114 research outputs found
Medium- and Long-Term Survival Rates of Implant-Supported Single and Partial Restorations at a Maximum Follow-up of 12 Years: A Retrospective Study
No full textPurpose: To present medium- and long-term biologic outcomes of implant-supported single-tooth restorations and fixed partial dentures and to analyze their correlations with prosthesis and patient characteristics. Materials and Methods: The records of patients treated with implant-supported fixed restorations between 2004 and 2019 reporting the presence or absence of peri-implantitis and/or implant failure were analyzed. The cumulative survival rate (%) over time was calculated, as well as the cumulative prevalence of units free of peri-implantitis. Results: A total of 344 implants in 112 patients were included, with a mean follow-up period of 5.3 +/- 4.0 years after loading. The cumulative survival rates for implants supporting single crowns and fixed partial dentures were 98.11% and 100% after 5 years, respectively, and 97.43% and 98.96% after 10 years, with an overall survival rate of 91.69% after 12 years. At the patient level, the implant survival rates were 95.42%, 92.73%, and 85.31% at 5, 10, and 12 years, respectively. The cumulative rate of implants free from peri-implantitis was 87.46% at the implant level and 72.39% at the patient level. Implant and prosthesis characteristics did not affect the long-term occurrence of implant failure or peri-implantitis. The development of peri- implantitis was statistically correlated with patient smoking habits, but not with history of periodontitis or with diabetes mellitus. Conclusion: Implants supporting single crowns and fixed partial dentures showed relatively high medium- and long-term survival rates that were not influenced by the implant or prosthesis characteristics, including the retention method. As for patient characteristics, only smoking was correlated with the occurrence of peri-implantitis
Systematic review and meta-analysis on the adjunctive use of host immune modulators in non-surgical periodontal treatment in healthy and systemically compromised patients
No full textAbstract Considering the central role of inflammation in the pathogenesis of periodontitis, the combination of NSPT with different agents that can modulate the host immune-inflammatory response has been proposed to enhance the outcomes of NSPT. The aim of this paper is to systematically review the literature on the efficacy of systemic host modulators (HMs) as adjuncts to non-surgical periodontal therapy (NSPT) in improving pocket depth (PD) reduction and clinical attachment level (CAL) gain in healthy and systemically compromised patients. RCTs with ≥ 3 months follow-up were independently searched by two reviewers. Meta-analysis was performed when ≥ 3 studies on the same HM were identified. The quality of the evidence was rated according to the GRADE approach to rate the certainty of evidence. 38 articles were included in the qualitative assessment and 27 of them were included in the meta-analysis. There is low/very low evidence that the adjunctive use of sub-antimicrobial dose of doxycicline, melatonin and the combination of omega-3 and low dose aspirin (in type 2 diabetic patients) to NSPT would improve PD and/or CAL. Conflicting evidence is available on the efficacy of probiotics. Future studies controlling for confounding factors, using composite outcomes to define the endpoint of therapy and considering not only the patient- but also as the site-specific effect of systemic HMs are warranted. The dosage, posology and long-term effect of HMs still need to be clarified, also in association to the presence of systemic conditions potentially affecting the response to HMs administration
Periodontal Regenerative Treatment of Intrabony Defects Associated with Palatal Grooves: A Report of Two Cases
No full textA palatal radicular groove (PRG) is a morphological deformity, occurring during tooth development. It is usually located on the palatal aspect of maxillary incisors and frequently associated with periodontal or endodontic-periodontal lesions. Some treatment options were described for such lesions, including primary endodontic treatment and periodontal surgery and extraction with intentional replantation after removal of a PRG and endodontic treatment. The present paper reported two cases of PRG-associated deep intrabony defects, successfully treated with periodontal surgery with enamel matrix derivative (EMD) application and mechanical removal of PRGs, avoiding endodontic treatment or retreatment. The complexity of the diagnostic process was also discussed
Fifteen-Year Follow-Up of a Case of Surgical Retreatment of a Single Gingival Recession
