Pre-restorative crown lengthening surgery: influence of restorative treatment timing on clinical outcomes-a pilot study.

OBJECTIVES: Aim of this study was to assess the influence of restorative treatment timing on the periodontal, patient and operator-reported outcomes following crown lengthening surgery (CLS). MATERIALS AND METHODS: Eighteen study participants requiring CLS were divided into two groups based on prosthetic rehabilitation timing (6 or 14 weeks postoperatively). Clinical parameters were recorded around treated and neighboring teeth before and after surgery, 6 and 14 weeks postoperatively, at prosthesis delivery, and three and six months after. Soft tissue and radiographic bone changes were evaluated. Patients assessed their perception of the procedure by means of a questionnaire. The final treatment outcome was rated by both patients and prosthodontists. RESULTS: CLS resulted in statistically significant and stable apical displacement of the gingival margin, at both treated and adjacent sites. Plaque and bleeding scores remained low throughout. No statistically significant differences were observed between groups for any clinical or radiographic parameter examined. Healing was uneventful and treatment outcome was satisfying for both patients and prosthodontists, without statistically significant differences between groups. CONCLUSIONS: The present study has been characterized as pilot, because it was not possible to reach the sample size indicated by the a priori power analysis. CLS is an effective pre-prosthetic procedure as long as it is performed under a certain surgical protocol which predicts for at least a 3 mm distance between bone crest and the flap margin at suturing. Within the limitations of this study, six weeks after surgery may be an adequate healing time for the onset of prosthetic restoration. CLINICAL RELEVANCE: Crown lengthening surgery is commonly performed in daily clinical practice with the aim to restore teeth with short clinical crowns. Based on periodontal, patient and operator-reported criteria, 6 weeks after CLS may be adequate healing time before the onset of prosthetic restoration. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03947658, 13/05/2019, retrospectively registered.

Could energy equilibrium and greenhouse gas emissions in agroecosystems play a key role in crop replacement? A case study in orange and kiwi orchards.

The development of agriculture is linked to energy resources. Consequently, energy analysis in agroecosystems could be a useful tool for monitoring some measures in the agricultural sector to mitigate greenhouse gas emissions. The objectives of this study were to (a) evaluate differences of energy indices in orange and kiwi orchards, and (b) point out whether inputs, outputs, efficiency, productivity, and carbon footprint can play a key role in crop replacement. Proportional stratified random sampling was used to select 26 orchards (10 oranges, 16 kiwis) from the Prefecture of Arta, western Greece, during 2015 and 2016. Univariate statistical methods were combined with multivariate ones. Nitrogen, Mg, Zn, herbicides, insecticides, fungicides, renewable energy inputs, fruit production, total outputs, and energy efficiency and productivity were statistically significantly high in the orange orchards. Phosphorus, Ca, irrigation, machinery, total inputs, intensity, non-renewable energy consumption, and carbon footprint were statistically significantly high in the kiwi orchards. The most important energy inputs for both fruit crops were fertilizers, fuels, irrigation, machinery, and herbicides. The orange orchards seem to be more friendly to the environment than the kiwi orchards by having low total energy inputs 32,210.3 MJ ha-1, intensity 1.4, consumption of non-renewable energy 0.7 MJ kg-1 and CO2 equivalent/fruit production 0.08 kg kg-1, and high energy outputs 105,120.0 MJ ha-1 and fruit production 53,648.0 kg ha-1. The findings of the present study show a relation between climate change and the production of farming systems, which can be a tool for decision makers. The correlation of the abovementioned parameters ensure higher profits and could help in achieving the best possible sustainable management of the agricultural ecosystems.

Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population-A Prospective Cohort Study.

While periodontitis deteriorates patients' quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients' perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters.

Changing Trends in Nutritional Behavior among University Students in Greece, between 2006 and 2016.

The objective of the present survey was to study the dietary behavior of university students residing away from the family home. In this context, we (a) compared their dietary habits in two time periods, namely 2006 and 2016; and (b) explored the possible impact of gender on the behavioral changes in nutritional choices. A total of four hundred and five university students (2006, n = 242; 2016, n = 163) participated in the study. Dietary assessment was carried out using a qualitative Food Frequency Questionnaire, while data about demographic and lifestyle factors were also collected. Students' dietary habits have been modified in a generally desirable direction, as reflected, e.g., in the elevated consumption of several plant-based foods. Gender was also significantly associated with Body Mass Index (BMI) and changes in dietary attitudes. Possible reasons for the transition towards healthier and more balanced dietary habits could involve the budgetary constraints facing Greece in the last decade, as well as increasing nutritional awareness and other socio-cultural factors characterizing this target group. A deeper understanding of these relations would be crucial to foster nutritional education and further enhance the effectiveness of health promotion campaigns.

