Association of specific nutritional intake with periodontitis.

BACKGROUND: The present study aimed to evaluate nutritional intake among a group of male patients in the dental clinic with and without periodontal disease to search for associations between nutritional profile and periodontal health. METHODS: To this purpose, nutritional intake of macronutrients, fiber, vitamins, and minerals were compared evaluating both clinical parameters and periodontal status. Non periodontitis patients were compared with stage III and IV periodontitis and its extension according to the 2017 classification. RESULTS: After multivariate analysis, statistically significant associations were found between the dietary intake of energy, total fat, cholesterol, calcium, saturated fat, monounsaturated fat and folic acid and iodine and periodontitis status. This study reports an inverse association between cholesterol and iodine and periodontitis and a direct association with saturated fat, monounsaturated fat, and folic acid. CONCLUSIONS: Maintaining an adequate intake of fat, iodine, calcium, and cholesterol and avoiding an excessive intake of energy, saturated fat, monounsaturated fat, and folic acid could be important to controlling periodontitis.

Molecular inflammation and oxidative stress are shared mechanisms involved in both myocardial infarction and periodontitis.

BACKGROUND AND OBJECTIVE: Our aims were to improve the understanding of the pathogenic relationship between cardiovascular diseases and periodontitis and to generate new perspectives in the prevention and treatment of acute myocardial infarction (AMI) and periodontitis. The present study evaluates possible differences in inflammation, oxidative stress, and autophagy markers among subject suffering AMI, periodontitis, or both, to explore possible common pathogenic mechanisms. MATERIAL AND METHODS: A total of 260 subjects were enrolled in the study: 106 subjects that survived to a first AMI (AMI group) and 154 subjects had no cardiac events in their clinical record (control group). A questionnaire was used to assess age, height, weight, blood pressure, and heart rate. The clinical probing depth, clinical attachment loss, number of remaining teeth, and average number of sites with bleeding on probing were assessed. Lipid peroxidation and protein levels of phosphorylated AMP-activated protein kinase (p-AMPK) and microtubule-associated proteins 1A/1B-light chain 3-II (LC3-II) were determined in isolated peripheral blood mononuclear cells by thiobarbituric acid reactive substances (TBARS) assay and Western blot, respectively. Plasma levels of interleukin-1ß were determined using a commercial ELISA kit. All the obtained variables were compared between subjects suffering an AMI with or without periodontitis and control subject periodontal healthy or with periodontitis. RESULTS: A higher proportion of subjects suffering AMI + periodontitis than only AMI (without periodontitis) was found. Higher levels of TBARS were found in subjects with periodontitis than in subjects without periodontitis in both AMI and control subjects. Positive correlations between IL-1ß levels and TBARS and between IL-1ß levels and LC3-II were found only in control subjects. CONCLUSION: Results from the present study are consistent with the suggestion of periodontitis as a potential risk factor for AMI. Periodontitis association with circulating lipid peroxides in both AMI and control subjects were found. The absence of differences in IL-1ß levels between AMI subjects (only AMI vs AMI + periodontitis) suggests that oxidative stress could be the main pathogenic link between AMI and periodontitis.

A review of the influence of periodontal treatment in systemic diseases.

The effects and consequences of periodontal diseases might not be confined to the oral cavity. A great body of evidence has arisen supporting the claim demonstrating an association with several systemic conditions and diseases. With different levels of evidence, an association between periodontal disease and cardiovascular disease, diabetes, psoriasis, rheumatoid arthritis, pregnancy outcomes and respiratory diseases has been established. However, the true nature of this association, if it is causal, still remains elusive. For a better understanding of the complex relationships linking different conditions, interventional studies now begin to focus on the possible outcomes of periodontal treatment in relation to the events, symptoms and biomarkers of several systemic disorders, assessing if periodontal treatment has any impact on them, hopefully reducing their severity or prevalence. Therefore, we proceeded to review the recent literature on the subject, attempting to present a brief explanation of the systemic condition or disease, what proposed mechanisms might give biological plausibility to its association with periodontal disease, and finally and more importantly, what data are currently available pertaining to the effects periodontal treatment may have. Raising awareness and discussing the possible benefits of periodontal treatment on overall systemic health is important, in order to change the perception that periodontal diseases are only limited to the oral cavity, and ultimately providing better and comprehensive care to patients.

