peri-implant diseases, evidence of their benefit is limited, and randomized, controlled human trials should be initiated where ethically possible. In addition, prospective cohort studies designed to monitor consecutive cases treated using specific treatment protocols are required. [ABSTRACT FROM AUTHOR]

Study Design: Cross-sectional., Objectives: To assess the reliability and validity of the French version of the Spinal Cord Injury Pain Instrument (SCIPI) and to determine its performance versus "Douleur Neuropathique 4 questions" (DN4) in diagnosing neuropathic pain (NeuP)., Setting: Clinique romande de réadaptation, spinal cord injury (SCI) center in the French-speaking part of Switzerland., Methods: Backward and forward translation in French of the 4-item SCIPI were performed by native speakers in both languages. Thirty persons with SCI were included in the validation study. Internal consistency was measured with the Kuder-Richardson (KR-20) coefficient. Cohen's kappa coefficients were used to assess the test-retest reliability and the agreement between SCIPI and DN4. Clinical assessment was used as the reference standard to diagnose NeuP. The area under the receiver operator characteristics curve (AUROC) was used to assess the performance of diagnostic tests., Results: KR-20 coefficient of internal consistency was 0.50 (95% CI 0.26, 0.74). Test-retest reliability coefficient was 0.86 (95% CI 0.76, 0.95). The best cutoff value was 2 points, resulting a sensitivity of 88% (95% CI 69%, 98%) and a specificity of 92% (95% CI 75%, 99%). SCIPI had an AUROC of 0.90 (95% CI 0.82, 0.98), which was not significantly lower than the AUROC for DN4, 0.92 (95% CI 0.85, 0.99, p = 0.56). Agreement between SCIPI and DN4 was of 0.88 (95% CI 0.77, 1.00)., Conclusion: The French version of the SCIPI is a reliable and valid tool that can identify the presence of NeuP in an individual with SCI., (© 2022. The Author(s), under exclusive licence to International Spinal Cord Society.)

Objective: The objective of this study was to evaluate whether evolution of bone mineral density (BMD) is associated with the thyroid hormone profile in a cohort of euthyroid women with no other known diseases within 1 year. Methods: This was a prospective cohort study conducted at the University of Campinas, Brazil. We used a database with 52 women aged 20–39 who were followed for 1 year in a family planning outpatient clinic. The inclusion criteria were body mass index (BMI) <30 kg/m2, no known diseases/medication use, fasting glucose <100 mg/dl, and 2 h glucose after a 75 g oral glucose load <140 mg/dl. The women were divided into groups of normal weight (n = 30) and overweight (n = 22). The main outcomes were BMD measured by dual-energy x-ray absorptiometry (DXA) and thyroid hormone profile (thyrotropin TSH, free triiodothyronine FT3, free thyroxine FT4, and T3/T4 ratio); other variables were body composition (DXA), calcium metabolism markers, and life habits. We used a repeated measures analysis of variance (ANOVA) and multiple regression analyses to evaluate associations. Results: At the baseline data collection, overweight women showed a higher T3/T4 ratio, leptin, calcium, BMD in the lumbar spine and total femur, total mass, mass, and percentage of fat mass than normal weight women. At 12 months, both groups had increased FT4, calcium, ALP, femoral neck BMD, and total mass by time effect. The normal weight group presented a decrease of vitamin D when compared to the baseline. Increased BMD of the femoral neck was associated with moderate coffee intake, and as such, there were no associations found between this increase and the thyroid hormone profile. Leptin and ALP were associated with total mass variation, while leptin and PTH were associated with fat mass variation. The normal BMI was inversely associated with the variation of total mass, mass, and percentage of fat mass, and engaging in regular physical activity was inversely associated with fat mass variation. Conclusions: In this sample of euthyroid healthy women who were both normal weight and overweight, the thyroid hormone profile was not associated with variations in bone mineral density and body composition after a 1 year follow-up. [ABSTRACT FROM AUTHOR]

