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Carra MC, Balagny P, Bouchard P. Sleep and periodontal health. Periodontol 2000 2024. [PMID: 39233377 DOI: 10.1111/prd.12611] [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: 05/14/2024] [Revised: 07/18/2024] [Accepted: 08/19/2024] [Indexed: 09/06/2024]
Abstract
Sleep is fundamental for health and well-being. An adequate amount and quality of sleep is a cardinal component of a healthy lifestyle at the basis of the prevention of many non-communicable chronic diseases. Recent evidence suggests that sleep disorders, particularly obstructive sleep apnea, represent an emerging risk factor for periodontal health. This review article provides a critical appraisal of the existing literature concerning the association between sleep duration, sleep quality, sleep disorders in general, and obstructive sleep apnea with periodontal diseases, including gingivitis and periodontitis. The putative mechanisms underlying these associations are described as well as the potential clinical implications for diagnosis and treatment.
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Affiliation(s)
- Maria Clotilde Carra
- UFR of Odontology, Université Paris Cité, Paris, France
- Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
- METHODS Team, CRESS, INSERM, INRAe, Université Paris Cité, Paris, France
| | - Pauline Balagny
- INSERM, UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, Paris, France
- Department of Physiology Functional Exploration, Hôpital Bichat (AP-HP), Paris, France
| | - Philippe Bouchard
- UFR of Odontology, Université Paris Cité, Paris, France
- URP 2496, Montrouge, France
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Zhan C, Qu W, Fok MR, Jin L, Lin Y. Motivational Interviewing on Periodontal Treatment Outcomes: A Meta-Analysis. Int Dent J 2024; 74:669-678. [PMID: 38307831 PMCID: PMC11287138 DOI: 10.1016/j.identj.2024.01.003] [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: 11/17/2023] [Revised: 12/16/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This systematic review investigated the clinical efficacy of motivational interviewing (MI) in improving oral hygiene and periodontal health in patients with periodontal diseases. METHODS A comprehensive literature search was conducted across various databases up to May 2023. Randomised controlled trials (RCTs) evaluating the effects of MI on periodontal conditions in patients with gingivitis, periodontitis, and peri‑implantitis were included. After data screening, a risk-of-bias assessment was performed using the Cochrane risk of bias (RoB) tool. The meta-analysis was performed using random-effects models. RESULTS Out of 2108 records screened, 7 RCTs involving 474 patients were included in the qualitative synthesis, with 6 of these studies included in the meta-analysis. Amongst these, 5 studies had a high RoB and 2 had some concerns about bias. Although individual studies reported varied results regarding the effects of MI on different periodontal indices and parameters at different time points, the pooled results revealed no significant difference in the overall effect on plaque level, bleeding on probing, and gingival inflammation between the MI and control groups. In addition, there is insufficient evidence to suggest any significant effect on attachment loss or probing depth. CONCLUSIONS The current evidence is insufficient to support the effectiveness of MI as an adjunctive intervention for improving oral hygiene and periodontal outcomes. However, these results should be interpreted with caution. Additional high-quality studies with standardised MI interventions are required to derive definite conclusions.
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Affiliation(s)
- Chaoning Zhan
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Wanting Qu
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Melissa Rachel Fok
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yifan Lin
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
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Chen X, Cheng Z, Xu J, Wang Q, Zhao Z, Jiang Q. No genetic association between sleep traits and periodontitis: A bidirectional two-sample Mendelian randomization study. Cranio 2024:1-10. [PMID: 39075864 DOI: 10.1080/08869634.2024.2384681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
OBJECTIVE This study aimed to investigate the potential genetic link between sleep traits and periodontitis. METHODS A two-sample bidirectional Mendelian randomization (MR) analysis was conducted using publicly available genome-wide association studies data on chronotype, daytime sleepiness, daytime napping frequency, insomnia, sleep duration, snoring, and the apnea-hypopnea index (AHI), along with a separate dataset on periodontitis. RESULTS Chronotype (OR = 0.929, 95% CI = 0.788-1.095), daytime sleepiness (OR = 0.492, 95% CI = 0.186-1.306), daytime napping frequency (OR = 1.178, 95% CI = 0.745-1.863), sleep duration (OR = 0.868, 95% CI = 0.644-1.169), AHI (OR = 1.124, 95% CI = 0.980-1.289), insomnia (OR = 0.832, 95% CI = 0.440-1.573), and snoring (OR = 0.641, 95% CI = 0.198-2.075) had no effect on periodontitis. Similarly, periodontitis demonstrated no significant effect on sleep traits. CONCLUSIONS There is no evidence of a bidirectional genetic relationship between sleep traits and the risk of periodontitis.
