A Novel Apparatus to Standardise the Polishing Protocol to Achieve Different Roughness of Titanium and Zirconia Disc Surfaces.

PURPOSE: This study aimed to propose and evaluate standardised polishing protocols for in vitro experiment using a custom-made apparatus under controlled force to create consistent surface roughness on titanium and zirconia disks. METHODS: A total of 160 discs were manufactured with a diameter of 10mm, 80 titanium (Ti), and 80 zirconium oxide (Zr). Specimens were categorised into 2 groups: controlled force (CF) and without controlled force (WCF). Specimens in the CF group were polished with a custom apparatus incorporating a tension gauge on the Ti and Zr disc surfaces to achieve consistent roughness. The WCF was polished without the use of a tension gauge. Each group had 4 subgroups (10 disks in each): control/machined (C) with no polishing, rough (R), smooth (S) and very smooth (VS). The subgroups were processed using a sequence of diamond-impregnated polishing burs and polishing paste. RESULTS: CF group showed consistent surface roughness and a gradual decrease in surface roughness. Control (Ra=6.5±0.03µm) in Ti and (Ra=5.4±0.04µm) in Zr; R (Ra=3.5± 0.06µm) in Ti and (Ra=3.2± 0.07 µm) in Zr; S (Ra=1.5±0.04µm) in Ti and (Ra=1.1±006µm) in Zr; VS (Ra=0.05± 0.002µm) in Ti and (Ra=0.02±0.005µm) in Zr. There were significant differences for R, S, and SV under CF and WCF in Ti and Zr surfaces. CONCLUSION: The specimens polished under control force produced significantly more uniform surface roughness than those polished without controlled force and were produced with a higher degree of consistency.

Longevity of Polymer-Infiltrated Ceramic Network and Zirconia-Reinforced Lithium Silicate Restorations: A Systematic Review and Meta-Analysis.

The purpose of this study was to systematically review the existing literature to assess the clinical survival and success of PICN and ZLS indirect restorations as the clinical evidence for them remains lacking. PubMed, SCOPUS, Embase, Cochrane Library, Web of Science, LILACs, and SciElo databases were searched from 1 January 2000 to 1 February 2021. Clinical trials and cohort studies published in English were included while case studies, case series, and in vitro studies were excluded. Results were analyzed qualitatively and a meta-analysis using a random effects model was performed. A strength of recommendation taxonomy (SORT) analysis was conducted and risk of bias (RoB) was assessed using the Newcastle-Ottawa scale and Cochrane RoB tools. An electronic search through the databases yielded 2454 articles, of which 825 remained after duplicate removal. Five studies investigating PICN and four investigating ZLS indirect restorations remained after assessing for eligibility. The overall survival rate of PICN over 1 year was 99.6% and 99.2% over 2 years. The overall survival rate of ZLS over 1 year was 99%. The main mode of failure for both materials was catastrophic fracture. One study had a high RoB, four had a moderate RoB, and four had a low RoB. Both materials demonstrated moderate strength of recommendation at a level 2 evidence for all studies based on SORT analysis. PICN and ZLS show promising short-term clinical performance as full and partial coverage indirect restorations, but longer follow-up studies are required to confirm their long-term performance.

Association between circulating exhausted CD4+ T cells with poor meningococcal C conjugate vaccine antibody response in HIV-infected children and adolescents.

OBJECTIVES: To investigate the expression levels of surface markers of activation (CD38 and HLA-DR), inhibition (PD-1, TIGIT and CD57) and co-stimulation (CD28 and CD127) on CD4+ T cells of children/adolescents with vertical HIV infection (HI patients) and HIV-uninfected (HU) controls vaccinated with the meningococcal C conjugate vaccine (MCC). METHODS: HI patients (n=12), aged 8-17 years, were immunized with two MCC injections, while HU controls (n=9), aged 5.3-10.7 years, received a single MCC dose (as per national recommendation at the time of this study, a single MCC vaccine dose should be given for healthy children and youth aged 1-18 years). The HI patients were categorized according to the combined antiretroviral therapy (cART) treatment. Blood samples were obtained before vaccination, after priming, and after the administration of a booster dose of vaccine to determine the serum bactericidal antibody (SBA) titers and the expression levels of surface markers on CD4+ T cells by flow cytometry. The levels of serum cytokines, IL-4 and CXCL-13 were also measured using Luminex kits. RESULTS: The co-expression of the TIGIT-HLA-DR-CD38 molecules increased in the CD4+ T cells of HI patients/no-cART who also showed a lower frequency of CD127+CD28+ CD4+ T cells than HI patients/cART and HU group subjects. There were significant negative correlations between the frequency of exhausted CD4+ T cells and the SBA response. IL-4 levels were higher in HI patients/cART and positively correlated with SBA titers but negatively associated with the expression of exhaustion markers. Moreover, the CXCL-13 levels were positively correlated with the exhausted CD4+ T cells. CONCLUSION: The results of our study suggest that the co-expression of exhaustion markers and/or loss of co-stimulatory molecules influence the SBA response in HI patients.

