Periodontal Pathogens and Adverse Pregnancy Outcomes: A Narrative Review.

Periodontal disease is a multi-microbial infection of the teeth-supporting apparatus that manifests as clinical attachment loss and alveolar bone loss. The association between periodontal disease and systemic diseases has been proposed in the literature owing to the former's chronic state of inflammation, and adverse pregnancy outcomes are no exception. As a result of periodontal pathogen invasion, a series of systemic inflammatory and immunologic events affecting the safety of the fetoplacental unit may unfold. This may be further exaggerated by physiologic hormonal and metabolic fluctuations during pregnancy. This can not only negatively affect the gestation period and consequently cause preterm low weight but also complicate the pregnancy via preeclampsia and gestational diabetes. This narrative review article aims to provide a summary of relevant available evidence pertinent to the relationship between periodontal diseases, associated periodontal pathogens and virulence mechanisms mediated by pro-inflammatory cytokines and prostaglandins, and adverse pregnancy outcomes. Furthermore, this article highlights some of the literature addressing the impact of periodontal therapy interventions and pregnancy outcomes.

Clinical outcomes of single full-coverage lithium disilicate restorations: A systematic review.

Introduction: Lithium disilicate glass-ceramic (LDC) restorations exhibit microorganism infiltration, recurrent caries, pulpal lesions, periodontal inflammation, and cement exposure to the oral environment over time. All these factors lead to restoration failure. This systematic review aimed to investigate the clinical outcomes of LDC full-coverage crowns (FCC) in permanent teeth compared with those of other full-coverage restoration materials. Materials & Methods: Search strategies were developed for four databases: Web of Science, OVID, PubMed, and Scopus. Data extraction and quality appraisals were performed by two independent reviewers. Data on the presence of caries, post-operative sensitivity, and periodontal changes were extracted from the included clinical studies. In addition to the outcome measures, data on the sample size, study groups, method of restoration fabrication, type of impression, and type of abutment were recorded. Results: We retrieved 3989 records for the title and abstract screening. Of these, 19 clinical studies met the inclusion criteria. The overall quality of the included studies indicates a low risk of bias. Most studies reported no pulpal involvement, recurrent caries, or post-operative sensitivity and presented a favorable periodontal response after the cementation of LDC-FCC during different follow-up periods. Conclusion: Based on the endodontic and periodontic clinical responses of natural tooth abutments and their supporting periodontium, LDC-FCC can be considered a clinically successful restorative option.

Impact of Metformin on Periodontal and Peri-Implant Soft and Hard Tissue.

Periodontal and peri-implant soft and hard tissue in diabetic patients have always been a topic of interest for researchers and clinicians alike. Among which, a subtopic that has attracted more attention is the beneficial effect of metformin (MF) on periodontal and peri-implant soft and hard tissue. This review aimed to assess the impact of MF on the periodontal and peri-implant soft- and hard-tissue healing among diabetic patients. Research was conducted using the keywords 'metformin', 'diabetes', 'periodontitis', 'implant', and 'peri-implantitis' via the Medline (PubMed) and Google Scholar databases. Selected articles were reviewed. A total of 21 articles, discussing the impact on periodontal health (six animal studies, seven clinical studies, and three systematic reviews) and five studies on peri-implant health (four animal studies and one clinical study) were included. All have reported a positive impact of MF on decreasing the inflammatory response, oxidative stress, and ultimate bone loss. Similarly, human studies reported a positive effect of MF on clinical and radiographic parameters compared with controls. Despite systematic reviews reporting heterogeneity among the included studies, MF has shown a positive impact on periodontal health. In animal, clinical studies, and systematic reviews, MF showed a protective impact on periodontal and peri-implant health.

Generalized Anxiety Disorder and Its Relationship with Dental Anxiety among Pregnant Women in Dammam, Saudi Arabia.

OBJECTIVE: To assess the relationship between generalized anxiety disorder (GAD), dental anxiety (DA), and other factors among pregnant women. METHODS: The Generalized Anxiety Disorder (GAD-7) scale and the Modified Dental Anxiety Scale (MDAS) were used to evaluate GAD and DA, respectively. Hard copies of self-administered questionnaires were distributed among 780 pregnant women attending hospitals/health centers in Dammam, Saudi Arabia. RESULTS: About 31.7% of the participants demonstrated minimal anxiety, 37.9% mild anxiety, 19.7% moderate anxiety, and 10.6% severe anxiety. The mean GAD score of the sample was 7.53 ± 5.16 which differed significantly among women in the first (7.74 ± 5.47), second (6.82 ± 4.64), and third trimesters (8.13 ± 5.37) (P=0.029). Pregnant women who performed routine dental visits demonstrated lower GAD (6.98 ± 5.23) than those who visited dentists for consultation, pain, or treatment (7.58 ± 5.07). The mean GAD score was significantly higher among participants with dental pain or discomfort during the last 12 months (8.12 ± 5.05) than among those without pain or discomfort (7.02 ± 5.2) (P 0.003). Similarly, the participants with DA showed a significantly higher mean GAD score (7.69 ± 5.17) than those without DA (5.93 ± 4.71) (P 0.006). Multivariate linear regression showed that GAD significantly correlated with DA (B = 0.225, P < 0.001). CONCLUSION: In the present study, GAD was common among pregnant women which significantly correlated with DA. Pregnant women with DA and dental pain demonstrated high GAD. Preventive and therapeutic measures should be taken to reduce GAD and DA during pregnancy.

