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.

The Roles of Mating, Age, and Diet in Starvation Resistance in Bactrocera oleae (Olive Fruit Fly).

The olive fruit fly (Bactrocera oleae (Rossi) (Diptera: Tephritidae)), although a pest of major economic importance for the olive industry, has not been sufficiently studied with respect to the factors affecting its survival resistance to food deprivation. In the present study, we examined the effect of the interaction between mating status (virgin/mated), age class (11-20/21-30/31-40/41-50), and diet quality (protein plus sugar or only sugar) on starvation resistance in B. oleae under constant laboratory conditions. We conducted a total of 16 treatments (2 × 4 × 2 = 16) for each gender. Our results showed that starvation resistance in B. oleae did not differ significantly between females and males. The main conclusions of our study regarding mating status, age, and diet indicated that mated adults showed much less starvation resistance compared to virgins, younger adults endured longer, and the adults fed a restricted diet endured longer than those fed a full diet. A three-way interaction between mating status, diet, and age class was also identified and was the same for both genders. The interaction between mating status, age class, and diet also had a significant influence on starvation resistance in both sexes.

Maternal Dietary Protein Patterns and Neonatal Anthropometrics: A Prospective Study with Insights from NMR Metabolomics in Amniotic Fluid.

This study aimed to characterize dietary protein patterns (DPPs) in a sample pool of 298 well-nourished pregnant women and explore potential associations between DPPs and neonatal anthropometrics. Maternal dietary data were collected using a validated food frequency questionnaire. Neonatal anthropometrics were abstracted from health booklets. A hierarchical cluster analysis identified three DPPs: "Dairy-focused", "Med-fusion", and "Traditional-inspired". The "Dairy-focused" DPP exhibited the highest protein intake (p < 0.001), predominantly animal protein (p < 0.001), while the "Traditional-inspired" DPP presented higher plant protein (p < 0.001) and fiber intakes (p < 0.001), and, therefore, a reduced carbohydrate-to-fiber quotient (p < 0.001). The "Med-fusion" DPP had the lowest protein-to-fat ratio (p < 0.001). Infants of women following the "Dairy-focused" DPP had the highest birth height centiles (p = 0.007) and the lowest ponderal index (p = 0.003). The NMR-metabolomics approach was implemented on a subset of women that provided amniotic fluid (AF) specimens (n = 62) to elucidate distinct metabolic signatures associated with DPPs. PCA and OPLS-DA models verified the adherence to three DPPs, revealing that the levels of several amino acids (AAs) were the highest in "Dairy-focused", reflecting its protein-rich nature. The "Traditional-inspired" DPP showed decreased AAs and glucose levels. This knowledge may contribute to optimizing maternal dietary recommendations. Further research is needed to validate these findings and better understand the relationships between maternal diet, AF metabolic signature, and neonatal anthropometrics.

Framework of Methodology to Assess the Link between A Posteriori Dietary Patterns and Nutritional Adequacy: Application to Pregnancy.

This study aimed to explore the nutritional profile of 608 women during the second trimester of pregnancy, in terms of nutrient patterns, dietary quality and nutritional adequacy. Dietary data were collected using a validated Mediterranean-oriented, culture-specific FFQ. Principal component analysis was performed on 18 energy-adjusted nutrients. Two main nutrient patterns, "plant-origin" (PLO) and "animal-origin" (ANO), were extracted. Six homogenous clusters (C) relative to nutrient patterns were obtained and analyzed through a multidimensional methodological approach. C1, C5 and C6 scored positively on PLO, while C1, C2 and C3 scored positively on ANO. When dietary quality was mapped on food choices and dietary indexes, C6 unveiled a group with a distinct image resembling the Mediterranean-type diet (MedDiet Score = 33.8). Although C1-C5 shared common dietary characteristics, their diet quality differed as reflected in the HEI-2010 (C1:79.7; C2:73.3; C3:70.9; C4:63.2; C5:76.6). The appraisal of nutritional adequacy mirrored a "nutritional-quality gradient". A total of 50% of participants in C6 had almost 100% adequate magnesium intake, while 50% of participants in C4 had a probability of adequacy of ≤10%. Our methodological framework is efficient for assessing the link between a posteriori dietary patterns and nutritional adequacy during pregnancy. Given that macro- and micronutrient distributions may induce metabolic modifications of potential relevance to offspring's health, public health strategies should be implemented.

