Clinical and Radiological Outcomes of Implants in Osteotome Sinus Floor Elevation with and without Grafting: A Systematic Review and a Meta-Analysis.

PURPOSE: To systematically appraise the clinical and radiological outcomes after osteotome sinus floor elevation (OSFE) with or without grafting in the published dental literature. METHODS: An electronic search was conducted using PubMed, Web of Science, and the Cochrane Central Register of Controlled Trial to identify studies after OSFE from January 1, 1994 to August 30, 2015. The primary outcome was the implant survival rates after OSFE with and without grafting materials. RESULTS: After search and evaluation of the literature according to the inclusion criteria, 7 studies were included in the review. The random-effect model meta-analysis based on 463 implants in patients without grafting and 415 implants in patients with grafting showed that the risk ratio difference of survival rates was 1.010 (95%CI 0.910, 1.120), which did not reach statistical significance (p = 0.99). The membrane perforation rates ranged from 0% to 10.80%. No significant difference of crestal bone loss was reported between graft and nongraft groups. CONCLUSIONS: Based on currently available evidence, OSFE techniques with and without grafting were both predictable in the short term. In addition, survival rates of dental implants in OSFE with or without grafting did not show any significant difference in the short term.

[Effect of keratinized gingival width on periodontal regenerative surgery for the treatment of intrabony defects: a retrospective study].

PURPOSE: To evaluate the effect of keratinized tissue width (KTW) on periodontal regenerative surgery for the treatment of intrabony defects. METHODS: The clinical data of 14 patients (44 intrabony defect sites) treated with periodontal regenerative surgery were retrospectively analyzed at baseline and 2-year of follow-up. Forty four sites were divided into KTW2 mm group and KTW≤2 mm group according to KTW at baseline. Periodontal clinical indicators of the 2 groups were analyzed by SPSS 25.0 software package. RESULTS: At 2-year post-treatment, probing depth (PD) and clinical attachment loss (CAL) in the 2 groups were decreased significantly compared with those at baseline(P<0.05). There was no significant difference in ΔPD, but ΔCAL in KTW2 mm group was significantly greater than that in KTW≤2 mm group. CONCLUSIONS: Periodontal regenerative surgery for the treatment of intrabony defects can effectively reduce periodontal pocket inflammation, decrease periodontal pocket depth and increase the level of attachment. When the width of the keratinized gingiva is insufficient(KTW≤2 mm), the regeneration of the attachment level obtained by surgery is limited, and the efficacy of regenerative surgery is poor.

[Analysis of correlation between maxillary molars and maxillary sinus mucosal thickening].

PURPOSE: To investigate the influence of maxillary molars on the thickening of maxillary sinus mucosa by cone-beam CT (CBCT). METHODS: A total of 72 patients with periodontitis were included in the study and 137 cases of maxillary sinus were evaluated using CBCT for the following parameters: location, tooth, maximal mucosal thickness, alveolar bone loss, vertical intrabony pockets and minimal residual bone height. The maxillary sinus mucosal thickness ≥2 mm was defined as mucosal thickening. The parameters that could influence the dimensions of the maxillary sinus membrane were assessed. The data were analyzed using univariate analysis and binary logistic regression by SPSS 25.0 software package. RESULTS: Mucosal thickening was present in 56.2% of 137 cases and increased in frequency as the alveolar bone loss of the corresponding molar progressed from mild (21.1%) to moderate (56.1%) to severe (69.2%), and the risk of maxillary sinus mucosal thickening increased by 6-7 times (moderate OR=7.13, 95%CI: 1.37-37.21; severe OR=6.29, 95%CI: 1.06-37.37). The severity of vertical intrabony pockets was correlated with the presence of mucosal thickness (no intrabony pockets 38.7%; type Ⅰ 63.4%; type Ⅱ 79.4%), with an increased risk of maxillary sinus mucosal thickening (type Ⅰ OR=3.72, 95%CI: 1.01-13.70; type Ⅱ OR=5.39, 95%CI: 1.15-25.30). The minimal residual bone height was negatively correlated with the presence of mucosal thickness(≤4 mm OR=99.00, 95%CI: 17.42-562.79). CONCLUSIONS: Alveolar bone loss, vertical intrabony pockets and the minimal residual bone height in maxillary molars were significantly associated with mucosal thickening of the maxillary sinus.

HIF-1α activator DMOG inhibits alveolar bone resorption in murine periodontitis by regulating macrophage polarization.

