Benralizumab improves patient reported outcomes and functional parameters in difficult-to-treat patients with severe asthma: Data from a real-life cohort

In the last decade, an increasing number of randomized controlled trials (RCTs) on biologic therapy in patients with severe asthma have included patient-reported outcomes (PROs) as secondary efficacy measures. The majority of these RCTs showed a benefit in symptoms and quality of life. However, the magnitude of this benefit remains uncertain, because it rarely exceeded the minimal important difference (MID), owing to a significant improvement in the control group (placebo effect). Real-life studies on biologic therapies assessing PRO are scarce. They may support and integrate RCT results through their different experimental design. This real-life retrospective study provides data on 15 patients with difficult-to-treat severe eosinophilic asthma treated with benralizumab up to 6 months. Asthma quality of life questionnaire (AQLQ) and asthma control test (ACT) were assessed and administered at each visit to minimize the Hawthorne effect. Changes in general accepted efficacy measures, such as forced expiratory volume in 1 s (FEV1), peak expiratory flux (PEF), exacerbation rate and blood eosinophils, from baseline were also assessed. AQLQ and ACT improved from 3.9 ± 0.4 to 5.2 ± 0.4 and from15.6 ± 5.7 to 18.1 ± 5.6, respectively. FEV1 increased of about 250 ml (+14%). PEF increased from 288 ± 107 to 333 ± 133 l/min. The number of exacerbations requiring OCS courses decreased from 2.8 ± 2.2 to 0.5 ± 0.8. Eosinophil counts dropped to 25.6 ± 15 cells/microliter. In conclusion, most patients reported improvements in AQLQ and ACT greater than MID, suggesting that these outcome represent a sensitive tool in real-life effectiveness studies. Our approach reduced the limitations of transition questions and the Hawthorne effect, increasing findings reliability

Parametri fondamentali della diagnosi parodontale.

In questo dossier vi verranno fornite le nozioni relative alla raccolta delle informazioni fondamentali per la formulazione di una diagnosi parodontale, con particolare attenzione alla descrizione dei segni clinici e alla loro traduzione in parametri quantitativi o semiquantitativi

Orbital and Periorbital Emphysema Following Maxillary Sinus Floor Elevation: A Case Report and Literature Review

During the past 150 years, subcutaneous emphysema has been described as a rare complication in dentistry, the etiology of which might be maneuvers performed by the patient (eg, sneezing while the mouth is closed, blowing the nose) or the dental professional through the use of specific dental instruments (eg, dental drill, air syringe, etc). Irrespective of etiology, air is forced through the soft tissues, thus producing rapid swelling of the area. According to the most recent literature reviews, the iatrogenic etiology is the most frequent. This report describes the first case of emphysema related to the orbital and periorbital region after a maxillary sinus floor elevation procedure

Learning curve of a minimally invasive technique for transcrestal sinus floor elevation: A split-group analysis in a prospective case series with multiple clinicians.

Aims: To assess the learning curve of a minimally invasive procedure for maxillary sinus floor elevation with a transcrestal approach (tSFE) and evaluate the influence of clinician's experience in implant surgery on its outcomes. Materials and Methods: Patients were treated by clinicians with different levels of experience in implant surgery and inexperienced with respect to the investigated tSFE technique. The initial (n = 13) and final (n = 13) groups treated by the expert clinician were compared for tSFE outcomes. Additionally, the high, moderate, and low groups (n = 20 each) treated by the expert, moderately experienced, and low experienced clinician, respectively, were compared. Results: (1) No significant differences in clinical and radiographic outcomes were observed between initial and final groups; (2) high, moderate, and low groups showed substantial vertical augmentation in limited operation time with treatment outcomes being influenced by the level of experience in implant surgery. Conclusions: The investigated technique allows for a substantial vertical augmentation at limited operation times when used by different clinicians. The extent of sinus lift (as radiographically assessed) seems to be influenced by the clinician's level of experience in implant dentistry

Prognostic value of a composite outcome measure for periodontal stability following periodontal regenerative treatment: A retrospective analysis at 4 years

