Influence of keratinized mucosa on peri-implant diseases: a retrospective cohort study in humans

OBJECTIVE

The present study aimed to assess the relationship between keratinized mucosa width and peri-implant diseases, namely peri-implant mucositis and peri-implantitis.

MATERIALS AND METHODS

Ninety-one dental implants in function for ≥ 6 months from 40 partially or completely edentulous non-smoker subjects (24 females and 16 males) were evaluated clinically and radiographically. The width of keratinized mucosa, probing depth, plaque index, bleeding on probing, and marginal bone levels were assessed. Keratinized mucosa width was categorized as ≥ 2 mm or < 2 mm.

RESULTS

There was no statistically significant association between keratinized buccal mucosa width and peri-implant mucositis or peri-implantitis (p ≥ 0.37). In the regression analysis, peri-implantitis was associated with longer implant function time (RR: 2.55, 95% CI: 1.25-11.81, p = 0.02) and implants in the maxilla (RR: 3.15, 95% CI: 1.61-14.93, p = 0.003). Mucositis was not associated with any of the factors analyzed.

CONCLUSION

In conclusion, in the present sample, keratinized buccal mucosa width was not associated with peri-implant diseases, suggesting that a band of keratinized mucosa may not be necessary to maintain peri-implant health. Prospective studies are required to better understand its role in the maintenance of peri-implant health.

Photodynamic therapy as adjunctive treatment of single-rooted teeth in patients with grade C periodontitis: A randomized controlled clinical trial

BACKGROUND

The present study aimed to evaluate the adjunctive effect of an antimicrobial photodynamic therapy (aPDT) protocol on single-rooted teeth of patients with grade C periodontitis.

METHODS

Sixty-four single-rooted teeth (14 patients) were included in each group of this double-blinded split-mouth randomized clinical trial. The teeth were randomly divided into scaling and root planing + aPDT (test group) and scaling and root planing+sham aPDT (control group). The aPDT protocol consisted of incubation with 1% methylene blue for 5 min, rinsing, and application of a diode laser (wavelength of 660 nm, power of 100 mW) for 10 s. aPDT was repeated after 7 days. Bleeding on probing (BoP), probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) were recorded before and 3 months after treatment. A 5% significance level was adopted for statistical analysis.

RESULTS

Final PD was significantly (P = 0.02) lower in the test group (2.87 ± 1.40 mm) compared to control (3.12 ± 1.69 mm). The test group showed a significantly higher percentage of sites with PD≤4 mm and concomitant BoP compared to control (91%x86%;P < 0.001). At sites with baseline PD>4 mm, final PD and CAL were significantly (P = 0.01) lower in the test group (4.11 ± 1.66 and 4.89 ± 2.49 mm, respectively) compared to control (4.88 ± 1.99 and 5.89 ± 2.74 mm, respectively).

CONCLUSIONS

aPDT combined with scaling and root planning provided slightly better periodontal clinical results than the latter procedure alone, exerting a superior effect at sites with greater baseline PD. aPDT might be used as adjunctive treatment in grade C periodontitis affecting single-rooted teeth since it improves the response to conventional periodontal treatment.

Impact of serum vitamin D levels on periodontal healing outcomes: a preliminary cohort study

OBJECTIVE

To evaluated the relationship between serum vitamin D levels and periodontal healing outcomes in patients with mild or moderate periodontitis.

METHODS

Serum vitamin D levels and periodontal pockets and gingival bleeding were evaluated in 51 patients before and six months after non-surgical periodontal treatment. A t-test and chi-square test were used to analyze the data (p ≤ 0.05).

RESULTS

The mean reduction of periodontal pocket depth was statistically significant higher in patients with vitamin D ≥ 30 ng/mL compared to those with < 30 ng/mL (CI= -0.23 - 0.42, p= 0.05), but not clinically significant. Vitamin D level was not associated with the percentage of sites gingival bleeding on probing at the final evaluation (OR= 0.58, 95% CI= 0.17-1.99, p= 0.39).

CONCLUSION

Lower serum vitamin D level was associated with a slightly reduced periodontal healing after non-surgical periodontal therapy, which should be further investigated in a larger population.

Oral manifestations of multisystemic inflammatory syndrome in children (MIS-C) and Kawasaki disease associated to COVID-19: A systematic review

Aims

Multisystemic inflammatory syndrome in children (MIS‐C) is a condition noted in some children asymptomatic but positive to Sars‐cov‐2 antibody and it presents clinical and laboratory changes similar to Kawasaki disease (KD). Oral changes have also been observed. This systematic review evaluated oral manifestations detected in children with MIS‐C and KD associated to COVID‐19.

