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Aristodemou E, Retzepi M, Calciolari E, Donos N. The effect of experimental diabetes and membrane occlusiveness on guided bone regeneration: A proof of principle study. Clin Oral Investig 2022; 26:5223-5235. [PMID: 35688955 DOI: 10.1007/s00784-022-04491-0] [Citation(s) in RCA: 2] [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: 02/08/2022] [Accepted: 04/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the effect of membrane occlusiveness and experimental diabetes on early and late healing following guided bone regeneration. MATERIAL AND METHODS A total of 30 Wistar rats were randomly allocated to three groups: healthy (H), uncontrolled diabetic (UD) and controlled diabetic (CD). A critical size calvarial defect (CSD) was created at the mid-portion of one parietal bone, and it was treated with a double layer of e-PTFE membrane presenting 0.5 mm perforations. The animals were killed at 7 and 30 days of healing, and qualitative and quantitative histological evaluations were performed. Data were compared with the ones previously obtained from other 30 animals (10H, 10UD, 10 CD), where two CSDs were randomly treated with a double-layer e-PTFE occlusive membrane or left empty. RESULTS Following application of cell occlusive or cell permeable membranes, significant regeneration can be observed. However, at 30 days in the H group occlusive compared to cell permeable membranes promoted enhanced bone regeneration (83.9 ± 7.3% vs. 52.5 ± 8.6%), while no significant differences were observed within the CD and UD groups. UD led to reduced regeneration compared to H when an occlusive barrier was applied, whereas comparable outcomes to H and CD were observed when placing perforated membranes. CONCLUSION The application of cell permeable membranes may have masked the potentially adverse effect of experimental UD on bone regeneration. CLINICAL RELEVANCE Membrane porosity might contribute to modulate the bone regenerative response in UD conditions. Future studies are needed to establish the degree of porosity associated with the best regenerative outcomes as well as the underlying molecular mechanisms.
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Affiliation(s)
| | - M Retzepi
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Dental School, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - N Donos
- Centre for Oral Clinical Research and Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.
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2
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Nibali L, Sousa V, Davrandi M, Liu LS, Spratt D, Donos N. Patterns of subgingival microbiota in different periodontal phenotypes. J Dent 2021; 117:103912. [PMID: 34890714 DOI: 10.1016/j.jdent.2021.103912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 07/05/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To compare the subgingival microbiota of patients with aggressive (AgP) or chronic periodontitis (CP) to healthy (H), non-periodontitis patients as well as to explore their relevant associations to different host genetic variants. METHODS Following clinical examination, blood and subgingival plaque sampling of 471 study participants (125 AgP, 121 CP, 225 H), subgingival community analysis was performed by next generation sequencing of the 16S rRNA. Microbial data from 266 participants (75 AgP, 95 CP, 98 H) were available for analysis. SNPs in the IL6, IL6R and FTO gene were selected for genetic marker analyses. RESULTS Combined periodontitis patients (AgP + CP), particularly those classified with AgP, exhibited lower alpha- and beta- diversity. Several genera (including Peptostreptococcaceae, Filifactor, Desulfobulbus, Tannerella and Lachnospiracee) and species were over-abundant in combined periodontitis vs. healthy individuals, while other genera such as Prevotella or Dialister were found to be more abundant in healthy cases. The only genus with difference in abundance between AgP and CP was Granulicatella. No associations between IL6, IL6RA and FTO genetic variants and microbial findings were detected. CONCLUSION This study suggests that limited microbial differences existed between AgP and CP and challenges the current notion that periodontitis is associated with increased subgingival microbial diversity compared with periodontal health. CLINICAL SIGNIFICANCE The findings of this study cast some doubts on the notion that the dysbiosis characteristic of periodontal disease is expressed as increased microbial diversity.
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Affiliation(s)
- L Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Centre for Oral, London, United Kingdom; Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom.
| | - V Sousa
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Centre for Oral, London, United Kingdom; Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom
| | - M Davrandi
- Microbiology Department, University College London Eastman Dental Institute, London, UK
| | - L S Liu
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
| | - D Spratt
- Microbiology Department, University College London Eastman Dental Institute, London, UK
| | - N Donos
- Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom
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Nibali L, Koidou V, Salomone S, Hamborg T, Allaker R, Ezra R, Zou L, Tsakos G, Gkranias N, Donos N. Minimally invasive non-surgical vs. surgical approach for periodontal intrabony defects: a randomised controlled trial. Trials 2019; 20:461. [PMID: 31351492 PMCID: PMC6660941 DOI: 10.1186/s13063-019-3544-8] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/29/2019] [Indexed: 12/03/2022] Open
Abstract
Background Periodontal intrabony defects are usually treated surgically with the aim of increasing attachment and bone levels and reducing risk of progression. However, recent studies have suggested that a minimally invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. The aim of this study is to compare the efficacy of a modified MINST approach with a surgical approach (modified minimally invasive surgical therapy, M-MIST) for the treatment of intrabony defects. Methods This is a parallel-group, single-centre, examiner-blind non-inferiority randomised controlled trial with a sample size of 66 patients. Inclusion criteria are age 25–70, diagnosis of periodontitis stage III or IV (grades A to C), presence of ≥ 1 ‘intrabony defect’ with probing pocket depth (PPD) > 5 mm and intrabony defect depth ≥ 3 mm. Smokers and patients who received previous periodontal treatment to the study site within the last 12 months will be excluded. Patients will be randomly assigned to either the modified MINST or the M-MIST protocol and will be assessed up to 15 months following initial therapy. The primary outcome of the study is radiographic intrabony defect depth change at 15 months follow-up. Secondary outcomes are PPD and clinical attachment level change, inflammatory markers and growth factors in gingival crevicular fluid, bacterial detection, gingival inflammation and healing (as measured by geometric thermal camera imaging in a subset of 10 test and 10 control patients) and patient-reported outcomes. Discussion This study will produce evidence about the clinical efficacy and potential applicability of a modified MINST protocol for the treatment of periodontal intrabony defects, as a less invasive alternative to the use of surgical procedures. Trial registration ClinicalTrials.gov, NCT03797807. Registered on 9 January 2019.
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Affiliation(s)
- L Nibali
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK. .,Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
| | - V Koidou
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - S Salomone
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - T Hamborg
- Pragmatic Clinical Trials Unit, Centre for Primary Care and Public Health, Queen Mary University of London (QMUL), London, UK
| | - R Allaker
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - R Ezra
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - L Zou
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - G Tsakos
- Department of Epidemiology and Public Health, University College London (UCL), London, UK
| | - N Gkranias
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
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Dereka X, Calciolari E, Donos N, Mardas N. Osseointegration in osteoporotic-like condition: A systematic review of preclinical studies. J Periodontal Res 2018; 53:933-940. [PMID: 29845622 DOI: 10.1111/jre.12566] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
Osteoporosis is one of the most common skeletal disorders affecting a significant percentage of people worldwide. Research data suggested that systemic diseases such as osteoporosis could act as risk factors for osseointegration, jeopardizing the healing process and thus the predictability of dental implant success on compromised patients. It is well accepted that preclinical studies in animal models reproducing the osteoporotic condition are one of the most important stages in the research of new biomaterials and therapeutic modalities. The aim of this systematic review was to investigate whether osteoporosis compromises dental implant osseointegration in experimental osteoporotic-like conditions. A 3-stage systematic literature research was conducted in MEDLINE via OVID and EMBASE up to and including March 2017. Experimental studies reporting on dental implant osseointegration on different osteoporotic animal models were assessed. The studies had to report on the percentage of bone-to-implant contact (%BIC) as the primary outcome. ARRIVE guidelines for reporting on animal research were applied to evaluate the methodological quality and risk of bias of the studies. Fifty-seven studies met the inclusion criteria and were assessed qualitatively. The most adopted animal model was the rat. A variability of %BIC values was observed, ranging from 30% to 99% and from 26% to 94% for the healthy and osteoporotic group, respectively. The great majority (47) of the included studies concluded that estrogen deficiency significantly affects BIC values, 9 studies stated that it was not possible to observe statistical differences in BIC between ovariectomized and healthy groups and 1 study did not provide a comparison between the healthy and osteoporotic group. Owing to the great heterogeneity in implant surface, study design, observation time-points, site of implant placement and reported outcomes, a meta-analysis could not be performed. An overall high risk of bias was observed, owing to the limited information on animal housing and husbandry, baseline characteristics and health status, ethical statement and allocation to the experimental groups provided. Although the available studies seem to suggest a lower osseointegration in osteoporotic-like conditions, no robust conclusions can be drawn due to the great heterogeneity and overall low quality of the available studies. Future studies with emphasis on minimizing the possible sources of bias and evaluating osseointegration of dental implants placed into jawbones instead of long bones are warranted.