This study aimed to investigate whether strontium (Sr) ion delivery to the surface of microstructured titanium (Ti) oral implants drives favorable osteoblast functions of mesenchymal stem cells (MSCs) under a Porphyromonas gingivalis lipopolysaccharide (LPS)-stimulated inflammatory condition. The goal is to gain insight for future surface engineering of Ti implants with increased resistance to peri-implantitis and better bone recovery capacity from peri-implant bone destruction. The Sr ions were introduced into a clinically available sandblasted/acid-etched (SLA) Ti implant surface by wet chemical treatment. The results showed that Sr ion incorporation enhances the osteogenesis-related cell functions of bipotent ST2 stem cells in the microstructured SLA type implant surface. Early spreading and osteogenic differentiation (osteogenesis-related mRNA expression, ALP activity and osteocalcin protein secretion) were notably increased in Sr-incorporated SLA implant surface under 1 µg of P. gingivalis LPS stimulation. In addition, Sr ion modification increased early osteogenic differentiation (ALP mRNA expression and ALP activity) of ST2 cells, again under the more severe inflammatory condition induced by a high dose of LPS (10 µg/mL). These results indicate that surface chemistry modification using Sr ions provides microstructured Ti oral implants with greater resistance to the development and progression of inflammatory bone tissue destruction, and increased bone recovery capacity in the bacterial LPS-contaminated Ti oral implant surface by enhancing the early osteogenic differentiation of MSCs. [ABSTRACT FROM AUTHOR]

Aim: To examine the adjunctive effect of a Lactobacillus reuteri probiotic (ATCC PTA 5289 & DSM 17938) on the re‐instrumentation of residual pockets. Materials and Methods: This randomized, double‐blind, placebo‐controlled study included 39 previously non‐surgically treated periodontitis patients. A re‐instrumentation was carried out, and probiotic and/or placebo drops were applied according to the study protocoll. Patients afterwards received lozenges to use 2×/day for 12 weeks. Probing pocket depth (PPD), recession, bleeding on probing and plaque levels were analysed, next to the microbiological impact. Results: No effects of the probiotic drops could be found. However, after 24 weeks, the overall PPD in the probiotic lozenges group (2.64 ± 0.33 mm) was significantly lower compared to the control lozenges (2.92 ± 0.42 mm). This difference was even more pronounced in moderate (4–6 mm) and deep (≥7 mm) pockets. In the probiotic lozenges group, there were also significantly more pockets converting from ≥4 mm at baseline to ≤3 mm at 24 weeks (67 ± 18% versus 54 ± 17%) and less sites in need for surgery (4 ± 4% versus 8 ± 6%). However, the probiotic products did not influence the microbiological counts of the periodontopathogens. Conclusion: The adjunctive consumption of L. reuteri lozenges after re‐instrumentation improved the PPD reduction, without an impact on pocket colonization with periodontopathogens. [ABSTRACT FROM AUTHOR]

The causal associations of smoking and alcohol and coffee intake with fracture and bone mineral density are unknown. We investigated the associations using Mendelian randomization (MR). Summary-level data from UK Biobank for bone fractures (main outcome) (53,184 cases; 373,611 non-cases) and estimated bone mineral density (eBMD) (n = 426,824 individuals) were used. Single-nucleotide polymorphisms associated with smoking initiation (n = 378) and alcohol (n = 99) and coffee (n = 15) intake at the genome-wide significance threshold (P = 5 × 10-8) were identified from published genome-wide association studies. Univariable and multivariable inverse-variance weighted, weighted median, MR-Egger, and MR-PRESSO methods were used for statistical analyses. Genetic predisposition to smoking initiation was associated with fracture but not eBMD. The odds ratio of fracture per one-unit increase in log odds of smoking was 1.09 (95% confidence interval 1.04, 1.15; P = 8.58 × 10-4) after adjustment for alcohol intake in the multivariable MR analysis. The association remained in complementary analyses. Genetically predicted alcohol and coffee intake was not associated with fracture or eBMD. Nevertheless, genetic liability to alcohol dependence, based on variants in the ALD1B gene, was associated with fracture and lower eBMD. The odds ratio was 1.06 (95% confidence interval 1.01, 1.12; P = 0.018) per genetically predicted one-unit higher log odds of liability to alcohol dependence. This MR study strengthens the causal inference on an association between smoking and higher fracture risk but found no linear association of modestly higher alcohol and coffee intake with fracture or BMD. However, alcohol dependence may increase fracture risk. [ABSTRACT FROM AUTHOR]