Methods and Results

This work was registered at PROSPERO (#CRD42020225909), following PRISMA guidelines. A comprehensive research was conducted in MEDLINE, Web of Science, EMBASE, LILACS, Scopus, and Grey Literature through August 2021, based on original research evaluating children diagnosed with MIS‐C or KD related to COVID‐19. Two authors independently screened all retrieved references. Twenty five selected studies evaluated 624 children, mean age 8.78 years. The assessment of the risk of bias (ROB) showed that most of them presented low ROB. Oral manifestations were erythematous mucous membrane, oral ulcers lesions, dry, swollen and cracked lips, and strawberry tongue.

Conclusion

MIS‐C and KD share the same oral manifestations and their identification may lead to an early diagnosis.

[Recommendation of tooth extraction and associated factors: cross-sectional study in the Kiriri indigenous population]

The scope of this cross-sectional study was to evaluate the prevalence and the associated factors of the recommendation of dental extraction in the adult Kiriri Indigenous population of northeastern Brazil. A total of 225 natives (≥19 years) were evaluated. The extraction criteria were teeth with clinical attachment loss ≥50% in at least 3 sites, and residual roots. Statistical models were used to evaluate associations between the need for dental extraction and selected variables. The percentage of teeth recommended for dental extraction was 4.98%, characterizing a mean of 1.24 tooth per individual. A regression analysis showed that age ≥35 years (OR=2.24, 95%CI: 1.13-4.43, p=0.02), income <R$ 570.00 (OR=3.34, 95%CI: 1.19-9.37, p=0.02) and plaque index ≥40% (OR=2.38, 95%CI: 1.24-4.56, p=0,01) were significantly associated with indication for dental extraction. A prevalence of 33% of subjects with dental extraction recommendation were associated with age older than 35 years, plaque index ≥40% and income less than a minimum wage were related with the recommendation for extraction. This study reflects the importance of prioritizing oral health prevention, as well as the need to expand complex dental services.

Association between occupational exposure to domestic solid waste and dental caries: a cross-sectional study

Studies have shown that domestic waste collectors are exposed to toxicants including infectious pathogens, which may be linked to their oral health conditions. This cross-sectional study evaluated the dental caries and its associated factors among domestic waste collectors. A total of 301 adult men who worked for a waste collection corporation were included; 171 men worked in direct contact with domestic solid waste and 130 did not. Sociodemographic data, working, and medical history were assessed. The decayed, missing, and filled permanent teeth (DMFT) index was examined. Logistic regression analysis was used to identify factors associated with dental status with a significance level of 5%. The overall mean DMFT score was 8.36±5.64. The mean DMFT, missing teeth (MT), and filled teeth (FT) were significantly higher in workers who did not have any direct contact with waste (p≤0.04). In the logistic analysis, DMFT ≥8 was only associated with older age (OR=8.41 [95% confidence interval (95%CI), 5.01-14.12], p<0.001). Decayed teeth (DT) ≥2 was associated with no previous oral hygiene instruction (OR=2.70 [1.50-4.81], p=0.001) and no daily dental flossing (OR=4.26 [1.92-9.43], p<0.001). MT ≥9 was associated with lower education level (OR=3.33 [1.57-7.10], p= 0.002). FT≥3 had a negative association with low income (OR= 0.42 [0.25-0.70], p<0.001) and no daily flossing (OR=0.42 [0.23-0.76], p=0.004). In conclusion, occupational exposure to domestic solid waste was not associated with poor dental status. Instead, age, education, income level, and oral hygiene were associated with dental health status. Missing teeth constituted the major component of the DMFT index. Therefore, prevention and oral rehabilitation programs are necessary to improve dental health.

Evaluation of alveolar process resorption after tooth extraction using the socket shield technique without immediate installation of implants: a randomised controlled clinical trial

Our aim was to evaluate resorption of the alveolar ridge using the socket shield technique (SST) without immediate placement of dental implants. This randomised controlled clinical trial included 27 patients: 14 maxillary non-molar teeth were partially extracted using the SST (test group) and 13 were extracted using a minimally traumatic extraction approach (control group). Alterations in height and thickness of the alveolar ridge were evaluated by cone beam computed tomograms taken immediately after, and 100 days after, surgery. Minor resorption was observed in the height of the buccal and palatal plates, without intergroup difference (p ≥ 0.10). The test group showed significantly better preservation of the buccal-to-palatal crest dimension (p ≤ 0.05). In the control group, preservation of buccal plate thickness was significantly greater (p ≤ 0.05), but intragroup vertical resorption of the buccal plate and reduction in the buccal-to-palatal crest distance were greater (p ≤ 0.05). The SST without the immediate placement of implants showed greater preservation of the buccal-to-palatal crest dimension and lower preservation of buccal wall thickness compared with minimally traumatic extraction. In addition, it provided superior maintenance of the baseline buccal wall height. The modified SST is a promising approach, but factors that interfere with the results should be investigated.

