Journal of the International Academy of Periodontology最新文献

Aim: Periodontal treatment is reported to be associated with an improved periodontal condition in diabetic patients. Therefore, a comprehensive review of meta-analyses was conducted to evaluate whether periodontal treatment can improve glycemic control in patients with type 2 diabetes.

Materials and methods: The search on electronic databases included PubMed-Medline, Cochrane Library, Scopus, and LILACS databases. The methodological quality of the systematic reviews was evaluated using AMSTAR, and primary studies were performed in accordance with PRISMA guidelines. The weighted mean difference (WMD) was calculated, nested in a random-effects model with corresponding Z scores, p-values, and 95% confidence intervals.

Results: A total of 11 meta-analyses were included, and a meta-analysis of 11 primary studies comprising a total of 1341 participants was carried out. All the studies evaluated glycosylated hemoglobin (Hb1Ac), and 6 of the 11 publications evaluated fasting plasma glucose (FPG). The AMSTAR scores ranged between 9 and 11, with a median of 10.3. Statistically significant reductions were observed in HbA1c values [-0.32% (3.5 mmol/ mol); 95%CI: -0.50 to -0.15] and FPG values (-11.59 mg/dl; 95%CI: -15.16 to -8.01).

Conclusion: The review of currently available clinical studies concludes that periodontal treatment is associated with improved glycemic control in patients with type 2 diabetes. New guidelines, including periodontal treatment as a routine public health measure to improve glycemic control in diabetic patients, would be of great value.

Aims: The purpose of this study was to evaluate the impact of fullfixed orthodontic appliances on the periodontium in adult patients.

Methods: Seventeen periodontally and systemically healthy subjects were selected from the Periodontal Clinic of Guarulhos University, 7 males and 10 females (mean age: 38.3 ± 6.3 years). The patients undergoing orthodontic treatment were submitted a clinical examination, a cone beam computed tomography at baseline and after 12 months of treatment. Subgingival biofilm samples were analyzed by Checkerboard DNA-DNA hybridization. Statistical analysis was performed by a Wilcoxon test.

Results: The percentage of sites with visible plaque increased (p =0.003), but no significant reduction in marginal bone was observed. The mean periodontal pocket depth was reduced (p=0.001) and the clinical attachment level significantly improved (p =0.001). There was a significant reduction in the mean proportions of the Actinomyces sp and an increase in the orange complex species. The proportions of the red complex species remained unchanged.

Conclusions: In spite of increase in plaque accumulation no significant clinical or tomographic iatrogenic changes in periodontally healthy adults undergoing orthodontic full-fixed appliance treatment could be detected. The microbiological changes did not affect the periodontal parameters in monitored adult patients that received short period of orthodontic treatment.

Aims: This study aimed to determine the dimensional change in the alveolar ridge after using an anodized titanium foil (Tseal) in association with bovine bone (BB) grafting in damaged extraction sockets by cone-beam computerized-tomography.

Materials and methods: Fifteen patients who had one hopeless tooth with over 80% of the buccal wall lost were selected and then the teeth were carefully extracted. The alveolar socket was filled with bovine bone and the Tseal was trimmed and adapted over the bone crest. The primary outcome variable was the change in the alveolar dimension (AD) measurements between baseline (T1) and 6 months (T2) after extraction in three points of analysis, 1mm, 3mm and 5mm below the palatal bone crest.

Results: Bone regeneration was observed to occur between 87% and 116% of the AD assessed at the baseline. No statistical differences were observed. The mean AD value varied from 7.82±2.75 mm (T1) to 8.02±2.43 mm (T2) in the 1 mm point, from 7.99±2.67 mm to 8.71±2.26 mm to 3 mm and 8.56±2.60 mm to 9.00±2.52 mm at 5 mm area.

Conclusion: Bovine bone graft in association with Tseal achieved horizontal reconstruction of the alveolar crest in compromised socket within 6 months after surgery.

Background: This systematic review evaluated the most effective therapeutic approach to treat periodontal furcation defects with a minimum follow-up of 12 months. The primary outcome was clinical attachment level (CAL). Secondary outcomes were probing pocket depth, gingival margin level, gingival index and plaque index.

Methods: A comprehensive search of studies published up to December 2019 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. Two reviewers independently searched eligible studies, made a final article selection, and extracted the data of the selected studies to evaluate qualitatively and quantitatively (meta-analysis).

