Periodontally Healthy Patients Research Articles

Retinol-Binding Protein 4 and Visfatin Levels in Patients with Periodontitis and Obesity/Overweight: A Systematic Review and Meta-Analysis.

Prior studies demonstrated an equivocal conclusion about the association between the level of retinol-binding protein 4 (RBP4)/visfatin and periodontitis patients with obesity. The aim of our study (Prospero ID: CRD42023469058) was to systematically review the available articles linking the biofluid levels of RBP4/visfatin to the comorbidity of periodontitis and obesity. Clinical trials were screened in accordance with specific inclusion criteria from seven databases up to November 2023. A quality assessment was performed with the Newcastle-Ottawa Scale and ROBINS-I tools for observational and interventional trials, respectively. The standard mean difference (SMD) with a 95% confidence interval (CI) related to the RBP4 level was recorded; the other indicators related to the visfatin level were measured via the mean difference (MD) with the corresponding 95% CI, and Fisher's Z transformation was measured to reveal the association using Review Manager 5.4. The current evidence was based on five observational studies and two interventional studies. All of them were included in the systematic review, and six of them were in the meta-analysis. Statistical analysis indicated that there was no significant difference in the circulating levels of RBP4 in the periodontitis patients with obesity or without, who were labeled as OP or NP, respectively (155 OP-107 NP: SMD = 1.38; 95% CI: -0.18-2.94, p = 0.08), as well as the periodontal healthy patients with a normal weight, who were labelled as NnP (116 OP-79 NnP: SMD = 6.76; 95% CI: -5.34-18.87, p = 0.27). Meanwhile, a significant higher level of serum visfatin was found in the OP patients than that of the NP (86 OP-45 NP: MD = 4.21; 95% CI: 2.65-5.77, p < 0.00001)/NnP (164 OP-88 NnP: MD = 13.02; 95% CI: 7.34-18.70, p < 0.00001) group. In addition, a positive association was observed between the serum RBP4 and body mass index/clinical attachment loss (CAL). And, then, there was a positive association between the serum visfatin and periodontal parameters, including the probing depth, CAL, and plaque index, as well as metabolic parameters, including the total cholesterol, triglycerides, fasting blood glucose, and low-density lipoprotein cholesterol. Here, the circulating RBP4 level was not independently related to the comorbidity of periodontitis and obesity, while serum visfatin was significantly associated with periodontitis and obesity. Notably, the positive association between circulating RBP4/visfatin and the periodontal parameters/metabolic parameters firmly suggested that the higher severity of the obese or periodontal status was associated with an elevated level of serum visfatin or RBP4 in the OP group. With more rigorous longitudinal research, the exact causations between RBP4/visfatin and the patients affected by obesity and periodontitis could be disentangled. RBP4 and visfatin might be novel, enlightening prospective bio-indexes for the targeted treatment of comorbidities.

Evaluation of Serum and Salivary Visfatin Prior to and Post-nonsurgical Periodontal Therapy in Periodontally Healthy and Chronic Periodontitis Patients

Evaluation of Serum and Salivary Visfatin Prior to and Post-nonsurgical Periodontal Therapy in Periodontally Healthy and Chronic Periodontitis Patients

Clinical outcomes of dental implants in patients with and without history of periodontitis: A 20-year prospective study.

To present the 20-year clinical outcomes of tissue-level implants in partially edentulous patients previously treated for periodontitis and in periodontally healthy patients (PHP). The original population consisted of 149 partially edentulous patients consecutively enrolled in a private specialist practice and divided into three groups: PHP, moderately periodontally compromised patients (mPCP) and severely PCP (sPCP). After successful completion of periodontal/implant therapy, patients were enrolled in an individualized supportive periodontal care (SPC) programme. Eighty-four patients rehabilitated with 172 implants reached the 20-year examination. During the observation time, 12 implants were removed (i.e., 11 due to biological complications and 1 due to implant fracture), leading to an overall implant survival rate of 93% (i.e., 94.9% for PHP, 91.8% for mPCP and 93.1% for sPCP [p= .29]). At 20 years, PCP compliant with SPC did not present with significantly higher odds of implant loss compared with PHP compliant with SPC (p&gt; .05). Conversely, PCP not compliant with SPC experienced implant loss with odds ratio of 14.59 (1.30-164.29, p= .03). Tissue-level implants, placed after comprehensive periodontal therapy and SPC, yield favourable long-term results. However, patients with a history of periodontitis and non-compliant with SPC are at higher risk of biological complications and implant loss.

