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Zaiger J, Leblebicioglu B, Meirelles L, Lu WE, Schumacher FL, Tatakis DN. Effects of extraoral storage time on autologous gingival graft early healing: A split-mouth randomized study. J Periodontal Res 2024. [PMID: 38634181 DOI: 10.1111/jre.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
AIMS Despite the established use of palatal tissue grafts for mucogingival procedures, there are no studies on the effect of extraoral storage time on graft outcomes. This prospective split-mouth randomized experimental clinical trial aimed to assess whether gingival graft extraoral storage time affects graft healing. METHODS Standardized grafts were harvested from the palate and stored extraorally for 2 (Control) or 40 (Test) minutes before being placed at recipient beds. Intraoral scans, clinical photographs, and tissue blood perfusion were obtained preoperatively, postoperatively, and at follow-up visits (Days 2 (PO2), 3 (PO3), 7 (PO7), and 14 (PO14)). Healing Score Index (HSI) and wound fluid (WF) biomarkers (angiogenin, IL-6, IL-8 (CXCL8), IL-33, VEGF-A, and ENA-78 (CXCL5)) were also assessed. RESULTS Twenty-three participants completed all study visits. Extraoral storage time was 2.3 ± 1.1 min and 42.8 ± 3.4 min for C and T grafts, respectively (p < .0001). Recipient beds remained open for 21.4 ± 1.7 min. No graft underwent necrosis or failed to heal by PO14. Minimal volumetric changes were observed, without significant intergroup differences (p ≥ .11). Graft perfusion initially decreased post-harvesting before peaking on PO7 for both C and T grafts, with no significant intergroup differences (p ≥ .14). HSI values progressively increased, with no significant intergroup differences (p ≥ .22). WF analysis revealed detectable levels for all biomarkers tested, without significant intergroup differences (p ≥ .23). CONCLUSION Extraoral storage time of 40 min has neither statistically significant nor clinically discernible effects on autologous graft revascularization, early healing, or survival, as determined by physiological, wound healing, and molecular parameters.
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Affiliation(s)
- James Zaiger
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Binnaz Leblebicioglu
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Luiz Meirelles
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Wei-En Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Fernanda L Schumacher
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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Tatakis DN, Paramitha V, Lu WE, Guo X. Upper lip characteristics and associated excessive gingival display etiologies in adults: Race and sex differences. J Periodontol 2024; 95:74-83. [PMID: 37436716 DOI: 10.1002/jper.23-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND This cross-sectional study aimed to examine upper lip (UL) and smile characteristics and soft tissue excessive gingival display (EGD) etiologies (hypermobile upper lip [HUL], altered passive eruption [APE], and short upper lip [SUL]) in a nondental adult population and to analyze interracial (Black and White) and intersex differences. METHODS Community participants, non-Hispanic Blacks (NHB) and non-Hispanic Whites (NHW), were recruited and examined for UL vertical dimensions at rest and maximum smile and for HUL, APE, and SUL. Associations between gingival display (GD) or EGD and UL anatomical characteristics, HUL, APE, and SUL were analyzed. RESULTS Participants included 66 NHB and 65 NHW adults. Ergotrid height (greater among NHW; p = 0.019) averaged 14.0 mm. Upper lip vermilion length (ULVL), total UL length, internal lip length, total UL length during smile, and UL mobility averaged 8.6, 22.5, 23.1, 16.6, and 5.9 mm, respectively (all significantly greater in NHB; p ≤ 0.012). SUL prevalence was 4.6%, found only among NHW. Lip length change from rest to smile (LLC) averaged 26.2% (significantly greater in females; p = 0.003). HUL prevalence was 10.7% (NHB 13.1%, NHW 3.5%; p = 0.024). NHB had significantly greater GD (p ≤ 0.017). EGD and APE prevalence (6.9% for both) showed significant interracial and intersex differences (p ≤ 0.014). Multivariate logistic regression analyses indicated that LLC and HUL were the most consistently significant EGD determinants. CONCLUSIONS UL anatomical and functional characteristics and soft tissue-related EGD etiologies exhibit significant interracial and intersex differences, with UL mobility/hypermobility being the most consistently significant determinant of GD.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Vanessa Paramitha
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
- Private Practice, Jakarta, Indonesia
| | - Wei-En Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Xiaohan Guo
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
- Global Biometric and Data Management, Pfizer, New Jersey, USA
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Taş D, Kurgan Ş, Güney Z, Serdar MA, Tatakis DN. The effect of smoking on clinical and biochemical early healing outcomes of coronally advanced flap with connective tissue graft: Prospective cohort study. J Periodontol 2024; 95:17-28. [PMID: 37436705 DOI: 10.1002/jper.23-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND This study aimed to determine the effects of smoking on early (≤3 months) clinical outcomes and relevant molecular biomarkers following root coverage surgery. METHODS Eighteen smokers and 18 nonsmokers, status biochemically verified, with RT1 gingival recession defects were recruited and completed study procedures. All patients received coronally advanced flap plus connective tissue graft. Baseline and 3 month recession depth (RD), recession width (RW), keratinized tissue width (KTW), clinical attachment level (CAL), and gingival phenotype (GP) were recorded. Root coverage (RC) percentage and complete root coverage (CRC) were calculated. Recipient (gingival crevicular fluid) and donor (wound fluid) site VEGF-A, HIF-1α, 8-OHdG, and ANG levels were determined. RESULTS There were no significant intergroup differences for any baseline or postoperative clinical parameters (P > 0.05), except for whole mouth gingival index (increased in nonsmokers at 3 months; P < 0.05). Compared to baseline, RD, RW, CAL, KTW, and GP significantly improved postoperatively, without significant intergroup differences. There were no significant intergroup differences for RC (smokers = 83%, nonsmokers = 91%, P = 0.069), CRC (smokers = 50%, nonsmokers = 72%, P = 0.177), and CAL gain (P = 0.193). The four biomarker levels significantly increased postoperatively (day 7; P ≤ 0.042) in both groups and returned to baseline (day 28) without significant intergroup differences (P > 0.05). Similarly, donor site parameters were not different between groups. Strong correlations, consistent over time, were found between biomarkers implicated in angiogenesis (VEGF-A, HIF-1α, and ANG). CONCLUSIONS The early (3 month) clinical and molecular changes after root coverage surgery utilizing a coronally advanced flap plus connective tissue graft are similar between smokers and nonsmokers.
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Affiliation(s)
- Duygu Taş
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- Graduate School of Health Sciences, Ankara University, Ankara, Turkey
| | - Şivge Kurgan
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Zeliha Güney
- Department of Periodontology, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey
| | - Muhittin A Serdar
- Department of Medical Biochemistry, School of Medicine, Acıbadem University, Ankara, Turkey
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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Tatakis DN, Silva CO. Contemporary treatment techniques for excessive gingival display caused by altered passive eruption or lip hypermobility. J Dent 2023; 138:104711. [PMID: 37730094 DOI: 10.1016/j.jdent.2023.104711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES Excessive gingival display (EGD), also known as gummy smile, has various causes, including altered passive eruption (APE) and hypermobile upper lip (HUL). This state-of-the art narrative review explores current concepts regarding soft tissue EGD etiologies and the contemporary modalities available for APE or HUL treatment. DATA, SOURCES, STUDY SELECTION Literature search was conducted for a narrative review on the etiology, diagnosis, and treatment of EGD caused by APE and HUL. Searching for articles was carried out in PubMed and Google Scholar. Published articles, including case reports, case series, observational and interventional clinical trials, and critical appraisals of the literature (e.g., systematic reviews) on the etiology, diagnosis, and treatment of EGD caused by APE and HUL were retrieved and reviewed. Particular focus was placed on novel treatment modalities introduced in the last five years. CONCLUSIONS Recent research evidence indicates that APE and HUL are the two major soft tissue-based EGD etiologies. Aesthetic crown lengthening (ACL) and lip repositioning surgery (LRS) are the established surgical treatment modalities for APE and HUL, respectively. The last few years have seen the introduction of new techniques for APE and HUL management, an expansion of the available ACL and LRS technique variations, and additional evidence further supporting the effectiveness of these two procedures. Several of the recently introduced approaches offer unique, innovative, and potentially impactful concepts. However, for many of these newly described treatments the available evidence is limited to case reports and the exact indications remain to be adequately defined. CLINICAL SIGNIFICANCE Altered passive eruption and hypermobile upper lip are the common soft tissue causes of gummy smile and can be successfully managed through aesthetic crown lengthening and lip repositioning surgery, respectively. A wide range of newly introduced approaches promises to further facilitate gummy smile treatment and improve outcomes.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA.
| | - Cléverson O Silva
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Kofina V, Monfaredzadeh M, Rawal SY, Dentino AR, Singh M, Tatakis DN. Patient-reported outcomes following guided bone regeneration: Correlation with clinical parameters. J Dent 2023; 136:104605. [PMID: 37419383 DOI: 10.1016/j.jdent.2023.104605] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/06/2023] [Accepted: 07/05/2023] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVES Postoperative oral health-related quality of life is procedure-dependent and may vary during early healing. There is scarce evidence on patient-reported outcome measures (PROMs) after extraction and guided bone regeneration (GBR) or on the clinical parameters influencing PROMs. This prospective observational study aimed to evaluate PROMs during the first 2 weeks following extraction and GBR and correlate them with clinical parameters. METHODS Patients undergoing extraction and GBR (bone graft and resorbable membrane) at a single tooth-bound site were recruited. PROMs (pain, swelling, difficulty of mouth opening, and OHIP-14) were recorded immediately preoperatively, and at 2, 7, and 14 days postoperatively. Flap advancement, gingival and mucosal thickness, duration of surgery, and wound opening were the clinical parameters assessed. RESULTS Twenty-seven patients were included. All PROMs peaked on postoperative day 2, decreased subsequently and were significantly correlated with each other. Although 41-56% of patients reported moderate to severe pain, swelling, or mouth opening difficulty on day 2, most patients experienced mild or no symptoms throughout the postoperative period. Pain, swelling and difficulty of mouth opening were determinants of OHIP-14 and were correlated with all OHIP-14 domains during different time points. Wound opening peaked on day 7. Flap advancement, soft tissue thickness, wound opening, duration of surgery and preoperative PROMs affected postoperative PROMs. CONCLUSIONS Within the limitations of the present study, postoperative symptoms after guided bone regeneration are worst on day 2 and oral health-related quality of life is significantly impacted by pain, swelling, difficulty of mouth opening, surgery duration and flap advancement. CLINICAL SIGNIFICANCE This is the first study to report PROMs following extraction and GBR with particulate bone graft and resorbable membrane in preparation for implant placement. It will help guide both practitioners and patients on what should be the anticipated experiences following such a routinely performed surgery.
