Journal of the International Academy of Periodontology最新文献

Aims: The purpose of this meta-analysis is to systematically evaluate published evidence literature pertaining to report the differences in the survival rate of immediate implant placement in infected sites and non-infected sites.

Materials and methods: After the application of the search strategy in PUBMED, SCOPUS, and EMBASE research databases, a total of 1864 papers were found. Titles and abstracts were screened, yielding 77 full-text papers. After the overall assessment, 23 articles were recruited based on the inclusion criteria for analysis of data.

Results: Out of 23 studies, 14 studies were combined to assess the risk ratio of survival rate of immediate implant placement between infected and non-infected sites, depicting no significant difference on the survival rate. Further pooled estimate of proportion of survival rates were 0.98 suggesting 98% survival rate of immediate implants placed in infected sockets when 9 retrospective and prospective studies (no control studies) were combined. These findings demonstrate that successful outcomes can be expected for immediate implants when placed into infected extraction sockets.

Conclusions: Within the limitations of this systematic review, equal predictability for successful osseointegration and long-term functioning of immediate implants was found in infected as well as in healthy extraction sites, but astringent antiseptic environment is mandatory for wound healing of immediate implants.

Aims: To investigate the association between the keratinized mucosa (KM) width and peri-implant diagnostic parameters in implant maintenance.

Materials and methods: A total of 331 posterior implant-supported fixed prostheses in 165 patients were evaluated. Demographic data were collected from history taking and treatment records. Plaque index, bleeding index, probing depth, mucosal recession, and bone level in relation to buccal keratinized mucosa were examined. The Kruskal-Wallis, Mann-Whitney U, and multivariable models were used as the statistical tests.

Results: The majority of subjects attended implant maintenance at least once a year and demonstrated optimal oral hygiene. keratinized mucosa width ranged from 0-7 mm. Considering the keratinized mucosa widths, a marked recession was determined at < 2 mm keratinized mucosa and less recession was determined at > 2 mm keratinized mucosa. The multivariate model indicated that < 2 mm keratinized mucosa was significantly associated with increased mucosal recession (B = 0.12; CI: 0.01, 0.23). Plaque accumulation, mucosal inflammation, and interproximal bone level were not related to keratinized mucosa width after adjusting for oral hygiene, smoking status, history of chronic periodontitis, and implant prosthesis type.

Conclusions: The presence of more than 2 mm of KM width was associated with mucosal recession. However, other peri-implant diagnostic parameters were not associated with the width of keratinized mucosa.

Aims: To test the hypothesis that higher periodontal inflamed surface area (PISA) positively correlates with the coefficient of variation of red cell distribution width (RDW-CV) in non-obese hypertensive patients.

Materials and methods: Hypertensive subjects aged between 40-60 years with and without periodontitis were enrolled for the study. They completed a structured questionnaire that included gender, height, weight, and other variables. Body mass index was calculated to exclude obese individuals. Clinical periodontal parameters were recorded. PISA was calculated, and participants were divided into four groups: Group 1: Non-hypertension without periodontitis, Group 2: Non-hypertensive with periodontitis, Group 3: Hypertensive without periodontitis, and Group 4: Hypertensive with periodontitis. The hematologic evaluation included red cell distribution width analysis.

Results: ANOVA showed age and diastolic blood pressure were significantly related to RDW-CV at p < 0.001. Periodontal parameters showed significant association with RDW-CV in both hypertensive and non-hypertensive groups at p < 0.001. Pearson correlation test showed a significant association between RDW-CV and PISA. Multivariate regression models showed PISA to be a significant predictor for RDW-CV in the periodontitis group compared to a non-periodontitis group.

Conclusions: The increase in the RDW-CV in the periodontitis group in both hypertensive and non-hypertensive indicates the independent role of increased inflammation on pathogenic alteration of red cell morphology.

Aims: This experimental study aimed to evaluate the effects of a three-dimensional matrix of chitosan-gelatin (CG) associated with 1% hyaluronic acid (HA) on gingival healing and repairing of intrabuccal bone defects in rats.

Materials and methods: Standardized bone defects were created in the region of the upper 1st molars of rats. Study groups were created according to bone defects (n=6/group) treatment: Control group (CO); blood clot; HA group; CG group, and HA+CG group. After 7 and 21 days, the animals were sacrificed for histological and histomorphometric analysis. Bone formation was quantified as the percentage of newly synthesized collagen, visualized by Gomori's trichromic. Clinical/macroscopic evaluation was based on predetermined scores of gingival healing.

Results: Treatment with HA improved gingival healing at day 7, but no statistical differences were found among groups at day 21. The morphometric analysis demonstrated better results after the treatment of bone defects with both HA and CG on day 21. The three-dimensional structure of CG prevented the invasion of epithelial tissue into the defect, preserving its original volume.

Conclusions: Isolated use of a chitosan-gelatin osteoconductive matrix promoted greater bone deposition and preserved the volume of the surgical site, irrespective of the presence of hyaluronic acid.

Aims: To assess the periodontal status in cannabis smokers in comparison with non-cannabis smokers.

Materials and methods: Electronic databases were searched as well as hand searches performed. Eligible studies followed the Population Exposure Comparison Outcome Study (PECOS) structure: P: dentate humans, E: cannabis smoking, C: non-cannabis smoking, O: Primary outcomes: periodontitis case definition, clinical attachment loss, probing depth; Secondary outcomes: bleeding on probing/ gingival inflammation, plaque index and calculus; S: observational studies. Qualitative analyses of the studies were done. The quality of cohort studies was assessed with the Newcastle-Ottawa scale and cross-sectional studies were assessed using a modified Newcastle-Ottawa scale.

Results: 2661 records were screened, of which 14 articles were included. Data from a cohort study showed that highly exposed participants were at higher risk of clinical attachment loss progression. Six cross-sectional studies reported worse gingival or periodontal conditions in cannabis smokers. Nevertheless, one did not find such association, neither did three case series. Three studies were of high, two of moderate and six were of low quality.

Conclusions: Based on the available data, frequent cannabis smoking could be detrimental for periodontal tissues and this could be dose-dependent. Studies including long-term cannabis smokers, and stratified for periodontal disease etiologic factors and risk factors/indicators are needed.

Aims: Gingival recession has been associated with dentin hypersensitivity and aesthetic impairment. The impact of gingival recession and periodontal surgical procedures on adult patients' quality of life are scarce. The aim of this study was to evaluate the quality of life of patients submitted to root coverage procedures with subepithelial connective tissue grafts and coronally advanced flap.

Materials and methods: Patients were asked to use a numerical rating scale to classify their dentin hypersensitivity, aesthetics, pain/discomfort, chewing, and brushing abilities in gingival recession sites treated with subepithelial connective tissue grafts plus coronally advanced flap. The patients answered a self-administered questionnaire about quality of life-related to oral health (OHIP-14) after 7, 14, 30, 90, and 180 days. Descriptive statistics were used to synthesize the data recorded.

Results: Mean percentage of root coverage was positively related to OHIP-14 (dimension 2- physical pain) in 90 days postoperatively. The quality of life (OHIP-14 total score) significantly improved from baseline to 90 and 180 days postoperatively. The numerical rating score analysis revealed significant improvement in the chewing and brushing abilities when period of 7 days was compared to 90 and 180 days and from 14 to 180 days.

Conclusions: Root coverage procedures with subepithelial connective tissue grafts plus coronally advanced flap result in a positive effect on adult patients' quality of life.

Background: The aim of this study was to assess the stress concentration in simulated periodontal alveolar bone containing healthy teeth with and without attachment loss.

Methods: Six 3-D models of a lower central incisor were created simulating the teeth structure, cancellous and cortical bone and periodontal ligament. Each model presented a 1mm increasing distance between cement-enamel junction (CEJ) and alveolar bone crest (ABC) (1 to 6mm). A 100N, 45-degree load was applied to the buccal face of the lower central incisor. The effects of Minimum Principal Stress (MPS) on lamina dura (LD) and ABC were analyzed.