Some epidemiological studies suggested caffeine consumption as the cause for bone mineral density loss. Certain genes involved in this process are regulated by vitamin D receptor (VDR). Therefore, we investigated if caffeine can affect inducible expression of VDR-regulated genes, some of them being involved in bone mineralization process. By employing reporter gene assay, polymerase chain reaction, and western blotting, we monitored the VDR activity and expression in cell cultures of intestinal (LS180), osteosarcoma (HOS), and normal human osteoblasts in vitro. While caffeine stimulated calcitriol-inducible VDR-dependent nanoluciferase activity in stable reporter cell line IZ-VDRE (derived from LS180), it rather modulated mRNA levels of target genes, like CYP24A1, BGLAP, SPP1, and TNSF11 in LS180 and HOS cells. However, caffeine significantly decreased calcitriol-inducible CYP24A1, TNSF11, and SPP1 transcripts in osteoblasts. This decrease had non-linear U-shaped profile. Our in vitro data demonstrate biphasic action of caffeine on the expression of certain calcitriol-inducible VDR-regulated genes in normal human osteoblasts. [ABSTRACT FROM AUTHOR]

Objectives: Our aim of this work was to investigate the regrowth of implant-related biofilms after various antimicrobial treatments in vitro. Methods: Saliva-derived microcosm biofilms were grown on titanium discs in an active attachment model. Treatments including hydrogen peroxide (HP), citric acid (CA), chlorhexidine (CHX), and distilled water (control), at different concentrations, were applied to 2-day biofilms for 1 or 5 min. The viability, lactic acid production, and composition of the biofilms were followed for 3 days. The biofilm composition was analyzed by 16S rDNA amplicon sequencing. Results: The short treatments of CA, CHX, and HP resulted in a 2–3 log reduction in biofilm viability and lactic acid production immediately. However, both parameters returned to the pre-treatment level within 2 days due to biofilm regrowth. The alpha diversity of the regrown biofilms in antimicrobial-treated groups tended to decrease, whereas the diversity of those in water-treated group increased. The composition of the regrown biofilms altered compared to those before treatments. Streptococcus and Enterobacteriaceae were enriched in the regrown biofilms. Conclusions: Although the antimicrobial treatments were efficient, the multi-species biofilms were indeed able to regrow within 2 days. The regrown biofilms display an altered microbial diversity and composition, which in the oral cavity may lead to an aggressive infection. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the adjunctive effect of modifying the implant‐supported prosthesis to facilitate access to oral hygiene when treating peri‐implant mucositis. Material and methods: A 6‐month randomized clinical trial was designed. Patients with peri‐implant mucositis were treated by implant surface debridement with plastic curettes and a plastic tipped ultrasonic device. Then, they were randomly assigned to either modifying their prosthesis to allow for better oral hygiene (test group) or not (control group). Subsequently in both groups, individualized oral hygiene instructions were provided. Clinical and radiographical outcomes were evaluated at baseline and 1, 3 and 6 months after treatment. Results: 48 patients were included, and 45 completed the clinical trial (24 test and 21 control patients). After 6 months, changes in the modified bleeding index between the control and test groups were 0.50 (standard deviation −SD = 0.70) and 1.14 (SD = 0.96), respectively (p = 0.01). The changes in implant probing pocket depth at 6 months were −0.02 (SD = 0.61) and 0.31 (SD = 1.20) mm, respectively (p = 0.04). Conclusions: Modifying the contour of the prostheses to improve access for oral hygiene significantly improved the clinical outcomes after standard mechanical treatment of peri‐implant mucositis. [ABSTRACT FROM AUTHOR]