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Affiliation(s)
- Vrisiis Kofina
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA.
| | - Morvarid Monfaredzadeh
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Swati Y Rawal
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Andrew R Dentino
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Maharaj Singh
- College of Nursing, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, 4121 Postle Hall, 305 W 12th Ave, Columbus, OH 43210, USA
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Kofina V, Wang YS, Fial A, Tatakis DN. Intra-marrow penetrations and root coverage outcomes: a systematic review. BMC Oral Health 2023; 23:256. [PMID: 37138270 PMCID: PMC10157995 DOI: 10.1186/s12903-023-02964-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/12/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Intra-marrow penetrations (IMPs) have been performed during guided tissue regeneration (GTR) procedures with reported clinical benefits. The aim of this systematic review was to investigate the use and effect of IMPs during root coverage procedures. METHOD A broad search for human and animal studies was performed on PubMed, Cochrane Database of Systematic Reviews and Cochrane Central Registry of Controlled Trials and Web of Science, following a registered review protocol (PROSPERO). All prospective study designs, case series and case reports on gingival recession treatment (follow-up ≥ 6 months) that employed IMPs were included. Root coverage, complete root coverage prevalence, and adverse effects were recorded, and risk of bias was assessed. RESULTS Of 16,181 screened titles, 5 articles (all of them human studies) met inclusion criteria. All studies (including two randomized clinical trials) treated Miller class I and II recession defects, using coronally advanced flap with IMPs alone or in conjunction with GTR protocols. Therefore, all treated defects received IMPs and no studies compared protocols with and without IMPs. Outcomes were indirectly compared with existing root coverage literature. Mean root coverage was 2.7 mm and 68.5% at 6.8 months (median: 6 months, range 6-15 months) for sites treated with IMPs. CONCLUSION IMPs are rarely used during root coverage procedures, have not been associated with intra-surgical or wound healing adverse effects and have not been investigated as independent factor. Future clinical studies are needed to directly compare treatment protocols with and without IMPs and investigate the potential benefits of IMPs for root coverage.
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Affiliation(s)
- Vrisiis Kofina
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI, 53201-1881, USA
| | - Ying S Wang
- Division of Periodontology, College of Dentistry, The Ohio State University, 4121 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
- Department of Periodontics, School of Dentistry, Texas A&M University, 3302 Gaston Avenue, Dallas, TX, 75246, USA
| | - Alissa Fial
- Raynor Memorial Libraries, Marquette University, P. O. Box 3141, Milwaukee, WI, 53201-3141, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, 4121 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA.
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Kotsailidi EA, Tatakis DN, Chen YW, Caton JG, Ercoli C, Barmak AB, Tsigarida A. Comparison of maxillary tuberosity and palatal donor sites for soft tissue augmentation at implant placement: A pilot controlled clinical study. Int J Oral Implantol (Berl) 2022; 15:353-365. [PMID: 36377626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE To compare the outcomes of soft tissue augmentation during one-stage implant placement using grafts harvested from the hard palate or the maxillary tuberosity. MATERIALS AND METHODS In this pilot controlled clinical study, non-smoking adults with a single missing tooth in the anterior or premolar region and adequate ridge dimensions for implant placement were enrolled. Each received a single implant and connective tissue graft harvested either from the hard palate (n = 10) or the maxillary tuberosity (n = 10). Digital impressions were taken prior to treatment (T0) and then 2 and 12 months postoperatively (T1 and T2, respectively). The primary study outcome was changes in horizontal ridge dimension. Secondary outcomes included marginal bone level changes over time, pain levels in the first 2 postoperative weeks (W1 and W2) and pink aesthetic score and patient-reported outcome measures at T2. Data analysis included repeated measures analysis of variance for intergroup comparisons. RESULTS The horizontal ridge dimension increased significantly in both groups (P ≤ 0.002) at all apico-coronal levels examined, with no significant intergroup differences. There was also no significant intergroup difference in marginal bone level changes (P = 0.376). The hard palate group experienced higher pain levels in the donor site compared to the tuberosity group at W1 (P = 0.023). The pink aesthetic score and patient-reported outcome measures were similar between groups at T2. CONCLUSIONS Soft tissue augmentation during one-stage implant placement results in significant increases in the horizontal ridge dimension.
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Tatakis DN. Lip Repositioning Techniques and Modifications. Dent Clin North Am 2022; 66:373-384. [PMID: 35738733 DOI: 10.1016/j.cden.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A common etiology of excessive gingival display is hypermobile upper lip, which can be managed by non-surgical and surgical approaches. Among the surgical options, lip repositioning surgery is a relatively simple procedure with minimal complications. Since the original description of the technique almost 50 years ago, several minor and major modifications have been introduced. The available evidence indicates that, when applied to properly diagnosed cases, the technique is effective in reducing gingival display and results in improved smile esthetics and high patient satisfaction. This article reviews the various techniques and modifications and summarizes the reported outcomes of the procedure.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Postle Hall, 305 West 12th Avenue, Columbus, OH 43210-1267, USA.
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Ceylan M, Erbak Yilmaz H, Narin F, Tatakis DN, Saglam M. Gingival crevicular fluid lipocalin-2 and semaphorin3A in stage III periodontitis: Non-surgical periodontal treatment effects. J Periodontal Res 2022; 57:724-732. [PMID: 35468224 DOI: 10.1111/jre.12995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/08/2022] [Accepted: 04/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Identification of biomarkers to assess individual risk and monitor periodontal health status is important. Research on lipocalin-2 (LCN2) and semaphorin3A (Sema3A) is lacking. This study aimed to evaluate gingival crevicular fluid (GCF) LCN2, Sema3A, and tumor necrosis factor-α (TNF-α) levels in periodontally healthy (H), gingivitis (G), and periodontitis (P) patients, and their changes following non-surgical periodontal therapy. METHODS Sixty systemically healthy and non-smoker participants, diagnosed as periodontally healthy, gingivitis, and stage III grade C periodontitis, were recruited (n = 20/group). Clinical periodontal parameters were recorded and GCF samples were obtained at baseline from all groups; for group P, these were repeated one and three months following non-surgical periodontal treatment. GCF LCN2, Sema3A, and TNF-α levels were evaluated with enzyme-linked immunosorbent assay. RESULTS GCF LCN2, Sema3A, and TNF-α total amounts were significantly higher in disease groups than group H (p < .001). Between P and G groups, only TNF-α levels were significantly different (p < .001). Non-surgical periodontal therapy resulted in significant improvement of all clinical parameters and significant decreases of GCF LCN2 and TNF-α levels, at both time points, compared with baseline (p < .001). Sema3A levels remained unchanged following treatment (p > .05). LCN2 and TNF-α levels were significantly positively correlated with clinical parameters. LCN2 (AUC [area under the curve] = 0.94) and TNF-α (AUC = 0.98) levels were similarly accurate in differentiating between periodontal disease (whether G or P) and healthy controls. CONCLUSIONS LCN2 and TNF-α levels in GCF are correlated with clinical parameters and could prove useful as non-invasive screening tools for periodontitis.
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Affiliation(s)
- Merve Ceylan
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Huriye Erbak Yilmaz
- Department of Medical Biochemistry, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey.,Izmir Biomedicine Genome Center, Dokuz Eylul University, Izmir, Turkey
| | - Figen Narin
- Department of Medical Biochemistry, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Mehmet Saglam
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Kandaswamy E, Sakulpaptong W, Guo X, Ni A, Powell HM, Tatakis DN, Leblebicioglu B. Titanium as a Possible Modifier of Inflammation Around Dental Implants. Int J Oral Maxillofac Implants 2022; 37:381-390. [PMID: 35476868 DOI: 10.11607/jomi.9271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The exact etiopathogenesis of peri-implant diseases remains unclear. While significant information on molecular markers is available, studies on biomarkers related to possible biocorrosion are sparse. This study aimed to evaluate periimplant crevicular fluid (PICF) for possible titanium (Ti) contamination and explore associations between clinical findings, inflammatory mediators, and Ti levels. MATERIALS AND METHODS Patients with implant-supported restoration (≥ 1 year in function) were recruited for this cross-sectional study. Demographics, systemic, and periodontal health history were recorded. Clinical evaluations were conducted to reach peri-implant/periodontal diagnoses and grade severity of peri-implant soft tissue inflammation. Crevicular fluid (CF) was collected from both implants and adjacent teeth (PICF, gingival crevicular fluid [GCF]) and analyzed for Ti (inductively coupled plasma mass spectrometry) and inflammatory mediators (V-plex assays). Multiple regression analysis with a linear mixed effect model was used to analyze possible associations between clinical diagnosis, PICF/GCF cytokine, and Ti concentrations. RESULTS Seventy-seven patients (aged 62 ± 2 years; 39 male) with 117 implants (9 ± 1 years in function) were recruited. Diabetes, positive periodontitis history, and current/former smoking were reported by 8%, 39%, and 39% of subjects, respectively. Seventy-nine implant sites (63 patients) were included in CF cytokine analysis, and 45 of these sites (42 patients) were paired with Ti analysis. Statistically significant increases from health to disease were noted in log-transformed PICF concentrations of IL-1β, IL-6, IL-10, and INF-γ (P ≤ .05). Also, statistically significant increases from health to severe clinical inflammation were detected in log-transformed PICF concentrations of IL-8, IL-13, and TNF-α (P ≤ .05). Ti was detected in the majority (82%) of PICF and GCF samples. There was no statistically significant difference in log-transformed Ti concentration based on disease status. However, log-transformed Ti concentration was positively correlated to IL-1β, IL-2, IL-4, IL-8, IL-13, and INF-γ concentrations when data were adjusted for site-specific health (P ≤ .05). CONCLUSION Ti was detectable in PICF and adjacent GCF, even in health. Specific inflammatory mediator concentrations were increased in peri-implant disease and significantly associated with Ti concentrations, even when data were adjusted for peri-implant health status. Increased GCF inflammatory mediator concentrations were also associated with increased Ti concentrations. Ti effects on peri-implant as well as periodontal tissues require additional longitudinal investigations.