Nutritional Inadequacy: Unraveling the Methodological Challenges for the Application of the Probability Approach or the EAR Cut-Point Method-A Pregnancy Perspective.

The aim of this study was to unravel the methodological challenges when exploring nutritional inadequacy, involving 608 healthy pregnant women. The usual intake of twenty-one nutrients was recorded by employing a validated FFQ. Simulated datasets of usual intake were generated, with randomly imposed uncertainty. The comparison between the usual intake and the EAR was accomplished with the probability approach and the EAR cut-point method. Point estimates were accompanied by bootstrap confidence intervals. Bootstrap intervals applied on the risk of inadequacy for raw and simulated data tended in most cases to overlap. A detailed statistical analysis, aiming to predict the level of inadequacy, as well as the application of the EAR cut-point method, along with bootstrap intervals, could effectively be used to assess nutrient inadequacy. However, the final decision for the method used depends on the distribution of nutrient-intake under evaluation. Irrespective of the applied methodology, moderate to high levels of inadequacy, calculated from FFQ were identified for certain nutrients (e.g., vitamins C, B6, magnesium, vitamin A), while the highest were recorded for folate and iron. Considering that micronutrient-poor, obesogenic diets are becoming more common, the underlying rationale may help towards unraveling the complexity characterizing nutritional inadequacies, especially in vulnerable populations.

Dental caries and psychosocial factors: Testing a conceptual model in adolescents.

OBJECTIVES: A conceptual model was designed to examine interrelations among psychosocial factors, oral health behaviour, and dental caries in a sample of adolescents. METHODS: This cross-sectional study design of 531 Greek families included an oral examination and a survey completed by adolescents, and a survey completed by mothers. The outcome measure was dental caries experience. Additionally, dental sealants were recorded. The participants provided information which comprised the Sense of Coherence (SoC) scale and 11 psychosocial and behavioural variables that formed 6 composite variables (life-course experiences, socio-economic status, perceived parental support, perceived parental punishment, preventive measures, sugar intake frequency). The composite variables of preventive measures and sugar intake formed the latent variable of oral health behaviour. The interrelations of the above factors were included in a conceptual model and tested using a Structural Equation Modelling analysis. RESULTS: Data fit the proposed conceptual model (χ2  = 23.338, df = 14, P = .055, RMSEA = 0.036). Among psychosocial variables, adolescent's SoC was the best predictor of both dental caries (Standardized Regression Coefficient - Std. RC ± Standard Error (SE) = -0.178 ± 0.04) and oral health behaviour (Std. RC ± SE = -0.378 ± 0.09). All psychosocial factors were associated with SoC (Std. RCs ± SE between -0.162 ± 0.04 and 0.211 ± 0.04) and via SoC with oral health behaviour (Std. RCs ± SE between -0.080 ± 0.03 and 0.061 ± 0.02). CONCLUSIONS: A conceptual model was tested that integrated SoC with the psychosocial factors theoretically shaping it and clarified all factors' predictive abilities on dental caries via oral health behaviour.

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.

Tooth Wear in a Sample of Community-Dwelling Elderly Greeks.

