1
|
Giller M, Holtfreter B, Ruge S, Völzke H, Bernhardt O. Effects of occlusal wear on 16-year progression of non-carious cervical lesions-Results of the study of health in Pomerania (SHIP-START). J Oral Rehabil 2024; 51:1184-1192. [PMID: 38532285 DOI: 10.1111/joor.13691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/04/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND It is still discussed whether occlusal wear (OW) affects the formation of non-carious cervical lesions (NCCLs). OBJECTIVE To estimate effects of OW on the presence and development of NCCLs, using 16-year follow-up data from a cohort study. METHODS Occlusal and cervical defects were measured in 728 cast models (one from the upper jaw and one from the lower jaw) of 364 participants. Adjusted mixed-effects ordinal logistic models analysing estimated cross-sectional (N = 1308 teeth/291 subjects) and longitudinal (N = 718 teeth/226 subjects) associations of OW with NCCLs using tooth level data. RESULTS OW size was cross-sectionally (OR = 1.74; 95% CI: 1.27-2.38 for OW size; OR = 0.97; 95% CI: 0.94-0.99 for squared OW size), but not longitudinally (OR = 1.14; 95% CI: 0.99-1.30) associated with odds of higher NCCL sizes. For cross-sectional analyses, predicted probabilities of an NCCL size of 0 decreased from about 0.996 to 0.010 for OW sizes of 0 to 25. CONCLUSION Results suggest an association between OW and NCCL size. However, as longitudinal results were non-significant, while consistent in direction, large-scaled cohort studies are demanded to more precisely estimate effect strength.
Collapse
Affiliation(s)
- Merle Giller
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Sebastian Ruge
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Olaf Bernhardt
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
2
|
Michałowski K, Brodzikowska A. Clinical Effect of Thioglycosides Extracted from White Mustard on Dental Plaque and Gingivitis: Randomized, Single-Blinded Clinical Trial. Int J Mol Sci 2024; 25:5290. [PMID: 38791329 PMCID: PMC11120871 DOI: 10.3390/ijms25105290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/10/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
The antibacterial and anti-inflammatory effect of thioglycosides has already been established. This study investigates the effects of thioglycosides extracted from white mustard, specifically the "Bamberka" variety, in the context of oral hygiene. The aim of the study is to clarify an evidence-based link between the documented antibacterial and anti-inflammatory effects attributed to thioglycosides and their practical application in oral care. A randomized, single-blinded (patient-blinded) clinical study was performed on 66 patients using mustard-based toothpaste for oral hygiene. The patients were examined at baseline and after 6 and 12 months. The values of the Approximal Plaque Index (API), the Plaque Index (PI), and Bleeding on probing (BOP) were taken into consideration. The results show a significant reduction in plaque accumulation, especially after 6 months of using mustard-based toothpaste in all examined parameters. This suggests that thioglycosides from mustard contribute to a considerable decrease in dental plaque accumulation, confirming their potential in natural oral care solutions, which is indicated in the main conclusions or interpretations.
Collapse
Affiliation(s)
| | - Aniela Brodzikowska
- Department of Conservative Dentistry, Medical University of Warsaw, ul. Binieckiego 6, 02-097 Warszawa, Poland;
| |
Collapse
|
3
|
Dridi SM, Ameline C, Heurtebise JM, Vincent-Bugnas S, Charavet C. Prevalence of the Gingival Phenotype in Adults and Associated Risk Factors: A Systematic Review of the Literature. Clin Pract 2024; 14:801-833. [PMID: 38804396 PMCID: PMC11130957 DOI: 10.3390/clinpract14030064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
The relevance of assessing the gingival phenotype prior to the initiation of periodontal, orthodontic, or prosthetic therapy has been clearly demonstrated. However, publications on this subject are either old or concerned with the means of assessing the gingival phenotype or the main factors likely to modify it. The main objective of this systematic review of the literature was therefore to investigate the prevalence of different gingival phenotypes in adults in good general health and with a healthy periodontium. A systematic review of the literature was performed following the guidelines of PRISMA recommendations using an electronic search strategy on four databases (PubMed, Scopus, Cochrane Library, and Embase) complemented by a manual search. Three independent authors were involved in study selection, data extraction, and bias assessment. Results: Of 807 articles, 17 of them, published between 2012 and 2023, involving 3277 subjects from 11 countries and 9766 dental sites, fulfilled the inclusion criteria. The prevalence of the gingival phenotype could not be determined at the level of an individual or a dental arch because all the publications assessed this phenotype only at the level of certain dental sectors, and were not chosen at random. The maxillary central incisors and maxillary or mandibular first molar sectors were associated with a high and thick gingival phenotype, independently of the dental morphology, gender, and age of adult subjects. Furthermore, in these regions, this gingival phenotype tended to be associated with a thick vestibular bone table. In contrast, maxillary and mandibular incisors and premolars more often had a thin gingival phenotype. For other teeth, the results were less conclusive. It is important not to rely solely on the overall appearance of the dentition but to independently assess the thickness and height of the gingiva at each dental site requiring intervention. Finally, this study highlights a key point, namely the need for further longitudinal studies to determine the prevalence in healthy adults. For practicality and feasibility reasons, these studies should be designed according to therapeutic needs, dental sector by dental sector, and within homogeneous source populations. PROSPERO registration: CRD 42023392602.
Collapse
Affiliation(s)
- Sophie-Myriam Dridi
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France; (C.A.); (S.V.-B.)
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
- Laboratoire MICORALIS, Université Côte d’Azur, UPR 7354, 06800 Nice, France;
| | - Clément Ameline
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France; (C.A.); (S.V.-B.)
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
| | - Jean Michel Heurtebise
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
| | - Séverine Vincent-Bugnas
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France; (C.A.); (S.V.-B.)
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
- Laboratoire MICORALIS, Université Côte d’Azur, UPR 7354, 06800 Nice, France;
| | - Carole Charavet
- Laboratoire MICORALIS, Université Côte d’Azur, UPR 7354, 06800 Nice, France;
- Département d’Orthodontie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France
- Unité d’Orthodontie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France
| |
Collapse
|
4
|
Parsegian K, Okano DK, Chandrasekaran S, Kim Y, Carter TC, Shimpi N, Fadakar S, Angelov N. The PocketPerio application significantly increases the accuracy of diagnosing periodontal conditions in didactic and chairside settings. Sci Rep 2024; 14:10189. [PMID: 38702352 PMCID: PMC11068793 DOI: 10.1038/s41598-024-59394-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/10/2024] [Indexed: 05/06/2024] Open
Abstract
The study aimed to determine the accuracy of diagnosing periodontal conditions using the developed web-based PocketPerio application and evaluate the user's perspective on the use of PocketPerio. First, 22 third-year dental students (DS3) diagnosed ten cases without PocketPerio (control) and with PocketPerio (test) during a mock examination. Then, 105 DS3, 13 fourth-year dental students (DS4), and 32 senior second-year International Standing Program students (ISP2) used PocketPerio chairside. Statistical analysis was performed using a non-parametric paired two-tailed test of significance with the Wilcoxon matched-pairs signed rank test. The null hypothesis that PocketPerio did not increase the accuracy of periodontal diagnoses was rejected at α < 0.01. Periodontal diagnoses made using PocketPerio correlated with those made by periodontics faculty ("gold standard") in all cases. During the mock examination, PocketPerio significantly increased the accuracy of periodontal diagnoses compared to the control (52.73 vs. 13.18%, respectively). Chairside, PocketPerio significantly increased the accuracy of primary (100 vs. 40.0%) and secondary (100 vs. 14.25%) periodontal diagnoses compared to the respective controls. Students regardless of their training year felt more confident in diagnosing periodontal conditions using PocketPerio than their current tools, provided positive feedback on its features, and suggested avenues for its further development.
Collapse
Affiliation(s)
- Karo Parsegian
- Division of Periodontics, Department of Diagnostic Sciences and Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17Th Ave, Rm 130J, Aurora, CO, 80045-2532, USA.
- Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - David K Okano
- Section of Periodontics, School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Sangeetha Chandrasekaran
- Division of Periodontics, Department of Diagnostic Sciences and Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17Th Ave, Rm 130J, Aurora, CO, 80045-2532, USA
| | - Yoolim Kim
- Division of Periodontics, Department of Diagnostic Sciences and Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17Th Ave, Rm 130J, Aurora, CO, 80045-2532, USA
| | - Tonia C Carter
- Center for Precision Medicine Research, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Neel Shimpi
- Center for Dental Benefits, Coding and Quality, American Dental Association, Chicago, IL, USA
| | - Sadaf Fadakar
- Predoctoral Dental Student, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nikola Angelov
- Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
5
|
Han SH, Ko Y, Ham LK, Park JH, Kim Y. Precautions and possibilities in orthodontic treatment of periodontally compromised patients: Current recommendations. J ESTHET RESTOR DENT 2024; 36:595-605. [PMID: 37994693 DOI: 10.1111/jerd.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE Orthodontic treatment plays a crucial role in achieving optimal dental esthetics and functional occlusion. However, when periodontally compromised patients are involved, additional precautions and considerations are critical. This article aims to provide up-to-date recommendations for the orthodontic treatment of periodontally compromised patients. CLINICAL CONSIDERATIONS Comprehensive diagnosis of the patient's periodontal status, inherent malocclusion, and secondary malocclusion resulting from periodontal disease are essential for achieving optimal esthetics and functional occlusion. This can be facilitated through the use of a simplified checklist. Prior to orthodontic treatment, pre-existing periodontal diseases should be managed. Light and controlled forces should be used to minimize the risk of adverse effects on the periodontium, and any potential traumatic occlusion during tooth movement should be minimized. Furthermore, careful anchorage management is required, and proper application of temporary anchorage devices can significantly expand the scope of orthodontic treatment. Finally, treatment results are maintained by ongoing supportive periodontal therapy even during the retention period. CONCLUSIONS This article presents clinical cases demonstrating the importance of accurate diagnosis in orthodontics and periodontics and the positive impact of orthodontic treatment on patients with pre-existing periodontal diseases. CLINICAL SIGNIFICANCE An up-to-date orthodontic treatment protocol for periodontally compromised patients is presented.
Collapse
Affiliation(s)
- Sung-Hoon Han
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Kore, Seoul, Republic of Korea
| | - Youngkyung Ko
- Department of Periodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Lyun Kwang Ham
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Kore, Seoul, Republic of Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA
- Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Kore, Seoul, Republic of Korea
| |
Collapse
|
6
|
Kadkhodazadeh M, Amid R, Moscowchi A, Mansouri H. Periodontal phenotype modification in orthodontic patients. J ESTHET RESTOR DENT 2024; 36:548-554. [PMID: 37850403 DOI: 10.1111/jerd.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the feasibility of phenotype modification in orthodontic patients using combined bone and soft tissue grafting substitutes. CLINICAL CONSIDERATION The surgical procedure was conducted on 18 patients (3 males, 15 females). Periodontal phenotype modification was conducted using demineralized freeze-dried bone allograft and a xenogeneic collagen matrix. The following parameters were recorded for each tooth at baseline and 12-month follow-up: O'Leary plaque index (PI), probing depth (PD), bleeding on probing (BOP), gingival thickness (GT), keratinized tissue width (KTW), gingival recession (GR), and vestibular depth (VD). The results showed a statistically significant increase in GT (2.02 ± 0.39 mm), KTW (1.11 ± 0.82 mm), and VD (0.18 ± 1.16 mm) (p < 0.05). GR was also significantly decreased (1.02 ± 0.99 mm) (p < 0.05). CONCLUSION Within the limitation of this study, the proposed approach enhanced the periodontal condition in orthodontic patients. However, further studies with a larger sample size are needed to ensure long-term stability. CLINICAL SIGNIFICANCE Hard and soft tissue conditions have paramount importance for long-term periodontal stability. Phenotype modification in orthodontic patients can diminish the probability of adverse consequences and result in optimal esthetic outcomes. The proposed technique using combined bone and soft tissue substitutes indicated promising results and could be recommended in orthodontic patients with thin periodontal phenotypes.
Collapse
Affiliation(s)
- Mahdi Kadkhodazadeh
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Mansouri
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
7
|
Cláudio MM, Garcia VG, Freitas RM, Rodrigues JVS, Wainwright M, Casarin RCV, Duque C, Theodoro LH. Association of active oxygen-releasing gel and photodynamic therapy in the treatment of residual periodontal pockets in type 2 diabetic patients: A randomized controlled clinical study. J Periodontol 2024; 95:360-371. [PMID: 38112075 DOI: 10.1002/jper.23-0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/14/2023] [Accepted: 09/18/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of active oxygen-releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in periodontal patients with type 2 diabetes mellitus (DM2). METHODS Patients with residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)-subgingival instrumentation in a single session; BM (n = 17)-SI followed by local application of active oxygen-releasing gel inside the periodontal pocket for 3 min; BM + aPDT (n = 17)-SI followed by application of BM for 3 min and pocket irrigation with methylene blue, and 660-nm diode laser irradiation at 100 mW for 50 s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α = 5%). RESULTS A significant reduction in BOP was verified at 90 and 180 days in the BM + aPDT group. The percentage of sites with PD ≥ 4 mm was significantly reduced at 90 days in BM + aPDT and BM, whereas after 180 days only BM showed a significant reduction. In the BM + aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90 days. There were no differences between the treatments. CONCLUSION The use of adjuvant active oxygen-releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.
