Journal of advanced periodontology & implant dentistry最新文献

Background: This study aimed to evaluate the clinical effect of aloe vera gel as an adjunct to scaling and root planing (SRP) on plaque index (PI), gingival index (GI), and probing pocket depth (PPD) in periodontitis treatment.

Methods: Randomized controlled trials (RCTs) were included, focusing on aloe vera gel as an adjunct to SRP in periodontitis patients. An extensive literature search was conducted across PubMed, PubMed Central, Scopus, OVID, Google Scholar, and Cochrane Library databases up to October 2024. The risk of bias was assessed using the Revised Cochrane Risk of Bias tool (ROB 2.0), and statistical analysis was performed using Review Manager 5.4.1.

Results: Fifteen RCTs were included in this systematic review, and separate meta-analyses were conducted for each outcome. For PI, the random effects model showed a mean difference (MD) of -0.23 (95% CI: -0.69, 0.23), favoring the experimental group (P=0.33). The fixed effects model for PI favored the control group (MD=0.12; P=0.20). For GI, the random effects model favored the experimental group (MD=-0.28, P=0.01), while the fixed effects model favored the control group (MD=0.17; P<0.001). For PPD, the random effects model favored the experimental group (MD=-0.45, P=0.009).

Conclusion: As an adjunct to SRP, aloe vera gel significantly improved PI, GI, and PPD in periodontitis patients.

Trial registration: PROSPERO ID: CRD42020201315.

Background: The host defense process against invading bacteria leads to the destruction of the periodontium. Lamin A is an important protein for protecting DNA and preventing premature cell aging. This study investigated the expression of the Lamin A gene in periodontitis patients.

Methods: Using an analytical cross-sectional design, Lamin A gene expression was evaluated in 23 periodontitis patients and 24 healthy individuals referred to the Periodontology Department of Mashhad Dental School and Hekmat Clinic, Mashhad, Iran. Gingival samples were collected, followed by RNA extraction, cDNA synthesis, and real-time PCR. Statistical analyses were conducted using SPSS.

Results: While the age distribution did not show significant differences between the groups, gender distribution was statistically different. Therefore, the study focuses on comparing Lamin A gene expression levels between the patient and healthy groups, separated by gender. Considering the analysis of 47 gingival tissue samples, the Lamin A gene expression level was higher in healthy participants, with the difference being statistically significant only in female participants (198.45±54.00 in healthy females vs. 143.52±29.29 in periodontitis females).

Conclusion: These findings suggest that the expression of the Lamin A gene was higher in healthy individuals than in periodontitis patients. More studies are needed to draw more accurate conclusions. If confirmed in larger studies, this protein group might serve as potential biomarkers, enhancing periodontitis assessment strategies.

Background: Desquamative gingivitis is an immunological chronic disease that is considered precancerous and has the potential to develop into squamous cell carcinoma. Carcinoembryonic antigen (CEA), a common tumor marker, increases in many cancers. The present study compared salivary CEA levels in desquamative gingivitis before and after topical corticosteroid therapy.

Methods: This case‒control study was conducted in the Department of Oral and Maxillofacial Medicine, Tabriz Faculty of Dentistry. Twenty patients with desquamative gingivitis in oral lichen planus (OLP) background were selected as the case group, with 20 healthy individuals as the control group. Desquamative gingivitis lesions were confirmed with biopsies. Salivary samples were obtained from both groups. Second, salivary samples were collected from the case group after a course of topical corticosteroid therapy. Salivary CEA levels were measured by a monobind kit using the ELISA method. Independent and paired t-tests were used to analyze the data in SPSS 17. P<0.05 was considered statistically significant.

Results: Before treatment, CEA levels were significantly higher in the case group (174.06±95.55) than in the control group (55.66±41.26 ng/mL) (P<0.001). Salivary CEA levels in the case group decreased significantly after the treatment (96.77±66.25 ng/mL) compared to before treatment (174.06±95.55 ng/mL) (P<0.001).