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Kofina V, Lindholm D, Harunani A, Dentino AR, Singh M, Tatakis DN. Post-surgical emergency after-hours calls: Prevalence, concerns, and management. J Dent Educ 2022; 86:814-822. [PMID: 35118665 DOI: 10.1002/jdd.12888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/08/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the prevalence, nature, and management of post-surgical emergency after-hours calls in a dental school setting with predoctoral students, graduate students/residents, and faculty providers. METHODS A patient chart review (March 2018-February 2020) for post-surgical calls through the emergency after-hours pager system was conducted at the Marquette University School of Dentistry. The total number of surgical procedures, procedure type, the timing of call, operator experience, concern, and recommendation given during the call were documented. RESULTS During the review period, 83 calls (from 75 patients) were recorded after 8,487 surgical procedures (1% of procedures). Patients were called 5.4 ± 0.8 days postoperatively. Procedure type affected call prevalence (p = 0.04), with most calls made after extractions (69.9% of all calls; 1% of extractions; 58/5,725), implant placement (6%; 0.9% of implant placements; 5/530) and periodontal plastic surgery (6%; 3.1% of all plastic surgeries; 5/161). The most common concern was pain (72.3%), then swelling (36.1%), bleeding (12%), and infection (9.6%). Operator experience did not affect call prevalence. Recommendations given were next business day follow-up (79.5%), reinforcement of already given postoperative instructions (51.8%), prescription (15.7%), and hospital emergency department (ED) visit (7.2%). CONCLUSIONS Post-surgical emergency after-hours calls in a dental school setting occur within the first postoperative week and are rare, unrelated to operator experience, typically prompted by pain, and rarely resulting in referral to hospital ED. The use of a pager system is adequate for the management of after-hours emergencies and may reduce self-referrals to the hospital ED.
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Affiliation(s)
- Vrisiis Kofina
- Department of Surgical Sciences, School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA
| | - Drake Lindholm
- Department of Surgical Sciences, School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA
| | - Abdulkareem Harunani
- Department of Surgical Sciences, School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA
| | - Andrew R Dentino
- Department of Surgical Sciences, School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA
| | - Maharaj Singh
- College of Nursing, Marquette University, Milwaukee, Wisconsin, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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13
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Longo BC, Rocha TTC, Santin GC, Tatakis DN, Silva CO. Gingival pigmentation: Concurrent assessment of distribution, intensity, and extent in a black population. J ESTHET RESTOR DENT 2021; 34:897-906. [PMID: 34825763 DOI: 10.1111/jerd.12846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/11/2021] [Accepted: 11/15/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate prevalence, distribution, intensity and extent of physiologic gingival melanin pigmentation (GMP) in black individuals. MATERIALS AND METHODS For this cross-sectional study, GMP was evaluated on digital images by three calibrated examiners, according to de Krom (distribution), DOPI (intensity) and Melanin Index (extent) classifications. Descriptive statistics, Wilcoxon, Mann-Whitney, Kruskal-Wallis, Two-way ANOVA, chi square, and K-means cluster analysis were used. RESULTS Seventy participants were recruited. The most prevalent GMP categories were: de Krom category 2 (34.3%), DOPI heavy intensity (57.2%), and Melanin index Degree IV (50%). Significant inter-group differences were found for age (p < 0.05) but not gender (p > 0.05). Significant correspondence/overlap was observed between classifications (p > 0.05). Three GMP clusters were identified: Cluster 1 (27%; n = 19) had mild asymmetric and interspersed pigmentation; Cluster 2 (46%; n = 32) had heavy pigmentation in one long continuous ribbon, with pink marginal gingiva; and Cluster 3 (27%; n = 19) had heavy pigmentation in one long continuous ribbon, symmetric, and uniform. CONCLUSIONS There may be overlap among GMP classification systems. In black individuals, the predominant GMP presentation is one of a broad zone of heavily pigmented attached gingiva, in a continuous strip from central incisors to canines, symmetrical across the midline, and with pink free marginal gingiva. CLINICAL RELEVANCE This is the first study to analyze distribution, intensity, and extent of gingival melanin pigmentation in the same population and to integrate the various classification systems through cluster analysis. The novel findings provide a foundation for patient assessment and counseling and for future studies.
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Affiliation(s)
- Bruna C Longo
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | - Talita T C Rocha
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | - Gabriela C Santin
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Cléverson O Silva
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
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14
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Miguel MMV, Mathias-Santamaria IF, Rossato A, Ferraz LFF, Rangel TP, Casarin RCV, Tatakis DN, Santamaria MP. Enamel matrix derivative effects on palatal mucosa wound healing: Randomized clinical trial. J Periodontal Res 2021; 56:1213-1222. [PMID: 34541683 DOI: 10.1111/jre.12934] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/06/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND This study was conducted to evaluate the clinical, immunologic, and patient-centered outcomes of enamel matrix protein derivative (EMD) on excisional wounds in palatal mucosa. MATERIALS Forty-four patients in need of ridge preservation were randomly allocated into two groups: control group (n = 22): open palatal wound after free gingival graft (FGG) harvest and EMD group (n = 22): open palatal wound after FGG harvest that received 0.3 ml of EMD. Clinical and patient-centered parameters were analyzed for 3 months post-treatment. Wound fluid levels of inflammatory markers were assessed 3 and 7 days postoperatively. RESULTS No significant inter-group difference was observed in remaining wound area and re-epithelialization. EMD and control groups achieved wound closure and re-epithelialization 30 days postoperatively (p < .001), without inter-group differences. Similarly, number of analgesics and Oral Health Impact Profile scores did not present significant inter-group differences (p > .05). EMD appeared to selectively modulate wound fluid levels of monocyte chemoattractant protein-1, macrophage inflammatory protein-1α, matrix metallopeptidase 9, and tissue inhibitor of metalloproteinases-2. CONCLUSION Within the limits of the present study, it can be concluded that EMD application to excisional palatal wounds using the investigated protocol does not provide clinical healing benefits, despite an apparent modulation of selected inflammatory markers.
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Affiliation(s)
- Manuela Maria Viana Miguel
- São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, Brazil
| | - Ingrid Fernandes Mathias-Santamaria
- São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, Brazil.,Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Amanda Rossato
- São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, Brazil
| | - Laís Fernanda Ferreira Ferraz
- São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, Brazil
| | - Thiago Perez Rangel
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, Piracicaba, Brazil
| | - Renato Corrêa Viana Casarin
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, Piracicaba, Brazil
| | - Dimitris N Tatakis
- College of Dentistry, Division of Periodontology, The Ohio State University (OSU), Columbus, Ohio, USA
| | - Mauro Pedrine Santamaria
- São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, Brazil.,College of Dentistry - Lexington, University of Kentucky, Lexington, Kentucky, USA
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15
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Silva CO, Rezende RI, Mazuquini AC, Leal VC, Amaral GSA, Guo X, Tatakis DN. Aesthetic crown lengthening and lip repositioning surgery: Pre- and post-operative assessment of smile attractiveness. J Clin Periodontol 2021; 48:826-833. [PMID: 33745186 DOI: 10.1111/jcpe.13461] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/04/2021] [Accepted: 03/09/2021] [Indexed: 12/20/2022]
Abstract
AIM To assess the effect of aesthetic crown lengthening (ACL) and lip repositioning surgery (LRS) on perception of smile attractiveness. MATERIALS AND METHODS Preoperative and 6-month postoperative smile photographs of ACL- or LRS-treated patients were evaluated by 100 raters (five gender-balanced groups of ten per procedure) of diverse background (dental students, general dentists, periodontists and laypersons with and without any aesthetic concerns about their own smile). Smile attractiveness was rated by visual analogue scale (VAS). Multivariate mixed-effect models were applied to determine the effect of procedure, rater (age, gender and group) and case (gingival display and GD) on smile attractiveness rating. RESULTS Average preoperative and postoperative VAS scores for ACL patients were 3.8 ± 2.0 and 6.2 ± 1.9, respectively. Corresponding LRS patient values were 4.8 ± 2.0 and 6.4 ± 1.9. Treatment, baseline GD and rater age were significant determinants (p < .001) of smile attractiveness for both procedures. Rater gender was not significant. Rater group was significant (p < .032) only for ACL. Procedure (p < .001), baseline VAS (p < .001), change in GD (p ≤ .002) and rater age (p ≤ .017) were significant determinants of smile attractiveness change from preoperative to postoperative. CONCLUSIONS ACL and LRS are two periodontal plastic surgery procedures that deliver significant smile attractiveness improvements, in the eyes of both laypersons and dental professionals.
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Affiliation(s)
- Cléverson O Silva
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | - Robson I Rezende
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | | | - Vinicius C Leal
- School of Dentistry, Ingá University (UNINGÁ), Maringá, Brazil
| | | | - Xiaohan Guo
- Department of Statistics, College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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16
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Sendyk DI, Souza NV, César Neto JB, Tatakis DN, Pannuti CM. Selective outcome reporting in root coverage randomized clinical trials. J Clin Periodontol 2021; 48:867-877. [PMID: 33745136 DOI: 10.1111/jcpe.13451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/31/2020] [Accepted: 02/16/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Outcome discrepancies between protocols and respective publications represent a concerning bias. The purpose of this study was to assess the prevalence of selective outcome reporting (SOR) in root coverage randomized clinical trials (RCTs). METHODS Published root coverage RCTs (July 2005 to March 2020) were included if a corresponding protocol could be identified in a public registry. Discrepancies between protocol and its correspondent publication(s) were compared regarding primary and secondary outcomes and other study characteristics. Associations between trial characteristics and SOR were evaluated. RESULTS Forty four studies (54 publications) were included. The majority of studies (77.3%) were retrospectively registered. SOR was frequent (40.9% of trials) and consisted of primary outcome downgrade (22.7%); secondary outcome upgrade (11.4%); new primary outcome introduced in publication (25%); protocol primary outcome omitted from publication (13.6%) and discrepancy in primary outcome timing (18.2%). SOR was unclear in 20.5% of studies and favoured statistical significance in 12 studies (27.3%). SOR was significantly associated with study significance (p < 0.001) and unclear outcome definition in the publication (p < 0.001). Only a third (32.8%) of primary outcomes were completely defined. CONCLUSIONS The present study identified high prevalence of SOR in root coverage RCTs.
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Affiliation(s)
- Daniel Isaac Sendyk
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Nathalia Vilela Souza
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João Batista César Neto
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Cláudio Mendes Pannuti
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
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17
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Andijani RI, Paramitha V, Guo X, Deguchi T, Tatakis DN. Lip repositioning surgery for gummy smile: 6-month clinical and radiographic lip dimensional changes. Clin Oral Investig 2021; 25:5907-5915. [PMID: 33745100 DOI: 10.1007/s00784-021-03896-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The present case series aimed to examine lip repositioning surgery (LRS) outcomes related to changes in external and internal upper lip (UL) dimensions, utilizing both conventional clinical and novel radiographic approaches. MATERIALS AND METHODS Patients (n = 13) diagnosed with hypermobile UL (>8-mm mobility during smile) and excessive gingival display (≥4-mm) were included and assessed at baseline and 6 months postoperatively. Clinical parameters at rest included total lip and internal lip length (vestibular depth). At maximum smile included total lip, philtrum (ergotrid), and vermilion lengths. Cephalometric parameters included anterior maxillary height; lip length; nasolabial angle; anteroposterior lip thickness; internal lip length (vestibular depth); and vestibular fornix position (using novel approach employing radiopaque marker). Linear mixed-effect models, Pearson's correlation, and linear regression were used for statistical analyses. RESULTS LRS did not affect total UL length at rest (p = 0.418). It resulted in significant internal UL length decrease (-3.8 ± 2.1 mm, p < 0.001) and significant increases of vermilion length (1.9 ± 1.0 mm, p < 0.001) and anteroposterior lip thickness (0.7 ± 0.7 mm, p = 0.002). The clinical and radiographic measurements of total UL length at rest (r ≥ 0.734) and of internal UL length (r ≥ 0.737), and the two radiographic assessments of vestibular depth (r = 0.842), were strongly correlated. CONCLUSIONS LRS resulted in significant decrease of vestibular depth/internal UL length and in significant increases of UL vertical vermilion length and UL anteroposterior thickness, without affecting total UL length at rest. CLINICAL RELEVANCE The documented lip dimensional outcomes should help practitioners when treatment-planning LRS and counseling patients seeking treatment for hypermobile UL.