Nutraceuticals in Periodontal Health: A Systematic Review on the Role of Vitamins in Periodontal Health Maintenance.

Periodontal disease, a relevant public health problem worldwide, is generally considered a common pathology of elderly people. In this respect, there is agreement about that nutritional status may be a modifying factor in the progression and healing of the periodontal tissues. Vitamins have been recommended as nutraceuticals for prevention and treatment of some pathological conditions, such as cardiovascular diseases, obesity or cancer. Thus, a systematic approach to determining how the different vitamin type could ameliorate periodontal risks or improve periodontal health is necessary to further the understanding of the potential benefits and risks of vitamins supplementation use. For this, a systematic review of English-written literature in PubMed until February 2018, which included both human and animal research on the relationship of each vitamin with periodontal disease, was conducted. Among all the analyzed vitamins those with antioxidant capacity and effects on immune system seem to be useful for prevention or improvement of periodontal disease, as well as those implicated in bone metabolism. In the first case, there are quite information in favor of various vitamins, mainly vitamin C, that is the most studied. In the second case, vitamin D seems to have the most relevant role.

Influence of the Periodontal Disease, the Most Prevalent Inflammatory Event, in Peroxisome Proliferator-Activated Receptors Linking Nutrition and Energy Metabolism.

Periodontal disease is considered one of the main pathologic diseases occurring in humans. Its pathologic process involves inflammatory reactions producing periodontal bone resorption and the tooth loss. But some patients do not present an evident clinical inflammation with bone resorption, and in others, the inflammation is prominent without bone resorption. A key question could be to investigate a different way of responding to aggression. Inflammation requires a complex intracellular metabolic process, starting with the harmful recognition and activation of the inflammasome, continues the energy supply with the alteration of oxidative stress conditions, and finishes with the elimination of the aggression with autophagy/apoptosis mechanisms, then concludes with recovery. Peroxisome proliferator-activated receptors (PPARs) are essential molecules produced in inflammation, and its genes and its activation have been related to periodontal disease. Also, an important aspect is the influence of PPARs in bone metabolism; the main periodontitis symptom is bone loss and PPARγ activation that can downregulate the bone resorption in experimental periodontitis, PPARγ-coated titanium dental implant surfaces could carry the antiinflammatory gene and restrain inflammation. PPARs could be one of the meeting background points with atherosclerosis/cardiovascular disease, diabetes and metabolic syndrome showing a modified proinflammatory statement such as it is described in periodontitis.

Role of Lipids in the Onset, Progression and Treatment of Periodontal Disease. A Systematic Review of Studies in Humans.

The risk of different oral problems (root caries, tooth mobility, and tooth loss) can be increased by the presence of periodontal disease, which has also been associated with a growing list of systemic diseases. The presence of some bacteria is the primary etiology of this disease; a susceptible host is also necessary for disease initiation. In this respect, the progression of periodontal disease and healing of the periodontal tissues can be modulated by nutritional status. To clarify the role of lipids in the establishment, progression, and/or treatment of this pathology, a systematic review was conducted of English-written literature in PubMed until May 2016, which included research on the relationship of these dietary components with the onset and progression of periodontal disease. According to publication type, randomized-controlled trials, cohort, case-control and cross-sectional studies were included. Among all the analyzed components, those that have any effect on oxidative stress and/or inflammation seem to be the most interesting according to current evidence. On one hand, there is quite a lot of information in favor of a positive role of n-3 fatty acids, due to their antioxidant and immunomodulatory effects. On the other hand, saturated fat-rich diets increase oxidative stress as well the as intensity and duration of inflammatory processes, so they must be avoided.

