Aim
To explore the implications for dentists and family doctors of the association between periodontal and systemic diseases and the role of dentists and family doctors in managing non‐communicable ...diseases (NCDs) and promoting healthy lifestyles.
Materials and Methods
The consensus reports of the previous Focused Workshops on the associations between periodontitis and diabetes (2017) and periodontitis and cardiovascular diseases (2019) formed the technical reviews to underpin discussions on both topics. For the association with respiratory diseases, a systematic review was specifically commissioned for the Workshop discussions. Working groups prepared proposals independently, and then the proposals were discussed and approved at plenary meetings.
Results
Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea and COVID‐19 complications. Dentists and family doctors should collaborate in managing NCDs, implementing strategies for early detection of periodontitis in primary care centres and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals (OHPs) should be informed about the relevance of NCDs and the associated risk factors.
Conclusions
Closer collaboration between OHPs and family doctors is important in the early detection and management of NCDs and in promoting healthy lifestyles. Pathways for early case detection of periodontitis in family medicine practices and of NCDs in dental practices should be developed and evaluated.
Objective
To investigate the functional changes of PDL fibroblasts in the presence of mechanical force, inflammation, or a combination of force and inflammation.
Materials and methods
Inflammatory ...supernatants were prepared by inoculating human neutrophils with
Porphyromonas gingivalis
. Primary human PDL fibroblasts (PDLF), gingival fibroblasts (GFs), and osteoblasts (Saos2) were then exposed to the inflammatory supernatants. Orthodontic force on the PDLFs was simulated by centrifugation. Analyses included cell proliferation, cell viability, cell cycle, and collagen expression, as well as osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-Β ligand (RANKL) expression.
Results
Mechanical force did not affect PDLF viability, but it increased the metabolic rate compared to resting cells. Force application shifted the PDLF cell cycle to the G0/G1 phase, arresting cell proliferation and leading to elevated collagen production, mild OPG level elevation, and robust RANKL level elevation. Including an inflammatory supernatant in the presence of force did not affect PDLF viability, proliferation, or cytokine expression. By contrast, the inflammatory supernatant increased RANKL expression in GFs, but not in Saos2 cells.
Conclusion
Applying mechanical force significantly affects PDLF function. Although inflammation had no effect on PDLF or Saos2 cells, it promoted RANKL expression in GF cells. Within the limitations of the in vitro model, the results suggest that periodontal inflammation and mechanical forces could affect bone catabolism through effects on different cell types, which may culminate in synergistic bone resorption.
In the present pilot, multicenter, randomized, single-blinded, controlled study, surgical treatment with or without the administration of D-PLEX500 (a biodegradable prolonged release local ...doxycycline formulated with β-tricalcium phosphate bone graft) was accessed for the treatment of peri-implantitis.
Subjects undergoing surgical treatment for intrabony peri-implantitis defects after flap elevation were randomly assigned, to adjunct D-PLEX500 placement group or to control group. Clinical and radiographic parameters were measured at 6 and 12 months.
Twenty-seven subjects (average age: 64.81 ± 7.61 years) were enrolled; 14 patients (18 implants) were randomized to the test group and 13 (14 implants) to the control group. There was no difference in plaque scores between the groups. There was no difference in the changes of mean periodontal probing depth between the test and control groups between baseline and the 6-month follow-up, whereas statistically significant difference was observed after 12 months' follow-up when analyzed for all sites averaged. There was a statistically significant difference in the changes of clinical attachment levels and radiographic bone levels between the groups between baseline and 12 months. These improvements were demonstrated when analyzed at both implant and subject levels. Only D-PLEX500 treatment led to improved bone levels at both time points. The improvement in bone levels was significant in the D-PLEX500 treatment group already after 6 months, and further improved over the 12-month follow-up. Implants were lost only in the control group (14%).
D-PLEX500 sustained release local antibiotic formulated with bone filler showed promising results in enabling healing of peri-implantitis lesions. The antibacterial component of the bone graft material might create favorable conditions that enable implant surface decontamination and soft and hard tissue healing over a prolonged period.
Objectives: An intra‐individual controlled clinical trial was conducted to evaluate and compare the amount of marginal bone loss (MBL) found around implants of a comparable design, with or without ...retention grooves (microthreads) or polished necks, during the early stages of healing.
Materials and methods: Forty‐eight (48) patients with missing mandibular posterior teeth were treated with two commercially available implants of the same brand (MIS): one with microthreads (S‐model) and the other with a polished neck (L‐model). MBL around each implant was measured on follow‐up radiograms taken 4 months after placement (exposure and crown cementation), and 6 and 12 months after loading.
Results: Forty‐six (46) patients completed the study, making 46 implant pairs available for statistical analysis. None of the implants failed to integrate. All the implants displayed some extent of bone loss throughout the follow‐up period. At each time point (exposure, 6 and 12 months after loading), the S‐model implants displayed statistically significant lower amounts of bone loss (0.22 vs. 0.76, 0.57 vs. 1.22 and 0.9 vs. 1.5 mm, respectively). Other than the type of the implant, no correlation was found between MBL and the implant stability values (PerioTest), dimensions, site of insertion or any of the other collected variables.
Conclusions: Implants with a roughened neck surface and microthreads are more resistant to MBL during the first phases of healing, as compared with implants with a polished neck.
Background
The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I–IV periodontitis provided evidence‐based recommendations for treating periodontitis patients, ...defined according to the 2018 classification. Peri‐implant diseases were also re‐defined in the 2018 classification. It is well established that both peri‐implant mucositis and peri‐implantitis are highly prevalent. In addition, peri‐implantitis is particularly challenging to manage and is accompanied by significant morbidity.
