Peri-implant diseases and metabolic syndrome components: a systematic review

OBJECTIVE: Metabolic syndrome (MetS) is defined as a spectrum of conditions associated with an increased risk of developing CVD and type 2 diabetes. MetS include: hyperglycemia, hypertension, visceral obesity, dyslipidemia with elevated values of triglycerides (TG) and low levels of HDL. The aim of this review is to provide current knowledge of the relationship between MetS, its components and peri-implant diseases. MATERIALS AND METHODS: An electronic literature search was conducted in the English language in several databases. The Newcastle-Ottawa Scale was used for quality assessment of cohort and cross-sectional studies; while systematic reviews were evaluated through AMSTAR; results were reported according to the PRISMA Statement. RESULTS: A total of 272 records were identified through database searching, six studies were included for qualitative analysis. No study directly related to MetS was found, there was inconsistent and controversial evidence regarding association with cardiovascular disease. A higher risk of peri-implantitis was detected in people with hyperglycemia. CONCLUSIONS: Future research should be orientated in assessing the risk of peri-implant diseases, evaluating patient's therapeutic response, analyzing directionality of the relationship between MetS, its components and biologic implant complications. Few studies have investigated the possible relationship between systemic conditions and peri-implant diseases. The aim of this review is to present, in a systematic manner, current evidence and knowledge regarding possible association between cardiovascular disease and implant biologic complications. Out of the one-hundred-eighty-nine studies screened, just five studies were selected for qualitative analysis: three cohort studies (one prospective and two retrospectives) and two cross-sectional studies. According to their results, there is inconsistent and controversial evidence regarding association of cardiovascular disease and implant biologic complications. Future research should be orientated in conducting longitudinal studies, evaluating patients affected by cardiovascular disease rehabilitated with dental implants

Implant survival and success rates in patients with risk factors: results from a long-term retrospective study with a 10 to 18 years follow-up

OBJECTIVE: Risk factors for implant therapy are represented by all general and local conditions that through various mechanisms can increase either short-term and long-term failure risk. The aim of this study is to assess the implant survival and implant success rates with single and multiple risk factors. PATIENTS AND METHODS: To address the research purpose, a retrospective cohort study was designed and implemented, including a sample of 225 patients with a total of 871 implants placed. The following risk factors were considered: smoking, bruxism, bone augmentation procedures and the presence of load risk (implants with crown/implant relation > 0.8; angulation > 25°; presence of cantilever). Follow-up ranged from 10 years to 18 years (average follow-up 13.6 years). Failures were subdivided into short-term failures, before the prosthetic phase, and long-term failures, after definitive prosthesis. The success criteria published by Albrektsson and Zarb were adopted. A Cox proportional hazard regression model was used to calculate hazard ratio, with a statistically significant p-value <0.05. RESULTS: Out of the 871 implants placed, 138 did not meet the success criteria, (success rate 84.16%), sixty (43.47%) were classified as "early failure" and seventy-eight as "late failure" (56.53%). A total of 70 dental implants were removed, with a survival rate of 91.96%. CONCLUSIONS: The presence of a single risk factor does not imply a marked increase of failure risk. Among the analyzed factors, the one that proved to be the most dangerous was bruxism, even when presented as the only risk factor. Bruxism with load risk proved to be the most dangerous association (success rate 69.23%) and could be included among the absolute contraindications for implant treatment

A randomized clinical trial about presence of pathogenic microflora and risk of peri-implantitis: comparison of two different types of implant-abutment connections