Effect of periodontal treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes.

OBJECTIVE: The aim of this study was to investigate the effect of periodontal therapy on the circulating concentration of high-sensitivity capsule-reactive protein (hs-CRP), fibrinogen (FIB), interleukin (IL)-4, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-alpha) and on the metabolic control in type 2 diabetes mellitus (T2DM) patients. MATERIAL AND METHODS: Twenty-three T2DM patients with chronic periodontitis were enrolled in this study. Periodontal clinical parameters, namely visible plaque index, gingival bleeding index, bleeding on probing, probing depth and clinical attachment levels, were evaluated. Blood samples for plasma were collected and assessed for the levels of hs-CRP, FIB, IL-4, IL-6, IL-8, IL-10 and TNF-alpha. The glycated haemoglobin (HbA(1c)) and fasting plasma glucose were also measured. All parameters were evaluated before and 3 months after non-surgical periodontal therapy. RESULTS: All clinical parameters were significantly improved 3 months after the periodontal therapy. A univariate comparison showed a tendency towards a decrease of the measured biomarkers, most pronounced for TNF-alpha and FIB, after therapy. Periodontal treatment also reduced HbA(1c) and hs-CRP levels, albeit not significantly. CONCLUSIONS: The clinically successful non-surgical periodontal therapy tended to reduce systemic inflammation and the concentration of some circulating cytokines.

The short-term effectiveness of non-surgical treatment in reducing levels of interleukin-1beta and proteases in gingival crevicular fluid from patients with type 2 diabetes mellitus and chronic periodontitis.

BACKGROUND: This study aimed to compare the effectiveness of non-surgical periodontal treatment in improving periodontal status and reducing gingival crevicular fluid (GCF) levels of interleukin (IL)-1beta and IL-18, elastase activity, and matrix metalloproteinase (MMP)--8 and --9 in periodontitis patients with and without type 2 diabetes mellitus (T2DM). METHODS: Twenty-three patients with T2DM (diabetes group) and 26 systemically healthy subjects (control group) with chronic periodontitis participated in this study. The clinical examination included visible plaque index, gingival bleeding index, probing depth, clinical attachment level, and bleeding on probing. GCF samples were collected from five or six deep sites to evaluate the levels of IL-1beta and -18, elastase, and MMP-8 and -9. Shallow sites were analyzed for IL-1beta and elastase. The glycemic control was analyzed by the concentration of glycated hemoglobin (HbA1c). The subjects received non-surgical periodontal treatment and were reexamined 90 days later. RESULTS: All clinical parameters showed a significant improvement after treatment, which was accompanied by a significant reduction in IL-1beta, elastase activity, and MMP-8 and -9 levels in deep sites. The shallow sites also showed significant reductions in IL-1beta and elastase activity levels. Treatment did not significantly reduce HbA1c concentrations in patients with T2DM. CONCLUSIONS: Non-surgical periodontal treatment was effective in reducing the levels of IL-1beta, elastase activity, and MMP-8 and -9 in GCF from diabetes and control groups. Patients with T2DM showed less reduction only in elastase activity in shallow sites compared to controls. This reduction was associated with improvement of the clinical periodontal status.

Decreased interleukin-1beta and elastase in the gingival crevicular fluid of individuals undergoing anti-inflammatory treatment for rheumatoid arthritis.

BACKGROUND: The primary aim of this study was to compare the inflammatory activity in the gingival crevicular fluid (GCF) in a group of patients with rheumatoid arthritis (RA) and a group of matched controls. Secondarily, we aimed to evaluate the effect of rheumatologic treatment on periodontal inflammation. METHODS: Seventeen individuals with RA with a mean duration of disease of 12.1 (+/- 9.9) years and the same number of systemically healthy individuals matched for age, gender, periodontal status, and tobacco use were selected. Medication data were registered, and GCF was collected by means of an intracrevicular washing method. Besides clinical registrations, periodontal inflammation was assessed by analysis of the cytokines interleukin (IL)-1beta and -18 and of elastase activity. RESULTS: Amounts of IL-1beta and total elastase were significantly lower in the patient group. IL-1beta and total elastase had a significant and strong correlation in the RA group (r(s) = 0.883). This correlation was not observed in the control group. CONCLUSION: The anti-inflammatory treatment taken by RA patients might influence the periodontal inflammation status represented by IL-1beta and elastase in the GCF.

