Recurrence Of Periodontitis Research Articles

Investigating Factors Affecting Compliance of Patients Who are Candidates for Non-Surgical Periodontal Treatment Referred to Yazd Faculty of Dentistry in 2023

Introduction: Considering the importance of periodontal supportive treatment in long-term preservation of teeth and prevention of recurrence of periodontitis, it was aimed to identify the factors affecting patients' compliance in continuing periodontal treatment. Methods: This cross-sectional study conducted on 233 patients referred to the periodontics and oral health and community dentistry departments and were candidate for non-surgical periodontal treatment. Data were collected by researcher-made questionnaires and the association between demographic characteristics and some possible external and internal influencing factors with the patients' attendance in first follow-up was investigated. Results: Only 39% of patients participated in the first follow-up. The patients' previous internal desire to participate in follow-up sessions had a statistically significant relationship with their compliance (P=0.001). Age, gender, education level, economic status, type of employment of patients and smoking did not show any significant relationship with following up the treatment. None of the investigated factors such as lack of time, the quality of mutual communication between the dentist and the patient, satisfaction with the treatment, providing health instructions by the dentist and explaining the consequences of not continuing the treatment to the patient did not affect the probability of the patient's adherence to continuing the treatment. Conclusion: There is no definite factor to increase the compliance rate of patients and it is necessary to increase the patients' motivation with different intervention methods, in a way that the importance of participating in the follow-up sessions is clarified for the patients.

Comparative Analysis of Plaque Removal and Wear between Electric-Mechanical and Bioelectric Toothbrushes.

Effective oral care is important for maintaining a high quality of life. Therefore, plaque control can prevent the development and recurrence of periodontitis. Brushing with a toothbrush and toothpaste is a common way to remove plaque; however, excessive brushing or brushing with abrasive toothpaste can cause wear and tear on the dental crown. Hence, we aimed to quantitatively compare the plaque-removal efficiency and tooth wear of toothbrushes using the bioelectric effect (BE) with those of electric-mechanical toothbrushes. To generate the BE signal, an electronic circuit was developed and embedded in a toothbrush. Further, typodonts were coated with cultured artificial plaques and placed in a brushing simulator. A toothpaste slurry was applied, and the typodonts were eluted with tap water after brushing. The plaques of the typodonts were captured, and the images were quantified. For the tooth wear experiment, polymethyl methacrylate disk resin blocks were brushed twice a day, and the thickness of the samples was measured. Subsequently, statistical differences between the experimental toothbrushes and typical toothbrushes were analyzed. The BE toothbrush had a higher plaque-removal efficiency and could minimize tooth wear. This study suggests that the application of BE may be a new solution for oral care.

Management of Endo-Perio lesion in a Tooth with an Unfavorable Prognosis: a Clinical Case Report with an 18-Month Follow-Up

The aim of this case study is to report a successful clinical case of an endo-perio lesion in a tooth with an initially unfavorable prognosis, followed up for 18 months. A male patient, public servant, non-smoker, without a history of diabetes, and married sought dental treatment in 1995 due to periodontal problems. He was then 40 years old and diagnosed with moderate to advanced periodontal disease. The initial treatment consisted of supra and subgingival scaling, followed by the extraction of teeth indicated for removal. After discharge, the patient adhered to a preventive periodic maintenance (PPM) program to control periodontal disease recurrence. In 2021, tooth 43 showed an unfavorable endo-perio lesion during a routine check-up. Despite treatment options, the patient opted for conservative treatment with endodontic and periodontal procedures. Simultaneously, PPM sessions were performed. The patient was monitored every six months, showing regression of periodontal pockets and significant improvement after 18 months. This case highlights the importance of patient adherence to PPM, demonstrating that a conservative approach and proper maintenance can lead to positive clinical outcomes even in cases with an initially unfavorable prognosis.

LIGHT protein: A novel gingival crevicular fluid biomarker associated with increased probing depth after periodontal surgery.