Antibacterial properties and abrasion-stability: Development of a novel silver-compound material for orthodontic bracket application.

Bacteria-induced white spot lesions are a common side effect of modern orthodontic treatment. Therefore, there is aneed for novel orthodontic bracket materials with antibacterial properties that also resist long-term abrasion. The aim of this study was to investigate the abrasion-stable antibacterial properties of anewly developed, thoroughly silver-infiltrated material for orthodontic bracket application in an in situ experiment. To generate the novel material, silver was vacuum-infiltrated into asintered porous tungsten matrix. Atooth brushing simulation machine was used to perform abrasion equal to 2years of tooth brushing. The material was characterized by energy dispersive X‑ray (EDX) analysis and roughness measurement. To test for antibacterial properties in situ, individual occlusal splints equipped with specimens were worn intraorally by 12periodontal healthy patients for 48 h. After fluorescence staining, the quantitative biofilm volume and live/dead distribution of the initial biofilm formation were analyzed by confocal laser scanning microscopy (CLSM). Silver was infiltrated homogeneously throughout the tungsten matrix. Toothbrush abrasion only slightly reduced the material's thickness similar to conventional stainless steel bracket material and did not alter surface roughness. The new silver-modified material showed significantly reduced biofilm accumulation in situ. The effect was maintained even after abrasion. Apromising, novel silver-infiltrated abrasion-stable material for use as orthodontic brackets, which also exhibit strong antibacterial properties on in situ grown oral biofilms, was developed. The strong antibacterial properties were maintained even after surface abrasion simulated with long-term toothbrushing.

To estimate the levels of gingival crevicular fluid YKL-40 in patients with chronic periodontitis and rheumatoid arthritis with chronic periodontitis - a clinico-biochemical study

Background and objectives: YKL-40, a C-reactive protein belongs to the positive acute-phase protein. It is also known as Human chitinase-3-like protein 1(HCI3L1) and is closely related to both acute and chronic inflammation. The present study aimed to detect and estimate the levels of YKL-40 in gingival crevicular fluid (GCF) in patients with healthy periodontium, chronic periodontitis, and rheumatoid arthritis with chronic periodontitis. Materials and methods: Forty-five patients in the age range of 25-55years were included in the study. Patients were divided into three groups: Group I-15 Periodontal healthy patients, Group II-15 Chronic Periodontitis patients, and Group III-15 Rheumatoid arthritis with chronic periodontitis patients. Clinical parameters recorded were Plaque index, Gingival index, Gingival bleeding index, probing depth, and Relative attachment level. GCF samples were analyzed using ELISA. p - value &lt; 0.05 was considered statistically significant. Results: The highest mean YKL-40 concentration in GCF was observed in rheumatoid arthritis with Chronic periodontitis. The mean concentration of YKL-40 in GCF showed a three to four folds increase in its levels when compared to healthy controls (p &lt; 0.001). Contrary, GCF YKL-40 levels between Group II and Group III were not significant. Conclusion: With the increase in severity of periodontal destruction from healthy periodontium to chronic periodontitis, there was a substantial increase in the concentration of YKL-40 in GCF. Correlation of GCF YKL-40 with clinical parameters demonstrated increased severity of the diseases increased its levels

The Effects of Prednisone/Ketoprofen Administration in Association with Amoxicillin Clavulanate Following Periodontal Surgical Therapy in Patients with Severe Chronic Periodontitis.

