Residual vertical defects: risk of disease progression, retreatment rates, and cost: a retrospective analysis.

OBJECTIVES: This study aimed to explore the relationship between Radiographic Residual Vertical Defects (RVDs) and the progression of periodontitis in patients undergoing periodontal maintenance therapy (PMT). MATERIALS AND METHODS: Teeth with RVDs were compared to the same contralateral teeth in the same patient. The study investigated the effect of smoking, diabetes, compliance, disease Stage, and Grade, baseline probing depth (PD), periodontal risk score (PRS), baseline pocket closure (PC) (≤ 4 mm), and tooth mobility on disease progression. We calculated the need for retreatment during PMT and its associated cost. Generalized estimation equations and linear and multilevel logistic regression analyses were employed for data analysis. RESULTS: Each group had 139 teeth, accounting for 80 patients. Although the group with RVDs had similar PD reduction compared to the control teeth, the prevalence of PC at the last follow-up was reduced to half in the RVDs group (odds ratio OR = 0.5; p-value = 0.028), regardless of PC status at the baseline. RVDs were also significant predictors of tooth loss due to periodontitis (TLP), with an OR of 2.28 (p = 0.043). Patients with diabetes, Stage IV, higher mobility, and higher PRS scores had a higher risk of tooth loss due to periodontitis (OR = 4.71, 3.84, 3.64, and 5.97, respectively (P < 0.01). Incidences of sites requiring retreatment were similar in both groups, but the cost of treatment was 30% higher for teeth with RVDs. Grade C had the most significant influence on receiving retreatments (OR = 18.8, p = 0.005). CONCLUSION: Teeth with RVDs represent a risk indicator for tooth loss compared to identical contralateral teeth with similar PD in the same patient. Teeth with RVD had more risk of pocket opening during follow-up. CLINICAL RELEVANCE: While teeth with RVDs can be maintained long-term, they have twice the risk of pocket opening and tooth loss due to periodontitis during follow-up. Patients with systemic and local risk factors need to be monitored closely as they are at the highest risk of losing teeth with RVDs. The increased cost of retreatment for teeth with RVDs also has implications in terms of retention versus extraction and replacement.

Analysis of risk factors for early crestal bone loss in osseointegrated, submerged implants prior to restoration.

BACKGROUND: Evidence on the etiology behind bone loss around submerged, prosthetically nonloaded implants is still limited. The long-term stability and success of implants with early crestal bone loss (ECBL), especially when placed as two-stage implants, is uncertain. Hence, the aim of this retrospective study is to analyze the potential patient-level, tooth- and implant-related factors for ECBL around osseointegrated, submerged implants, before restoration as compared with healthy implants with no bone loss. METHODS: Retrospective data were collected from patient electronic health records between 2015 and 2022. Control sites included healthy implants with no bone loss and test sites included implants with ECBL, both of which were submerged. Patient, tooth and implant level data were collected. ECBL was assessed using periapical radiographs obtained during implant placement and second-stage surgeries. Generalized estimating equation logistic regression models were used to account for multiple implants within patients. RESULTS: The total number of implants included in the study was 200 from 120 patients. Lack of supportive periodontal therapy (SPT) was shown to have nearly five-times higher risk of developing ECBL and was statistically significant (p < 0.05). Guided bone regeneration (GBR) procedures before implant placement had a protective effect with an odds ratio of 0.29 (p < 0.05). CONCLUSIONS: Lack of SPT was significantly associated with ECBL, while sites that received GBR procedures prior to implant placement were less likely to exhibit ECBL. Our results underscore the importance of periodontal treatment and SPT for peri-implant health, even when the implants are submerged and unrestored.

Effect of non-surgical therapy on plasma C-reactive protein levels in patients with periodontitis: A single arm prospective clinical trial.

BACKGROUND: This study aimed to evaluate the effect of scaling and root planing (SRP) on levels of plasma C-reactive protein (CRP). METHODS: A total of 30 patients with advanced periodontitis as determined by Clinical Periodontal Sum Score (CPSS) were recruited. Venous whole blood samples were drawn to obtain serum samples from all participants at baseline and 1 month after SRP (post-SRP). High-sensitivity CRP (hs-CRP) was measured by highly sensitive immunoturbidimetric assay. Wilcoxon signed-rank test was used for data analysis. Spearman rank correlation analysis was conducted to test the correlations between CPSS and hs-CRP at baseline and post-SRP. RESULTS: There was a statistically significant reduction in the post-SRP CPSS values from the baseline values (z = 4.783, p < 0.0001). Similarly, there was a statistically significant reduction in the post-SRP hs-CRP levels from the baseline levels (z = 4.782, p < 0.0001). Moreover, there was positive association between the baseline levels of CPSS and hs-CRP (ρ = 0.5703) and the post-SRP values of CPSS and hs-CRP (ρ = 0.7507). CONCLUSION: The present study suggests that SRP can significantly reduce the levels of CRP.