To evaluate the protein profiles in gingival crevicular fluid (GCF) in relation to clinical outcomes after periodontal surgery and examine if any selected proteins affect the mRNA expression of pro-inflammatory cytokines in human gingival fibroblasts. This exploratory study included 21 consecutive patients with periodontitis. GCF was collected, and the protein pattern (n = 92) and clinical parameters were evaluated prior to surgery and 3, 6 and 12 months after surgery. Fibroblastic gene expression was analysed by real-time quantitative polymerase chain reaction. Surgical treatment reduced periodontal pocket depth (PPD) and changed the GCF protein pattern. Twelve months after surgery, 17% of the pockets showed an increase in PPD. Levels of a number of proteins in the GCF decreased after surgical treatment but increased with early signs of tissue destruction, with LIGHT being one of the proteins that showed the strongest association. Furthermore, LIGHT up-regulated the mRNA expression of pro-inflammatory cytokines interleukin (IL)-6, IL-8 and MMP9 in human gingival fibroblasts. LIGHT can potentially detect subjects at high risk of periodontitis recurrence after surgical treatment. Moreover, LIGHT induces the expression of inflammatory cytokines and tissue-degrading enzymes in gingival fibroblasts.

Awareness of Periodontal Treatment Modalities among Dentists of Bathinda District of Punjab: A Questionnaire Survey

Abstract Introduction: Periodontal disease is a chronic, inflammatory disease that can lead to various destructive changes in the periodontium as well as systemic health. Periodontology is a fast-growing dental specialty ranging from new advances in diagnosis and treatment. Despite these new advances, the knowledge of periodontal diagnosis and treatment in the minds of general dentists is still lagging. General dentists need to be aware of how to diagnose and treat periodontal disease in the early stage, so there is a need for periodontal health awareness programs to be held at regular intervals. This questionnaire study aims to identify the knowledge regarding periodontal diagnosis and treatment modalities available for patients among practicing dental professionals. Materials and Methods: Two hundred dental practitioners having their dental clinics in any area of Bathinda, Punjab, were interviewed through a questionnaire. Dental practitioners with minimum qualifications of BDS and experience of at least 1 year in the private clinical setup were included in the study. The questionnaire consisted of 15 questions ranging from the chief periodontal complaints of the patients, availability of the treatment, and different techniques used to the level of satisfaction of private dentists after the periodontal treatment. Results: There is enough awareness regarding periodontal problems and its management, as 157 dentists out of 200 refer their patients to periodontists. General dentists perform scaling and root planing, advice oral hygiene instructions, provide diet counseling, and refer to periodontists only for surgical procedure. Lack of maintenance and awareness toward oral hygiene measures was identified by the survey as the chief factor for recurrence of periodontal disease. Conclusion: Such studies performed at different time intervals can provide an idea about the changing trends and patterns of dental treatment performed by general dental practitioners.

Quercetin promotes autophagy to alleviate cigarette smoke-related periodontitis.

Cigarette smoking has been reported as an independent risk factor for periodontitis. Tobacco toxins affect periodontal tissue not only locally but also systemically, leading to the deterioration and recurrence of periodontitis. However, the mechanism of cigarette smoke-related periodontitis (CSRP) is unclear and thus lacks targeted treatment strategies. Quercetin, a plant-derived polyphenolic flavonoid, has been reported to have therapeutic effects on periodontitis due to its documented antioxidant activity. This study aimed to evaluate the effects of quercetin on CSRP and elucidated the underlying mechanism. The cigarette smoke-related ligature-induced periodontitis mouse model was established by intraperitoneal injection of cigarette smoke extract (CSE) and silk ligation of bilateral maxillary second molars. Quercetin was adopted by gavage as a therapeutic strategy. Micro-computed tomography was used to evaluate the alveolar bone resorption. Immunohistochemistry detected the oxidative stress and autophagy markers in vivo. Cell viability was determined by Cell Counting Kit-8, and oxidative stress levels were tested by 2,7-dichlorodihydrofluorescein diacetate probe and lipid peroxidation malondialdehyde assay kit. Alkaline phosphatase and alizarin red staining were used to determine osteogenic differentiation. Network pharmacology analysis, molecular docking, and western blot were utilized to elucidate the underlying molecular mechanism. Alveolar bone resorption was exacerbated and oxidative stress products were accumulated during CSE exposure in vivo. Oxidative stress damage induced by CSE caused inhibition of osteogenic differentiation in vitro. Quercetin effectively protected the osteogenic differentiation of human periodontal ligament cells (hPDLCs) and periodontal tissue by upregulating the expression of Beclin-1 thus to promote autophagy and reduce oxidative stress damage. Our results established a role of oxidative stress damage and autophagy dysfunction in the mechanism of CSE-induced destruction of periodontal tissue and hPDLCs, and provided a potential application value of quercetin to ameliorate CSRP.