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Affiliation(s)
- X Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Mardas
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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Calciolari E, Donos N. The use of omics profiling to improve outcomes of bone regeneration and osseointegration. How far are we from personalized medicine in dentistry? J Proteomics 2018; 188:85-96. [DOI: 10.1016/j.jprot.2018.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 12/12/2022]
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Calciolari E, Hamlet S, Ivanovski S, Donos N. Pro-osteogenic properties of hydrophilic and hydrophobic titanium surfaces: Crosstalk between signalling pathways in in vivo models. J Periodontal Res 2018; 53:598-609. [DOI: 10.1111/jre.12550] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2018] [Indexed: 12/12/2022]
Affiliation(s)
- E. Calciolari
- Centre for Oral Immunobiology and Regenerative Medicine; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
- Centre for Oral Clinical Research; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
| | - S. Hamlet
- School of Dentistry and Oral Health; Gold Coast Campus; Griffith University; Southport QLD Australia
- Menzies Health Institute Queensland; Griffith University; Gold Coast QLD Australia
| | - S. Ivanovski
- School of Dentistry; University of Queensland; Brisbane QLD Australia
| | - N. Donos
- Centre for Oral Immunobiology and Regenerative Medicine; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
- Centre for Oral Clinical Research; Institute of Dentistry, Barts and The London School of Medicine and Dentistry; Queen Mary University of London (QMUL); London UK
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Calciolari E, Ravanetti F, Strange A, Mardas N, Bozec L, Cacchioli A, Kostomitsopoulos N, Donos N. Degradation pattern of a porcine collagen membrane in an in vivo model of guided bone regeneration. J Periodontal Res 2018; 53:430-439. [PMID: 29446096 DOI: 10.1111/jre.12530] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Although collagen membranes have been clinically applied for guided tissue/bone regeneration for more than 30 years, their in vivo degradation pattern has never been fully clarified. A better understanding of the different stages of in vivo degradation of collagen membranes is extremely important, considering that the biology of bone regeneration requires the presence of a stable and cell/tissue-occlusive barrier during the healing stages in order to ensure a predictable result. Therefore, the aim of this study was to investigate the degradation pattern of a porcine non-cross-linked collagen membrane in an in vivo model of guided bone regeneration (GBR). MATERIAL AND METHODS Decalcified and paraffin-embedded specimens from calvarial defects of 18, 10-month-old Wistar rats were used. The defects were treated with a double layer of collagen membrane and a deproteinized bovine bone mineral particulate graft. At 7, 14 and 30 days of healing, qualitative evaluation with scanning electron microscopy and atomic force microscopy, and histomorphometric measurements were performed. Markers of collagenase activity and bone formation were investigated using an immunofluorescence technique. RESULTS A significant reduction of membrane thickness was observed from 7 to 30 days of healing, which was associated with progressive loss of collagen alignment, increased collagen remodeling and progressive invasion of woven bone inside the membranes. A limited inflammatory infiltrate was observed at all time points of healing. CONCLUSION The collagen membrane investigated was biocompatible and able to promote bone regeneration. However, pronounced signs of degradation were observed starting from day 30. Since successful regeneration is obtained only when cell occlusion and space maintenance exist for the healing time needed by the bone progenitor cells to repopulate the defect, the suitability of collagen membranes in cases where long-lasting barriers are needed needs to be further reviewed.
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Affiliation(s)
- E Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK
| | - F Ravanetti
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - A Strange
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, UK
| | - N Mardas
- Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK
| | - L Bozec
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, UK
| | - A Cacchioli
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - N Kostomitsopoulos
- Laboratory Animal Facilities, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK
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Calciolari E, Mardas N, Dereka X, Anagnostopoulos AK, Tsangaris GT, Donos N. Protein expression during early stages of bone regeneration under hydrophobic and hydrophilic titanium domes. A pilot study. J Periodontal Res 2017; 53:174-187. [PMID: 29063586 DOI: 10.1111/jre.12498] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES There is significant evidence that, during the early stages of osseointegration, moderately rough hydrophilic (SLActive) surfaces can accelerate osteogenesis and increase bone-to-implant contact in comparison to hydrophobic (SLA) surfaces. However, very little is known regarding the molecular mechanisms behind the influence that surface chemistry modifications to increase hydrophilicity determine on bone healing. The aim of this study was to describe for the first time the proteins and related signalling pathways expressed during early osseous healing stages under SLA and SLActive titanium domes for guided bone regeneration. MATERIAL AND METHODS One SLA and 1 SLActive dome with an internal diameter of 5.0 mm and a height of 3.0 mm were secured to the parietal bones of nine 6-month-old male New Zealand rabbits. Three animals were randomly euthanized at 4, 7 and 14 days and the newly formed tissues retrieved under the domes were analysed with liquid chromatography-mass spectrometry/mass spectrometry. STRING and KEGG databases were applied for Gene Ontology and pathway analyses. RESULTS A different modulation of several pathways was detected between the 2 groups at all healing times. The main differences in the osseous healing response associated to the 2 surfaces were related to pathways involved in regulating the inflammatory response, differentiation of osteoblast precursors and skeletogenesis. At day 7, the highest number of proteins and the highest cellular activity were observed in both groups, although a more complex and articulated proteome in terms of cellular metabolism and signal transduction was observed in SLActive samples. CONCLUSION This is the first study describing the proteome expressed during early healing stages of guided bone regeneration and osseointegration. A combination of enhanced early osteogenic response and reduced inflammatory response were suggested for the hydrophilic group. Future studies are needed to corroborate these findings and explore the molecular effects of different titanium surfaces on the cascade of events taking place during bone formation.