Association between circulating exhausted CD4+ T cells with poor meningococcal C conjugate vaccine antibody response in HIV-infected children and adolescents

OBJECTIVES: To investigate the expression levels of surface markers of activation (CD38 and HLA-DR), inhibition (PD-1, TIGIT and CD57) and co-stimulation (CD28 and CD127) on CD4+ T cells of children/adolescents with vertical HIV infection (HI patients) and HIV-uninfected (HU) controls vaccinated with the meningococcal C conjugate vaccine (MCC). METHODS: HI patients (n=12), aged 8-17 years, were immunized with two MCC injections, while HU controls (n=9), aged 5.3-10.7 years, received a single MCC dose (as per national recommendation at the time of this study, a single MCC vaccine dose should be given for healthy children and youth aged 1-18 years). The HI patients were categorized according to the combined antiretroviral therapy (cART) treatment. Blood samples were obtained before vaccination, after priming, and after the administration of a booster dose of vaccine to determine the serum bactericidal antibody (SBA) titers and the expression levels of surface markers on CD4+ T cells by flow cytometry. The levels of serum cytokines, IL-4 and CXCL-13 were also measured using Luminex kits. RESULTS: The co-expression of the TIGIT-HLA-DR-CD38 molecules increased in the CD4+ T cells of HI patients/no-cART who also showed a lower frequency of CD127+CD28+ CD4+ T cells than HI patients/cART and HU group subjects. There were significant negative correlations between the frequency of exhausted CD4+ T cells and the SBA response. IL-4 levels were higher in HI patients/cART and positively correlated with SBA titers but negatively associated with the expression of exhaustion markers. Moreover, the CXCL-13 levels were positively correlated with the exhausted CD4+ T cells. CONCLUSION: The results of our study suggest that the co-expression of exhaustion markers and/or loss of co-stimulatory molecules influence the SBA response in HI patients.

Subgingival microflora in inflammatory bowel disease patients with untreated periodontitis.

OBJECTIVE: To analyze the subgingival microflora composition of inflammatory bowel disease (IBD) patients with untreated chronic periodontitis and compare them with systemically healthy controls also having untreated chronic periodontitis. METHOD: Thirty IBD patients [15 with Crohn's disease (CD) and 15 with ulcerative colitis (UC)] and 15 control individuals participated in the study. All patients had been diagnosed with untreated chronic periodontitis. From every patient, subgingival plaque was collected from four gingivitis and four periodontitis sites with paper points. Samples from the same category (gingivitis or periodontitis) in each patient were pooled together and stored at -70 °C until analysis using a checkerboard DNA-DNA hybridization technique for 74 bacterial species. RESULTS: Multiple-comparison analysis showed that the groups differed in bacterial counts for Bacteroides ureolyticus, Campylobacter gracilis, Parvimonas micra, Prevotella melaninogenica, Peptostreptococcus anaerobius, Staphylococcus aureus, Streptococcus anginosus, Streptococcus intermedius, Streptococcus mitis, Streptococcus mutans, and Treponema denticola (P<0.001). CD patients had significantly higher levels of these bacteria than UC patients either in gingivitis or in periodontitis sites (P<0.05). CD patients harbored higher levels of P. melaninogenica, S. aureus, S. anginosus, and S. mutans compared with controls both at gingivitis and at periodontitis sites (P<0.05). UC patients harbored higher levels of S. aureus (P=0.01) and P. anaerobius (P=0.05) than controls only in gingivitis sites. CONCLUSION: Our study showed that even with similar clinical periodontal parameters, IBD patients harbor higher levels of bacteria that are related to opportunistic infections in inflamed subgingival sites that might be harmful for the crucial microbe-host interaction.

The Short-Term Effectiveness of Non-Surgical Treatment in Reducing Levels of Interleukin-1ß and Proteases in Gingival Crevicular Fluid From Patients With Type 2 Diabetes Mellitus and Chronic Periodontitis.

BACKGROUND: This study aimed to compare the effectiveness of non-surgical periodontal treatment in improving periodontal status and reducing gingival crevicular fluid (GCF) levels of interleukin (IL)-1ß and IL-18, elastase activity, and matrix metalloproteinase (MMP)--8 and --9 in periodontitis patients with and without type 2 diabetes mellitus (T2DM). METHODS: Twenty-three patients with T2DM (diabetes group) and 26 systemically healthy subjects (control group) with chronic periodontitis participated in this study. The clinical examination included visible plaque index, gingival bleeding index, probing depth, clinical attachment level, and bleeding on probing. GCF samples were collected from five or six deep sites to evaluate the levels of IL-1ß and -18, elastase, and MMP-8 and -9. Shallow sites were analyzed for IL-1ß and elastase. The glycemic control was analyzed by the concentration of glycated hemoglobin (HbA1c). The subjects received non-surgical periodontal treatment and were reexamined 90 days later. RESULTS: All clinical parameters showed a significant improvement after treatment, which was accompanied by a significant reduction in IL-1ß, elastase activity, and MMP-8 and -9 levels in deep sites. The shallow sites also showed significant reductions in IL-1ß and elastase activity levels. Treatment did not significantly reduce HbA1c concentrations in patients with T2DM. CONCLUSIONS: Non-surgical periodontal treatment was effective in reducing the levels of IL-1ß, elastase activity, and MMP-8 and -9 in GCF from diabetes and control groups. Patients with T2DM showed less reduction only in elastase activity in shallow sites compared to controls. This reduction was associated with improvement of the clinical periodontal status.