Changes in some indexes of protein homeostasis and pro-oxidant protection in the oral fluid of young people with periodontitis under the influence of the proposed complex therapy

Periodontal diseases comprise an actual problem nowadays due to their high prevalence. Young people in particularly remain susceptible to aggressive periodontal disorders that affect the suspensory apparatus of the teeth. The aim of the study was to establish some indexes of protein peroxidation and total protein content in the oral liquid of young people affected by stage I periodontitis, degree A and B observed before and after the appointed complex therapy. Conducted investigations demonstrate that there are significant changes in protein homeostasis and pro-oxidant protection in the oral liquid of young people in case of stage I periodontitis, degree A and B. The latter indicates an increase of the total protein content as well as a rise of oxidative protein modifications of both aldehyde and ketone derivatives, which are neutral and basic in nature. The recorded dynamic of the gained results of protein metabolism and pro-oxidant protection in the oral liquid of young people in case stage I periodontitis, degree A and B obtained at different terms after administered treatment suggests that the introduced management provides a pronounced positive effect on the regulation of these indexes. Moreover, herbal remedies as a part of the proposed agents for local and general administration show a good antioxidant effect and contribute to long-term maintenance of gained results. They also prevent recurrence of periodontitis and contribute to prolonged remission.

CONDITION OF PERIODONTAL TISSUES ON THE BACKGROUND OF HELICOBACTER INVASION: THE CONCEPT OF PATHOGENESIS.

The aim: To analyze the state of periodontal tissues against the background of Helicobacter pylori invasion in dynamics and to propose a possible mechanism of development of inflammatory periodontal diseases in patients with Helicobacter pylori-associated pathology of the gastrointestinal tract. Materials and methods: We examined 43 patients with Helicobacter pylori-associated gastrointestinal pathology and 42 patients of the same age without somatic pathology, including without gastrointestinal pathology associated with Helicobacter pylori. Clinical and laboratory research methods (clinical, instru-mental, biochemical, histological methods) were used. Results: Comparing the data of clinical observations and the results of laboratory studies of patients with inflammatory periodontal disease on the background of Helicobacter pylori-associated gastrointestinal pathology, obtained in different observation periods, we can assume that basic dental treatment of periodontal disease in such patients undergoing eradication therapy does not provide stable anti-inflammatory, antimicrobial and antioxidant effect, which leads to reduced periods of remission and recurrence of periodontal disease, where oral dysbiosis plays a crucial role. Conclusions: Comparing the data of clinical observations and the results of laboratory studies of patients with chronic gingivitis on the background of Helicobacter pylori-associated gastrointestinal pathology, obtained in different observation periods, we can say that they correlate with each other and suggest that the basic dental treatment of chronic gingivatis on the background of H.pylori-associated pathology of the gastrointestinal tract, which is currently undergoing a course of eradication, does not give a stable anti-inflammatory, antimicrobial and antioxidant effect, which leads to recurrence of periodontal disease and shortening remission periods, where oral dysbiosis plays a crucial role.