Collapse
Affiliation(s)
- Marina M Cláudio
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Valdir G Garcia
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - Rubens M Freitas
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - João Victor S Rodrigues
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba, SP, Brazil
| | - Mark Wainwright
- Department of Biology, Edge Hill University, Ormskirk, Lancashire, UK
| | - Renato C V Casarin
- Department of Periodontics, State University of Campinas, Piracicaba, SP, Brazil
| | - Cristiane Duque
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Leticia H Theodoro
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba, SP, Brazil
| |
Collapse
|
8
|
Ferrando Cascales Á, Ferrando Cascales R, Lacal Luján J, Abella Sans F. Forced orthodontic extrusion for an apparently hopeless anterior tooth by using a simplified approach. J Prosthet Dent 2024; 131:361-369. [PMID: 36137812 DOI: 10.1016/j.prosdent.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 12/01/2022]
Abstract
When restoring severely compromised teeth, respecting the supracrestal tissue attachment and retaining the most coronal and radicular tooth structure is essential to achieving a sufficient ferrule. Forced orthodontic extrusion is a minimally invasive method that allows hard- and soft-tissue conservation. This article describes the treatment of a severely damaged maxillary central incisor that was managed by using a simplified orthodontic extrusion method with intracoronal elastic and metal ligatures applied through a palatal bar and followed by the biologically oriented preparation technique (BOPT). This orthodontic procedure reduces a forward clockwise advance during vertical extrusion, thus maintaining the buccal bone plate.
Collapse
Affiliation(s)
- Álvaro Ferrando Cascales
- Associate Professor, Faculty of Health Sciences, San Antonio de Murcia Catholic University (UCAM), Murcia, Spain
| | - Raúl Ferrando Cascales
- Associate Professor, Faculty of Health Sciences, San Antonio de Murcia Catholic University (UCAM), Murcia, Spain; Director of the Master with Exclusive Dedication in Orthodontics and Dentofacial Orthopedics (UCAM)
| | - José Lacal Luján
- Associate Professor, Department of Oral Surgery, University of Murcia, Murcia, Spain
| | - Francesc Abella Sans
- Director, Department of Restorative Dentistry and Endodontics, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.
| |
Collapse
|
9
|
Moin Ahmed M, Altuwayjiri OSH. Periodontal and Systemic Diseases: A Descriptive Analysis of Awareness Among the General Saudi Population. Cureus 2024; 16:e56088. [PMID: 38618416 PMCID: PMC11010732 DOI: 10.7759/cureus.56088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 04/16/2024] Open
Abstract
Background Taking into account the limited availability of research data, this study aimed to determine the general Saudi population's awareness of the link between periodontal diseases and systemic diseases. Methodology A structured online questionnaire with eight awareness items, apart from demographic variables, was distributed through email, WhatsApp, and Telegram to a sample of 500 individuals. The data were analyzed using a simple descriptive statistical approach and interpreted as ratios for comparison. The awareness regarding systemic diseases associated with periodontal diseases was classified into the following four categories based on the Bloom cutoff points: high (>80%), average (60-79%), low (40-59%), and extremely low (<40%). Results A response rate of 68% was reached with the participation of 340 Saudi citizens residing in the Al Qassim region. Overall, 61.22% of research participants had an average awareness of the link between periodontal and systemic diseases. Almost two-thirds (>60%) of participants were aware that periodontal diseases and systemic diseases have an association and that individuals with systemic diseases need a periodontal checkup. A majority (85%) of participants opined that periodontal treatment has the potential to enhance overall health. Nonetheless, only a few participants (60%) were aware of the association between diabetes mellitus and periodontal diseases, and they had a limited awareness of the association with other systemic diseases. Conclusions Although the Saudi general population possesses average awareness about the relationship between periodontal diseases and systemic diseases, their awareness about different systemic diseases and conditions is extremely low, particularly regarding infertility, stroke, and metabolic diseases. The present research indicates a deficiency in the efforts by healthcare professionals, community service providers, and community administrators to educate the general public regarding the association between periodontal diseases and systemic diseases. This awareness is crucial for individuals to control these intricate, interconnected diseases.
Collapse
Affiliation(s)
- Muzammil Moin Ahmed
- Department of Dental and Oral Health, College of Applied Health Sciences in Ar Rass, Qassim University, Al Qassim, SAU
| | - Osama Saleh H Altuwayjiri
- Department of Dental and Oral Health, College of Applied Health Sciences in Ar Rass, Qassim University, Al Qassim, SAU
| |
Collapse
|
10
|
Bergmann A, Feng C, Chochlidakis K, Russo LL, Ercoli C. A comparison of alveolar ridge mucosa thickness in completely edentulous patients. J Prosthodont 2024; 33:132-140. [PMID: 37470112 DOI: 10.1111/jopr.13738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE The purpose of this cross-sectional clinical study was to determine and compare alveolar ridge mucosa thickness at crestal, buccal, and lingual locations of the maxillary and mandibular arches in completely edentulous patients using a dedicated, ultrasonic gingival scanner. MATERIALS AND METHODS Thirty-eight completely edentulous subjects were included in the study. In each subject, soft tissue thickness was measured at 28 sites of the edentulous ridge by a single calibrated examiner. Intra-observer reliability was calculated with Intraclass Correlation Coefficients by measuring 10 subjects twice, after 1 week. Measurements (mm) were taken at the buccal, lingual, and crestal aspects of the ridge with a dedicated ultrasonic scanner. Repeated measures ANOVA and paired t-tests were used to compare the mean buccal, lingual, and crestal soft tissue thicknesses at each site. The Generalized Estimating Equations model was used to study the effects of age, sex, and race. Confidence level was set to 95%. RESULTS Mean tissue thickness ranged from 0.96 to 1.98 mm with a mean of 1.63 ± 0.25 mm. Intraclass Correlation Coefficients were > 0.97. No significant differences between buccal, crestal, and lingual sites were noted for the mandibular arch as well as at 4 sites on the maxillary arch (maxillary right second molar, maxillary right canine, maxillary left first premolar, maxillary left second molar). However, significant differences in soft tissue thickness were noted for all remaining maxillary sites. Race was found to be positively correlated with tissue thickness, with Black individuals showing a significantly greater thickness than White individuals at 4 sites (maxillary right first molar, maxillary left canine, mandibular right second premolar, mandibular right first molar). Age was found to be positively correlated with tissue thickness at 4 sites (maxillary left central incisor, maxillary left first molar, maxillary left second molar, mandibular left second premolar) and negatively correlated at 2 sites (mandibular right canine, mandibular right second molar). Female sex was positively (maxillary left second premolar, maxillary left second molar) and negatively (mandibular right canine) correlated, respectively, with tissue thickness at 3 sites. When data for anterior and posterior sites were respectively pooled, tissue thickness was significantly less at anterior sextant lingual and crestal sites, while no difference was seen for buccal sites. CONCLUSION Statistically significant differences for alveolar ridge mucosa thickness were found at several sites in the maxilla and between anterior and posterior sextants for lingual and crestal sites in the maxillary and mandibular arches. Tissue thickness differences were also noted for race with Black individuals showing greater tissue thickness at some sites. Age and sex did not show a clear effect on tissue thickness. Recorded differences in tissue thickness were however small and appear of uncertain clinical significance.
Collapse
Affiliation(s)
- Andrew Bergmann
- Departments of Prosthodontics and Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Konstantinos Chochlidakis
- Departments of Prosthodontics and Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Lucio Lo Russo
- Department of Prosthodontics, School of Dentistry, University of Foggia, Foggia, Italy
| | - Carlo Ercoli
- Departments of Prosthodontics and Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| |
Collapse
|
11
|
D'Ambrosio F. Periodontal and Peri-Implant Diagnosis: Current Evidence and Future Directions. Diagnostics (Basel) 2024; 14:256. [PMID: 38337772 PMCID: PMC10855505 DOI: 10.3390/diagnostics14030256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Dentistry and periodontology in particular are constantly evolving in terms of both diagnostic and therapeutic tools [...].
Collapse
Affiliation(s)
- Francesco D'Ambrosio
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| |
Collapse
|
12
|
Borgnakke WS. Current scientific evidence for why periodontitis should be included in diabetes management. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 4:1257087. [PMID: 38274772 PMCID: PMC10809181 DOI: 10.3389/fcdhc.2023.1257087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.
Collapse
Affiliation(s)
- Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
13
|
Carneiro VMDA, Gomes AMS, Marinho MU, de Melo GS, Kasabji F, An TL, Stefani CM, Guimarães MDCM, Andrade CAS. Dental and periodontal dimensions stability after esthetic clinical crown lengthening surgery: a 12-month clinical study. Clin Oral Investig 2024; 28:76. [PMID: 38180519 PMCID: PMC10769982 DOI: 10.1007/s00784-023-05458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES To evaluate the stability of periodontal tissues 3 (T3), 6 (T6), and 12 (T12) months after esthetic crown lengthening (ACL) and the possible correlations between changes in those structures. MATERIALS AND METHODS Twenty individuals were evaluated through clinical assessment, photography, and tomography. Measurements included gingival margin (GM), clinical crown length (CCL), interdental papilla height (PH) and width (PW), gingival thickness (GT), bone thickness (BT), probing depth (PD), distance between alveolar crest and GM, distance between alveolar crest and cementoenamel junction. Nonparametric and correlation statistics were performed (p < 0.05). RESULTS CCL at T0 was 7.42 ± 0.70 mm and increased to 9.48 ± 0.49 mm immediately after ACL, but it decreased to 8.93 ± 0.65 mm at T12. PD decreased 0.60 mm from T0 to T6, and it increased 0.39 mm from T6 to T12. BT decreased 0.20 mm, while GT increased 0.29 mm from T0 to T12. Both PW and PH showed enlargement in T12. A positive moderate correlation was found between CCL/T0 and CCL/T12, GT/T0 and AC-GM/T12, BT/T0 and GT/T12. A few negative moderate correlations were PD/T0 and CCL/T12, PD/T0 and PH/T0, PD/T0 and BT/T12. CONCLUSIONS ACL procedure was effective. Although some rebound occurred, that was not clinically important. PD tended to reestablish its original length, partially due to a migration of GM during the healing period. Besides, a thickening of supracrestal soft tissues was observed. CLINICAL RELEVANCE The present study centers on the factors influencing the stability of periodontal tissues after esthetic crown lengthening, underscoring the procedure's influence on esthetics and biology and the need for careful treatment planning.
Collapse
Affiliation(s)
- Valéria Martins de Araújo Carneiro
- Faculdade de Ciências da Saúde, Departamento de Odontologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil
| | - Andressa Meireles Seabra Gomes
- Faculdade de Ciências da Saúde, Departamento de Odontologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil
| | - Mônica Umpierre Marinho
- Faculdade de Ciências da Saúde, Departamento de Odontologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil
| | - Gabriel Simino de Melo
- Faculdade de Medicina e Odontologia, Departamento de Periodontia, Faculdade São Leopoldo Mandic, Rua Dr. José Rocha Junqueira 13, Campinas-SP, 13045-755, Brazil
| | - Feras Kasabji
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Kassai Út 26, 4028, Debrecen, Hajdú-Bihar, Hungary
| | - Tien-Li An
- Faculdade de Ciências da Saúde, Departamento de Odontologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil
| | - Cristine Miron Stefani
- Faculdade de Ciências da Saúde, Departamento de Odontologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil
| | - Maria do Carmo Machado Guimarães
- Faculdade de Ciências da Saúde, Departamento de Odontologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília-DF, 70910-900, Brazil
| | - Carlos Alexandre Soares Andrade
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Kassai Út 26, 4028, Debrecen, Hajdú-Bihar, Hungary.
| |
Collapse
|
14
|
Manfredini D, Ahlberg J, Aarab G, Bender S, Bracci A, Cistulli PA, Conti PC, De Leeuw R, Durham J, Emodi-Perlman A, Ettlin D, Gallo LM, Häggman-Henrikson B, Hublin C, Kato T, Klasser G, Koutris M, Lavigne GJ, Paesani D, Peroz I, Svensson P, Wetselaar P, Lobbezoo F. Standardised Tool for the Assessment of Bruxism. J Oral Rehabil 2024; 51:29-58. [PMID: 36597658 DOI: 10.1111/joor.13411] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/06/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. METHODS The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. RESULTS The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. CONCLUSIONS The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.
