Journal of the International Academy of Periodontology最新文献

Aims: This study aimed to determine the possible clinical and histological periodontal effects of long-term coca leaf chewing habit in habitants of the highland region of Peru.

Materials and methods: A total of 100 residents, were recruited for the study. Fifty individuals were habitual coca leaf chewers and 50 were non-users. Eligibility criteria were: 60-80 years old, ≥20 teeth present (excluding third molars), systemically healthy (controlled systemic disease), not using medication affecting the gingiva. Chronic tobacco smokers were excluded. All participants completed questionnaires, received clinical periodontal examination, and had gingival biopsies harvested for histopathological assessment.

Results: Most coca leaf chewers reported several oral changes resulting from the habit, such as bitterness, numbness and mouth dryness, while none of the non-chewers reported experiencing such changes. Within the clinical periodontal parameters, it was found that there was a significant difference in terms of clinical attachment level loss, with a p value of 0.014 in those who chewed coca leaves, who appeared to have less clinical attachment loss.

Conclusions: Chewing coca leaf produce bitterness, numbness and mouth dryness, and clinical attachment loss. Histologically higher number of inflammatory cells in the stratum spinosum, with more acanthosis, clear cell, and higher number of blood vessels.

Aims: To estimate the change in the alveolar ridge by means of a new alveolar ridge preservation (ARP) approach, using an anodized titanium foil (Tseal) associated with a bovine bone graft (BBG) by cone-beam computerized tomography.

Materials and methods: Sixteen patients, each presenting one hopeless tooth, were selected and these teeth were carefully extracted. The alveolar socket was filled with BBG and the Tseal was trimmed and adapted to the bone crest. The primary outcome variable was the change in the alveolar dimension (AD) measurements between baseline (T1) and 6 months (T2) 1mm below the palatal bone.

Results: Imaging assessment of AD demonstrated a decreased value in all subjects. The absolute rate and percentage of absorption between T1 and T2 time point showed statistically significant differences. The mean AD varied from 9.88 ± 2.04 mm (T1) to 8.85 ± 1.92 mm (T2). On average, this ARP procedure maintained 89.55% ± 6.11% of the distance of between the buccal and palatal wall. No differences were observed between the maxilla and mandible (p greater than 0.05).

Conclusion: The application of a bovine bone graft covered with Tseal resulted in clinically important horizontal preservation of the alveolar ridge at 6 months after extraction.

Aims: To test that the osteogenic capacity of periodontal ligament (PDL) fibroblasts can be mediated by TLR2 and TLR4 activation.

Materials and methods: Human PDL fibroblasts were cultured in osteogenic medium and treated with TLR2 and TLR4 agonists (Pam3CSK4 and monophosphoryl Lipid A (MPLA), respectively). Cell proliferation was measured by MTT and BrdU incorporation. Osteogenic differentiation was measured by alkaline phosphatase (ALP) activity. Nodule formation was measured for osteoblast function. The expression of markers of potential signaling pathways (RUNX2, OCN, BSP and Osterix) was evaluated by quantitative PCR.

Results: PDL fibroblasts grew at the same rate during the first 5 days in response to both Pam3CSK5 and MPLA. On day 7, cells cultured in the presence of Pam3CSK4 had a significantly higher rate of DNA replication, while cells in MPLA group had a significantly lower DNA replication rate (one-third) compared to the control (p less than 0.05). Pam3CSK4 induced significantly higher ALP activity and larger calcified nodules. TLR4 activation significantly reduced the expression of RUNX2 and osterix and enhanced OCN. Neither TLR2 nor TLR4 affected BSP expression.

Conclusions: These data suggest that the activation of TLR2 and TLR4 differentially and perhaps antagonistically modulate osteogenesis by human PDL fibroblasts and have a direct role of TLR-mediated PDL function during periodontal regeneration as a potential target for therapeutics.

Aims: To determine the differences in the long-term clinical outcomes between Regeneration (REG) and Conservative Surgery (CS) in infra-bony defects.

