Aim
To evaluate the inter‐examiner reliability in classifying periodontitis using the 2018 classification of periodontal diseases, when used by postgraduate students, academics, and specialist ...clinicians trained in European Federation of Periodontology (EFP) and American Academy of Periodontology (AAP) postgraduate‐accredited programmes.
Materials and Methods
An online survey including five patients with periodontitis was sent twice to seven specialists in periodontology to provide the staging and grading characteristics. After agreeing on a “gold‐standard” classification, the same questionnaire was sent to 16 EFP and 73 AAP postgraduate programmes, to be answered by their faculty, graduates, and students. The responses were compared with the gold‐standard classification, and the inter‐examiner agreement was calculated.
Results
One‐hundred and seventy‐four participants completed the survey. The inter‐examiner agreement resulted in 68.7% in assigning the stage, 82.4% in assigning the grade, and 75.5% in assigning the extent. The academic position and the experience of the participants did not have any significant influence on classifying periodontitis as the gold standard.
Conclusions
The use of the 2018 periodontitis classification resulted in high inter‐examiner reliability when used by a specialist group of clinicians, postgraduate students, and academicians, irrespective of their current position and experience. Given the low response rate and potential selection bias, results pertaining to the use of this system in classifying periodontitis should be interpreted with caution.
Objectives
The first focused question (FQ1) was: What is the efficacy of connective tissue graft (CTG), as compared to the absence of soft tissue grafting procedure, in terms of gain in peri‐implant ...soft tissue thickness (STT) reported by randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs)? The second focused question (FQ2) was: What is the efficacy of CTG, as compared to soft tissue substitutes, in terms of gain in peri‐implant STT reported by RCTs or CCTs?
Materials and methods
A manual and electronic search was performed for each question to identify RCTs and CCTs published up to July 2020. The primary outcome variable was changes in peri‐implant STT and secondary outcomes were marginal bone level (MBL), clinical parameters for the diagnosis of peri‐implant health, changes in the position of peri‐implant soft tissues, esthetic outcomes, and patient‐related outcome measures (PROMs). For primary and secondary outcomes, data reporting mean values and standard deviations for each study were extracted. Weighted mean differences (WMDs) or standardized mean differences as well as 95% confidence intervals (CIs) and prediction intervals (PIs) were calculated.
Results
Eight trials were included to answer the first focused question and eight to answer the second one, providing data for 254 and 192 patients, respectively. For the first focused question, a statistically significant difference of 0.64 mm in STT was found in favor of the grafted group (n = 8; 95% CI 0.16; 1.13; 95% PI −1.06; 2.35; p = .01). Moreover, sites treated with CTG exhibited statistically significant less recession than implants without a graft (n = 4; WMD = 0.50 mm; 95% CI 0.19; 0.80; 95% PI −0.70; 1.69; p < .001). For the second focused question, the meta‐analysis showed a statistically significant gain of STT in the CTG group when compared to soft tissue substitutes (n = 8; WMD = 0.51 mm; 95% CI 0.28; 0.75; 95% PI −0.09; 1.12; p < .001). Furthermore, the use of CTG resulted in significantly higher pink esthetic score values (n = 3; WMD = 1.02; 95% CI 0.29; 1.74; 95% PI −3.67; 5.70; p = .01) and less recession (n = 2; WMD = 0.50 mm; 95% CI 0.10; 0.89; 95% PI not estimable; p = .014) when compared to soft tissue substitutes. No statistically significant differences between groups were observed for any of the following secondary variables: MBL, clinical parameters for the diagnosis of peri‐implant health, position of the interproximal tissues, keratinized mucosa or PROMS (p > 0.05), except for medication intake, which was significantly higher when using CTG as compared to soft tissue substitutes (n = 2; WMD = 1.68; 95% CI 1.30; 2.07; 95% PI not estimable; p < .001).
Conclusions
Soft tissue augmentation procedures are efficacious on soft tissue thickening and, in particular, CTG demonstrated a significant STT gain when compared to no graft or soft tissue substitutes.
Objectives
To evaluate early and late implant loss rates in a sample of patients who had received implant therapy in a university setting as well as patient‐ and implant‐related variables for implant ...failure.
Material and methods
This is a retrospective analysis in a cohort of patients who were treated with implant‐supported restorative therapy during the period 2001–2012. Patients were randomly selected from an electronic database and scheduled for an appointment to record subject and implant characteristics. The primary study outcome was implant loss (i.e., early and late implant failure).