Background and Objectives: The aim of this study was to evaluate and compare the effects of two different anti-inflammatory drugs (ketoprofen and prednisone) combined with an antibiotic (amoxicillin + clavulanic acid) and periodontal surgery on dental and periodontal parameters in patients with severe chronic periodontitis. In addition, salivary stress expressed by cortisol levels was assessed. Materials and Methods: An interventional study was performed on 22 periodontal subjects and 19 clinical healthy controls. The patients were divided in four groups, depending on treatment planning, as follows: eight patients received prednisone and antibiotherapy, associated with surgical periodontal therapy; seven patients received ketoprofen and antibiotherapy, associated with surgical periodontal therapy (group II); seven patients received only prednisone. Periodontal healthy patients underwent routine scaling and polishing. Bleeding on probing (BOP), dental mobility and salivary cortisol (ng/mL) were assessed before and after treatment. The means and standard deviations for the salivary cortisol levels (SCLs), dental and periodontal parameters were calculated for all groups using each patient as a unit of analysis. Results: Data analyses showed that the two different anti-inflammatory drugs associated with or without surgical therapy were efficient on inflammation periodontal parameters (BOP, dental mobility). Prednisone treatment alone was associated with a significant decrease of SCLs between pretreatment and post-treatment. Conclusions: In the present study, the effects of either of the anti-inflammatory drugs on inflammation evolution and salivary stress were comparable in patients undergoing antibiotherapy and surgical periodontal therapy.

Assessment of Peri-Implant Soft Tissues Conditions around Short and Ultra-Short Implant-Supported Single Crowns: A 3-Year Retrospective Study on Periodontally Healthy Patients and Patients with a History of Periodontal Disease.

The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.

Inflammatory cytokine profiles in the crevicular fluid around clinically healthy dental implants compared to the healthy contralateral side during the early stages of implant function

ObjectiveTo describe and compare cytokines levels in clinically healthy sites of dental implants and natural teeth. Materials and methodsA total of 90 dental implants in 71 periodontal healthy patients with function time of less than 6 months after the completion of the implant prosthesis were included in this study. PICF (peri-implant crevicular fluid) and GCF (gingival crevicular fluid) samples were collected from implants and the contralateral natural teeth. In addition, we performed a dynamic collection of crevicular fluid from 18 dental implants and their contralateral natural teeth at four time nodes (first day, first week, first month, third month). The profiles of 45 common cytokines in PICF and GCF were analyzed by Luminex multiplex assays. ResultsThe total volume of PICF was significantly higher when compared to the volume of GCF (p < 0.01). In contrast, the concentrations of IL-18, IL-2, IL-23, IL-21, IL-1α, IL-12p70, VEGF-A, HGF, FGF-2, BDNF, PlGF-1, MIP-1β, TNF-α, and IFN-γ in PICF were significantly lower than those in GCF (p < 0.05). In the longitudinal component of the study, the cytokines found in PICF underwent a brief wave of expression in the 3-month period, with the smallest gap difference of cytokine expression between the PICF and the GCF being at first month. ConclusionsThis study observed that the levels of 14 cytokine profiles were lower in PICF than in GCF. Within the implants load for one month, the levels of above differential cytokines in PICF increased and gradually approached the cytokine profiles in GCF.

Fixed orthodontic treatment has an insignificant effect on clinical attachment level.

Data sources Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, Web of Knowledge, Virtual Health Library, Google Scholar and ISRCTN registry databases.Study selection Randomised controlled trials (RCTs) and prospective or retrospective non-randomised clinical trials on periodontal healthy human patients receiving comprehensive fixed appliance treatment were considered.Data extraction and synthesis Two reviewers independently extracted data and assessed risk of bias using either the Cochrane tool for RCTs or the ROBINS-I (Risk Of Bias In Non-randomised Studies - of Interventions) tool for non-randomised studies. A Paule-Mandel random-effects meta-analyses was conducted for clinical attachment loss. Results Nine prospective non-randomised trials involving a total of 335 periodontally healthy patients were included. The patients' average age was 22.6 years (range 11.4 - 42.1 years). Seven of the nine studies were assessed as being at moderate risk of bias. Orthodontic treatment was associated with a mean clinical attachment loss of 0.11 mm (95 %CI: 0.12 mm gain to 0.34 mm loss; P = 0.338, I2 = 99.6%), which was neither statistically nor clinically significant.Conclusions The findings suggest that orthodontic treatment might have little or no clinically relevant detrimental effect on the clinical attachment levels of patients.

A retrospective cohort study of peri-implant condition in Chinese patients with different periodontal condition and maintenance frequency.

