Enamel matrix proteins in the regenerative therapy of deep intrabony defects A multicentre randomized controlled clinical trial

Abstract Aim: This prospective multicentre randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of enamel matrix proteins (EMD). Material and methods: 172 patients with advanced chronic periodontitis were recruited in 12 centers in 7 countries. All patients had at least one intrabony defect of у3mm. Heavy smokers (у20 cigarettes/day) were excluded. The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure. After debridement, roots were conditioned for 2 min with a gel containing 24% EDTA. EMD was applied in the test subjects, and omitted in the controls. Postsurgically, a strict plaque control protocol was followed. At baseline and 1 year following the interventions, clinical attachment levels (CAL), pocket probing depths (PPD), recession (REC), full-mouth plaque scores and full-mouth bleeding scores were assessed. A total of 166 patients were available for the 1-year follow-up

Microbial colonization patterns predict the outcomes of surgical treatment of infrabony defect

Aim: To explore the impact of bacterial load and microbial colonization patterns on the clinical outcomes of periodontal surgery at deep intrabony defects. Materials and Methods: One hundred and twenty-two patients with advanced chronic periodontitis and at least one intrabony defect of 43mm were recruited in 10 centres. Before recruitment, the infection control phase of periodontal therapy was completed. After surgical access and debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CAL), pocket probing depths (PPD), recession (REC), full-mouth plaque scores and full-mouth bleeding scores were assessed. Microbial colonization of the defect-associated pocket was assessed using a DNA\u2013DNA checkerboard analysis. Results: Total bacterial load and counts of red complex bacteria were negatively associated with CAL gains 1 year following treatment. The probability of achieving above median CAL gains (43 mm) was significantly decreased by higher total bacterial counts, higher red complex and T. forsythensis counts immediately before surgery. Conclusions: Presence of high bacterial load and specific periodontal pathogen complexes in deep periodontal pockets associated with intrabony defects had a significant negative impact on the 1 year outcome of surgical/regenerative treatmen

Genetic Risk Factors for the Development of Periimplantitis

Introduction: Periimplantitis etiology is multifactorial. The aim of this review is to identify the available data so far concerning the association between genetic polymorphisms and periimplantitis risk. Materials and Methods: A literature search was performed in MEDLINE using the PubMed database of the US National Library of Medicine for articles published until March 2018. In addition, a manual search was performed. Our search and application of eligibility criteria provided 23 articles. Genes in these 23 studies could be divided into 3 overlapping categories: genes associated with (a) immune function, (b) bone growth, and (c) regulation of gene expression. Discussion: The pathogenesis of periimplantitis is not currently well understood. There are some polymorphisms, for which different studies state consistent results. However, there are many polymorphisms with conflicting results, which could be attributed to differences in study design. Conclusion: The identification of genetic biomarkers associated with periimplantitis risk could be valuable in daily clinical practice. However, no robust conclusions could be drawn from the current literature. The inequality of these studies' design necessitates the conduction of further studies using larger population samples and from different ethnic groups. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

A comprehensive and critical review of dental implant placement in diabetic animals and patients