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Affiliation(s)
- Xin Chen
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangsu, China
| | - Zheng Cheng
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangsu, China
| | - Junyu Xu
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangsu, China
| | - Qianyi Wang
- Department of Cardiology, Jiangyin People's Hospital Affiliated to Nantong University, Jiangsu, China
| | - Zhibai Zhao
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Jiangsu, China
| | - Qianglin Jiang
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangsu, China
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Marruganti C, Luthra S, Hussain SB, Suvan J, D'Aiuto F. Healthy lifestyles and better periodontal health: Results from two large population-based surveys. J Periodontal Res 2024. [PMID: 38953498 DOI: 10.1111/jre.13320] [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: 04/17/2024] [Revised: 06/10/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024]
Abstract
AIM To ascertain whether healthy lifestyles are associated with periodontal diseases in two large-scale surveys in the US (National Health and Nutrition Examination Survey - NHANES) and the UK Biobank. METHODS 9854 US adults and 111 679 UK adults were included in the analyses. A healthy lifestyle score (HLS), ranging between 0 and 5, was calculated based on the reported number of healthy behaviours, including never smoking, no heavy alcohol consumption, top third of leisure-time physical activity, higher dietary quality, and ideal sleep duration. The prevalence of periodontal diseases was the primary outcome in both surveys. In the NHANES, periodontal status was assessed through a full-mouth periodontal examination, while in the UKB, only self-reported periodontal status was available. RESULTS Multiple regression analyses confirmed that the presence of at least 2-3 healthy behaviours (vs. 0-1) was associated with lower odds of overall and severe periodontitis (ORs 0.5, 0.4-0.6; p < .001 and 0.5, 0.3-0.8; p = .003, respectively) in the NHANES, and of bleeding gums (OR = 0.9, 0.8-1.0; p = .092) and loose teeth (OR = 0.6, 0.5-0.7; p < .001) in UKB. This association increased when considering prevalence of 4-5 healthy behaviours (vs. 0-1) in both the NHANES (periodontitis: OR = 0.3, 0.2-0.4; p < .001; severe periodontitis: OR = 0.1, 0.01-0.2; p < .001) and the UKB (bleeding gums: OR = 0.8, 0.7-0.9; p < .001; loose teeth: OR = 0.5, 0.4-0.6; p < .001). Mediation analyses revealed how these protective associations could be partially mediated (1-14%) by differences in biomarkers of systemic inflammation (white blood cells and neutrophils count as well as C-reactive protein). CONCLUSIONS Adoption of healthy lifestyle behaviours is associated with a lower prevalence of periodontal diseases within two large population-based samples. This relationship exhibits a dose-response pattern, implying that greater adherence to healthy habits leads to a more significant protective effect against the odds of periodontal diseases. Additionally, our findings suggest that this protective effect is, in part, mediated by reductions in systemic inflammation.
