Periodontitis and Systemic Disease: Association or Causality?

PURPOSE OF REVIEW: The aim was to assess recent evidence that diabetes, metabolic syndrome (MetS) and obesity impact the progression of periodontitis. RECENT FINDINGS: Electronic searches using Embase, Medline, and Web of Science were carried out for epidemiological studies on humans, published between 2014 and 2016. A small number of prospective studies and systematic reviews were identified that in general provide further support for the hypothesis that diabetes, metabolic syndrome and obesity can adversely affect the periodontal condition. SUMMARY: Confounding remains the most challenging issue in the interpretation of the associations found between diabetes, MetS, obesity and periodontal disease. Recent research applying a Mendelian randomisation approach concluded that the association between obesity and periodontitis is confounded and questioned a role for obesity in causation. Further studies are warranted to assess the issue of causality

Implementation of a Food Science and Nutrition Module in a Dental Undergraduate Curriculum

Although it is generally acknowledged that nutrition should be a core subject in curricula, most dental programmes do not specifically include nutrition education.1–5 The rationale for improving the nutrition education of dental students is supported by the multidirectional and synergistic relationship between nutrition and oral health.6,7 As highlighted recently, achieving a population-wide reduction in free sugar consumption has now become a central tenet for public health authorities and professional healthcare workers globally.8 However, dentists do not have the confidence or competencies to assess or deliver appropriate dietary interventions

Characterisation of the Fibroblast Growth Factor Dependent Transcriptome in Early Development

BACKGROUND: FGF signaling has multiple roles in regulating processes in animal development, including the specification and patterning of the mesoderm. In addition, FGF signaling supports self renewal of human embryonic stem cells and is required for differentiation of murine embryonic stem cells into a number of lineages. METHODOLOGY/PRINCIPAL FINDINGS: Given the importance of FGF signaling in regulating development and stem cell behaviour, we aimed to identify the transcriptional targets of FGF signalling during early development in the vertebrate model Xenopus laevis. We analysed the effects on gene expression in embryos in which FGF signaling was inhibited by dominant negative FGF receptors. 67 genes positively regulated by FGF signaling and 16 genes negatively regulated by FGF signaling were identified. FGF target genes are expressed in distinct waves during the late blastula to early gastrula phase. Many of these genes are expressed in the early mesoderm and dorsal ectoderm. A widespread requirement for FGF in regulating genes expressed in the Spemann organizer is revealed. The FGF targets MKP1 and DUSP5 are shown to be negative regulators of FGF signaling in early Xenopus tissues. FoxD3 and Lin28, which are involved in regulating pluripotency in ES cells are shown to be down regulated when FGF signaling is blocked. CONCLUSIONS: We have undertaken a detailed analysis of FGF target genes which has generated a robust, well validated data set. We have found a widespread role for FGF signaling in regulating the expression of genes mediating the function of the Spemann organizer. In addition, we have found that the FGF targets MKP1 and DUSP5 are likely to contribute to the complex feedback loops involved in modulating responses to FGF signaling. We also find a link between FGF signaling and the expression of known regulators of pluripotency

A split mouth, double blind, placebo controlled trial to assess the impact of a lidocaine / prilocaine 2.5%

TX-1-839The aim of the study was to evaluate the efficacy of an intra-pocket anaesthetic gel (Oraqix?, Dentsply Pharmaceutical, York, Pennsylvania, USA) in the reduction of pain on periodontal probing in a group of untreated generalised chronic periodontitis subjects

Relationship between periodontal disease and nutrition

Periodontitis has been defined as "a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth supporting apparatus". Epidemiological data suggests that periodontitis affects 45-50% of all adults, with severe periodontitis affecting 11.2% of the world's population, thus representing a significant public health challenge. In addition to well-established local and systemic risk factors for periodontal disease, attention has recently turned to the role of nutrition in disease development. The aim of this chapter is to discuss the evidence of the impact macro- and micronutrient malnutrition may have on periodontal diseases.<br/

Efficacy of chemical approaches for implant surface decontamination in conjunction with sub-marginal instrumentation, in the non-surgical treatment of peri-implantitis:A systematic review