Biofilm-growing cells show an enhanced antimicrobial tolerance with respect to the same cells growing in a free-floating way. This is due to physical or chemical diffusion barriers and increased transfer of resistance markers. Thus, tissue- and medical device-related biofilms can be considered among the leading sources of antibiotic treatment failure, causing many of the deadliest chronic infections afflicting humans nowadays. To find a satisfying way to counteract this major health threat, a great effort has been made in recent years to develop safe, effective and fast-acting anti-biofilm strategies. In this review, we summarise and evaluate the most promising tools and molecules that have demonstrated their ability to modulate steps involved in biofilm formation or to disperse pre-formed biofilms, without conferring evolutionary pressure to microorganisms. [ABSTRACT FROM AUTHOR]

Peri-implantitis is an inflammatory disease of tissues surrounding osseointegrated dental implants. Inflammation affecting soft and hard peri-implant tissues can cause alveolar bone resorption and subsequent implant loss. Clinical surveillance and early diagnosis are of paramount importance to reduce clinical failures and improve implant survival. Current diagnosis of implants is based on clinical and radiological signs. Molecular tests are an emerging diagnostic methodology, which potentially can help to detect and prevent early peri-implantitis and monitor the efficacy of therapy as well. A plethora of potential biomarkers are potentially available to support the clinical diagnosis of peri-implantitis. However, conflicting diagnostic conclusions have been reached, probably related to weak statistical results due to limited sample size or disease heterogeneity. The present paper reviews candidate diagnostic biomarkers for peri-implantitis, including infective agents, genetic susceptibility factors, and key proteins related to inflammation and tissue remodeling. [ABSTRACT FROM AUTHOR]

Summary: This meta-analysis included 16 studies, involving seven cohort studies and nine case-control studies, and the results indicated that tea consumption may be associated with a reduced the risk of fractures. Introduction: Regarding relationship of tea consumption with the risk of fractures remains controversial. We performed a meta-analysis to elucidate the association between tea consumption and the risk of fractures. Methods: Relevant articles were identified up to March 2019 by searching PubMed, Web of Science, and Embase databases. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were computed utilizing fixed or random effects model based on heterogeneity. Results: Altogether 16 studies (seven cohort and nine case-control studies) were included in this meta-analysis, involving 772,707 participants with 37,166 fracture cases. The RRs (95% CIs) of fracture for the highest versus lowest category of tea consumption were 0.86 (0.78–0.94). Subgroup analysis indicated significant associations in cohort studies (0.90 (0.86–0.94)) and case-control studies (0.77 (0.69–0.85)). Conclusions: The current meta-analysis indicates that tea consumption may be associated with a reduced the risk of fractures. [ABSTRACT FROM AUTHOR]

Objectives: Clinical and microbiological longitudinal changes in individuals with peri-implant mucositis (PM) with or without preventive maintenance therapy (PMT) have not been reported, especially in long periods of monitoring. This 5-year follow-up study aimed to assess the clinical and microbiological changes along time in individuals initially diagnosed with PM. Materials and methods: Eighty individuals diagnosed with PM (T1) and followed during 5 years (T2) were divided into one group with PMT during the study period (GTP; n = 39) and another group without PMT (GNTP; n = 41). Full-mouth periodontal/peri-implant examinations were performed. Peri-implant microbiological samples were collected and analyzed through qPCR for Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Actinomyces naeslundii at T1 and T2. Results: GNTP presented higher incidence of peri-implantitis than GTP. Moreover, GNTP showed significantly higher total bacterial load and higher frequency of the evaluated orange complex bacteria than GTP. Individuals who progressed to peri-implantitis presented significantly higher total bacterial load and higher frequencies of P. gingivalis, T. denticola, and F. nucleatum. Conclusions: The absence of regular appointments for PMT was associated with a higher incidence of peri-implantitis and a significant increase in total bacterial load. Clinical relevance: Regular visits during PMT positively influenced subgingival microbiota and contributed to peri-implant homeostasis and clinical status stability during a 5-year monitoring period. Compliance with PMT programs should be reinforced among individuals rehabilitated with dental implants. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is common after spinal cord injury (SCI) and dedicated SCI cognitive behavioural therapy pain management programmes (CBT-PMPs) have a growing evidence base to support their uptake clinically. The development of internet-delivered treatment options may overcome barriers to the access and uptake of centre-based programmes. This study examines such an approach on quality of lie (QoL), pain, mood and sleep.Methods: Adults with SCI pain (>3 months) were recruited and randomly assigned to the intervention or control group. The intervention comprised a six module CBT-PMP delivered once weekly. A blinded assessor determined changes in self-reported outcome measures post-intervention and at 3 months. Linear mixed models and effect sizes based on changes between groups were reported. Significance was set p < 0.05.Results: The recruitment rate was 32% (intervention n = 35, control n = 34), and the drop-out rate at 3 months was 26%. On average, participants accessed three (SD 2.1) of six modules. While no difference in QoL was reported, a significant group*time interaction was found for NRS of current pain (χ2  = 8.22, p = 0.016), worst pain (χ2  = 11.20, p = 0.004), and Brief Pain Inventory (interference) (χ2  = 6.924, p = 0.031). Moderate to large effect sizes favouring the intervention were demonstrated at each time point for the pain metrics (Cohen's d: 0.38-0.84). At 3-month follow-up, 48% of the intervention group rated themselves improved or very much improved (p < 0.05).Conclusions: This study demonstrates the potential of an internet-delivered SCI specific CBT-PMP in reporting significant statistical and clinical benefit in pain intensity and interference. Strategies to improve engagement are needed. [ABSTRACT FROM AUTHOR]

