Periodontal treatment needs and systemic diseases in an older population in Greece

Background: To evaluate the relationship between systemic diseases, body mass index and periodontal treatment needs in an older population in Greece. Material and Methods: A total of 262 older people were clinically examined about their periodontal status and medical histories were recorded using a health history questionnaire. Additionally, weight and height measurements as well as demographic data were obtained from the participants in the study. Results: Older people exhibited mean age of 63.98 years, weight of 78.76 kg and height of 1.64 m. The mean CPITN score was 2.84. 31.7% of the study population were smokers and 53.8% females. No statistically significant difference was observed in seniors between periodontal treatment needs and systemic diseases. Females exhibited statistically significant more often osteoporosis, thyroid disorders ( p <0.001) and hypercholesterolemia ( p =0.014) than males. High CPTIN scores were not associated with higher levels of BMI. Conclusions: Within the limitation of this study, older adults’ periodontal treatment needs are not associated significantly with a great number of systemic diseases and body mass inde

Photodynamic therapy in the treatment of aggressive periodontitis: a systematic review

Background: Aggressive periodontitis (AgP) is a severe form of periodontal diseases with rapid destruction of the supporting bone around teeth. The efficacy of PDT in suppressing periodontal pathogens may be crucial in adopting new protocols for the treatment of AgP. Thus, the aim of this systematic review was to investigate the possible role of PDT in the treatment of AgP as an adjunctive therapy or monotherapy. Material and Methods: A systematic search of the literature was performed. Additionally, the references from all the selected full-text studies were searched for relevant articles. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held. Results: Initial screening of electronic databases yielded 418 potentially relevant publications. After screening of the titles and full-text examination, five studies were included in the systematic review. Four publications evaluated the effects of PDT adjunctive to SRP in patients with AgP: two of them compared the clinical outcomes of SRP and PDT with a control group that received therapy with SRP and antibiotics (metronidazole and amoxicillin); two publications included SRP and PDT in the test group, and SRP alone in the control group. In one study, PDT was tested as a monotherapy compared with SRP alone. Conclusions: Within the limitations of this review, PDT may exhibit a beneficial role in the therapy of aggressive periodontitis after repeated applications. In the future, more methodologically sound, long-term randomized clinical trials are needed to be conducte

Sclerostin And WNT-5A Gingival Protein Levels In Chronic Periodontitis And Health

University of Minnesota M.S. thesis. May 2018. Major: Dentistry. Advisors: Larry Wolff, Kim Mansky. 1 computer file (PDF); x, 164 pages.Background: Wnt signaling is fundamental to a myriad of biological processes including embryogenesis, organogenesis and tumorigenesis. It drives the expression of important genes for the proliferation, differentiation, maturation and activity of osteoblast-lineage cells. Pathways associated with Wnt signaling are regulated by their physiological antagonists such as sclerostin (SOST) as well as Wnt-5a that play important roles in the pathophysiology of several inflammatory conditions. Objectives: To compare the levels of SOST, Wnt-5a and TNF-α between chronic periodontitis and periodontally healthy sites as well as to determine the correlation between clinical periodontal parameters and protein levels. Material and methods: In a cross-sectional assessment, 25 chronic periodontitis cases and 25 periodontally healthy controls were measured for probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI) and percentage of radiographic bone loss. Gingival crevicular fluid (GCF) was collected cross sectionally from one periodontitis (deepest pocket) and one healthy (shallowest pocket) site in each case, and from one randomly selected site in each control subject. The protein levels of SOST, Wnt-5a and TNF-α in GCF were measured by ELISA. The Shapiro-Wilk test was utilized to assess the normality of the distribution and non-parametric comparisons were performed. Results: Protein levels of SOST and Wnt-5a were similar between healthy and chronic periodontitis sites as well as the SOST levels between periodontally affected and healthy sites in the chronic periodontitis group (p > 0.05). Periodontally involved sites exhibited statistically significantly higher total Wnt-5a levels than the healthy sites in the periodontitis cases (p = 0.017). When the data were expressed as concentration, significant differences were found among the study groups (p-values range from < 0.001 to 0.003). Significant positive correlations were found between SOST and 1) full-mouth PPD (p = 0.044), CAL (p = 0.010), BOP (p = 0.035); 2) PPD of the sampled sites (p = 0.037); and 3) sites with PPD 4-6 mm (p = 0.018). A trend of a negative correlation was found between SOST and sites with a CAL 0-2 mm (p = 0.052). Among all included subjects, males showed a statistically significantly higher Wnt-5a levels than females (p = 0.031). Conclusions: Within the limitations of this cross-sectional study, sites with chronic periodontitis exhibited significantly elevated levels of Wnt-5a when compared to periodontally healthy sites in chronic periodontitis patients. No statistically significant association was found with SOST and TNF-α levels

Association between susceptible genotypes to periodontitis and clinical outcomes of periodontal regenerative therapy: a systematic review