Collapse
Affiliation(s)
- Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Steven Bender
- Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, Texas, USA
| | | | - Peter A Cistulli
- Sleep Research Group, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Respiratory & Sleep Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | | | - Reny De Leeuw
- Department of Oral Health Science, Orofacial Pain Center, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Justin Durham
- Newcastle University's School of Dental Sciences, Newcastle, UK
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dominik Ettlin
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | | | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Gary Klasser
- Department of Diagnostic Sciences, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gilles J Lavigne
- Faculty of Dental Medicine, Universite de Montréal, Quebec, Montréal, Canada
| | - Daniel Paesani
- School of Dentistry, University of Salvador/AOA, Buenos Aires, Argentina
| | - Ingrid Peroz
- Department for Prosthodontics, Gerodontology and Craniomandibular Disorders, Charité Centre for Oral Sciences, Charité - University Medicine of Berlin, Berlin, Germany
| | - Peter Svensson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
15
|
Wang D, Dai L, Cui Z, Xing W, Huang X, Yang H, Shan Y. Association between periodontal diseases and chronic obstructive pulmonary disease: Evidence from sequential cross-sectional and prospective cohort studies based on UK Biobank. J Clin Periodontol 2024; 51:97-107. [PMID: 37850252 DOI: 10.1111/jcpe.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
AIM To investigate the association between periodontal diseases, airflow limitation and incident chronic obstructive pulmonary disease (COPD) in a large-scale prospective UK Biobank cohort. MATERIALS AND METHODS Our approach comprised a cross-sectional study and a prospective cohort. Periodontal diseases were determined based on the participants' self-reported dental symptoms, including painful gums, bleeding gums and loose teeth. Logistic regression and Cox proportional hazards models were used to evaluate the association of periodontal diseases with airflow limitation and incident COPD in the cross-sectional study and the prospective cohort, respectively. RESULTS The cross-sectional study involved 495,610 participants. Multivariable analysis found that periodontal diseases were significantly associated with airflow limitation (odds ratio = 1.036, 95% confidence interval [CI]: 1.015-1.059). The cohort study included 379,266 participants with a median follow-up period of 12.68 years. An elevated risk of incident COPD was associated with the presence of periodontal diseases (hazard ratio: 1.248, 95% CI: 1.174-1.326). The effect was consistent among subgroups, including baseline age (≤65 or >65 years), sex, smoking status and diabetes mellitus. CONCLUSIONS Periodontal diseases are associated with airflow limitation and elevated COPD incidence. Maintaining good periodontal health in patients with chronic bronchitis and emphysema may help prevent the onset of COPD.
Collapse
Affiliation(s)
- Dongyun Wang
- Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
| | - Liang Dai
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
| | - Zhengqian Cui
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China
| | - Weili Xing
- Internal Medicine, Distinct Health Care, Guangzhou, China
| | - Xiaoyan Huang
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hongyu Yang
- Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
| | - Ying Shan
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
16
|
Yamazaki K. Oral-gut axis as a novel biological mechanism linking periodontal disease and systemic diseases: A review. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:273-280. [PMID: 37674899 PMCID: PMC10477752 DOI: 10.1016/j.jdsr.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/20/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023] Open
Abstract
Substantial evidence suggests that periodontal disease increases the risk of developing and progressing extraoral manifestations such as diabetes, atherosclerosis, rheumatoid arthritis, and inflammatory bowel disease. The most probable causative mechanism behind this is the influx of bacteria and/or bacterial products (endotoxin) and inflammatory cytokines into the systemic circulation originating from inflamed periodontal tissues. However, recent studies have revealed that oral bacteria, especially periodontopathic bacteria, play a role in inducing dysbiosis of the gut microbiota resulting induction of gut dysbiosis-related pathology associated with systemic diseases. Conversely, the disruption of gut microbiota has been shown to have a negative impact on the pathogenesis of periodontal disease. Based on our study findings and the available literature, this review presents an overview of the relationship between periodontal disease and systemic health, highlighting the mouth-gut connection.
Collapse
Affiliation(s)
- Kazuhisa Yamazaki
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-Cho, Tsurumi-Ku, Yokohama, Kanagawa 230-0045, Japan
| |
Collapse
|
17
|
Zhang Y, Zhang Y, Tan Y, Luo X, Jia R. Increased RBP4 and Asprosin Are Novel Contributors in Inflammation Process of Periodontitis in Obese Rats. Int J Mol Sci 2023; 24:16739. [PMID: 38069063 PMCID: PMC10706687 DOI: 10.3390/ijms242316739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
There is a significant comorbidity between obesity and periodontitis, while adipokines are pivotal in the immunoinflammatory process, which may play a role in this special relationship. We aimed to assess the effect of adipokines as mediators in the progression of periodontitis in obese Sprague Dawley rats. Rats were divided into four groups: normal body weight with and without periodontitis and obesity with and without periodontitis. Experimental obesity and periodontitis were induced by a high-fat diet or ligaturing, and the effect was measured using metabolic and micro-computed tomography analysis and histological staining. Compared with the other three groups, the group of periodontitis with obesity (OP) had the heaviest alveolar bone absorption, the largest increase in osteoclasts, the utmost inflammatory cell infiltration and the highest expressions of pro-inflammatory cytokines and nuclear factor-kappa B ligand (RANKL); meanwhile, its expression of the osteogenesis-related gene was the lowest among the four groups. The expressions of leptin, visfatin, resistin, retinol-binding protein 4 (RBP4) and asprosin were upregulated, while adiponectin was decreased significantly in OP. The strong positive associations between the periodontal or circulating levels of RBP4 (or asprosin) and the degree of alveolar resorption in experimental periodontitis and obese rats were revealed. The upregulated expression of inflammation biomarkers, the corresponding degradation in connective tissue and the generation of osteoclasts in periodontitis were activated and exacerbated in obesity. The elevated level of RBP4/asprosin may contribute to a more severe periodontal inflammatory state in obese rats.
Collapse
Affiliation(s)
- Yuwei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.Z.); (Y.Z.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Yifei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.Z.); (Y.Z.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Yutian Tan
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China;
| | - Xiao Luo
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China;
| | - Ru Jia
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.Z.); (Y.Z.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Digital Oral Implantology and Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| |
Collapse
|
18
|
Felemban MF, Khattak O, Alsharari T, Alzahrani AH, Ganji KK, Iqbal A. Relationship between Deep Marginal Elevation and Periodontal Parameters: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1948. [PMID: 38003997 PMCID: PMC10673413 DOI: 10.3390/medicina59111948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/07/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: This review focuses on reviewing studies from the literature regarding the effects of deep margin elevation on the surrounding periodontium. Materials and Methods: A review of the literature was carried out using the following online databases: Embase, The Cochrane Library, MEDLINE-PubMed and Google Scholar. Our search was limited to articles from 2010 to 2023. The search terms consisted of keywords and MeSH terms, which were 'deep margin elevation', 'coronal margin relocation', 'periodontium' and 'periodontal tissues'. The literature was searched thoroughly by two reviewers. Initially, the titles of the articles were extracted. After removing irrelevant and duplicate articles, abstracts were assessed for relevant articles. Finally, the reviewers analyzed full-text articles. Results: A total of twelve articles, including one randomized clinical trial, three systematic reviews, two prospective cohort, three case series, one a clinical study, one pilot study and one a retrospective study, were selected and analyzed. Conclusions: The review suggests potential benefits of Deep Margin Elevation (DME) over surgical crown lengthening due to reduced invasiveness, yet conclusive effects on periodontal tissue remain unclear, warranting further studies on clinical parameters and inflammatory biomarkers.
Collapse
Affiliation(s)
- Mohammed Fareed Felemban
- Department of Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia;
| | - Osama Khattak
- Department of Restorative Dental Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Thani Alsharari
- Department of Restorative and Dental Science, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia;
| | | | - Kiran Kumar Ganji
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
- Department of Periodontology & Oral Implantology, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Sawangi (Meghe), Wardha 442107, India
| | - Azhar Iqbal
- Department of Restorative Dental Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia;
| |
Collapse
|
19
|
de Vasconcelos Gurgel BC, Peixe PG, Queiroz SIML, de Almeida Freitas R, de Aquino Martins ARL, Duarte PM. Comparison of immunoexpression of dendritic cells, mast cells and blood vessels in periodontal disease between adults and elderly. Clin Oral Investig 2023; 27:6823-6833. [PMID: 37814161 DOI: 10.1007/s00784-023-05297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The aim of this study was to compare, in adults and elderly individuals, the immunoexpression of immature and mature dendritic cells (DCs), mast cells, and blood vessels in healthy and diseased gingival tissues. MATERIALS AND METHODS The expressions of immunohistochemical markers, including CD1a (immature dendritic cells), CD83 (mature dendritic cells), tryptase (mast cells) and CD34 (blood vessels), were analyzed in gingival biopsies from elderly (n = 27) and adult (n = 127) patients presenting health, gingivitis and periodontitis. Positive cells for each specimen and marker were counted. RESULTS There were no differences in the immunostaining of DCs, mast cells and the amount of blood vessels among gingival biopsies with health, gingivitis and periodontitis in adult and elderly subjects (p > 0.05). Immature DCs were more frequent in tissues with gingivitis and periodontitis in elderly patients, when compared to adults (p < 0.05). Furthermore, degranulated mast cell counts were higher, whereas the number of microvessels was lower in gingivitis in the elderly, when compared to adults (p < 0.05). CONCLUSIONS Diseased periodontal sites in the elderly present an overall significant overexpression of immature DCs and degranulated mast cells, in relation to those of adults. Furthermore, gingivitis in elderly is associated with decreased microvessel growth. These immunoinflammatory differences between elderly and adults may have implications in periodontal tissue breakdown in the late adulthood. Further studies should be performed to elucidate this hypothesis. CLINICAL RELEVANCE Understading the relationship between aging and changes in immune cells during periodontal inflammation may lead to therapeutic targets for the future management of periodontal diseases.
Collapse
Affiliation(s)
- Bruno Cesar de Vasconcelos Gurgel
- Department of Dentistry, Federal University of Rio Grande do Norte, 1787, Senador Salgado Filho Ave, Lagoa Nova, Natal, Rio Grande do Norte, CEP: 59056-000, Brazil.
| | - Patrícia Guerra Peixe
- Department of Dentistry, Federal University of Rio Grande do Norte, 1787, Senador Salgado Filho Ave, Lagoa Nova, Natal, Rio Grande do Norte, CEP: 59056-000, Brazil
| | - Salomão Israel Monteiro Lourenço Queiroz
- Department of Dentistry, Federal University of Rio Grande do Norte, 1787, Senador Salgado Filho Ave, Lagoa Nova, Natal, Rio Grande do Norte, CEP: 59056-000, Brazil
| | - Roseana de Almeida Freitas
- Department of Dentistry, Federal University of Rio Grande do Norte, 1787, Senador Salgado Filho Ave, Lagoa Nova, Natal, Rio Grande do Norte, CEP: 59056-000, Brazil
| | - Ana Rafaela Luz de Aquino Martins
- Department of Dentistry, Federal University of Rio Grande do Norte, 1787, Senador Salgado Filho Ave, Lagoa Nova, Natal, Rio Grande do Norte, CEP: 59056-000, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, University of Florida, 1395 Center Dr, Gainesville, FL, 32610, USA
| |
Collapse
|
20
|
Khocht A, Paster B, Lenoir L, Irani C, Fraser G. Metabolomic profiles of obesity and subgingival microbiome in periodontally healthy individuals: A cross-sectional study. J Clin Periodontol 2023; 50:1455-1466. [PMID: 37536958 DOI: 10.1111/jcpe.13860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023]
Abstract
AIM Since blood metabolomic profiles of obese individuals are known to be altered, our objective was to examine the association between obesity-related metabolic patterns and subgingival microbial compositions in obese and non-obese periodontally healthy individuals. MATERIALS AND METHODS Thirty-nine periodontally healthy subjects were enrolled. Based on body mass index scores, 20 subjects were categorized as lean and 19 as obese. A comprehensive periodontal examination was performed. Subgingival plaque and blood samples were collected. Plaque samples were analysed for bacteria using 16S rDNA sequencing. Untargeted metabolomic profiling (mass spectrometry) was used to quantify metabolites in serum. RESULTS Obese subjects were statistically associated with several periodontopathic taxa including Dialister invisus, Prevotella intermedia, Prevotella denticola, Fusobacterium nucleatum_subsp.vincentii, Mogibacterium diversum, Parvimonas micra and Shuttleworthia satelles. In obese individuals, an amino acid-related metabolic pattern was elevated; however, there was a decrease in metabolic patterns related to lipids and cofactor/vitamins. These metabolic perturbations were associated with multiple subgingival bacterial species that differentiated lean from obese individuals. CONCLUSIONS Obesity-related perturbations in circulating blood metabolites are associated with the development of periodontopathic bacterial colonization in the subgingival microbiome and consequently may increase the risk for periodontal disease in obese individuals.