A Systematic Review on the Implication of Minerals in the Onset, Severity and Treatment of Periodontal Disease.

Periodontal disease is an inflammatory disease with high prevalence in adults that leads to destruction of the teeth-supporting tissues. Periodontal therapy has been traditionally directed at reduction of the bacterial load to a level that encourages health-promoting bacteria and maintenance of oral-hygiene. The role of nutrition in different chronic inflammatory diseases has been the subject of an increasing body of research in the last decades. In this sense, there has been an important increase in the volume of research on role of nutrition in periodontitis since the diet has known effects on the immune system and inflammatory cascades. Minerals play a key role in all these processes due to the multiple pathways where they participate. To clarify the role of the different minerals in the establishment, progression and/or treatment of this pathology, a systemically review of published literature cited in PubMed until May 2016 was conducted, which included research on the relationship of these elements with the onset and progression of periodontal disease. Among all the minerals, calcium dietary intake seems important to maintain alveolar bone. Likewise, dietary proportions of minerals that may influence its metabolism also can be relevant. Lastly, some observations suggest that all those minerals with roles in immune and/or antioxidant systems should be considered in future research.

Assessment of periodontal and opportunistic flora in patients with peri-implantitis.

AIM: To assess the presence of periodontal and opportunistic organisms in patients with peri-implantitis. MATERIAL AND METHODS: Thirty-three partially edentulous subjects (22 women, 11 men), aged 32-90 years, who had one or more implants with peri-implantitis were included. Peri-implantitis was defined as: (i) the presence of bleeding on probing and/or suppuration and (ii) radiographic images showed marginal bone loss >1.8 mm after 1 year in function. Criteria for inclusion were: (i) partially edentulous patients having at least one implant diagnosed with peri-implantitis; (ii) no antibiotic therapy for 6 months prior to clinical examination. Following this definition, a total of 48 implants were diagnosed with peri-implantitis. Subgingival bacterial samples were obtained with sterile paper points from infected implants and selected teeth of each individual. Periodontopathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola) were detected by multiplex PCR targeting 16S rDNA. Samples were placed in reduced transport medium and cultured for opportunistic pathogens (Staphylococcus aureus, enteric bacteria, Pseudomonas and yeasts). RESULTS: Twenty-two patients yielded positive results for P. gingivalis, 25 for T. forsythia, eight for P. intermedia and 13 for T. denticola. None of the patients yielded a positive result for A. actinomycetemcomitans. Non-periodontal species were found in five patients (15% of total). P. aeruginosa was found in four (12%) patients, and C. albicans (3%) and S. aureus in one patient (3%) each. In two cases of peri-implantitis, none of the periodontal or opportunistic microorganisms studied were detected in either implant or tooth samples. When results of the periodontopathic bacteria from the implant and tooth samples of the same patient were compared, 18 patients (54%) showed the same results for both samples and 15 (45%) patients different results. CONCLUSIONS: The implant surface may be colonized with pathogens different from periodontal bacteria. Opportunistic pathogens such as P. aeruginosa, S. aureus and C. albicans may be associated with implant failure.

Advances in surfaces and osseointegration in implantology. Biomimetic surfaces.

The present work is a revision of the processes occurring in osseointegration of titanium dental implants according to different types of surfaces -namely, polished surfaces, rough surfaces obtained from subtraction methods, as well as the new hydroxyapatite biomimetic surfaces obtained from thermochemical processes. Hydroxyapatite's high plasma-projection temperatures have proven to prevent the formation of crystalline apatite on the titanium dental implant, but lead to the formation of amorphous calcium phosphate (i.e., with no crystal structure) instead. This layer produce some osseointegration yet the calcium phosphate layer will eventually dissolve and leave a gap between the bone and the dental implant, thus leading to osseointegration failure due to bacterial colonization. A new surface -recently obtained by thermochemical processes- produces, by crystallization, a layer of apatite with the same mineral content as human bone that is chemically bonded to the titanium surface. Osseointegration speed was tested by means of minipigs, showing bone formation after 3 to 4 weeks, with the security that a dental implant can be loaded. This surface can be an excellent candidate for immediate or early loading procedures.

Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction?

As many diseases have been shown to have several or indirect causes (i.e. are multifactorial) the question is what is the relative importance of each factor in a given disease? Also, what happens when some diseases, although apparently disparate, share causative factors and/or tissue pathologies? Host inflammation response mechanisms are largely shared by the body's different tissues and systems and only recently has special attention been paid to the possible linkages among chronic periodontitis and other chronic systemic diseases. The aim of this review was to consider and discuss the mounting evidence that the basis for the inter-relationships between chronic periodontitis and atheromatous disease and diabetes lie at a fundamental intracellular level, namely oxidative stress and mitochondrial dysfunction, as a meeting background among such chronic diseases and periodontitis.

Burnout, depression and suicidal ideation in dental students.

OBJECTIVES: To investigate the prevalence, gender influence, and relationships between burnout, depression and suicidal ideation within the last year among second, fourth and fifth-year dental students. STUDY DESIGN: A cross-sectional study was carried out in 212 dental students enrolled in the second, fourth and fifth years at the School of Dentistry of Seville using the Maslach Burnout Inventory-Student Survey and the MBI-Human Services Survey, the "Patient Health Questionnaire-2", and the "Questions about Suicidal Ideation and Attempted Suicide". RESULTS: The response rate among dental students was 80%. Burnout prevalence in dental students was higher in second and fourth years than in fifth year (p = 0.059 and p = 0.003, respectively). Depression prevalence in the fourth year approached significance (p = 0.051). Prevalence of suicidal ideation within the past year was higher, yet not reaching significance, in fourth year. No gender-related differences were found. A significant association was observed between burnout and depression, and between depression and suicidal ideation (p < 0.001), but no association was found between burnout and suicidal ideation. CONCLUSIONS: This study has brought our attention to the high prevalence of burnout and depression, and reported for the first time the prevalence of suicidal ideation among dental students in preclinical and clinical years.

Assessment of Osstell ISQ's reliability for implant stability measurement: a cross-sectional clinical study.

UNLABELLED: Resonance frequency analysis (RFA) allows assess implant stability by measuring implant oscillation frequency on the bone. RFA is an objective and non-invasive method for implant stability measurement, although scarce evidence has been provided so far on its reliability. OBJECTIVE: Assess the Osstell ISQ system's reliability (i.e., its measurement reproducibility and repeatability) by means of the intraclass correlation coefficient (ICC) as statistical method. DESIGN OF THE STUDY: Two implant stability registers were completed by means of Osstell ISQ on 85 implants on 23 patients. Six measurements were completed on each implant by means of two different SmartPegs (types I and II); that is, three consecutive measurements with each transducer. RESULTS: Average ISQ was 72.40, 72.22 and 72.79, and 72.06, 72.59 and 72.82 in the first, second, and third measurements with SmartPegs I and II, respectively. Equal values or differences below three ISQ points were observed in 52.9% and 62.4% of the cases with SmartPegs I and II, respectively. The intraclass correlation coefficient was 0.97 for both SmartPegs, and repeatability and reproducibility also reached 0.97 for both SmartPegs. CONCLUSIONS: The RFA system Osstell ISQ presents almost perfect repeatability and reproducibility after intraclass correlation coefficient analysis. Osstell ISQ measurements are highly reliable regarding reproducibility. Therefore, one measurement proves enough.

Prevalence of undiagnosed diabetes and prediabetes related to periodontitis and its risk factors in elderly individuals.