Objectives: A thorough and exhaustive analysis of the available studies concerning placement of endosseous dental implants in diabetic subjects has not been previously published. The aim of the present study was to perform a comprehensive and critical review of experimental and clinical studies published in the international peer-reviewed literature in the English language regarding endosseous implant installation in diabetic subjects and to draw evidence-based conclusions on the effectiveness and predictability of dental implant therapy in diabetic patients. Material and methods: Literature search for articles published up to and including March 2005 in the English language was performed with a personal computer (PC) using The National Library Of Medicine () and Cochrane Oral Health Group databases. Search strategy included a specific series of terms and key words. The reference lists of identified publications, relevant texts and previous workshops were also scanned. Data sources also included several hand-searched journals and contact with experts, when it was considered appropriate. Search was conducted independently by the three reviewers (S. K., I. K. K., I. F.). At the first phase of selection the titles and abstracts and at the second phase full papers were screened independently by the three reviewers. Disagreement regarding inclusion of full papers was resolved by discussion among the reviewers. Results: The search provided 227 potentially relevant titles and abstracts. At the first phase of evaluation, 199 publications were rejected based on title and abstract. At the second phase, the full text of the remaining 28 publications was retrieved for more detailed evaluation. These publications included 11 experimental studies and 16 clinical studies (one clinical study corresponded to two publications). Finally, 11 experimental and eight clinical studies were accepted. Clinical studies included four prospective and four retrospective studies. Because of the limited number of available studies and their heterogeneity, focusing on a specific predefined question to be answered by a systematic review was not feasible and therefore no meta-analysis was planned. Conclusion: Within the limits of the existing investigations, experimental studies seem to reveal an impaired bone healing response to implant placement in diabetic animals compared with non-diabetic controls, both quantitatively and qualitatively. The majority of clinical studies tend to indicate that diabetes is no contraindication for implant placement, on condition that it remains under metabolic control. However, definitive guidelines with objective criteria, such as type and duration of diabetes and glucosylated hemoglobin levels, need to be established in the future. Copyright © Blackwell Munksgaard 2006

Diode laser for excisional biopsy of a peripheral ossifying fibroma: A case report

Peripheral Ossifying Fibroma is one of the most common reactive lesions of connective tissue located on gingivae. It appears as a well-defined, benign, fibrous overgrowth and is associated with chronic trauma or irritation. It can be pedunculated or sessile, usually covered by smooth normal epithelium and it can sometimes appear ulcerated as a result of mechanical trauma.&nbsp;Conventional treatment of Peripheral Ossifying Fibroma includes excision of lesion down the level of periodontal ligament and periosteum. Another contemporary modality of excising oral soft-tissue lesions are dental lasers. They have been widely accepted and increasingly used in daily practice. More specifically, in oral soft tissue surgery, lasers minimize operative and postoperative bleeding, swelling and scarring, and are easy to handle. Moreover, lasers do not alter the microarchitecture of the biopsy specimen and are well accepted by the patients.&nbsp;In this case report, we present a 30-year old man diagnosed with a recurrent peripheral ossifying fibroma in the mandibular incisors’ region. The patient was firstly diagnosed with peripheral ossifying fibroma at the age of 18 and had a few recurrence episodes after excision of the lesion with traditional surgical treatment. This oral lesion was excised by using diode laser (980nm), and the specimen was sent for histopathological analysis. In this case report we describe advantages and superiority of diode laser application in excision of Peripheral Ossifying Fibroma. In general, diode laser may be an alternative reliable and effective treatment option for excision of oral soft-tissue lesions.</p

A comprehensive and critical review of dental implant prognosis in periodontally compromised partially edentulous patients: Review

The outcome of implant treatment in periodontally compromised partially edentulous patients has not been completely clarified. Therefore, the aim of the present study was to perform, applying a systematic methodology, a comprehensive and critical review of the prospective studies published in English up to and including August 2006, regarding the short-term (&lt;5 years) and long-term (≥5 years) prognosis of osseointegrated implants placed in periodontally compromised partially edentulous patients. Using The National Library Of Medicine and Cochrane Oral Health Group databases, a literature search for articles published up to and including August 2006 was performed. At the first phase of selection the titles and abstracts and at the second phase full papers were screened independently and in duplicate by the three reviewers (I. K. K., S. K., I. F.). The search provided 2987 potentially relevant titles and abstracts. At the first phase of evaluation, 2956 publications were rejected based on title and abstract. At the second phase, the full text of the remaining 31 publications was retrieved for more detailed evaluation. Finally, 15 prospective studies were selected, including seven short-term and eight long-term studies. Because of considerable discrepancies among these studies, meta-analysis was not performed. No statistically significant differences in both short-term and long-term implant survival exist between patients with a history of chronic periodontitis and periodontally healthy individuals. Patients with a history of chronic periodontitis may exhibit significantly greater long-term probing pocket depth, peri-implant marginal bone loss and incidence of peri-implantitis compared with periodontally healthy subjects. Even though the short-term implant prognosis for patients treated for aggressive periodontitis is acceptable, on a long-term basis the matter is open to question. Alterations in clinical parameters around implants and teeth in aggressive periodontitis patients may not follow the same pattern, in contrast to what has been reported for chronic periodontitis patients. However, as only three studies comprising patients treated for aggressive periodontitis were selected, more studies, specially designed, are required to evaluate implant prognosis in this subtype of periodontitis. As the selected publications exhibited considerable discrepancies, more studies, uniformly designed, preferably longitudinal, prospective and controlled, would be important. © 2007 Blackwell Munksgaard

