Probing Depth Research Articles

Salivary advanced glycated end products, their receptors, and aMMP-8 in periodontitis patients with varying glycemic levels: A cross-sectional study.

Advanced glycation end products (AGE) and their receptors (RAGE) have been implicated in developing periodontal complications in diabetic patients. This study aimed to identify salivary AGE, RAGE, soluble RAGE (sRAGE), and active-matrix metalloproteinase-8 (aMMP-8) levels at varying glycemic levels in periodontitis patients. Ninety-eight participants were categorized into uncontrolled DM-PD group (n=27)-periodontitis patients with uncontrolled Type 2 diabetes mellitus (T2DM) (glycated hemoglobin [HbA1c] ≥7%); controlled DM-PD group (n=33)-periodontitis patients with controlled T2DM (HbA1c 5.7%-6.9%); SH-PD group (n=18)-systemically healthy periodontitis patients; and SH-PH group (n=20)-systemically and periodontally healthy individuals. HbA1c along with the periodontal parameters bleeding on probing (BoP), periodontal probing depth (PPD), clinical attachment loss (CAL), number of missing teeth, and periodontal inflamed surface area (PISA) were estimated. Enzyme-linked immunosorbent assay (ELISA) was used for analyzing salivary AGE, RAGE, sRAGE, and aMMP-8. Multiple linear regression analysis was conducted to develop predictive models for HbA1c based on relevant predictor variables. Periodontitis participants with uncontrolled T2DM exhibited significantly higher BoP, PPD, CAL, number of missing teeth, and PISA, along with elevated AGE, RAGE, and aMMP-8, compared to other groups (p<0.01). A significant positive association was observed between RAGE and HbA1c levels (p<0.01). Among the predictors, BoP (p=0.046) and CAL (p<0.001) demonstrated a significant positive effect on salivary AGE. PPD was positively associated with RAGE (p<0.05), and BoP was negatively associated with salivary sRAGE levels (p=0.038). Salivary biomarkers like RAGE and aMMP-8 exert a potential role in monitoring periodontal health and glycemic control in T2DM patients. Advanced glycation end products (AGE) and their receptors (RAGE) have been implicated in developing periodontal complications in diabetic patients. This study aimed to identify salivary AGE, RAGE, soluble RAGE (sRAGE), and aMMP-8 levels at varying glycemic levels in periodontitis patients. Ninety-eight participants were categorized into Group 1 (n=27)-periodontitis patients with uncontrolled Type 2 diabetes mellitus (T2DM); Group 2 (n=33)-periodontitis patients with controlled T2DM; Group 3 (n=18)-systemically healthy periodontitis patients; and Group 4 (n=20)-systemically and periodontally healthy individuals. Enzyme-linked immunosorbent assay (ELISA) was used for analyzing salivary AGE, RAGE, sRAGE, and aMMP-8. The study revealed that participants with uncontrolled T2DM and severe periodontitis exhibited significantly higher levels of salivary AGE, RAGE, and aMMP-8, along with increased periodontal parameters, compared to controlled T2DM and systemically healthy groups. Conversely, salivary sRAGE levels were significantly lower in the uncontrolled T2DM group. The study also found significant associations between salivary RAGE levels and glycated hemoglobin (HbA1c), as well as between aMMP-8, AGE, and clinical periodontal parameters. The findings of this study highlight the potential clinical utility of salivary biomarkers, particularly RAGE and aMMP-8, as noninvasive diagnostic and monitoring tools to evaluate glycemic control and periodontal health in individuals with diabetes.

Clinical Outcomes and Cytokine Profile of Standard and Short Implant-supported Prostheses in Diabetics Treated for Periodontal Disease: A 5-year Study.