Collapse
Affiliation(s)
- Ahmed Khocht
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Bruce Paster
- Department of Molecular Genetics, Forsyth Institute, Cambridge, Massachusetts, USA
| | - Leticia Lenoir
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Crissy Irani
- Institute for Community Partnerships, Loma Linda University Health, Loma Linda, California, USA
| | - Gary Fraser
- Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, California, USA
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| |
Collapse
|
21
|
Lê S, Laurencin-Dalicieux S, Minty M, Assoulant-Anduze J, Vinel A, Yanat N, Loubieres P, Azalbert V, Diemer S, Burcelin R, Canceill T, Thomas C, Blasco-Baque V. Obesity Is Associated with the Severity of Periodontal Inflammation Due to a Specific Signature of Subgingival Microbiota. Int J Mol Sci 2023; 24:15123. [PMID: 37894804 PMCID: PMC10606428 DOI: 10.3390/ijms242015123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the link between periodontal microbiota and obesity in humans. We conducted a cohort study including 45 subjects with periodontitis divided into two groups: normo-weighted subjects with a body mass index (BMI) between 20 and 25 kg/m2 (n = 34) and obese subjects with a BMI > 30 kg/m2 (n = 11). Our results showed that obesity was associated with significantly more severe gingival inflammation according to Periodontal Inflamed Surface Area (PISA index). Periodontal microbiota taxonomic analysis showed that the obese (OB) subjects with periodontitis were characterized by a specific signature of subgingival microbiota with an increase in Gram-positive bacteria in periodontal pockets, associated with a decrease in microbiota diversity compared to that of normo-weighted subjects with periodontitis. Finally, periodontal treatment response was less effective in OB subjects with persisting periodontal inflammation, reflecting a still unstable periodontal condition and a risk of recurrence. To our knowledge, this study is the first exploring both salivary and subgingival microbiota of OB subjects. Considering that OB subjects are at higher periodontal risk, this could lead to more personalized preventive or therapeutic strategies for obese patients regarding periodontitis through the specific management of oral microbiota of obese patients.
Collapse
Affiliation(s)
- Sylvie Lê
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Sara Laurencin-Dalicieux
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- INSERM U1295, CERPOP, Epidémiologie et Analyse en Santé Publique, Risques, Maladies Chroniques et Handicaps, 37 Allées Jules Guesdes, 31000 Toulouse, France
| | - Matthieu Minty
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Justine Assoulant-Anduze
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Alexia Vinel
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR 1297 Inserm, Team ESTER, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France
| | - Noor Yanat
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Pascale Loubieres
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Vincent Azalbert
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Swann Diemer
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Remy Burcelin
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Thibault Canceill
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Charlotte Thomas
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Vincent Blasco-Baque
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| |
Collapse
|
22
|
Leblebicioglu B, Tatakis DN. Complications following alveolar ridge augmentation procedures. Periodontol 2000 2023; 93:221-235. [PMID: 37489632 DOI: 10.1111/prd.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/15/2023] [Accepted: 06/18/2023] [Indexed: 07/26/2023]
Abstract
Oral rehabilitation through implant supported dental restorations often requires a ridge augmentation procedure (RAP) prior to implant fixture placement since tooth extraction/loss results in alveolar ridge deficiencies. Although RAP-related surgical techniques and biomaterials have been in practice for several decades, outcomes are not always predictable. Post-surgical complications experienced during the early or late wound healing phases may jeopardize the targeted ideal ridge dimensions, required for implant fixture placement, and may have other consequences, such as negatively impacting the patient's quality of life. This review describes reported post-surgical complications following RAP under the following subtitles: complications by tissue type, complications in function and aesthetics, complications by healing time, complications by biomaterial type, and complications by surgical protocol modalities. Specifically, RAP performed by using particulate bone graft substitutes and related complications are explored. Modalities developed to prevent/manage these complications are also discussed.
Collapse
Affiliation(s)
- Binnaz Leblebicioglu
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
23
|
Pedrinaci I, Calatrava J, Flores J, Hamilton A, Gallucci GO, Sanz M. Multifunctional anatomical prototypes (MAPs): Treatment of excessive gingival display due to altered passive eruption. J ESTHET RESTOR DENT 2023; 35:1058-1067. [PMID: 37078683 DOI: 10.1111/jerd.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To describe a strategy using digital technologies for improving the diagnosis, treatment planning, and surgical execution of patients with excessive gingival display (EGD) due to altered passive eruption (APE). CLINICAL CONSIDERATIONS An important component for successful patient's management is to fulfill their esthetic expectations whilst delivering predictable and long-term therapeutic outcomes. To achieve this goal in patients with excessive gingival display due to altered passive eruption, it is essential to perform an accurate diagnosis and to communicate to the patient the expected customized results using digital technologies. Computer-aided designed and manufactured multifunctional anatomical prototypes (MAPs) may contribute to these purposes. Additionally, they can guide the surgical crown lengthening procedure or serve as a reference during the surgical guide fabrication providing information of the required anatomical landmarks. CONCLUSIONS This novel strategy protocol for diagnosis, communication, and treatment management of patients with excessive gingival display follows functional and biological principles within the frame of a digital workflow, which improves the diagnostic capabilities, enhances communication, and guides the surgical treatment as shown in the 12 months follow-up of the reported case. CLINICAL SIGNIFICANCE Developing a virtual patient by combining multiple digital data sets including cone-beam computed tomography (CBCT), intra-oral scans and digital photography, supports the clinician and the patient to achieve a comprehensive diagnosis and to better communicate the expected results to the patient. Furthermore, this digital treatment exercise based on anatomical and biological principles will facilitate the surgical precision and the achievement of successful outcomes, thus fulfilling the patient needs and expectations.
Collapse
Affiliation(s)
- Ignacio Pedrinaci
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Javier Calatrava
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Juan Flores
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Australia
| | - German O Gallucci
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| |
Collapse
|
24
|
Zhao H, Zhang L, Li H, Hieawy A, Shen Y, Liu H. Gingival phenotype determination: Cutoff values, relationship between gingival and alveolar crest bone thickness at different landmarks. J Dent Sci 2023; 18:1544-1552. [PMID: 37799899 PMCID: PMC10547992 DOI: 10.1016/j.jds.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/03/2023] [Indexed: 03/15/2023] Open
Abstract
Background/purpose Gingival phenotype (GP) has been reported to influence the treatment planning and clinical outcomes in several dental specialties. This study aimed to investigate optimal cutoff values for gingival thickness (GT) measurement at different landmarks to determine GP. The correlations between GT and bone thickness (BT) of buccal alveolar crest were also analyzed. Materials and methods A total of 600 teeth were included. GP was clinically determined by the transparency of a periodontal probe through the gingival margin (TRAN). Measurements for free gingival thickness (GT1), cementoenamel junction gingival thickness (GT2), supracrestal gingival thickness (GT3), subcrestal 1 mm gingival thickness (GT4) and BT at 1, 3 mm apical from the alveolar crest edge (BT1 and BT2) were assessed on cone-beam computed tomography (CBCT) images. Spearman's correlation coefficient was used to evaluate correlations between GT and BT. Results The optimal cutoff values of GT using CBCT method to discriminate GP were 0.75 mm for GT1, 0.85 mm for GT2, 1.15 mm for GT3 and 0.45 mm for GT4. There was significantly positive correlation between GT and BT at all levels (r: 0.375-0.903). The correlations between GT3 and BT (r: 0.789-0.903) were strong, while correlations between GT4 and BT were weak (r: 0.375-0.467). Conclusion The optimal cutoff values of gingival thickness using CBCT method to discriminate gingival phenotype at each gingival landmark were determined. The supracrestal gingival thickness might be an indicator of buccal alveolar crest bone thickness, which could provide valuable perspectives on clinical diagnosis, treatment planning and decision-making.
Collapse
Affiliation(s)
- Haiyan Zhao
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Lei Zhang
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Heng Li
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Ahmed Hieawy
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Ya Shen
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - He Liu
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| |
Collapse
|
25
|
Duarte PM, Felix E, Santos VR, Figueiredo LC, da Silva HDP, Mendes JAV, Feres M, Miranda TS. Patients with type 2 diabetes and severe periodontitis harbor a less pathogenic subgingival biofilm than normoglycemic individuals with severe periodontitis. J Periodontol 2023; 94:1210-1219. [PMID: 37133975 DOI: 10.1002/jper.22-0657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Whether, and to what extent, diabetes mellitus (DM) can affect the subgingival biofilm composition remains controversial. Thus, the aim of this study was to compare the composition of the subgingival microbiota of non-diabetic and type 2 diabetic patients with periodontitis using 40 "biomarker bacterial species." METHODS Biofilm samples of shallow (probing depth [PD] and clinical attachment level [CAL] ≤3 mm without bleeding) and deep sites (PD and CAL ≥5 mm with bleeding) of patients with or without type 2 DM were evaluated for levels/proportions of 40 bacterial species by checkerboard DNA-DNA hybridization. RESULTS A total of 828 subgingival biofilm samples from 207 patients with periodontitis (118 normoglycemic and 89 with type 2 DM) were analyzed. The levels of most of the bacterial species evaluated were reduced in the diabetic compared with the normoglycemic group, both in shallow and in deep sites. The shallow and deep sites of patients with type 2 DM presented higher proportions of Actinomyces species, purple and green complexes, and lower proportions of red complex pathogens than those of normoglycemic patients (P < 0.05). CONCLUSIONS Patients with type 2 DM have a less dysbiotic subgingival microbial profile than normoglycemic patients, including lower levels/proportions of pathogens and higher levels/proportions of host-compatible species. Thus, type 2 diabetic patients seem to require less remarkable changes in biofilm composition than non-diabetic patients to develop the same pattern of periodontitis.
Collapse
Affiliation(s)
- Poliana M Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Edcarlos Felix
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Vanessa R Santos
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Luciene C Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Hélio D P da Silva
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Juliana A V Mendes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Tamires S Miranda
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
- Department of Periodontology, College of Dentistry, São Judas Tadeu University, São Paulo, SP, Brazil
| |
Collapse
|
26
|
Huang X, Wei L, Ning Y, Lin Z, Hong Y. Multisensory Preclinical Training Strategy of Periodontal Scaling for Undergraduates. Int Dent J 2023; 73:709-716. [PMID: 37045688 PMCID: PMC10509394 DOI: 10.1016/j.identj.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/11/2023] [Accepted: 03/11/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Invisibility of subgingival scaling is the most important negative factor affecting the performance of periodontal treatment. A multisensory teaching strategy is used in the preclinical training of undergraduates in order to increase the haptic-auditory-visual feedback, aiming to overcome the invisibility and achieve minimal postoperative complications, improving patients' treatment experience. METHODS One hundred undergraduate dental students in grade 5 were divided into a multisensory teaching strategy group (MTS: n = 50) and a conventional training pattern group (CTP: n = 50). All participants attended a lecture on using an ultrasonic subgingival scaler (USS) and Gracey curettes (GRA), followed by a 3-week training programme. Students in the MTS group were trained in a haptic/auditory-visual feedback manner, whereas students in the CTP group were trained conventionally. After the training phase, paired students in the 2 different groups performed subgingival scaling in paired patients with equivalent teeth of periodontitis using USS and GRA. Objective and subjective postoperative evaluations were recorded. Probing depth (PD) and gingival index (GI) were evaluated before and 4 weeks after scaling by the same periodontal specialist. RESULTS MTS significantly reduced treatment time and ameliorated postoperative complications (gingival injury, haemorrhage and root surface roughness; P < .05). Postoperative sensitivity was reduced in the MTS group from day 1 to day 7 (D1-D5: P < .001; D6: P = .002; D7: P = .003), whereas postoperative pain was reduced on day 1 (P = .006), compared with that in the CTP group. The PD reduction was not significant between the groups (MTS: 3.17 ± 0.95 mm vs CTP: 3.07 ± 0.97 mm, P > .05), whereas the GI change showed a significant difference between the groups (MTS: 1.71 ± 0.41 vs CTP: 1.67 ± 0.41, P < .05). CONCLUSIONS Multisensory teaching strategies in the preclinical periodontal training of undergraduates can reduce postoperative complications (gingival injury, postoperative haemorrhage, and root surface roughness) and provide a better treatment experience (decreased treatment time and postoperative pain and sensitivity) for patients.