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Affiliation(s)
- Reem I Andijani
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH, 43210, USA
- Dentistry Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Vanessa Paramitha
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH, 43210, USA
| | - Xiaohan Guo
- Department of Statistics, College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH, 43210, USA.
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18
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Altıngöz SM, Kurgan Ş, Önder C, Serdar MA, Ünlütürk U, Uyanık M, Başkal N, Tatakis DN, Günhan M. Salivary and serum oxidative stress biomarkers and advanced glycation end products in periodontitis patients with or without diabetes: A cross-sectional study. J Periodontol 2021; 92:1274-1285. [PMID: 33277933 DOI: 10.1002/jper.20-0406] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/09/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Non-invasive methods for periodontitis diagnosis would be a clinically important tool. This cross-sectional study aimed to investigate the association between oxidative stress, glycation, and inflammation markers and periodontal clinical parameters in periodontitis and periodontally healthy patients with type 2 diabetes and corresponding systemically healthy controls. METHODS Sixty-seven periodontally healthy (DM-H, n = 32) and periodontitis (DM-P, n = 35) patients with type 2 diabetes, and 54 systemically healthy periodontitis (H-P, n = 26) and periodontally healthy (H-H, n = 28) controls were included. Clinical periodontal parameters, body mass index, fasting glucose, hemoglobin A1c (HbA1c), along with saliva and serum 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), 4-hydroxy-2-nonenal (4-HNE), advanced glycation end products (AGE), AGE receptor (RAGE) and high sensitivity C-reactive protein (hsCRP) levels were recorded and analyzed. RESULTS Salivary 8-OHdG levels were significantly higher in periodontitis compared to periodontally healthy patients, regardless of systemic status (P < 0.001). Salivary MDA levels were significantly higher in all disease groups compared to H-H group (P ≤ 0.004). Serum AGE levels were significantly higher in diabetic groups than systemically healthy groups (P < 0.001) and in H-P compared to H-H (P < 0.001). Bleeding on probing (BOP) and clinical attachment level (CAL) strongly correlated with salivary 8-OHdG and serum hsCRP (P < 0.001). In systemically healthy patients, salivary 8-OHdG was the most accurate marker to differentiate periodontitis from controls (AUC = 0.84). In diabetics salivary 4-HNE and RAGE were the most accurate (AUC = 0.85 for both). CONCLUSION Salivary 8-OHdG alone or in combination with 4-HNE, AGE and RAGE for diabetics, and salivary 8-OHdG alone or in combination with MDA and hsCRP for systemically healthy persons, could potentially serve as non-invasive screening marker(s) of periodontitis.
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Affiliation(s)
- Sema Merve Altıngöz
- Department of Periodontology, Faculty of Dentistry, Lokman Hekim University, Ankara, Turkey
| | - Şivge Kurgan
- Department of Periodontoloy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Canan Önder
- Department of Periodontoloy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Muhittin A Serdar
- Department of Medical Biochemistry, School of Medicine, Acıbadem University, Ankara, Turkey
| | - Uğur Ünlütürk
- Department of Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Metin Uyanık
- Department of Medical Biochemistry, School of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Nilgün Başkal
- Department of Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Meral Günhan
- Department of Periodontoloy, Faculty of Dentistry, Ankara University, Ankara, Turkey
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19
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Wang YS, Bissonnette C, Brett C, McNamara KK, Tatakis DN. Multiple Epithelial Origin Complications Following Subepithelial Connective Tissue Graft for Root Coverage. Clin Adv Periodontics 2021; 11:140-144. [PMID: 33393182 DOI: 10.1002/cap.10146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/23/2020] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The subepithelial connective tissue graft (SCTG) and flap combination is a highly predictable root coverage procedure, with low complication rates. To our knowledge, this article reports the first case of two late SCTG complications, epithelial cell discharge, and subsequent epidermal inclusion cyst (EIC) formation. CASE PRESENTATION A 35-year-old male presented with a 3-mm deep Miller Class II recession defect on the mandibular right canine and mesial root of mandibular right first molar. A mild discomfort was reported at 8 weeks after envelope flap+SCTG in #27. At 4 months after the procedure, the patient presented with persistent discomfort and minimally compressible recipient site diffuse swelling with discharge, which was cytologically diagnosed as normal epithelial cells. One year postoperatively, enlargement of the lesion was seen, and excisional biopsy was performed simultaneously with SCTG in #30. The lesion was diagnosed as EIC. At 8 months follow-up, the site healed uneventfully, the patient remained asymptomatic, and the site exhibited scar formation and no recurrence of the lesion. CONCLUSION This report highlights epithelial cell discharge and EIC formation as a rare yet possible SCTG complication and emphasizes the importance of an excisional biopsy as the means to obtain a definitive diagnosis and manage this complication.
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Affiliation(s)
- Ying S Wang
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Caroline Bissonnette
- Division of Oral and Maxillofacial Pathology, College of Dentistry, The Ohio State University, Columbus, OH.,Current affiliation: Department of Oral Medicine, Atrium Health, Charlotte, NC
| | - Christopher Brett
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH.,Current affiliation: Private practice, Tulsa, OK
| | - Kristin K McNamara
- Division of Oral and Maxillofacial Pathology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
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20
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Wang Y, Tatakis DN. Integrative mRNA/miRNA expression analysis in healing human gingiva. J Periodontol 2020; 92:863-874. [PMID: 32857863 DOI: 10.1002/jper.20-0397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/11/2020] [Accepted: 08/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND MicroRNAs (miRNAs) are implicated in the epigenetic regulation of complex biological processes. Their possible role in human oral wound healing, a process that differs from cutaneous wound healing by being faster and typically scar-free, has been unexplored. This report presents the miRNA expression profile of experimental human oral wounds and an integrative analysis of mRNA/miRNA expression. METHODS Nine healthy volunteers provided standardized normal and 5-day healing palatal biopsies, used for next generation miRNA and mRNA sequencing analysis, correlation and network analysis, real-time PCR (qPCR) and immunohistochemistry. RESULTS On average, 169 significantly regulated precursor miRNAs were detected, including 21 novel miRNAs, selectively confirmed by PCR. Hsa-miR-223-3p and hsa-miR-124-3p were, respectively, the most up- and downregulated miRNAs in healing gingiva. Hsa-miR-124-3p had the most predicted mRNA target interactions, with angiogenesis-related genes the most enriched. Correlation analysis showed the highest correlation between hsa-miR-181a-3p and SERPINB1; hsa-miR-223-5p and SLC2A3; hsa-miR-1301 and MS4A7. In addition, SERPINB1 mRNA had the most associations with differentially regulated miRNAs. IL33 was the only cytokine significantly correlated with miRNAs (ρ > 0.95). qPCR and immunohistochemistry verified the significant upregulation of SERPINB1 and IL33 in healing gingiva. CONCLUSIONS This study is the first to report on the miRNome of healing human gingiva and to provide an integrative analysis of miRNA/mRNA expression during human oral wound healing; the results offer novel insights into the participating molecular mechanisms and raise the possibility of SERPINB1 and IL-33 as potential wound healing therapeutic targets.
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Affiliation(s)
- Yun Wang
- 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
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21
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Miguel MMV, Mathias-Santamaria IF, Rossato A, Ferraz LFF, Figueiredo-Neto AM, de Marco AC, Casarin RCV, Wallet SM, Tatakis DN, Mathias MA, Santamaria MP. Microcurrent electrotherapy improves palatal wound healing: Randomized clinical trial. J Periodontol 2020; 92:244-253. [PMID: 32783220 DOI: 10.1002/jper.20-0122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/07/2020] [Accepted: 05/31/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study was conducted to assess the clinical, immunological, and patient-centered outcomes of microcurrent electrotherapy on palatal wound healing. METHODS This was a parallel, double-masked randomized clinical trial, in which 53 patients with ridge preservation indications were selected and randomly assigned to one of two groups. In the control (sham) group (n = 27), palatal wounds, after free gingival grafts (FGG) harvest, received sham application of electrotherapy. In the test (electrotherapy treatment [EE]) group (n = 26), palatal wounds, after FGG harvest, received application of microcurrent electrotherapy protocol. Clinical parameters, patient-centered outcomes, and inflammatory markers were evaluated, up to 90 days postoperatively. RESULTS The EE group achieved earlier wound closure (P <0.001) and epithelialization (P <0.05; P = 0.03) at 7 and 14 days after harvest when compared with the sham group. Painful symptomatology was reported less frequently in the EE group than in the sham group at 3-day follow-up (P = 0.008). Likewise, an improvement in Oral Health Impact Profile was reported 2 days after the procedure by the EE group (P = 0.04). In addition, favorable modulation of inflammatory wound healing markers occurred when electrotherapy was applied. CONCLUSION Within the limits of the present study, it can be concluded that the use of a low-intensity electrotherapy protocol may accelerate palatal wound healing and decrease patient discomfort after FGG harvest.
