Aging is accompanied by profound changes in many physiological functions, leading to a decreased ability to cope with stressors. Many changes are subtle, but can negatively affect nutrient intake, ...leading to overt malnutrition. Poor oral health may affect food selection and nutrient intake, leading to malnutrition and, consequently, to frailty and sarcopenia. On the other hand, it has been highlighted that sarcopenia is a whole-body process also affecting muscles dedicated to chewing and swallowing. Hence, muscle decline of these muscle groups may also have a negative impact on nutrient intake, increasing the risk for malnutrition. The interplay between oral diseases and malnutrition with frailty and sarcopenia may be explained through biological and environmental factors that are linked to the common burden of inflammation and oxidative stress. The presence of oral problems, alone or in combination with sarcopenia, may thus represent the biological substratum of the disabling cascade experienced by many frail individuals. A multimodal and multidisciplinary approach, including personalized dietary counselling and oral health care, may thus be helpful to better manage the complexity of older people. Furthermore, preventive strategies applied throughout the lifetime could help to preserve both oral and muscle function later in life. Here, we provide an overview on the relevance of poor oral health as a determinant of malnutrition and sarcopenia.
The impact of the COVID-19 infection in dentistry Passarelli, Pier Carmine; Rella, Edoardo; Manicone, Paolo Francesco ...
Experimental biology and medicine (Maywood, N.J.),
06/2020, Volume:
245, Issue:
11
Journal Article
Peer reviewed
Open access
The novel Coronavirus pandemic defines a new risk for all dental practitioners, hygienists, and dental assistants. As an increasing number of dentists are now developing this disease, we wanted to ...provide some measures to manage this risk in the dental practice, by undergoing a review of the current literature. This minireview searches the literature for articles that both defined the infection risk in the dental practice and provided evidence on the efficacy of some procedures on reducing the infection risk. Several articles have already pointed out some necessary measures: fewer patients have to be admitted to the practice, a short triage should be carried out, and the appropriate measures of protection have to be used. On the basis of the literature collected, a short questionnaire and a flowchart is proposed to define the risk that each patient carries, and to appropriately adapt each procedure based on the patient’s risk. The literature is still limited on this subject, but on the basis of what is available, dental practices have to adapt to the situation in order to protect dental health professionals.
Impact statement
Dentists have always been taught how to protect themselves and their patients from potential blood-borne pathogens, but the Coronavirus pandemic has brought a new unprecedented challenge to the world of dentistry; we therefore reviewed the literature to provide suggestions on how to accordingly change dental practice prevention.
Dentistry has evolved significantly with the introduction of digital technologies and materials; however, clinical evidence for the performance of the complete digital workflow for single ...implant–supported posterior crowns is lacking.
The purpose of this cross-sectional retrospective clinical study was to compare the clinical outcomes of 2 types of implant-supported crown used to replace a single missing posterior tooth in a completely digital workflow: transocclusal screw-retained monolithic lithium disilicate crowns versus transocclusal screw-retained monolithic zirconia crowns.
A total of 38 participants who had been provided with dental implants and transocclusal screw-retained monolithic lithium disilicate or zirconia single crowns were evaluated in the study. Clinical and esthetic outcomes were recorded after a 3-year follow-up.
Both groups had comparable clinical outcomes with a survival rate of 100%. In the lithium disilicate group, 89% of the participants were free of technical complications, and 95%, in the zirconia group. Only 1 patient experienced minor chipping affecting a lithium disilicate crown. All complications were considered minor and were easily resolved, and none of the participants required replacement of a crown. No biological complications were recorded in either group.
Within the limitations of this cross-sectional retrospective clinical study, monolithic lithium disilicate and zirconia screw-retained single crowns fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) and a fully digital workflow were found to be reliable and suitable clinical options for restoring a posterior missing tooth on a dental implant.
: The aim of this study was to evaluate oral status, the reasons for tooth extractions and related risk factors in adult patients attending a hospital dental practice.
: 120 consecutive patients ...ranging from 23 to 91 years in age (mean age of 63.3 ± 15.8) having a total of 554 teeth extracted were included. Surveys about general health status were conducted and potential risk factors such as smoking, diabetes and age were investigated.
: a total of 1795 teeth were missing after extraction procedures and the mean number of remaining teeth after the extraction process was 16.8 ± 9.1 per patient. Caries (52.2%) was the most common reason for extraction along with periodontal disease (35.7%). Males were more prone to extractions, with 394 of the teeth extracted out of the total of 554 (71.1%). Male sex (β = 2.89; 95% CI 1.26, 4.53; p = 0.001) and smoking habit (β = 2.95; 95% CI 1.12, 4.79; p = 0.002) were related to a higher number of teeth extracted. Age (β = -0.24; 95% CI -0.31, -0.16; p < 0.001) and diabetes (β = -4.47; 95% CI -7.61, -1.33; p = 0.006) were related to a higher number of missing teeth at evaluation time. Moreover, periodontal disease was more common as a reason of extraction among diabetic patients than among non-diabetic ones (p = 0.04).
: caries and periodontal disease were the most common causes of extraction in a relatively old study population: further screening strategies might be required for the early interception of caries and periodontal disease.
