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OBJECTIVE To assess the prevalence and severity of periodontitis (P) among Italian patients affected by rheumatoid arthritis (RA). MATERIALS AND METHODS A full-mouth periodontal examination and a rheumatologic examination were performed. RA disease activity was scored using the DAS28. Serum analyses investigated levels of rheumatoid factor, anti-citrullinated protein antibodies (ACPAs), C-reactive protein, erythrocyte sedimentation rate and fibrinogen. Information concerning smoking, body mass index and RA medical therapy was collected. Data were analysed by Student's t test, chi-square test, binary logistic regression and Spearman's rank. RESULTS This cross-sectional study included 120 subjects, 77 had both diseases while 43 only had RA. The number of teeth present was statistically lower in the RA-P compared to the RA group (p

Objectives To determine the efficacy of 4 different oral hygiene regimens involving adjunctive interdental cleaning devices in unsupervised young subjects with intact interdental papilla. Material and methods Sixty periodontally healthy subjects were randomly allocated to 4 groups following different oral hygiene regimens (T-7): use of manual toothbrush alone; manual toothbrush plus dental floss; manual toothbrush plus interdental brushes; and manual toothbrush plus rubber interdental picks. Oral hygiene instructions (OHI) were given. One week after (T0), professional supragingival scaling and polishing was performed, and subjects were then reseen every 2 weeks (T14 and T28). At T-7, T0, T14 and T28, full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS) and angulated bleeding index (AngBI) were taken. Results During the first week (T-7/T0 unclean phase), FMPS decreased significantly in all groups except the group using dental floss. At T28, a significant decrease in FMPS (P

Background: To assess the nutraceutical effects of twice/daily intake of kiwifruit on periodontal parameters and systemic health before and after initial periodontal treatment (IPT). Methods: At baseline, participants were randomly assigned to test and control group, and either consumed two kiwifruits/day for 5 months or no kiwifruit. In the first 2 months, no periodontal treatment was delivered (2 M). Subsequently, a session of full-mouth IPT within 24 hours was performed. Participants were then re-assessed after 3 months (5 M). Blood samples, evaluating systemic biomarkers and vital signs, were also collected atbaseline, 2 M, and 5 M. Results: Groups were balanced at baseline. At 2 M no within-groups differences could be detected for any parameter but the bleeding score, which decreased significantly in the kiwifruit group by 6.67% ± 11.90% (P < 0.01). Comparison of test and control group showed that 2 months of kiwifruit consumption resulted in significant lower values of bleeding, plaque, and attachment loss. After IPT both groups demonstrated substantial significant clinical benefits however the control group showed significant greater reductions of bleeding, plaque and attachment loss than the test group. Systemic biomarkers and vital signs did not show clinically relevant differences between test and control group. Conclusions: Kiwifruit consumption reduces gingival inflammation despite the lack of any periodontal instrumentation or patient's behavioral changes. No adjunctive effect to periodontal treatment of dietary intake of kiwifruit was noted. (NCT NCT03084484).

The purpose of the study was to evaluate the efficacy of conservative surgical treatment of medication related osteonecrosis of the jaw (MRONJ) in patients affected by osteoporosis and exposed to oral bisphosphonates (BPs). Subjects diagnosed with MRONJ and osteoporosis under oral BPs that had undergone conservative surgery and had at least 24 months follow-up were included. All patients received medical-antibiotic therapy and then underwent conservative surgical treatment consisting of sequestrectomy, soft tissue debridement and bone curettage with limited or no extension. A total of 53 patients, mean age of 71.9 ± 10.2 years (range 41-87), were enrolled. Two years after conservative surgical therapy 45 patients (91.8%) showed complete healing. The presence of rheumatoid arthritis (p = 0.003) and a more severe initial MRONJ stage (p = 0.023) were associated with a negative surgical outcome while the presence of bone sequestrum was strongly associated with a positive outcome (p = 0.036). Conservative surgical treatment of MRONJ lesions in patients affected by osteoporosis and receiving only oral BPs may represent a valid therapeutic approach determining a high number of complete healing cases. Conservative surgery should be encouraged at early MRONJ stages and after medical therapy failure.

Objectives To systematically review the performance of access flap (OFD) in the treatment of class II furcation defects (FD). Methods RCTs evaluating surgical treatment of class II FD with OFD, minimum 6 months follow-up were identified. Screening, data extraction, and quality assessment were conducted independently by three reviewers. The primary outcomes were tooth survival and change in the horizontal clinical attachment level (HCAL). Changes in vertical clinical attachment level (VCAL), reduction of pocket probing depth (PPD), recession increase (REC), horizontal (HBL), and vertical bone level (VBL) were also collected. Results The search identified 1571 studies out of which 11 articles met the inclusion criteria. Data analysis was performed on 199 patients and 251 FD. Tooth survival was seldom reported. Altogether with inflammatory amelioration, the weighted mean differences were for HCAL 0.96 mm [CI: (0.60, 1.32), p

Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression.