OBJECTIVE: The prevalence of undiagnosed diabetes was estimated to increase with age and can reach 3.5%. The purpose of the study was to evaluate the prevalence of undiagnosed diabetes and prediabetes in the elderly patients who attended a dental clinic and to find common risk factors. METHODS: Male patients, older than 50 years, attended their first dental visit to the School of Dentistry for a period of two years, and it was proposed to evaluate undiagnosed type 2 diabetes mellitus. Periodontal, biochemical, microbiological examinations, nutritional profile, and physical activity were performed. RESULTS: A total of 106 patients were examined, 6 (5.6%) had diabetes, and 37 (34.9%) had prediabetes without prior diagnosis. The severity of periodontitis was greater in patients with diabetes. Most of the patients were overweight and had increased systolic blood pressure. Patients with prediabetes and periodontitis had a low adherence to the Mediterranean diet. Tannerella forsythia was present in more patients with periodontitis, and the prevalence of Aggregatibacter actinomycetemcomitans is practically absent in groups with periodontitis, except for the group with diabetes. CONCLUSIONS: In the population studied, the prevalence of patients without a diagnosis of diabetes and prediabetes was very high and underestimated. The increased severity of periodontitis in patients with diabetes and in conjunction with the high level of cortisol seen in patients with periodontitis, especially those with diabetes, emphasize the dysregulation of the immunoinflammatory system. CLINICAL SIGNIFICANCE: It is essential to add all this data to our dental practice to cover patient health with a broader landscape.

Autophagy in periodontitis patients and gingival fibroblasts: unraveling the link between chronic diseases and inflammation.

BACKGROUND: Periodontitis, the most prevalent chronic inflammatory disease, has been related to cardiovascular diseases. Autophagy provides a mechanism for the turnover of cellular organelles and proteins through a lysosome-dependent degradation pathway. The aim of this research was to study the role of autophagy in peripheral blood mononuclear cells from patients with periodontitis and gingival fibroblasts treated with a lipopolysaccharide of Porphyromonas gingivalis. Autophagy-dependent mechanisms have been proposed in the pathogenesis of inflammatory disorders and in other diseases related to periodontitis, such as cardiovascular disease and diabetes. Thus it is important to study the role of autophagy in the pathophysiology of periodontitis. METHODS: Peripheral blood mononuclear cells from patients with periodontitis (n = 38) and without periodontitis (n = 20) were used to study autophagy. To investigate the mechanism of autophagy, we evaluated the influence of a lipopolysaccharide from P. gingivalis in human gingival fibroblasts, and autophagy was monitored morphologically and biochemically. Autophagosomes were observed by immunofluorescence and electron microscopy. RESULTS: We found increased levels of autophagy gene expression and high levels of mitochondrial reactive oxygen species production in peripheral blood mononuclear cells from patients with periodontitis compared with controls. A significantly positive correlation between both was observed. In human gingival fibroblasts treated with lipopolysaccharide from P. gingivalis, there was an increase of protein and transcript of autophagy-related protein 12 (ATG12) and microtubule-associated protein 1 light chain 3 alpha LC3. A reduction of mitochondrial reactive oxygen species induced a decrease in autophagy whereas inhibition of autophagy in infected cells increased apoptosis, showing the protective role of autophagy. CONCLUSION: Results from the present study suggest that autophagy is an important and shared mechanism in other conditions related to inflammation or alterations of the immune system, such as periodontitis.

Clinical indicators of periodontal disease in patients with coronary heart disease: a 10 years longitudinal study.

OBJECTIVES: There is evidence about a possible relationship existing between periodontal diseases and coronary heart disease. The aim of the present longitudinal study was to investigate the changes in periodontal evolution after etiological periodontal treatment, comparing a healthy control group with another having coronary heart disease. STUDY DESIGN: The study included initially 55 patients of which 44 finished it. They were placed into two groups: Healthy Control Group (HCG) n =9, and Coronary Heart Disease Group (CHDG) n=35. The gingival level (GL), probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP) were measured to compare the periodontal status in both groups. The patients were examined and etiological periodontal treatment was performed and they were then examined at the end of 1 and 10 years. STATISTICAL METHOD: A one way-ANOVA and a MR-ANOVA were established; significance p<0.05. RESULTS: No significant differences between both groups were detected on the first visit (p>0.5). However, at the second visit the CHDG presented a significantly higher PD (p<0.05) and PI (p<0.01). CHDG patients gradually increase PD through time and in comparison to the control group (p<0.041). CHDG patients present a significantly higher CAL loss (p<0.0385) and a significant increase in PI (p<0.0041) at the end of one year, while on the third visit no significant differences were detected in any of these indices. Likewise, a similar fact can be observed on evaluating BOP at the end of ten years causal treatment, a smaller decrease in the cardiac group was observed in regards to the initial values (p<0.001). CONCLUSION: Patients with coronary heart disease showed a worse evolution of periodontal indices than healthy ones, when referring to probing depth, plaque index and bleeding on probing index.