Results
A total of 190 patients and 710 implants were included. The mean time in function was 8.2 (SD 2.4) years. Four implants (0.6%) failed in four patients (2.1%) prior to connection of the restoration within a mean period of 1.5 (SD 1.3) months after surgical procedure. Moreover, 17 subjects (8.9%) exhibited late implant failure, representing 26 implants (3.7%), after a mean follow‐up of 5 years (SD 2.2) from prosthesis connection. The final multivariable model indicated three factors related to late implant failure: subjects <55 years (OR = 3.62; 95% CI 1.46–10.22; p = .002), smokers/former smokers (OR = 6.25; 95% CI 1.70–17.52; p = .005), and implants with no access to interproximal hygiene (OR = 7.25; 95% CI 2.20–28.25; p < .001).
Conclusions
The rate for early and late implant failure in a sample of 190 patients who had received implant therapy in a university setting was 2.1% and 8.9%, respectively, at subject level. Subjects <55 years and smokers/former smokers as well as implants with inadequate access to interproximal hygiene were significantly associated with late implant failure.
Objective
To compare clinical efficacy, chairside time and post‐treatment hypersensitivity of four instruments used for subgingival periodontal debridement.
Materials & Methods
Seventeen patients ...with stage II and III periodontitis were enrolled in this randomized clinical trial using a split‐mouth design. Quadrants were randomly divided into four treatment groups: Group A: Gracey curettes‐Hu‐Friedy®; Group B: piezoelectric ultrasonic (Satelec®) with No.1S insert; Group C: diamond burs 40 µm (Intensiv Perioset®); and Group D: piezosurgery ultrasonic (Mectron®) with PP1 insert. Clinical outcomes, chairside time and hypersensitivity were assessed at 1, 2, 4 and 8 weeks after treatment. The primary outcome variable was improvement in clinical attachment level.
Results
At 8 weeks post‐treatment, Gracey curettes, piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) were statistically more effective than diamond burs in increasing attachment level and reducing probing pocket depth. Comparison of piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) with the other instruments showed a statistical difference (p < 0.001) in chairside time. Regarding post‐treatment hypersensitivity, no statistical differences were observed in any of the groups.
Conclusions
Gracey curettes, piezoelectric ultrasonic (Satelec®) and piezosurgery ultrasonic (Mectron®) were clinically more effective than diamond burs 40 µm. The ultrasonic instruments showed a significant reduction in chairside time.
Objectives
To assess the clinical and radiographic outcomes of the regenerative treatment of peri-implantitis using a vancomycin and tobramycin impregnated allograft (VTA) after a 12-month period.
...Material and methods
Thirteen consecutive patients who required a regenerative treatment of peri-implantitis were recruited. For the 17 implant sites, a flap was raised, and after mechanical and chemical implant decontamination, a vancomycin and tobramycin impregnated allograft was placed in the defect and then covered with a collagen membrane. Soft tissues were sutured allowing a non-submerged healing. Clinical and radiographic variables were evaluated at baseline and at 12 months after treatment.
Results
No signs of continuous bone loss were observed and no implant was lost, yielding a 100% survival rate. All patient’s clinical examination at 12 months revealed peri-implant health showing absence of suppuration and a statistically significant reduction in terms of bleeding on probing scores (70.6%,
P
= 0.001). Initial probing pocket depth (7.88 ± 1.22 mm) was significantly reduced at 12 months healing, a mean reduction of 4.23 ± 1.47 mm (
P
= 0.001) was achieved. The mean radiological infrabony defect at baseline reached 4.33 ± 1.62 mm, and was significantly reduced up to 0.56 ± 0.88 mm, which represents an 86.99 ± 18.2% bone fill from the original infrabony defect.
Conclusions
Within the limits of the study, the application of VTA with a collagen membrane yielded positive outcomes in terms of radiographic bone fill, pocket depth reduction, and attachment gain after a 12-month period. Thus, VTA plus a collagen membrane seem to be suitable for the regenerative treatment of peri-implantitis.
Clinical relevance
The use of locally delivered antibiotic together with the bone graft may reduce the undesirable effects related to the systemic administration and the risk of resistances. In the light of the results obtained, these grafting materials might offer new treatment strategies in the surgical regenerative treatment of peri-implantitis.
Background
To explore the diagnostic usefulness of extracellular vesicles (EVs), and their subpopulations (micro‐vesicles and exosomes), and microRNAs (miRNA‐21‐3p, miRNA‐150‐5p, and miRNA‐26a‐5p) in ...peri‐implant crevicular fluid (PICF) of subjects with healthy, peri‐implant mucositis and peri‐implantitis implants.