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Affiliation(s)
- Crystal Marruganti
- Periodontology Unit, Eastman Dental Institute, University College London, London, UK
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Shailly Luthra
- Periodontology Unit, Eastman Dental Institute, University College London, London, UK
| | - Syed Basit Hussain
- Periodontology Unit, Eastman Dental Institute, University College London, London, UK
| | - Jeanie Suvan
- University of Glasgow Dental School, Glasgow, UK
| | - Francesco D'Aiuto
- Periodontology Unit, Eastman Dental Institute, University College London, London, UK
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Vitiello F, Monterubbianesi R, Sparabombe S, Bourgeois D, Tosco V, Alshehri FA, Carrouel F, Putignano A, Orsini G. Use of over-the-counter mouthwashes as an additional measure in individual oral prophylaxis on adults with plaque-induced gingivitis: a double-blind, parallel, randomized controlled trial. BMC Oral Health 2024; 24:83. [PMID: 38229032 DOI: 10.1186/s12903-023-03779-1] [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: 09/11/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Plaque-induced gingivitis is a chronic inflammatory condition characterized by complete reversibility of tissue damage once the periodontal biofilm has been disorganised. The aim of this study was to evaluate the efficacy of two commercially available mouthwashes (MWs) versus a chlorhexidine (CHX) 0.12% MW in reducing gingival bleeding (GB) in adults with plaque-induced gingivitis. METHODS The present study was a double-blind, parallel, randomized controlled trial involving 6492 gingival sites (i.e. 39 subjects × 28 teeth × 6 sites/tooth) aged 18-75 years. During a 2-week period, subjects were randomized to receive MWs: a control CHX 0.12% MW (group C, 1818 sites); a MW test containing CHX 0.09% + Citrox®/P complex (group CX, 2628 sites); a MW test based on natural compounds (group P, 2016 sites). GB was assessed at the inclusion visit (T0) and after 2 weeks of MW use (T1). Analyses of GB were compared between groups and then restricted to subjects with bleeding sites between 10 and 30% (moderate gingivitis) or ≥ 30% (severe gingivitis) at T0. Pairwise comparisons were made between groups and logistic regression was used to identify correlates of GB (T1). RESULTS For total bleeding site analysis, GB reduction between T0 and T1 ranged from 23% (C), 26% (CX) and 36% (P), respectively (all p < 0.05). Multiple comparison between groups showed that group C was significantly less effective (p < 0.05) than groups CX and P. Splitting the analysis, in patients with severe gingivitis (≥ 30% bleeding sites at T0), all MWs had a positive effect on GB with a reduction at T1 of 36% (C), 33% (CX) and 42% (P), respectively. While GB reduction between T0 and T1, was significant for all groups, the comparison among groups showed no significant difference between group C and CX, whereas the improvement was significant for group P. On the other hand, in adults with moderate gingivitis (< 30% bleeding sites at T0), only CX and P had a positive effect on GB reduction at T1(9% in CX and 2% in P, respectively), although the differences between the three groups were not significant. CONCLUSION The daily use of MWs with natural components (groups P and CX) for 2 weeks should be considered positively as an adjunct to individual oral prophylaxis to reduce GB compared to the control MW containing CHX 0.12% (group C) in healthy adults with plaque-induced gingivitis. For subjects with severe gingivitis, it is advisable to first use natural MW (P) and then MW based on CHX 0.09% with natural components (CX), compared to MW with CHX 0.12% (C). For adults with moderate gingivitis, P and CX can be advisable, even if no definitive recommendations can be drawn. TRIAL REGISTRATION ACTRN12622000215729, 07/02/2022.
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Affiliation(s)
- Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Scilla Sparabombe
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Denis Bourgeois
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Fahad Ali Alshehri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia
| | - Florence Carrouel
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- National Institute of Health and Science of Aging (INRCA), Ancona, 60124, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy.
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Lafaurie GI, Sabogal MA, Contreras A, Castillo DM, Gualtero DF, Avila JD, Trujillo TG, Duque A, Giraldo A, Duarte S, Gutierrez SJ, Ardila CM. Factors Associated with the Extent of Clinical Attachment Loss in Periodontitis: A Multicenter Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7043. [PMID: 37998274 PMCID: PMC10671280 DOI: 10.3390/ijerph20227043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
Periodontitis has significant public health implications, affecting individuals' overall health, well-being, and quality of life. This study aimed to assess the risk factors associated with the extent of clinical attachment loss (CAL) in a population diagnosed with periodontitis. Six hundred and sixty-seven patients with different degrees of CAL (mild, n = 223; moderate, n = 256; and advanced, n = 188) were enrolled. Socio-demographics, lifestyle, microbiological profiles, specific immune response, obesity, and single-nucleotide polymorphism of the IL1 gene were determined. Unconditional logistic regression models were conducted to determine the factors associated with the extent of CAL. Aging, smoking, microbial factors, plaque index, and IgG2 antibodies against Aggregatibacter actinomycetemcomitans were associated with advanced CAL. IgG2 antibodies against A. actinomycetemcomitans (OR 1.50; CI 95% 1.23-1.81), plaque accumulation (OR 2.69; CI 95% 2.20-3.29), Porphyromonas gingivalis (OR 1.93; CI 95% 1.35-2.76), Tanerella forsythia (OR 1.88; CI 95%1.30-2.70), and current smoking (OR 1.94; CI 95% 1.31-2.87) were associated with advanced CAL. Gene IL polymorphisms, obesity, and stress were not associated with the extent of CAL. Aging, plaque accumulation, smoking, and having antibodies against A. actinomycetemcomitans were the most critical factors associated with advanced CAL. In contrast, obesity, stress, and gene polymorphisms were not associated with the extent of CAL.
