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The effect of loading on microleakage and microtensile bond strength of MOD composite restorations bonded with either self-etching or etch-and-rinse adhesive was investigated. MOD cavities were prepared in 28 extracted molar teeth. 14 teeth were bonded with a one-step self-etching adhesive (G-Bond) and 14 with an etch-and-rinse adhesive (Optibond Solo Plus) then restored with resin composite. For each adhesive, 7 teeth were loaded and 7 unloaded (controls). Loading was achieved with an axial force of 80 N at 2.5 cycles/s for 250,000 cycles. All the teeth were stored in 0.25% rhodamine solution for 24 h and sectioned in a bucco-lingual direction at the proximal boxes to examine microleakage then further sliced mesiodistally into beams for the (xTBS test. Failure modes were de-termined using confocal and scanning electron microscopy. ANOVA assessed the effect of loading on microleakage and bond strength. After loading, restorations bonded with G-Bond exhibited significantly greater dye penetration compared to Optibond Solo Plus at both the axial walls and cavity floor. On the other hand, loading significantly reduced the nTBS of Optibond Solo Plus, whereas it had no significant effect on the pTBS of G-Bond. [ABSTRACT FROM AUTHOR]

Background: A number of studies have suggested that implant failure and associated bone loss is greater in subjects with a history of periodontitis. Purpose: To evaluate the risk for marginal bone loss around implants and implant failure in subjects with a history of periodontitis compared with periodontally healthy subjects in studies with a minimum 3-year follow-up. Materials and Methods: Data sources: The MEDLINE, EMBASE, and PubMed databases and relevant journals were searched up to July 1, 2008, with restriction to English language. Review Methods: Prospective and retrospective longitudinal observational clinical studies comparing periodontal/peri-implant variables among subjects with periodontitis and subjects who were periodontally healthy were included. Screening of studies, quality assessment, and data extraction were conducted independently and in duplicate. Clarification of missing and unclear information was not sought. Outcome measures were: implant survival/failure, peri-implant parameters, changes in radiographic marginal bone level, probing pocket depth, and gingival index. Results: Seventeen potential studies were identified and six studies were accepted comparing patients with periodontitis and periodontally healthy patients treated with implants. Five studies were eligible for meta-analysis of implant survival and four studies were eligible for meta-analysis of bone loss around implants. The odds ratio for implant survival was significantly in favor of periodontally healthy patients (3.02, 95% confidence intervals 1.12–8.15). A random effects model showed more marginal bone loss in periodontitis subjects compared with periodontally healthy subjects (standard mean difference 0.61, 95% confidence interval 0.14–1.09). Conclusions: Within the limitations of the heterogenous studies available, a moderate level of evidence indicates that periodontitis subjects were at significantly higher risk for implant failure and greater marginal bone loss as compared with periodontally healthy subjects. Prospective observational studies with subject-based designs are recommended. [ABSTRACT FROM AUTHOR]

Background: The acute-phase response involves molecules including tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and C-reactive protein (CRP). This study aimed to determine whether subgingival scaling resulted in rapid changes in plasma concentrations of these molecules., Methods: Twenty-three non-smoking adults with chronic periodontitis received subgingival scaling for 60 minutes. Venous blood samples were taken at 0, 15, 30, 60, and 120 minutes. TNF-alpha and IL-6 were assayed from all samples and CRP from the baseline and final samples. Lipopolysaccharide (LPS) was assayed at 0, 15, and 30 minutes using limulus lysate assay (LAL) and EndoCAb Ig assays., Results: LPS assays were suggestive of a transient low-grade bacteremia, but changes in LPS approaching significance (P=0.061) were seen with LAL only. There was a significant increase in circulating TNF-alpha (P=0.0387) and IL-6 (P<0.0001), and the degree of change in TNF-alpha was correlated with the severity of periodontal breakdown (P=0.001). There was also a significant correlation between levels of IL-6 and TNF-alpha (P<0.001)., Conclusions: Chronic periodontitis patients undergoing an episode of subgingival scaling show a significant elevation in circulating TNF-alpha and IL-6. This may account for anecdotal reports of pyrexia following treatment and may be significant in terms of the relationship between periodontal disease, bacteremia, and cardiovascular disease.