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Affiliation(s)
- Manuela Maria Viana Miguel
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Ingrid Fernandes Mathias-Santamaria
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil.,National Institute of Science and Technology-Complex Fluids, São Paulo, Brazil
| | - Amanda Rossato
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Laís Fernanda Ferreira Ferraz
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | | | - Andrea Carvalho de Marco
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Renato Corrêa Viana Casarin
- Department of Prosthodontics and Periodontics, Division of Periodontics, University of Campinas Piracicaba Dental School Piracicaba, São Paulo, Brazil
| | | | - Dimitris N Tatakis
- College of Dentistry, Division of Periodontology, The Ohio State University, Columbus, OH, USA
| | - Marcio Antonio Mathias
- FEI University, Department of Electrical Engineering, São Bernardo do Campo, São Paulo, Brazil
| | - Mauro Pedrine Santamaria
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
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22
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Doshi A, McAuley JW, Tatakis DN. Topical phenytoin effects on palatal wound healing. J Periodontol 2020; 92:409-418. [PMID: 32761909 DOI: 10.1002/jper.20-0340] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The clinical benefits of autogenous soft tissue grafts are countered by donor site morbidity. The aim of this prospective split-mouth clinical trial is to assess clinical, histological and patient outcomes following topical phenytoin (PHT) treatment of experimental palatal wounds. METHODS Systemically healthy adults were recruited. One 6 mm diameter wound (posterior) and one 4 mm diameter wound (anterior), each 1-1.5 mm deep, were created on both sides of the palate. Wounds on one randomly chosen side received 10% phenytoin USP and contralateral wounds received carrier alone. Biopsies were harvested from anterior wounds (Day 1 or Day 5) and were routinely processed for histology. Posterior wounds were left undisturbed to clinically evaluate healing (using photographs and Healing Score Index) on Days 1, 5, 14, and 21. Questionnaires were used to assess patient-centered outcomes. Data analysis was performed using generalized logistic and generalized linear mixed models. RESULTS Twenty participants completed all visits. 30% of participants reported more pain on control side than the PHT side at Day 1 (P = 0.014). PHT treated sites were more likely to not exhibit swelling (OR = 9.35; P = 0.009) and to not experience pain on palpation (OR = 6.278; P = 0.007). PHT significantly and time-dependently affected granulation tissue appearance (P = 0.004). Histologically, there were no significant differences between control and PHT, at any time point (P ≥ 0.853). CONCLUSIONS The results of the present study, the first one to report on topical PHT as palatal wound treatment, suggest that PHT application on palatal wounds could result in improved healing outcomes.
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Affiliation(s)
- Anuja Doshi
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.,Currently: College of Dental Medicine, University of New England, Portland, Maine, USA
| | - James W McAuley
- College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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23
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Kofina V, Demirer M, Erdal BS, Eubank TD, Yildiz VO, Tatakis DN, Leblebicioglu B. Bone grafting history affects soft tissue healing following implant placement. J Periodontol 2020; 92:234-243. [PMID: 32779206 DOI: 10.1002/jper.19-0709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study aimed to determine and compare soft tissue healing outcomes following implant placement in grafted (GG) and non-grafted bone (NGG). METHODS Patients receiving single implant in a tooth-bound maxillary non-molar site were recruited. Clinical healing was documented. Volume and content of wound fluid (WF; at 3, 6, and 9 days) were compared with adjacent gingival crevicular fluid (GCF; at baseline, 1, and 4 months). Buccal flap blood perfusion recovery and changes in bone thickness were recorded. Linear mixed model regression analysis and generalized estimating equations with Bonferroni adjustments were conducted for repeated measures. RESULTS Twenty-five patients (49 ± 4 years; 13 males; nine NGG) completed the study. Soft tissue closure was slower in GG (P < 0.01). Differential response in WF/GCF protein concentrations was detected for ACTH (increased in GG only) and insulin, leptin, osteocalcin (decreased in NGG only) at day 6 (P ≤0.04), with no inter-group differences at any time(P > 0.05). Blood perfusion rate decreased immediately postoperatively (P < 0.01, GG) followed by 3-day hyperemia (P > 0.05 both groups). The recovery to baseline values was almost complete for NGG whereas GG stayed ischemic even at 4 months (P = 0.05). Buccal bone thickness changes were significant in GG sites (P ≤ 0.05). CONCLUSION History of bone grafting alters the clinical, physiological, and molecular healing response of overlying soft tissues after implant placement surgery.
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Affiliation(s)
- Vrisiis Kofina
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, Ohio, USA
| | - Mutlu Demirer
- Department of Radiology, College of Medicine, Ohio State University, Columbus, Ohio, USA
| | - Barbaros S Erdal
- Department of Radiology, College of Medicine, Ohio State University, Columbus, Ohio, USA
| | - Timothy D Eubank
- Department of Microbiology, Immunology, & Cell Biology, College of Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Vedat O Yildiz
- Department of Biomedical Informatics, Center for Biostatistics, Ohio State University, Columbus, Ohio, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, Ohio, USA
| | - Binnaz Leblebicioglu
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, Ohio, USA
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24
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Neves FLDS, Augusto Silveira C, Mathias-Santamaria IF, Miguel MMV, Ferraz LFF, Casarin RCV, Sallum EA, Tatakis DN, Santamaria MP. Randomized clinical trial evaluating single maxillary gingival recession treatment with connective tissue graft and tunnel or trapezoidal flap: 2-year follow-up. J Periodontol 2020; 91:1018-1026. [PMID: 31867724 DOI: 10.1002/jper.19-0436] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/04/2019] [Accepted: 11/17/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND The literature lacks long-term evidence regarding outcomes of the coronally advanced tunnel flap (TUN) combined with connective tissue graft (CTG) when compared to the trapezoidal coronally advanced flap (CAF) and CTG combination. This study presents 2-year results of a randomized clinical trial comparing CTG combined with either CAF or TUN in the treatment of single maxillary gingival recession (GR) defects. METHODS Thirty-nine patients, each contributing a single Miller Class I or II GR defect, were treated by CAF+CTG (control; n = 19) or TUN+CTG (test; n = 20) and completed the 2-year follow up. Clinical, patient centered, and esthetic evaluations were performed and differences among groups were analyzed. RESULTS At 2 years, mean root coverage for control and test group was 89.5% ± 14.6% and 87.7% ± 18.4%, respectively (P = 0.5). The corresponding complete root coverage prevalence was 68.4% and 50% (P = 0.4). Dentin hypersensitivity significantly decreased for both groups. The two groups showed improvement in esthetics, as assessed by both professionals and patients, without significant intergroup differences (P > 0.5). TUN+CTG sites were much more likely to present improvement in root coverage between 6 months and 2 years, exhibiting creeping attachment of 0.7 ± 0.6 mm. CONCLUSIONS At 2 years of follow up, both CAF+CTG and TUN+CTG resulted in significant clinical and esthetic improvements and provided similar results in the treatment of single maxillary GRs.
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Affiliation(s)
- Felipe Lucas da Silva Neves
- UNESP - São Paulo State University, Division of Periodontology, College of Dentistry, São José dos Campos, Brazil
| | - Camila Augusto Silveira
- UNESP - São Paulo State University, Division of Periodontology, College of Dentistry, São José dos Campos, Brazil
| | | | - Manuela Maria Viana Miguel
- UNESP - São Paulo State University, Division of Periodontology, College of Dentistry, São José dos Campos, Brazil
| | | | - Renato Correa Viana Casarin
- Department of Prosthodontics and Periodontics, Periodontics Division, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Enilson Antônio Sallum
- Department of Prosthodontics and Periodontics, Periodontics Division, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Mauro Pedrine Santamaria
- UNESP - São Paulo State University, Division of Periodontology, College of Dentistry, São José dos Campos, Brazil
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25
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Abstract
Clinical parameters available to evaluate early healing phases of bone regeneration procedures are limited. This study explores wound fluid (WF) content for molecular markers to differentiate wound healing responses in the early postoperative period after bone graft placement. Fifteen patients (50 ± 5 years old; 8 men) scheduled to receive tooth extraction and bone graft placement at maxillary nonmolar single-tooth sites were recruited. Primary wound closure was not intended at time of surgery. Gingival crevicular fluid from adjacent teeth or WF from surgical wound edges were collected (30 seconds) at baseline, at 3, 6, and 9 days, and at 1 and 4 months. Multiplex protein assay was used to determine concentration of various wound healing mediators. Immediately after surgery, 87% of surgical sites exhibited open wound. At day 9, mean wound exposure was 4.8 ± 0.4 mm. At 1 month, all wounds were clinically closed. The WF tripled in volume at day 3 and day 6 (P ≤ .05), compared with baseline gingival crevicular fluid, and gradually decreased as wounds closed. The WF concentrations of interleukin (IL)-6, placental growth factor, plasminogen activator inhibitor 1, insulin-like growth factor binding protein 1, and soluble cluster determinant 40 ligand were increased during early healing days, generally with peak concentration at day 6 (P ≤ .004). Conversely, WF concentrations of IL-18 and epidermal growth factor were decreased after surgery, generally not reaching baseline values until wound closure (P ≤ .008). In general, WF cytokine expression kinetics were concordant with wound closure dynamics (P ≤ .04). These results suggest that WF molecular markers such as IL-6, and to a lesser extent placental growth factor and IL-18, might help differentiate wound healing responses after bone regeneration procedures.
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Affiliation(s)
- Binnaz Leblebicioglu
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio
| | - Lamees Alssum
- Department of Periodontics & Community Dentistry, College of Dentistry, King Saud University, Saudi Arabia; previously with The Ohio State University, Columbus, Ohio
| | - Timothy D Eubank
- Department of Microbiology, Immunology and Cell Biology, School of Medicine, West Virginia University, Mogantown, WV
| | - Vedat O Yildiz
- Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio
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26
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Cheng GL, Tatakis DN. Collagen Strip Technique: A Novel Approach for Ridge Preservation and Concomitant Oroantral Communication Management After Implant Explantation. Clin Adv Periodontics 2020; 10:135-139. [PMID: 32065734 DOI: 10.1002/cap.10092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/29/2019] [Indexed: 11/11/2022]
Abstract
INTRODUCTION This case report introduces a technique for managing oroantral communication (OAC) using a collagen membrane strip to repair the perforated sinus membrane and simultaneously graft the alveolar ridge. CASE PRESENTATION A 55-year-old Asian male presented for a second-opinion consultation regarding an endosseous dental implant that had been placed overly subcrestal at #13 edentulous site. The 8 mm fixture had been placed 3 to 4 mm subcrestally with more than half the implant length into the maxillary sinus. The patient stated that no sinus augmentation procedure had been performed. The implant was considered to be non-restorable and treatment planned for explantation with ridge preservation. Explantation revealed a sinus perforation with OAC. A collagen membrane strip (30 × 6 mm) was folded into a U-shape, to hold bone allograft for ridge preservation, and placed with the bottom of the U-shape level with the sinus floor and the ends extending to the buccal and palatal, beyond the crest. A second collagen membrane covered the graft at ridge crest level, followed by primary closure. Implant placement (4.1 × 10 mm) with indirect sinus augmentation was performed in 6 months. The implant was uncovered and subsequently restored following a 5-month osseointegration period. The 13-month follow-up examination revealed successful outcomes, with normal clinical and radiographic parameters. CONCLUSION This novel technique achieved the dual goals of ridge preservation and repair of a sinus membrane perforation simultaneously after implant explantation in the posterior maxilla. It further allowed a successful implant placement with simultaneous sinus augmentation and subsequent restoration.
