Correlation between periodontal disease management and metabolic control of type 2 diabetes mellitus: a systematic literature review

Background: Diabetes and periodontal disease share common features in terms of inflammatory responses. Current scientific evidence suggests that treatment of periodontal disease might contribute to glycemic control. The objective of the study is a review of the last three years. Material and Methods: A literature search was performed in the MEDLINE (PubMed), Cochrane, and Scopus databases, for articles published between 01-01-2013 and 30-06-2015, applying the key terms “periodontal disease” AND “diabetes mellitus”. The review analyzed clinical trials of humans published in English and Spanish. Results: Thirteen clinical trials were reviewed, representing a total of 1,912 patients. Three of them had samples of 40 patients, representing a total of 1,804. Only one article achieved a Jadad score of five. Seven articles (998 patients, 52.3% total), presented a statistically significant decrease in HbA1c (p<0.05) as a result of periodontal treatment. In the six remaining articles (representing 914 patients, 47.8% of the total), the decrease in HbA1c was not significant. Patient follow-up varied between 3 to 12 months. In three articles, the follow-up was of 3, 4, and 9 months, in two 6 and 12 months. Conclusions: The majority of clinical trials showed that radicular curettage and smoothing, whether associated with antibiotics or not, can improve periodontal conditions in patients with diabetes mellitus. However, few studies suggest that this periodontal treatment improves metabolic control. However, there is no clear evidence of a relation between periodontal treatment and improved glycemic control in patients with type 2 diabetes mellitu

Apical periodontitis and glycemic control in type 2 diabetic patients : cross-sectional study

The objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control. In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis. The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ? 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 ? 3.09; p = 0.31). The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients

Adherencia bacteriana en los materiales de sutura de uso habitual en cirugía bucal. Revisión sistemática

Objetivo: Demostrar la existencia de agregación bacteriana a los materiales de sutura que suelen emplearse en la práctica odontológica, comprobar si dicha agregación está relacionada con la inflamación que sucede al acto quirúrgico y por último dar recomendaciones sobre qué tipo de sutura se adapta mejor para la prevención de la adherencia bacteriana. Material y método: Búsqueda bibliográfica a través de las bases de datos PubMed, Cochrane y Scielo empleando las palabras clave: surgical sutures, bacterial adherence. Como criterios de inclusión se aceptaron los estudios publicados en los últimos 15 años, in vivo o in vitro en relación con la cirugía oral y con un nivel de evidencia científico superior a 3 según los criterios de evidencia científica. Fueron excluidas todas aquellas publicaciones que no tenían como objeto de estudio las sutura seda, Nylon , Supramid , Monocryl , Vicryl o Vicryl Plus . También se excluyeron todas aquellas publicaciones que no relacionaban los materiales de sutura a la agregación bacteriana. Resultados: Un total de 9 publicaciones se organizaron en función del tipo de sutura empleada, si eran estudios in vivo o in vitro, el número de pacientes/muestras, tiempo transcurrido hasta la remoción de las suturas, si se realizaron controles, si existió algún tipo de reacción inflamatoria, que tipo de bacterias se agregaron y que material obtuvo mayor agregación. Discusión: Los materiales de sutura que mayor acúmulo de placa bacteriana presentan bajo las mismas condiciones de tiempo de exposición a bacterias, son los de tipo multifilamento reabsorbible no tratados con antimicrobianos

Valoración inicial de la capacidad de regeneración ósea del plasma rico en plaquetas, médula ósea y fosfato tricálcico mediante técnica de matlab

En la práctica odontológica, existen numerosos procedimientos médico-quirúrgicos cuyo resultado es la pérdida de tejido óseo. Existen en la literatura numerosos trabajos que valoran la capacidad de regeneración del propio hueso, de forma fisiológica o en asociación a biomateriales, pero los resultados son contradictorios aspecto que justifica investigaciones sobre el tema

Laterally stretched flap with connective tissue graft: a novel approach to treat deep/narrow gingival recessions in lower incisors

EuroPerio 9 Congress. European Federation of Periodontology. Amsterdam, Holland Poster Presentation PD171 Background: Different alternatives of treatment of deep/narrow gingival recessions with connective tissue grafts have been proposed: Tunneling procedures1 leave a considerable area of the graft exposed conditioning its nutrition.2,3 Coronally advancing the flap to cover the graft requires extensive repositioning of a -mostly mucosal- flap and the mucogingival junction; while lateral displacement4 is generally achieved by placing vertical incisions, potentially leaving visible scars. The aim of this case series is to present the technical description, and the results obtained with 21 gingival recessions treated with a recently published novel approach: the laterally stretched flap (LSF) with connective tissue graft (CTG).5 Technical variants, and keys to success will be reviewed. Clinical Procedure: 17 patients with 21 deep/narrow Miller class II and III gingival recessions were treated and followed-up between 6 months and 4 years. Recession depth (Rec) and keratinized tissue (KT) were registered at baseline and at final evaluation (Table 1). Mean % root coverage (MRC) and complete root coverage (CRC) were calculated. Briefly, the recipient site was prepared with intracrevicular incisions and a partial thickness envelope performed with tunneling instruments until ample tissue elasticity was obtained.5 A connective tissue graft was harvested from the palate with a modified single incision technique utilizing a parallel blade scalpel.6 The graft was inserted into the envelope and held with sutures at both lateral ends.7,8 The lateral edges of the recession were finally approximated with sutures to cover the graft. Outcomes: Clinical Outcomes: Class I and II recessions gained 99.2% of MRC and 88.5% of sites achieved CRC. Miller class III showed 79.2% of MRC and 23.1% of the sites reached CRC. KT was increased in all cases (Table 1). Conclusions: Laterally stretching the flap to cover the graft improved revascularization of the graft and wound stability rendering excellent esthetic outcomes with minimal patient discomfort

Postsurgical Prosthetic Rehabilitation after Mandibular Ameloblastoma Resection: A 7-Year Follow-Up Case Report

Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed