Association Between Periodontal Disease and Erectile Dysfunction: A Systematic Review.

A limited number of studies have reported an association between erectile dysfunction (ED) and chronic periodontitis (CP). The aim of the present study is to assess the association between CP and ED through a systematic review of published literature. To address the focused question, "Is there a relationship between ED and CP?" indexed databases were searched till December 2015 using various key words "erectile dysfunction," "periodontal disease," "periodontitis," "dental infection," and "impotence." Letters to the editor, commentaries, historic reviews, and experimental studies were excluded. The pattern of the present systematic review was customized to primarily summarize the pertinent data. Nine studies were included. Seven studies had a cross-sectional design and two studies were randomized control trials. The number of study participants ranged between 53 and 513,258 individuals with age ranging between 20 years and 85 years (median age ranging between 34.9 ± 4.9 years and 50.9 ± 16.6 years). In all studies, a positive relationship between CP and ED was reported. In four studies, odds ratio were reported, ranging between 1.53 and 3.35. From the literature reviewed, there seems to be a positive association between ED and CP; however, further well-designed controlled clinical trials are needed in this regard. It is emphasized that physicians should refer patients with ED to oral health care providers for a comprehensive oral evaluation and treatment.

Role of Osteogenic Coatings on Implant Surfaces in Promoting Bone-To-Implant Contact in Experimental Osteoporosis: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the role of osteogenic coatings (placement of a thin film of organic and inorganic osteoinductive and osteoproliferative materials) on implant surfaces in augmenting bone-to-implant contact (BIC) in osteoporotic bone. DATA SOURCES: To answer the focused question "Do osteogenic coatings on implant surfaces increase BIC in osteoporotic bone?" PubMed/MEDLINE, EMBASE, ISI Web of Knowledge, Scopus, and Google-Scholar databases were searched till June 2017 using different combinations of the following key words: bone-to-implant contact, coating, implant surface, osseointegration, and osteoporosis. Letters to the Editor, review articles, case-reports/case-series, and commentaries were excluded. RESULTS: Six animal studies were included, in which osteoporosis was induced by bilateral ovariectomy. In all studies, implant surface roughness was increased by various osteogenic surface coatings including alumina, hydroxyapatite, calcium phosphate, and zoledronic acid. Five studies showed that bone volume and BIC are significantly higher around implants with coated surfaces than noncoated implants. In 1 study, there was no difference in BIC around coated and noncoated implants. CONCLUSION: Although experimental studies have shown that osteogenic coatings are effective in enhancing BIC, their clinical relevance requires further investigations.

Efficacy of Local and Systemic Statin Delivery on the Osseointegration of Implants: A Systematic Review.

PURPOSE: In indexed literature, a systematic review of the efficacy of statins in enhancing osseointegration is lacking. The aim of this systematic review was to assess the efficacy of local and systemic statin delivery on the osseointegration of implants. MATERIALS AND METHODS: To address the focused question, "Does local and systemic statin delivery affect osseointegration around implants?", indexed databases were searched from 1965 through November 2015 using various keywords. Letters to the Editor, case reports/case series, historic reviews, and commentaries were excluded. The pattern of this systematic review was customized to primarily summarize the pertinent data. RESULTS: Nineteen studies were included. All studies were experimental and were performed in animal models. In seven studies, statins were delivered systemically via oral, intraperitoneal, intraosseous, subcutaneous, and percutaneous routes. Among the 12 studies, where statins were delivered locally, statin-coated implants were used in seven studies, whereas in the remaining studies, statins were delivered via topical application on the bone cavities. The follow-up duration ranged between 1 and 12 weeks. Results from 18 studies showed that statin administration enhanced new bone formation (NBF) around implants and/or bone-to-implant contact. One study showed that statin-coated implant surfaces impaired osseointegration. Seven studies reported that statin administration enhanced NBF around implants in osteoporotic rats. CONCLUSION: On experimental grounds, local and systemic statin delivery seems to enhance osseointegration; however, from a clinical perspective, further studies are needed to assess the role of statins in promoting osseointegration around dental implants.