Comparison of enamel matrix derivative (Emdogain) and subepithelial connective tissue graft for root coverage in patients with multiple gingival recession defects: A randomized controlled clinical study.

OBJECTIVE: The purpose of the present study was to compare the clinical efficiency of enamel matrix derivative (EMD) placed under a coronally advanced flap (CAF; test group), to a connective tissue graft (CTG) placed under a CAF (control group), in patients with multiple recession defects. METHOD AND MATERIALS: Twelve patients with multiple Miller's Class I or II gingival recessions in contralateral quadrants of the maxilla were selected. The primary outcome variable was the change in depth of the buccal recession (REC), at 6 months (T6) after surgery. The secondary outcome parameters included the clinical attachment level (CAL), the probing pocket depth (PPD), and the width of keratinized gingiva (WKT) apical to the recession. Recession defects were randomly divided to the test or control group by using a computer-generated randomization list. Data were analyzed within the frame of Mixed Linear Models with the ANOVA method. RESULTS: There were no statistically significantly differences observed between test and control groups in regards with the depth of buccal recession with a mean REC of 1.82 mm (CTG) and 1.72 mm (EMD) respectively. Similarly the mean PPD value was 1.3 mm for both groups at T6, while the respective value for CAL was 1.7 mm (EMD) and 1.8 mm (CTG). Statistically significant differences were observed only for the WKT, which were 3.0 mm and 3.6 mm for the test and control groups respectively (P < .001) at T6. CONCLUSION: The use of EMD in conjunction with a CAF resulted in similar results as compared to the CTG plus CAF.

Influence of Body Mass Index and Other Periodontitis-associated Risk Factors and Risk Indicators on Periodontal Treatment Needs: A Cross-sectional Study.

PURPOSE: To record periodontal treatment needs in a randomised sample and evaluate the association between body mass index (BMI) and periodontal treatment needs, as well as the association between diabetes, smoking, BMI and periodontal treatment needs. MATERIALS AND METHODS: The study sample comprised 633 patients aged 18 to 85 years visiting an outpatient clinic. Body mass index (BMI) and periodontal status were recorded. Demographic data including gender, year of birth, smoking habits and medical history were collected from each patient. RESULTS: 216 subjects (36%) were overweight, while 188 subjects (31.3%) were obese. CPITN (Community Periodontal Index of Treatment Needs) scores of 2 and 3 (minimal to moderate periodontal treatment needs) were widespread among this population (68.2%). Using model-based clustering, the total sample of 600 subjects was divided into four clusters of 202, 241, 111 and 46 subjects. CONCLUSION: The periodontal treatment needs of the sample were generally minimal to moderate, with only a weak association between the BMI and treatment needs. However, diabetics, smokers and older subjects classified as overweight or obese needed moderate to complex periodontal treatments.

Second trimester amniotic fluid uric acid, potassium, and cysteine to methionine ratio levels as possible signs of early preeclampsia: A case report.

OBJECTIVE: The precise etiopathogenesis of preeclampsia (PE) still remains enigmatic. In recent published work, there is a scientific trend aiming to unveil early biomarkers of PE based on amniotic fluid compositional changes before the development of clinical symptoms. CASE REPORT: We describe a case of an apparently clinically healthy woman, whose amniotic fluid, retrieved after amniocentesis at 222/7 gestational week, had elevated uric acid and potassium concentration, as well as cysteine to methionine ratio. At the time of amniocentesis, conventional clinical signs of PE were absent. The woman developed severe PE and intrauterine growth restriction, at the 280/7 week of gestation. CONCLUSION: Although the limitation of such studies lies in the fact that amniocentesis is an invasive procedure, and thus employed only under specific indications, our scientific observations might be useful for future research towards unraveling the causes of PE.

The utilization of a diode laser in the surgical treatment of peri-implantitis. A randomized clinical trial.