Background: Further validation of the risk indicators / predictors for peri-implant diseases is required to allow clinicians and patients to make informed decisions and optimize dental implant treatment outcomes. The aim of this study was to build prediction models, using Chi-square automatic interaction detection (CHAID) analysis, to determine which systemic-, patient-, implant-, site-, surgical- and prostheses-related risk indicators had more impact on the onset of peri-implant diseases.Methods: A retrospective analysis of 200 patients who received implant-supported prostheses between 1998 and 2011 was conducted to evaluate the prevalences and risk indicators for peri-implant mucositis and peri-implantitis. The data were further analyzed using CHAID to produce two predictive models.Results: The prevalence of peri-implant mucositis was 20.2% and 10.2% for patients and implants, respectively, while the prevalence of peri-implantitis was 10.1% at the patient level and 5.4% at the implant level. CHAID decision tree analysis identified three predictors (history of treated periodontitis, absence of regular supportive peri-implant maintenance, and use of bone graft) for peri-implant mucositis and three predictors (smoking, absence of regular supportive peri-implant maintenance, and placement of ≥2 implants) for peri-implantitis.Conclusions: Within the limitations of this study, CHAID decision tree analysis identified the most plausible risk indicators and provided two predictive models for use in a particular university setting that would allow early detection and ensure appropriate care and maintenance of patients at high risk of peri-implant diseases. [ABSTRACT FROM AUTHOR]

Purpose: Especially in oral and maxillofacial surgery, where procedures involving the aero-digestive tract considered clean contaminated, surgical site infections (SSI) represent a severe health care burden. To improve implementation and methodological standard, an upgrade of the existing S1 guideline to a consensus-guided S3 guideline was initiated by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF, register number 067/009) and 25 collaborating medical societies. Methods: A systematic literature search based on the Scottish Intercollegiate GL Network (SIGN)-search string for the guideline "Antibiotic prophylaxis in surgery" from 2014 was performed and equivalent exclusion/inclusion criteria were applied. An additional hand search provided latest evidence. Results: In total, 80 clinical trials, retrospective studies, reviews, and meta-analysis were analyzed. For orthognathic surgery, prolonged antibiotic regimen may reduce risk for SSI but there is lack of evidence for the effects of short- vs. long-term therapy. For maxillofacial traumatology, antibiotic prophylaxis might reduce SSI but prolonged postoperative dosing shows no benefit. For clean-contaminated oncological interventions, anti-infectious therapy for 24 h only can reduce SSI; patients may not benefit from prolonged regimen. In contrast, for dentoalveolar procedures such as implantology or third molar removal, literature reveals ambivalent results. Conclusion: In summary, consensus process of the planned S3 guideline is much in need to transfer the indecisive results for antibiotic prophylaxis in dentoalveolar surgery in clinical praxis and encourage adherence to guidelines. [ABSTRACT FROM AUTHOR]