Severe alveolar bone resorption in Felty syndrome: a case report

BackgroundFelty syndrome is defined by three conditions: neutropenia, rheumatoid arthritis, and splenomegaly. Neutropenia associated with pancytopenia may further affect the dental condition of a patient. Periodontal treatment and surgery in patients with Felty syndrome necessitates cooperation with a hematologist. Here we present a case of a patient with Felty syndrome who was initially referred to the oral surgery hospital attached to the School of Dentistry for extensive periodontitis. She was effectively treated in collaboration with the hematology department.Case presentationA 55-year-old Asian woman visited our department with concerns of worsening tooth mobility, discomfort, and spontaneous gingival bleeding. Initial periodontal examination revealed generalized severe periodontitis (Stage IV Grade C) resulting from leukopenia/neutropenia and poor oral hygiene. A thorough treatment strategy involving comprehensive dental procedures, such as multiple extractions and extensive prosthetic treatment, was implemented. Following the diagnosis of Felty syndrome, the patient was started on treatment with oral prednisolone 40 mg/day, which effectively controlled the disease. Furthermore, there was no recurrence of severe periodontitis after the periodontal treatment.ConclusionsDentists and physicians should be aware that immunocompromised individuals with pancytopenia and poor oral hygiene are at risk of developing extensive periodontitis. If their susceptibility to infection and pancytopenia-related bleeding can be managed, such patients can still receive comprehensive dental treatment, including teeth extractions and periodontal therapy. Cooperation among the dentist, hematologist, and patient is necessary to improve treatment outcomes and the patient’s quality of life.

Effect of supragingival plaque control on recurrent periodontitis and clinical stability among individuals under periodontal maintenance therapy: 10-year follow-up.

The aim of this study was to evaluate the effect of supragingival plaque control on the recurrence of periodontitis (RP) and the achievement of a stable periodontal clinical endpoint after 10years of periodontal maintenance therapy (PMT). The present retrospective cohort study included 225 individuals in continuous PMT. The plaque index (PI) determining the oral hygiene (OH) status, periodontal clinical parameters, and other variables of interest were collected at three time points: T1 (prior to active periodontal therapy [APT]), T2 (after APT), and T3 (10years after T2). According to PI records at T3, participants were categorized into: (1) good OH (GOH; PI≤30%, n=63); (2) fair OH (FOH; PI>30% and ≤40%, n=73); and (3) poor OH (POH; PI>40%, n=88). Data were analyzed using the chi-square and Student t tests, analysis of variance (ANOVA), and mediation and regression analyses. Significant differences in all periodontal clinical parameters between the GOH, FOH, and POH groups were observed at T3. The POH group exhibited higher mean bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL), as well as higher tooth loss (POH>FOH>GOH; P<.001). There was an increased risk for RP in the FOH (odds ratio [OR] 2.02; CI, 1.10-4.38) and POH (OR 4.33; CI, 2.17-8.65) groups. Moreover, the FOH and POH groups had an approximately 2.5 and 6.0 times greater chance of not achieving a stable periodontal clinical endpoint, respectively. After 10years of monitoring in PMT, individuals with higher PI scores (>30%) presented an unhealthier periodontal status, a higher risk for RP, and a lower chance of achieving ≤4 sites with PD≥5mm.

Modified minimally invasive surgical technique in human intrabony defects with or without regenerative materials-10-year follow-up of a randomized clinical trial: Tooth retention, periodontitis recurrence, and costs.

The modified minimally invasive surgical technique (M-MIST) optimizes wound stability in the treatment of intrabony defects. Short-term observations show similar results as with flap alone or adjunctive regenerative materials. This study aims to compare the stability of the long-term outcomes, complication-free survival, and costs of the three treatment options. Forty-five intrabony defects in 45 patients were randomized to M-MIST alone (N= 15), combined with enamel matrix derivative (M-MIST + EMD, N= 15), or EMD plus bone-mineral-derived xenograph (M-MIST + EMD + BMDX, N= 15). Supportive periodontal care (SPC) and necessary re-treatment were provided for 10 years. Three subjects were lost to follow-up. Clinical attachment level differences between 1 and 10 years were -0.1± 0.7 mm for M-MIST, -0.1± 0.8 mm for M-MIST + EMD, and -0.3± 0.6 mm for M-MIST + EMD + BMDX (p> .05 for within- and between-group differences). Four episodes of recurrence occurred in the M-MIST group, four in the M-MIST + EMD group, and five in the M-MIST + EMD + BMDX group. No significant differences in complication-free survival were observed between the three groups (p= .47). Complication-free survival was 7.46 years (95% confidence interval: 7.05-7.87) for the whole population. The M-MIST + EMD + BMDX group lost one treated tooth. Data indicated no significant inter-group difference of the total cost of recurrence over 10 years. When the baseline cost of treatment was considered, the total cost was lower for M-MIST alone. Teeth with deep pockets associated with intrabony defects can be successfully maintained over the long term with either M-MIST alone or by adding a regenerative material in the context of a careful SPC programme. M-MIST alone provided similar short- and long-term benefits as regeneration, at a lower cost. These findings need to be confirmed in larger, independent studies.