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Affiliation(s)
- E Calciolari
- Centre for Clinical Oral Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
| | - N Mardas
- Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
| | - X Dereka
- Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece
| | - A K Anagnostopoulos
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - G T Tsangaris
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - N Donos
- Centre for Clinical Oral Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
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Retzepi M, Calciolari E, Wall I, Lewis MP, Donos N. The effect of experimental diabetes and glycaemic control on guided bone regeneration: histology and gene expression analyses. Clin Oral Implants Res 2017; 29:139-154. [PMID: 28719032 DOI: 10.1111/clr.13031] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To investigate the effect of experimental diabetes and metabolic control on intramembranous bone healing following guided bone regeneration (GBR). MATERIAL AND METHODS Ninety-three Wistar rats were allocated to three experimental groups, healthy (H), uncontrolled diabetes (D) and controlled diabetes (CD). Twenty one days following diabetes induction, a standardised 5-mm defect was created at the mid-portion of each parietal bone. In 75 animals (25H, 25D, 25CD), one defect was treated with an intracranial and extracranial membrane according to the GBR principle, and one defect was left empty (control); five animals per group were then randomly sacrificed at 3, 7, 15, 30 and 60 days and processed for decalcified histology. In 18 animals (6H, 6D, 6CD), both defects were treated according to the GBR principle; three animals from each group were then randomly sacrificed at 7 and 15 days of healing and employed for gene expression analysis. RESULTS Application of the GBR therapeutic principle led to significant bone regeneration even in the D group. However, at 15 and 30 days, the osteogenesis process was impaired by uncontrolled diabetes, as shown by the significant reduction in terms of defect closure (38-42%) and newly formed bone (54-61%) compared to the healthy group. The comparison of the D vs. H group at 15 days of healing yielded the largest number of genes with significantly differential expression, among which various genes associated with the ossification process (bmp4, ltbp4, thra and cd276) were identified. CONCLUSIONS Uncontrolled diabetes seems to affect early phases of the bone regeneration following GBR. A misregulation of genes and pathways related to cell division, energy production, inflammation and osteogenesis may account for the impaired regeneration process in D rats. Further studies are warranted to optimise the GBR process in this medically compromised patient population.
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Affiliation(s)
- M Retzepi
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - I Wall
- Regenerative Medicine Bioprocessing Unit, UCL Advanced Centre for Biochemical Engineering, London, UK
| | - M P Lewis
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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Dufty J, Gkranias N, Petrie A, McCormick R, Elmer T, Donos N. Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study. Clin Oral Investig 2016; 21:1935-1944. [PMID: 27830369 DOI: 10.1007/s00784-016-1979-9] [Citation(s) in RCA: 2] [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: 01/04/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Necrotizing ulcerative gingivitis (NUG) has been seen in military populations throughout history. This study aims to determine the prevalence, treatment modality and risk factors associated with NUG in the British Armed Forces. MATERIALS AND METHODS A whole population dataset of the British Armed Forces was searched to determine cases of NUG during the period 1 January to 31 December 2012. Individual case records were identified, and a case-control study undertaken with data gathered and analysed against a randomised control group, matched for age, sex and service. RESULTS A prevalence rate for NUG of 0.11 % was determined against the whole military population. The majority of cases received (alone or in combination) the following: oral hygiene instruction (66.5 %), antibiotics (64.4 %) and a mouthwash (58.1 %). Of the cases, 48.7 % received debridement. Analgesics were only prescribed in 8.4 % of the cases, and smoking cessation advice was only given in 10.7 % of the cases. Analysis of risk factors against the control group showed an increase in odds ratios for diagnosis of NUG of 3.4 (95 % CI 2.0-5.7) for current smokers and 7.3 (95 % CI 1.9-28.0) for individuals with an overall Basic Periodontal Examination (BPE) score of 3. CONCLUSIONS Whilst NUG is a rare disease, it is evident from this study that it still occurs within the British Armed Forces. A strong association was shown between NUG and current smokers and those cases with an overall BPE score of 3. CLINICAL RELEVANCE This study provides prevalence data for NUG in the British Armed Forces and description of its treatment and associated risk factors. Oral hygiene and smoking must be addressed in patients with NUG and prescribing protocols should be carefully followed.
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Affiliation(s)
- J Dufty
- Defence Medical Services, Ministry of Defence, London, UK
| | - N Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - A Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK
| | - R McCormick
- Defence Medical Services, Ministry of Defence, London, UK
| | - T Elmer
- Defence Medical Services, Ministry of Defence, London, UK
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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11
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Al-Kattan R, Retzepi M, Calciolari E, Donos N. Microarray gene expression during early healing of GBR-treated calvarial critical size defects. Clin Oral Implants Res 2016; 28:1248-1257. [PMID: 27616585 DOI: 10.1111/clr.12949] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate the gene expression and molecular pathways implicated in the regulation of the osseous healing process following guided bone regeneration (GBR). MATERIAL AND METHODS Six 6-month-old Wistar male rats were used. Standardized 5-mm critical size defects were created in the parietal bones of each animal and treated with an extracranial and intracranial ePTFE membrane, according to the GBR principle. Three animals were randomly sacrificed after 7 and 15 days of healing. Total RNA was extracted from each sample and prepared for gene expression analysis. RNA quality and quantity were assessed, followed by hybridization of the cRNA to Affymetrix GeneChip Rat Genome 230 2.0 Arrays. The Affymetrix data were processed, and first-order analysis, quality control and statistical analysis were performed. Biological interpretation was performed via pathway and Gene Ontology (GO) analysis. RESULTS Between the 7- and 15-day samples, 538 genes were differently regulated. At day 7, inflammatory and immune responses were clearly upregulated. In addition, GO terms related to angiogenesis and cell cycle regulation were overexpressed. At day 15, a more complex cellular activity and cell metabolism were evident. The bone formation processes were significantly overexpressed, with several genes encoding growth factors, enzyme activity, and extracellular matrix formation found as upregulated. Remarkably, a negative regulation of Wnt signalling pathway was observed at 15 days. DISCUSSION The gene expression profile of the cells participating in osseous formation varied depending on the healing stage. A number of candidate genes that seem differentially expressed during early stages of intramembranous bone regeneration was suggested.
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Affiliation(s)
- R Al-Kattan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - E Calciolari
- Department of Periodontology, UCL Eastman Dental Institute, London, UK.,Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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12
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Calciolari E, Mardas N, Dereka X, Anagnostopoulos AK, Tsangaris GT, Donos N. The effect of experimental osteoporosis on bone regeneration: part 2, proteomics results. Clin Oral Implants Res 2016; 28:e135-e145. [PMID: 27580862 DOI: 10.1111/clr.12950] [Citation(s) in RCA: 19] [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] [Accepted: 07/25/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To identify and describe protein expression in a Wistar rat calvarial critical size defect (CSD) model following treatment with guided bone regeneration in healthy and osteoporotic conditions. MATERIAL AND METHODS Thirty-six 10-month-old female Wistar rats were used. Half of them were ovariectomized (OVX) and fed with a low-calcium diet to induce an osteoporotic-like status. In each animal of both groups, two 5-mm calvarial CSDs were treated with deproteinized bovine bone mineral graft particles and a bilayer collagen membrane. Six OVX and six control rats were randomly euthanized at 7, 14, and 30 days. One defect/animal was randomly chosen for proteomic analysis. Differently expressed proteins between the two groups were identified with matrix-assisted laser desorption time-of-flight mass spectrometry and liquid chromatography-mass spectrometry/mass spectrometry. RESULTS At 7 days, 29 and 27 proteins were, respectively, identified in the healthy and OVX animals. At 14 days, 103 proteins were detected in the healthy controls and 20 proteins in the OVX rats, while at 30 days, 31 and 75 proteins were identified, respectively. Only limited proteins known to play a role in the later stages of bone formation and maturation were identified within the animals 'proteomes. DISCUSSION The osseous formation process was quite immature even at 30 days of healing. An overexpression of inflammatory and stress response pathways was detected in the OVX animals, as well as a tendency toward a delayed maturation of the osseous wound and a reduced/delayed differentiation of osteoblast cell precursors.