Conclusion: This study demonstrated that CEA levels significantly decreased in patients with desquamative gingivitis associated with oral lichenoid reaction after receiving topical corticosteroid therapy.

Background: The current study aimed to systematically review the existing evidence on potential links between gene polymorphisms and the occurrence of peri-implant mucositis (PIM) or peri-implantitis (PI).

Methods: The electronic search was executed through six databases in November 2022: PubMed, Embase, Google Scholar, Scopus, Cochrane CENTRAL, and Web of Science. The search sought studies delving into the possible association of gene polymorphisms with PIM or PI. To showcase the effect size, odds ratios along with 95% confidence intervals were used. The meta-analysis was performed on polymorphisms/alleles reported in at least two studies.

Results: The initial search yielded 2162 results, which were reduced to 1327 following deduplication. After evaluating titles, abstracts, and full texts, 30 studies were deemed suitable for inclusion. Forty-nine gene polymorphisms were examined among 50 PIM patients, 1603 PI patients, and 2407 healthy controls spanning seven ethnicities. The meta-analysis showed that IL-1α -889 (95% CI: 1.070‒2.850, OR=1.746, P=0.026), IL-1β+3954 (95% CI: 1.265‒2.851, OR=1.899, P=0.002), and OPG -3618 (95% CI: 1.158‒2.983, OR=1.859, P=0.010) gene polymorphisms significantly differed between healthy controls and PI patients. However, IL-1β -511, IL-6 -174, OPG -3617, and TNF-α -308 gene polymorphisms did not significantly alter PI risk. Due to insufficient data, performing a meta-analysis on PIM was not feasible.

Conclusion: The findings suggest that IL-1α -889, IL-1β+3954, and OPG -3618 gene polymorphisms are associated with the predisposition to PI. However, further research among diverse populations is warranted to draw more definitive conclusions.

Dental implant placement in the esthetic zone is associated with challenges for clinicians. The best esthetic outcome of this procedure can be obtained through precise management of hard and soft tissue. Orthodontic forced eruption (OFE) has presented an alternative approach to augment hard and soft tissues, which can be applied rapidly or slowly. OFE of hopeless teeth with its periodontal attachment results in a favorable implant preparation site. Therefore, the present systematic review evaluated the effect of implant site preparation using OFE in hopeless teeth. A complete electronic search was performed in PubMed/MEDLINE, Scopus, and Google Scholar from June 2020 to November 2023. The search was limited to clinical English language studies. Studies were excluded if OFE was performed without implant placement. Finally, 15 studies with a total of 21 teeth, all located in the maxillary anterior region, were included in this study. In eight studies, bone grafting procedures were performed before implant placement. Using OFE could rapidly prepare the implant site by enhancing hard and soft tissues. However, additional interventions like guided bone regeneration should be considered case-dependent.

Background: Recurrence of gingival pigmentation following depigmentation procedures is common, raising the question of the influence of an underlying cause, if any. Melanin, a non-hemoglobin-derived brown pigment, is the most common endogenous pigment contributing to gingival pigmentation. Hemoglobin derivatives are among the other prime pigments that contribute to gingival color. This exploratory cross-sectional study evaluated the influence of hemoglobin levels on the distribution and severity of gingival melanin pigmentation in periodontitis, gingivitis, and healthy periodontium.

Methods: Twenty subjects with periodontitis (group 1), gingivitis (group 2), and healthy periodontium (group 3) were recruited in this observational study, totaling 60 subjects. The hemoglobin levels in g/dL and Hedin Melanin Index (HMI-1977) scores were recorded for all subjects, and relevant statistical tests were applied (P<0.05).

Results: A negative correlation was observed between the hemoglobin levels and the HMI scores for the whole sample and each group. This correlation was statistically significant for the whole sample and for the gingivitis group in which the correlation was moderate.

Conclusion: The inverse and significant relation between the hemoglobin levels and distribution and severity of melanin pigmentation observed for the whole sample and the gingivitis group requires further research and validation to identify and manage the confounding factors in the treatment of gingival pigmentation.