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Affiliation(s)
- Guo-Liang Cheng
- Periodontology, College of Dentistry, The Ohio State University, Columbus, OH.,Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan
| | - Dimitris N Tatakis
- Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
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27
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Wang Y, Anderson EP, Tatakis DN. Whole transcriptome analysis of smoker palatal mucosa identifies multiple downregulated innate immunity genes. J Periodontol 2020; 91:756-766. [DOI: 10.1002/jper.19-0467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Yun Wang
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
| | - Eric P. Anderson
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
- Private practice Aurora CO
| | - Dimitris N. Tatakis
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
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28
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Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2019; 89 Suppl 1:S74-S84. [PMID: 29926944 DOI: 10.1002/jper.17-0719] [Citation(s) in RCA: 310] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 12/21/2022]
Abstract
Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.
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Affiliation(s)
- Iain L C Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, UK
| | - Brian L Mealey
- University of Texas Health Science Center at San Antonio, USA
| | | | | | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Oral Medicine, Johann Wolfgang Goethe-University Frankfurt, Germany
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, USA
| | | | | | - Moshe Goldstein
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Terrence J Griffin
- Periodontal Department, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Palle Holmstrup
- Periodontology, Section 1, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Georgia K Johnson
- Department of Periodontology, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Yvonne Kapila
- Orofacial Sciences, University of California San Francisco, USA
| | - Niklaus P Lang
- Department of Periodontology, University of Bern, Switzerland
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Germany
| | - Shinya Murakami
- Department of Periodontology, Graduate School of Dentistry, Osaka University, Japan
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M College of Dentistry, Dallas, TX, USA
| | - Giuseppe A Romito
- Division of Periodontology, Department of Stomatology, Dental School, University of São Paulo, Brazil
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, OH, USA
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Belgium
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy
| | - Clemens Walter
- Department of Periodontology, Endodontology & Cariology, University Centre for Dental Medicine, University of Basel School of Dentistry, Switzerland
| | - Gernot Wimmer
- Department of Prosthodontics, School of Dentistry, Medical University Graz, Austria
| | - Pinelopi Xenoudi
- Orofacial Sciences, School of Dentistry, University of California San Francisco, USA
| | - Hiromasa Yoshie
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Japan
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29
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S46-S73. [PMID: 29926936 DOI: 10.1002/jper.17-0576] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC. IMPORTANCE A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance. FINDINGS Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.
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Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Cléverson O Silva
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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30
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Abstract
Ideal implant placement may reduce surgical complications, such as nerve injury and lingual cortical plate perforation, and minimize the likelihood of functional and prosthetic compromises. Guided implant surgery (GIS) has been used as the means to achieve ideal implant placement. GIS refers to the process of digital planning, custom-guide fabrication, and implant placement using the custom guide and an implant system-specific guided surgery kit. GIS includes numerous additional steps beyond the initial prosthetic diagnosis, treatment planning, and fabrication of surgical guide. Substantial errors can occur at each of these individual steps and can accumulate, significantly impacting the final accuracy of the process with potentially disastrous deviations from proper implant placement. Pertinent overall strategies to reduce or eliminate these risks can be summarized as follows: complete understanding of the possible risks is fundamental; knowledge of the systems and tools used is essential; consistent verification of both diagnostic and surgical procedures after each step is crucial; proper training and surgical experience are critical. This review article summarizes information on the accuracy and efficacy of GIS, provides insight on the potential risks and problems associated with each procedural step, and offers clinically relevant recommendations to minimize or eliminate these risks.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Andreas O Parashis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.,Private Practice Limited to Periodontology and Implant Surgery, Athens, Greece
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31
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Chavez MB, Kolli TN, Tan MH, Zachariadou C, Wang C, Embree MC, Lira Dos Santos EJ, Nociti FH, Wang Y, Tatakis DN, Agarwal G, Foster BL. Loss of Discoidin Domain Receptor 1 Predisposes Mice to Periodontal Breakdown. J Dent Res 2019; 98:1521-1531. [PMID: 31610730 DOI: 10.1177/0022034519881136] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The discoidin domain receptors, DDR1 and DDR2, are nonintegrin collagen receptors and tyrosine kinases. DDRs regulate cell functions, and their extracellular domains affect collagen fibrillogenesis and mineralization. Based on the collagenous nature of dentoalveolar tissues, we hypothesized that DDR1 plays an important role in dentoalveolar development and function. Radiography, micro-computed tomography (micro-CT), histology, histomorphometry, in situ hybridization (ISH), immunohistochemistry (IHC), and transmission electron microscopy (TEM) were used to analyze Ddr1 knockout (Ddr1-/-) mice and wild-type (WT) controls at 1, 2, and 9 mo, and ISH and quantitative polymerase chain reaction (qPCR) were employed to assess Ddr1/DDR1 messenger RNA expression in mouse and human tissues. Radiographic images showed normal molars but abnormal mandibular condyles, as well as alveolar bone loss in Ddr1-/- mice versus WT controls at 9 mo. Histological, histomorphometric, micro-CT, and TEM analyses indicated no differences in enamel or dentin Ddr1-/- versus WT molars. Total volumes (TVs) and bone volumes (BVs) of subchondral and ramus bone of Ddr1-/- versus WT condyles were increased and bone volume fraction (BV/TV) was reduced at 1 and 9 mo. There were no differences in alveolar bone volume at 1 mo, but at 9 mo, severe periodontal defects and significant alveolar bone loss (14%; P < 0.0001) were evident in Ddr1-/- versus WT mandibles. Histology, ISH, and IHC revealed disrupted junctional epithelium, connective tissue destruction, bacterial invasion, increased neutrophil infiltration, upregulation of cytokines including macrophage colony-stimulating factor, and 3-fold increased osteoclast numbers (P < 0.05) in Ddr1-/- versus WT periodontia at 9 mo. In normal mouse tissues, ISH and qPCR revealed Ddr1 expression in basal cell layers of the oral epithelia and in immune cells. We confirmed a similar expression pattern in human oral epithelium by ISH and qPCR. We propose that DDR1 plays an important role in periodontal homeostasis and that absence of DDR1 predisposes mice to periodontal breakdown.
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Affiliation(s)
- M B Chavez
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - T N Kolli
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - M H Tan
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - C Zachariadou
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - C Wang
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - M C Embree
- TMJ Biology and Regenerative Medicine Laboratory, College of Dental Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - E J Lira Dos Santos
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA.,Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas-UNICAMP, Piracicaba, SP, Brazil
| | - F H Nociti
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas-UNICAMP, Piracicaba, SP, Brazil
| | - Y Wang
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - D N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - G Agarwal
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - B L Foster
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
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32
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César Neto JB, Cavalcanti MC, Sekiguchi RT, Pannuti CM, Romito GA, Tatakis DN. Root Coverage for Single Deep Gingival Recessions: Outcomes Based on a Decision-Making Algorithm. Int J Dent 2019; 2019:1830765. [PMID: 30805000 PMCID: PMC6362491 DOI: 10.1155/2019/1830765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/01/2018] [Accepted: 12/10/2018] [Indexed: 12/05/2022] Open
Abstract
AIM The aim of this study is to report root coverage outcomes in single deep gingival recessions (GR) following a proposed decision-making algorithm. MATERIALS AND METHODS A retrospective, practice-based study included single deep (≥5 mm) Miller Class II and III defects. The step-by-step decision-making algorithm led to a choice among three different flap designs (coronally advanced flap (CAF), double papilla envelope flap (DPE) or modified lateral sliding flap (LSF)) used with a connective tissue graft. Recession depth (RD) at 6 months follow-up and the corresponding root coverage (RC) were the primary outcomes assessed. RESULTS Sixteen GR defects were included, with baseline RD of 6.7 ± 1.8 mm. Six months postoperatively, RD was significantly reduced to 1.2 ± 0.8 mm (p < 0.05). Mean RC was 81.7 ± 13.0%, without significant differences between Miller Class II (87.1 ± 9.2%; n=9) and Class III (74.6 ± 14.5%; n=7) GRs (p=0.07). Postoperatively, keratinized tissue width increase was greater for LSF (3.5 ± 1.1) and DPE (4.2 ± 1.4 mm) than for CAF (1.9 ± 0.9 mm). CONCLUSIONS Following the proposed decision-making algorithm, root coverage outcomes for GR defects ≥5 mm were comparable to outcomes reported for shallow defects. Prospective clinical trials are needed to validate the proposed approach and techniques. PRACTICAL IMPLICATIONS The proposed algorithm allows the clinician to select the appropriate surgical technique for treatment of single deep gingival recessions with good predictability.
