Journal of the International Academy of Periodontology最新文献

Background and objectives: Applications of porous titanium granule (PTG) in periodontal (furcation defects) and non-periodontal treatments have shown promising results. However, its role in periodontal intrabony defects still remains unexplored. Thus, we aim to assess the feasibility of PTG in obtaining reconstruction in intrabony defects and compare the outcome with that of open flap debridement (OFD).

Methods: Ten patients (three females and seven males) with a mean age of 34.7 years who constituted twenty (20) bilateral intrabony defects were recruited. Each patient contributed to two defects which were randomly treated by OFD alone (control group) or by OFD followed by grafting with PTG (test group). All the clinical and radiological parameters were recorded at baseline, three, six and nine months and statistically analyzed.

Results: The results of this study demonstrated that in clinical parameters there is no significant differences in the improvement from baseline to nine months. However, regarding the radiographic defect fill, there was significant gain from baseline to nine months only in the PTG sites.

Conclusion: Within the limits of our study, the results of this trial indicate that reconstructive periodontal surgery with PTG offers minimal radiographic defect resolution with no significant improvements in clinical endpoints compared to open flap debridement.

Objective: The selection of proper outcome measures is a critical step in clinical research. Most randomized clinical trials (RCTs) assessing the effects of initial anti-infective periodontal therapies use surrogate outcomes as primary outcome variables, such as mean changes in probing depth (PD) or in clinical attachment. However, these parameters do not reflect disease remission/control at patient level, which has led to subjective interpretations of the data from RCTs and Systematic Reviews. Based on a comprehensive analysis of 724 patients from USA, Germany and Brazil treated for periodontitis, this paper suggests that the clinical endpoint of "≤4 sites with PD≥5mm" is effective in determining disease remission/control after active periodontal treatment and therefore, may represent a pertinent endpoint for applying the treat-to-target concept in RCTs. Furthermore, regression models showed that the presence of >10% and >20% sites with bleeding on probing in the mouth post-treatment increases the risk of a patient leaving the endpoint from 1-2 years (OR=3.5 and 8.7, respectively). Researchers are encouraged to present results on this outcome when reporting their trials, as this will allow for an objective comparison across studies and facilitate systematic reviews, and consequently, the extrapolation of data from research to clinical practice.

Objectives: To evaluate periodontal parameters of abutment teeth and interproximal sites, in patients with mandibular class I Kennedy Removable Partial Dentures (RPD), after 4 years of periodontal treatment.

Methods: Fourteen patients with periodontal disease were treated and evaluated for the following parameters: plaque index (PI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), clinical attachment loss (CAL) and keratinized mucosa (KM). Parameters were compared between abutment teeth with direct and indirect retainers at all time-points. Periodontal maintenance was recorded at 6, 18 and 48 months. Data were analyzed using the Friedman and Wilcoxon Tests.

Results: Most patients (n=11; 78.6%) included were female and had a mean age of 66 years (± 7.8). After 48 months, a significant reduction was only observed in PI for both abutment teeth; in contrast, PD, GR, CAL and KM all increased by the end of the study. BOP increased at 48 months for the abutment teeth with direct retainers. The distal site of the abutment teeth with direct retainers presented higher values for GR and CAL.

Conclusions: Non-surgical periodontal therapy was effective during the first 18 months, but periodontal conditions were worse at 48 months after therapy. The distal sites of abutment teeth with direct retainers presented the worst periodontal conditions.

Objectives: This study investigated changes induced by Porphyromonas gingivalis and on gastrointestinal histology and gut microbiome in a mouse model of experimental periodontitis. The effect of probiotic Lactobacillus rhamnosus GG (LGG) in altering these changes was also investigated.

Methods: IThirty-six mice were allocated into six groups. Experimental alveolar bone loss was induced by oral inoculation with P. gingivalis and F. nucleatum. LGG was orally inoculated or orally gavaged. Gastrointestinal tissue changes were assessed using histological analysis and immunohistochemistry. Caecal microbiome was analysed by sequencing 16S rRNA genes of caecal content.