Retrospective analysis of the effects of non-communicable diseases on periodontitis treatment outcomes.

PurposeWe retrospectively analysed patients’ dental and periodontal status according to the presence of non-communicable diseases (NCDs) and the effects of NCDs on periodontal treatment outcomes. Factors influencing disease recurrence were investigated using decision tree analysis.MethodsWe analysed the records of patients who visited the Department of Periodontology, Pusan National University Dental Hospital from June 2014 to October 2019. As baseline subjects, 1,362 patients with periodontitis and who underwent full-mouth periodontal examinations before periodontal treatment were selected. Among them, 321 patients who underwent periodontal examinations after the completion of periodontal treatment and 143 who continued to participate in regular maintenance were followed-up.ResultsForty-three percent of patients had a NCD. Patients without NCDs had more residual teeth and lower sum of the number of total decayed, missing, filled teeths (DMFT) scores. There was no difference in periodontal status according to NCD status. Patients with a NCD showed significant changes in the plaque index after periodontal treatment. The decision tree model analysis demonstrated that osteoporosis affected the recurrence of periodontitis.ConclusionsThe number of residual teeth and DMFT index differed according to the presence of NCDs. Patients with osteoporosis require particular attention to prevent periodontitis recurrence.

Recurrence and progression of periodontitis and methods of management in long-term care: A systematic review and meta-analysis.

To systematically review the literature to evaluate the recurrence of disease of people in long-term supportive periodontal care (SPC), previously treated for periodontitis, and determine the effect of different methods of managing recurrence. The review focused on stage IV periodontitis. An electronic search was conducted (until May 2020) for prospective clinical trials. Tooth loss was the primary outcome. Twenty-four publications were retrieved to address recurrence of disease in long-term SPC. Eight studies were included in the meta-analyses for tooth loss, and three studies for disease progression/recurrence (clinical attachment level [CAL] loss ≥2 mm). For patients in SPC of 5-20 years, prevalence of losing more than one tooth was 9.6% (95% confidence interval [CI] 5%-14%), while experiencing more than one site of CAL loss ≥2 mm was 24.8% (95% CI 11%-38%). Six studies informed on the effect of different methods of managing recurrence, with no clear evidence of superiority between methods. No data was found specifically for stage IV periodontitis. A small proportion of patients with stage III/IV periodontitis will experience tooth loss in long-term SPC (tendency for greater prevalence with time). Regular SPC appears to be important for reduction of tooth loss. No superior method to manage disease recurrence was found.

Periodontal treatment outcomes in smokers: A narrative review.

Smoking is considered as the major environmental risk factor for periodontal diseases. Smokers have a higher risk for severe periodontitis with more periodontal tissue destruction, more gingival recession, and more susceptibility for tooth loss. The aim of this narrative review is to provide up-to-date evidence on the clinical outcomes of periodontal treatment in smokers. Electronic databases were searched for studies that compare the clinical outcomes in smokers and non-smokers following non-surgical and surgical periodontal treatment modalities and also during the supportive periodontal treatment. Clinical studies published before May 2021 were included in the review. Smokers have a higher risk for recurrence of periodontal disease and the response to non-surgical as well as surgical periodontal treatment is not as good as that of non-smokers. Moreover, there is a dose-response effect in the adverse effects of smoking on periodontal health. Compared to non-smokers, smoker patients with periodontitis tend to respond less favorably to non-surgical and surgical periodontal treatment, and exhibit recurrence more frequently during supportive periodontal treatment. Along with the periodontal treatment, smokers may be encouraged to quit. Long follow-up and the communication between the dentist and the patient give a great opportunity for such counseling.

Long-term clinical outcomes of periodontal regeneration with enamel matrix derivative: A retrospective cohort study with a mean follow-up of 10 years.

