Prevention and treatment of peri-implant diseases—The EFP S3 level clinical practice guideline

Background: The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I–IV periodontitis provided evidence-based recommendations for treating periodontitis patients, defined according to the 2018 classification. Peri-implant diseases were also re-defined in the 2018 classification. It is well established that both peri-implant mucositis and peri-implantitis are highly prevalent. In addition, peri-implantitis is particularly challenging to manage and is accompanied by significant morbidity. Aim: To develop an S3 level CPG for the prevention and treatment of peri-implant diseases, focusing on the implementation of interdisciplinary approaches required to prevent the development of peri-implant diseases or their recurrence, and to treat/rehabilitate patients with dental implants following the development of peri-implant diseases. Materials and Methods: This S3 level CPG was developed by the European Federation of Periodontology, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations, and a structured consensus process involving leading experts and a broad base of stakeholders. Results: The S3 level CPG for the prevention and treatment of peri-implant diseases culminated in the recommendation for implementation of various different interventions before, during and after implant placement/loading. Prevention of peri-implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded. Once the implants are loaded and in function, a supportive peri-implant care programme should be structured, including periodical assessment of peri-implant tissue health. If peri-implant mucositis or peri-implantitis are detected, appropriate treatments for their management must be rendered. Conclusion: The present S3 level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to maintain healthy peri-implant tissues, and to manage peri-implant diseases, according to the available evidence at the time of publication

Ethanol enhances collective dynamics of lipid membranes

From inelastic neutron-scattering experiments and all atom molecular dynamics simulations we present evidence for a low-energy dynamical mode in the fluid phase of a 1,2-dimyristoyl-sn-glycero-3-phoshatidylcholine (DMPC) bilayer immersed in a 5% water/ethanol solution. In addition to the well-known phonon that shows a liquidlike dispersion with energies up to 4.5 meV, we observe an additional mode at smaller energies of 0.8 meV, which shows little or no dispersion. Both modes show transverse properties and might be related to molecular motion perpendicular to the bilayer

Concerted motions in allosteric model proteins at terahertz frequencies

PDZ3 is an allosteric protein that represents an ideal test system to analyze the molecular determinants at the basis of the allosteric mechanism. Recent computational studies of the terahertz (THz) fluctuations of this protein have highlighted a response nucleus for binding modulated by the ligand that is visible only at THz frequencies and that overlaps with the known allosterically responding residues (Conti Nibali et al. 2017). With the aim of further characterizing the changes in the terahertz dynamics of this allosteric protein following the binding event, we have carried out an analysis of the correlation motions of pairs of PDZ3 residues from molecular dynamic simulations. We identify concerted and non-random THz fluctuations in the main secondary structure elements of the PDZ3. Importantly, we highlight a concerted motion of some residues belonging to the allosteric response nucleus for binding

Molecular Dynamics of POPC Phospholipid Bilayers through the Gel to Fluid Phase Transition: An Incoherent Quasi-Elastic Neutron Scattering Study

The microscopic dynamics for the gel and liquid-crystalline phase of highly aligned D2O-hydrated bilayers of 1-palmitoyl-oleoyl-sn-glycero-phosphocholine (POPC) were investigated in the temperature range from 248 to 273 K by using incoherent quasi-elastic neutrons scattering (QENS). We develop a model for describing the molecular motions of the liquid phase occurring in the 0.3 to 350 ps time range. Accordingly, the complex dynamics of hydrogen are described in terms of simple dynamical processes involving different parts of the phospholipid chain. The analysis of the data evidences the existence of three different motions: the fast motion of hydrogen vibrating around the carbon atoms, the intermediate motion of carbon atoms in the acyl chains, and the slower translational motion of the entire phospholipid molecule. The influence of the temperature on these dynamical processes is investigated. In particular, by going from gel to liquid-crystalline phase, we reveal an increase of the segmental motion mainly affecting the terminal part of the acyl chains and a change of the diffusional dynamics from a localized rattling-like motion to a confined diffusion