Results: Inoculation with P. gingivalis and F. nucleatum induced inflammation throughout gastrointestinal tract (p less than 0.05), increased expression of IL-6 in ileum (p = 0.052) and altered composition of caecal microbiome (p less than 0.05) in experimental mice compared to controls. Mice treated with LGG had reduced tissue inflammation in duodenum (p = 0.044) and lowered levels of IL-6 in ileum (p = 0.048) when compared with disease. LGG therapy influenced gut microbiome changes.

Conclusion: P. gingivalis and F. nucleatum inoculation induced significant changes in intestinal inflammation and caecal microbiome. Oral gavage with LGG exerted a protective effect against intestinal inflammation and limited gut microbiome changes associated with P. gingivalis and F. nucleatum.

Aim: Periodontitis is often associated with diabetes mellitus and may be considered one of the chronic complications of this disease. Increasing evidence indicates that periodontal disease (gingivitis and periodontitis) has an adverse effect on glycemic control and participates in the pathophysiology of complications related to type 2 diabetes mellitus. Thus, this study aimed to evaluate the influence of obesity on clinical periodontal parameters of patients with type 2 diabetes mellitus with stage II or III periodontitis grade C after conventional periodontal treatment.

Methods: For this study, 36 patients, aged 25 to 65 years, were evaluated; 20 patients with type 2 diabetes mellitus and moderate to severe periodontitis (Non-Obese Group) and 16 patients with type 2 diabetes mellitus with obesity and moderate to severe periodontitis (Obese Group). These patients underwent conventional periodontal treatment and were evaluated using plaque index, probing depth, clinical attachment level, bleeding on probing and gingival crevicular fluid analysis, as well as laboratory tests of glycated hemoglobin, fasting glycemia, total cholesterol, and fractions of triglycerides. Periodontal and laboratory parameters were evaluated at baselineand six months.

Results: The results showed improvements in periodontal and clinical laboratory parameters(p less than 0.05) in the evaluated periods; however, the non-obese group presented significantly better results when compared to the obese group.

Conclusion: It can be concluded that the presence of obesity may hinder the improvement of periodontal clinical parameters after conventional periodontal treatment in patients with diabetes mellitus and periodontitis.

Objective: To evaluate gingival phenotypes in 100 subjects (n = 100), with regard to maxillary central incisors and surrounding periodontium in an observational diagnostic study.

Materials and methods: Individuals were grouped based on: Probing depth (PD); keratinized mucosa (KM); Ratio Height/Width Crown (CH/CW), papilla area (PA), gingival thickness (GT) and Gingival Volume (GV). ANOVA and chi-square tests were performed with a significance level of 5%. Results: PD (p=0.860) and CH/CW (p=0.086) were not statistically significant. Cluster analysis identified three groups: Cluster I (n = 32) had the lowest values: KM (4.54mm), GT (0.83mm), PA (15.64mm²) and GV (3.80mm³); Cluster II (n = 43) presented KM (8.02mm); GT (1.40mm); GV (11.18mm³) and PA (14.10mm²); Cluster III (n = 19) exhibited an average KM of 5.57mm, GT (1.14mm), PA (20.08mm²) and GV (6.48mm³).

Results: Cluster I was characterized as a thin phenotype; cluster II as thick, and cluster III, as an intermediate. Significant associations were found when transparency on probing was compared among clusters (p less than 0.05) and gingival exposure when smiling (p less than 0.05).

Conclusion: Thin phenotype was found in 34.04% of the sample (cluster I), thick phenotype in 45.75% (cluster II) and intermediate phenotype in 20.21% (Cluster III)..

Objective: Prolactin (PRL) acts as a hormone and as a cytokine and is linked to the pathogenesis of a variety of chronic inflammatory diseases. This study aimed to investigate a potential role for prolactin in the pathogenesis of periodontitis by assessing its local gingival crevicular levels before and after periodontal treatment, compared to controls.