BackgroundDespite the large body of evidence on the efficacy of enamel matrix derivative (EMD) in the treatment of periodontal intrabony defects, few studies reported long‐term data (≥10‐year).MethodsPeriodontal patients treated with regenerative surgery with EMD between 1999 and 2012 were invited to participate in a clinical examination. The following clinical parameters were recorded and compared at baseline (T0), 6 months after surgery (T1) and after at least 8 years of follow‐up (T2): probing depth (PD), gingival recession (GR), clinical attachment level (CAL), plaque and bleeding scores. The primary outcome variable was CAL change.ResultsForty‐one patients with 75 treated teeth were available for analysis. Out of these, 68 (tooth survival rate: 90.7%) reached the latest follow‐up with a mean observation period of 10.3 years (range: 8.0 to 21.3). The most frequent reason for tooth loss was recurrence of periodontal disease. Tooth survival curves showed a statistically significant difference between smokers and non‐smokers (P = 0.028). Mean CAL changed from 8.43 ± 1.86 (T0) to 6.47 ± 1.70 (T1) (P < 0.001) and to 5.91 ± 1.83 (T2) (P < 0.001). At T1, a CAL gain of ≥3 mm was measured in 35% of the defects whereas at T2 it was detected in 51% of cases.ConclusionsWithin their limitations, the present results have shown that in intrabony defects, the clinical improvements obtained following regenerative surgery with EMD can be maintained on a mean period of 10 years. Smoking status and maxillary molars were correlated with an increased risk for tooth and CAL loss, respectively.

The human oral virome: Shedding light on the dark matter.

Mediators of the initiation, development, and recurrence of periodontitis include the oral microbiome embedded in subgingival plaque and the host immune response to a dysbiosis within this dynamic and complex microbial community. Although mediators have been studied extensively, researchers in the field have been unable to fully ascribe certain clinical presentations of periodontitis to their nature. Emergence of high‐throughput sequencing technologies has resulted in better characterization of the microbial oral dysbiosis that extends beyond the extensively studied putative bacterial periodontopathogens to a shift in the oral virome composition during disease conditions. Although the biological dark matter inserted by retroviruses was once believed to be nonfunctional, research has revealed that it encodes historical viral‐eukaryotic interactions and influences host development. The objective of this review is to evaluate the proposed association of herpesviruses to the etiology and pathogenesis of periodontal disease and survey the highly abundant prokaryotic viruses to delineate their potential roles in biofilm dynamics, as well as their interactions with putative bacterial periodontopathogens and eukaryotic cells. The findings suggest that potential novel periodontal therapies targeting or utilizing the oral virome can alleviate certain clinical presentations of periodontitis. Perhaps it is time to embrace the viral dark matter within the periodontal environment to fully comprehend the pathogenesis and systemic implications of periodontitis.

Serum proteins associated with periodontitis relapse post-surgery: A pilot study.

The knowledge of which genes and proteins that are connected to the susceptibility to gingivitis with subsequent local tissue degradation seen in periodontitis is insufficient. Changes of serum proteins associated with recurrence of bleeding on probing (BOP) and increased periodontal pocket depths (PPD) after surgical treatment of periodontitis could reveal molecules that could be early signals of tissue destruction and/or of importance for systemic effects in other tissues or organs. We performed a longitudinal pilot study and followed 96 inflammation-related proteins over time in serum from patients who underwent surgical treatment of periodontitis (n=21). The samples were taken before (time 0), and then at 3, 6, and 12 months after surgery. Changes in protein levels were analysed in relation to the clinical outcome measures, that is, proportion of surfaces affected by BOP and PPD. Changes in treatment outcomes with early signs of relapse in periodontitis after surgical treatment, for example, increased BOP and PPDs, were during 12-months follow up associated with increased serum levels of high-sensitivity C-reactive protein (hs-CRP) and programmed death-ligand 1 (PD-L1), and reduced serum levels of cystatin-D protein. This study shows that clinical signs of recurrence of periodontitis after surgery are reflected in serum, but larger studies are needed for verification. Our novel findings of an association between increased PD-L1- and decreased cystatin D-levels and recurrence in periodontitis are interesting because PD-L1 has been shown to facilitate bacterial infections and chronic inflammation and cystatin D to inhibit tissue destruction. Our results justify mechanistic studies regarding the role of these molecules in periodontitis.