Collapse
Affiliation(s)
- Xin Huang
- Guanghua School and Hospital of Stomatology, Sun Yat-sen University, Yuexiu District, Guangzhou, China
| | - Linhesheng Wei
- Guanghua School and Hospital of Stomatology, Sun Yat-sen University, Yuexiu District, Guangzhou, China
| | - Yang Ning
- Guanghua School and Hospital of Stomatology, Sun Yat-sen University, Yuexiu District, Guangzhou, China
| | - Zhengmei Lin
- Corresponding author. Guanghua School and Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuan West Road, Yuexiu District, Guangzhou, China, 510055.
| | - Yun Hong
- Corresponding author. Guanghua School and Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuan West Road, Yuexiu District, Guangzhou, China, 510055.
| |
Collapse
|
27
|
Kus-Bartoszek A, Lipski M, Jarząbek A, Manowiec J, Marek E, Droździk A. Evaluation of Gingival Phenotype in the Early Transitional Dentition Phase in Children-Comparison of Three Non-Invasive Methods. J Clin Med 2023; 12:5897. [PMID: 37762838 PMCID: PMC10532342 DOI: 10.3390/jcm12185897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Gingival phenotype (GP) is determined based on the thickness and width of the gingival tissue. An evaluation of GP is essential for adequate treatment planning and outcome monitoring, including orthodontic treatments in a paediatric population. The present study aimed to compare the reliability of the visual and TRAN methods with that of the ultrasound biometer measurements in the early transitional dentition phase. One hundred ninety three generally healthy, 7-year-old children were examined. An assessment of GP was performed by a paedodontist and a periodontist. The average thickness of the gingiva was 0.76 ± 0.36 mm, which was classified as a thin GP. The agreement between a visual assessment and the biometric ultrasound measurements reached the highest (94%) level when assessing a very thin GP (Spearman's rank correlation coefficient r = 0.37, p < 0.01). Similarly, 99% agreement in the diagnosis of a thin GP was recorded for the TRAN and ultrasound methods (Spearman's rank correlation coefficient r = 0.49, p < 0.001). In total, 86% of cases diagnosed as having a thick GP using the TRAN method turned out to be thin according to the ultrasound measurements. The dentist's specialization and professional experience in the assessment of GP were irrelevant (Spearman's rank correlation coefficient r = 0.49, p < 0.001). All methods tested in the present study were proven to be easy to perform and well accepted by the children. The visual assessment and TRAN methods, despite the fact that they enabled the diagnosis of a thin GP (crucial for treatment planning), cannot be recommended during the teeth replacement period. A misdiagnosis of thick GP may deprive a young at-risk patient of special supervision, which may develop into mucogingival deformities. A biometric ultrasound, although expensive, allows for reliable assessment of the gingiva thickness when needed.
Collapse
Affiliation(s)
- Agnieszka Kus-Bartoszek
- Laboratory of Paediatric Dentistry, Pomeranian Medical University in Szczecin, Powstancow Wlkp 72, 70-111 Szczecin, Poland; (A.K.-B.); (A.J.); (J.M.)
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Powstancow Wlkp 72, 70-111 Szczecin, Poland; (M.L.); (E.M.)
| | - Anna Jarząbek
- Laboratory of Paediatric Dentistry, Pomeranian Medical University in Szczecin, Powstancow Wlkp 72, 70-111 Szczecin, Poland; (A.K.-B.); (A.J.); (J.M.)
| | - Joanna Manowiec
- Laboratory of Paediatric Dentistry, Pomeranian Medical University in Szczecin, Powstancow Wlkp 72, 70-111 Szczecin, Poland; (A.K.-B.); (A.J.); (J.M.)
| | - Ewa Marek
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Powstancow Wlkp 72, 70-111 Szczecin, Poland; (M.L.); (E.M.)
| | - Agnieszka Droździk
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, Powstancow Wlkp 72, 70-111 Szczecin, Poland
| |
Collapse
|
28
|
Penoni DC, Torres SR, Oliveira ML, Farias MLF, Vettore MV, Leão ATT. Untreated osteoporosis and higher FRAX as risk factors for tooth loss: a 5-year prospective study. J Bone Miner Metab 2023; 41:727-737. [PMID: 37432542 DOI: 10.1007/s00774-023-01451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/11/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION Studies have shown that an impaired bone condition, represented by osteoporosis and increased fracture risk, may potentially aggravate periodontal disease and, consequently, the risk of tooth loss. This 5-year prospective study aimed to investigate whether systemic bone condition represents risk factor for tooth loss due to periodontal disease amongst elderly women. MATERIAL AND METHODS Seventy-four participants, aged ≥ 65 years, who attended the 5-years recall for periodontal evaluation were involved. Baseline exposures were osteoporosis and fracture risk probabilities (FRAX). Women were grouped according to bone mineral density (BMD) and years of bone treatment for osteoporosis. The primary outcome at a 5-year follow-up was the number of tooth loss due to periodontal disease. Periodontitis staging and grading, and causes of tooth loss were recorded. RESULTS The multivariate Poisson regression models showed that women with untreated/shortly treated osteoporosis were 4 times more likely to present higher number of tooth loss due to periodontal disease than those with normal BMD or treated for ≥ 3 years (risk ratio (RR) = 4.00, 95% CI 1.40-11.27). Higher FRAX was also linked to tooth loss (RR = 1.25, 95% CI 1.02-1.53). Receiver-operating characteristic (ROC) curve suggested that women with history of ≥ 1 tooth losses have higher chances of worse major FRAX (sensitivity = 72.2%; specificity = 72.2%). CONCLUSION In this 5-year study, higher FRAX and untreated osteoporosis were risk factors for tooth loss. Women with normal BMD or treated for osteoporosis for ≥ 3 years did not show increased risk. Management of skeletal conditions should be emphasized with periodontal care for the prevention of tooth loss in elderly women.
Collapse
Affiliation(s)
- Daniela Cia Penoni
- Division of Dentistry, Brazilian Navy, Hospital Naval de Brasília, SEPS Q 711/911, Federal District, Asa Sul, Brasília, DF, 70390-115, Brazil.
- Division of Periodontics, Department of Dental Clinic, Dental School, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco 325, Rio de Janeiro, 21941-617, Brazil.
| | - Sandra Regina Torres
- Department of Oral Pathology and Diagnosis, Dental School, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco 325, Rio de Janeiro, 21941-617, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Postal 52, Piracicaba, SP, 13414-903, Brazil
| | - Maria Lucia Fleiuss Farias
- Division of Endocrinology, Department of Internal Medicine, Clementino Fraga Filho Hospital, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco 255, Rio de Janeiro, 21941-617, Brazil
| | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Universitetsveien 25, 4630, Kristiansand, Norway
| | - Anna Thereza Thomé Leão
- Division of Periodontics, Department of Dental Clinic, Dental School, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco 325, Rio de Janeiro, 21941-617, Brazil
| |
Collapse
|
29
|
Covani U, Giammarinaro E, Di Pietro N, Boncompagni S, Rastelli G, Romasco T, Velasco-Ortega E, Jimenez-Guerra A, Iezzi G, Piattelli A, Marconcini S. Electron Microscopy (EM) Analysis of Collagen Fibers in the Peri-Implant Soft Tissues around Two Different Abutments. J Funct Biomater 2023; 14:445. [PMID: 37754859 PMCID: PMC10532031 DOI: 10.3390/jfb14090445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
The design of the implant prosthesis-abutment complex appears crucial for shaping healthy and stable peri-implant soft tissues. The aim of the present animal study was to compare two implants with different healing abutment geometries: a concave design (TEST) and a straight one (CTRL). Transmission electron microscopy (TEM) was used to quantify the three-dimensional topography and morphological properties of collagen at nanoscale resolution. 2 swine were included in the experiment and 6 implants per animal were randomly placed in the left or right hemimandible in either the physiologically mature bone present between the lower canine and first premolar or in the mandibular premolar area, within tooth extraction sites. Each CTRL implant was positioned across from its respective TEST implant on the other side of the jaw. After 12 weeks of healing, 8 specimens (4 CTRL and 4 TEST) were retrieved and prepared for histological and TEM analysis. The results showed a significantly higher percentage of area covered by collagen bundles and average bundle size in TEST implants, as well as a significant decrease in the number of longitudinally oriented bundles with respect to CTRL implants, which is potentially due to the larger size of TEST bundles. These data suggest that a concave transmucosal abutment design serves as a scaffold, favoring the deposition and growth of a well-organized peri-implant collagen structure over the implant platform in the early healing phase, also promoting the convergence of collagen fibers toward the abutment collar.
Collapse
Affiliation(s)
- Ugo Covani
- Department of Stomatology, Tuscan Dental Institute, 55041 Lido di Camaiore, Italy; (U.C.); (E.G.); (S.M.)
| | - Enrica Giammarinaro
- Department of Stomatology, Tuscan Dental Institute, 55041 Lido di Camaiore, Italy; (U.C.); (E.G.); (S.M.)
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (G.I.)
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
| | - Simona Boncompagni
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giorgia Rastelli
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (G.I.)
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
| | - Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41013 Seville, Spain; (E.V.-O.); (A.J.-G.)
| | - Alvaro Jimenez-Guerra
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41013 Seville, Spain; (E.V.-O.); (A.J.-G.)
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (G.I.)
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy;
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Simone Marconcini
- Department of Stomatology, Tuscan Dental Institute, 55041 Lido di Camaiore, Italy; (U.C.); (E.G.); (S.M.)
| |
Collapse
|
30
|
Kazakova R, Vlahova A, Tomov G, Dimitrova M, Kazakov S, Zlatev S, Forte M, Barile G, Corsalini M, Capodiferro S. A Comparative Analysis of Post-Retraction Changes in Gingival Height after Conventional and Surgical Gingival Displacement: Rotary Curettage, Diode and Er:YAG Laser Troughing. Healthcare (Basel) 2023; 11:2262. [PMID: 37628460 PMCID: PMC10454077 DOI: 10.3390/healthcare11162262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of the current article is to analyze and compare post-retraction gingival height changes resulting from six different types of gingival-displacement methods, encompassing both conventional and surgical approaches. The study involved a comparative analysis of 263 teeth (consisting of 128 front teeth, 69 premolars, and 66 molars) from 23 patients. For the investigation, three classic retraction methods were utilized, namely the single-cord technique, retraction paste Expasyl, and retraction paste Astringent. Additionally, three surgical techniques were employed, which included ceramic bur rotary curettage, Er:YAG laser troughing, and diode laser troughing. A randomized split-mouth design was implemented, and a significance level of 0.05 was used for the study. The recovery of the free gingival margin height was assessed on gypsum models that were scanned using an intraoral scanner during the first and second week after the retraction procedure. The results revealed that all retraction methods, except for ceramic bur rotary curettage, led to clinically insignificant levels of gingival recession. The article provides insights into the effectiveness and safety of various gingival-displacement techniques, highlighting that most methods tested in the study resulted in minimal or negligible gingival recession post-retraction.
Collapse
Affiliation(s)
- Rada Kazakova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (S.Z.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria
| | - Angelina Vlahova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (S.Z.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria
| | - Georgi Tomov
- Department of Periodontology and Oral Mucosa Diseases, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria;
- Laser Dental Center, Research Institute, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria
| | - Mariya Dimitrova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (S.Z.)
| | - Stoyan Kazakov
- Oral Surgeon, Private Dental Practice–Sofia, 1000 Sofia, Bulgaria;
| | - Stefan Zlatev
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (S.Z.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University–Plovdiv, 4000 Plovdiv, Bulgaria
| | - Marta Forte
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.F.); (M.C.); (S.C.)
| | - Giuseppe Barile
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.F.); (M.C.); (S.C.)
| | - Massimo Corsalini
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.F.); (M.C.); (S.C.)
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.F.); (M.C.); (S.C.)
| |
Collapse
|
31
|
Sumbayak IA, Masulili SLC, Tadjoedin FM, Sulijaya B, Mutiara A, Khoirowati D, Soeroso Y, Bachtiar BM. Changes in Interleukin-1β, Tumor Necrosis Factor-α, and Interleukin-10 Cytokines in Older People with Periodontitis. Geriatrics (Basel) 2023; 8:79. [PMID: 37623272 PMCID: PMC10454687 DOI: 10.3390/geriatrics8040079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Aging can change the ability to respond to various stimuli and physical conditions. A decreased immune response is a form of deterioration of function in older people, who then become more vulnerable when exposed to pathogens. Periodontitis is an inflammatory disease of the periodontal tissues that often occurs in older people. This study aimed to clinically analyze the periodontal status and cytokine levels of IL-1β, TNF-α, and IL-10 in older people and adults with periodontitis. This clinical study examined 20 persons in a group of older people and 20 persons in a group of adults. The clinical measurements of periodontal status included the Simplified Oral Hygiene Index (OHI-S), Plaque Index (PlI), and Papilla Bleeding Index (PBI). The cytokine levels in gingival crevicular fluid (GCF) were quantified by using ELISA kits. The OHI-S, PlI, and PBI were found to be higher in the older group. The mean values of cytokines were higher in the older group than in adults, although no statistically significant differences were found. A strong correlation was found between the clinical measurements and the cytokine levels in the GCF. There was an increasing tendency of pro-inflammatory and anti-inflammatory cytokines in the older group compared to the adult group.