Periodontitis is initiated by serious and sustained bacterial infection and ultimately results in chronic immune-mediated inflammation, tissue destruction, and bone loss. The pathogenesis of periodontitis remains unclear. Host immunological responses to periodontal bacteria ultimately determine the severity and mechanisms governing periodontitis progression. This study aimed to clarify the effect of the hypoxia-inducible factor-1α (HIF-1α) activator dimethyloxalylglycine (DMOG) on a mouse periodontitis model and its underlying role in macrophage polarization. qRT-PCR analysis showed that DMOG inhibited the M1-like polarization of both RAW264.7 macrophages and murine bone marrow macrophages (BMMs) and downregulated TNF-α, IL-6, CD86, and MCP-1 expression in vitro. Immunofluorescence staining and flow cytometry also confirmed the less percentage of F4/80 + CD86 + cells after DMOG treatment. The phosphorylation of NF-κB pathway was also inhibited by DMOG with higher level of HIF-1α expression. Furthermore, mice treated with DMOG showed decreased alveolar bone resorption in the experimental periodontitis model, with significant increases in alveolar bone volume/tissue volume (BV/TV) and bone mineral density (BMD). DMOG treatment of mice decreased the ratio of M1/M2 (CD86+/CD206+) macrophages in periodontal tissues, resulting in the downregulation of proinflammatory cytokines such as TNF-α and IL-6 and increased levels of anti-inflammatory factors such as IL-4 and IL-10. DMOG treatment promoted the number of HIF-1α-positive cells in periodontal tissues. This study demonstrated the cell-specific roles of DMOG in macrophage polarization in vitro and provided insight into the mechanism underlying the protective effect of DMOG in a model of periodontitis.

[Efficacy of subgingival scaling of the molars with conventional scalers in vitro].

PURPOSE: To evaluate the efficacy of traditional manual scaling and piezoelectric and magnetostrictive ultrasonic scaling in regard to periodontal pocket depth and power setting. METHODS: Thirty extracted human molars were assigned to receive manual scaling or ultrasonic scaling (both on the full or half power setting) with probing depth of 5 and 7 mm for 2 min. The remained oil materials on the roots were calculated as supplementary data. The data were compared using SAS6.12 software package. RESULTS: The procedures of ultrasonic scaling resulted in reductions of the values than manual scaling in all groups. The data of the magnetostrictive group were significantly smaller than the piezoelectric group in 5 mm pocket depth (P<0.01) on full power setting, while the opposite in 7 mm pocket depth. There was no significant difference between piezoelectric and magnetostrictive scaling in both 5 mm (P=0.217) and 7 mm (P=0.574) pocket depth on half power setting. The data increased significantly from 5 to 7 mm pocket depth (P<0.01), but no significant influence on different power settings. CONCLUSIONS: The study indicates that ultrasonic scaling instruments are more effective than a hand curette and the scaling efficacy decreased in deeper periodontal pocket.The results reveal no significant difference between magnetostrictive and piezoelectric ultrasonic instruments whether on half or full power settings.

Diagnostic accuracy of NicAlert cotinine test strips in saliva for verifying smoking status.

Semiquantitative immunoassay technology, in the form of rapid test strips, offers a less time-consuming and less costly alternative to other methods of verifying self-reported smoking status, such as gas chromatography-nitrogen phosphorus detection (GC). Unfortunately, information on the validity and reliability of some test strips in urine and saliva samples is not always available. This paper describes the diagnostic accuracy of one type of test strip currently available (NicAlert cotinine test strips; NCTS). GC was used as the reference standard and saliva as the sample medium. The study involved 86 people (41 smokers and 45 nonsmokers) aged 18 years or over, who were able to understand written English and provide written consent. Pregnant women, women with infants less than 6 weeks old, and people who had eaten 30 min prior to sample collection were excluded. Two saliva samples were collected simultaneously from each participant, with one sample tested using NCTS and the other by GC analysis. People with at least 10 ng/ml cotinine (in both tests) in their saliva were considered smokers. NCTS were found to have a specificity of 95% (95% CI 89%-100%), a sensitivity of 93% (95% CI 85%-100%), a positive predictive value of 95% (95% CI 89%-100%), and a negative predictive value of 93% (95% CI 86%-100%). The use of NCTS is a valid and reliable method, compared with GC, to test saliva samples for verification of smoking status.