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Affiliation(s)
- João B. César Neto
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marília C. Cavalcanti
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ricardo T. Sekiguchi
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Claudio M. Pannuti
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Giuseppe A. Romito
- Division of Periodontology, College of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Dimitris N. Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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Andijani RI, Tatakis DN. Hypermobile upper lip is highly prevalent among patients seeking treatment for gummy smile. J Periodontol 2018; 90:256-262. [DOI: 10.1002/jper.18-0468] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/23/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Reem I. Andijani
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH
| | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH
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Santamaria MP, Silveira CA, Mathias IF, Neves FLDS, Santos LM, Jardini MAN, Tatakis DN, Sallum EA, Bresciani E. Treatment of single maxillary gingival recession associated with non‐carious cervical lesion: Randomized clinical trial comparing connective tissue graft alone to graft plus partial restoration. J Clin Periodontol 2018; 45:968-976. [DOI: 10.1111/jcpe.12907] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Mauro Pedrine Santamaria
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Camila Augusto Silveira
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Ingrid Fernandes Mathias
- Department of Restorative DentistryCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
- Department of Restorative Dental SciencesCollege of DentistryUniversity of Florida Gainesville Florida
| | - Felipe Lucas da Silva Neves
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Lúcio Murilo Santos
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Maria Aparecida Neves Jardini
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Dimitris N. Tatakis
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus Ohio
| | - Enilson Antônio Sallum
- Piracicaba Dental SchoolDepartment of Prosthodontics and PeriodonticsDivision of PeriodonticsUNICAMP ‐ University of Campinas Piracicaba São Paulo Brazil
| | - Eduardo Bresciani
- Department of Restorative DentistryCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
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Chapple IL, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018; 45 Suppl 20:S68-S77. [DOI: 10.1111/jcpe.12940] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Iain L.C. Chapple
- Periodontal Research Group; Institute of Clinical Sciences; College of Medical & Dental Sciences; University of Birmingham; UK
| | - Brian L. Mealey
- University of Texas Health Science Center at San Antonio; USA
| | | | | | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry; Charité - Universitätsmedizin Berlin; Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Oral Medicine; Johann Wolfgang Goethe-University Frankfurt; Germany
| | | | | | | | - Moshe Goldstein
- Department of Periodontology; Faculty of Dental Medicine; Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Terrence J. Griffin
- Periodontal Department; Tufts University School of Dental Medicine; Boston MA USA
| | - Palle Holmstrup
- Periodontology; Section 1; Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
| | - Georgia K. Johnson
- Department of Periodontology; University of Iowa College of Dentistry; Iowa City IA USA
| | - Yvonne Kapila
- Orofacial Sciences; University of California San Francisco; USA
| | - Niklaus P. Lang
- Department of Periodontology; University of Bern; Switzerland
| | - Joerg Meyle
- Department of Periodontology; University of Giessen; Germany
| | - Shinya Murakami
- Department of Periodontology; Graduate School of Dentistry, Osaka University; Japan
| | - Jacqueline Plemons
- Department of Periodontics; Texas A&M College of Dentistry; Dallas TX USA
| | - Giuseppe A. Romito
- Division of Periodontology; Department of Stomatology; Dental School; University of São Paulo; Brazil
| | - Lior Shapira
- Department of Periodontology; Faculty of Dental Medicine; Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; Ohio State University; Columbus OH USA
| | - Wim Teughels
- Department of Oral Health Sciences; Periodontology; KU Leuven & Dentistry; University Hospitals Leuven; Belgium
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Italy
| | - Clemens Walter
- Department of Periodontology, Endodontology & Cariology; University Centre for Dental Medicine; University of Basel School of Dentistry; Switzerland
| | - Gernot Wimmer
- Department of Prosthodontics; School of Dentistry, Medical University Graz; Austria
| | - Pinelopi Xenoudi
- Orofacial Sciences; School of Dentistry; University of California San Francisco; USA
| | - Hiromasa Yoshie
- Division of Periodontology; Niigata University Graduate School of Medical and Dental Sciences; Japan
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Clin Periodontol 2018; 45 Suppl 20:S44-S67. [DOI: 10.1111/jcpe.12939] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | | | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
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Gibson MP, Tatakis DN. Treatment of Gummy Smile of Multifactorial Etiology: A Case Report. Clin Adv Periodontics 2017; 7:167-173. [PMID: 31539214 DOI: 10.1902/cap.2017.160074] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/20/2017] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This case report describes the management of a patient diagnosed with excessive gingival display caused by altered passive eruption and hyperactive lip. Treatment for this patient was staged and included esthetic crown lengthening and a subsequent lip repositioning procedure. CASE PRESENTATION A 17-year-old female was referred for assessment of a "gummy smile." The patient reported a history of mouth breathing and a sports injury causing a non-vital tooth #9, which had been temporarily restored. After periodontal evaluation, the patient was diagnosed with plaque-induced gingivitis and excessive gingival display due to hyperactive lip and altered passive eruption. After initial therapy, an esthetic crown lengthening procedure was performed on the maxillary anterior sextant, resulting in ideal maxillary anterior crown contours. Six weeks after esthetic crown lengthening, the patient was treated for hyperactive lip by a modified lip repositioning surgery. Subsequently, the patient received a permanent restoration on tooth #9. During the 1.5-year follow-up time the patient repeatedly expressed her satisfaction with the improvement of her smile. Persistent mouth breathing and associated recurrent gingival inflammation remained a challenge. CONCLUSIONS The presented case illustrates results of sequentially applied techniques for management of a gummy smile of multifactorial etiology and limitations imposed by unresolved factors. Excessive gingival display can be a significant esthetic concern for patients. Understanding the etiology can be challenging due to multiple factors that may be concomitantly involved. Accurate diagnosis and treatment planning are critical for proper management. When multifactorial etiology is present, multiple treatment modalities, including various surgical approaches, are necessary to obtain positive outcomes in such patients.
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Affiliation(s)
- Monica P Gibson
- Currently, Division of Periodontology, Faculty of Medicine and Dentistry, University of Alberta School of Dentistry, Edmonton, AB; previously, Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University
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Gordon RI, Parashis AO, Tatakis DN. Extraoral Uses of Autologous Oral Soft Tissue Grafts: A Different Bridge Between Mouth and Body Health. Clin Adv Periodontics 2017; 7:215-220. [PMID: 31539215 DOI: 10.1902/cap.2017.160076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/20/2017] [Indexed: 11/13/2022]
Abstract
Focused Clinical Question: Are there any extraoral uses for intraoral soft tissue grafts? Summary: Despite extensive literature on the intraoral uses of soft tissue autografts harvested from oral sites, the periodontal literature is lacking information on the extraoral uses of such grafts. The purpose of this article is to review the autologous use of certain oral soft tissue grafts for extraoral indications. A literature search revealed that several medical specialties, including otolaryngology, ophthalmology, dermatology, plastic surgery, and urology, have a track record of positive outcomes with the use of free gingival, buccal fat pad, and buccal mucosa grafts for a wide variety of reconstructive procedures at diverse body sites. Conclusions: The numerous successful extraoral uses of oral soft tissue autografts underscore the versatility of these tissues in reconstructive surgery and suggest there is potential for collaboration between periodontal and medical specialists for the benefit of patients in need of such reconstructions. Broader awareness of these applications of oral soft tissue grafts could help expand their current uses and would allow practitioners to better answer possible patient inquiries.
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Affiliation(s)
- Ross I Gordon
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Andreas O Parashis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH.,Private practice, Athens, Greece
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
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Zeza B, Pilloni A, Tatakis DN, Mariotti A, Di Tanna GL, Mongardini C. Implant Patient Compliance Varies by Periodontal Treatment History. J Periodontol 2017; 88:846-853. [DOI: 10.1902/jop.2017.160528] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Blerina Zeza
- Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Section of Periodontics, University of Rome, Rome, Italy
| | - Andrea Pilloni
- Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Section of Periodontics, University of Rome, Rome, Italy
| | - Dimitris N. Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Angelo Mariotti
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Gian Luca Di Tanna
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K
| | - Claudio Mongardini
- Department of Dentistry and Maxillofacial Surgery, School of Dentistry, Section of Periodontics, University of Rome, Rome, Italy
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Queiroz LA, Casarin RCV, Dabdoub SM, Tatakis DN, Sallum EA, Kumar PS. Furcation Therapy With Enamel Matrix Derivative: Effects on the Subgingival Microbiome. J Periodontol 2017; 88:617-625. [PMID: 28304211 DOI: 10.1902/jop.2017.160542] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although enamel matrix derivative (EMD) has been used to promote periodontal regeneration, little is known of its effect on the microbiome. Therefore, this investigation aims to identify changes in periodontal microbiome after treatment with EMD using a deep-sequencing approach. METHODS Thirty-nine patients with mandibular Class II buccal furcation defects were randomized to beta-tricalcium-phosphate/hydroxyapatite graft (BONE group), EMD+BONE, or EMD alone. Plaque was collected from furcation defects at baseline and 3 and 6 months post-treatment. Bacterial DNA was analyzed using terminal restriction fragment length polymorphism and 16S pyrotag sequencing, resulting in 169,000 classifiable sequences being compared with the Human Oral Microbiome Database. Statistical comparisons were made using parametric tests. RESULTS At baseline, a total of 422 species were identified from the 39 defects, belonging to Fusobacterium, Pseudomonas, Streptococcus, Filifactor, and Parvimonas. All three regenerative procedures predictably altered the disease-associated microbiome, with a restitution of health-compatible species. However, EMD and BONE+EMD groups demonstrated more long-term reductions in a higher number of species than the BONE group (P <0.05), especially disease-associated species, e.g., Selenomonas noxia, F. alocis, and Fusobacterium. CONCLUSIONS EMD treatment predictably alters a dysbiotic subgingival microbiome, decreasing pathogen richness and increasing commensal abundance. Further investigations are needed to investigate how this impacts regenerative outcomes.
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Affiliation(s)
- Lucas A Queiroz
- Department of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Renato C V Casarin
- Department of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Shareef M Dabdoub
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Enilson A Sallum
- Department of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Purnima S Kumar
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
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Exposto CR, Oz U, Callard JS, Allen MJ, Khurana H, Atri AD, Mo X, Fernandez SA, Tatakis DN, Edmonds K, Westgate PM, Huja SS. Oncologic doses of zoledronic acid induce site specific suppression of bone modelling in rice rats. Orthod Craniofac Res 2017. [PMID: 28643933 DOI: 10.1111/ocr.12164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the effect of zoledronic acid (ZOL) on cortical bone modelling and healing of extraction sockets in the jaw bones of a rodent model. We hypothesized ZOL suppresses both the bone formation in the modelling mode in the jaw bones and alters the extraction site healing. MATERIAL & METHODS Rice rats were administered saline solution and two dose regimens of ZOL: 0.1 mg/kg, twice a week, for 4 weeks (n=17, saline=8 & ZOL=9) and a higher dose of 0.4 mg/kg, weekly, for 9 weeks (n=30, saline=15 & ZOL=15). Two pairs of fluorochrome bone labels were administered. Extraction of maxillary teeth was performed in maxilla. Mineral apposition rate, mineralizing surface and bone formation rate (BFR) were quantified on periodontal (PDL), alveolar and basal bone surfaces, and in the trabecular bone of proximal tibia. Bone volume (BV) was evaluated at extraction sockets. Multivariate Gaussian models were used to account for repeated measurements, and analyzes were conducted in SAS V9.3. RESULTS ZOL suppressed bone modelling (BFR/BS) at the PDL surfaces in the mandible (P<.05), but its effect was not significant at the periosteal surfaces of both jaws. BV for the healing sockets of ZOL treated animals was not significantly different (P=.07) compared to the saline group. ZOL suppressive effect was higher in the tibia compared to the jaws. CONCLUSION ZOL severely suppresses coupled remodelling in the tibia, and the suppression of bone formation in the modelling mode in the jaws demonstrates the site specific effects of ZOL in rice rats.