Collapse
Affiliation(s)
- Ines Augustina Sumbayak
- Department of Periodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; (I.A.S.); (F.M.T.); (B.S.); (A.M.); (D.K.); (Y.S.)
| | - Sri Lelyati C. Masulili
- Department of Periodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; (I.A.S.); (F.M.T.); (B.S.); (A.M.); (D.K.); (Y.S.)
| | - Fatimah Maria Tadjoedin
- Department of Periodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; (I.A.S.); (F.M.T.); (B.S.); (A.M.); (D.K.); (Y.S.)
| | - Benso Sulijaya
- Department of Periodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; (I.A.S.); (F.M.T.); (B.S.); (A.M.); (D.K.); (Y.S.)
| | - Arrum Mutiara
- Department of Periodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; (I.A.S.); (F.M.T.); (B.S.); (A.M.); (D.K.); (Y.S.)
| | - Diana Khoirowati
- Department of Periodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; (I.A.S.); (F.M.T.); (B.S.); (A.M.); (D.K.); (Y.S.)
| | - Yuniarti Soeroso
- Department of Periodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; (I.A.S.); (F.M.T.); (B.S.); (A.M.); (D.K.); (Y.S.)
| | - Boy M. Bachtiar
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia;
| |
Collapse
|
32
|
Rosa RAC, Rodrigues JVS, Cláudio MM, Franciscon JPS, Mulinari-Santos G, Cirelli T, de Molon RS, Gouveia Garcia V, Theodoro LH. The Relationship between Hypertension and Periodontitis: A Cross-Sectional Study. J Clin Med 2023; 12:5140. [PMID: 37568542 PMCID: PMC10419474 DOI: 10.3390/jcm12155140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Recent evidence suggests an association between hypertension and periodontitis, although the pathways and implications underlying both chronic conditions are still poorly understood. Therefore, the aim of this study was to evaluate the relationship between hypertension and periodontitis through an observational clinical study using periodontal, physical, and biochemical analyses in hypertensive and non-hypertensive individuals with periodontitis. A total of one hundred patients were divided into two groups. The first group was hypertensive patients with periodontitis. The second group was non-hypertensive patients with periodontitis. Periodontal parameters of probing depth, bleeding on probing, and clinical attachment level were evaluated. The systolic, diastolic, mean, and differential blood pressure were measured in the physical examination. In addition, body mass index and waist-hip ratio were verified. Biochemical tests for glycated hemoglobin, fasting blood glucose, estimated blood glucose, total cholesterol, high-density lipoprotein, creatinine, glutamate pyruvate transaminase, glutamic oxaloacetic transaminase, and C-reactive protein were evaluated. The data were submitted for statistical analysis (α = 0.05%). The results of this study demonstrated that patients with cardiovascular disease did not present with worse periodontal clinical parameters in the conditions studied. However, it is important to bear in mind that this cross-sectional study has some inherent limitations to its design; therefore, to study the relationship between hypertension and periodontitis further, an interventional randomized clinical trial should be conducted.
Collapse
Affiliation(s)
- Rossana Abud Cabrera Rosa
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.A.C.R.); (J.V.S.R.); (M.M.C.); (J.P.S.F.); (G.M.-S.); (R.S.d.M.)
| | - João Victor Soares Rodrigues
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.A.C.R.); (J.V.S.R.); (M.M.C.); (J.P.S.F.); (G.M.-S.); (R.S.d.M.)
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba 16015-050, SP, Brazil
| | - Marina Module Cláudio
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.A.C.R.); (J.V.S.R.); (M.M.C.); (J.P.S.F.); (G.M.-S.); (R.S.d.M.)
| | - João Paulo Soares Franciscon
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.A.C.R.); (J.V.S.R.); (M.M.C.); (J.P.S.F.); (G.M.-S.); (R.S.d.M.)
| | - Gabriel Mulinari-Santos
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.A.C.R.); (J.V.S.R.); (M.M.C.); (J.P.S.F.); (G.M.-S.); (R.S.d.M.)
| | - Thamiris Cirelli
- Department of Dentistry, University Center of Associated School (UNIFAE), São João da Boa Vista 13870-377, SP, Brazil;
| | - Rafael Scaf de Molon
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.A.C.R.); (J.V.S.R.); (M.M.C.); (J.P.S.F.); (G.M.-S.); (R.S.d.M.)
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education (ILAPEO), Curitiba 80710-150, PR, Brazil;
| | - Leticia Helena Theodoro
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.A.C.R.); (J.V.S.R.); (M.M.C.); (J.P.S.F.); (G.M.-S.); (R.S.d.M.)
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba 16015-050, SP, Brazil
| |
Collapse
|
33
|
Couso-Queiruga E, Barboza EP, Avila-Ortiz G, Gonzalez-Martin O, Chambrone L, Rodrigues DM. Relationship between supracrestal soft tissue dimensions and other periodontal phenotypic features: A cross-sectional study. J Periodontol 2023; 94:944-955. [PMID: 36797817 DOI: 10.1002/jper.22-0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The purpose of this study was to determine the association between periodontal supracrestal soft tissue dimensions (PSSTDs) and other phenotypic features in non-molar maxillary teeth. MATERIALS AND METHODS Adult subjects in need of comprehensive dental treatment were recruited. Periodontal phenotypic variables (i.e., facial and palatal gingival thickness [GT], alveolar bone thickness [BT], and PSSTDs, namely distance from the gingival margin to the bone crest defined as periodontal supracrestal tissue height [PSTH] and distance from the cementoenamel junction to the bone crest [CEJ-BC]) were recorded using cone-beam computed tomography scans. Standardized intraoral photographs were obtained to assess facial keratinized tissue width (KTW) and other anatomical parameters (i.e., tooth type, gingival architecture, and interproximal papilla height). RESULTS The study sample was constituted of 87 participants that contributed with a total of 522 maxillary anterior teeth. Differences in mean values of PSSTDs, KTW, GT, and BT were observed between tooth types and sex. Males exhibited a thicker GT and BT, and taller PSTH and KTW compared to females. Shorter CEJ-BC was associated with shorter PSTH, wider KTW, and thicker GT and BT. Shorter PSTH was associated with thicker facial BT. Notably, BT and GT were positively correlated at both facial and palatal sites, meaning that the thicker the gingival phenotype, the thicker the bone morphotype. Facial BT and facial GT were positively correlated with KTW. A flat gingival architecture was associated with the thick periodontal phenotype. Square teeth had shorter CEJ-BC, wider KTW, and thicker GT. CONCLUSIONS Periodontal phenotypic features vary across and within subjects, between facial and palatal sites at different apico-coronal levels, and as a function of sex and tooth type. The shorter the PSSTDs, the wider the KTW and the thicker the GT and BT. PSSTDs, particularly PSTH, should be considered an integral component of the periodontal phenotype.
Collapse
Affiliation(s)
- Emilio Couso-Queiruga
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Eliane Porto Barboza
- Department of Dental Clinic, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Gustavo Avila-Ortiz
- Private Practice, Atelier Dental Madrid, Madrid, Spain
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Oscar Gonzalez-Martin
- Private Practice, Atelier Dental Madrid, Madrid, Spain
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Department of Periodontology, Complutense University of Madrid, Madrid, Spain
| | - Leandro Chambrone
- Evidence-Based Hub, Interdisciplinary Research Center Egas Moniz (CiiEM), Egas Moniz-Cooperative of Higher Education, Caparica, Almada, Portugal
- Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Diogo Moreira Rodrigues
- Department of Periodontology, National Institute of Dental Sciences (INCO 25), Niterói, Rio de Janeiro, Brazil
| |
Collapse
|
34
|
Salvi GE, Roccuzzo A, Imber JC, Stähli A, Klinge B, Lang NP. Clinical periodontal diagnosis. Periodontol 2000 2023. [PMID: 37452444 DOI: 10.1111/prd.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 03/14/2023] [Indexed: 07/18/2023]
Abstract
Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.
Collapse
Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
35
|
Barootchi S, Tavelli L, Majzoub J, Stefanini M, Wang HL, Avila-Ortiz G. Alveolar ridge preservation: Complications and cost-effectiveness. Periodontol 2000 2023; 92:235-262. [PMID: 36580417 DOI: 10.1111/prd.12469] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/30/2022]
Abstract
Alveolar ridge preservation is routinely indicated in clinical practice with the purpose of attenuating postextraction ridge atrophy. Over the past two decades numerous clinical studies and reviews on this topic have populated the literature. In recent years the focus has primarily been on analyzing efficacy outcomes pertaining to postextraction dimensional changes, whereas other relevant facets of alveolar ridge preservation therapy have remained unexplored. With this premise, we carried out a comprehensive evidence-based assessment of the complications associated with different modalities of alveolar ridge preservation and modeled the cost-effectiveness of different therapeutic modalities as a function of changes in ridge width and height. We conclude that, among allogeneic and xenogeneic bone graft materials, increased expenditure does not translate into increased effectiveness of alveolar ridge preservation therapy. On the other hand, a significant association between expenditure on a barrier membrane and reduced horizontal and vertical ridge resorption was observed, though only to a certain degree, beyond which the return on investment was significantly diminished.
Collapse
Affiliation(s)
- Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa, College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
- Private Practice, Atelier Dental Madrid, Madrid, Spain
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| |
Collapse
|
36
|
Stefanini M, Marzadori M, Sangiorgi M, Rendon A, Testori T, Zucchelli G. Complications and treatment errors in peri-implant soft tissue management. Periodontol 2000 2023; 92:263-277. [PMID: 36594486 DOI: 10.1111/prd.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/24/2022] [Accepted: 07/26/2022] [Indexed: 01/04/2023]
Abstract
Inadequate quality, quantity, or aesthetics of the peri-implant soft tissues can result from a combination of factors related to the outcome of treatments performed before, during, or after implant placement. In this paper, we describe in detail the treatment errors that can pave the way for the onset of mucositis or give rise to soft tissue complications such as peri-implant soft tissue discoloration or dehiscence, graft exposure, or scar formation. By tracing the error back to the planning or surgical stage, clinical insights on surgical soft tissue management are provided to avoid or treat complications that affect the status of the peri-implant soft tissues. Mastering the learning curve and knowing the limitations of each technique are fundamental for preventing added treatment failures that can result in increased patient morbidity and overall discontent.
Collapse
Affiliation(s)
- Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Matteo Marzadori
- Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Matteo Sangiorgi
- Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Alexandra Rendon
- Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Orthopedic Institute Galeazzi, Dental Clinic, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, Michigan, USA
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, Michigan, USA
| |
Collapse
|
37
|
Adhikary R, Mohan P, Wadhawan A, Tyagi P. Gingival Augmentation in the Thin Phenotype Using Injectable Platelet-Rich Fibrin and Microneedling. Cureus 2023; 15:e40435. [PMID: 37456469 PMCID: PMC10349171 DOI: 10.7759/cureus.40435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Objective This study set out to examine the results of microneedling (MN) with and without injectable platelet-rich fibrin (i-PRF) in treating individuals with thin periodontal phenotypes, specifically focusing on the effects on gingival thickness (GT) and keratinized tissue width (KTW). Materials and methods This was a split-mouth study involving 32 healthy patients with 64 sites having thin phenotypes classified into two groups. On the one side, i-PRF was injected (Group A), while on the other side (Group B), MN along with i-PRF was used at intervals of 10 days for a month. GT and KTW were measured at baseline, three months, and six months. The parameters were compared intra and intergroup-wise at baseline, three months, and six months using the IBM SPSS Statistics software version 24 (IBM Corp., Armonk, NY) and the chi-square test. Results The findings revealed that when comparing Group A, which received just i-PRF, to Group B, which had i-PRF in conjunction with MN, there was a statistically significant increase in GT in Group B. Conclusions This is a novel method in that it does not need surgical innervations to expand the gingiva in breadth or thickness. Although MN's neoangiogenesis impact contributed to thicker gingiva, i-PRF showed a greater capacity for the release of several growth factors.
Collapse
Affiliation(s)
- Rajnandini Adhikary
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
| | - Prerna Mohan
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
| | - Amit Wadhawan
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
| | - Prashant Tyagi
- Department of Periodontology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, IND
| |
Collapse
|
38
|
Jia R, Zhang Y, Wang Z, Hu B, Wang Z, Qiao H. Association between lipid metabolism and periodontitis in obese patients: a cross-sectional study. BMC Endocr Disord 2023; 23:119. [PMID: 37231396 DOI: 10.1186/s12902-023-01366-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND To investigate the association between clinical periodontal parameters of periodontitis, serum lipid metabolism markers and adipokines' levels in patients with obesity and periodontitis. METHODS A total of 112 patients admitted to Hospital of Xi'an Jiaotong University were included in this study. They were divided into normal body weight group (18.5 < body mass index, BMI < 25, n = 36), overweight group (25 ≤ BMI < 30, n = 38), and obesity group (BMI ≥ 30, n = 38) accordingly. The diagnosis of periodontitis was based on the newest international classification of periodontitis. Full-mouth clinical periodontal measurements included: plaque index, periodontal pocket depth, clinical attachment level, and bleeding on probing. Gingival crevicular fluid samples were analyzed for: Interleukin-1β, tumor necrosis factor-α, Interleukin-6 and C-reactive protein. Serum triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and glycosylated hemoglobin levels were measured. Visfatin, leptin, resistin, and adiponectin levels in serum were also measured. RESULTS The ratio of participants without periodontitis was significantly highest in normal weight group, and the proportion of severe periodontitis (stage III and IV) was highest in obesity group. The periodontal pocket depth, clinical attachment level, and the inflammatory cytokines in gingival crevicular fluid in obesity group and overweight group were higher than those in normal body weight group. The BMI and waist-to-hip ratio (WHR) were significantly positive correlated with periodontal pocket depth and clinical attachment level. Using a Multivariate logistic regression model, periodontitis correlates to BMI, WHR, serum levels of triglyceride, total cholesterol, low density lipoprotein, and adipokines such as visfatin, leptin, and resistin. CONCLUSIONS Obesity is positively correlated with the aggravation of periodontitis. Obesity may aggravate the damage to periodontal tissue by regulating the secretion level of adipokines.