Evaluation of peri-implant tissues condition after 10-15 years of loading in treated chronic periodontitis patients attending a private practice setting: A retrospective study.

To retrospectively evaluate the conditions of the peri-implant tissues in treated patients with chronic periodontitis (CP) and in patients without chronic periodontitis (noCP). A chart review was used to evaluate 267 implants, 134 placed in 42 CP treated patients and 133 placed in 46 noCP patients. The primary outcome was to evaluate the condition of the peri-implant tissues (health, peri-mucositis, and peri-implantitis). The secondary outcome was to evaluate the possible association of some variables, such as, Plaque Index (PI), Bleeding Index (BI), probing pocket depth (PD), bleeding on probing (BoP), bone level (BL), loading time, type of implant placement and loading protocol, type of prosthesis, type of bone, implant manufacturer, and implant diameter and length, with the implant health condition. The analysis of patient files revealed that after 10-15years of loading (mean loading time 13.4±2.07years), six noCP patients (13%) experienced implant loss with a total of nine implants (6.7%) lost. The remaining 124 implants were classified: 54 (43.5%) as healthy, 45 (36.3%) with peri-implant mucositis, and 25 (20.2%) with peri-implantitis. Twelve CP subjects (28.5%) experienced implant loss with a total of 19 implants (14.1%) lost. The remaining 115 implants were classified: 34 (29.5%) as healthy, 40 (34.7%) with peri-implant mucositis and 41 (35.6%) with peri-implantitis. Compared with noCP subjects, only treated CP subjects with recurrent periodontal disease (RPD) showed differences statistically significant (p<.05). After 10-15years of loading, in CP patients treated in a private practice setting, most implants (70.1%) were classified with some type of peri-implant inflammation. In patients with RPD, a higher tendency for implant loss and peri-implant biologic complications was found.

Longevity of Teeth and Dental Implants in Patients Treated for Chronic Periodontitis Following Periodontal Maintenance Therapy in a Private Specialist Practice: A Retrospective Study with a 10-Year Follow-up

The aim of the present study was to retrospectively evaluate the longevity of teeth and implants during a long-term period in a cohort of periodontally compromised patients, treated and maintained in a private specialist periodontal practice, and to analyze the associated risk factors. Fifty-eight patients (30 men, 28 women) who had received active periodontal therapy (APT) and regular periodontal maintenance (PM) ≥ 10 years were included and evaluated. The following were evaluated: (1) statistically significant differences of clinical parameters assessed at six tooth or implant sites (plaque scores, bleeding score, periodontal probing depth, bleeding on probing, and gingival recession) and radiographic parameters (mesial and distal bone crest loss) between patients with and without tooth/implant loss during PM; and (2) associations between the number of teeth and implants lost and potential risk factors. During PM, the overall average tooth loss was 0.07 teeth/patient/year (0.04 teeth/patient/year for periodontal reasons), while the overall average implant loss was 0.4 implants/patient/year. The overall implant failure was 10.08%, and the rate of implant failure due to biologic reasons was 9.8%. Incidence of implant failures in patients with vs without recurrent periodontal disease was 83.3% vs 16.7% (P < .05). Results showed that in chronic periodontitis patients, ATP followed by long-term PM is successful in keeping the majority of periodontally compromised teeth. In the same patients, a higher tendency for implant loss than tooth loss was found.

Concentrations of Interleukin-1ß in Gingival Crevicular Fluid and Saliva - a Potential Diagnostic Biomarker of Periodontal Diseases.

Bacterial challenge in periodontal diseases activates both local and systemic immune responses of a macroorganism by increasing multiple proinflammatory factors that can be discovered in gingival crevicular fluid (GCF) and in saliva. We tested the hypothesis that IL-1β concentration in GCF and saliva correlates with periodontal health and diseases.Materials and methods: The study included 62 people (mean age 36±14 yrs), divided into three groups - patients with periodontitis (24 people), patients with gingivitis (19 people) and periodontally healthy people (19 people). Saliva and GCF samples were taken from all participants and the levels of IL-1β in all samples were determined by ELISA. IL-1β concentrations in GCF of healthy individuals were significantly lower than the IL-1β concentration in GCF of patients with gingivitis (p=0.009) and with periodontitis (p.