OBJECTIVE: The aim of this in vivo study was to evaluate two different types of implant-abutment connections: screwed connection and cemented connection, analyzing peri-implant bacteria microflora as well as other clinical parameters. PATIENTS AND METHODS: Twenty implants were selected, inserted in 20 patients, 10 with a screwed implant-abutment connection (Group 1) and 10 with a cemented implant-abutment connection (Group 2). The peri-implant microflora was collected, after at least 360 days from the prosthetic rehabilitation, using paper points inserted in peri-implant sulcus for 30 s. Polymerase chain reaction (PCR) Real-time analyzed the presence of 9 bacteria periodontal-pathogens and Candida albicans. RESULTS: Our findings showed that bacteria colonized all Groups analyzed, the average bacterial count was 3.7 E +08 (±1.19) in Group 1, compared to 2.1 E +08 (±0.16) in Group 2; no statistically significant differences were observed (p>0.0.5). In Group 1, however, bacterial colonization of peri-implant sulci was over the pathogenic threshold for 5 bacteria, indicating a high-risk of peri-implantitis. Also in Group 2, results showed a microflora composed by all bacteria analyzed but, in this case, bacterial colonization of peri-implant sulci was over the pathogenic threshold for only 1 bacterium, indicating a lower risk of peri-implantitis. Moreover, clinical parameters (PPD > 3 mm and m SBI > 0) confirmed a greater risk of peri-implantitis in Group 1 compared to Group 2 (p<0.05). CONCLUSIONS: We concluded that, also after only 360 days, implants with screwed connection showed a higher risk of peri-implantitis that implants with cemented connection

Corrosion behavior of dental implants immersed into human saliva: Preliminary results of an in vitro study

Over the years, dif- ferent implant surfaces have been used to try to maximize bone to implant contact. The aim of this study was to compare levels of metallic ions and particles dissolution collected from two dif- ferent dental implants surfaces immersed into human saliva. PATIENTS AND METHODS: A total of 60 den- tal implants were tested. Group A: sanded with aluminium oxide medium grade particles and ac- id-etched; Group B: micro-sanded with calcium phosphate powders and acid-etched. Forty im- plants were immersed in 20 ml of human saliva, twenty, as a control, in sterile saline solution. ICP-MS was performed to detect any metallic ions released from dental implants at T0, on day 1 (T1), on day 3 (T2), after one week (T3), on day 14 (T4), after 3 months (T5) and after 6 months (T6). RESULTS: Dissolution of metallic particles of titanium and nickel, absent in human saliva (T0), were found after one week (T3) for Group B and after 3 months (T5) for Group A. Vanadium was already detected in small concentrations in either group after 1 day, with an exponential growth for Group B. CONCLUSIONS: Preliminary results reported signi cant values of Ti, Ni and V released by Group B, showing for the rst time statistically signi cant values of vanadium

Histological and immunohistochemical evaluation of mandibular bone tissue regeneration

The purpose of the study was to perform an immunohistochemical and histological evaluation of samples taken from different bone regeneration procedures in atrophic human mandible. 30 patients (15 men and 15 women, age range of 35-60 years), non-smokers, with good general and oral health were recruited in this study and divided into three groups. The first group included patients who were treated with blood Concentration Growth Factors (bCGF), the second group included patients who were treated with a mixture of bCGF and autologous bone, while the third group of patients was treated with bCGF and tricalcium phosphate/hydroxyapatite (TCP-HA). Six months after the regenerative procedures, all patients undergone implant surgery, and a bone biopsy was carried out in the site of implant insertion. Each sample was histologically and immunohistochemically examined. Histological evaluation showed a complete bone formation for group II, partial ossification for group I, and moderate ossification for group III. Immunohistochemical analysis demonstrated a statistically significant difference between the three groups, and the best clinical result was obtained with a mixture of bCGF and autologous bone

Monolithic zirconia and digital impression: case report

The aim of this study is to present a clinical case of a full arch prosthetic rehabilitation on natural teeth, combining both digital work-flow and monolithic zirconi

Perancangan Logo & Corporate Identity Hotel Gowin Bali

Logo dan corporate identity merupakan salah satu faktor yang sangat penting dalam membangun identitas atau citra sebuah Perusahaan yang dapat menentukan bagaimana nasib suatu Perusahaan, baik dalam hal citranya di mata masyarakat maupun berkembang tidaknya suatu Perusahaan. Melihat betapa pentingnya peranan logo dan corporate identity, maka hotel Gowin yang akan segera membuka USAha dalam bidang perhotelan tentu juga memerlukannya. Berlokasi di wilayah Bali yang penuh dengan persaingan ketat dalam bidang bisnis pariwisata, membuat hotel Gowin perlu menonjolkan keistimewaannya yang dapat diwujudkan dalam bentuk lambang identitas logo dan corporate identity, sehingga mampu bersaing dan tidak kalah bersaing dengan hotel-hotel lainnya. Logo dan corporate identity hotel Gowin dirancang sesuai dengan visi misi dan citra Perusahaan yang ingin ditampilkan sehingga dihasilkan logo dan corporate identity yang modern namun tetap tidak meninggalkan ciri khas tradisional khas Bali

