Aim
To evaluate the prevalence of peri‐implant diseases and to identify risk/protective indicators of peri‐implantitis.
Materials and Methods
Two hundred and forty randomly selected patients from a ...university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri‐implant health and diseases. Peri‐implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri‐implant health category between peri‐implant mucositis and peri‐implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri‐implantitis.
Results
Ninety‐nine patients with a total of 458 dental implants were analyzed. The prevalences of pre‐periimplantitis and of peri‐implantitis were, respectively, 31.3% and 56.6% at patient‐level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri‐implantitis: smoking (OR = 3.59; 95% CI: 1.52–8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20–6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05–4.73), plaque (OR = 3.49; 95% CI: 1.13–10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17–6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76–11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19–5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45–29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11–0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01–0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01–0.56).
Conclusions
Peri‐implant diseases are highly prevalent among patients with dental implants in this university‐based population. Several factors were identified as risk‐ and protective‐ indicators of peri‐implantitis.
Aim
There are no nationally representative epidemiological studies available reporting on the different recession types according to the 2018 classification system or focusing on the aesthetic zone. ...The aims of this cross‐sectional study were (a) to provide estimates on the prevalence, severity and extent of mid‐buccal GRs according to the 2018 classification and (b) to identify their risk indicators in the adult U.S. population from the NHANES database.
Materials and Methods
Data from 10,676 subjects, representative of 143.8 millions of adults, were retrieved from the NHANES 2009–2014 database. GR prevalence was defined as the presence of at least one mid‐buccal GR ≥1 mm. GRs were categorized following the 2018 World Workshop classification system (RT1, RT2, RT3) and according to different severity cut‐offs. An analysis for GR risk indicators was also performed, selecting subjects without periodontitis.
Results
The patient‐level prevalence of mid‐buccal GRs (all types) was 91.6%, while it decreased to 70.7% when considering only the aesthetic zone. When focusing on RT1 GRs, the patient‐level prevalence (whole mouth) was 12.4%, while it was 5.8% considering only the aesthetic zone. The majority of RT1 GRs were considered as mild (1–2 mm). The whole‐mouth patient‐level prevalence of RT2 and RT3 GRs was 88.8% and 55.0%, respectively. Age (35–49 years), gender (female), ethnicity (non–Hispanic Whites), last dental visit (>6 months before), tooth type (incisors) and the arch (mandible) resulted as risk indicators associated with the presence of RT1 GR.
Conclusions
Mid‐buccal GRs affect almost the entire US population. Age, gender, ethnicity, dental care exposure, tooth type and arch were identified as risk indicators for RT1 GRs.
Aim
To evaluate the prevalence of buccal peri‐implant soft tissue dehiscence (PISTD) in anterior implants and to identify the risk/protective indicators of PISTD in implants not suffering ...peri‐implantitis.
Materials and methods
240 randomly selected patients from a university clinic database were invited to participate in the present cross‐sectional study. Those who accepted, after the evaluation of their medical and dental records, were clinically examined to assess the prevalence of buccal PISTD in non‐molar implants. Multilevel multivariate logistic regression analyses were then carried out to identify those factors associated either positively (risk) or negatively (protective) with buccal PISTD in implants without peri‐implantitis.
Results
92 patients with a total of 272 dental implants were analysed. At implant‐level, the prevalence of buccal PISTD was 16.9%, while when selecting only implants without peri‐implantitis it was 12.0%. Buccal PISTD was present in 26.7% of the implants diagnosed with peri‐implantitis. The following factors were identified as risk/protective indicators of buccal PISTD in implants without peri‐implantitis: malposition (too buccal vs. correct: OR=14.67), thin peri‐implant phenotype (OR=8.31), presence of at least one adjacent tooth (OR=0.08) and presence of abutment (OR=0.12).
Conclusions
PISTD are highly prevalent among patients with dental implants in this university‐based population, and several factors were identified as risk and protective indicators of PISTD in implants not suffering peri‐implantitis.
Periodontal and peri-implant regeneration is the technique that aims to restore the damaged tissue around teeth and implants. They are surrounded by a different apparatus, and according to it, the ...regenerative procedure can differ for both sites. During the last century, several biomaterials and biological mediators were proposed to achieve a complete restoration of the damaged tissues with less invasiveness and a tailored approach. Based on relevant systematic reviews and articles searched on PubMed, Scopus, and Cochrane databases, data regarding different biomaterials were extracted and summarized. Bone grafts of different origin, membranes for guided tissue regeneration, growth factors, and stem cells are currently the foundation of the routinary clinical practice. Moreover, a tailored approach, according to the patient and specific to the involved tooth or implant, is mandatory to achieve a better result and a reduction in patient morbidity and discomfort. The aim of this review is to summarize clinical findings and future developments regarding grafts, membranes, molecules, and emerging therapies. In conclusion, tissue engineering is constantly evolving; moreover, a tailor-made approach for each patient is essential to obtain a reliable result and the combination of several biomaterials is the elective choice in several conditions.