Job satisfaction and depression in the Spanish Society of Periodontology and Research (SEPA) members, and their relation to the burnout syndrome. Creation of a structural model.

OBJECTIVE: This study is aimed at getting to know the existing relationship between the dimensions of the burnout syndrome and job satisfaction, on one hand, and depressive feelings on the other through the creation of a structural model aimed at relating all these concepts on a sample of Spanish periodontists. STUDY DESIGN: The initial sample comprised 284 individuals, who represented 20% of the members of the Spanish Society of Periodontology and Research (www.SEPA.es). These individuals were chosen randomly by means of stratified sampling with proportional affixation by their autonomous community of residence. All participants were sent by post the MBI, CET and job-satisfaction questionnaires. The software package used for data analysis was LISREL v. 8.7 by checking models of structural equations so as to prove the proposed model's adjustment. RESULTS: The total number of answered questionnaires was 170 (59.85%). A positive relation was observed between emotional tiredness and depersonalization and depression. However, this dimension correlated negatively with job satisfaction and self-realization. CONCLUSIONS: The obtained results show that, in this sample of periodontists, job satisfaction acts as a modulator in the transition from emotional tiredness to depression.

Accidental displacement and migration of endosseous implants into adjacent craniofacial structures: a review and update.

OBJECTIVES: Accidental displacement of endosseous implants into the maxillary sinus is an unusual but potential complication in implantology procedures due to the special features of the posterior aspect of the maxillary bone; there is also a possibility of migration throughout the upper paranasal sinuses and adjacent structures. The aim of this paper is to review the published literature about accidental displacement and migration of dental implants into the maxillary sinus and other adjacent structures. STUDY DESIGN: A review has been done based on a search in the main on-line medical databases looking for papers about migration of dental implants published in major oral surgery, periodontal, dental implant and ear-nose-throat journals, using the keywords "implant," "migration," "complication," "foreign body" and "sinus." RESULTS: 24 articles showing displacement or migration to maxillary, ethmoid and sphenoid sinuses, orbit and cranial fossae, with different degrees of associated symptoms, were identified. Techniques found to solve these clinical issues include Cadwell-Luc approach, transoral endoscopy approach via canine fossae and transnasal functional endoscopy surgery. CONCLUSION: Before removing the foreign body, a correct diagnosis should be done in order to evaluate the functional status of the ostiomeatal complex and the degree of affectation of paranasal sinuses and other involved structures, determining the size and the exact location of the foreign body. After a complete diagnosis, an indicated procedure for every case would be decided.

Resonance frequency analysis-reliability in third generation instruments: Osstell mentor®.