Surgical guides for esthetic crown lengthening procedures: Periodontal and prosthetic aspects.

BACKGROUND: In patients with gingival exposure on smiling due to altered passive eruption, esthetic crown lengthening is often indicated. Meticulous planning and surgical precision are key for successful outcomes. Surgical guides are helpful tools that are seldomly reported on in the literature related to esthetic crown lengthening procedures. TYPES OF STUDIES REVIEWED: The authors searched the literature for articles that described the planning, tools, and execution related to esthetic crown lengthening procedures. RESULTS: Several techniques have been reported to guide the esthetic crown lengthening procedure, ranging from direct bone level measurement to 3-dimensional printed surgical guides. PRACTICAL IMPLICATIONS: This review serves the clinician as an aid in the decision-making process for esthetic crown lengthening procedures and available surgical guide options, including computer-based guides.

PATIENT PREFERENCE OF TOOTHBRUSH AND SKILL LEVEL MAY DETERMINE SUCCESS OF PLAQUE REMOVAL IN PERIODONTAL MAINTENANCE.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Slot DE, Valkenburg C, Van der Weijden GAF. Mechanical plaque removal of periodontal maintenance patients: A systematic review and network meta-analysis. J Clin Periodontol. 2020 Jul;47 Suppl 22:107-124. doi:10.1111/jcpe.13275. PMID: 32716118. SOURCE OF FUNDING: The authors declare that they have no conflicts of interest. However, Van der Weijden, Slot, and their research team at ACTA have previously received either external advisor fees, lecturer fees, or research grants from toothbrush, dentifrice, and interdental devices manufacturers. Those manufacturers included: Braun AG, Colgate, Dentaid, GABA, Lactona, Oral-B, Philips, Procter & Gamble, Sara Lee, TePe, Sunstar, Water Pik, and Unilever. TYPE OF STUDY/DESIGN: Systematic review with network meta-analysis.

Knowledge of dentists, dental auxiliaries, and students regarding the COVID-19 pandemic in Saudi Arabia: a cross-sectional survey.

BACKGROUND: This study aimed to assess the knowledge of dental professionals in Saudi Arabia regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19). METHODS: A questionnaire was developed to assess various dental professionals from both governmental and private sectors through online and social media outlets. RESULTS: A total of 1,033 questionnaires were collected (273 dental students, 193 dental auxiliary personnel, 544 dentists). In all, 63.4% of the respondents worked in hospitals. Of all the respondents, 44.9%, 33.4%, and 21.7% worked in governmental clinics, academia, and the private sector, respectively. Overall knowledge of the incubation period and route of transmission of SARS-CoV-2 was consistent across all dental professions. Knowledge of hand-soap cleaning time was significantly different among dental professionals (p < 0.001). Dental professionals displayed significant disagreement on the survival of SARS-CoV-2 outside the host (p < 0.001). Furthermore, 75.1% of the respondents were reluctant to treat a suspected COVID-19 patient, and 92% of the participants believed that the mode of transmission was droplet inhalation. Fever, coughing, and shortness of breath were identified as the most common symptoms of COVID-19. Most standard methods of prevention in the dental office were selected by at least 50% of the participants. CONCLUSIONS: Dental professionals seem to be consistent regarding their knowledge of the incubation period of SARS-CoV-2. However, knowledge of viral survivability and recommended hand-soap washing time was significantly variable among the professionals. A high degree of apprehension toward suspected COVID-19 patients existed among all dental professionals. Pandemic-awareness campaigns are essential among healthcare providers.

Obesity May Be a Risk Factor for Progression of Periodontal Attachment Loss in Women.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effect of obesity on periodontal attachment loss progression: a 5-year population-based prospective study. Gaio EJ, Haas AN, Rösing CK, Opermann RV, Albandar JM, Susin C. J Clin Periodontol 2016;43(7): 557-65. SOURCE OF FUNDING: Foundation for Post-Graduate Education (CAPES), Brasilia, Brazil (grant #1614/99-1) Foundation for Research of Rio Grande do Sul, Porto Alegre, Brazil (grant #PPSUS-0700481) TYPE OF STUDY/DESIGN: Cohort Study.

Alcohol Consumption May Increase the Risk for Periodontal Disease in Some Adult Populations.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Alcohol consumption and risk of periodontitis: a meta-analysis. Wang J, Lv J, Wang W, Jiang X. J Clin Periodontol 2016;43(7):572-83. SOURCE OF FUNDING: The authors reported that no external funding sources, apart from the support of the authors' institutions, were available for this study TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.