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

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

Patients’ Socio-Economic Status, Tobacco and Medical History Associated with Implant Failure

Svrha: Željela se istražiti moguća veza između pacijenata kod kojih se dogodilo odbacivanje implantata i onih s uspješnom implantoprotetičkom terapijom. Materijali i metode: Ovo retrospektivno istraživanje temelji se na 186 slučajeva s odbacivanjem implantata i 186 uspješnih slučajeva s usporedivom dobi i spolom, što je činilo ukupno 372 pacijenta. Zabilježeni su dob tijekom postupka, spol, povijest bolesti, pušenje, status zdravstvenog osiguranja, poštanski broj i ishod liječenja (odbacivanje implantata/uspješno liječenje implantatom). Rezultati: Sudjelovalo je 47,6 % žena, 48,9 % pojedinaca sa zdravstvenim osiguranjem i 9,7 % pušača. Pronađena je statistički značajna povezanost (p ≤ 0,05) između odbacivanja implantata i uspješne implantoprotetičke terapije s obzirom na pušenje, socijalno-ekonomski status i povijest bolesti. Status zdravstvenog osiguranja i područje implantacije (regija, zubni luk) nisu statistički značajno utjecali (p > 0,05) na rezultat implantoprotetičke terapije. Zaključci: Uzimajući u obzir ograničenja ove retrospektivne studije slučaja, pojedinci s visokim socijalno-ekonomskim statusom, a pritom nepušači i s preboljelim srčanim udarom, imali su veću vjerojatnost za uspješno liječenje implantatima od onih s niskim socijalno-ekonomskim statusom i bez srčanog udara u povijesti bolesti.Objective: To examine the potential association between patients’ characteristics that experienced implant failure and those who had successful implant treatment. Materials and methods: This retrospective case-control study is based on 186 dental records of implant failure and 186 age and gender matched successful treatments for a total of 372 patients. Age at the time of the procedure, gender, medical history, tobacco use, dental insurance status, ZIP code and type of treatment provided (implant failure/successful implant treatment) were recorded. Results: The population consisted of 47.6% females, 48.9% individuals with dental insurance and 9.7% self-reported tobacco users. A statistically significant association (p≤0.05) was found between implant failure and successful implant treatment in regards to tobacco use, socio-economic status and medical history. Insurance status and implant location (region, arch) did not affect significantly (p>0.05) the outcome of implant therapy. Conclusions: Within the limitation of this retrospective case-control study, individuals with high socio-economic status, no history of tobacco use and history of heart attack were more likely to have a successful implant treatment than those with a low socio-economic status, tobacco users and without history of heart attack

Interleukin-6 and Interleukin-10 Gene Polymorphisms in Patients with Chronic Periodontitis and Response to Treatment after 3 Years