Salivary flow rates and buffer capacity and its relationship with oral health status: a cross-sectional study on crack-cocaine-addicted males

This cross-sectional study evaluated the saliva profile in crack-cocaine-addicted males and its relationship with dental caries, periodontal disease, and oral mucosal lesion (OML) using 148 adult male volunteers (37 addicted; 111 non-addicted) at the School of Dentistry, Federal University of Bahia. Data on decayed, missing and filled teeth (DMFT), periodontal disease and OML were collected from the clinical examination of the participants. Samples were analysed for the salivary flow rate (SFR) of unstimulated and wax-stimulated whole saliva and the saliva buffer capacity. Bivariate and regression analyses were conducted to assess the salivary profile and its association with the oral status of addicted participants (α = 0.05). The mean buffer capacity of stimulated saliva was significantly lower in the addicted participants (pH 5.2 ± 1.7) than in the non-addicted group (pH 5.8 ± 1.3, p = 0.03). In the addicted group, OML was associated with a stimulated SFR < 1.0 mL/min (OR = 11.98, 95% CI = 1.30-27.10, p = 0.04). The DMFT index and periodontal disease were not associated with the salivary profile, but with older age (OR = 7.20, 95% CI = 1.51-31.14, p = 0.01) and lower education levels (OR = 24.00, 95% CI = 1.68-341.00, p = 0.02), respectively. In conclusion, addiction was associated with the lower buffer capacity of stimulated saliva, and OML was associated with lower-stimulated salivary flow rate. Periodontal disease or DMFT was not associated with salivary factors in addicted males. Therapy approaches dealing with saliva status may be important for use with addicted males to reduce OMLs.

Association between oral mucosal lesions and crack and cocaine addiction in men: a cross-sectional study

The aim of this cross-sectional study was to evaluate the prevalence of oral mucosal lesions (OMLs) and their association with crack/cocaine addiction in men. Clinical oral examination was performed in 161 adult male patients at the School of Dentistry of the Federal University of Bahia, Brazil. Crack/cocaine addiction was determined from the medical records, and all drug-addicted individuals used both crack and cocaine. All participants (40 crack/cocaine-addicted men and 121 non-addicted men) underwent a systematic evaluation of the lips, labial mucosa, commissures, buccal mucosa and sulcus, gingiva and alveolar ridge, tongue, floor of the mouth, and soft and hard palate by a single examiner. Bivariate and regression analyses were conducted to assess for the presence of OMLs and the association of OMLs with crack/cocaine addiction. OMLs were found in 22 participants with a significantly greater prevalence in the crack/cocaine-addicted group (25 vs. 9.9%; p = 0.01). The most prevalent types of lesions in the addicted group were traumatic ulcer and actinic cheilitis (7.5% for each) followed by fistulae associated with a retained dental root (5%). After adjusting for covariates, crack/cocaine addiction was significantly associated with OMLs (OR = 2.87; 95% CI = 1.08-7.67; p = 0.03). The prevalence of OMLs was higher in crack/cocaine-addicted individuals, and crack/cocaine addiction was significantly associated with OMLs. A public health program aimed at the early diagnosis and treatment of OMLs is vital to improving the oral health status of individuals addicted to crack/cocaine.

Survival of all-ceramic restorations after a minimum follow-up of five years: A systematic review

OBJECTIVE

The purpose of this systematic review was to compare the survival and complication rates of all-ceramic restorations after a minimum follow-up time of 5 years.

DATA SOURCES

A comprehensive search of studies published from 2005 to November 2015 and listed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the PRISMA statement. Two reviewers independently analyzed the abstracts. Relevant studies were selected according to predetermined inclusion criteria.

RESULTS

Twenty-nine studies were selected for the final analysis from an initial yield of 514. Only four studies fulfilled the requirement of having a randomized design, and 25 studies were prospective with a mean follow-up period of 5 to 16 years. Overall, the 5-year complication rates were low. The most frequent complications were secondary caries, endodontic problems, ceramic fractures, ceramic chipping, and loss of retention.

CONCLUSION

This systematic review showed that all-ceramic restorations fabricated using the correct clinical protocol have an adequate clinical survival for at least 5 years of clinical service with very low complication rates. Minor ceramic chipping and debonding did not affect the longevity of the restorations.

CLINICAL RELEVANCE

Long-term clinical performance of all-ceramic restorations manufactured using various ceramic systems provides clinical evidence of complications and long-term management of these restorations. Available evidence indicates the effectiveness of many ceramic systems for numerous clinical applications. Correct planning and a rigorous technical execution protocol increase clinical success. Studies of ceramic prostheses indicate more problems with ceramic failure and debonding.

Altered vascular permeability in the dental pulp of traumatised rat teeth

A study was made of the vascular permeability changes occurring in the dental pulp of rat teeth subjected to trauma of the occlusal surface with a special steel burr. The vascular response was measured by leakage of 131I-labelled human serum albumin and of colloidal carbon. The effect of a variety of inhibitors of increased vascular permeability was observed. The results obtained support the hypothesis that in the model studied the vascular response of the dental pulp is mediated by the sequential release of histamine and 5-HT, kinins and prostaglandins.