Collapse
Affiliation(s)
- Ru Jia
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuwei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
| | - Zhiyu Wang
- Department of Stomatology, Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bo Hu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhenzhen Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hu Qiao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China.
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| |
Collapse
|
39
|
Kumar A. Gingival recession: Narrow perception - erroneous; wider canvass - out-of-focus! J Indian Soc Periodontol 2023; 27:227-229. [PMID: 37346861 PMCID: PMC10281307 DOI: 10.4103/jisp.jisp_118_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Affiliation(s)
- Ashish Kumar
- Professor and Head, Department of Periodontics, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India. E-mail:
| |
Collapse
|
40
|
Yang M, Li C, Yang W, Chen C, Chung CH, Tanna N, Zheng Z. Accurate gingival segmentation from 3D images with artificial intelligence: an animal pilot study. Prog Orthod 2023; 24:14. [PMID: 37121951 PMCID: PMC10149545 DOI: 10.1186/s40510-023-00465-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Gingival phenotype plays an important role in dental diagnosis and treatment planning. Traditionally, determining the gingival phenotype is done by manual probing of the gingival soft tissues, an invasive and time-consuming procedure. This study aims to evaluate the feasibility and accuracy of an alternatively novel, non-invasive technology based on the precise 3-dimension (3D) soft tissue reconstruction from intraoral scanning and cone beam computed tomography (CBCT) to predict the gingival biotype. METHODS As a proof-of-concept, Yorkshire pig mandibles were scanned, and the CBCT data were fed into a deep-learning model to reconstruct the teeth and surrounding bone structure in 3D. By overlaying the CBCT scan with the intraoral scans, an accurate superposition was created and used for virtual measurements of the soft tissue thickness. Meanwhile, gingival thicknesses were also measured by a periodontal probe and digital caliper on the buccal and lingual sides at 3 mm apical to the gingival margin of the posterior teeth and compared with the virtual assessment at the same location. The data obtained from virtual and clinical measurements were compared by Wilcoxon matched-pairs signed-rank analysis, while their correlation was determined by Pearson's r value. The Mann-Whitney U test was used for intergroup comparisons of the amount of difference. RESULTS Among 108 investigated locations, the clinical and virtual measurements are strongly positively correlated (r = 0.9656, P < 0.0001), and only clinically insignificant differences (0.066 ± 0.223 mm) were observed between the two assessments. There is no difference in the agreement between the virtual and clinical measurements on sexually matured samples (0.087 ± 0.240 mm) and pre-pubertal samples (0.033 ± 0.195 mm). Noticeably, there is a greater agreement between the virtual and clinical measurements at the buccal sites (0.019 ± 0.233 mm) than at the lingual sites (0.116 ± 0.215 mm). CONCLUSION In summary, the artificial intelligence-based virtual measurement proposed in this work provides an innovative technique potentially for accurately measuring soft tissue thickness using clinical routine 3D imaging systems, which will aid clinicians in generating a more comprehensive diagnosis with less invasive procedures and, in turn, optimize the treatment plans with more predictable outcomes.
Collapse
Affiliation(s)
- Min Yang
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40Th St., Philadelphia, PA, 19104, USA
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40Th St., Philadelphia, PA, 19104, USA.
| | - Wen Yang
- The Webb Schools, Claremont, CA, 91711, USA
| | - Chider Chen
- Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center of Innovation and Precision Dentistry, School of Dental Medicine, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40Th St., Philadelphia, PA, 19104, USA
| | - Nipul Tanna
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40Th St., Philadelphia, PA, 19104, USA
| | - Zhong Zheng
- David Geffen School of Medicine, University of California, Los Angeles, 675 Charles E. Young Drive, South, MRL 2641A, Los Angeles, CA, 90095, USA.
- School of Dentistry, University of California, Los Angeles, 675 Charles E. Young Drive, South, MRL 2641A, Los Angeles, CA, 90095, USA.
| |
Collapse
|
41
|
Rinaldi T, Santamaría-Laorden A, Orejas Pérez J, Godoy Ruíz L, Serrano Granger C, Gómez Cogolludo P. Periodontal Healing with Fixed Restorations Using the Biologically Oriented Preparation Technique Combined with a Full Digital Workflow: A Clinical Case Report. Healthcare (Basel) 2023; 11:healthcare11081144. [PMID: 37107978 PMCID: PMC10137619 DOI: 10.3390/healthcare11081144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Gingival inflammation is an ongoing challenge in tooth-supported fixed restorations, especially when the prosthetic margin does not consider the supracrestal tissues of patients. This case report aimed to present the case of a patient who was periodontally compromised due to a previous invasion of the supracrestal tissue attachment with fixed restorations and evaluate the healing response of periodontal tissues to a vertical edgeless preparation technique: bleeding upon probing (BOP), periodontal probing depth (PPD) and clinical attachment level (CAL). (2) After tooth preparation, the new restorations were adapted, this time without invading the supracrestal space of the patient, and CAD/CAM monolithic zirconia crowns were fabricated. (3) Optimal maturation of the soft tissue was observed, achieving correction of the marginal contour of periodontal tissues and improvement of periodontal indexes. (4) It can be concluded that the BOPT technique combined with a full digital workflow is a valid option for the correction and remodeling of gingival architecture.
Collapse
Affiliation(s)
- Tommaso Rinaldi
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Andrea Santamaría-Laorden
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Jaime Orejas Pérez
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Laura Godoy Ruíz
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Carlos Serrano Granger
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Pablo Gómez Cogolludo
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| |
Collapse
|
42
|
Moreira MA, Silveira VR, Alcantara VO, Sousa FB, Sousa BC. Prior Restorative Procedures to Endodontic Treatment. Cureus 2023; 15:e37106. [PMID: 37153307 PMCID: PMC10158847 DOI: 10.7759/cureus.37106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
Tooth loss due to fracture and the failure of endodontic treatment (ET) are common situations in teeth with extensive tissue destruction. This is due to the fragility of the remaining dental structure and the difficulty in sealing cavities, which is sometimes associated with the violation of the supracrestal insertion tissue. The previous restoration of marginal ridges or cusps with composite resin (CR) restores their fracture resistance, due to the adhesive characteristics of the restorative material, while also protecting the quality of endodontic treatment through better sealing. However, the protocol adopted in teeth requiring endodontic treatment involves performing the restorative procedure only after the endodontic procedures. The objective of this study was to report a case in which restoration of marginal ridges and/or cusps was performed prior to endodontic treatment, focusing on maintaining the tooth in function without dental fracture. The restoration was performed with an inverted operative sequence before the endodontic treatment. There was a violation of the supracrestal insertion tissue, requiring crown lengthening surgery (CLS) prior to the restorative procedure. Clinical and radiographic evaluations were performed postoperatively at seven days, three, six, and nine months, and five years. Tooth function was maintained without dental fractures or restoration loss. Periradicular space healing occurred with the disappearance of the lesion. Performing the restorative procedure prior to endodontic treatment in teeth with extensive coronal destruction is an alternative technique that facilitates clinical procedures, reduces the likelihood of dental loss due to fracture, and promotes endodontic treatment success.
Collapse
|
43
|
Lai D, Ma W, Wang J, Zhang L, Shi J, Lu C, Gu X. Immune infiltration and diagnostic value of immune-related genes in periodontitis using bioinformatics analysis. J Periodontal Res 2023; 58:369-380. [PMID: 36691896 DOI: 10.1111/jre.13097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/14/2022] [Accepted: 12/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND OBJECTIVES Periodontitis, which is a chronic inflammatory periodontal disease resulting in destroyed periodontal tissue, is the leading cause of tooth loss in adults. Many studies have found that inflammatory immune responses are involved in the risk of periodontal tissue damage. Therefore, we analyzed the association between immunity and periodontitis using bioinformatics methods to further understand this disease. MATERIALS AND METHODS First, the expression profiles of periodontitis and healthy samples were downloaded from the GEO database, including a training dataset GSE16134 and an external validation dataset GSE10334. Then, differentially expressed genes were identified using the limma package. Subsequently, immune cell infiltration was calculated by using the CIBERSORT algorithm. We further identified genes linking periodontitis and immunity from the ImmPort and DisGeNet databases. In addition, some of them were selected to construct a diagnostic model via a logistic stepwise regression analysis. RESULTS AND CONCLUSIONS Two hundred sixty differentially expressed genes were identified and found to be involved in responses to bacterial and immune-related processes. Subsequently, immune cell infiltration analysis demonstrates significant differences in the abundance of most immune cells between periodontitis and healthy samples, especially in plasma cells. These results suggested that immunity doses play a non-negligible role in periodontitis. Twenty-one genes linking periodontitis and immunity were further identified. And nine hub genes of them were identified that may be key genes involved in the development of periodontitis. Gene ontology analyses showed that these genes are involved in response to molecules of bacterial origin, cell chemotaxis, and response to chemokines. In addition, three genes of them were selected to construct a diagnostic model. And its good diagnostic performance was demonstrated by the receiver operating characteristic curves, with an area under the curve of 0.9424 for the training dataset and 0.9244 for the external validation dataset.
Collapse
Affiliation(s)
- Donglin Lai
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.,Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.,School of Pharmacy, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Wenhao Ma
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.,Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.,School of Pharmacy, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jie Wang
- Department of prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luzhu Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junfeng Shi
- Department of prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Changlian Lu
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xuefeng Gu
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.,School of Pharmacy, Shanghai University of Medicine and Health Sciences, Shanghai, China
| |
Collapse
|
44
|
González-Febles J, Romandini M, Laciar-Oudshoorn F, Noguerol F, Marruganti C, Bujaldón-Daza A, Zabalegui I, Sanz M. Tunnel vs. coronally advanced flap in combination with a connective tissue graft for the treatment of multiple gingival recessions: a multi-center randomized clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04975-7. [PMID: 36988824 DOI: 10.1007/s00784-023-04975-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE To evaluate the efficacy of the partial-thickness non-advanced tunnel technique (TUN) versus the coronally advanced flap (CAF), both combined with a connective tissue graft, in the treatment of multiple gingival recessions. MATERIALS AND METHODS Twenty-nine patients (83 teeth) affected by multiple gingival recessions were treated in two clinical centers with either the test (TUN) or the control (CAF) intervention combined with a connective tissue graft. Outcomes at 3 and 6 months after surgery included complete root coverage (CRC-primary outcome), mean root coverage (mRC), changes in recession depth (RD), probing pocket depth (PPD), and keratinized tissue height (KT). Root sensitivity and root coverage esthetic score (RES) were also evaluated at 6-month examination. Surgery duration, wound healing index (WHI), and patient-reported outcome measures (PROMs) were additionally considered. RESULTS At 6 months, CRC was observed in 80.9% and 79.5% of the teeth treated with TUN and CAF, respectively (odds ratio = 1.2; p = 0.802). No differences between groups were also observed in terms of mRC (TUN = 94.0%; CAF = 91.1%), RD and PPD reductions, root sensitivity, RES, and WHI. KT increase was significantly higher in teeth treated with TUN (Difference in Means - MD = - 1.0 mm; p = 0.001). Surgery duration was shorter (MD = - 19.3 min; p = 0.001), and patients reported less intra-surgical pain (MD = - 16.4; p = 0.028) as well as postoperative morbidity in TUN compared with CAF. CONCLUSIONS Both surgical interventions showed a similar efficacy in terms of root coverage, albeit TUN was associated with a higher increase in KT and with a milder patient's surgical experience. CLINICAL RELEVANCE Both techniques have shown similar efficacy for the coverage of exposed root surfaces, although clinicians may consider TUN as less invasive. TRIAL REGISTRATION Clinicaltrials.gov (NCT05122468).