To compare the periodontal and peri-implant conditions of Chinese patients with a history of moderate or severe periodontitis and periodontally healthy patients (PHP); to evaluate the influence of maintenance therapy frequency on the outcome of implant therapy. A total of 140 participants with 227 sand-blasted acidetched (SLA) implants were divided into three groups: PHP, moderate periodontally compromised patients (PCP) and severe PCP. The three groups were further categorized into two groups based on the frequency of maintenance (MF): MF≥1 per year and MF<1 per year. The following clinical parameters of implants were assessed: implant survival/loss, peri-implant probing depth (PDi), peri-implant bleeding index (BIi), peri-implant bleeding on probing (BOPi), implant bone loss (BLi). Comparisons of the peri-implant conditions were performed between the patients with different periodontal conditions. Implant survival rate was 100% for all three groups. The severe PCP group showed significantly higher deepest PDi, mean PDi, mean BIi, and PLIi compared with PHP (p<0.05). The severe PCP group had more implants affected with PDi≥5mm and BOPi+ compared with the PHP group (Adjusted OR=10.89, 95% CI: 2.34, 50.74). In the patients with severe PCP, the MF<1 per year group had a greater prevalence of PDi≥5mm and BOPi+ compared with the MF≥1 per year group (Adjusted OR=8.23, 95% CI: 2.44, 27.78). The patients in the severe PCP group were at greater risk of peri-implant disease than those in the PHP group. In particular, severe PCP who had poor adherence to maintenance care showed a higher incidence of biologic complications.

Interleukin-34 levels in gingival crevicular fluid and plasma in periodontal health and disease with and without type-2 diabetes mellitus.

The aim of the present study was to evaluate and correlate the levels of interleukin-34 (IL-34) in gingival crevicular fluid (GCF) and plasma in chronic periodontitis (CP) patients with and without type-2 diabetes mellitus (DM). A total of 175 patients were divided into five groups: (a) group I had 35 periodontally-healthy patients; (b) group II had 35 chronic gingivitis patients; (c) group III had 35 CP patients without type-2 DM; (d) group IV had 35 CP patients with type-2 DM; and (e) group V had 35 type-2 DM patients without CP. The GCF and plasma levels of IL-34 were quantified using enzyme-linked immunosorbent assay. Clinical and systemic parameters, such as gingival index, probing pocket depth, clinical attachment loss, and glycated hemoglobin levels, were evaluated. The mean IL-34 concentration in GCF and plasma was highest for group IV, followed by groups III, V, and II, and lowest in group I. The difference between them was statistically significant (P<.05). There was a positive correlation between IL-34 concentration in GCF and plasma in the study groups, with the exception of group I, for which there was a negative correlation. IL-34 can be considered a possible GCF and plasma inflammatory biomarker of periodontal disease progression and DM.

Assessing a multiplex-targeted proteomics approach for the clinical diagnosis of periodontitis using saliva samples.

The present study focused on the research of new biomarkers based on the liquid chromatography-multiple-reaction monitoring (MRM) proteomic profile in whole saliva of patients with periodontitis compared with periodontal healthy patients. A 30-min multiplexed liquid chromatography-MRM method was used for absolute quantification of 35 plasma biomarkers in saliva from control patients and patients with periodontitis. Three proteins namely hemopexin, plasminogen andα-fibrinogen were shown to be clearly related to the presence of periodontitis compared with healthy patients. Apolipoprotein H was found to discriminate for the first time chronic and aggressive periodontitis. Our results indicate that this innovative MRM method could be used to screen for periodontitis in clinical environment. Furthermore, apolipoprotein H was found to be a discriminant biomarker of aggressive periodontitis.

Plasma of Argon Cleaning Treatment on Implant Abutments in Periodontally Healthy Patients: Six Years Postloading Results of a Randomized Controlled Trial.