The present cross-sectional study aimed to assess the clinico-radiographic parameters as well as salivary levels of receptor activator of nuclear factor kappa-Β ligand (RANKL), osteoprotegerin (OPG), interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-α) around standard and short dental implants (SDIs)-supported fixed partial denture in partially dentate type-II diabetes mellitus (T2DM) patients treated for periodontitis. The study comprised 4 groups: group 1 included T2DM patients with standard implants (n = 20); group II included non-T2DM patients with standard implants (n = 20); group III included T2DM patients with SDIs (n = 20); and group IV included non-T2DM patients with SDIs (n = 20). Participants eligible for the study included medically diagnosed T2DM patients with glycated hemoglobin (HbA1c) levels ≥ 6.5%, and non-T2DM participants with HbA1c levels between 4.0% and 5.0%. All had undergone previous periodontal therapy and had at least one standard implant and one SDI in the posterior maxillary or mandibular region. Exclusions were subjects with systemic conditions other than T2DM, recent use of steroids or antimicrobials, pregnancy or lactation, edentulism, misaligned dentition, or alcohol/tobacco use. Treatment involved non-surgical periodontal therapy, implant placement, and prosthetic procedures, with assessments including clinical (plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]) parameters, and salivary cytokine levels including RANKL, OPG, IL-6, and TNF-α. The study groups, each comprising 20 participants, showed no significant differences in demographics, restoration type, T2DM duration, family history, body mass index, or brushing routine (p>0.05). At baseline and 5-year follow-up, T2DM participants exhibited poorer periodontal parameters compared to non-T2DM, with higher PI (baseline: 62.2 ± 5.8% vs 29.6 ± 3.7%; 5-year follow-up: 69.2 ± 6.1% vs 32.8 ± 3.8%), BOP (baseline: 30.5 ± 3.2% vs 18.2 ± 2.6%; 5-year follow-up: 35.5 ± 3.9% vs 20.5 ± 2.5%), PD (baseline: 5.5 ± 1.1 mm vs 3.1 ± 0.9 mm; 5-year follow-up: 4.2 ± 0.8 mm vs 2.4 ± 0.7 mm), and CBL (baseline: 4.4 ± 0.4 mm vs 2.0 ± 0.2 mm; 5-yearfollow-up: 4.9 ± 0.5 mm vs 2.3 ± 0.3 mm), regardless of implant type. Salivary cytokine levels (RANKL, OPG, IL-6, TNF-α) were consistently higher in T2DM groups than non-T2DM across both implant types. Participants with SDIs showed comparable clinico-radiographic outcomes and salivary levels of cytokines to standard implants. The application of SDI-supported rehabilitation in T2DM and non-diabetics showed comparable clinico-radiographic outcomes and salivary levels of cytokines to standard dental implants. Furthermore, T2DM patients exhibit poorer periodontal health and elevated inflammatory markers in patients with standard implants and SDIs.

Efficacy of adjunctive systemic or local antibiotic therapy in peri-implantitis: a systematic review and meta-analysis of randomized controlled clinical trials.

This systematic review and meta-analysis considered the results of randomized controlled clinical trials (RCTs) to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis. Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria. A meta-analysis was performed to evaluate the weighted mean differences in survival rate (SR) and changes in pocket probing depth (PPD), bone level (BL), and clinical attachment level (CAL). The study cohorts were defined as antibiotic and control groups with subgroups for analysis. Seven studies including 309 patients (390 implants) were considered. Within the limitations of this review, patients in the antibiotic groups exhibited significant improvements in PPD. Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL. It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis, whether through surgical or non-surgical approaches, and also shows moderate performance regarding BL and CAL. Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics, careful clinical judgment is still necessary.

Computer-generated holography enables high-uniformity, high-efficiency depth-of-focus extension in endoscopic OCT

Fiber-form optics extends the high-resolution tomographic imaging capabilities of optical coherence tomography (OCT) to the inside of the human body, i.e., endoscopic OCT. However, it still faces challenges due to the trade-off between probe size, resolution, and depth of focus (DOF). Here we introduce a method for extending the DOF in endoscopic OCT with high uniformity and efficiency. On the basis of multi-level diffractive optics, we leverage the multi-dimensional light-field modulation capabilities of computer-generated holography (CGH) to achieve precise control of the intensity distribution of the off-axis portion of the OCT probe light. Our method eliminates the need for an objective lens, allowing for direct fabrication at the distal facet of a single-mode fiber using femtosecond laser two-photon 3D printing. The superiority of our method has been verified through numerical simulation, beam measurement, and imaging results obtained with our home-built endoscopic OCT system.