UNLABELLED: Few studies assess repeatability and reproducibility in registers of resonance frequency analysis (a value of dental implant stability). OBJECTIVE: Few studies assess repeatability and reproducibility in resonance frequency analyses (implant stability evaluation). This study is aimed at assessing reliability (repeatabilty and reproducibility) in the Osstell Mentor® system using the intraclass correlation coefficient (ICC) as the statistical method. STUDY DESIGN: ISQ measurements of RFA were carried out by means of the Osstell Mentor® instrument in 58 implants in 19 patients. Six measurements were performed on each implant by means of two different Smart-Pegs (I and II). Three consecutive measurements were registered with each transducer. RESULTS: Average ISQ varied from 72.43 to 72.60 and 73.26 in the first, second and third measurements, respectively with the SamrtPeg I and from 72.98 to 73.26 and 73.74 in the first, second and third measurements, respectively with the SamrtPeg II . Exactly equal values were observed in 10.43 and 12.1% of the cases with Smart-Pegs I and II, respectively. The intraclass correlation coefficient was 0.96 and 0.96 for Smart Pegs I and II, respectively. Repeatability and reproducibility was 0.97 for both Smart-Pegs I and II. CONCLUSIONS: The RFA system contributed by Osstell Mentor® renders almost perfect reproducibility and repeatability, as proven by statistical analysis carried out by means of ICC with 95% confidence level. This instrument contributes highly reliable RFA measurements in dental implants.

Incidence of Peri-Implantitis and Relationship with Different Conditions: A Retrospective Study.

Articles on the prevalence of peri-implant diseases showed that 90% of peri-implant tissues had some form of inflammatory response and a prevalence of peri-implantitis from 28% to 51% according to various publications. Objective: To provide an overview of how risk factors can be related with peri-implantitis. Methods: A retrospective longitudinal study including 555 implants placed in 132 patients was evaluated based on the presence of peri-implantitis following the criteria of Renvert et al. 2018. Results: In total, 21 patients (15.9%) suffered peri-implantitis (PPG) and 111 patients (84.1%) did not suffer peri-implantitis (NPG). The results reveal that smokers have a high incidence of peri-implantitis (72.7%) compared to non-smokers (27.3%) (p < 0.0005). Another variable with significant results (p < 0.01) was periodontitis: 50% PPG and 23.9% NPG suffered advanced periodontitis. Systemic diseases such as arterial hypertension, diabetes mellitus, osteoporosis, and cardiovascular diseases do not show a statistically significant influence on the incidence of peri-implantitis. Patients who did not attend their maintenance therapy appointment had an incidence of peri-implantitis of 61.4%, compared to 27.3% in those who attend (p < 0.0001). From the results obtained, we can conclude that relevant factors affect peri-implantitis, such as tobacco habits, moderate and severe periodontitis, and attendance in maintenance therapy.

Periodontitis and Other Risk Factors Related to Myocardial Infarction and Its Follow-Up.

The main issue in the prevention of myocardial infarction (MI) is to reduce risk factors. Periodontal disease is related to cardiovascular disease and both share risk factors. The purpose of this study is to investigate whether periodontitis can be considered a risk factor for MI and common risk factors in a case-control study and in a prospective follow-up study in patients with MI. The test group (MIG) was made up of 144 males who had MI in the previous 48 h. The control group (CG) was composed of 138 males without MI. Both groups were subdivided according to the presence or absence of stage III and IV of periodontitis. General data; Mediterranean diet and physical activity screening; periodontal data; and biochemical, microbiological and cardiological parameters were recorded. ANOVA, Mann-Whitney U and Kruskal-Wallis statistical tests and binary logistic regression analysis were applied. No differences in anthropometric variables were observed between the four groups. The average weekly exercise hours have a higher value in CG without periodontitis. The number of leukocytes was higher in MIG, the number of monocytes was higher in CG and the number of teeth was lower in MIG with periodontitis. Adherence to the Mediterranean diet was higher in CG. Porphyromonas gingivalis and Tannerella forsythia were higher in CG with periodontitis and in MIG with and without periodontitis. At follow-up, the left ventricular ejection fraction (LVEF) data were better in the non-periodontitis group: 15 patients had Mayor Cardiovascular Adverse Events (MACE), 13 of them had periodontitis and 2 did not show periodontitis. Periodontitis, exercise, diet and smoking are risk factors related to MI. MACE presented in the 'MI follow-up' shows periodontitis, weight, exercise hours and dyslipidemia as risk factors. LVEF follow-up values are preserved in patients without periodontitis. Our data suggest that periodontitis can be considered a risk factor for MI and MACE in the studied population.