Subgingival periodontal pathogens in Down syndrome children without periodontal breakdown. A case-control study on deciduous teeth

Aim Down syndrome is the most common form of aneuploidia compatible with a long survival. The affected subjects are more susceptible to severe early-onset periodontal disease and show a lower risk to develop dental caries than the non-affected population. This study investigated the prevalence of periodontal pathogens in the subgingival plaque of deciduous teeth in children with Down syndrome without signs of periodontal breakdown. Methods Thirty children suffering from Down syndrome and 46 matched healthy subjects were studied. A total of 228 subgingival plaque samples from deciduous teeth were separately collected and evaluated by polymerase chain reaction assays. Results The prevalence of Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans and Tannerella forsythia was investigated. Aggregatibacter actinomycetemcomitans and Tannerella forsythia were significantly more prevalent in Down syndrome children (respectively 8 and 9 times) than in controls. Conclusion In absence of periodontal impairment, Down syndrome children display a clear presence of periodontal pathogens already in the deciduous dentition. The hypothesis of an intrinsic predisposing condition is here supported

Telemedicine for Facio-Scapulo-Humeral Muscular Dystrophy: A multidisciplinary approach to improve quality of life and reduce hospitalization rate?

Background: Facio-Scapulo-Humeral Muscular Dystrophy (FSHD) is an autosomal dominant inherited disorder characterized by a variable and asymmetric involvement of facial, trunk, upper and lower extremity muscles. Although respiratory weakness is a relatively unknown feature of FSHD, it is not rare. Telemedicine has been used in a variety of health care fields, but only recently, with the advent of sophisticated technology, its interest among health professionals became evident, even in such diseases. Objective: To demonstrate the telemedicine efficacy in FSHD. Methods: Four siblings affected by a severe form of FSHD, living in a rural area far away from the referral center for neuromuscular diseases, who used a wheelchair, suffered from chronic respiratory failure and were provided with long-term non-invasive mechanical ventilation, received a 6-month period of telemedicine support. This consisted of video conferencing (respiratory physiotherapy, psychological support, neurological and pneumological assessment, nurse-coach supervision) and telemonitoring of cardiorespiratory variables (oxygen saturation, blood pressure, and heart rate). Results: We performed 540 video conference sessions per patient, including three daily contacts with short monitoring oximetry measurements, blood pressure, and heart-rate measurements, psychological support, neurological and pneumological assessment, nurse-coach supervision. Conclusions: Our findings indicate that our telemedicine system was user-friendly, efficient for the home treatment of FSHD, and allowed reducing hospital admissions

What is that 2?: Advertisements of follow-up formula and their perception by pregnant women and mothers in Italy

Background: In most European countries advertisements of infant formula are forbidden, while those of follow-on formula are allowed. Recent researches carried out in Australia and Great Britain have suggested that advertisement of toddler formula is used by the producing industry as a line extension to promote infant and follow-on formulas. Objectives: The objective of the study is to assess how advertisements of follow-on formulas are perceived by pregnant women and mothers in Italy. Materials and Methods: The study was carried out in 8 cities of the North, Centre and South of Italy and had two components: 1) a quantitative analysis of 562 self-administered questionnaires for mothers of children under 3 years of age, to explore their exposure to and perception of formula advertisements; 2) a qualitative analysis of 80 in-depth semi-structured interviews to 80 pregnant women, in their 32-36 weeks of gestation with no other children, on their understanding and perception of two advertisements for follow-on formulas. Results: Asked in the self-administered questionnaires whether they had ever come across advertisements of infant formulas, 81% of mothers reported that they had, despite the fact that such advertisements are prohibited by law. The qualitative interviews to pregnant women showed their inability to identify the advertised products at first glance due to the ambiguity of the numeral 2 and the presumed age of the portrayed babies; this confusion did not disappear after careful observation of the advertisements and reading of the text. Conclusions: Advertisements of follow-on formulas are perceived by many pregnant women and mothers as promoting infant formulas