PURPOSE: Increased wear of teeth may constitute a major problem in the future for the elderly. The aim of the present study was to investigate tooth wear in a sample of elderly Greeks and explore the presence and extent of severe occlusal/incisal wear in relation to the parameters of age, gender and remaining teeth. MATERIALS AND METHODS: A convenience sample of 70 dentate elderly (60-92 years old) was examined. Tooth wear was assessed using a modification of the tooth wear index. The presence of severe occlusal/incisal wear was explored using the multiple correspondence analysis (MCA) and x2 tests and the extent (% of surfaces) with analysis of variance (ANOVA). RESULTS: Increased prevalence of severe wear was observed in the occlusal/incisal and, to a lesser extent, in the cervical surfaces of the examined teeth. Seventy per cent (70%) of the participants had at least one severely worn tooth surface. Advanced age seemed to be associated with severe occlusal/incisal wear (>70 years: 79.4%; 60-70 years: 52.8%; x2 test, p = 0.024). The mean (± SD) percentage of severely worn teeth and surfaces was 34.2 ± 32.6% and 9.6 ± 9.6%, respectively. ANOVA showed that males and those with less than 20 remaining teeth exhibited more severely worn occlusal/incisal surfaces (p = 0.031 and p = 0.000, respectively). CONCLUSIONS: The presence and the extent of severe wear in the sample of the examined elderly is high compared to elderly populations in other countries. Severe wear was more prevalent with advanced age and more extensive in the occlusal/incisal surfaces in males and those having less than 20 remaining teeth.

An efficient framework for conducting systematic literature reviews in agricultural sciences.

Systematic review has generally been accepted as an effective, more complete, repeatable, and less biased type literature review that can successfully lead to evidence-based conclusions. This study attempts to develop a framework for systematic review with guidelines on how to conduct an effective systematic review for agricultural research. Systematic reviews require more time and effort but they can be used to conduct a comprehensive literature review, identifying potentially eligible articles on primary agricultural research and answering certain focused questions. A systematic review is also conducted as an example to examine whether systematic reviews are used in agricultural sciences. It was found that in the last two decades about a third (N = 29 out of 89 or 32.5%) of the eligible studies, classified as reviews related to agricultural research, are available as free full-text from publisher, while only eighteen of them were finally eligible to be included in this systematic review.

Chemometric characterization of virgin olive oils of the two major Cypriot cultivars based on their fatty acid composition.

The effects of the geographical region and the botanical origin of olive oils on the profile of fatty acids isolated from monovarietal virgin olive oils from Cyprus were investigated, in order to establish, for the first time, promising models for authentication and classification of monovarietal virgin olive oils produced on the island. The two dominant Cypriot olive cultivars, Cypriot (ladoelia), and Koroneiki (lianolia), were analyzed for fatty acid composition by GC/FID after preparation of Fatty Acid Methyl Esters from olive oil, using a cold esterification method. The data obtained were analyzed statistically using multivariate and univariate ANOVA, principal components analysis (PCA) and hierarchical cluster analysis. Results showed that the olive oils can be separated into two distinct groups using the FAME data bank obtained from 225 samples. Significant differences in the proportion of some variables such as polyunsaturated linoleic acid, and the ratio C18:1/C18:2 from oils of different varieties and geographical regions were detected. The ratios C18:1/C18:2 and MUFA/PUFA, as well SFA, ω-9 and PUFA showed the higher discriminant power based on the cultivar.

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.

Psychosocial factors and traumatic dental injuries among adolescents.

OBJECTIVES: To examine the association of traumatic dental injuries (TDI) and psychosocial factors in adolescents and to identify psychological profiles associated with TDI. METHODS: A cross-sectional study was conducted involving 531 students aged 13-16 years. Data were collected through oral examination and a structured interview with the adolescents, in conjunction with a questionnaire answered by their mothers. Associations between TDI and independent variables were analysed using a model-based approach, while an exploratory data analysis was applied to identify homogenous clusters of adolescents in relation to their sense of coherence (SoC), perception of parental support and their mothers' SoC. These clusters were examined further for associations with TDI and psychosocial variables. RESULTS: The prevalence of TDI was 15.8%. Adolescents with high TDI prevalence were males, nonfirstborns, or those frequently engaging in physical activity. In addition, both their own SoC and that of their mother were low and they reported low parental support. They were also prone to complaining about the behaviour of their peer group. The hierarchical cluster analysis (HCA) demonstrated three homogenous clusters. The cluster with the highest scores for all psychological variables included adolescents with low TDI prevalence, low paternal punishment, spacious home environment, high Family Affluence Scale (FAS) score, good school grades, few complaints about schoolmates and higher maternal education. CONCLUSIONS: Psychosocial factors appear to influence an adolescent's risk of TDI. High parental support, high own and maternal SoC and a higher socioeconomic status (SES) are typical of adolescents with low TDI experience.