OBJECTIVES: A comparison of different treatment modalities of peri-implantitis can lead to the development and application of more effective and efficient methods of therapy in clinical practice. This study compares the effectiveness of open flap debridement used alone, with an approach employing the additional use of a diode laser for the treatment of peri-implantitis. MATERIALS AND METHODS: Nineteen patients were divided into two groups and treated for peri-implantitis. In the control group (C group), the therapy utilized access flaps, plastic curettes, and sterilized gauzes soaked in saline. The test group (L group) was treated similarly but with additional irradiation using a diode laser. The parameters studied were pocket depth (PD) as the primary outcome variable, clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI) as secondary variables. Measurements were performed at three different time points, baseline (BSL), 3 months, and 6 months after treatment. Three months after treatment, a mean PD reduction of 1.19 mm for the control group and 1.38 mm for the laser group was recorded. The corresponding BOP changes were 72.9 and 66.7%, respectively. These changes were significant and remained at the same levels at the 6-month examination (p < 0.05). CAL was reduced significantly only in group L from 5.25 mm at baseline to 4.54 mm at 3 months, remaining at this level at 6 months (p < 0.05). PI was reduced significantly in group C at 3 months from 37.5 to 6.3%. The 6-month data showed no statistically significant difference (p < 0.05) from the 3-month measurements. RESULTS: The two methods of therapy for peri-implantitis examined seemed to be equally efficient in the reduction of the PD and BOP 3 months after surgery, with the results sustained at the same levels after 6 months. CAL significantly improved only in the test group after 3 months. PI was reduced and maintained at low levels in both groups. CONCLUSIONS: Surgical treatment of peri-implantitis by access flaps leads to improvement of all clinical parameters studied while the additional use of diode laser does not seem to have an extra beneficiary effect. CLINICAL RELEVANCE: The additional use of a diode laser in the surgical treatment of peri-implantitis offers a limited clinical benefit.

Second trimester amniotic fluid glucose, uric acid, phosphate, potassium, and sodium concentrations in relation to maternal pre-pregnancy BMI and birth weight centiles.

OBJECTIVE: To study the evolution profile of amniotic fluid (AF) glucose, uric acid, phosphate, potassium, and sodium, in the second trimester of pregnancy, and explore the possible relations between the concentration of these components and maternal, as well as neonatal characteristics. METHODS: AF of 52 pregnant women was analyzed using an automatic multichannel analyzer. Maternal age, pre-pregnancy Body Mass Index (BMI), inter-pregnancy intervals, and smoking status were derived from questionnaires. Information on pregnancy and delivery was collected from medical records. RESULTS: Uric acid increased (r = 0.423, p < 0.01), while phosphate and glucose concentrations decreased during the period of 16-26th week of pregnancy (r = -0.590, p < 0.001 and r = -0.314, p < 0.05, respectively). Maternal pre-pregnancy BMI was significantly correlated with AF uric acid concentration (r = 0.460, p < 0.01) and marginally with AF glucose (r = 0.274, p = 0.052) and sodium (r = 0.254, p = 0.070) levels. Multiple linear regression indicated that mid-trimester AF uric acid and phosphate levels were significantly related to birth weight centiles (R(2)( )= 0.345, p < 0.05). CONCLUSIONS: Our results suggest that: (a) AF phosphate levels reflect gestational age to a satisfactory extent, (b) maternal pre-pregnancy BMI is significantly correlated with AF uric acid concentration, and (c) in appropriate for gestational age infants, AF phosphate and uric acid levels may serve as potential biomarkers of birth weight centiles. Further studies on AF composition may help to unravel the biochemical pathways underlying fetal development and could offer insight on the potential impact of maternal nutritional management on fetal growth regulation.

A systematic review and meta-analysis of abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysms.

OBJECTIVE: Limited data exist regarding the development of abdominal compartment syndrome (ACS) after endovascular repair of ruptured abdominal aortic aneurysms (RAAAs). We aimed to record the incidence, management, and outcome of this complication. METHODS: A systematic review and meta-analysis of the English language literature was undertaken through June 2012. Articles reporting data on outcome after endovascular repair of RAAAs were identified, and information regarding ACS was sought. RESULTS: Included were 39 eligible studies reporting 1134 patients. The pooled perioperative mortality was 21% (95% confidence interval [CI], 18%-24%). A total of 109 cases of ACS were recorded. There was significant within-study heterogeneity (Cochran Q = 94.1; P < .0001), and the pooled ACS rate was 8% (95% CI, 5.6%-10.8%). Only six studies accurately defined ACS, and four focused specifically on ACS. When the meta-analysis was repeated after including only studies with a definition and those focusing on ACS, the pooled rate increased to 17% (95% CI, 10%-26%) and 21% (95% CI, 13%-30%), respectively. A random-effects meta-regression analysis investigating the effect of ACS and other risk factors on mortality revealed a significant linear correlation between hemodynamic instability and death (r = 0.303) and a nonlinear (second degree polynomial) association between bifurcated endograft approach and death (R(2) = 0.348; P = .0027). However, no statistically significant association could be found between ACS and death. A further meta-regression analysis failed to identify any statistically significant predictors of ACS. Treatment included open decompression in 86 patients, percutaneous drainage in 18 (catheter only in five, combined with tissue plasminogen activator infusion in 13), and conservative measures in five. Data on outcome of ACS were only available for 76 patients; 35 of these died, for a mortality rate of 47%. CONCLUSIONS: The pooled ACS rate was calculated at 8%, but this figure may be >20% with improved awareness and vigilant monitoring. Although no statistically significant association could be found between ACS and death, almost half the patients who developed ACS after endovascular repair of RAAAs were likely to die.