Materials and methods: Three databases were searched [PubMed, Medline and Embase] up to April 2019. Following screening, 17 studies were included. Randomized Controlled Clinical Trials, Controlled Clinical Trials and retrospective studies with long-term clinical observations (≥ 24-months) were selected. After subgrouping the studies regarding the grafting material and the used flap, meta-analysis was performed for different outcomes [clinical attachment level gain (CALGain), probing pocket depth reduction (PPDRed), recession increase (RECInc) and bone fill (BF)] at different follow-ups (24-, 36-, 48- to 60- and 120- to 240-months).

Results: The time-related meta-analysis favoured REG at every interval for every outcome. In subgroup analysis, enamel matrix derivative (EMD) performed significantly better for both CALGain [24- (p less than 0.0001), 36- (p=0.02) and 60-months (p less than 0.00001)] and PPDRed [24- (p=0.0004), 36- (p=0.003) and 60-months (p less than 0.00001)]. For Ceramic Grafts (CGs), CALGain at 48-months (p less than 0.00001) and PPDRed at 24- (p=0.0006), 36- (p less than 0.00001) and 48-months (p less than 0.00001) follow-up showed better results.

Conclusion: The better outcomes from REG using EMD or CGs can be maintained for a longer duration, suggesting a potential longevity of the occurred healing.

Aims: To investigate the use of ω-3 fatty acids and low-dose aspirin as adjuncts to periodontal debridement in a patient with periodontitis and metabolic syndrome.

Methods: Periodontal and systemic parameters were assessed at baseline and 6 months. Gingival crevicular fluid was analyzed for interleukin (IL)-1β, IL-6 and interferon (IFN)-γ levels by multiplex ELISA at baseline, 3 and 6 months.

Results: The treatment was effective in reducing probing depth, clinical attachment level, bleeding on probing and plaque index, and glycated hemoglobin, triglycerides IL-1β, IL-6 and IFN-γ levels over time.

Conclusions: The adjunctive use of ω-3 and low-dose aspirin to periodontal debridement might have potential benefits in the treatment of periodontitis in a patient with metabolic syndrome.

Aims: To report the periodontal condition of two siblings (ages 2 and 4) diagnosed with congenital Amegakaryocytic Purpura (AP), who underwent allogeneic hematopoietic stem cell transplant (HSCT) and developed graft-versus-host disease (GVHD) with oral manifestations.

Methods: Clinical history was obtained through physical examination and medical records. Patients received clinical and microbiological assessment at 2 months post-HSCT, when they started to show signs and symptoms of GVHD and were monitored at 8/15-months post-transplant. They were treated by means of prophylaxis and oral hygiene instruction. Two supragingival biofilm samples were collected from each patient and analyzed by Checkerboard DNA-DNA hybridization.

Results: Patients developed severe periodontal clinical attachment loss (CAL) in deciduous dentition associated with recession of the periodontal tissues. They also presented GVHD lesions in the oral mucosa, lips and tongue. Caries lesions, gingivitis, and heavy biofilm deposits were identified. The microbiological profile of biofilm samples presented high levels and proportions of periodontal pathogens, such as Aggregatibacter actinomycetemcomitans.

Conclusion: The cases presented suggested that severe periodontal CAL in children with AP may be an atypical manifestation associated with AP and/or GVHD, which may be aggravated by the presence of a dysbiotic biofilm containing periodontal pathogens, especially A. actinomycetemcomitans.

Aims: To evaluate the effect of periodontal disease (PD) and cognitive deficit (CD) on behavioral state, oxidative stress parameters, and alveolar bone loss (ABL).

Materials and methods: Fifty male Wistar rats were randomly divided into five groups: control; scopolamine; periodontal disease (PD); PD+scopolamine evaluated by the Morris water maze behavioral test; PD+scopolamine assessed by the inhibitory avoidance behavioral test. PD and CD were, respectively, induced by ligature and scopolamine. Both the maxilla and mandible were morphometrically analyzed for ABL. For all animal groups, the study duration was one month. For the ligated animals, the final evaluation was performed 14 days after the ligature placement. Reduced glutathione (GSH), total sulfhydryl (TS), thiobarbituric acid, catalase, and superoxide essays were assessed in the brain tissues (cortex and hippocampus).