The aim of this randomized, match-paired, triple-blinded, controlled clinical trial was to assess the 6-year radiographic changes around customized platform-switched abutments placed according to the one abutment-one time concept, with and without plasma of argon cleaning treatment. A total of 20 periodontally healthy patients received one maxillary implant between the premolars. Immediately before stage 2 surgery and abutment connection, patients were randomly assigned to the control (cleaning protocol by steam) or test group (plasma of argon treatment). Periapical standardized digital radiographs were taken at the time of crown connection (T₀) and at 12 (T₁), 24 (T₂), 48 (T₄), 60 (T₅), and 72 months (T₆) after the final restoration delivery. Primary outcome measures were the success rates of the implants and prostheses and the occurrence of any technical and biologic complications during the follow-up period. Secondary outcome measures were peri-implant marginal bone level changes, bleeding on probing, and plaque score. Two patients (one in test and one in control group) dropped out at the last follow-up. Neither implant nor prosthetic complications were detected in the analyzed patients of both groups during the 6-year follow-up examinations. Radiographic analysis revealed a statistically significant higher mean bone loss in the control group than in the test group at T₂ (0.4 ± 0.28 mm; P = .018), T₄ (0.52 ± 0.63 mm; P = .037), T₅ (0.61 ± 0.70 mm; P = .038), and T₆ (0.71 ± 0.66 mm; P = .011), but not at T₁ (P = .131). From baseline to the 6-year follow-up, intragroup comparisons showed an absence of statistically significant difference in the test group (P = .08). Conversely, significant differences were found in the control group (P = .01). All implants demonstrated successful periodontal parameters, with no significant differences between groups. The results of this present study indicate that contaminant and bacterial removal from abutments in two-stage implants using plasma of argon could represent a positive strategy to minimize peri-implant bone resorption and longitudinally stabilize esthetic outcomes.

Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies

Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence. Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, P<0.000 01), as well as serum total cholesterol (TC) (MD=17.54, 95% confidence interval=10.91-24.18, P<0.000 01). Furthermore, the risks of TG and TC in the serum of patients with chronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, P<0.000 01) and 3.62 times (OR=3.62, 95% confidence interval=2.18-6.03, P<0.000 01) of that of periodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipoprotein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.

Effects of uncontrolled periodontitis on marginal bone alterations around implants: A case-control study.

The hypothesis of bacterial infection initiating marginal bone loss around dental implant in analogy with natural tooth is still in debate. The aim of this retrospective study was to investigate the effects of uncontrolled periodontitis on marginal bone alterations around implants compared with the periodontal health group at a mean follow-up of at least 6 years. Thirty consecutive uncontrolled periodontally compromised patients (PCP) and 30 periodontally healthy patients (PHP), with a total of 96 Straumann implants (PCP = 55, PHP = 41) were matched for age, gender, smoking, and implant characteristics. The inclusion criteria for PCPs were continuing tooth loss due to uncontrolled periodontal disease and no supportive periodontal maintenance after implant therapy. Peri-implant conditions were examined and the number of teeth lost during the follow-up periods was recorded in both groups. Radiographic marginal bone loss of implants and adjacent teeth was calculated having the restoration time point as baseline. No implant loss occurred in both groups. The mean number of teeth lost during the follow-up periods was 0.67 ± 0.80 in the PHP group, 3.93 ± 2.36 in the PCP group with statistical significance. The average overall bone loss was significantly greater at teeth than that around implants in the PCP group (0.54 ± 0.27 versus 0.22 ± 0.25 mm, P < .001), while no statistically significant differences were observed in the PHP group (0.18 ± 0.08 versus 0.22 ± 0.18 mm, P = .317). No statistically significant differences were observed between PC and PH patients when comparing the peri-implant marginal bone loss. No significant correlations were found between teeth loss and crestal bone loss at implants sites in both groups. This study indicated that the marginal bone level around implants seemed more stable in comparison to that around the natural teeth when exposed to uncontrolled periodontal disease.

Long-Term Results of Peri-implant Conditions in Periodontally Compromised Patients Following Lateral Bone Augmentation.