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Affiliation(s)
- E Calciolari
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.,Periodontology Department, UCL Eastman Dental Institute, London, UK
| | - N Mardas
- Centre for Adult Oral Health, Bart's & The London School of Dentistry & Medicine, Queen Mary University of London (QMUL), London, UK
| | - X Dereka
- Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece
| | - A K Anagnostopoulos
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - G T Tsangaris
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - N Donos
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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13
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Moschouris P, Retzepi M, Petrie A, Donos N. Effect of Wnt3a delivery on early healing events during guided bone regeneration. Clin Oral Implants Res 2016; 28:283-290. [DOI: 10.1111/clr.12796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 12/21/2022]
Affiliation(s)
- P Moschouris
- Periodontology Unit; Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - M Retzepi
- Periodontology Unit; Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - A Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - N Donos
- Periodontology Unit; Department of Clinical Research; UCL Eastman Dental Institute; London UK
- Centre for Oral Clinical Research; Institute of Dentistry; Barts & The London School of Medicine & Dentistry; London UK
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14
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Nibali L, Novoa L, Donos N, Henderson B, Blanco J, Tomas I. Leukocyte receptor expression in chronic periodontitis. Clin Oral Investig 2016; 20:2559-2564. [PMID: 26961374 DOI: 10.1007/s00784-016-1774-7] [Citation(s) in RCA: 2] [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: 07/31/2015] [Accepted: 02/29/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Microbial recognition in the periodontium through specific leukocyte receptors gives rise to the response which in susceptible individuals can lead to periodontal diseases. The aim of this study was to explore the expression of leukocyte receptors in the gingival tissues of chronic periodontitis patients and to analyse differences between diseased and control sites (sites with probing pocket depth <4 mm). MATERIAL AND METHODS Thirty-seven chronic periodontitis patients were included in the study. Gingival biopsies were harvested from diseased and control sites and processed by flow cytometry for the determination of the expression of 16 leukocyte receptors (CD4, CD8, CD11b, CD14, CD16, CD19, CD25, CD28, CD49d, CD49e, CD62, CD71, CD80, CCR7, Ly6G and HLA-DR). RESULTS Expression of all studied receptors was higher in test compared with control sites (p < 0.005). Sampled sites with less bleeding on probing exhibited higher expression of CD16 and CD14 receptors (p = 0.020 and 0.011, respectively). CONCLUSIONS This study points towards considerable differences in the expression of leukocyte receptors between diseased and control sites in the same periodontal patients.
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Affiliation(s)
- L Nibali
- Clinical Oral Research Centre, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - L Novoa
- Oral Sciences Research Group, Periodontology and Special Needs Units, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - N Donos
- Clinical Oral Research Centre, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - B Henderson
- Division of Microbial Diseases, UCL Eastman Dental Institute, London, UK
| | - J Blanco
- Oral Sciences Research Group, Periodontology and Special Needs Units, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - I Tomas
- Oral Sciences Research Group, Periodontology and Special Needs Units, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
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15
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Abstract
Adhesion of bacteria to dental implant surfaces is the critical initial step in the process of biofilm colonization; however, the specific nanoadhesive interactions occurring during the first contact between bacterial cells and biomaterial substrates remain poorly understood. In this report, we utilize single-cell force spectroscopy to characterize the dynamics of the initial interaction between living Staphylococcus aureus cells and machined titanium surfaces at the nanoscale. Values for maximum adhesion force were found to increase from 0-s (-0.27 ± 0.30 nN) to 60-s (-9.15 ± 0.78 nN) surface delays, with similar results observed for total adhesion work (7.39 ± 2.38 and 988.06 ± 117.08 aJ, respectively). Single unbinding events observed at higher surface delays were modeled according to the wormlike chain model, obtaining molecular contour-length predictions of 314.06 ± 9.27 nm. Average single-bond rupture forces of -0.95 ± 0.04 nN were observed at increased contact times. Short- and long-range force components of bacterial adhesion were obtained by Poisson analysis of single unbinding event peaks, yielding values of -0.75 ± 0.04 and -0.58 ± 0.15 nN, respectively. Addition of 2-mg/mL chlorhexidine to the buffer solution resulted in the inhibition of specific adhesive events but an increased overall adhesion force and work. These results suggest that initial attachment of S. aureus to smooth titanium is mostly mediated by short-range attractive forces observed at higher surface delays.
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Affiliation(s)
- S Aguayo
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
| | - N Donos
- Periodontology Unit, UCL Eastman Dental Institute, University College London, London, UK
| | - D Spratt
- Division of Microbial Diseases, UCL Eastman Dental Institute, University College London, London, UK
| | - L Bozec
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
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16
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Nibali L, Rizzo M, Li Volti G, D'Aiuto F, Giglio RV, Barbagallo I, Pelekos G, Donos N. Lipid subclasses profiles and oxidative stress in aggressive periodontitis before and after treatment. J Periodontal Res 2015; 50:890-6. [DOI: 10.1111/jre.12283] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2015] [Indexed: 12/19/2022]
Affiliation(s)
- L. Nibali
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - M. Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties; University of Palermo; Palermo Italy
- Euro-Mediterranean Institute of Science and Technology; Palermo Italy
| | - G. Li Volti
- Euro-Mediterranean Institute of Science and Technology; Palermo Italy
- Department of Biomedicine and Biotechnologies; University of Catania; Catania Italy
| | - F. D'Aiuto
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - R. V. Giglio
- Biomedical Department of Internal Medicine and Medical Specialties; University of Palermo; Palermo Italy
| | - I. Barbagallo
- Euro-Mediterranean Institute of Science and Technology; Palermo Italy
- Department of Drug Sciences; University of Catania; Catania Italy
| | - G. Pelekos
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - N. Donos
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
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17
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Abstract
The use of the atomic force microscope (AFM) in microbiology has progressed significantly throughout the years since its first application as a high-resolution imaging instrument. Modern AFM setups are capable of characterizing the nanomechanical behaviour of bacterial cells at both the cellular and molecular levels, where elastic properties and adhesion forces of single bacterium cells can be examined under different experimental conditions. Considering that bacterial and biofilm-mediated infections continue to challenge the biomedical field, it is important to understand the biophysical events leading towards bacterial adhesion and colonization on both biological and non-biological substrates. The purpose of this review is to present the latest findings concerning the field of single-bacterium nanomechanics, and discuss future trends and applications of nanoindentation and single-cell force spectroscopy techniques in biomedicine.
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Affiliation(s)
- S Aguayo
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK
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18
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Calciolari E, Donos N, Park JC, Petrie A, Mardas N. Panoramic measures for oral bone mass in detecting osteoporosis: a systematic review and meta-analysis. J Dent Res 2014; 94:17S-27S. [PMID: 25365969 DOI: 10.1177/0022034514554949] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Different quantitative and qualitative indices calculated on oral panoramic radiographs have been proposed as useful tools to screen for reduced skeletal bone mineral density (BMD). Our aim was to systematically review the literature on linear and qualitative panoramic measures and to assess the accuracy of these indices by performing a meta-analysis of their sensitivity and specificity. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was followed. Fifty studies were included in the qualitative appraisal and 19 were considered for meta-analysis. The methodological quality of the retrieved studies, assessed with the QUADAS-2 tool, was on average low. Three indices were reported by most of the studies: mandibular cortical width, panoramic mandibular index, and the Klemetti index. Mandibular cortical width presented with a better accuracy in excluding osteopenia/osteoporosis (specificity), since patients with a cortical width more than 4 mm had a normal BMD in 90% of the cases. Almost all studies used a cutoff of 0.3 for the panoramic mandibular index, resulting in an estimated sensitivity and specificity in detecting reduced BMD, respectively, of 0.723 (SE 0.160; 95% confidence interval [CI], 0.352-0.926) and 0.733 (SE 0.066; 95% CI, 0.587-0.841). The presence of any kind of mandibular cortical erosion gave an estimated sensitivity and specificity in detecting reduced BMD, respectively, of 0.789 (SE 0.031; 95% CI, 0.721-0.843) and 0.562 (SE 0.047; 95% CI, 0.47-0.651) and a sensitivity and specificity in detecting osteoporosis, respectively, of 0.806 (SE 0.105; 95% CI, 0.528-0.9200) and 0.643 (SE 0.109; 95% CI, 0.417-0.820). The mandibular cortical width, panoramic mandibular index, and Klemetti index are overall useful tools that potentially could be used by dentists to screen for low BMD. Their limitations are mainly related to the experience/agreement between different operators and the different image quality and magnification of the panoramic radiographs.
