Background
Diabetes and periodontitis are chronic non‐communicable diseases independently associated with mortality and have a bidirectional relationship.
Aims
To update the evidence for their ...epidemiological and mechanistic associations and re‐examine the impact of effective periodontal therapy upon metabolic control (glycated haemoglobin, HbA1C).
Epidemiology
There is strong evidence that people with periodontitis have elevated risk for dysglycaemia and insulin resistance. Cohort studies among people with diabetes demonstrate significantly higher HbA1C levels in patients with periodontitis (versus periodontally healthy patients), but there are insufficient data among people with type 1 diabetes. Periodontitis is also associated with an increased risk of incident type 2 diabetes.
Mechanisms
Mechanistic links between periodontitis and diabetes involve elevations in interleukin (IL)‐1‐β, tumour necrosis factor‐α, IL‐6, receptor activator of nuclear factor‐kappa B ligand/osteoprotegerin ratio, oxidative stress and Toll‐like receptor (TLR) 2/4 expression.
Interventions
Periodontal therapy is safe and effective in people with diabetes, and it is associated with reductions in HbA1C of 0.27–0.48% after 3 months, although studies involving longer‐term follow‐up are inconclusive.
Conclusions
The European Federation of Periodontology (EFP) and the International Diabetes Federation (IDF) report consensus guidelines for physicians, oral healthcare professionals and patients to improve early diagnosis, prevention and comanagement of diabetes and periodontitis.
Diabetes and periodontitis are chronic non-communicable diseases independently associated with mortality and have a bidirectional relationship.
To update the evidence for their epidemiological and ...mechanistic associations and re-examine the impact of effective periodontal therapy upon metabolic control (glycated haemoglobin, HbA1C).
There is strong evidence that people with periodontitis have elevated risk for dysglycaemia and insulin resistance. Cohort studies among people with diabetes demonstrate significantly higher HbA1C levels in patients with periodontitis (versus periodontally healthy patients), but there are insufficient data among people with type 1 diabetes. Periodontitis is also associated with an increased risk of incident type 2 diabetes.
Mechanistic links between periodontitis and diabetes involve elevations in interleukin (IL)-1-β, tumour necrosis factor-α, IL-6, receptor activator of nuclear factor-kappa B ligand/osteoprotegerin ratio, oxidative stress and Toll-like receptor (TLR) 2/4 expression.
Periodontal therapy is safe and effective in people with diabetes, and it is associated with reductions in HbA1C of 0.27–0.48% after 3 months, although studies involving longer-term follow-up are inconclusive.
The European Federation of Periodontology (EFP) and the International Diabetes Federation (IDF) report consensus guidelines for physicians, oral healthcare professionals and patients to improve early diagnosis, prevention and comanagement of diabetes and periodontitis.
Periodontitis has been defined as the Sixth complication of Diabetes Mellitus. Since both diabetes mellitus and periodontitis have a high prevalence in the general population, the Italian Society of ...Diabetology, the Italian Society of Periodontology and Implantology and the Italian Association of Clinical Diabetologists revised the present scientific literature in the present consensus report.
A bi-directional interaction was demonstrated: Patients affected by type 1 and type 2 diabetes have a higher prevalence of periodontitis than the general population, due to several metabolic factors (e.g. chronic hyperglycemia, autoimmunity, dietary and life-style factors); similarly, periodontitis predisposes to type 2 diabetes mellitus mainly via the increase of systemic cytokines release. Conversely, improvement of metabolic control of diabetic patients delay the progression of periodontitis as well as periodontitis treatment reduces glycosylated hemoglobin levels in blood.
Due to the bi-directional causal interaction between periodontitis and diabetes mellitus, a strict collaboration among dentists and diabetologists is required and strongly recommended. The inter-societies consensus proposes specific flow-diagrams to improve the treatment of patients and management of the general population regarding the issue of periodontitis and diabetes.
•Periodontitis has been defined as the Sixth complication of Diabetes Mellitus.•A bi-directional interaction was demonstrated.•Patients affected by type 1 and type 2 diabetes have a higher prevalence of periodontitis than the general population.•Improvement of metabolic control of diabetic patients delay the progression of periodontitis as well as periodontitis treatment reduces glycosylated hemoglobin levels in blood.•The inter-societies consensus proposes specific guidelines outlined in flow-diagrams to better consul and treat patients and general population.
Diabetes and periodontitis are chronic non-communicable diseases independently associated with mortality and have a bi-directional relationship.
To update the evidence for their epidemiological and ...mechanistic associations and re-examine the impact of effective periodontal therapy upon metabolic control (glycated hemoglobin, HbA1C).
There is strong evidence that people with periodontitis have elevated risk for dysglycemia and insulin resistance. Cohort studies among people with diabetes demonstrate significantly higher HbA1C levels in periodontitis patients (vs. periodontally healthy), but there is insufficient data among people with type 1 diabetes. Periodontitis is also associated with an increased risk of incident type 2 diabetes.