The aim of this retrospective study was to compare long-term (≥ 5 years) outcomes of implants placed in patients treated for chronic periodontitis versus those placed in periodontally healthy patients. In both groups, the implants were placed in alveolar ridges that were laterally augmented with autogenous bone block grafts using a split bone block technique. Two hundred ninety-two patients were screened in the course of supportive periodontal treatment examinations. Nonsmoking patients without any severe systemic diseases who had adhered to regular supportive periodontal treatment for a minimum of 5 years after undergoing autogenous lateral grafting (using the split bone block technique), implant placement, and prosthetic reconstructions were classified into two groups based on their presurgical status: periodontally healthy patients (PHP) and periodontally compromised patients (PCP). Clinical outcomes for 77 patients, 38 PHP and 39 PCP, were examined. All had been successfully treated for severe lateral atrophy and received a total of 241 endosseous implants between 2002 and 2008. At the final examination, mean bleeding on probing was 7.08% ± 7.27% in PHP and 14.49% ± 18.14% in PCP, a statistically significant difference. Significantly higher Plaque Index and more recession were associated with a narrow (< 2 mm) width of keratinized mucosa. Implants in alveolar ridges laterally augmented using a split bone block technique revealed similar clinical peri-implant conditions in both PHP and PCP. Using autogenous bone block grafts without biomaterials resulted in long-term peri-implant tissue stability.

Technical complications rates and plaque control of fixed dental prostheses in patients treated for periodontal disease

To compare the incidence of technical complications of implant-supported fixed dental prostheses in Chinese patients with a history of moderate or severe periodontitis and periodontally healthy patients(PHP) and analyze the effects of interproximal papillae patterns on food impaction and efficacy of plaque control. A total of 103 partially edentulous patients treated with implant-supported fixed dental prostheses between December 2009 and December 2012 for a minimum 1-year follow-up period were recruited from Department of Periodontology, Peking University, School and Hospital of Stomatology. Based on the initial periodontal examination, the participants were divided into three groups: 30 PHP, 36 moderate periodontally compromised patients(mPCP) and 37 severe periodontally compromised patients(sPCP). Implant survival/loss, technical complications, plaque index, papilla index, food impaction and degree of proximal contact tightness of each patient were assessed around the implants at follow-up. According to the implant papilla index, the implants were divided into two groups: the "filling" group with the mesial and distal aspects with papilla index=3 and the "no filling" group with at least one aspect with papilla index<3. Data on implant survival, technical complications were analyzed. Comparisons of the incidence of technical complications were performed between the patients with different periodontal conditions with chi-square or Fisher's exact test. The influences of the interproximal papillae loss on food impaction and efficacy of plaque control were estimated with chi-square and Mann-Whitney U tests. The total implant survival rate was 100%(162/162) for all three groups. Technical complications were as following: veneer fractures(1.9%, 3/162), abutment screw loosening(1.9%, 3/162), prosthetic screw loosening(3.1%, 5/162) and decementation(3.1%, 5/162) in all subjects. No implant/screw fracture was noted. The incidence of technical complications in sPCP, mPCP and PHP did not yield statistically significant differences(P>0.05). The proportion of the implant with the mesial and distal papilla index=3 in the sPCP was less than that in the PHP and mPCP. The interproximal papillae loss did not appear to affect the food impaction and the plaque index in all three groups(P>0.05). However, for the PHP, the accumulation of plaque at buccal aspect was more in the "no filling" group compared with the "filling" group (implant plaque index[M(Q)]: 1[1] vs 0[0]), and for the sPCP, the accumulation of plaque at lingual aspect was more in the "filling" group compared with the "no filling" group(implant plaque index[M(Q)]: 1[1] vs 0[1], (P<0.05). The patients with a history of severe periodontitis did not exhibit more technical problems compared with the periodontally healthy patients. The interproximal papillae loss did not show a negative impact on the plaque control and food impaction. However, for the sPCP, changing the morphology and the position of the interproximal contact point to reduce the interdental black triangle may lead to accumulation of plaque at lingual aspect. More attention should be placed on the morphology design of prosthesis, but not the papillae filling up the interproximal space.

Use of molecular indicators of inflammation to assess the biocompatibility of all-ceramic restorations.

