Evidence of microbiota-host dysbiosis between periodontitis and cerebral small vessel disease.

OBJECTIVES: To investigate the correlation between periodontitis and cerebral small vessel disease (CSVD) from the clinical and microbiological aspects. SUBJECTS AND METHODS: Periodontitis patients (CP group, n = 31) and CSVD patients (CSVD group, n = 30) were examined for neurological and periodontal condition. Subgingival plaque was collected and performed using 16S rRNA sequencing. Logistic regression and LASSO regression were used to analyze the periodontal parameters and subgingival microbiota related to CSVD, respectively. Inflammatory factors in gingival crevicular fluid (GCF) were also detected and compared between the two groups. RESULTS: Clinical attachment level (CAL), teeth number and plaque index demonstrated a significant difference between CP and CSVD group, meanwhile, CAL was independently associated with CSVD. Besides, the microbial richness and composition were distinct between two groups. Five genera related to periodontal pathogens (Treponema, Prevotella, Streptococcus, Fusobacterium, Porphyromonas) were screened out by LASSO regression, suggesting a potential association with CSVD. Finally, the levels of inflammatory factors in GCF were statistically higher in CSVD group than those in CP group. CONCLUSIONS: Cerebral small vessel disease patients demonstrated worse periodontal condition, meanwhile the interaction between microbiota dysbiosis and host factors (inflammation) leading to a better understanding of the association between periodontitis and CSVD.

The application of individualized abutment-crown integrated provisional restoration in optimizing the peri-implant soft tissue contour in the esthetic zone.

OBJECTIVE: This article introduced a modified method to fabricate an individualized abutment-crown integrated provisional restoration for single-tooth implant restoration in the esthetic zone, which created a satisfactory peri-implant soft tissue architecture. CLINICAL CONSIDERATIONS: Three months after the implant placement, the individualized abutment-crown integrated provisional restoration was designed and fabricated in the laboratory, by referring to the profile of natural contra-lateral tooth digitally, and seated on the implant afterwards. The peri-implant soft tissue architecture was evaluated and the Pink Esthetic Score (PES) was recorded. The provisional restoration stayed on the implant for 3 months until the individualized definitive ceramic abutment and crown were fixed on the implant. CONCLUSIONS: This protocol provided an alternative solution for shaping the peri-implant soft tissue morphology in the esthetic zone by using an individualized abutment-crown integrated provisional restoration and showed promising effect on the esthetics of anterior single-tooth implant restoration. CLINICAL SIGNIFICANCE: The individualized abutment-crown integrated provisional restoration whose emergence profile mirroring that of the natural contra-lateral tooth, was designed with the help of computer-aided design-manufacture (CAD/CAM). It may help shaping the peri-implant soft tissue in the esthetic zone with merits of saving amount of hand labor of technicians as well as clinicians, and reducing the visits of patients.

Evaluation of Outcomes of Dental Implants Inserted by Flapless or Flapped Procedure: A Meta-Analysis.

PURPOSE: The purpose of this meta-analysis was to evaluate the failure risk and marginal bone loss of dental implants inserted by flapless or flapped procedure. MATERIALS AND METHODS: Studies were identified by searching PubMed, Web of Knowledge, and the Cochrane Library within 10 years, along with a hand search of the reference lists of the retrieved articles. RESULTS: A total of 2717 articles were filtered after the searching strategy, and 31 studies were finally selected. Failure rate of dental implants was statistically affected by different insertion procedures (flapless or flapped) with a risk ratio (RR) of 1.70 (95% confidence interval [CI]: 1.13-2.55; P = 0.01; heterogeneity: I = 0.0%; P heterogeneity = 0.97). Subgroup analysis indicated that in the situation of immediate/early loading, the flapless procedure showed a higher risk of implant failure comparing with flapped procedure (RR = 2.24; 95% CI: 1.05-4.78; P = 0.04; heterogeneity: I = 0.0%; P heterogeneity = 0.91). Mean difference of marginal bone loss between the flapless group and the flapped group was -0.10 mm (95% CI: -0.18 to -0.02; P = 0.02; heterogeneity: I = 82%; P heterogeneity = 0.00). CONCLUSIONS: This meta-analysis revealed that flapless procedure may increase the failure risk of the dental implants, especially in the situation of immediate/early loading. Nevertheless, flapless procedure showed a superiority in preserving bone tissues.

Suppressing ROS generation by apocynin inhibited cyclic stretch-induced inflammatory reaction in HPDLCs via a caspase-1 dependent pathway.

It has been reported that cyclic stretch could induce inflammatory reaction in human periodontal ligament cells (HPDLCs). Though reactive oxygen species (ROS) has been reported to be involved in pathogen-induced periodontal inflammatory reaction, its role in the force-related periodontal diseases has not been well clarified. This study inspected the role of ROS in the cyclic stretch-induced inflammatory reaction in HPDLCs and studied the inhibitory effect of antioxidant apocynin on this inflammatory reaction. Results confirmed that cyclic stretch induced inflammatory reaction and production of ROS in HPDLCs. This inflammatory reaction was inhibited by apocynin through blocking the production of ROS. The cyclic stretch also induced the expression of caspase-1 and NLRP3 inflammasome, which could also be inhibited by apocynin. Moreover, the cyclic stretch-induced inflammatory reaction was inhibited by caspase-1 inhibitor. Collectively, it is the first time that increased intracellular ROS was proved to play as an intermediate signal in the cyclic stretch-induced inflammatory reaction in HPDLCs, via a caspase-1-dependent pathway. The inhibitory effect of apocynin on the cyclic stretch-induced inflammatory reaction in HPDLCs shows the potential of antioxidants in the treatment of force-related periodontal inflammatory diseases.