Materials and methods: 40 participants were included and divided into 2 groups. Group 1; included 20 patients suffering from moderate to severe periodontitis and group 2; included 20 healthy controls. GCF samples were collected from both groups after initial clinical examination and 3 months after scaling and root planning for the periodontitis group only. Levels of prolactin were tested by enzyme linked immunosorbent assay.

Results: At baseline, a statistically significant elevated PRL levels were shown in the periodontitis group compared to controls (p less than 0.001), with a non significant difference between males and females (p greater than 0.05) . Periodontal debridement caused a significant reduction in PRL levels but these levels remained significantly higher compared to controls levels. A 100% diagnostic accuracy was shown for PRL levels in the tested groups.

Conclusion: Our results suggest a role for PRL in the pathogenesis of periodontitis, further, it could represent a reliable biomarker for disease activity and prognosis.

Background: Correct soft tissue management and achieving tension-free primary closure are pre-requisites for the success of bone augmentation procedures. Several techniques have been developed to facilitate a passive soft tissue primary closure. However, the current techniques are highly invasive and require advanced surgical skills. Hence, the present case series report will describe a novel and simple flap management technique.

Methods: The Periosteal Flap Stretch technique was utilized in bone augmentation procedures for four patients who presented with horizontal and vertical alveolar ridge deficiencies in the anterior maxilla, anterior mandible, posterior mandible, and posterior maxilla. This technique is performed using a blunt surgical curette that engages the periosteum of the mucosa below the mucogingival line of the full-thickness flap and stretches the periosteum in a coronal and outward direction, which results in stretching of the flap without the need for vertical or periosteal releasing incisions.

Results: Healing was uneventful for four all cases. No membrane exposure, no soft tissue dehiscence, or any other complications were observed during the six-months healing period after the respective bone augmentation procedures of cases.

Conclusions: The Periosteal Flap Stretch technique is a novel and simple technique that facilities achieving passive and predictable primary soft tissue closure.

Loss of tooth-supporting structures results in tooth mobility. Increased tooth mobility adversely affects function, aesthetics, and the patient's comfort. Splints are used to over-come all these problems. When faced with the dilemma of how to manage periodontally compromised teeth, splinting of mobile teeth to stronger adjacent teeth is a viable option. This prolongs the life expectancy of loose teeth, gives stability for the periodontium to reattach, and improves comfort, function and aesthetics. Although splinting has been used since ancient times, it has been a topic of controversy because of its ill effects on oral health, including poor oral hygiene and adverse effects on supporting teeth. There have been considerable advancements in the materials used for splinting, resulting in fewer ill effects. This article is intended to provide the clinicians with an updated overview of splinting, types and classification of splints, with their indications, contraindications,rationale and effects on oral health.

Objective: The aim of this study was to assess the feasibility of extracellular matrix membrane (DynaMatrix®) in obtaining root coverage and compare it to the connective tissue graft for the treatment of Miller's Class I or Class II recession defects.

Methods: Ten patients with a mean age of 31.2 years with bilateral Miller's Class I or Class II recession defects in the upper premolars were recruited. Each patient contributed two defects that were randomly treated by coronally advanced fl ap with connective tissue graft (CAF+CTG) and by coronally advanced flap underlaid with extracellular membrane (DynaMatrix®; CAF+DM). All the clinical parameters were recorded at baseline, three months and six months after surgery and data were statistically analyzed.

Results: The results of this study demonstrated that both the procedures were effective and predictable in root coverage procedures. However, no statistically signifi cant differences in gingival recession reduction were noted between extra cellular membrane and gold standard connective tissue graft.

Conclusion: Within the limits of this clinical study, the use of extracellular membrane (DynaMatrix®) may represent an acceptable alternative to the connective tissue graft for treating gingival recession.