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Affiliation(s)
- E Calciolari
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - N Donos
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - J C Park
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom Department of Periodontology, College of Dentistry, Dankook University, Cheonan, South Korea
| | - A Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, United Kingdom
| | - N Mardas
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
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19
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Needleman I, Ashley P, Petrie A, Fortune F, Turner W, Jones J, Niggli J, Engebretsen L, Budgett R, Donos N, Clough T, Porter S. ORAL HEALTH AND IMPACT ON PERFORMANCE OF ATHLETES PARTICIPATING IN THE LONDON 2012 OLYMPIC GAMES. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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20
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Needleman I, Ashley P, Petrie A, Fortune F, Turner W, Jones J, Niggli J, Engebretsen L, Budgett R, Donos N, Clough T, Porter S. Oral health and impact on performance of athletes participating in the London 2012 Olympic Games: a cross-sectional study. Br J Sports Med 2013; 47:1054-8. [PMID: 24068332 PMCID: PMC3812828 DOI: 10.1136/bjsports-2013-092891] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/03/2022]
Abstract
BACKGROUND Oral health is important both for well-being and successful elite sporting performance. Reports from Olympic Games have found significant treatment needs; however, few studies have examined oral health directly. The aim of this study was to evaluate oral health, the determinants of oral health and the effect of oral health on well-being, training and performance of athletes participating in the London 2012 Games. METHODS Cross-sectional study at the dental clinic within the Polyclinic in the athletes' village. Following informed consent, a standardised history, clinical examination and brief questionnaire were conducted. RESULTS 302 athletes from 25 sports were recruited with data available for 278. The majority of athletes were from Africa, the Americas and Europe. Overall, the results demonstrated high levels of poor oral health including dental caries (55% athletes), dental erosion (45% athletes) and periodontal disease (gingivitis 76% athletes, periodontitis 15% athletes). More than 40% of athletes were 'bothered' by their oral health with 28% reporting an impact on quality of life and 18% on training and performance. Nearly half of the participants had not undergone a dental examination or hygiene care in the previous year. CONCLUSIONS The oral health of athletes attending the dental clinic of the London 2012 Games was poor with a resulting substantial negative impact on well-being, training and performance. As oral health is an important element of overall health and well-being, health promotion and disease prevention interventions are urgently required to optimise athletic performance.
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Affiliation(s)
- I Needleman
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | - P Ashley
- Unit of Paediatric Dentistry, UCL Eastman Dental Institute, London, UK
| | - A Petrie
- Unit of Biostatistics, UCL Eastman Dental Institute, London, UK
| | | | | | | | | | - L Engebretsen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sports Science, Oslo, Norway
- Orthopaedic Center, Ullevål University Hospital, University of Oslo, Oslo, Norway
- International Olympic Committee Medical Commission, Lausanne, Switzerland
| | - R Budgett
- International Olympic Committee Medical Commission, Lausanne, Switzerland
| | - N Donos
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | | | - S Porter
- Unit of Oral Medicine, UCL Eastman Dental Institute, London, UK
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21
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Suvan J, Petrie A, Moles DR, Nibali L, Patel K, Darbar U, Donos N, Tonetti M, D'Aiuto F. Body mass index as a predictive factor of periodontal therapy outcomes. J Dent Res 2013; 93:49-54. [PMID: 24165943 DOI: 10.1177/0022034513511084] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Body mass index (BMI) and obesity are associated with the prevalence, extent, and severity of periodontitis. This study investigated the predictive role of overweight/obesity on clinical response following non-surgical periodontal therapy in patients with severe periodontitis. Two hundred sixty adults received an intensive course of non-surgical periodontal therapy. Periodontal status at baseline and 2 months was based upon probing pocket depths (PPD), clinical attachment levels (CAL), and whole-mouth gingival bleeding (FMBS) as assessed by two calibrated examiners. Generalized estimating equations (GEE) were used to estimate the impact of BMI and overweight/obesity on periodontal treatment response while controlling for baseline status, age, smoking status (smoker or non-smoker), and full-mouth dental plaque score. BMI (continuous variable) and obesity (vs. normal weight) were associated with worse mean PPD (p < .005), percentage of PPD > 4 mm (p = .01), but not with FMBS (p > .05) or CAL (p > .05) at 2 months, independent of age, smoking status, or dental plaque levels. The magnitude of this association was similar to that of smoking, which was also linked to a worse clinical periodontal outcome (p < .01). BMI and obesity appear to be independent predictors of poor response following non-surgical periodontal therapy.
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Affiliation(s)
- J Suvan
- Unit of Periodontology, UCL, Eastman Dental Institute, London, UK
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22
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Kim DW, Park JC, Rim TT, Jung UW, Kim CS, Donos N, Cha IH, Choi SH. Socioeconomic disparities of periodontitis in Koreans based on the KNHANES IV. Oral Dis 2013; 20:551-9. [PMID: 24033864 DOI: 10.1111/odi.12168] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 12/30/2012] [Revised: 06/26/2013] [Accepted: 07/12/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to identify the socioeconomic factors associated with the prevalence of periodontitis in Koreans. METHODS Cross-sectional data from 12 763 subjects, 15 years old and above, who underwent periodontal examinations were obtained from the Korean National Health and Nutrition Examination Survey IV (2007-209). Multivariate linear and logistic regression analyses were applied to estimate the association between socioeconomic indicators and prevalence of periodontitis. RESULTS A significant association was found between increasing age and periodontitis. Participants with higher income were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.78-0.98, and aOR = 0.7 and 95% CI = 0.60-0.80 in the middle and highest quintiles of monthly household income, respectively). In addition, participants living in rural areas were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.81-0.99), and current smokers were more likely to have periodontitis (aOR = 1.7 and 95% CI = 1.49-1.89). The analysis of comorbidities revealed that individuals with diabetes mellitus (DM) were significantly more likely to have periodontitis (aOR = 1.4 and 95% CI = 1.18-1.68). CONCLUSIONS In a rapidly increasing Korean population, the lower socioeconomic groups as well as individuals with DM were significantly more likely to present with periodontitis.
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Affiliation(s)
- D W Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
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23
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Abstract
Aggressive periodontitis (AgP) is thought to have a faster rate of progression than chronic periodontitis (CP). However, there is a lack of studies systematically investigating disease progression and tooth loss in AgP. A systematic search of the literature was conducted by two independent reviewers for longitudinal studies including patients with AgP (previously known as 'periodontosis', 'juvenile' or 'early-onset' periodontitis) indicating measures of disease progression. Ovid MEDLINE(®) and Embase databases were searched for at least 5-year longitudinal human studies in AgP patients. In total, 16 studies were included in the review, from an initial search of 1,601 titles. Heterogeneity was detected for disease definition and clinical data reporting; hence meta-analysis was feasible only for the objective measure 'tooth loss'. The average tooth loss for all AgP cases was 0.09 (95% C.I. = 0.06-0.16) per patient-year. The corresponding values by diagnosis were 0.05, 0.14, and 0.12 tooth loss per patient-year, respectively, for LAgP, GAgP, and un-specified AgP. For studies reporting tooth loss during the 'observational period' (excluding extractions at initial therapy), the average tooth loss for AgP was 0.09 per patient-year. High heterogeneity was detected for these analyses. In conclusion, most studies report good long-term stability of treated AgP cases.