Background: The interdental papilla plays a crucial role in the esthetic of the smile. Papilla reconstruction surgery is one of the most unpredictable periodontal procedures. This study compared the effect of the non-surgical application of a commercial hyaluronic acid (HA) gel with an autogenous gel named "albumin with platelet-rich fibrin" (Alb-PRF) on interdental papilla reconstruction.

Methods: This trial was conducted on 46 incomplete interdental papillae with class I or II defects. The papillae were randomly divided into two experimental groups, and commercial HA or Alb-PRF (prepared from the patient's peripheral blood) was injected into the papillae twice at a 21-day interval. Three and six months after the intervention, photographs were taken from the black triangles and the black surfaces compared to each other. Patient satisfaction and dental plaque index were also evaluated at the end of the study.

Results: The black triangles' surfaces significantly decreased over time in both experimental groups (P<0.001). However, there were no significant differences between the two groups (P=0.994). The intervention resulted in the patients' relative satisfaction with the treatment results in both groups. However, the difference between the two groups was not statistically significant (P=0.965). In addition, no statistically significant differences were observed in plaque index between the two groups (P=0.566).

Conclusion: HA or Alb-PRF injection into the incomplete interdental papilla may restore the soft tissue to a great extent and lead to patient satisfaction by reducing the area of black triangles that threaten esthetics; however, more studies are needed.

Background: The present study evaluated the effects of cranberry juice enriched with omega-3 on inflammatory, oxidative stress, and periodontal status in diabetic patients with periodontal disease.

Methods: Forty-one patients with diabetes (35‒67 years old) and periodontal disease were assigned to four groups: C: control (n=12), I1: omega-3 (n=10, 1 g), I2: cranberry juice (n=9, 200 mL), and I3: cranberry juice enriched with omega-3 (n=10, 200 mL, containing 1 g of omega-3) twice daily for 8 weeks. Serum and salivary total antioxidant capacity (TAC), malondialdehyde (MDA), serum uric acid, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), clinical attachment loss (CAL), pocket depth (PD), bleeding on probing (BOP), and plaque index were evaluated in all the subjects before and after the intervention.

Results: Serum and salivary TAC increased, and salivary MDA decreased in the I3 group compared with the control group. Additionally, serum MDA decreased in the I2 and I3 groups while serum TAC increased. Serum hs-CRP, IL-6, and TNF-α decreased in the I3 group compared with the baseline. Furthermore, serum hs-CRP and IL-6 decreased in the I3 group compared with the control group. After the intervention, PD and CAL significantly reduced in all the groups.

Conclusion: The consumption of cranberry juice enriched with omega-3 can be helpful as adjuvant therapy with non-surgical periodontal treatment in decreasing serum levels of IL-6 and hs-CRP, as well as serum and salivary levels of MDA while also increasing serum and salivary levels of TAC.

Background: Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, are inflammatory conditions caused by biofilms that can lead to the loss of surrounding soft tissues and bone. The most effective treatment involves non-surgical mechanical debridement to remove plaque, but other treatment modalities have shown limited success. This study investigated the anti-inflammatory and immunomodulatory effects of atorvastatin (ATV) gel as an additional treatment for peri-implant mucositis.

Methods: In this double-masked, randomized clinical trial, 49 patients with peri-implant mucositis were randomly divided into two treatment groups: mechanical debridement (MD)+placebo or MD+ATV gel. At baseline, 1 month, and 3 months after the intervention, periodontal parameters, including probing depth (PD), bleeding on probing (BOP), clinical attachment level (CAL), and pain on probing (POP), were measured. Data were analyzed using independent t-test and paired t-test.

Results: Statistically significant improvements in CAL and POP were observed from baseline to each time point throughout the study period (P≤0.001). PD and BOP were statistically significant 1 month and 3 months after the intervention, respectively (P<0.05).

Conclusion: The clinical parameters associated with peri-implant mucosal inflammation further improved when ATV gel was used with MD.