Effects of Local and Systemic Metronidazole as Adjunctive Treatment in Chronic Periodontitis Patients

ABSTRACTObjectivesThis study aimed to compare the effects of local and systemic metronidazole in patients with chronic periodontitis.Materials and MethodsIn this randomized clinical study, 30 patients (3 teeth per patient) were treated in three groups: scaling and root planing (SRP) treatment alone, metronidazole tablet as adjunctive treatment, and metronidazole gel as adjunctive treatment. BOP (bleeding on probing), PPD (pocket probing depth), and CAL (clinical attachment level) data were collected at the beginning and 3 months later. Collected data were tested by Wilcoxon and Kruskal–Wallis tests.ResultsBOP, CAL, and PPD levels were significantly different at the beginning of treatment and after 3 months, and this was true for all treatments. BOP, CAL, and PPD levels did not differ significantly between the three groups after the treatment (p &gt; 0.05).ConclusionThe effectiveness of these methods was all equal and SRP is still considered as the gold standard in the treatment of periodontal diseases. Further studies are needed to confirm the findings. Chronic periodontitis is a progressive disease that can cause tooth loss. The accepted treatment is SRP. Antibiotics used systemically can penetrate the depth of the periodontal pockets but have several side effects. Hence, using a less complicated medicinal form as a topical gel as adjunctive therapy in treating chronic periodontitis can be more effective.Trial Registration: Iranian clinical trial https://en.irct.ir/: IRCT20210408050898N1

A 10-Year Follow-Up of Reconstructive Treatment of Peri-Implantitis Using Mineralized Dehydrated Allograft and Resorbable Membrane: A Retrospective Case Series.

To evaluate the 10-year clinical and radiographic outcomes of peri-implantitis intrabony defects treated with mineralized dehydrated bone allograft (MDBA) and resorbable membrane in patients undergoing a regular supportive peri-implant/periodontal therapy (STP). The original study participants were 34 (34 defects). After mechanical debridement and chemical decontamination of implant surfaces, intrabony defects were filled with MDBA and covered by a resorbable membrane. Patients were enrolled in a maintenance program with a recall interval of 6 months. The primary outcome was the absence of additional marginal peri-implant bone loss ≥ 1.0 mm after surgery. The composite outcome was no additional marginal peri-implant bone loss ≥ 1.0 mm and the absence of probing depth (PD) ≥ 5 mm, bleeding on probing and suppuration. Of the original 34 implants, 20 completed the 10-year follow-up, and three failed. Related to the primary outcome, the mean peri-implant marginal bone level changed from 4.78 mm (SD 1.84) at baseline to 3.10 mm (SD 1.73) after surgery and 3.71 mm (SD 1.78) at the follow-up end point. According to the composite outcome for disease resolution, 19 of the 34 original implants were successfully treated at the 10-year follow-up with a statistically significant difference between 1 (31/34 implants) and 5 years (20/34 implants) (p = 0.003) and 1 and 10 years (p = 0.001) but not between 5 and 10 years (p = 1.000). Ten years after the reconstructive treatment, followed by regular SPT, the cumulative successful treatment rate, according to the primary and the composite outcomes, was 58% (20/34 implants) and 53% (19/34) implants, respectively.

Reconstructive surgical treatment of peri-implantitis with use of a chitosan brush for decontamination- case series with 1-year follow-up

Introduction and aimThere is a need for studies assessing the efficacy of different therapeutic approaches in the reconstructive surgical treatment of peri-implantitis. The aim of this case series is to evaluate the clinical outcomes and radiographic bone fill of reconstructive surgical treatment using the oscilating chitosan brush for implant surface decontamination.Materials and methodsNine patients with 11 Class I and III peri-implantitis defects were included. Following implant surface decontamination performed with a chitosan brush, guided bone regeneration (GBR) was performed by means of a bovine derived cancellous bone graft and collagen membrane. Clinical parameters such as full mouth plaque score (FMPS), probing depth (PD), bleeding on probing (BoP), recession, and radiographic bone level (RBL) were recorded at baseline and 1 year following treatment.ResultsAll evaluated parameters, including PD, BoP, recession, RBL, and full mouth plaque scores, revealed significant improvements at 1 year follow-up compared to baseline (p < 0.05). The mean PD values reduced from 7.30 ± 1.29 to 3.78 ± 0.65 (p = 0.000). RBL was detected 5.50 ± 1.31 and 1.38 ± 0.74 at baseline and 1-year, respectively (p = 0.010).ConclusionReconstructive surgical treatment of Class I and III peri-implantitis defects with GBR may be an effective treatment protocol when an oscilitating chitosan brush is used for surface decontamination.Clinical trial numberNot applicable.

Severe Periodontitis is Associated With Recurrent Cardiovascular Events-A 10-Year Longitudinal Cohort Study.