Results: The results showed an increase of MPS in the surrounding bone (ABC and LD) due to periodontal attachment loss. The 6mm attachment loss model showed the highest (p less than 0.001) magnitude in MPS. Each millimeter increase in CEJ-ABC distance generated a 12% pattern of attachment loss and an increase at least of 65.7% for ABC and 33.6% for LD.

Conclusion: Under simulated conditions, attachment loss increases stress concentration in the surrounding bone suggesting a partly explanation regarding bone resorption risk for teeth with periodontal attachment loss.

Background: The present review aimed to assess the impact of being a complier to supportive periodontal therapy (SPT), when compared to not being a complier, on tooth loss in patients with periodontitis.

Methods: Prospective and retrospective observational studies were included. MEDLINE, EMBASE, and LILACS databases were searched up to May 2019. The odds-ratio (OR) and standard error (SE) values of the studied groups (compliant or non-compliant) were converted to logOR, and the results of individual studies were grouped using a random effects model.

Results: From a total of 1815 articles initially searched, 13 retrospective studies and one prospective study comparing tooth loss of complier and non-complier individuals in SPT were included. Meta-analysis of eight studies showed that non-compliers in SPT have an increased risk of tooth loss when compared with compliers. Overall meta-analysis demonstrated that non-compliant patients in SPT have a 26% increased risk of tooth loss when compared with compliant patients (OR = 1.26; 95% CI = 1.06 to 1.51, Heterogeneity: I2 = 0%, p = 0.008).

Conclusions: Patients with periodontitis who do not comply in SPT have a higher risk of tooth loss than compliant patients. Oral health professionals should implement measures to obtain optimal adherence by patients in SPT.

This article describes the removal of a malpositioned dental implant, using an implant retriever, followed by guided tissue regeneration with the use of an xenogeneic graft and a dense polytetrafluorethylene membrane that remained partially exposed for 28 days, and the post-surgical prosthetic and orthodontic treatment until conclusion of the oral rehabilitation procedure. The patient, 50 years of age, presented to a private clinic for evaluation of an implant supported fixed crown, with unsatisfactory esthetic appearance and function. The treatment plan involved the removal of this implant, guided bone regeneration, and placement of a new implant in a better 3D position. Subsequently, the patient received a provisional dental prosthesis, orthodontic treatment in order to realign the gingival margins, and additional rehabilitation with the application of some ceramic veneers to enhance the patient's esthetic appearance, improve function, and show the 1-year follow-up of the case. The treatment plan was shown to be appropriate for this case, in which soft and hard tissue were adequately regenerated, and resulted in good oral rehabilitation with tissue stability around the teeth and implant.

Objectives: To compare the outcomes of root coverage when the (1) donor site of connective tissue graft is the palate or tuberosity and (2) when connective tissue graft is harvested with intra- or extra-oral de-epithelization techniques.

Methods: The primary outcome was patient satisfaction. Secondary outcomes included complete root coverage, percentage of root coverage and keratinized tissue width. Searches were conducted until December 2019 in PubMed, EMBASE, Scopus and CENTRAL.

Results: 3275 studies were retrieved, but no randomized trials (randomized controlled trials) were found comparing tuberosity and palate. Data were extracted for one arm assessing any connective tissue graft technique from 56 randomized controlled trials to compare intra-oral de-epithelization and extra-oral de-epithelization outcomes. Among these studies, none have harvested connective tissue graft from tuberosity. Patient satisfaction for intra-oral de-epithelization and extra-oral de-epithelization ranged between 79% and 95%. Complete root coverage for intra-oral de-epithelization and extra-oral de-epithelization techniques was 55% (95%CI 46-65) and 70% (95%CI 63-77). Metaregression analyzes demonstrated that free gingival graft presented 4.41 higher chance of CRC [odds ratio (OR)=4.41, p=0.001] compared to single incision technique, followed by Bruno's (OR=4.39) and double-blade (OR=3.85) techniques. There were no differences between de-epithelization techniques for percentage of root coverage and keratinized tissue width.

Conclusion: No evidence was found to support the use of connective tissue grafts from the tuberosity. If complete root coverage is the major clinical goal, extra-oral deepithelization may be preferred over intra-oral de-epithelization techniques.