Aim
To develop an S3 level CPG for the prevention and treatment of peri‐implant diseases, focusing on the implementation of interdisciplinary approaches required to prevent the development of peri‐implant diseases or their recurrence, and to treat/rehabilitate patients with dental implants following the development of peri‐implant diseases.
Materials and Methods
This S3 level CPG was developed by the European Federation of Periodontology, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations, and a structured consensus process involving leading experts and a broad base of stakeholders.
Results
The S3 level CPG for the prevention and treatment of peri‐implant diseases culminated in the recommendation for implementation of various different interventions before, during and after implant placement/loading. Prevention of peri‐implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded. Once the implants are loaded and in function, a supportive peri‐implant care programme should be structured, including periodical assessment of peri‐implant tissue health. If peri‐implant mucositis or peri‐implantitis are detected, appropriate treatments for their management must be rendered.
Conclusion
The present S3 level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to maintain healthy peri‐implant tissues, and to manage peri‐implant diseases, according to the available evidence at the time of publication.
There is little knowledge about healing patterns for the socket with an intentionally retained root fragment: a socket shield. The clinical observation is soft tissue ingrowth next to the socket ...shield. The aim of this study was to evaluate the effectiveness of autologous grafting matrices in preventing soft tissue ingrowth.
Patient data from a private clinic were searched for sockets with a socket shield left to heal with blood clot or grafted with autologous materials: autologous platelet-rich fibrin (PRF), scraped particulate bone, cortical tuberosity bone plate, or particulate dentin and covered with PRF membranes. The included sites were exposed by the flap 4 months after the first surgery, and soft tissue ingrowth depth and width next to the root fragment were measured by a scaled probe and documented.
Evaluation of 34 sites showed the greatest depth of soft tissue ingrowth in the nongrafted sockets (6.0 ± 0.0 mm). Grafting with PRF plugs (depth of 2.3 ± 0.2 mm) or particulate bone (depth of 2.7 ± 0.6 mm) decreased soft tissue ingrowth. Grafting with particulate dentin or cortical tuberosity bone plate resulted in a soft tissue ingrowth depth of only 1 mm, yielding the best clinical outcome. Radiography confirmed those findings.
Autologous dentin particulate or tuberosity cortical bone plate is most effective for preventing soft tissue ingrowth.
To retrospectively evaluate the clinical outcomes of subgingival debridement (e.g. scaling and root planing, SRP) and application of either a chlorhexidine chip (PerioChip, PC) or Arestin (AR) ...minocycline microspheres in patients with chronic periodontitis during supportive periodontal treatment (SPT).
Patients diagnosed with moderate to severe chronic periodontitis who were treated with SRP and a slow-release device during SPT were evaluated (total n = 53; n = 37 received PC, n = 16 received AR). Clinical measurements at baseline, 3, 6 and 12 months included changes in probing pocket depth (PD), bleeding on probing (BOP) and clinical attachment level (CAL).
Both treatments led to a reduction in PD and gain of CAL. AR showed higher improvements in pockets of ≥7 mm compared with PC. In contrast, PC was more effective in 5-6 mm PD. At one year following treatment, both treatments reduced the need-for-surgery index (95% to 100%) of the sites at baseline to 30% for AR and 42% for PC, with no differences between PC and AR.
In patients enrolled in SPT, the use of both PC and AR in conjunction with subgingival mechanical debridement represents an effective treatment modality for improving the clinical outcomes and reducing the need for surgery.
We present ASIST, a technique for transforming point clouds by replacing objects with their semantically equivalent counterparts. Transformations of this kind have applications in virtual reality, ...repair of fused scans, and robotics. ASIST is based on a unified formulation of semantic labeling and object replacement; both result from minimizing a single objective. We present numerical tools for the efficient solution of this optimization problem. The method is experimentally assessed on new datasets of both synthetic and real point clouds, and is additionally compared to two recent works on object replacement on data from the corresponding papers.
Objectives: To compare the amount of newly formed bone after sinus floor augmentation with two different particle sizes of bovine bone mineral (BBM) using clinical, micro‐computerized tomography (CT) ...and histological techniques.
Methods: Bilateral sinus floor augmentations were performed in 10 patients. Six to 9 months later, bone samples were retrieved and analyzed.
Results: Results: Both groups were not different in vertical bone height achieved after augmentation, post‐operative complications and maximal torque for the insertion of implants. Micro‐CT measurements could not detect a statistically significant difference in bone volume between the groups (with a tendency for new more bone in the small granules group). Histomorphometric analysis revealed that both granule sizes produced the same pattern of bone formation, surrounding the graft granules, and producing a shape of a network, “bridging” between the BBM particles. Multi‐nucleated giant cells, probably osteoclasts, were observed directly on the BBM particle surface in both groups. The osteoclast‐like cells preferred the small‐size BBM particles and not the large particles both in the small‐size and the large‐size granules group.
Conclusion: Both sizes of BBM granules preformed equally and achieved the aim of the sinus floor augmentation procedure clinically and histologically.
To cite this article:
Chackartchi T, Iezzi G, Goldstein M, Klinger A, Soskolne A, Piattelli A, Shapira L. Sinus floor augmentation using large (1–2 mm) or small (0.25–1 mm) bovine bone mineral particles: a prospective, intra‐individual controlled clinical, micro‐computerized tomography and histomorphometric study. Clin. Oral Impl. Res22, 2011; 473–480 doi: 10.1111/j.1600‐0501.2010.02032.x
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