The study aimed to elucidate a putative association between severe periodontitis and the incidence of recurrent cardiovascular events in patients with cardiovascular disease (CVD) within 10 years after their initial hospitalisation. A cohort of 1002 stationary patients with angiographically proven CVD was included. They were examined regarding prevalence of severe periodontitis (≥ 30% of the teeth with proximal attachment loss of ≥ 5 mm), probing depth, clinical attachment loss, bleeding on probing, number of missing teeth and oral care habits. Recurrent events were summarised as combined end point (myocardial infarction, stroke/transitory ischemic attack, cardiovascular death and death caused by stroke). Survival analyses were carried out after a 10-year follow-up period. Hazard ratios (HRs) were adjusted for known cardiac risk factors using Cox regression. The follow-up was completed by 792 patients. The overall incidence of the combined end point was 42.8%. Severe periodontitis was associated with recurrent cardiovascular events (adjusted hazard ratio [HR] = 1.26, 95% confidence interval [CI] 1.0-1.58 and Standard error [SE] 0.11), whereas both, tooth brushing more than once a day (adjusted HR = 0.74, 95% CI 0.57-0.97, SE 0.13) and performing interdental hygiene (adjusted HR = 0.71, 95% CI 0.52-0.99, SE 0.16) decreased this risk. Severe periodontitis is a putative risk factor for recurrent cardiovascular events. ClinicalTrials.gov identifier: NCT01045070.

Assessing the Effectiveness of A-PRF+ for Treating Periodontal Defects: A Prospective Interventional Pilot Study Involving Smokers.

Background and Objectives: This study aimed to evaluate the effects of advanced platelet-rich fibrin (A-PRF+) tissue regeneration therapy on clinical periodontal parameters in non-smokers and smoker patients. The anticipated biological mechanisms of A-PRF+ include stimulating angiogenesis, thereby promoting the formation of new blood vessels, which is essential for tissue healing. Additionally, A-PRF+ harnesses the regenerative properties of platelet-rich fibrin, contributing to the repair and regeneration of periodontal tissues. Materials and Methods: The study was conducted on 55 patients, divided into two groups: non-smoker patients (n = 29) and smoker patients (n = 26). A single operator conducted the surgical procedure. Following the administration of local anesthesia with articaine 4% with adrenaline 1:100,000 precise intracrevicular incisions were made, extending towards the adjacent teeth, until the interproximal spaces, with meticulous attention to conserving the interdental gingival tissue to the greatest extent possible. Extended, full-thickness vestibular and oral flaps were carefully lifted, and all granulation tissue was meticulously removed from the defect without altering the bone contour. After debridement of the defects, A-PRF+ was applied. BOP (bleeding on probing), PI (plaque index), CAL (clinical attachment loss), and probing depth (PD) were determined at baseline and six months post-surgery. Results: Significant reductions were observed in PD and CAL after six months. In the non-smokers group, PD decreased from 7.0 ± 1.0 mm to 3.1 ± 0.1 mm (p < 0.001), while in the smokers group, PD decreased from 6.9 ± 1.1 mm to 3.9 ± 0.3 mm (p < 0.001). CAL decreased in the non-smokers group from 5.8 ± 0.7 mm to 2.6 ± 0.2 mm and from 5.7 ± 0.9 mm to 3.2 ± 0.2 mm (p < 0.001) in smokers. Notably, the reductions in CAL and PD were statistically more significant in the non-smokers group. Conclusions: Even though the clinical periodontal improvements were considerable in smoker patients, they did not reach the level observed in non-smoker patients.

Effect of Omega-3 Fatty Acid Supplementation on Periodontal Inflammation and Pocket Depth Reduction