The 'Danse Macabre'-Neutrophils the Interactive Partner Affecting Oral Cancer Outcomes.

Over the past few decades, tremendous advances in the prevention, diagnosis, and treatment of cancer have taken place. However for head and neck cancers, including oral cancer, the overall survival rate is below 50% and they remain the seventh most common malignancy worldwide. These cancers are, commonly, aggressive, genetically complex, and difficult to treat and the delay, which often occurs between early recognition of symptoms and diagnosis, and the start of treatment of these cancers, is associated with poor prognosis. Cancer development and progression occurs in concert with alterations in the surrounding stroma, with the immune system being an essential element in this process. Despite neutrophils having major roles in the pathology of many diseases, they were thought to have little impact on cancer development and progression. Recent studies are now challenging this notion and placing neutrophils as central interactive players with other immune and tumor cells in affecting cancer pathology. This review focuses on how neutrophils and their sub-phenotypes, N1, N2, and myeloid-derived suppressor cells, both directly and indirectly affect the anti-tumor and pro-tumor immune responses. Emphasis is placed on what is currently known about the interaction of neutrophils with myeloid innate immune cells (such as dendritic cells and macrophages), innate lymphoid cells, natural killer cells, and fibroblasts to affect the tumor microenvironment and progression of oral cancer. A better understanding of this dialog will allow for improved therapeutics that concurrently target several components of the tumor microenvironment, increasing the possibility of constructive and positive outcomes for oral cancer patients. For this review, PubMed, Web of Science, and Google Scholar were searched for manuscripts using keywords and combinations thereof of "oral cancer, OSCC, neutrophils, TANs, MDSC, immune cells, head and neck cancer, and tumor microenvironment" with a focus on publications from 2018 to 2021.

Applying the Three Delays Model to understand emergency care seeking and delivery in rural Bangladesh: a qualitative study.

OBJECTIVES: The Three Delays Model has been commonly used to understand and prevent maternal mortality but has not been systematically applied to emergency medical conditions more generally. The objective of this study was to identify delays in emergency medical care seeking and delivery in rural Bangladesh and factors contributing to these delays by using the Three Delays Model as a framework. DESIGN: A qualitative approach was used. Data were collected through focus group discussions and in-depth interviews using semistructured guides. Two analysts jointly developed a codebook iteratively and conducted a thematic analysis to triangulate results. SETTING: Six unions in Raiganj subdistrict of Bangladesh. PARTICIPANTS: Eight focus group discussions with community members (n=59) and eight in-depth interviews with healthcare providers. RESULTS: Delays in the decision to seek care and timely receipt of care on reaching a health facility were most prominent. The main factors influencing care-seeking decisions included ability to recognise symptoms and decision-making power. Staff and resource shortages and lack of training contributed to delays in receiving care. Delay in reaching care was not perceived as a salient barrier. Both community members and healthcare providers expressed interest in receiving training to improve management of emergency conditions. CONCLUSIONS: The Three Delays Model is a practical framework that can be useful for understanding barriers to emergency care and developing more tailored interventions. In rural Bangladesh, training community members and healthcare providers to recognise symptoms and manage acute conditions can reduce delays in care seeking and receiving adequate care at health facilities.

Short-term retention of labeled chondrocyte subpopulations in stratified tissue-engineered cartilaginous constructs implanted in vivo in mini-pigs.

It is likely that effective application of cell-laden implants for cartilage defects depends on retention of implanted cells and interaction between implanted and host cells. The objectives of this study were to characterize stratified cartilaginous constructs seeded sequentially with superficial (S) and middle (M) chondrocyte subpopulations labeled with fluorescent cell tracking dye PKH26 (*) and determine the degree to which these stratified cartilaginous constructs maintain their architecture in vivo after implantation in mini-pigs for 1 week. Alginate-recovered cells were seeded sequentially to form stratified S*/M (only S cells labeled) and S*/M* (both S and M cells labeled) constructs. Full-thickness defects (4 mm diameter) were created in the patellofemoral groove of adult Yucatan mini-pigs and filled with portions of constructs or left empty. Constructs were characterized biochemically, histologically, and biomechanically, and stratification visualized and quantified, before and after implant. After 1 week, animals were sacrificed and implants retrieved. After 1 week in vivo, glycosaminoglycan and collagen content of constructs remained similar to that at implant, whereas DNA content increased. Histological analyses revealed features of an early repair response, with defects filled with tissues containing little matrix and abundant cells. Some implanted (PKH26-labeled) cells persisted in the defects, although constructs did not maintain a stratified organization. Of the labeled cells, 126 +/- 38% and 32 +/- 8% in S*/M and S*/M* constructs, respectively, were recovered. Distribution of labeled cells indicated interactions between implanted and host cells. Longer-term in vivo studies will be useful in determining whether implanted cells are sufficient to have a positive effect in repair.