Results: Both groups with induced PD+CD (0.46±0.04mm and 0.47±0.04mm for maze and inhibitory avoidance behavioral tests, respectively) presented a significantly higher ABL in comparison to the group that received only scopolamine (0.22±0.01mm). PD and PD+scopolamine groups presented significantly lower GSH and TS in comparison to the control group. Regarding the memory latency tests, there were no statistically significant differences among groups.

Conclusion: The induction of PD was capable to modulate the CD, decreasing the action of the antioxidant agents in the brain. However, PD was not capable of impairing the short and long-term spatial memory retention behavioral.

Aims: This study evaluated the mechanical properties of mandibular bone tissue retrieved from postmenopausal women under alendronate treatment.

Methods: Twenty postmenopausal women were divided into two groups: healthy postmenopausal subjects (control group) and osteoporotic subjects treated with alendronate (alendronate group). Mandibular bone samples were retrieved with a trephine bur at the time of dental implant placement and fixed in 4% formalin. Samples were processed for hard tissue histology, and the bone surface was analyzed for nanohardness measurement. Nanohardness and elastic modulus were evaluated by using a Berkovich tip with elastic modulus of 1.016x106 MPa, Poisson coefficient of 0.3, and a load of 100 mN. Each cycle was configured with a load time of 18 seconds (speed of 1 mN/second), the discharge time of 18 seconds, and a rest time of 5 seconds during indentation at a depth of 10 μm.

Results: The control group presented the highest values for nanohardness and elastic modulus (p less than 0.05) in relation to the osteoporotic subjects.

Conclusions: Within the limitations of the study, it can be concluded that treatment with alendronate negatively influenced the mechanical properties of mandibular bone in postmenopausal women by reducing bone nanohardness and elastic modulus.

Aims: The purpose of the present study was to compare the effect of a new mouth wash formulation consisting of chlorhexidine and chitosan on dental plaque and its reduction to that of chlorhexidine or chitosan alone.

Materials and methods: This study was a single-blind randomized clinical trial with a parallel group design of 3 months duration. Patients (20-40 years) who fulfilled the inclusion and exclusion criteria were assigned equally to group 1: chlorhexidine (0.2%), group 2: chitosan (0.5%) or group 3: chlorhexidine - chitosan combination group. The clinical parameters were recorded at baseline, 6weeks and at 3months. All patients received thorough oral prophylaxis and were instructed to rinse with 10ml of mouthwash twice daily for 1 minute.

Results: The combination of chitosan and chlorhexidine showed a statistically significant reduction (p less than0.05) in plaque indices from baseline at all time intervals when compared to that of chlorhexidine or chitosan alone.

Conclusions: Our study demonstrates that by unifying the properties of chitosan and chlorhexidine may result in a superior antiplaque effect than that of chlorhexidine alone.

Aims: To systemically review the literature on the effect of hand and sonic/ultrasonic instruments used for the non-surgical treatment of periodontitis.

Materials and methods: Five databases were searched for randomized clinical trials that compared the results of periodontal treatment using hand and sonic/ultrasonic for nonsurgical periodontal treatment. Four meta-analyses were performed, using the calculated mean differences (MD) between baseline and 3-months or 6-months after periodontal treatment for clinical attachment level (CAL), and probing pocket depth (PPD).

Results: Eighteen studies were included. All included studies showed significant improvement, in at least one periodontal parameter, in both tested periodontal therapies. The sonic/ultrasonic instruments spend significantly less time in comparison to manual instrumentation. At both 3- and 6-months after periodontal therapy, no statistically significant differences were detected for CAL gain between therapies (MD; 95%CI: 0.05; -0.21-0.30 and -0.23; -0.59-0.12). Similarly, no statistically significant differences were detected for PPD reduction between therapies at 3-months of follow-up (MD; 95%CI: -0.03; -0.34-0.28). After 6-months, the PPD reduction was 0.21 (95%CI: -0.43-0.00, p=0.05).

Conclusion: Similar results may be expected for the periodontal treatment performed with hand and sonic/ultrasonic instruments. However, further studies with lower risk of bias are warranted.