Aim: To answer the following PICOS question: In adult patients with peri-implantitis, what is the efficacy of sub-marginal instrumentation combined with chemical surface decontamination in comparison with sub-marginal instrumentation with or without placebo, in terms of changes in probing depth (PD) and/or bleeding on probing, as reported in prospective randomized controlled trials, non-randomized controlled trials, or prospective cohort studies, with a minimum of 6-month “follow-up”.Materials and Methods: A systematic literature search was performed in PubMed, Web of Science, Embase, Scopus, Ovid Medline, and The Cochrane Library of the Cochrane Collaboration (CENTRAL) for articles published until March 2022. Data addressing the primary and secondary outcomes were extracted.Results: The search gave 2033 results of which 3 fulfilled the inclusion criteria. Two studies investigated the use of anti-microbial photodynamic therapy as adjunct to sub-marginal instrumentation and the third study assessed the adjunctive use of a desiccant material. A meta-analysis was not deemed meaningful because of the large heterogeneity among the studies. All three studies showed favourable results in terms of PD reduction for chemical surface decontamination over control approaches, but were inconsistent or showed no differences for the other outcome variables.Conclusions: Adjunctive chemical approaches for implant surface decontamination may offer an advantage over sub-marginal instrumentation alone, in terms of improved PD.</p

Desquamative Gingivitis – Aetiology, Diagnosis and Management

The diagnosis and classification of mucosal disease for the busy general dental practitioner can be difficult since many mucosal diseases present with a similar oral appearance. The term desquamative gingivitis (DG) is often used as a descriptive term because the aetiology of the inflammation may originate from multiple oral conditions. In this review article, we discuss oral lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris as the main mucocutaneous diseases associated with DG. The importance of plaque control is emphasized in the initial management of these cases. CPD/Clinical Relevance: As an oral complaint, patients will likely seek dental advice as their first point of contact for symptoms associated with DG. Therefore, an understanding of potential conditions that are causing their symptoms, as well as some general measures which may help improve their condition, are important. </jats:p

What is the influence of implant surface characteristics and/or implant material on the incidence and progression of peri‐implantitis? : A systematic literature review

Objectives: To answer the focused question, 'In animals or patients with dental implants, does implant surface characteristics and/or implant material have an effect on incidence and progression of peri-implantitis?' Material and methods: Pre-clinical in vivo experiments on experimental peri-implantitis and clinical trials with any aim and design, and ≥5 years follow-up, where the effect of ≥2 different type of implant material and/or surface characteristics on peri-implantitis incidence or severity, and/or progression, implant survival or losses due to peri-implantitis, and/or marginal bone levels/loss was assessed. Results: Meta-analyses based on data of pre-clinical experiments, using the ligature induced peri-implantitis model in the dog, indicated that after the spontaneous progression phase implants with a modified surface showed significantly greater radiographic bone loss (effect size 0.44 mm; 95%CI 0.10-0.79; p = .012; 8 publications) and area of infiltrated connective tissue (effect size 0.75 mm2 ; 95%CI 0.15-1.34; p = .014; 5 publications) compared to non-modified surfaces. However, in 9 out of the 18 included experiments, reported in 25 publications, no significant differences were shown among the different implant surface types assessed. Clinical and/or radiographic data from 7605 patients with 26,188 implants, reported in 31 publications (20 RCTs, 3 CTs, 4 prospective cohort, and 4 retrospective studies; 12 with follow-up ≥10 years), overall did not show significant differences in the incidence of peri-implantitis, when this was reported or could be inferred, among the various implant surfaces. In general, high survival rates (90-100%) up to 30 years and no clinically relevant differences in marginal bone loss/levels, merely compatible with crestal remodelling, were presented for the various implant types. Conclusion: Pre-clinical in vivo experiments indicate that surface characteristics of modified implants may have a significant negative impact on peri-implantitis progression, while clinical studies do not support the notion that there is a difference in peri-implantitis incidence among the various types of implant surfaces. No assumptions can be made regarding the possible impact of implant material on incidence and/or peri-implantitis progression due to limited information

Periodontitis and airflow limitation in older Swedish individuals

Aim: To investigate whether there was an association between periodontitis and airflow limitation in older Swedish individuals. Materials and Methods: Study individuals were randomly selected from the Swedish civil registration database representing the ageing population in Karlskrona, Sweden. Clinical and radiographic examinations were performed, alongside which participants completed questionnaires gathering information on their medical history, social circumstances, demographic background and tobacco use. A physical examination assessed anthropometric measures. Standard spirometry was performed to identify subjects with airflow limitation. Periodontitis was defined based on radiographic periodontal bone loss. Analysis included multiple logistic regression with adjustment for various confounders. Results: A total of 826 Caucasian dentate subjects were included in the analysis. The median age of participants was 73.2 (IQR 66–81) years, and 443 (54.6%) subjects were female. Eighty-six (10.4%) individuals presented with airflow limitation. The proportion of participants presenting with periodontitis in the airflow limitation group was 65.1% compared to 41.5% with normal respiratory function (p <.001). Multiple logistic regression analysis showed that periodontitis was independently associated with airflow limitation with an odds ratio of 2.31 (95% CI 1.27–4.22) p <.01. Conclusion: In this group of older dentate individuals, periodontitis was significantly associated with airflow limitation independent of other known risk factors