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Affiliation(s)
- C R Exposto
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - U Oz
- Department of Orthodontics, Near East University, North Nicosia, Northern Cyprus
| | - J S Callard
- Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - M J Allen
- Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - H Khurana
- Division of Orthodontics, The Ohio State University, Columbus, OH, USA
| | - A D' Atri
- Division of Orthodontics, The Ohio State University, Columbus, OH, USA
| | - X Mo
- Biostatistics, The Ohio State University, Columbus, OH, USA
| | - S A Fernandez
- Biostatistics, The Ohio State University, Columbus, OH, USA
| | - D N Tatakis
- Periodontics, The Ohio State University, Columbus, OH, USA
| | - K Edmonds
- School of Natural Sciences, Indiana University Southeast, New Albany, IN, USA
| | - P M Westgate
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - S S Huja
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Alssum L, Eubank TD, Roy S, Erdal BS, Yildiz VO, Tatakis DN, Leblebicioglu B. Gingival Perfusion and Tissue Biomarkers During Early Healing of Postextraction Regenerative Procedures: A Prospective Case Series. J Periodontol 2017. [PMID: 28644107 DOI: 10.1902/jop.2017.170117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Postextraction alveolar bone loss, mostly affecting the buccal plate, occurs despite regenerative procedures. To better understand possible determinants, this prospective case series assesses gingival blood perfusion and tissue molecular responses in relation to postextraction regenerative outcomes. METHODS Adults scheduled to receive bone grafting in maxillary, non-molar, single-tooth extraction sites were recruited. Clinical documentation included the following: 1) probing depth (PD); 2) keratinized tissue width (KT); 3) tissue biotype (TB); and 4) plaque level. Wound closure was clinically evaluated. Gingival blood perfusion was measured by laser Doppler flowmetry (LDF). Wound fluid (WF) and gingival biopsies were analyzed for protein levels and gene expression, respectively, of relevant molecular markers. Bone healing outcomes were determined radiographically (cone-beam computed tomography). Healing was followed for 4 months. RESULTS Data from 15 patients are reported. Postoperatively, neither complications nor changes in PD, KT, or TB were observed. LDF revealed decreased perfusion followed by hyperemia that persisted for 1 month (P ≤0.05). WF levels of angiopoietin-2, interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), and vascular endothelial growth factor peaked on day 6 (P ≤0.05) and decreased thereafter. Only IL-8 and TNF-α exhibited increased gene expression. Linear bone changes were negligible. Volumetric bone changes were minimal but statistically significant, with more bone loss when membrane was used (P = 0.05). CONCLUSIONS Gingival blood perfusion after postextraction bone regenerative procedures follows an ischemia-reperfusion model. Transient increases in angiogenic factor levels and prolonged hyperemia characterize the soft tissue response. These soft tissue responses do not determine radiographic bone changes.
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Affiliation(s)
- Lamees Alssum
- Currently, Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia; previously, Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH
| | - Timothy D Eubank
- Department of Microbiology, Immunology and Cell Biology; School of Medicine; West Virginia University; Morgantown, WV
| | - Sashwati Roy
- Department of Surgery, College of Medicine, The Ohio State University
| | - Barbaros S Erdal
- Department of Radiology, College of Medicine, The Ohio State University
| | - Vedat O Yildiz
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University
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Gamsjaeger S, Robins SP, Tatakis DN, Klaushofer K, Paschalis EP. Identification of Pyridinoline Trivalent Collagen Cross-Links by Raman Microspectroscopy. Calcif Tissue Int 2017; 100:565-574. [PMID: 28246932 DOI: 10.1007/s00223-016-0232-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/26/2016] [Indexed: 10/20/2022]
Abstract
Intermolecular cross-linking of bone collagen is intimately related to the way collagen molecules are arranged in a fibril, imparts certain mechanical properties to the fibril, and may be involved in the initiation of mineralization. Raman microspectroscopy allows the analysis of minimally processed bone blocks and provides simultaneous information on both the mineral and organic matrix (mainly type I collagen) components, with a spatial resolution of ~1 μm. The aim of the present study was to validate Raman spectroscopic parameters describing one of the major mineralizing type I trivalent cross-links, namely pyridinoline (PYD). To achieve this, a series of collagen cross-linked peptides with known PYD content (as determined by HPLC analysis), human bone, porcine skin, predentin and dentin animal model tissues were analyzed by Raman microspectroscopy. The results of the present study confirm that it is feasible to monitor PYD trivalent collagen cross-links by Raman spectroscopic analysis in mineralized tissues, exclusively through a Raman band ~1660 wavenumbers. This allows determination of the relative PYD content in undecalcified bone tissues with a spatial resolution of ~1 μm, thus enabling correlations with histologic and histomorphometric parameters.
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Affiliation(s)
- Sonja Gamsjaeger
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Simon P Robins
- Rowett Institute of Nutrition and Health, Bucksburn, Aberdeen, AB21 9SB, Scotland, UK
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Klaus Klaushofer
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Eleftherios P Paschalis
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria.
- Ludwig Boltzmann Institute of Osteolgy, Hanusch Kh., Heinrich Collin Str. 30, 1140, Vienna, Austria.
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Rotenberg SA, Steiner R, Tatakis DN. Collagen-Coated Bovine Bone in Peri-implantitis Defects: A Pilot Study on a Novel Approach. Int J Oral Maxillofac Implants 2017; 31:701-7. [PMID: 27183078 DOI: 10.11607/jomi.4303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE As dental implants have become routine therapy, clinicians are more frequently being faced with treating peri-implantitis. To date, no single treatment protocol has been shown to be the preferred means to treat peri-implantitis. The aim of this retrospective case series is to present a novel approach utilizing porcine collagen-coated bovine bone (CBB) to treat peri-implantitis. MATERIALS AND METHODS Eleven patients, with no history of periodontitis, presenting with peri-implantitis around a single restored dental implant, were included in the study. At initial and follow-up examinations, bleeding on probing (BOP), probing depth (PD), and gingival margin location (GM) were recorded. Following surgical debridement of the peri-implant defect and treatment of the implant surface with a 0.12% chlorhexidine gluconate solution, bony defects were grafted with CBB. All patients had 12 months of follow-up. RESULTS Upon presentation, average PD at the deepest site (DS) was 7.6 ± 1.9 mm. At the time of surgery, excess cement was found around nine implants (81%). All patients healed uneventfully without postoperative complications. At 6 and 12 months, all implants showed favorable results with average DS PD reduction of 3.9 ± 1.5 mm and 4.1 ± 1.6 mm, respectively. All implants showed radiographic signs of bone fill, while GM showed no changes from preoperative measurements at either 6 (0.1 ± 0.5 mm) or 12 (0.0 ± 0.6 mm) months. CONCLUSION The use of a porcine collagen-coated bovine bone graft to treat peri-implantitis represents a potentially predictable therapeutic modality. Randomized controlled trials are necessary to substantiate the treatment outcomes.
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Santamaria MP, Neves FLDS, Silveira CA, Mathias IF, Fernandes‐Dias SB, Jardini MAN, Tatakis DN. Connective tissue graft and tunnel or trapezoidal flap for the treatment of single maxillary gingival recessions: a randomized clinical trial. J Clin Periodontol 2017; 44:540-547. [DOI: 10.1111/jcpe.12714] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Mauro Pedrine Santamaria
- Department of Periodontology College of Dentistry – FOSJC UNESP – São Paulo State University São Paulo Brazil
| | - Felipe Lucas da Silva Neves
- Department of Periodontology College of Dentistry – FOSJC UNESP – São Paulo State University São Paulo Brazil
| | - Camila Augusto Silveira
- Department of Periodontology College of Dentistry – FOSJC UNESP – São Paulo State University São Paulo Brazil
| | - Ingrid Fernandes Mathias
- Department of Restorative Dentistry College of Dentistry – FOSJC UNESP – São Paulo State University São Paulo Brazil
| | | | | | - Dimitris N. Tatakis
- Division of Periodontology College of Dentistry The Ohio State University Columbus OH USA
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Abstract
OBJECTIVES To investigate the gene expression profile of human gingiva following surgical wounding. METHODS Ten volunteers had one side of the palate wounded. Five days later, biopsies were harvested from both wounded (healing gingiva) and contra-lateral site (normal gingiva). Tissue samples were processed for gene expression (RNA-Seq, real-time PCR) and immunohistochemistry. Gene set enrichment/pathway analysis was also performed. RESULTS Seven hundred genes were significantly differentially expressed in healing gingiva. Among genes with >twofold change (FC) in expression, 399 genes were up-regulated and 88 down-regulated, several not previously reported expressed in gingiva. Most increased in expression (≥30-FC) were MMP1, CCL18, SPP1, MUC21, CTHRC1, MMP10, and SERPINE1; most decreased (≥7-FC) were COCH, SIAH3, MT4, IGFL3, KY, and SYT16. Real-time PCR confirmed significantly changed mRNA levels for selective genes tested. Gene set enrichment analysis revealed several significantly enriched biological pathways. Immunohistochemistry confirmed protein expression of MUC21, CTHRC1, CTGF, and SYT16 in normal and healing gingiva. CONCLUSIONS This first comprehensive analysis of the human gingival transcriptome during surgical wound healing offers novel insights into the participating molecular and biological mechanisms. The present results could serve as basis for future investigations into gingival wound healing following surgical, traumatic, or other type of injury.
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Affiliation(s)
- Yun Wang
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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Abstract
Papillon-Lefèvre syndrome (PLS), palmoplantar hyperkeratosis with periodontitis, has been genetically characterized. However, suspected associated immune dysfunctions remain elusive. The purpose of this study was to evaluate peripheral blood lymphocyte levels and natural killer (NK) cell cytotoxicity in PLS. Twenty patients and 20 healthy controls were examined. Peripheral blood lymphocytes were analyzed by flow cytometry for surface markers. NK cell cytotoxicity against K562 cells was determined by means of a 51Cr release assay. White blood cell differential and proportions of B-, T-, T-helper, T-suppressor, and NK cells revealed only sporadic borderline variations from control values. In contrast, NK cell cytotoxicity was consistently and severely depressed (32–53% of control values) in all patients. To the best of our knowledge, this newly described impairment of NK cell cytotoxic function is the first consistent immune dysfunction reported in PLS. This suggests that the impaired NK cell cytotoxicity might contribute to the pathogenesis of PLS-associated periodontitis.
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Affiliation(s)
- T Lundgren
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
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Abstract
Evidence indicates that incisor crown form correlates with clinical periodontal features. It was hypothesized that incisor crown form may explain subject differences in gingivitis expression. The present experimental gingivitis study aimed to assess the effect of incisor crown form on plaque accumulation and gingival inflammation, and on individual susceptibility to plaque-induced gingivitis. Eighty-five periodontally healthy subjects were evaluated. A negative correlation was found between incisor crown width/crown length ratio and bleeding score (p = 0.045). From the 85 subjects, two groups of subjects with either ‘long-narrow’ or ‘short-wide’ incisor form were identified. The ‘long-narrow’ group had a significantly higher bleeding score than the ‘short-wide’ group (p = 0.014). No significant differences were found in the incisor crown width/crown length ratio between previously identified ‘high responder’ and ‘low responder’ subjects ( Trombelli et al., 2004a ). In conclusion, incisor crown form appears to affect the bleeding response of inflamed gingival tissues, while it exerts no influence on explaining differences in individuals’ susceptibility to plaque-induced gingivitis.
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Affiliation(s)
- L Trombelli
- Research Center for the Study of Periodontal Diseases, University of Ferrara, Corso Giovecca 203, 44100, Italy.
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Pilalas I, Tsalikis L, Tatakis DN. Pre-restorative crown lengthening surgery outcomes: a systematic review. J Clin Periodontol 2016; 43:1094-1108. [DOI: 10.1111/jcpe.12617] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ioannis Pilalas
- Department of Preventive Dentistry, Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
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Chambrone L, Tatakis DN. Long-Term Outcomes of Untreated Buccal Gingival Recessions: A Systematic Review and Meta-Analysis. J Periodontol 2016; 87:796-808. [DOI: 10.1902/jop.2016.150625] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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