The IL-1 family in relation to psoriasis

Psoriasis is a common chronic inflammatory skin disease which can also affect the joints. Its pathogenesis is still to be fully elucidated and involves a wide range of inflammatory mediators, tissue and immune cells. At present, there is no treatment available to cure psoriasis. Although biologics have considerably improved the treatment of the most severe cases there is still a pressing clinical need to improve therapy for specific disease subtypes (e.g. pustular psoriasis) and the vast majority of patients suffering from psoriasis classified as mild to moderate. In particular, efficient and well tolerated topical approaches are lacking. This work has focused 1) on advancing our understanding of IL-36 cytokines which are recognised for their significance in pustular psoriasis, 2) on identifying endogenous disease limiting mediators such as IL-18 binding protein and how they could be manipulated in a therapeutic approach and 3) on IL-17 neutralising RNA aptamers as tools for topical therapy. Main results include the identification of biologic activity of processed and non-processed IL-36 members. N-terminal cleavage is required to increase activity of all IL-36 members. The protease responsible for IL-36RA processing was elucidated. Neutrophil proteases as well as kallikrein 7 can cleave pro-inflammatory IL-36 members. However, a second processing step seems necessary for full activation and the potentially responsible aminopeptidase remains to be identified. Secondly, it was found that human primary fibroblasts produce significant levels of IL-18BP, which controls pro-inflammatory function of IL-18. Endogenous IL-18BP can be induced by IL-27 which, when given in combination with hydrocortisone does not induce pro-inflammatory responses. Thirdly, an IL-17 specific aptamer was verified to block IL-17A activity in fibroblast and fibroblast Th17 co-cultures but not in keratinocyte cultures. Significant uptake of the RNA aptamer by keratinocytes was identified as potentially responsible for the lack of neutralising capacity

Primary Hyperparathyroidism and Monoclonal Gammopathy

Coexistent primary hyperparathyroidism and monoclonal gammopathy, although rare, has been reported previously by a number of investigators. We report four patients with such an occurrence who were seen between 1976 and 1988. Another patient with primary hyperparathyroidism also had multiple myeloma and was in remission for 12 years. These patients represent approximately 1% of the 386 patients with primary hyperparathyroidism seen during the same 12-year period. Although several mechanisms have been proposed to explain this concurrence, we believe it is the result of a chance occurrence. A review of the literature, an estimate of the chance occurrence of coincidental monoclonal gammopathy, benign or malignant, in patients with primary hyperparathyroidism, and some practical implications of this interesting coexistence are presented

Glial cells are functionally impaired in juvenile neuronal ceroid lipofuscinosis and detrimental to neurons.

The neuronal ceroid lipofuscinoses (NCLs or Batten disease) are a group of inherited, fatal neurodegenerative disorders of childhood. In these disorders, glial (microglial and astrocyte) activation typically occurs early in disease progression and predicts where neuron loss subsequently occurs. We have found that in the most common juvenile form of NCL (CLN3 disease or JNCL) this glial response is less pronounced in both mouse models and human autopsy material, with the morphological transformation of both astrocytes and microglia severely attenuated or delayed. To investigate their properties, we isolated glia and neurons from Cln3-deficient mice and studied their basic biology in culture. Upon stimulation, both Cln3-deficient astrocytes and microglia also showed an attenuated ability to transform morphologically, and an altered protein secretion profile. These defects were more pronounced in astrocytes, including the reduced secretion of a range of neuroprotective factors, mitogens, chemokines and cytokines, in addition to impaired calcium signalling and glutamate clearance. Cln3-deficient neurons also displayed an abnormal organization of their neurites. Most importantly, using a co-culture system, Cln3-deficient astrocytes and microglia had a negative impact on the survival and morphology of both Cln3-deficient and wildtype neurons, but these effects were largely reversed by growing mutant neurons with healthy glia. These data provide evidence that CLN3 disease astrocytes are functionally compromised. Together with microglia, they may play an active role in neuron loss in this disorder and can be considered as potential targets for therapeutic interventions