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Affiliation(s)
- L Nibali
- Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK
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24
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Affiliation(s)
| | - N. Donos
- Periodontology unit, Department of clinical research; UCL Eastman Dental Institute; London; UK
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25
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Nibali L, Medlar A, Stanescu H, Kleta R, Darbar U, Donos N. Linkage analysis confirms heterogeneity of hereditary gingival fibromatosis. Oral Dis 2012; 19:100-5. [PMID: 22849749 DOI: 10.1111/j.1601-0825.2012.01965.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 06/11/2012] [Accepted: 06/12/2012] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Hereditary Gingival Fibromatosis (HGF) is a rare benign fibrous lesion of the gingival tissues presumably caused by single gene defects. The aim of this study was to identify the genetic defect leading to HGF in an extended pedigree. MATERIALS AND METHODS We report the clinical features and genetic analysis of a family affected by HGF. A total of 17 subjects were assessed clinically and had blood samples taken for DNA extraction. Multipoint parametric linkage analysis was performed to identify the possible chromosomal location responsible for HGF in this family. RESULTS Presence of severe HGF associated with tooth impaction was confirmed for seven members of this three-generation family. Linkage analysis revealed that loci on chromosomes 7, 10, 13, 15, 16, 17, 19 and 20 were linked to this trait. Previously found mutations in the SOS1 and GINGF loci were therefore excluded by this analysis. CONCLUSIONS This study brings further evidence for genetic heterogeneity of HGF and points towards the existence of different, not-yet-identified genes linked to this condition.
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Affiliation(s)
- L Nibali
- Periodontology Unit and Department of Clinical Research, University College London, Eastman Dental Institute and Hospital, London, UK
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26
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Patel K, Mardas N, Donos N. Radiographic and clinical outcomes of implants placed in ridge preserved sites: a 12-month post-loading follow-up. Clin Oral Implants Res 2012; 24:599-605. [PMID: 22672611 DOI: 10.1111/j.1600-0501.2012.02500.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this clinical study was to evaluate the interproximal radiographic bone levels and the survival/success rate of dental implants placed in alveolar ridges previously preserved with a synthetic bone substitute or a bovine xenograft. MATERIAL AND METHODS Alveolar ridge preservation was performed in 27 patients who were randomly assigned in two groups. In the test group (n = 14), the extraction socket was treated with a synthetic bone graft Straumann Bone Ceramic; SBC and a collagen barrier, whereas in the control group (n = 13) a deproteinized bovine bone mineral (DBBM) and the same collagen barrier were used. After 8 months of healing, titanium dental implants with a hydrophilic surface were placed in the preserved ridges. During surgery, 9/13 implants in the SBC group and 8/12 implants in the DBBM group presented with either dehiscence or fenestration defects and required additional bone augmentation. The implants were loaded at 4 months following placement and were followed up for 1 year post-loading. Interproximal radiographic bone levels were evaluated in standardized periapical radiographs at loading and 1 year post-loading. Probing pocket depth, gingival recession and bleeding upon probing were recorded at implants and neighbouring teeth. The success rate of the implants was evaluated according to criteria set by Albrektsson et al. (1986). RESULTS The survival rate of the implants in both groups was 100% at 1-year post-loading. No statistically significant differences in any of the clinical and radiographic measurements were detected between the two groups (P < 0.05). The success rate of the implants was 84.6% (11/13) in the SBC group and 83.3% (10/12) in the DBBM group. CONCLUSION Equivalent success and survival rates (as well as similar radiographic changes) of dental implants placed in alveolar ridges previously preserved with SBC or DBBM should be anticipated.
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Affiliation(s)
- K Patel
- Restorative Dentistry, UCLH Eastman Dental Hospital, London, UK
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Khan MR, Donos N, Salih V, Brett PM. The enhanced modulation of key bone matrix components by modified Titanium implant surfaces. Bone 2012; 50:1-8. [PMID: 21906701 DOI: 10.1016/j.bone.2011.07.040] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 07/26/2011] [Accepted: 07/29/2011] [Indexed: 02/02/2023]
Abstract
Modifications to Titanium (Ti) implant surfaces enhance osseointegration by promoting bone-implant contact and peri-implant bone accrual; which in vitro analyses of osteoblastic cells suggest is due to an enhancement in cellular phenotypic maturation and function. To evaluate these effects on uncommitted cells, this study examined the osteogenic mineralisation and phenotypic marker expression of human marrow derived stromal cells (hBMSCs) from three unrelated donors cultured on tissue culture plastic (TCP), polished (P), rough-hydrophobic (SLA) and rough-hydrophilic (modSLA) Ti surfaces over the course of 21 days. Transcriptional analyses indicated a significant early up-regulation of both Runx2 (p<0.05) and Osteopontin (OP) (p<0.05) but not Bone Sialoprotein 2 (BSP2) (p<0.05) by rough surfaces 1 day post seeding. The phenotypic analyses showed that whilst cellular proliferation was relatively restricted and slower on the rough substrates; osteogenic mineralisation, assessed by quantifying extracellular matrix calcium deposition, collagen formation and the ratio of collagen to mineral deposited were significantly higher (p<0.05); as was alkaline phosphatase (ALP) activity (p<0.05). The rough surfaces caused an increase of secreted osteoblastic markers Osteoprotegrin (OPG) (p<0.05), growth differentiation factor 15 (GDF-15) (p<0.05) and Osteocalcin (OC) (p<0.05). These findings suggest that modified Ti surfaces induce an enhancement in osteogenic commitment and differentiation, which likely underlie the deposition of more stable bone matrix early in the healing process in vivo.