Cilj: Istraživalo se utječe li genetska osjetljivost na kronični parodontitis, potvrđena genotipom IL-6-572GGili alelom IL-10-592A, na rezultate nekirurške parodontne terapije (NSPT) nakon duljeg vremena. Materijal i metode: U dvije skupine raspoređeno je 37 pacijenata s kroničnim parodontitisom prema genotipu i to kao podložni (SCP) i otporni (NSCP). Svi ispitanici klinički su procijenjeni na početku i tri godine poslije NSPT-a. Uzorci krvi za određivanje polaznih vrijednosti prikupljeni su od onih koji su ispunili uvjete za sudjelovanje. Svi su primili NSPT od jednog specijalista parodontologije koji nije znao genotip statusa pacijenata. Provedena je statistička analiza usporedbom varijabli za skupine u kojima se koristio Mann-Whitneyjev U-test, između Wilcoxov test. Rezultati: Prosječna dob ispitanika bila je 47,68 ± 8,64 godine, a sudjelovalo je 51,4 % žena, 48,6 % pušača i 45,9 % konzumenata alkohola. Nakon genetske analize zaključeno je da su 70,3 % pacijenata homozigotni nositelji IL-6-572G(IL-6 SCP), a njih 46,0 % bili su nositelji alela IL-10 592A(IL-10 SCP). NSPT je smanjio sve ispitivane parametre ispitanicima (dubina sondiranja, gubitak epitelnog pričvrstka, krvarenje poslije sondiranja, postotak mjesta sa džepovima od 4 do 6 mm i ≥ 7 mm i gubitak epitelnog pričvrstka), ali ishod liječenja nije bio povezan s genotipom. Osobe s SCP-om i NSCP-om imale su slične kliničke parametre na početku tretmana i poslije tri godine. Zaključak: Unutar ove trogodišnje kohortne studije u kojoj su sudjelovali bijelci s dijagnosticiranim kroničnim parodontitisom, pojedincima podložnima parodontitisu, kako je određeno prisutnošću genotipa IL-6 -572GGili alela IL-10 -592A, nakon NSPT-a rezultat liječenja bio je sličan.Objective: The aim of this study was to investigate whether genetic susceptibility to chronic peri-odontitis, conferred by the presence of the IL-6 -572GG genotype or the IL-10 -592A allele, influences the outcomes following a non-surgical periodontal therapy (NSPT)over a long period of time. Material and methods: Thirty-seven chronic periodontitis patients were divided into two groups according to genotype as susceptible (SCP) and non-susceptible (NSCP). All subjects were clinically evaluated at baseline and 3 years following NSPT. Blood samples were collected at baseline from the individuals who fulfilled the inclusion criteria. All participants received NSPT from a single periodontist who was blind to the genotype status of each patient. A statistical analysis was performed by comparing the variables between groups using the Mann-Whitney U test and between baseline and 3 years for each group using the Wilcoxon test. Results: The mean age of the population was estimated to be 47.68±8.64 years and it included 51.4% females, 48.6% smokers, and 45.9% alcohol consumers. Following a genetic analysis, 70.3% of patients were homozygous carriers of the IL-6 -572G (IL-6 SCP), and 46.0% of them were carriers, bleeding on probing, percentage of sites with 4-6mm and ≥7mm pocket depth and attachment loss) to all participants, but the treatment outcome NSCP individuals showed similar clinical parameters at baseline and at 3 years. Conclusions: Within the limitations of this 3-year prospective cohort study in Caucasians diagnosed with chronic periodontitis, individuals susceptible to periodontal disease as determined by the presence of the IL-6 -572GG genotype or the IL-10 -592A allele showed similar treatment outcome following NSPT

Ofeleein i mi Vlaptin-Volume II: Immunity Following Infection or mRNA Vaccination, Drug Therapies and Non-Pharmacological Management at Post-Two Years SARS-CoV-2 Pandemic.

The persistence of the coronavirus disease 2019 (COVID-19) pandemic has triggered research into limiting transmission, morbidity and mortality, thus warranting a comprehensive approach to guide balanced healthcare policies with respect to people's physical and mental health. The mainstay priority during COVID-19 is to achieve widespread immunity, which could be established through natural contact or vaccination. Deep knowledge of the immune response combined with recent specific data indicates the potential inferiority of induced immunity against infection. Moreover, the prevention of transmission has been founded on general non-pharmacological measures of protection, albeit debate exists considering their efficacy and, among other issues, their socio-psychological burden. The second line of defense is engaged after infection and is supported by a plethora of studied agents, such as antibiotics, steroids and non-steroid anti-inflammatory drugs, antiviral medications and other biological agents that have been proposed, though variability in terms of benefits and adverse events has not allowed distinct solutions, albeit certain treatments might have a role in prevention and/or treatment of the disease. This narrative review summarizes the existing literature on the advantages and weaknesses of current COVID-19 management measures, thus underlining the necessity of acting based on the classical principle of "ofeleein i mi vlaptin", that is, to help or not to harm