Purpose: To compare the difference in alveolar bone resorption around implants after immediate placement in a bacterial induced experimental periimplantitis murine model. The various conditions that were examined were: Effect of implant surface characteristics and the onset of the induced infection. Materials and Methods: Screw‐shaped titanium implants, smooth‐surface or sand‐blasted large‐grit acid‐etched (SLA) coated, were inserted immediately after extraction of the first upper left molar, in 90 5‐6‐week‐old BALB/c mice. The mice were infected with Porphyromonas gingivalis and Fusobacterium nucleatum 21 (early infection) or 42 days (delayed infection) after implantation. Six weeks post infection, bone volume around inserted implants was measured using micro‐CT, and was compared to alveolar bone level around teeth. Histological analysis was also performed. Results: The level of bone loss was significantly higher around the implants compared to the teeth, for smooth surface implants the bone loss was higher than of the SLA surface in both control and infected groups with no statistical significance. The survival rate of the implants in immediate infection was 75% compared of the 100% survival of the delayed infection and control mice. There is no significant difference between the early and the delayed infection in alveolar bone loss level around the implants. Conclusions: This model can assist in studying the differences in alveolar bone resorption in different implants and their effect on the development of the disease. [ABSTRACT FROM AUTHOR]

Background: Efficacy of mechanical debridement (MD) with adjunctive probiotic therapy (PT) in the treatment of peri‐implant mucositis (PiM) in cigarette‐smoking and never‐smoking subjects remains uninvestigated. Purpose: The aim was to assess the efficacy of MD with adjunctive PT in the treatment of PiM in cigarette‐smoking and never‐smoking individuals. Materials and Methods: Patients with (group I) and without PiM (group II) were included. Demographic data was collected using a questionnaire. Treatment‐wise, patients in groups I and II were subdivided into: (a) Patients that underwent MD with adjunct PT (using Lactobacillus reuteri); and (b) MD alone. In all groups, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were measured at baseline and compared after 3‐ and 6‐months. Baseline peri‐implant crestal bone levels were also measured. Sample‐size estimation was performed, and statistical comparisons were done using one‐way analysis of variance and Bonferroni post‐hoc adjustment tests. P values under.05 were deemed significant. Results: Eighty individuals (group I: 40 cigarette‐smokers and group II: 40 never‐smokers) with PiM participated in this study. At all‐time intervals, no significant difference in PD, PI, and BOP were observed in all patients in group I. At 3‐months' follow‐up, the differences in BOP (P < .05), and PI (P < .05) were significantly higher in group II that underwent MD + PT than MD alone. At 6‐months' follow‐up, there was no difference in the changes in BOP and PI among subjects that underwent MD with and without adjunct PT. Conclusion: On a short‐term basis, MD with adjunct PT is more effectual in the treatment of PiM than MD alone in never‐smokers. Cigarette‐smoking compromises peri‐implant soft tissue healing following MD with or without adjunct PT. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the accuracy in volumetric measurements obtained on an experimental model using an intraoral scanner and a gravimetric method. Three identical partial dentate maxillary acrylic models with three fabricated alveolar defects, in anterior and posterior regions, were scanned using an intraoral scanner (20 scans/defects). The defects differed in terms of size and distance of neighbouring teeth. As references, replicas of each defect were created using a dimensional stable silicone impression material. After measuring the mass of each replica, the volume was calculated by dividing the mass of each replica by the density of the impression material. The defects had a volume, according to the gravimetric method, ranging from 40.5 to 143.7 mm3. The scans were imported to metrology software for analyses. Accuracy was determined in terms of trueness and precision. The mean trueness for all defect types was 0.168 mm3 (SD 0.691, range 2.82). There was no statistical significant difference between the mean trueness for all defects measured (p = 0.910). The mean precision for all defect types was 0.147 mm3 (SD 0.524, range 2.86). There were no statistical significant differences between the dental models in regard to mean precision (p = 0.401), however, there were statistical significant differences between defects in position 1 and 2 (p = 0.002) and 1 and 3 (p = 0.001). Based on the findings of this study, the intraoral scanner utilized in the current study presented an acceptable level of accuracy when measuring volume of defects. [ABSTRACT FROM AUTHOR]