ABSTRACT Background: Chronic inflammation of the tooth’s supporting tissues is known as periodontal disease. It causes pockets to develop, attachments to break, and eventually the loss of teeth. Because of their well-known anti-inflammatory qualities, omega-3 fatty acids have been recommended as an additional therapy for periodontal inflammation. Materials and Methods: A randomized controlled study of 60 individuals suffering from persistent periodontitis was carried out. Two groups of participants were randomly assigned: The test group (n = 30) got conventional periodontal treatment with omega-3 fatty acid supplementation (1000 mg/day), while the control group (n = 30) received normal periodontal therapy alone. Measurements of periodontal parameters were made at baseline, 3 months, and 6 months after therapy, including bleeding on probing (BOP) and pocket depth. Paired t-tests and analysis of variance were used in the statistical analysis to determine the significance of the group differences. Results: Participants in the test group showed a greater reduction in probing pocket depth (PPD) and BOP at both 3 and 6 months. Specifically, the mean PPD decreased from 5.4 ± 0.7 mm to 3.0 ± 0.4 mm, and BOP reduced from 71.2 ± 14.5% to 28.3 ± 9.2% in the test group, with both outcomes showing statistically significant differences compared to the control group (P &lt; 0.01). Conclusion: In individuals with chronic periodontitis, omega-3 fatty acid supplementation dramatically improves the decrease of periodontal pocket depth and inflammation when administered as an adjuvant to regular periodontal treatment.

Correlation of serum vitamin D and IL-8 to stages of periodontitis: a case-control analysis

ObjectivesThe current literature lacks the correlation between serum levels of vitamin D and interleukin-8 (IL-8) to the stages of periodontitis. The present research objectives are to evaluate the serum levels of vitamin D and IL-8 in periodontitis participants and healthy controls and to measure their correlation with the stages of periodontitis.MethodsThe current case-control study was conducted on patients with periodontitis and healthy controls. After obtaining a questionnaire from the participants, the following clinical parameters were measured; periodontal probing depth (PPD), clinical attachment loss (CAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and tooth count. The serum levels of vitamin D and IL-8 were measured using ELISA kits. Then, we measured the correlation of the stages of periodontitis with the serum levels of vitamin D and IL-8.ResultsNinety-eight participants; 52 with periodontitis and 46 healthy controls were included. The patients with periodontitis showed a significantly lower level of vitamin D, higher PPD, CAL, BOP, and lower number of teeth than the controls. In addition, serum vitamin D significantly correlated with the stages of periodontitis. Serum IL-8 showed no significant difference between the study and control groups while it does not significantly correlate with the stages of periodontitis.ConclusionThe current study’s findings suggest a potential association between serum level of vitamin D with severity of periodontitis which necessitates screening vitamin D status in patients with periodontitis and investigating the possibility of vitamin D supplementation in decreasing the progression of periodontitis.

The Efficacy of Ozonated Water in One-stage Full-mouth Disinfection amongst Chronic Periodontitis Patients: A Randomised Control Trial

Abstract Introduction: Periodontal disease, causing tooth-supporting structure damage due to bacterial build-up, is linked to various risk factors. Traditional treatment involved scheduled scaling and root planing. Full-mouth disinfection (FMD), introduced in 1995, involves comprehensive cleaning and chlorhexidine (CHX) application within 24 h to prevent bacterial spread. CHX, a potent antimicrobial, is widely used in FMD, but concerns about emerging resistance have led to the exploration of alternatives like ozonated water, which has shown promising antimicrobial properties and the potential to improve periodontal health. Materials and Methods: This is a randomised controlled trial involving 40 participants with Stage II or III periodontitis who were randomly grouped into two groups. Group A was advised to use 0.2% CHX solution, and Group B used a 10 μg concentration of ozonated water. Both the groups cleaned their dorsum of the tongue, rinsed their mouth, had a pharyngeal spray and had periodontal pockets irrigated using the respective solutions. Plaque index, papillary bleeding index, gingival index, relative attachment level and probing depth were measured at baseline, 3 months and 6 months. Results: Significant differences were found at baseline, 3-month and 6-month values of periodontal index, papillary bleeding index, probing depth, gingival index and relative attachment level amongst Group A and B participants. Differences were noted in between Groups A and B in the periodontal index at 6 months between CHX and ozonated water and between 3 and 6 months for probing depth. Around 68%, 70%, 66%, 68% and 63% improvements were noted in the periodontal index, probing depth, gingival index, papillary bleeding index and relative attachment loss amongst Group B. Conclusion: Ozonated water represents a promising adjunctive therapy for chronic periodontitis, demonstrating significant clinical efficacy in one-stage FMD protocols.

Active-Matrix Metalloproteinase-8, Myeloperoxidase in Relation With Periodontics, Preterm Birth.