Results: Overall, 19 studies were selected for the analysis. Six hundred and eighteen patients (mean age, 45.3) were treated. More commonly used treatment was polytetrafluoroethylene barrier (ePTFE), followed by enamel matrix derivative (EMD) and open-flap debridement (OFD). Only one study evaluated maxillary arch and remaining evaluated mandibular arch. All treatments provided CAL gain, but meta-analysis did not show significant difference among more commonly used treatments and controls (P=0.91; P=0.47; P=0.08, respectively).

Conclusion: There is no difference on effectiveness of main therapeutic approaches evaluated for treatment of Class II periodontal furcation defects.

Objective: Human beta-defensins (hBDs) play an important role in the susceptibility to periodontitis. This study aimed to evaluate the levels of hBD-2 and hBD-3 in gingival crevicular fluid (GCF) of individuals with and without periodontitis.

Methods: Twenty periodontally healthy individuals (H) and 20 with periodontitis (P) were recruited. GCF samples were collected from healthy sites (Hh; n=20) from H individuals; and from healthy sites (Ph; n=20), sites with gingival inflammation but no attachment loss (Pg; n=20) and sites with inflammation and attachment loss (Pp; n=20) from P individuals. Levels of hBDs (pg/mL) were determined using ELISA. Comparisons between individuals and among sites were performed through hierarchical linear modelling.

Results: GCF levels [median(Q3-Q1)] of hBD-2 were: Hh=4.80 (0.00-30.69); Ph=33.29 (28.04-38.25); Pg=27.56 (23.14-35.50); and Pp=26.20 (23.20-42.54); and of hBD-3 were: Hh=0.00 (0.00-0.00); Ph=978.44 (760.48-1268.12); Pg=938.19 (806.75- 1266.38); and Pp=613.63 (325.50-854.68). Periodontitis at the individual level was associated with higher levels of hBD-2 (p=0.023) and hBD-3 (p greater than 0.001). No influence of site phenotype was observed on hBDs levels.

Conclusion: Individuals with periodontitis presented higher levels of hBD-2 and hBD-3 in the GCF. These levels seemed to be influenced by periodontitis at the individual level but not by periodontal site.

Aim: The aim of this study was to determine the effects of probiotics on peri-implant diseases.

Materials and methods: PubMed-MEDLINE, Scopus, Literature in the Health Sciences in Latin America and the Caribbean (LILACS) and Science Direct were searched until September 2019. Three authors independently carried out this search, using the following search algorithm to explore databases using Boolean operators ("peri-implant diseases" OR "dental implants") AND ("probiotics" OR "lactobacillus"). Randomized clinical trials were included. No limits were applied to the year and articles were restricted to those in the English, Spanish and Portuguese languages. Review articles, reports of clinical cases and works without mention of the topic were excluded.

Results: Five randomized clinical trials were analyzed in the final review process. For the primary outcomes - Periodontal probing depth (PPD) and bleeding on probing (BOP); and for the secondary outcames - plaque index, gingival index, gingival crevicular fluid and microbiological tests - no significant clinical effects of probiotics were observed.

Conclusion: Probiotics could be used during the treatment of peri-implant diseases. However, the most appropriate form of probiotic administration or the effectiveness of this approach are still unclear. There is currently insufficient evidence to demonstrate the benefits of the use of probiotics as an adjunctive therapy in patients with peri-implant diseases.

Aims: This case series study aimed to assess the clinical outcomes of a novel protocol for the treatment of patients with severe periodontitis.

Materials and methods: Twenty (20) patients with severe periodontitis underwent a single session of One-Stage Full-Mouth Instrumentation (OSFMI) involving supra- and sub-gingival air-polishing with erythritol and chlorhexidine powder and ultrasonic root surface debridement and calculus removal, in association with systemic amoxicillin and metronidazole. Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Recession (REC), Bleeding on Probing (BOP) and Plaque Index (PI) were collected at baseline (T0), 6 weeks (T1), 3 months (T2) and 6 months (T3).

Results: At 6 months, 30% of subjects reached the primary clinical endpoint (less than or equal to4 sites with PD greater than or equal to 5 mm). The percentage of BOP decreased from 49.08 (CI95% 36.06; 62.1) at T0 to 12.97 (CI95% 7.57; 18.37) at T3. The mean number pockets with PPD≥ 5 mm and PPD greater than or equal to 7 mm decreased significantly, from 46.0 and 20.6 at T0 to 11.5 and 2.8 at T3 respectively (p less than 0.001).