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.

Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis.

OBJECTIVE: To investigate the outcomes of implant therapy in partially dentate patients treated for aggressive periodontitis (GAgP) in comparison to periodontally healthy (HP) and patients treated for chronic periodontitis (CP) utilizing radiographic and clinical parameters. MATERIAL AND METHODS: An electronic search of databases, supplemented by hand searching, was conducted to identify relevant clinical studies. Sequential screenings at the title, abstract and full-text levels were performed independently and in duplicate. A random effects meta-analysis was conducted and bias corrected bootstrap 95 % confidence intervals were estimated for group comparisons. RESULTS: The search strategy revealed a total of 899 results. After title screening, abstract scanning, and full-text reading, seven articles fulfilled the inclusion criteria. The 3-year survival rate for CP and HP patients was 100 % while in GAgP subjects, the respective value was 97.98 %; this difference being statistically significant. The 3-year mean marginal bone loss (MBL) was 1.07 mm for the GAgP group, 0.47 mm for the CP group, and 0.69 mm for the HP group. A significant difference between the GAgP and CP groups was identified (p < 0.05). The weighted mean differences of MBL concerning the above groups were also calculated and examined for statistical significance in both 1 and 3 years. CONCLUSIONS: The 3-year survival rate and peri-implant marginal bone loss was found statistically significantly lower in GAgP subjects (SR 97.98 % vs 100 %) in comparison to HP and CP individuals. CLINICAL RELEVANCE: The outcome of implant therapy in terms of survival rate and marginal bone loss is considered very important for the clinician in decision making when placing implants in patients with a history of aggressive periodontitis.

Development and Validation of a Mediterranean Oriented Culture-Specific Semi-Quantitative Food Frequency Questionnaire.

The objectives were to develop a Mediterranean oriented semi-quantitative food frequency questionnaire (FFQ) and evaluate its validity in measuring energy and nutrient intakes. For FFQ development, the main challenge was to merge food items and practices reflecting cultural Mediterranean preferences with other food choices ensuing from diet transition to more westernized dietary patterns. FFQ validity was evaluated by comparing nutrient intakes against the average of two 24-h dietary recalls for 179 pregnant women. Although the mean intake values for most nutrients and energy tended to be higher when determined by the FFQ, the Cohen's d was below 0.3. Bland-Altman plots confirmed the agreement between the two methods. Positive significant correlations ranged from 0.35 to 0.77. The proportion of women classified correctly was between 73.2% and 92.2%, whereas gross misclassification was low. Weighted kappa values were between 0.31 and 0.78, while intraclass correlation coefficients were between 0.49 and 0.89. Our methodological approach for the development and validation of this FFQ provides reliable measurements of energy, macro- and micronutrient intakes. Overall, our culture-specific FFQ could serve as a useful assessment tool in studies aiming at monitoring dietary intakes, especially in the Mediterranean region, where countries share common cultural dietary habits.

Investigating the compatibility of the biocontrol agent Clonostachys rosea IK726 with prodigiosin-producing Serratia rubidaea S55 and phenazine-producing Pseudomonas chlororaphis ToZa7.

This study was carried out to assess the compatibility of the biocontrol fungus Clonostachys rosea IK726 with the phenazine-producing Pseudomonas chlororaphis ToZa7 or with the prodigiosin-producing Serratia rubidaea S55 against Fusarium oxysporum f. sp. radicis-lycopersici. The pathogen was inhibited by both strains in vitro, whereas C. rosea displayed high tolerance to S. rubidaea but not to P. chlororaphis. We hypothesized that this could be attributed to the ATP-binding cassette (ABC) proteins. The results of the reverse transcription quantitative PCR showed an induction of seven genes (abcB1, abcB20, abcB26, abcC12, abcC12, abcG8 and abcG25) from subfamilies B, C and G. In planta experiments showed a significant reduction in foot and root rot on tomato plants inoculated with C. rosea and P. chlororaphis. This study demonstrates the potential for combining different biocontrol agents and suggests an involvement of ABC transporters in secondary metabolite tolerance in C. rosea.