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Affiliation(s)
- Gloria Inés Lafaurie
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - María Alejandra Sabogal
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Adolfo Contreras
- Periodontal Medicine Group, Universidad del Valle, Cali 760042, Colombia; (A.C.); (S.J.G.)
| | - Diana Marcela Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Diego Fernando Gualtero
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Juliette De Avila
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Tamy Goretty Trujillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Andrés Duque
- Research Group in Basic Sciences and Clinical Dentistry, CES University, Medellin 050021, Colombia; (A.D.); (A.G.)
| | - Astrid Giraldo
- Research Group in Basic Sciences and Clinical Dentistry, CES University, Medellin 050021, Colombia; (A.D.); (A.G.)
| | - Silvia Duarte
- Dental Research Center-CIO, Pontificia Universidad Javeriana, Bogota 110311, Colombia;
| | | | - Carlos Martín Ardila
- Biomedical Stomatology Research Group, Faculty of Dentistry, Universidad de Antioquia UdeA, Medellin 050010, Colombia
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Ferrarotti F, Baima G, Rendinelli M, Citterio F, Mariani GM, Mussano F, Romano F, Romandini M, Aimetti M. Pocket closure after repeated subgingival instrumentation: a stress test to the EFP guideline for stage III-IV periodontitis. Clin Oral Investig 2023; 27:6701-6708. [PMID: 37773418 PMCID: PMC10630226 DOI: 10.1007/s00784-023-05279-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES To study the effects of one or two repeated subgingival instrumentations (RSI) in achieving the endpoints of therapy (EoT) in open pockets [residual probing pocket depth (PPD) ≥ 6 mm and PPD 4-5 mm with bleeding on probing (BoP)] after steps I-II of therapy. MATERIALS AND METHODS Twenty-five patients (3,552 total sites; 1,450 open pockets) with stage III-IV periodontitis received steps I-II of periodontal therapy and were re-evaluated after 4-6 weeks (T1). Residual pockets received RSI at T1 and at 3 months (T2). EoT (PPD < 4 or PPD < 6 BoP-) rate at T1, T2 and 6 months (T3) was computed. The number of needed surgeries and treatment costs were calculated. RESULTS At T1, 67.6% of open pockets achieved EoT. At residual PPD ≥ 6 mm at T1 (n = 172), one and two RSI resulted in 33.1% and 45.9% of EoT at T2 and T3, respectively. At residual PPD 4-5 mm with BoP at T1 (n = 298), one and two RSI resulted in 66.8% and 72.1% of EoT at T2 and T3, respectively. PPD at T1 predicted EoT after RSI in both cases, while tooth type only in residual PPD 4-5 mm BoP + . At T1, mean number of surgeries per patient and associated costs were significantly higher than after one/two RSI. CONCLUSIONS RSI may achieve EoT in residual PPD 4-5 mm BoP + and PPD ≥ 6 mm in a considerable number of cases. CLINICAL RELEVANCE These findings may support the administration of one/two cycles of RSI prior to surgical approach. PROTOCOL REGISTRATION ClinicalTrials.gov identification number: NCT04826926.
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Affiliation(s)
- Francesco Ferrarotti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy.
- Politecnico di Torino, Turin, Italy.
| | - Martina Rendinelli
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Giulia Maria Mariani
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Federico Mussano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Geitmyrsveien, 69, 0455, Oslo, Norway.
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
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