Fractured prosthetic abutments in osseointegrated implants: A technical complication to cope with

In the present report a repair set to retrieve fractured abutments remaining in the implants of the ITI® Dental Implant System is presented. In 1 case in which such fractures occurred, the repair set was successfully applied. After removal of all particles of the fractured prosthetic abutments and recutting the threads, new abutments were used, and the original suprastructure could be reinserted. The causes for such technical failures are discussed considering the relatively sparse information in the literature on that topic. © Munksgaard 2000.link_to_subscribed_fulltex

A systematic review and meta-analysis on the effect of implant length on the survival of rough-surface dental implants

Background: A meta-analysis on the survival of short implants compared to conventional implants has never been performed. Therefore, the aim of this study was to address the focused question &apos;&apos;Is there a significant difference in survival between short (≤8 or &lt;10 mm) and conventional (≥10 mm) rough-surface dental implants placed in 1) totally or 2) partially edentulous patients?&apos;&apos; by conducting a systematic review and meta-analysis of prospective studies published in the dental literature in the English language up to and including August 2007. Methods: PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were scanned electronically, and seven journals were searched manually. In the first phase of selection, titles and abstracts, and in the second phase, full texts, were evaluated autonomously and in duplicate by two reviewers. Extensive contact with authors was carried out in search of missing, unclear, or unpublished data. Results: The electronic and manual search provided, respectively, 1,056 and 14,417 titles and abstracts. In the second phase of selection, the complete text of 300 articles was examined, and 37 articles reporting on 22 patient cohorts were selected. Meta-analyses revealed no statistically significant difference in survival between short (≤8 or &lt;10 mm) and conventional (≥10 mm) rough-surface implants placed in totally or partially edentulous patients. Conclusions: Within the limitations of this systematic review, the placement of short rough-surface implants is not a less efficacious treatment modality compared to the placement of conventional rough-surface implants for the replacement of missing teeth in either totally or partially edentulous patients

Therapy of peri-implantitis: A systematic review: Review article

Aim: The objective of this study was to provide a systematic review of randomized controlled and/or comparative clinical trials published in the international peer-reviewed literature in the English language, up to and including July 2007, concerning the efficacy of all treatment modalities implemented for the therapy of peri-implantitis. Material and Methods: PubMed and The Cochrane Library databases were searched electronically and numerous journals were examined manually. In the first phase of selection, the titles and abstracts, and in the second phase, complete papers were screened independently and in duplicate by three reviewers (S. K., I. K. K. and M. T.). Results: The search yielded 1304 possibly relevant titles and abstracts. After the first phase of selection, 13 publications were singled out for a rigorous evaluation. Following the second phase, five studies were selected. Conclusions: The selected studies are too limited in number and exhibit small sample sizes and short follow-up periods. Therefore, there is a definite need for more well-designed, preferably longitudinal, randomized controlled clinical trials. Within the limitations of the selected studies, mechanical debridement combined with antiseptic/antibiotic therapy, the Er:YAG laser or regenerative techniques may be used for treating peri-implantitis, but the indications for each of these techniques have not been delineated clearly. © 2008 Blackwell Munksgaard