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Affiliation(s)
- M R Khan
- Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London WC1X 8LD, UK
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Donos N. Summary of: Specialists' management decisions and attitudes towards mucositis and peri-implantitis. Br Dent J 2012; 212:30-1. [DOI: 10.1038/sj.bdj.2012.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ivanovski S, Hamlet S, Retzepi M, Wall I, Donos N. Transcriptional profiling of “guided bone regeneration” in a critical-size calvarial defect. Clin Oral Implants Res 2011; 22:382-9. [DOI: 10.1111/j.1600-0501.2010.02104.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ivanovski S, Hamlet S, Salvi G, Huynh-Ba G, Bosshardt D, Lang N, Donos N. Transcriptional profiling of osseointegration in humans. Clin Oral Implants Res 2011; 22:373-81. [DOI: 10.1111/j.1600-0501.2010.02112.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Donos N, Retzepi M, Wall I, Hamlet S, Ivanovski S. In vivo gene expression profile of guided bone regeneration associated with a microrough titanium surface. Clin Oral Implants Res 2011; 22:390-8. [DOI: 10.1111/j.1600-0501.2010.02105.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Donos N, Hamlet S, Lang NP, Salvi GE, Huynh-Ba G, Bosshardt DD, Ivanovski S. Gene expression profile of osseointegration of a hydrophilic compared with a hydrophobic microrough implant surface. Clin Oral Implants Res 2011; 22:365-72. [DOI: 10.1111/j.1600-0501.2010.02113.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Nibali L, Donos N, Farrell S, Ready D, Pratten J, Tu Y, D'Aiuto F. Association Between Interleukin-6 −174 Polymorphism andAggregatibacter actinomycetemcomitansin Chronic Periodontitis. J Periodontol 2010; 81:1814-9. [DOI: 10.1902/jop.2010.100084] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [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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Liñares A, Mardas N, Dard M, Donos N. Effect of immediate or delayed loading following immediate placement of implants with a modified surface. Clin Oral Implants Res 2010; 22:38-46. [DOI: 10.1111/j.1600-0501.2010.01988.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nibali L, Madden I, Franch Chillida F, Heitz-Mayfield L, Brett P, Donos N. IL6 -174 genotype associated with Aggregatibacter actinomycetemcomitans in Indians. Oral Dis 2010; 17:232-7. [PMID: 20860759 DOI: 10.1111/j.1601-0825.2010.01731.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIM Genetic factors have recently been associated with presence of Aggregatibacter actinomycetemcomitans subgingivally in populations living in industrialized countries. The aim of this study was to analyse associations between Interleukin-6 (IL6) single nucleotide polymorphisms and presence and levels of A. actinomycetemcomitans and other subgingival microbes in a rural Indian population. SUBJECTS AND METHODS A total of 251 individuals from a rural village in India with a periodontal phenotype ranging from healthy to severe periodontitis were included. Checkerboard DNA-DNA analysis was performed to detect 40 periodontal taxa in subgingival plaque samples. Genomic DNA was extracted to genotype five polymorphisms in the IL6 promoter region. RESULTS The IL6-74 GG genotype was associated with high (above median) counts of A. actinomycetemcomitans (both in all subjects and in periodontally healthy only) and with presence and counts of Capnocytophaga sputigena. Differences in detection of several other bacteria were noted between periodontitis and healthy subjects. CONCLUSIONS These findings support the influence of genetic factors on the subgingival microbiota.
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Affiliation(s)
- L Nibali
- Periodontology Unit and Division of Clinical Research, Eastman Dental Hospital, University College London (UCL), London, UK.
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Abstract
Periodontal infections have been associated with a state of chronic inflammation. To ascertain whether severe periodontitis and its treatment are associated with oxidative stress, we recruited 145 cases (periodontitis) and 56 controls in a case-control study. A further pilot intervention study of 14 cases (periodontal therapy) was performed. Blood samples were taken at baseline (case-control) and 1, 3, 5, 7, and 30 days after treatment (intervention). Diacron-reactive oxygen metabolites (D-ROM), anti-oxidant potential, C-reactive protein (CRP), interleukin-6, and lipid profiles were determined with high-sensitivity assays in serum. Patients with severe periodontitis exhibited higher D-ROM levels (P < 0.001) and lower total anti-oxidant capacity (P < 0.001) compared with healthy control individuals. These findings were independent of age, gender, smoking habits, ethnicity, and standard lipids differences. D-ROM levels were positively correlated with CRP (R = 0.4, P < 0.001) and clinical periodontal parameters (R = 0.20, P < 0.05). Acute increases of D-ROM (P < 0.01) were observed following periodontal therapy. Analysis of these data suggests a positive association between severe periodontitis and oxidative stress.
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Affiliation(s)
- F D'Aiuto
- Periodontology Unit, Division of Clinical Research, UCL Eastman Dental Institute and Hospital, 256 Gray's Inn Road, London WC1X 8LD, UK.
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Bostanci N, Heywood W, Mills K, Parkar M, Nibali L, Donos N. Application of Label-Free Absolute Quantitative Proteomics in Human Gingival Crevicular Fluid by LC/MSE(Gingival Exudatome). J Proteome Res 2010; 9:2191-9. [DOI: 10.1021/pr900941z] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Diabetes mellitus and, in particular, type 1 diabetes has been associated with impaired osseous wound healing properties. The scope of the present review is to discuss the clinical evidence supporting a higher rate of complications during fracture healing in diabetic patients and the histological evidence indicating impaired potential for intramembranous and endochondral ossification in the presence of uncontrolled experimental diabetes. The article further provides a synthesis of our current understanding of the plausible molecular mechanisms underlying the diabetic bone healing pathophysiology and of the role of insulin treatment in promoting osseous healing in the diabetic status.
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Affiliation(s)
- M Retzepi
- Periodontology Unit, Clinical Research Division, UCL Eastman Dental Institute, London, UK.
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Nibali L, O'Dea M, Bouma G, Parkar M, Thrasher A, Burns S, Donos N. Genetic Variants Associated With Neutrophil Function in Aggressive Periodontitis and Healthy Controls. J Periodontol 2010; 81:527-34. [DOI: 10.1902/jop.2010.090543] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [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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Dashti A, Ready D, Salih V, Knowles JC, Barralet JE, Wilson M, Donos N, Nazhat SN. In vitro antibacterial efficacy of tetracycline hydrochloride adsorbed onto Bio-Oss® bone graft. J Biomed Mater Res B Appl Biomater 2010; 93:394-400. [DOI: 10.1002/jbm.b.31594] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Donos N, Mardas N, Buser D. An outline of competencies and the appropriate postgraduate educational pathways in implant dentistry. Eur J Dent Educ 2009; 13 Suppl 1:45-54. [PMID: 19281514 DOI: 10.1111/j.1600-0579.2008.01528.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The use of dental implants has become a widely accepted and well-documented treatment option offering to both patients and dentists an alternative to traditional treatment modalities and at the same time opening a brand new area in dental postgraduate education. As such, it is necessary to define the competencies that the graduate student/dentist will need at the different levels of clinical practice in Implant Dentistry and the educational pathways that are required to convey those competencies in a structured manner. The present position paper provides an initial suggestion for the knowledge, skills and behaviour necessary for a graduate student to practice implant dentistry at the different levels of clinical complexity. An outline of the necessary competencies and structure of various levels of postgraduate university courses is provided together with different educational approaches to support them. The present paper should be evaluated as a platform for discussion for future development of postgraduate curricula in implant dentistry rather than a manual on how to design and operate such curricula.
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Affiliation(s)
- N Donos
- UCL Eastman Dental Institute, Periodontology Unit, London, UK.
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Mattheos N, Albrektsson T, Buser D, De Bruyn H, Donos N, Hjørting Hansen E, Lang NP, Sanz M, Nattestad A. Teaching and assessment of implant dentistry in undergraduate and postgraduate education: a European consensus. Eur J Dent Educ 2009; 13 Suppl 1:11-17. [PMID: 19281510 DOI: 10.1111/j.1600-0579.2008.00556.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This paper constitutes a summary of the consensus documents agreed at the First European Workshop on Implant Dentistry University Education held in Prague on 19-22 June 2008. Implant dentistry is becoming increasingly important treatment alternative for the restoration of missing teeth, as patients expectations and demands increase. Furthermore, implant related complications such as peri-implantitis are presenting more frequently in the dental surgery. This consensus paper recommends that implant dentistry should be an integral part of the undergraduate curriculum. Whilst few schools will achieve student competence in the surgical placement of implants this should not preclude the inclusion of the fundamental principles of implant dentistry in the undergraduate curriculum such as the evidence base for their use, indications and contraindications and treatment of the complications that may arise. The consensus paper sets out the rationale for the introduction of implant dentistry in the dental curriculum and the knowledge base for an undergraduate programme in the subject. It lists the competencies that might be sought without expectations of surgical placement of implants at this stage and the assessment methods that might be employed. The paper also addresses the competencies and educational pathways for postgraduate education in implant dentistry.
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Affiliation(s)
- N Mattheos
- School of Medicine and Oral Health, Griffith University, Gold Coast, Australia.