Under steady-state circumstances, the oral microbiota is in equilibrium with host tissues, thus contributing to local and systemic health. Any interruption of such equilibrium leads to a condition of ...dysbiosis with the proliferation of oral pathogens able to cause gingivitis and periodontal disease. The mechanisms of periodontitis will be described, mostly emphasizing the noxious effects exerted by oral pathogens on the periodontium either directly or indirectly via the release of an array of mediators, even including pro-inflammatory cytokines, chemokines, and enzymes. The persistence of local inflammation ultimately leads to systemic inflammation; therefore, the link between periodontitis and obesity, diabetes and cardiovascular disease will be elucidated. Some natural compounds, such as polyphenols, prebiotics, and probiotics, will be discussed for their ability to exert anti-inflammatory and anti-oxidant activities in the context of the inflamed buccal cavity and systemically, as well as for their modulation of the altered gum-gut microbiota.
Most studies indicate that the mechanical removal of the bacterial biofilm from the implant surface is the central goal of peri-implantitis therapy. However, controversial results in the treatment of ...peri-implantitis have led to the consideration of additional strategies that include surgical approaches and chemical adjuvants. Local/topical antibiotics, such as minocycline, azithromycin, tetracycline, amoxicillin, doxycycline, and metronidazole, may improve the efficacy of the definitive treatment of the disease, but the lack of conclusive findings prevents their use in clinical practice. This systematic review aimed to evaluate the effect of local/topical antibiotics for peri-implantitis treatment. Randomised controlled studies (RCT) on patients with peri-implantitis and comparing the efficacy of local/topical antibiotics vs. placebo or mechanical debridement were included. A systematic search strategy was carried out using three registered databases (PubMed, Web of Science, and Scopus). RoB2 was used to assess risk of bias. Five RCTs were identified (n = 250 patients and 333 implants). Contrast results emerged among the included studies, and a high heterogeneity level was observed. Risk of bias revealed some concerns for three studies out of five, while one study was judged at high risk. Only one study analysed the limitations of its findings. Overall, local antibiotic use can be considered a valid approach in the treatment of peri-implantitis. Therefore, future long-term clinical trials with standardised protocols and antibiotics with similar biological activity profiles should be tested to achieve a valid and definitive conclusion.
Background: The aims of this study are to retrospectively compare the clinical, radiographic and esthetic outcomes of platform switching (PS) and platform matching (PM) dental implants in the ...anterior maxilla after ≥ 10 years of functional loading. Methods: Marginal bone loss (MBL) levels were recorded; furthermore, peri-implant clinical parameters (PPD, BOP, PI) were collected and the Pink and White Esthetic scores (PES/WES) were used to evaluate the esthetic outcomes. Wilcoxon signed rank tests were performed to compare collected parameters among the two groups, with a p-value < 0.05. Results: A final sample of 58 patients was enrolled in this study (PM implants = 29; PS implants = 29). PS implants showed lower MBL levels (1.02 ± 0.81 mm vs. 1.67 ± 0.99 mm, p = 0.028) and PPD values (3.69 ± 1.1 vs. 5.16 ± 1.09 mm, p < 0.001) compared to PM implants. Mean PES values were higher in the PS group compared to the PM group (8.46 ± 0.69 vs. 7.89 ± 0.78, p < 0.005), while there were no differences for WES values (7.82 ± 1.09 vs. 7.71 ± 0.85, p > 0.05) and peri-implant diseases’ prevalence (p > 0.05). Conclusions: After 10 years, PS implants showed statistically significant lower MBL and PPD values and higher PES values compared to PM implants.
Odontogenic sinusitis (ODS) refers to the maxillary sinus infection, which is secondary to either adjacent infectious dental pathologies or procedures. The aim of this retrospective study is to ...report the experiences of the department of integrated therapies in otolaryngology (Campus Bio-Medico Foundation, Rome, Italy) in classifying and treating patients that are affected by odontogenic sinusitis derived from "classic complications". A total of 68 patients responding to the criteria and to the definition as a classical odontogenic complication were included. The surgical therapy consisted of a combined oral and nasal simultaneous approach for 28 patients (43%), a combined non-simultaneous approach for 4 patients (6%), a nasal only approach for 14 patients (21%), and an oral only approach for 20 patients (30%). All the patients presented a complete resolution of the symptoms. The choice of performing a nasal, oral, or combined approach is based on the presence of anatomical elements that facilitate sinusitis and reinfection occurrence, such as deviated nasal septum, concha bullosa, or obstructed osteo-meatal complex. The correct use of validated classification, the pre-operative CT scan, a multidisciplinary approach, and an appropriate presurgical examination are the necessary elements to obtain a good success rate.
The stability of bone regenerated through Guided Bone Regeneration (GBR) around implants is crucial for long-term success. In this case series, changes in marginal bone levels (MBL) around implants ...placed in a regenerated bone using heterologous cortical lamina technique were radiographically measured. In addition, bone samples were obtained and submitted to histological and histomorphometric analysis. Thirty implants were placed in regenerated bone sites 8 months after the regenerative surgery; in the same surgical stage, a hard tissue biopsy was taken using a trephine bur and submitted to histologic and histomorphometric analysis. Changes in the marginal bone level, mesial and distal to the implant shoulder, were measured between prosthetic loading and the last follow-up, 2 years later. No implants were lost, and all could be deemed successful at the last follow-up. Only a minimal mean variation in the position of the marginal bone level was observed, both at the mesial (0.11 ± 0.49 mm) and at the distal level (0.03 ± 0.19 mm). The bone lamina had been resorbed after 8 months, and new bone had developed in close connection to the biomaterial. The average percentage of newly formed bone was 28%, while only 10% of the samples were composed of residual biomaterial; bone marrow and connective tissue composed the remaining part of the samples. This regeneration technique allowed, thanks to the rigidity of the lamina, the regeneration of new bone, which is stable after the prosthetic load. Further studies are needed to compare this procedure with those adopting non-resorbable, titanium-supported membranes.
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