The ultimate goal of periodontal therapy is to prevent further disease progression in order to reduce the risk of tooth loss. This objective can be achieved through a number of therapeutic modalities comprising both the nonsurgical and surgical phases of periodontal therapy. Nonsurgical periodontal treatment has been shown to control periodontal infection and to arrest progression of the disease in a significant number of cases. However, despite completion of nonsurgical treatment, a number of periodontal pockets, defined as 'residual', often remain. The presence of residual pockets may jeopardize tooth survival and be a risk factor of further disease progression, and ultimately tooth loss. Therefore, the aim of this review is to analyze the knowledge available on the indications for and the performance of periodontal surgical treatment of residual pockets in terms of 'traditional' (clinical, microbiological), patient-based and systemic health outcomes.

We evaluated retrospectively the efficacy of local resection for patients who presented with bisphosphonate-related osteonecrosis of the jaw (BRONJ). We studied 120 subjects with who required local resection of 129 BRONJ lesions that had not responded to medical treatment. The primary outcomes were improvement of the clinical stage of BRONJ and resolution of disease, and the secondary outcome was the influence of the surgeon's experience on the healing of the lesions. Age, sex, underlying diseases, smoking, and coexisting conditions were recorded. Logistic regression analysis was used to isolate factors that could potentially affect the outcome. Most of the lesions (n=107, 84%) improved postoperatively, 20 showed no change, and one got worse. One patient died. Stratification indicated complete healing and total resolution of disease for all 26 stage I lesions, improvement for 67 of the 77 stage II lesions, and for 14 of the 25 stage III lesions. The disease resolved in 67 of the 69 stage II lesions, and 14 of the stage III cases. Logistic regression indicated that smoking and the stage of disease could affect the outcome. Analysis of the surgeons' learning curve showed that performance improved significantly over time. Complete healing after local resection increased from 40% to 80% over a period of eight years (p

The aim of this study was to investigate the earlier phase of the osseointegration of a laser-treated implant surface in terms of human protein adsorption.Titanium surfaces were divided into machined (M), sandblasted (SB), and laser-treated (LT). The LT surfaces were created with an Nd diode-pumped laser in Q-switching, whereas the SB were treated with Al2O3. An x-ray photoelectron spectroscopy (XPS) analysis of titanium surface was performed. Titanium discs were used for albumin and fibronectin adsorption evaluation through fluorescence intensity. Fibronectin evaluation was also made with Western Blot analysis on experimental implants.LT discs appeared to trigger a higher albumin and fibronectin adsorption with a regular pattern. The mean count of albumin adsorption was 0.29 and 3.8 for SB and LT, respectively (P = 0.016), whereas fibronectin values were 0.67 and 4.9 for (SB) and (LT) titanium (P = 0.02). XPS analysis showed that titanium, oxygen, carbon, and nitrogen were found on all 3 surfaces.Laser-engineered porous titanium surface seems to promote, in vitro, the adsorption of albumin and fibronectin more than sandblasted (SB) or machined (M) implants.

The objective of this study was to determine, retrospectively, the influence of various risk factors on the staging of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a population attending a department of dentistry and oral surgery in Italy. Data were collected from the electronic and paper medical records of 90 patients receiving intravenous bisphosphonates. Two experienced and calibrated examiners used the American Association of Oral and Maxillofacial Surgeons updated 2009 classification to record the stage of BRONJ lesions. Multivariate ordinal logistic regression was performed to determine individual risk factors negatively affecting BRONJ staging. The factors associated with a worse BRONJ staging were high bisphosphonate cumulative dose (odds ratio (OR) 1.70, 95% confidence interval (CI) 1.02-2.82; P=0.04), smoking (OR 1.80, 95% CI 1.03-2.80; P=0.04), steroid intake (OR 1.70, 95% CI 1.00-2.87; P=0.05), and a maxillary location of the lesion (OR 3.50, 95% CI 1.81-6.77; P

Objectives To estimate the influence of educational level and oral hygiene behaviours on the prevalence and severity of dental caries and periodontal disease in an adult Italian population attending the Oral Hygiene department of a public Dental Clinic. Methods Dental caries was diagnosed according to the World Health Organization criteria. The DMFT index (decayed, missing, filled tooth) was used to record the dental caries' experience. The periodontal status was assessed using the community periodontal index of treatment needs (CPITN). Questionnaires on educational level and oral hygiene behaviours were also collected. Results A total of 350 patients were enrolled. The mean DMFT value reported was 4.37 ± 3.06, and higher values were observed for male patients (P