Mechanistic links between periodontitis and diabetes involve elevations in interleukin (IL) 1-β, tumor necrosis factor-α, IL-6, receptor activator of nuclear factor-kappa B ligand/osteoprotegerin ratio, oxidative stress and toll-like receptor (TLR)2/4 expression.
periodontal therapy is safe and effective in people with diabetes and it is associated with reductions in HbA1C of 0.27-0.48% after 3-months, although studies involving longer-term follow up are inconclusive.
European Federation of Periodontology (EFP) and the International Diabetes Federation (IDF) report consensus guidelines for physicians, oral health care professionals and patients in order to improve early diagnosis, prevention and co-management of diabetes and periodontitis. This article is protected by copyright. All rights reserved.
The COVID-19 pandemic caused by SARS-CoV-2 has made the development of safe and effective vaccines a critical priority. To date, four vaccines have been approved by European and American authorities ...for preventing COVID-19, but the development of additional vaccine platforms with improved supply and logistics profiles remains a pressing need. Here we report the preclinical evaluation of a novel COVID-19 vaccine candidate based on the electroporation of engineered, synthetic cDNA encoding a viral antigen in the skeletal muscle. We constructed a set of prototype DNA vaccines expressing various forms of the SARS-CoV-2 spike (S) protein and assessed their immunogenicity in animal models. Among them, COVID-eVax—a DNA plasmid encoding a secreted monomeric form of SARS-CoV-2 S protein receptor-binding domain (RBD)—induced the most potent anti-SARS-CoV-2 neutralizing antibody responses (including against the current most common variants of concern) and a robust T cell response. Upon challenge with SARS-CoV-2, immunized K18-hACE2 transgenic mice showed reduced weight loss, improved pulmonary function, and lower viral replication in the lungs and brain. COVID-eVax conferred significant protection to ferrets upon SARS-CoV-2 challenge. In summary, this study identifies COVID-eVax as an ideal COVID-19 vaccine candidate suitable for clinical development. Accordingly, a combined phase I-II trial has recently started.
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We report the development, characterization, and preclinical evaluation of COVID-eVax, a novel COVID-19 vaccine candidate with improved supply and logistics profiles. The technology is based on the electroporation of engineered, synthetic cDNA encoding a secreted monomeric form of the receptor-binding domain of the SARS-CoV-2 spike protein.
Nowadays, finite element tyre models are often used to perform vehicle NVH (noise, vibration, harshness) simulations. To account for the specific operating conditions, a road surface must be properly ...included in the model. This paper deals with a methodology to experimentally evaluate and process road irregularity measurements, so as to generate a road surface input. These surfaces are used to simulate the tyre/road interaction at the footprint, which is modelled as a contact surface in finite element tyre models. For this reason, a linear profile of the road surface is not suitable for these simulations and the whole surface must be considered. Starting from the measurements taken through a test equipment specifically designed to carry laser sensors and scan road profiles, the Power Spectral Density (PSD) of a specific track is estimated and then interpolated considering piecewise functions. Finally, a model to generate a road surface starting from the measured PSD is developed, discussed and validated.
Demand for innovation represents a driver not only in the industrial field but also in niche markets such as orthodontics. Among different type of orthodontic devices, functional appliances are used ...for the correction of class II skeletal malocclusion, mostly in young patients. In a previous study based on a systematic design approach, several concepts were generated for this device. This work shortly introduces the concept selection and the interactive design process of the device. The concept consisting of two-side guiding surfaces, obtained by TRIZ inventive principles, has been selected by the decision matrix. This concept consists in guiding the jaw movements without any connections between the parts of the device. Operating on patient morphometrics parameters, the proposed approach allows to establish a virtual interaction during the design of the device by facilitating the collaboration between orthodontist, dental technician, designer and the software, through a dedicated user interface. Dedicated algorithms were also developed to simulate the occlusion correction and the mandible path, and to support the geometric modelling in a virtual environment. As a result, the proposed approach allows manufacturing patient-customized devices using a digital interactive workflow in an innovative way.
Primary hyperparathyroidism is a common endocrinopathy which is nowadays diagnosed incidentally. Calcium levels range from "normal" to extremely high which can be life-threatening. We report the case ...of a female patient who was admitted to hospital for unspecific symptoms ultimately referable to severe hypercalcemia secondary to a large parathyroid tumor. After an intensive medical treatment (hydration, diuretics, steroids, bisphosphonate) leading to reduction of calcium levels, the patient underwent surgery with exeresis of the parathyroid mass proved an adenoma and normalization of calcium levels; nevertheless a few days after discharge symptomatic hypocalcemia occurred and was successfully managed by means of calcium and vitamin D therapy which is still required three months after surgery.
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