Collapse
Affiliation(s)
- Jerián González-Febles
- Section of Post-Graduate Periodontology, Faculty of Odontology, Department of Dental Clinical Specialties, University Complutense, Plaza Ramón Y Cajal, 3, 28040, Madrid, Spain
- Clínica Periodontal Antonio Bujaldón, Almería, Spain
| | - Mario Romandini
- Section of Post-Graduate Periodontology, Faculty of Odontology, Department of Dental Clinical Specialties, University Complutense, Plaza Ramón Y Cajal, 3, 28040, Madrid, Spain.
| | - Florencia Laciar-Oudshoorn
- Section of Post-Graduate Periodontology, Faculty of Odontology, Department of Dental Clinical Specialties, University Complutense, Plaza Ramón Y Cajal, 3, 28040, Madrid, Spain
| | - Fernando Noguerol
- Section of Post-Graduate Periodontology, Faculty of Odontology, Department of Dental Clinical Specialties, University Complutense, Plaza Ramón Y Cajal, 3, 28040, Madrid, Spain
| | - Crystal Marruganti
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Antonio Bujaldón-Daza
- Section of Post-Graduate Periodontology, Faculty of Odontology, Department of Dental Clinical Specialties, University Complutense, Plaza Ramón Y Cajal, 3, 28040, Madrid, Spain
- Clínica Periodontal Antonio Bujaldón, Almería, Spain
| | - Ion Zabalegui
- Section of Post-Graduate Periodontology, Faculty of Odontology, Department of Dental Clinical Specialties, University Complutense, Plaza Ramón Y Cajal, 3, 28040, Madrid, Spain
| | - Mariano Sanz
- Section of Post-Graduate Periodontology, Faculty of Odontology, Department of Dental Clinical Specialties, University Complutense, Plaza Ramón Y Cajal, 3, 28040, Madrid, Spain
| |
Collapse
|
45
|
Soundarajan S, Malaippan S. Injectable Platelet-Rich Fibrin and Microneedling—A Non-Surgical Approach for Gingival Augmentation: A Randomized Controlled Clinical Trial. JOURNAL OF ADVANCED ORAL RESEARCH 2023. [DOI: 10.1177/23202068231157997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
Aim: The present study aimed to assess the efficacy of combining microneedling (MN) and injectable platelet-rich fibrin (i-PRF) administration with i-PRF alone in augmenting the thickness of gingiva to manage thin periodontal phenotype. Methodology: The clinical trial involved 36 patients who were diagnosed with thin periodontal phenotype. They were randomized under two groups: MN + i-PRF versus i-PRF alone, carried out as a split-mouth trial. One quadrant was treated only with i-PRF delivery through the gingival sulcus, while the contralateral side was treated with MN and i-PRF in 3 sessions at 10-day intervals. The primary parameter measured was the thickness of the gingiva, at baseline and 3 months following therapy. Statistical analysis was performed using the Mann-Whitney U test. Wilcoxon’s signed ranking test for inter-group and intra-group analysis, respectively. Results: The study results showed a significantly greater increase in gingival thickness (GT) in sites where both MN and i-PRF injection was done, compared to i-PRF alone, with a p value of .04. Conclusion: Both treatment modalities showed improvement in GT, being a minimally invasive alternative for mucogingival surgery. Adjunctive MN was found to be more beneficial than i-PRF alone. However, further research should be carried out to address the drawbacks of the study and for a better understanding of this novel approach.
Collapse
|
46
|
Zhang Y, Chen F, Kang N, Duan J, Xue F, Cai Y. Clinical and computed tomographic evaluations of periodontal phenotypes in a Chinese population: a cross-sectional study. Clin Oral Investig 2023:10.1007/s00784-023-04970-y. [PMID: 36964225 DOI: 10.1007/s00784-023-04970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/19/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVES To investigate the diagnostic value of probe transparency related to gingival thickness (GT) and keratinized gingival width (KGW) at individual and site levels and explore the relationship of buccal bone plate thickness (BT) with GT and KGW. MATERIALS AND METHODS A total of 1,606 teeth from 167 patients with periodontally healthy maxillary anterior region were included. GT was measured with probe transparency and transgingival probing. KGW was measured directly. BTs were assessed at the level 1 mm apical to the alveolar crest (BT1) and midpoint of the root (BT2) and evaluated at individual and tooth levels along with their mutual associations. RESULTS The prevalence of thick gingiva was 53% with probe transparency measurement and 51% with transgingival probing. The cutoff gingival thickness was 0.8 mm, which correlated moderately with a Cohen's kappa of 0.386. The mean GT, KGW, and BTs (BT1 and BT2) in the maxillary anterior region were 0.97 ± 0.46, 5.51 ± 1.62, 0.85 ± 0.31, and 0.79 ± 0.32 mm, respectively. GT and KGW correlated mildly (r = 0.261), and GT and BTs correlated moderately (BT1: r = 0.298; BT2: r = 0.338). GT and BTs differed significantly between men and women and among different tooth sites. CONCLUSIONS GT and BTs correlated positively in the maxillary anterior region and varied within and among individuals. Sex was a factor influencing the gingival phenotype and bone morphotype. CLINICAL RELEVANCE GT measured with transgingival probing, with a cutoff of 0.8 mm, could serve as an objective measure to distinguish different gingival phenotypes.
Collapse
Affiliation(s)
- Yong Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China
| | - Fan Chen
- Department of Stomatology, People's Hospital of Peking University, Beijing, 100044, People's Republic of China
| | - Ni Kang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, No.22 South Avenue Zhongguancun, Beijing, 100081, People's Republic of China
| | - Jinyu Duan
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China
| | - Fei Xue
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China.
| | - Yu Cai
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, No.22 South Avenue Zhongguancun, Beijing, 100081, People's Republic of China.
| |
Collapse
|
47
|
Portes J, Bullón B, Gallardo I, Fernandez-Riejos P, Quiles JL, Giampieri F, Bullón P. Prevalence of undiagnosed diabetes and prediabetes related to periodontitis and its risk factors in elderly individuals. J Dent 2023; 132:104480. [PMID: 36948381 DOI: 10.1016/j.jdent.2023.104480] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE The prevalence of undiagnosed diabetes was estimated to increase with age and can reach 3.5%. The purpose of the study was to evaluate the prevalence of undiagnosed diabetes and prediabetes in the elderly patients who attended a dental clinic and to find common risk factors. METHODS Male patients, older than 50 years, attended their first dental visit to the School of Dentistry for a period of two years, and it was proposed to evaluate undiagnosed type 2 diabetes mellitus. Periodontal, biochemical, microbiological examinations, nutritional profile, and physical activity were performed. RESULTS A total of 106 patients were examined, 6 (5.6%) had diabetes, and 37 (34.9%) had prediabetes without prior diagnosis. The severity of periodontitis was greater in patients with diabetes. Most of the patients were overweight and had increased systolic blood pressure. Patients with prediabetes and periodontitis had a low adherence to the Mediterranean diet. Tannerella forsythia was present in more patients with periodontitis, and the prevalence of Aggregatibacter actinomycetemcomitans is practically absent in groups with periodontitis, except for the group with diabetes. CONCLUSIONS In the population studied, the prevalence of patients without a diagnosis of diabetes and prediabetes was very high and underestimated. The increased severity of periodontitis in patients with diabetes and in conjunction with the high level of cortisol seen in patients with periodontitis, especially those with diabetes, emphasize the dysregulation of the immunoinflammatory system. CLINICAL SIGNIFICANCE It is essential to add all this data to our dental practice to cover patient health with a broader landscape.
Collapse
Affiliation(s)
- Juliana Portes
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain; Dental School, Veiga de Almeida University, Rua Ibituruna, 108, 20271-020, Maracanã, Rio de Janeiro, Brazil
| | - Beatriz Bullón
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain
| | - Isabel Gallardo
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain
| | | | - Jose Luis Quiles
- Department of Physiology, Institute of Nutrition and Food Technology 'José Mataix', Center for Biomedical Research, Universidad de Granada, 18071 Armilla, Spain
| | - Francesca Giampieri
- Resarch Group on Food, Nutritional Biochemistry and Health. Univeridad Europea del Atlantico.39011 Santander, Spain
| | - Pedro Bullón
- Department of Periodontology, Dental School, University of Seville, C/Avicena, s/n, 41009 Seville, Spain.
| |
Collapse
|
48
|
Santamaria P, Paolantonio M, Romano L, Serroni M, Rexhepi I, Secondi L, Paolantonio G, Sinjari B, De Ninis P, Femminella B. Gingival phenotype changes after different periodontal plastic surgical techniques: a single-masked randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04944-0. [PMID: 36930368 DOI: 10.1007/s00784-023-04944-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Abstract
ABSTRACT: OBJECTIVES: Aim of this clinical study was to evaluate the effects on gingival thickness of three surgical techniques for root coverage: the coronally advanced flap (CAF) alone, with a sub-epithelial connective tissue graft (SCTG) or with leukocyte- and platelet-rich fibrin (L-PRF) membranes. METHODS Sixty patients with RT1 single maxillary gingival recession were treated with CAF + L-PRF (20 patients), CAF + SCTG (20 patients) or CAF alone (20 patients). At baseline and 6-month after treatment, gingival thickness (GT), keratinized tissue width (KT), gingival recession (GR), clinical attachment level (CAL), probing depth (PD), PROMs, and the aesthetic outcome were recorded. RESULTS CAF + SCTG and CAF + L-PRF groups showed a significantly greater mean GT increase than CAF alone (0.31 ± 0.10 mm) with no significant differences between CAF + SCTG (0.99 ± 0.02 mm) and CAF + L-PRF (0.92 ± 0.52 mm) groups (p = 0.55). CAF + SCTG was associated with a significantly greater KT gain (3.85 ± 1.04 mm), while in CAF + L-PRF (2.03 ± 0.53 mm) and CAF (1.50 ± 0.69 mm) groups, KT was not significantly increased. Both GR and CAL showed a significant within groups' improvement, without among-groups differences. No significant among-groups difference for the aesthetic outcome but greater discomfort and pain-killer consumption in CAF + SCTG group was detected. CONCLUSION All investigated surgical techniques produced significant GR reduction and CAL gain. GT was similarly augmented by CAF + L-PRF and CAF + SCTG techniques; however, the CAF + SCTG technique produced a more predictable KT and GT increase. CLINICAL RELEVANCE The results of our study suggest that the CAF + SCTG technique represents the most predictable method for the clinician to improve the gingival phenotype, an important factor for long term gingival margin stability.
Collapse
Affiliation(s)
- Pasquale Santamaria
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Michele Paolantonio
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Luigi Romano
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Imena Rexhepi
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Lorenzo Secondi
- Department of Surgical Science, Plastic and Reconstructive Surgery, Tor Vergata University, Rome, Italy
| | - Giulia Paolantonio
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Bruna Sinjari
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Paolo De Ninis
- "Luisa D'Annunzio" Institute for High Culture, Pescara, Italy
| | - Beatrice Femminella
- Department of Innovative Technologies in Medicine & Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| |
Collapse
|
49
|
de Medeiros RA, da Silva YM, Miranda YMS, Gomes DDS, Carvalho TRB, Tanaka EB, de Oliveira PGFP, Nogueira JSE, de Menezes SAF, Menezes TODA, Laurentino RV, Fonseca RRDS, Machado LFA. Digital Form for Assessing Dentistry Undergraduates Regarding Periodontal Disease Associated with Cardiovascular Diseases. Medicina (B Aires) 2023; 59:medicina59030509. [PMID: 36984510 PMCID: PMC10053880 DOI: 10.3390/medicina59030509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Throughout recent years, periodontal disease (PD) has been linked to innumerable medical systemic conditions, such as cardiovascular disease (CVD). This association could negatively impact oral health, so the knowledge of dentists who have graduated must follow modern dentistry in order to promote oral health, mainly in systemically compromised patients. Therefore, the present study aimed to determine and evaluate the knowledge level of dentistry undergraduate students (DUS) regarding the correct periodontal treatment and management of cardiac patients with PD. Methods: This cross-sectional and populational-based study was conducted between March and June 2022 in northern Brazil. A total of 153 DUS received an anonymous digital form (Google Forms Platform) using a non-probabilistic “snowball” sampling technique. The digital form was composed of four blocks of dichotomous and multiple-choice questions. After signing the informed consent term, DUS were divided into three groups according to their period/semester in dentistry graduation during the study time (G1: 1st period/semester; G2: 5th period/semester and G3: 10th period/semester). A total of 25 questions referring to demographic, educational and knowledge data about the dental and periodontal care of cardiac patients with PD were asked, and all data were presented as descriptive percentages and then analyzed using the Kappa test. Results: From a total of 153 (100%) DUS, the sample was mostly composed of 104 (68%) female participants, with an average age of 21.1 years. Regarding basic knowledge, the majority of answers were no, with G1 being higher than G2 and G3. Regarding clinical questions, 1247 (58.3%) answers were no. Additionally, regarding fundamental clinical questions 1, 2, 3, 7, 9, 11, 13 and 14, the majority of G1, G2 and G3 answered no, demonstrating a major lack of knowledge. Conclusions: In our study, DUS demonstrated a low knowledge level of the dental and periodontal care of cardiac patients with PD and its bi-directional link. Thus, according to our results, an improvement in dentistry educational programs regarding periodontal medicine must be implemented.
Collapse
Affiliation(s)
| | | | | | | | | | - Erich Brito Tanaka
- School of Dentistry, University Center of State of Pará, Belém 66060-575, PA, Brazil
| | | | | | | | | | - Rogério Valois Laurentino
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Ricardo Roberto de Souza Fonseca
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Luiz Fernando Almeida Machado
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
- Correspondence:
| |
Collapse
|
50
|
Periodontal tissue changes after crown lengthening surgery: A systematic review and meta-analysis. Saudi Dent J 2023; 35:294-304. [DOI: 10.1016/j.sdentj.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
|