Methods
A total of 54 patients were enrolled into healthy, peri‐implant mucositis, and peri‐implantitis groups. PICF samples were collected, EVs subpopulations (MVs and Exo) were isolated and characterized by nanoparticle tracking analysis and transmission electron microscopy. The expression of miRNA‐21‐3p, miRNA‐150‐5p and miRNA‐26a‐5p was quantified by qRT‐PCR. Logistic regression models and accuracy performance tests were estimated.
Results
PICF samples show the presence of EVs delimited by a bi‐layered membrane, in accordance with the morphology and size (< 200 nm). The concentration of PICF‐EVs, micro‐vesicles and exosomes was significantly increased in peri‐implantitis implants compared to healthy implants (P = 0.023, P = 0.002, P = 0.036, respectively). miRNA‐21‐3p and miRNA‐150‐5p expression were significantly downregulated in patients with peri‐implantitis in comparison with peri‐implant mucositis sites (P = 0.011, P = 0.020, respectively). The reduced expression of miRNA‐21‐3p and miRNA‐150‐5p was associated with peri‐implantitis diagnosis (OR:0.23, CI 0.08‐0.66, P = 0.007 and OR:0.07, CI 0.01‐0.78, P = 0.031, respectively). The model which included the miRNA‐21‐3p and miRNA‐150‐5p expression had a sensitivity of 93.3%, a specificity of 76.5%, a positive predictive value of 77.8%, and a negative predictive value of 92.9%. The positive and negative likelihood ratios were 3.97 and 0.09, respectively. The area under the receiver operating characteristics curve for the model was 0.84.
Conclusions
An increase concentration of EVs with a downregulation expression of miRNA‐21‐3p and miRNA‐150‐5p could be related with the peri‐implantitis development.
Este artículo, de reporte de caso, busca una reflexión en el plano abstracto y concreto sobre la situación de las lenguas indígenas en el Caribe colombiano. El contexto rural y el urbano han ...presentado diferentes condiciones para el uso de las lenguas indígenas, en el urbano el trabajo formal e informal ha llevado al uso de otras lenguas y en el rural la presencia de grupos armados ha imposibilitado, en algunos casos, el uso de estas lenguas como formas de control. Desde estas dos situaciones se trata de mostrar que la política del bilingüismo como forma de superar las brechas económicas, sociales y culturales en el Caribe colombiano, no ha sido efectiva y se ha validado el uso del español en algunos pueblos indígenas. De esta manera, el adelanto investigativo que acá se presenta tiene como objetivo analizar la situación del uso de las lenguas indígenas en el contexto rural y urbano de los pueblos Ette Ennaka, Kankuamo, Arhuaco, Kogui, Wayú.
Aim
To evaluate the efficacy of professionally administered chemical agents as an adjunctive treatment to sub‐marginal instrumentation (SMI) in the therapy of peri‐implant mucositis.
Materials and ...Methods
The primary outcome criteria were reduction in bleeding on probing (BOP), whereas resolution of disease, elimination of suppuration, including suppuration on probing, reduction of peri‐implant probing pocket depth, reduction of plaque, and patient‐reported outcome measures were considered as secondary outcome parameters. A literature search was performed on three electronic databases (01/1980 to 05/2022) focused on clinical studies with at least 3 months of follow‐up, and meta‐analyses were performed when appropriate.
Results
From a total of 139 publications, 40 articles were identified for full‐text reading, and 5 randomized controlled clinical trials (RCTs) on antimicrobial photodynamic therapy (aPDT), 1 RCT on chlorhexidine (CHX), and 1 RCT on sodium hypochlorite (NaOCl) were included. Three studies had a low risk of bias and four had a mid‐level (some concerns) risk of bias. The application of aPDT, 0.95% NaOCl, or 0.12% CHX as an adjunctive treatment to SMI showed no difference in changes in BOP and PD compared with SMI alone (p > .05).
Conclusions
Within the limitations of this review and based on a low level of evidence from seven RCTs, it is concluded that the professional adjunctive topical application of aPDT, 0.95% NaOCl, and 0.12% CHX may not be effective to improve changes for BOP and PD when compared with SMI alone.
Ischemic stroke is a leading cause of death and disability worldwide. A serious risk of acute ischemic stroke (AIS) arises after the stroke event, due to inflammation and edema formation. ...Inflammation and edema in the brain are mediated by bradykinin, the formation of which is dependent upon a multi-ligand receptor protein called gC1qR. There are currently no preventive treatments for the secondary damage of AIS produced by inflammation and edema. This review aims to summarize recent research regarding the role of gC1qR in bradykinin formation, its role in inflammation and edema following ischemic injury, and potential therapeutic approaches to preventing post-stroke inflammation and edema formation.
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