Aim
Due to its potential to influence systemic inflammation and oxidative stress, and to predispose to bacterial infections, sleep duration could potentially be a risk factor for periodontitis. The ...aim of this cross‐sectional study was to evaluate if there was in 2012 an association between periodontitis and sleep duration in a representative sample of the South Korean population.
Materials and Methods
A total of 5812 subjects representative of 39.4 million of adults were examined. Multivariate logistic regressions were applied controlling for age, gender, education, smoking status, alcoholism and consumption frequency of coffee, tea, chocolate and red wine.
Results
Compared to the group sleeping ≤5 h/day, the adjusted odds ratios for periodontitis prevalence defined as Community Periodontal Index (CPI) = 4 were OR = 2.46 (95% CI: 1.20–5.06) in the 6 h/day sleepers group, OR = 2.66 (95% CI: 1.35–5.25) in the 7 h/day sleepers group, OR = 2.29 (95% CI: 1.13–4.63) in the 8 h/day sleepers group and OR = 4.27 (95% CI: 1.83–9.97) in the ≥9 h/day sleepers group. The association has shown to be highlighted in middle‐aged people, females, non‐smokers, lower educated, with lower lead and higher cadmium blood levels and with higher carotene dietary intake ones and to be partially mediated by lipid profile alterations, diabetes, serum Vitamin D levels and WBC count.
Conclusions
A novel, direct and independent association between sleep duration and the prevalence of periodontitis was found. However, it needs to be investigated how the factors influencing the sleep duration affect this association.
Periodontitis has been linked to an increased risk of various chronic non-communicable diseases, including gastrointestinal cancers. Indeed, dysbiosis of the oral microbiome and immune-inflammatory ...pathways related to periodontitis may impact the pathophysiology of the gastrointestinal tract and its accessory organs through the so-called “gum–gut axis”. In addition to the hematogenous spread of periodontal pathogens and inflammatory cytokines, recent research suggests that oral pathobionts may translocate to the gastrointestinal tract through saliva, possibly impacting neoplastic processes in the gastrointestinal, liver, and pancreatic systems. The exact mechanisms by which oral pathogens contribute to the development of digestive tract cancers are not fully understood but may involve dysbiosis of the gut microbiome, chronic inflammation, and immune modulation/evasion, mainly through the interaction with T-helper and monocytic cells. Specifically, keystone periodontal pathogens, including Porphyromonas gingivalis and Fusobacterium nucleatum, are known to interact with the molecular hallmarks of gastrointestinal cancers, inducing genomic mutations, and promote a permissive immune microenvironment by impairing anti-tumor checkpoints. The evidence gathered here suggests a possible role of periodontitis and oral dysbiosis in the carcinogenesis of the enteral tract. The “gum–gut axis” may therefore represent a promising target for the development of strategies for the prevention and treatment of gastrointestinal cancers.
Periodontitis is a dysbiosis‐driven inflammatory disease affecting the tooth‐supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step‐wise ...therapeutic approach is employed for periodontitis. After an initial behavioral and non‐surgical phase, intra‐bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra‐bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.
This review comprehensively examines regenerative technologies in periodontal therapy, exploring biomaterials' composition, action mechanisms, and clinical applications. It critically assesses the quality of related clinical trials and discusses future research directions. The paper highlights the necessity for functional regeneration and the potential of emerging bio‐inspired materials, emphasizing the evolving landscape of periodontal treatment methodologies.
Air pollutants can influence local and systemic inflammation, oxidative stress and microbiome composition. Therefore, air pollution may potentially represent an unexplored modifiable risk indicator ...for periodontitis. The aim of the current cross-sectional study was to investigate the epidemiological association between outdoor air pollution and periodontitis in a representative sample of the South Korean population.
A total of 42,020 individuals, which were representative of 35.2 million South Koreans, were examined. The mean annual levels of particulate matter of 10 μm (PM10), ozone, sulfur dioxide (SO
), nitrogen dioxide (NO
) and humidity, were studied. Periodontitis was defined according to the Community Periodontal Index (CPI ≥ 3). Simple and multiple regression analyses using four different models were applied.
Every 5-μg/m
increase in PM10 (OR = 1.17; 95% confidence interval-CI: 1.11-1.24) and of 0.005 ppm in ozone levels (OR = 1.4; 95% CI: 1.00-1.30) were positively associated with periodontitis prevalence. Conversely, every 5% increase in humidity (OR = 0.94; 95% CI: 0.90-0.99) and 0.003 ppm increase in NO
levels (OR = 0.93; 95% CI: 0.89-0.96) were inversely associated with periodontitis occurrence.
In this nationally representative population several air pollutants were found to be associated with periodontitis occurrence. Hence, the present results suggest that air pollution may be a new modifiable risk indicator for periodontitis.
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