To investigate serum, placental levels of active-matrix metalloproteinase-8 (aMMP-8), myeloperoxidase (MPO) in preterm-birth with/without pre-eclampsia and term counterparts in relation with clinical periodontal parameters. Clinical periodontal measurements were recorded. Serum and placenta samples were collected during 173 full-term (FT), pre-term (PT) or pre-term complicated by pre-eclampsia (PTPE) deliveries. aMMP-8 levels were measured by IFMA. MPO levels in the serum and placenta samples were determined by ELISA. Data were tested using non-parametric tests. PTBE group exhibited higher full-mouth probing depth and clinical attachment loss values than the other two groups (p < 0.05). Percentages of sites with plaque and bleeding on probing were lower in the PTBE group than in the other groups (p < 0.05). Serum aMMP-8 and MPO concentrations were higher in PTPE group than in the other groups (p < 0.05). Placenta aMMP-8 level was higher in the control group than in the PTPE group (p < 0.05). There was no significant difference between the groups in the placenta MPO levels (p > 0.05). Within the limits of this cross-sectional study, it may be suggested that serum aMMP-8 and MPO concentrations together with placenta aMMP-8 levels may be associated with and reflect adverse pregnancy outcomes. Clinical periodontal findings did not reveal significant associations with these proteolytic and oxidative biomarkers.

Does adjunctive phototherapy have better outcomes than adjunctive antibiotic therapy for the management of peri-implantitis?

Elsevier's Scopus, Web of Science and Pubmed through Medline identified 431 articles, which were reduced to 206 when duplicates were removed. 8 articles were screened, and 1 excluded after reading the full-text, leaving 7 studies. 6 of these were randomised controlled trials, and 1 a non-randomised controlled clinical trial. Studies selected were either blinded, double-blinded, split-mouth clinical studies, comparative or controlled clinical studies, or randomised controlled trials in humans. There were no limitations on year of publication or language of studies. Most studies had a control of mechanical debridement (MD) with adjuvant antibiotics; 1 was surgical therapy. The test group was MD with adjuvant phototherapy. Exclusions were in vitro reports, animal studies, treatment with sole laser therapy, treatment with no additional antimicrobial therapy alongside MD. Pre-prints, reviews, abstracts, opinion articles, editorials, case reports and case series were also excluded. Data were extracted electronically by a single author and a senior librarian from the 3 databases. Titles and abstracts of articles were screened by the author if they contained Medical Subject Headings either in free terms or with Boolean operators. Full text studies that met the inclusion criteria were included. Data were also searched manually in 6 journals. For missing or conflicting information, the author of the article was contacted for clarification. Data extracted were country of origin of article, study design, sample size, research groups, diagnostic criteria, frequency of intervention, follow-up visits, and outcome of parameters which included clinically: plaque index (PI), probing depth (PD), bleeding on probing (BOP) and radiographically: crestal bone loss (CBL). Additional data on lasers were also collected, although not all studies had complete data on this. RevMan was used for statistical analysis. Inconsistencies were evaluated using I2 value > 50% and Cochrane's Q test, with a P value < 0.05 considered. Standard Mean Differences (SMD) were calculated and Confidence Interval was set at 95%. A random effects model was used for each meta-analysis. PI had no statistical difference, with high heterogeneity. PD had no statistical difference, with no heterogeneity. BOP had a statistically significant difference and a high level of heterogeneity, favouring adjunctive phototherapy. MBL had statistically non-significant differences between control and test groups, and no heterogeneity. The findings from the systematic review differed from the meta-analysis, suggesting that application of adjuvant phototherapy was equally as effective as adjunctive antibiotic therapy in outcomes such as PI, PD, BOP and MBL. The meta-analysis found that implants treated with adjuvant phototherapy had superior outcomes in relation to BOP only.

The Effectiveness of Probiotics on Oral Health During Adult Orthodontic Treatment With Fixed Appliances: A Two-Arm Parallel-Group Randomized Controlled Clinical Trial.