No full textPurpose. The aim of the present case report was to describe the retreatment of the single gingival recession in aesthetic area, in the presence of scar formation and consequent impairment of aesthetic appearance. Methods. A young patient with one single recession of 4 mm of 2.1 was treated with coronally advanced flap and subepithelial connective tissue graft, through a microsurgical approach that aimed at the removal of the scarred fibrous tissue. The intervention was performed using a surgical microscope as a magnification device. Results. Fifteen years after the surgical treatment, a substantial stable resolution of the gingival recession could be observed. Moreover, a further improvement of the aesthetic appearance could be observed. Conclusions. This case report suggests that periodontal microsurgery could be an effective approach for the retreatment of gingival recessions and, in long-term evaluation, to reduce the aesthetic problem due to the presence of scar formation. Further studies with a larger sample size are needed to better evaluate its efficacy
Coronally advanced flap with or without subepithelial connective tissue graft for the treatment of single recession : 5-year outcomes from a comparative study
No full textGingival recession can cause an esthetic impairment or dentin hypersensitivity due to root surface exposure to the oral cavity. These conditions may require specific surgical interventions to achieve root coverage. This controlled clinical trial on 20 subjects compared coronally advanced flap (CAF) technique and CAF plus subepithelial connective tissue graft (CTG) for the treatment of single maxillary gingival recession. Recession height (REC) and complete root coverage (CRC) were considered as primary outcomes. The residual REC was 2.90 ± 0.99 mm at baseline, 1.10 ± 0.99 mm after 1 year, and 1.15 ± 1.06 mm after 5 years in the CAF group and 2.70 ± 0.48 mm at baseline, 0.55 ± 0.69 mm after 1 year, and 0.44 ± 0.62 mm after 5 years in the CAF + CTG group. The differences between groups at 5 years of follow-up was statistically significant. CRC was obtained in 60% of teeth in the CAF group and in 70% of teeth in the CAF + CTG group at the 5-year followup. The results showed a significant difference between CAF and CAF + CTG techniques for the treatment of single recession with regard to REC; no significant difference was found in the percentage of teeth presenting CRC after 5 years
Chairside Screening for Undiagnosed Diabetes and Prediabetes in Patients with Periodontitis
No full textINTRODUCTION: Globally, it is estimated that half of all people with diabetes are undiagnosed. Because of the well-documented bidirectional link between diabetes and periodontitis, dentists and dental hygienists may have the possibility to screen a targeted population for diabetes during routine dental visits. The aim of the present study is to investigate the effectiveness of one device for diagnosis of diabetes/prediabetes used in one private dental practice and investigate the correlation between the levels of HbA1c and periodontal parameters. METHODS: Periodontal patients that were never diagnosed with diabetes were asked to fill a risk assessment questionnaire for type 2 diabetes mellitus. PD, CAL, FMBS%, FMPS%, and HbA1c through a prick-finger test were measured before and after periodontal therapy or only once in patients following supportive periodontal therapy. RESULTS: A total of 98 subjects were screened, and among them, one had diabetes and 30 had prediabetes. The mean value of HbA1c was 5.62% for patients with untreated periodontitis and 5.42% for periodontally treated patients. The diagnosis of diabetes resulted to be correlated to FMBS% and FMPS%, while HbA1c levels were correlated to FMBS%, FMPS%, and periodontitis grade. CONCLUSION: The present chairside diabetes-screening protocol allowed a consistent proportion of patients to become aware of their pathological or prepathological condition and to seek proper and timely medical care. Thus, dentists and dental hygienists could provide health promotion services and preventive measures
Novel surfaces and osseointegration in implant dentistry
No full textSurvival, differentiation capability, and activity of cells are strictly related to structural features and the composition of the extracellular matrix, and its variation affects tissue homeostasis. Placement of a dental implant in bone tissue activates a sequence of molecular and cellular events that lead to the apposition of newly-formed bone directly onto the titanium surface. Due to implant's interaction with the mineralized tissue, osseointegration is affected by the surface structure of the implanted material. Surface nanotopography and microtopography can modify the shape and activity of mesenchymal stem cells leading to a higher differentiation rate of these cells into osteogenic lineage with the upregulation of osteoblastic genes. Several approaches for implant surface modification are currently under investigation or have been recently proposed to improve osseointegration. Most surface treatments are aimed at the formation of a thick layer of titanium oxide, at the alteration of surface chemical composition by incorporating bioactive molecules and drugs, and at the creation of a surface topography that is more attractive for osteoblast differentiation, adhesion, and osteogenic activity. Data on the cellular-substrate interaction, as well as in vivo studies assessing the response to these novel surfaces, are reviewed in the present study. The application of modern surfaces in dental clinical practice might increase and accelerate implant osseointegration, but could also reduce the occurrence of peri-implant bone loss and favor the re-osseointegration of an affected surface