Conclusion: The OSFMI protocol led to clinical results comparable to those obtained with traditional SRP. Researchers are encouraged to test this protocol in randomized clinical trials with longer periods of observation.

Objectives: The objective of this study was to assess the quality of randomised clinical trials (RCT) published in the field of periodontology in compliance with CONSORT guidelines and also to identify any associated influencing factors.

Methods: Quality of reporting in accordance with the 2010 CONSORT checklist was assessed and scored for RCTs published between 2015-2018 in three major periodontal journals: Journal of Periodontology (JP), Journal of Periodontal Research (JPR) and Journal of Clinical Periodontology (JCP). Descriptive statistics and linear regression with univariate analysis were carried out to identify the variables associated with mean CONSORT score. Mean scores were compared between various variables.

Results: 177 RCTs were identified from1875 published scientific articles accounting for 9.4% of the total publications screened. Europe (54%) produced more than half of the RCTs followed by Asia (19.2%). A large number of RCTs failed to report satisfactorily many items from the CONSORT checklist with no significant difference between three journals. The mean CONSORT score for JCP was the highest, at 70.5% (95% CI: 68.8 to 72.1), followed by JOP, at 69.9% (95% CI: 68.1 to 71.7) and 68.8% (95% CI: 65.6 to 71.9) for the JPR at p=0.631. Though, the mean CONSORT score increased from 70.4% in 2015 to 71.0% in 2018 but differences were not significant at p=0.653. RCTs reported by more than six authors had better CONSORT score compared to RCTs reported by fewer than six authors at p=0.01.

Conclusions: Inadequate reporting of several items of the CONSORT statement in published periodontal RCTs highlights the shared responsibility of researchers, journal reviewers and editors in maintaining the quality of reporting of RCTs.

Background: Skin-related disorders and periodontitis are distinct diseases that have been associated with altered levels of testosterone. Understanding the mechanisms through which testosterone mediates gingival enlargement in animals and humans is crucial for preventing or treating this condition. In this study, we investigated the impact of different doses of androgens, the role of aromatase inhibition, and the effects of testosterone association with sex hormone receptor antagonists or aromatase inhibitors on human gingival fibroblast proliferation and migration in vitro.

Methods: Fibroblasts were cultivated in Dulbecco's Modified Eagle's Medium in a humidified atmosphere and treated with different doses of testosterone or dihydrotestosterone, and testosterone in association with: aromatase inhibitor - anastrozole; antagonist of androgen receptors - flutamide; and antagonist of estrogen receptors - fulvestrant.

Results: Low (1nM) and high (1μM) doses of testosterone significantly increased cell migration, but the higher dose did not alter cell proliferation. Those effects were related to both androgen and estrogen receptors activation, as evidenced by the dihydrotestosterone and drug interaction groups.

Conclusions: Testosterone association with sex hormone receptor antagonists flutamide and fulvestrant suggests that not only androgen receptors, but also estrogen receptors, may take part in fibroblast cell proliferation and migration in vitro.

Objective: The aim of this study was to evaluate the association between depressive disorders and periodontal condition and the recurrence of periodontitis, during periodontal maintenance therapy (PMT).

Methods: From a 6-year prospective cohort study with 268 individuals under PMT, 124 individuals had complete periodontal clinical data recorded between T1 (baseline) and T2 (final data at the last PMT appointment). Individuals were divided into two groups, being 35 individuals with depressive disorders (DD) and 89 individuals without DD (NDD). Full-mouth periodontal examination was evaluated at T1 and T2.

Results: The periodontal status of NDD was significantly better then DD at T2. In the NDD group, the recurrence of periodontitis was 50.6% whereas in the DD group was 62.8%. Moreover, the following variables were significantly associated with recurrence of periodontitis in final multivariate logistic regression model: DD, age, co-habitation status without companion, smoking and the interaction between DD and smoking.

Conclusion: Individuals with DD undergoing PMT presented higher rates of recurrence of periodontitis and tooth loss when compared to individuals without DD. Additionally, the interaction between DD and smoking significantly increased the risk for the recurrence of periodontitis.