Fixed orthodontic appliances interfere with daily oral care procedures, causing more plaque accumulation and thus increasing the risk of periodontal diseases. Probiotics have been suggested to maintain oral health using beneficial bacteria. However, the evidence to determine the clinical benefits of probiotics as a supplement to oral health in orthodontic patients is still insufficient. This trial aimed to investigate the protective effect of probiotics on oral health and prevent the development of inflammation of the gingiva and periodontal tissues during orthodontic treatment using fixed orthodontic appliances. This was a single-blinded, single-center, two-arm randomized controlled trial conducted between March 2023 and June 2024.A total of 50 patients (13 males (26%) and 37 females (74%) with a mean age of 21.33±2.04) who required a non-extraction-based treatment using fixed orthodontic appliances were enrolled and randomly divided into two groups: the probiotics group (PG) who underwent orthodontic treatment with probiotic tablets of Lactobacillus reuteri and the control group (CG) who underwent orthodontic treatment without probiotics. The following periodontal parameters were recorded: plaque index (PI), gingival index (GI), papillary bleeding index (PBI), and probing depth (PD). These indices were assessed three times: before the start of orthodontic treatment (T0) and after three months (T1) and after six months (T2) of applying fixed appliances. The mean values for PI, GI, PBI, and PD were statistically significantly lower in the PG compared to the CG at both time points T2 and T3 (p<0.05). In the PG, there was a significant difference in the PI between time points T0 and T1 (p<0.001), but there was no significant difference between T1 and T2 (p=0.074). The GI, PBI, and PD differences were also insignificant (p>0.05). Conversely, all studied periodontal parameters significantly increased during the assessment periods in the CG (p<0.001). Using probiotic lozenges that contain Lactobacillus reuteri, alongside regular teeth brushing, during the first six months of fixed orthodontic treatment in adults can help maintain good oral hygiene. This approach reduces plaque buildup and helps prevent the onset of clinical signs associated with periodontal disease.

Estimation of Scattering Properties Modifications Caused by InVivo Human Skin Optical Clearing Using Line-Field Confocal Optical Coherence Tomography.

The image contrast and probing depth of optical methods applied to invivo skin could be improved by reducing skin scattering using the optical clearing method. The aim of this study was to quantify, from line-field confocal optical coherence tomography (LC-OCT) 3D images, the modifications of skin scattering properties invivo during optical clearing. Nine mixtures of optical clearing agents were used in combination with physical and chemical permeation enhancers on the human skin of three healthy volunteers. Scattering coefficient and anisotropy factor of the epidermis and the upper dermis were estimated from the 3D LC-OCT images of skin using an exponential decay model of the in-depth intensity profile. We were able to demonstrate a decrease in epidermal scattering (down to 33%) related to optical clearing, with the best results obtained by a mixture of polyethylene glycol, oleic acid, and propylene glycol.

A Study Into Systemic and Oral Levels of Proinflammatory Biomarkers Associated With Endpoints After Active Non-Surgical Periodontal Therapy.

To analyse whether some selected inflammatory biomarkers collected from venous blood and gingival crevicular fluid (GCF) were associated with the outcome of non-surgical periodontal therapy. Two-hundred and nine patients affected by periodontitis were enrolled in the study, who had undergone steps I and II therapy as well as a non-surgical re-instrumentation (NSRI) of periodontal pockets after 6 months. Serum (SE), plasma (PL) and GCF samples were quantitatively analysed for the following inflammatory biomarkers: active matrix metalloproteinase-8 (aMMP-8), prostaglandin E2 (PGE2) and surfactant protein D (SP-D). Therapy outcomes were evaluated using a 'treat-to-target' endpoint (T2T) at the patient level, defined as ≤ 4 sites with pocket depth ≥ 5 mm. Patients presented with 23 ± 6 teeth (mean ± SD) at baseline. After steps I and II therapy, 41.6% of the patients reached T2T and after NSRI 47.4%. Univariate analysis identified a potential association between high levels of PL-SP-D and more favourable treatment outcomes. Multivariate binary logistic regression adjusted for sex, mean baseline probing depth, diabetes and current smoking status confirmed an independent relationship between baseline PL-SP-D and the T2T after steps I and II therapy (aOR 0.432, p = 0.011), implying that a higher level PL-SP-D at baseline is associated with a > 50% reduced risk of failing T2T. However, no such association was found for PL-SP-D and NSRI. Higher baseline PL-SP-D levels might be associated with more favourable treatment outcomes after steps I and II therapy. This may be due to its role in the regulation of neutrophil function. However, further investigation is required to confirm this hypothesis. If proven, PL-SP-D could play a role as a biomarker for identifying individuals who respond differentially to primary therapy.

Influence of Lateral Hard-Tissue Grafting on Peri-Implant Health or Disease: A Cross-Sectional Study.