The effect of the use of proton pump inhibitors, serotonin uptake inhibitors, antihypertensive, and anti‐inflammatory drugs on clinical outcomes of functional dental implants: A retrospective study
No full textOBJECTIVE: The present retrospective study investigated the effect of chronic intake of proton pump inhibitors, selective serotonin uptake inhibitors, anti‐inflammatory, and antihypertensive drugs on the survival of dental implants and on the occurrence of peri‐implantitis. MATERIALS AND METHODS: Survival analyses for implant failure and peri‐implantitis were performed patient level for each drug subcategory and for risk factors. The HR for each drug was calculated with adjusted models as compared with a control group made of subjects not assuming the specific drug. Multilevel logistic regression was used to explore the influence of implant‐level and patient‐level variables on the outcomes. RESULTS: A total of 270 subjects receiving 1118 dental implants were included, with a mean follow‐up time of 5.19 ± 4.22 years. After 10 years, the survival rate was 86.9% (patient level), and according to survival analysis, 61.3% of subjects were free from peri‐implantitis. The use of anti‐inflammatory medicines produced a significant effect (p = .04) on peri‐implantitis as compared to subjects not using the drug, with a 2.7‐year drop in the mean survival time. The HR was slightly above the level of significance in a semiadjusted model (p = .058). The multilevel analysis found a significant effect on the entire sample and not when considering only subjects with implants with more than 1‐year follow‐up. CONCLUSIONS: We found a possible relationship between anti‐inflammatory drug use and the occurrence of peri‐implantitis in the examined cohort of patients, and no correlation for the other drugs
Prevalence of Peri-Implant Mucositis and Peri-Implantitis in Patients Treated with a Combination of Axial and Tilted Implants Supporting a Complete Fixed Denture
No full textObjectives. The aim of this retrospective study was to assess the incidence and prevalence of peri-implant mucositis and peri-implantitis in patients with a fixed full-arch prosthesis supported by two axial and two tilted implants. Materials and Methods. Sixty-nine patients were included in the study. Each patient received a fixed full-arch prosthesis supported by two mesial axial and two distal tilted implants to rehabilitate the upper arch, the lower arch, or both. Three hundred thirty-six implants for 84 restorations were delivered. Patients were scheduled for follow-up visits every 6 months in the first 2 years and yearly after. At each follow-up visit peri-implant mucositis and peri-implantitis were diagnosed if present. Results. The overall follow-up range was from 12 to 130 months (mean 63,2 months). Three patients presented peri-implantitis. The prevalence of peri-implant mucositis ranged between 0 and 7,14% of patients (5,06% of implants) while the prevalence of peri-implantitis varied from 0 to 4,55% of patients (3,81% of implants). Conclusions. The prevalence and incidence of peri-implant mucositis and peri-implantitis are lower than most of the studies in literature. Therefore this kind of rehabilitation could be considered a feasible option, on the condition of adopting a systematic hygienic protocol
Differentiating Gender and Sex in Dental Research: A Narrative Review
No full textWhile in humans the term “sex” refers to the biological attributes that distinguish subjects as male, female, and intersex, the term “gender” refers to psychological, social, and cultural factors that strongly influence attitudes, behaviors, and relationships of individuals. Recently, it has been emphasized how the integration of these two terms in the design of the research can improve the methodology of the research itself. However, in dental research, the influence of gender has not gained enough consideration and it is often used indiscriminately as a synonym for sex. This narrative review discusses the usefulness of considering gender and sex in dental research, whose guidelines have been provided so far on this topic, and whether the top 20 dental scientific journals promote the analysis of sex and gender in their guidelines. Sex and gender analysis in dental research could be important both for analyzing biological differences such as those in the immune or neuro-immune system, cardiovascular physiology, developmental anomalies or deformities, and psychosocial differences such as lifestyle, pain experience and prevalence of chronic pain, eating behavior, and access to healthcare services. As for the specific policies for sex and gender analysis and reporting, only five out of 20 biomedical journals have included them in their editorial policy, which refers mainly to the correct use of the terms “sex” and “gender.” In conclusion, we found that no specific and differentiated sex and gender analysis and reporting are required in dental journals. Their integration, which is still not routinely applied, may be improved in the future by updating editorial guidelines and developing more specific methodological recommendations
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