The purpose of this in vivo study was quantification of inflammatory reaction to ceramic restorations made from lithium disilicate and zirconia by measurement of the concentration of indicators of inflammation in the gingival crevicular fluid (GCF). Patients out of three prospective cohort-studies investigating three different all-ceramic restoration materials for crowns and fixed dental prostheses were included. Patients needed an associated, unrestored tooth to serve as control. GCF samples were taken from the sulcus of the restored teeth and the related controls (n = 59 pairs) and the concentrations of IL1-beta, IL-1ra and aMMP-8, as indicators of inflammation, were determined by use of ELISA tests. Periodontal status was also assessed clinically by measurement of pocket depth (PD), plaque index (PI) and bleeding on probing (BOP). The concentrations of the inflammation indicators were not significantly different between restored teeth and controls or between lithium disilicate and zirconia restorations (p > 0.05). Furthermore, no significant difference between PD of restored teeth and controls or between groups could be shown. Within the limitation of the study, treatment with all-ceramic restorations did not induce inflammatory reactions in a group of periodontal healthy patients. No differences between the gingiva reactions of lithium disilicate and zirconia restorations could be shown.

Analysis of protein expression in periodontal pocket tissue: a preliminary study.

BackgroundThe periodontal disease is caused by a set of inflammatory disorders characterized by periodontal pocket formation that lead to tooth loss if untreated. The proteomic profile and related molecular conditions of pocket tissue in periodontally-affected patients are not reported in literature. To characterize the proteomic profile of periodontally-affected patients, their interproximal periodontal pocket tissue was compared with that of periodontally-healthy patients. Pocket-associated and healthy tissue samples, harvested during surgical therapy, were treated to extract the protein content. Tissues were always collected at sites where no periodontal-pathogenic bacteria were detectable. Proteins were separated using two-dimensional gel electrophoresis and identified by liquid chromatography/mass spectrometry. After identification, four proteins were selected for subsequent Western Blot quantitation both in pathological and healty tissues.ResultsA significant unbalance in protein expression between healthy and pathological sites was recorded. Thirty-two protein spots were overall identified, and four proteins (S100A9, HSPB1, LEG7 and 14-3-3) were selected for Western blot analysis of both periodontally-affected and healthy patients. The four selected proteins resulted over-expressed in periodontal pocket tissue when compared with the corresponding tissue of periodontally-healthy patients. The results of Western blot analysis are congruent with the defensive and the regenerative reaction of injured periodontal tissues.ConclusionsThe proteomic analysis was performed for the first time directly on periodontal pocket tissue. The proteomic network highlighted in this study enhances the understanding of periodontal disease pathogenesis necessary for specific therapeutic strategies setting.

Long‐term results of a three arms prospective cohort study on implants in periodontally compromised patients: 10‐year data around sandblasted and acid‐etched (SLA) surface

The aim of this study was to compare the long-term outcomes of sandblasted and acid-etched (SLA) implants in patients previously treated for periodontitis and in periodontally healthy patients (PHP). One hundred and forty-nine partially edentulous patients were consecutively enrolled in private specialist practice and divided into three groups according to their periodontal condition: PHP, moderately periodontally compromised patients (PCP) and severely PCP. Implants were placed to support fixed prostheses, after successful completion of initial periodontal therapy. At the end of active periodontal treatment (APT), patients were asked to follow an individualized supportive periodontal therapy (SPT) program. Diagnosis and treatment of peri-implant biological complications were performed according to cumulative interceptive supportive therapy (CIST). At 10 years, clinical and radiographic measures were recorded by two calibrated operators, blind to the initial patient classification, on 123 patients, as 26 were lost to follow up. The number of sites treated according to therapy modalities C and D (antibiotics and/or surgery) during the 10 years was registered. Six implants were removed for biological complications. The implant survival rate was 100% for PHP, 96.9% for moderate PCP and 97.1% for severe PCP. Antibiotic and/or surgical therapy was performed in 18.8% of cases in PHP, in 52.2% of cases in moderate PCP and in 66.7% cases in severe PCP, with a statistically significant differences between PHP and both PCP groups. At 10 years, the percentage of implants, with at least one site that presented a PD ≥ 6 mm, was, respectively, 0% for PHP, 9.4% for moderate PCP and 10.8% for severe PCP, with a statistically significant difference between PHP and both PCP groups. This study shows that SLA implants, placed under a strict periodontal control, offer predictable long-term results. Nevertheless, patients with a history of periodontitis, who did not fully adhere to the SPT, presented a statistically significant higher number of sites that required additional surgical and/or antibiotic treatment. Therefore, patients should be informed, from the beginning, of the value of the SPT in enhancing long-term outcomes of implant therapy, particularly those affected by periodontitis.