BackgroundRecently, a composite outcome measure (COM) was proposed to describe the short-term results of periodontal regenerative treatment. The present retrospective study aimed at evaluating the prognostic value of COM on clinical attachment level (CAL) change over a 4-year period of supportive periodontal care (SPC). MethodsSeventy-four intraosseous defects in 59 patients were evaluated at 6 months and 4 years following regenerative treatment. Based on 6-month CAL change and probing depth (PD), defects were classified as: COM1 (CAL gain & GE;3 mm, PD & LE;4 mm); COM2 (CAL gain <3 mm, PD & LE;4 mm); COM3 (CAL gain & GE;3 mm, PD >4 mm); or COM4 (CAL gain <3 mm, PD >4 mm). COM groups were compared for "stability" (i.e., CAL gain, no change in CAL or CAL loss <1 mm) at 4 years. Also, groups were compared for mean change in PD and CAL, need for surgical retreatment, and tooth survival. ResultsAt 4 years, the proportion of stable defects in COM1, COM2, COM3, and COM4 group was 69.2%, 75%, 50%, and 28.6%, respectively, with a substantially higher probability for a defect to show stability for COM1, COM2, and COM3 compared with COM4 (odds ratio 4.6, 9.1, and 2.4, respectively). Although higher prevalence of surgical reinterventions and lower tooth survival were observed in COM4, no significant differences were detected among COM groups. ConclusionsCOM may be of value in predicting CAL change at sites undergoing SPC following periodontal regenerative surgery. Studies on larger cohorts, however, are needed to substantiate the present findings

Strumentazione meccanica e antimicrobici domiciliari: effetti microbiologici.

In pazienti affetti da parodontite, lE’ stato valutato E’ stato valutato ll’effetto microbiologico della strumentazione meccanica (SM) sulla riduzione della conta batterica totale e dei maggiori patogeni parodontali uso domiciliare di antimicrobici, …in un gruppo di pazienti (n=52) affetti da parodontite cronica (CP) ( n=14) e aggressiva generalizzata (G-AgP) ( n=38). determina una riduzione della conta batterica totale. Tale riduzione sembra essere aspecifica, coinvolgendo anche i batteri maggiormente parodontopatogeni, e persiste a 12 settimane dalla SMUM

Regenerative Periodontal Treatment with the Single Flap Approach in Smokers and Nonsmokers

The present study was performed to evaluate the impact of smoking status on 6-month clinical outcomes of a regenerative procedure based on enamel matrix derivative and deproteinized bovine bone mineral in the treatment of intraosseous defects accessed with buccal single flap approach. A total of 22 defects were selected in smoking (n = 11) and nonsmoking (n = 11) patients. Regenerative treatment resulted in similar clinical attachment level (CAL) gain in both smokers and nonsmokers. A trend toward lower 6-month CAL gain and probing depth reduction was observed in patients smoking 11 to 20 cigarettes per day compared to those smoking 1 to 10 cigarettes per day

Single-Flap Approach in Combination with Enamel Matrix Derivative in the Treatment of Periodontal Intraosseous Defects

Twenty-four periodontal intraosseous defects were accessed with a buccal single-flap approach (SFA) and treated with enamel matrix derivative (EMD) or EMD + deproteinized bovine bone mineral (DBBM) according to the surgeon,s discretion. EMD with or without DBBM was clinically effective in the treatment of periodontal intraosseous defects accessed with a buccal SFA. The adjunctive use of DBBM in predominantly one-wall defects seemed to compensate for, at least in part, the unfavorable osseous characteristics in terms of the outcomes of the procedure

Significance of a simplified method for periodontal risk assessment in predicting periodontitis recurrence during supportive periodontal therapy: a retrospective cohort study

Aim: To evaluate whether patient-related risk scores generated with a simplified method for periodontal risk assessment (UniFe; Trombelli et al. 2009) may predict periodontitis recurrence during supportive periodontal therapy (SPT). Material and Methods: At 2 clinical centers, data were retrospectively obtained from the record charts of 109 patients (age range: 22\u201362 years). According to the individual treatment plan, patients had undergone active periodontal therapy (APT) and had been enrolled in a SPT program for a mean of 5.6 2.2 years. Patient-related risk scores referred to the first visit following APT were calculated on a scale from 1 (low risk) to 5 (high risk) according to UniFe. Patients were grouped according to risk scores and compared for tooth loss as well as changes in radiographic bone levels and pocket probing depth (PPD) occurred during SPT. Results: After APT, 5, 6, 20, 65, and 13 patients showed a risk score of 1, 2, 3, 4 and 5, respectively. The mean number of teeth lost during SPT ranged from 0 to 1.8 2.5 teeth in patients with a risk score of 1 and 5, respectively (p = 0.041), with a mean yearly rate between 0 (risk score 1) and 0.32 0.51 teeth/year (risk score 5) (p = 0.053). Mean bone loss and PPD increase during SPT were both 640.50 mm in all risk groups, without inter-group differences. Conclusion: Within its limits, the present study indicate that risk assessment according to the UniFe method may help to identify patients at risk for tooth loss during SPT

Morbidity following transcrestal and lateral sinus floor elevation: A randomized trial

To comparatively evaluate the morbidity following maxillary sinus floor elevation according to either transcrestal (tSFE) or lateral (lSFE) approach with concomitant implant placement