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Nibali L, D’Aiuto F, Donos N, Griffiths G, Parkar M, Tonetti M, Humphries S, Brett P. Association between periodontitis and common variants in the promoter of the interleukin-6 gene. Cytokine 2009; 45:50-4. [DOI: 10.1016/j.cyto.2008.10.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 09/20/2008] [Accepted: 10/30/2008] [Indexed: 10/21/2022]
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Nibali L, Donos N, Brett PM, Parkar M, Ellinas T, Llorente M, Griffiths GS. A familial analysis of aggressive periodontitis - clinical and genetic findings. J Periodontal Res 2008; 43:627-34. [DOI: 10.1111/j.1600-0765.2007.01039.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Retzepi M, Tonetti M, Donos N. Comparison of gingival blood flow during healing of simplified papilla preservation and modified Widman flap surgery: a clinical trial using laser Doppler flowmetry. J Clin Periodontol 2007; 34:903-11. [PMID: 17850609 DOI: 10.1111/j.1600-051x.2007.01119.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIM This prospective randomized-controlled clinical trial compared the gingival blood flow responses following simplified papilla preservation (test) versus modified Widman flap (control). MATERIALS AND METHODS Twenty contra-lateral upper sites with pocket depth > or = 5 mm after initial treatment in 10 chronic periodontitis patients were randomly assigned to either test or control treatment, using a split-mouth design. Laser Doppler flowmetry recordings were performed pre-operatively, following anaesthesia, immediately post-operatively and on days 1, 2, 3, 4, 7, 15, 30 and 60, at nine selected sites per flap. RESULTS Significant ischaemia was observed at all sites following anaesthesia and immediately post-operatively. At the mucosal flap basis, a peak hyperaemic response was observed on day 1, which tended to resolve by day 4 at the test sites, but persisted until day 7 at the control sites. The buccal and palatal papillae blood perfusion presented the maximum increase on day 7 in both groups and returned to baseline by day 15. Both surgical modalities yielded significant pocket depth reduction, recession increase and clinical attachment gain. CONCLUSIONS Periodontal access flaps represent an ischaemia-reperfusion flap model. The simplified papilla preservation flap may be associated with faster recovery of the gingival blood flow post-operatively compared with the modified Widman flap.
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Affiliation(s)
- M Retzepi
- Periodontology Unit, Eastman Dental Institute, University College London, London, UK
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Abstract
AIM To investigate the pattern of gingival blood flow changes following periodontal access flap surgery by laser Doppler flowmetry (LDF). MATERIAL AND METHODS Fourteen patients with chronic periodontitis presenting upper anterior sites with pocket depth >or=5 mm after initial treatment were included in the study. Periodontal access flap surgery was performed on the experimental areas and LDF recordings were taken at baseline, following anaesthesia, immediately postoperatively and on days 1, 2, 3, 4, 7, 15, 30 and 60 of healing, at nine predetermined sites per flap. RESULTS Significant ischaemia was observed at all flap sites following anaesthesia and immediately postoperatively. At the alveolar mucosal sites, a peak increase of the gingival blood flow was observed on postoperative day 1 (p<0.001), which persisted until day 7 (p=0.012) and resolved by day 15. The mucosal sites close to the flap periphery presented higher blood perfusion compared with the sites located centrally in the flap. The microcirculatory perfusion of the buccal and palatal papillae was maximum on postoperative day 7 (p=0.013 and <0.001, respectively) and returned to baseline by day 15. CONCLUSION Topographically distinct areas of the periodontal access flap consistently present different patterns of microvascular blood flow alterations during the wound-healing period.
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Affiliation(s)
- M Retzepi
- Periodontology Unit, Eastman Dental Institute, University College London, London, UK
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Graziani F, Cei S, Ducci F, Giuca MR, Donos N, Gabriele M. In vitro effects of different concentration of PRP on primary bone and gingival cell lines. Preliminary results. Minerva Stomatol 2005; 54:15-22. [PMID: 15902059] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM Platelet rich plasma (PRP) is utilized in oral surgery to enhance bone healing and it has been suggested to accelerate soft tissue healing. Nevertheless, there is no evidence on biological concentration of platelets needed to determine the higher biological response. Therefore, aim of this study is to evaluate the action of PRP in vitro on osteoblasts and fibroblasts and to evaluate which is the most effective concentration of PRP. METHODS PRP was obtained from volunteers donors by standard apheresis. Osteoblasts were growth for 72 hours in a medium added with platelet concentration of 230%. Fibroblasts were treated with different platelet density for 24 hours and 72 hours. Platelet density was increased of 230%, 350%, 460% and 700% the normal blood count. Cell proliferation was evaluated with MTT test. ANOVA test was used to assess cells proliferation data. RESULTS Osteoblasts proliferation, at 72 hours, showed an increase of proliferation in PRP group compared to plasma (P < 0.001). Fibroblast proliferation after 24 hours increases when PRP is added (P < 0.05). However, no significant differences were detected among the various concentration of PRP. Yet, at 72 hours, MTT values increases when platelet concentrate is 230% and 350%. At 700% platelet density MTT values were lower than control group (P < 0.05). CONCLUSIONS Our results indicated that PRP has an enhancing effect on osteoblasts and fibroblasts proliferation when it is prepared only within certain ranges of concentrations. However, further experimental studies are needed to confirm our hypothesis.
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Affiliation(s)
- F Graziani
- Department of Neurosciences, University of Pisa, Pisa, Italy
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Donos N, Sculean A, Glavind L, Reich E, Karring T. Wound healing of degree III furcation involvements following guided tissue regeneration and/or Emdogain®. J Clin Periodontol 2003; 30:1061-8. [PMID: 15002892 DOI: 10.1046/j.0303-6979.2003.00429.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The use of enamel matrix proteins (EMD) has been recently introduced as a new treatment alternative for periodontal regeneration. However, no histological studies are available investigating the effect of EMD in the treatment of degree III furcation involvements. OBJECTIVES The aim of this study was to evaluate the healing of mandibular degree III furcation involvements histologically following treatment with guided tissue regeneration (GTR), EMD and a combination of EMD and GTR. MATERIAL AND METHODS Degree III furcation involvements were surgically created at the teeth 36, 37, 46, 47 in three monkeys (Macaca fascicularis). Spontaneous healing of the defects was prevented by placing impression material into the defects. After 6 weeks, full-thickness flaps were elevated at the buccal and lingual aspect of the experimental teeth. Following removal of all granulation tissue from the furcation defects, scaling/root planing and conditioning of the root surfaces with 24% EDTA gel, the defects were treated with one of the following treatment modalities: (i) EMD, (ii) GTR or (iii) a combination of EMD and GTR. The defects serving as control did not receive any treatment, except from complete coverage with coronally displaced flaps. After 5 months of healing, the animals were killed and perfused with 10% buffered formalin for fixation. The experimental teeth with surrounding tissues were dissected free, decalcified in EDTA, dehydrated and embedded in paraffin. 8 microm thick histological sections were cut and stained and subsequently examined under the light microscope. RESULTS The histological analysis revealed that with GTR or combined EMD and GTR treatment, new attachment formation (new cementum with inserting collagen fibers) had occurred on almost the entire circumference of the furcation and new bone was almost filling the defect in the situations where the membrane was not exposed. The sites treated only with EMD exhibited new attachment and new bone formation to a varying extent, while the control sites presented only limited new attachment and bone formation. CONCLUSION The results provided histological evidence suggesting that both GTR and EMD may result in true periodontal regeneration, and suggest that this type of healing might be favored by such treatments in comparison with flap surgery.
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Affiliation(s)
- N Donos
- Department of Periodontology, Royal Dental College, University of Aarhus, Denmark.
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