To investigate the influence of lateral hard-tissue grafting performed simultaneously to implant placement on peri-implant health or disease. A total of 299 patients exhibiting 897 implants placed either simultaneously with lateral bone grafting using a bovine bone mineral with or without adjunctive native collagen membrane (n = 131/269 patients/implants; LatGr group) or at pristine bone sites without lateral bone grafting (n = 168/628 patients/implants; NoGr group) were enrolled in this cross-sectional analysis. Clinical outcomes (i.e., modified plaque index (mPI), bleeding on probing (BOP), probing depth (PD), mucosal recession (MR)), keratinized mucosa (KM), and the frequency of peri-implant disease were evaluated. Univariate and multiple ordinal regression analyses with mixed effects were conducted to identify factors associated with peri-implant disease. After a mean follow-up period of 59.47 ± 24.66 months, mPI, BOP, and KM values were significantly higher in the control group, whereas no difference between the groups was found for PD and MR. Peri-implantitis was diagnosed in 31.30% of patients and 13.4% of implants in the LatGr group, and in 32.74% of patients and 24.8% of implants in the NoGr group. The corresponding values for peri-implant mucositis at the patient and implant level in the LatGr and NoGr groups were 29.77% and 29.0%, and 26.19% and 28.5%, respectively. Implants of the LatGr group were associated with a significantly lower chance to be affected by peri-implant disease (OR = 0.69, 95%-CI: (-0.72, -0.03), p = 0.032). The presence of plaque at implant sites and smoking significantly correlated with peri-implant disease (OR = 2.92, 95%-CI: (2.11, 4.03), p < 0.001 and OR = 0.22; 95%-CI: (0.06, 0.84), p = 0.027, respectively). Lateral hard-tissue grafting performed simultaneously with implant placement demonstrated comparable peri-implant tissue health to pristine bone sites without lateral bone grafting.

Clinical and Microbiological Periodontal Biofilm Evaluation of Patients with Type I Diabetes.

Background/Objectives: The purpose of this study was to assess the microbial composition and density of subgingival plaque samples for periodontal pathogens while correlating the values with glycemic control levels via glycated hemoglobin (HbA1c), a type of hemoglobin that has chemically linked glucose, in type I diabetes individuals who will undergo complex oral rehabilitation through orthodontic treatment and implant surgery. Methods: A cohort of 42 adults with type I diabetes were included in this study. The subjects sustained a comprehensive periodontal clinical examination as well as microbiological assessments of their subgingival plaque samples through quantitative real-time PCR. The samples were collected from the two deepest pockets of each subject. Results: The highest number of periodontopathogenic bacteria was observed in the pockets of 5-7 mm. T. forsythia showed the highest prevalence (20.48%), with decreasing numbers as follows: T. denticola (13.31%), P. gingivalis (11.26%), A. actinomycetemcomitans (7%), and P. intermedia (4.9%). T. denticola and T. forsythia were significantly more commonly observed in individuals with elevated HbA1c serum levels. No correlation was observed between P. gingivalis, A. actinomycetemcomitans, P. intermedia presence, and the HbA1c value. Conclusions: Periodontopathogenic agents' presence in subgingival biofilm samples varied in accordance with the pocket probing depth and metabolic control of the diabetic individuals. In our study, the appearance of these periodontopathogenic agents was linked to lowered metabolic control in patients with type I diabetes mellitus.

Comparing Medium to Long-Term Esthetic, Clinical, and Patient-Reported Outcomes Between Freehand and Computer-Assisted Dental Implant Placement: A Cross-Sectional Study.

The aim of the study was to compare medium to long-term clinical and patient-reported outcomes between implants placed with computer-assisted implant surgery (CAIS) and freehand protocols. Thirty dental implants in the anterior maxillary region with an average of 4 years after loading were assessed by means of Pink Esthetic Scores (PESs), marginal bone level (MBL), and clinical and patient-reported outcomes. CAIS significantly outperformed freehand placement with regard to PES scores (p = 0.011). Likewise, implants placed with CAIS showed significantly higher MBLs (p < 0.001). Bleeding on probing, probing depth, and prevalence of mucositis did not differ between the groups, while no peri-implantitis was diagnosed. The use of CAIS leads to superior outcomes in terms of esthetics and MBLs for implants placed in the esthetic zone as observed in medium to long-term follow-up. No difference was however observed with regard to peri-implant mucosa inflammation. This article highlights the outcome of computer-assisted implant surgery in achieving higher esthetic, MBL, and esthetic satisfaction compared to freehand implant placement. TCTR20240422015.