Background: The aim of this review is to systematically investigate the effect of a susceptible genotype to periodontitis with the clinical outcomes of periodontal regeneration. Material and Methods: Based on a focused question, an electronic search identified 155 unique citations. Three journals (Journal of Periodontology, Journal of Clinical Periodontology and Journal of Periodontal Research), references of relevant studies and review articles were hand-searched. Two independent reviewers implementing eligibility inclusion criteria selected the studies. Results: Of the 155, four studies fulfilled the inclusion criteria. All studies were published between 2000 and 2004 and the samples’ size was 40 to 86 patients. Polymorphisms of Interleukin-1 (IL-1) gene were included in all. Three out of four studies failed to identify an association between susceptible genotypes to periodontitis and clinical outcomes of periodontal regeneration, while one found an association. The heterogeneity and small number of studies included prevented the conduct of a meta-analysis. No studies were identified evaluating the effect of other genotypes and as a result only IL-1 genotype studies were included. Conclusions: Within the limits of the present review, no direct conclusion for the effect of a susceptible IL-1 genotype status to the clinical outcome after periodontal regeneration could be drawn. The need of more qualitative studies to explore a possible association emerge

Dental implant failure and bone augmentation : a retrospective study

To retrospectively assess the failure rate of implants placed in augmented and non-augmented sites and to investigate whether the time of implant and bone placement are associated with the risk of implant failure in a university setting. In this retros

Implant failure and history of failed endodontic treatment : a retrospective case-control study

Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment

Association of susceptible genotypes to periodontal disease with the clinical outcome and tooth survival after non-surgical periodontal therapy: A systematic review and meta-analysis

Background: The real clinical utility of genetic testing is the prognostic value of genetic factors in the clinical outcome of periodontal treatment and the tooth survival. A meta-analysis was undertaken to estimate the effect of a susceptible genotype to periodontitis on the clinical outcomes of non-surgical periodontal therapy and the tooth survival. Material and Methods: A systematic search of MEDLINE-Pubmed, Cochrane Library and Scopus was performed. Additionally, a hand search was done in three journals. No specific language restriction was applied. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held. Results: Initial screening of electronic databases resulted in 283 articles. Ten studies met the inclusion criteria, nine of them examined the clinical outcome, while the other one investigated the tooth survival in susceptible individuals after non-surgical periodontal therapy. Eight of included studies were selected for the meta-analysis. IL-1 positive genotypes increase the risk of tooth loss, while no association found between the bleeding on probing (BOP), clinical attachment loss (CAL) and plaque index (PI) with the genotype status. Probing pocket depth (PPD) reduction in the first three months and in long-term results found to have a significant association with the genotype. Conclusions: There is no difference in the clinical measurements after non-surgical periodontal treatment, apart from PPD. More publications are needed to identify a cause-effect relationship

Clinical response to non-surgical periodontal treatment in patients with interleukin-6 and interleukin-10 polymorphisms

Genetic polymorphisms are commonly associated with altered transcriptional activity and possibly make individuals more susceptible to periodontal disease development, increased disease severity and poor treatment outcome. The study aimed to determine the effect of Interleukin-6 (IL-6) -572 G/C (rs1800796) and IL-10 -592 C/A (rs1800872) polymorphisms on the outcomes of non-surgical periodontal therapy in a Caucasian population. Sixty-eight patients with chronic periodontal disease were grouped according to their genotype: IL-6, IL-10, IL-6 and IL-10 susceptible (SCP) and non-susceptible (NSCP). All individuals were clinically evaluated at the first visit, and blood sample were collected from patients after checking the inclusion and exclusion criteria of the study. All patients received non-surgical periodontal therapy from a single-blinded periodontist. Clinical periodontal measurements were repeated 45 days after therapy. This population mean aged 47.63 years included 52.2% females and 58.2% non-smokers. Following DNA separation and genotyping, 65.7% of patients were homozygous carriers of the IL-6 - 572G; 49.3% were carriers of the IL-10 -592A- allele (AA and CA genotypes); and 35.8% carried SCP genotypes for both polymorphisms. The clinical parameters after therapy were not associated with the genotype status. The multiple logistic regression analysis did not show any statistically significant association between the genotypes and the variables tested. Within the limitations of this longitudinal study, it can be suggested that IL-6 -572 G/C and IL-10 -592 C/A polymorphisms as well as their combination do not influence the outcome of nonsurgical periodontal therapy in Caucasian patients diagnosed with chronic periodontal disease

Large-scale fine-grained semantic indexing of biomedical literature based on weakly-supervised deep learning

Semantic indexing of biomedical literature is usually done at the level of MeSH descriptors, representing topics of interest for the biomedical community. Several related but distinct biomedical concepts are often grouped together in a single coarse-grained descriptor and are treated as a single topic for semantic indexing. This study proposes a new method for the automated refinement of subject annotations at the level of concepts, investigating deep learning approaches. Lacking labelled data for this task, our method relies on weak supervision based on concept occurrence in the abstract of an article. The proposed approach is evaluated on an extended large-scale retrospective scenario, taking advantage of concepts that eventually become MeSH descriptors, for which annotations become available in MEDLINE/PubMed. The results suggest that concept occurrence is a strong heuristic for automated subject annotation refinement and can be further enhanced when combined with dictionary-based heuristics. In addition, such heuristics can be useful as weak supervision for developing deep learning models that can achieve further improvement in some cases.Comment: 48 pages, 5 figures, 9 tables, 1 algorith