Influence of the orthognathic surgical procedure Le Fort I osteotomy on the vascularity and neurosensory response of the dental pulp: A systematic review.

OBJECTIVE: Abnormalities of the midface and maxilla are frequently corrected using Le Fort I surgery. This osteotomy passes near the apices of the maxillary teeth, severing the blood vessels and nerves supplying the teeth. The aim of this review was to determine the effect of Le Fort I osteotomy on pulpal vascularity and neurosensory response. DATA SOURCES: A systematic search of the literature was performed in PubMed/ Medline, Google Scholar, EMBASE, and ISI Web of Knowledge from 1969 up to and including December 2015 using the following key words: Le Fort 1, tooth vitality, maxillary osteotomy, pulp, orthognathic. Reference lists of relevant articles were hand-searched for additional articles. RESULTS: Sixty-two studies were located by initial screening; 38 did not meet the eligibility criteria; three were excluded after full-text review, 13 were excluded after quality assessment, leaving nine studies eligible that met all inclusion criteria for this systematic review. The postoperative follow-up period of the included studies ranged from 3 months to 28 months. Five studies assessed pulpal blood flow using laser Doppler flowmetry and eight studies assessed the pulpal neurosensory response using electric pulp testing. CONCLUSION: There is a decrease in pulpal vascularity and neurosensory response following a Le Fort I osteotomy in the early postoperative period (1 to 10 days) that is likely temporary. Further controlled clinical studies with standardized parameters are required to determine the long-term effects of Le Fort I osteotomy on the vascular and neural healing of the dental pulp.

Is mechanical curettage with adjunct photodynamic therapy more effective in the treatment of peri-implantitis than mechanical curettage alone?

BACKGROUND: The aim of the present study was to review the pertinent literature on the effects of mechanical curettage (MC) with and without adjunct photodynamic therapy (PDT) for the management of peri-implantitis. METHODS: The addressed focused question was "Is PDT effective in the treatment of peri-implantitis?" A search without language or time restrictions up to March 2016 was conducted using various key words. The exclusion criteria included; review papers, in vitro Studies, case reports, commentaries, interviews, and letters to the editors. RESULTS: In total 9 studies were included. Among them 5 studies were clinical and 4 were experimental. All the studies used PDT as an adjunctive to MC in their test groups. The laser wavelengths used ranged from 660nm to 830nm. One study showed significant reduction of the bleeding scores, inflammatory exudates and Aggregatibacter actinomycetemcomitans count in group with PDT as an adjunctive when compared to MC and 0.2% chlorhexidine. However, in four clinical studies comparable periodontal parameters were reported when PDT is used as an adjunct to MC was compared to MC in treatment of peri-implantitis. In three experimental studies, outcomes were significantly better in group with PDT as an adjunct to MC when compared to MC alone at follow-up. CONCLUSION: The role of PDT as an adjunct to MC in the treatment of peri-implantitis is debatable. Further longterm randomised control trails are needed to justify the role PDT as an adjunct to MC in treatment of peri-implantitis.

Success rate of short dental implants supporting single crowns and fixed bridges.

OBJECTIVE: Bone grafts (sinus lift and/or ridge augmentation) may become an obstacle for some patients who desire implant treatment. The objective of this study was to evaluate the success of six- and eight-millimeters rough surface design short dental implants, for up to 2 years in function, when compared to conventional length (11 mm) implants. MATERIALS AND METHODS: A total of 25.6-, 20.8- and 35.11-mm length implants were placed and restored in 30 subjects (11 males, 19 females) between the age of 22 and 80, following a standard protocol. Implant mobility, crestal bone loss as well as periodontal parameters were evaluated immediately after restoration placement, at 6, 12 and 24 months. RESULTS: There was one failure of one 6-mm implant during the healing phase and one restorative failure. The median crestal bone loss at 24 months was 0.45 mm for the 6-mm implants, 0.55 mm for the 8 mm implants and 0.65 mm for the 11-mm implants. The success rate for 6-mm implants was 97% and for 8-mm and 11-mm implants 100%. CONCLUSIONS: Based on this preliminary data, we conclude that rough surface design short dental implants (6 and 8 mm in length) have similar success rate when compared to 11-mm implants. Long-term data with larger number of implants and subjects are needed to confirm these results.

Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review.

The aim of this study was to review the cytokine profiles in the synovial fluid (SF) of patients with temporomandibular joint disorders (TMJD). Databases were searched from 1965 till September 2015 using different combinations of the following key words: "Temporomandibular joint"; "Cytokine"; "disorder"; and "synovial fluid" and "inflammation". Titles and abstracts of studies identified using the above-described protocol were screened and checked for agreement. Full-texts of articles judged by title and abstract to be relevant were read and independently evaluated. Hand-searching of the reference lists of potentially relevant original and review articles was also performed. The pattern of the present systematic review was customized to mainly summarize the relevant data. Fifteen studies were included. In 12 studies, cytokine profile of patients with TMJD was assessed using enzyme linked immunosorbent assay; and in 2 studies, histological analysis was performed to assess the cytokine profile of patients with TMJD. Patients with TMJD presented raised levels of interleukin (IL)-6 in 8 studies, IL-1beta (1ß) in 5 studies and tumor necrosis factor-alpha (TNF-α) in 5 studies. Two studies showed no significant difference in TNF-α levels in patients with and without TMJD; and IL-1ß levels were comparable in patients with and without TMJD in 2 studies. Raised levels of IL-6, TNF-α, IL-1ß, IL-8, and IFN-γ in the SF have been associated with inflammation in patients with TMJD. Cytokines IL-10, osteoclastogenesis inhibitory factor/osteoprotegerin (OCIF/OPG), and VEGF found in the SF of TMJs could have an anti-inflammatory effect.

Role of antimicrobial photodynamic therapy in the treatment of aggressive periodontitis: A systematic review.

BACKGROUND: The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in the treatment of aggressive periodontitis (AgP). METHODS: The addressed focused question was "Is aPDT effective in the treatment of AgP?" MEDLINE/PubMed, EMBASE, Scopus, ISI Web of knowledge and Google-Scholar databases were searched from 1977 till May 2015 using combinations of the following keywords: antimicrobial; photochemotherapy; photodynamic therapy; photosensitizing agents; AgP; scaling and root-planing (SRP). Reviews, case reports, commentaries, and articles published in languages other than English were excluded. RESULTS: Seven studies were included. In 5 studies, aPDT was performed as an adjunct to SRP. Laserwavelengths and duration of irradiation ranged between 660-690 nm and 60-120 s, respectively. Laser power output as reported in 2 studies was 75 mW. One study showed significant improvement in periodontal parameters for subjects receiving aPDT as an adjunct to SRP as compared to treatment with SRP alone at follow up. However, comparable periodontal parameters were reported when aPDT as an adjunct to SRP was compared to SRP alone in the treatment of AgP in one study. One study showed comparable outcomes when aPDT was compared to SRP in the treatment of AgP. In two studies, adjunctive antibiotic administration to SRP showed significantly better outcomes when compared to application of adjunctive use of aPDT to SRP. CONCLUSION: aPDT is effective as an adjunct to SRP for the management of AgP, however, further randomized clinical trials with well defined control groups are needed in this regard.

Efficacy of non-surgical periodontal therapy with adjunct Nd:YAG laser therapy in the treatment of periodontal inflammation among patients with and without type 2 diabetes mellitus: A short-term pilot study.

BACKGROUND AND AIM: Effect of non-surgical periodontal therapy (NSPT) with and without adjunctneodymium-doped:yttrium, aluminum and garnet (Nd:YAG) lasertherapy in the treatment of periodontal inflammation in patients with type 2 diabetes mellitus (T2DM) remains uninvestigated. The aim of the present short-term pilot study was to assess efficacy of NSPT with adjunct Nd:YAG laser therapy in the treatment of periodontal inflammation in patients with and without T2DM. METHODS: Twenty-two patients with T2DM (Group-1) and 22 controls (Group-2) were included. Teeth on test- and control-sites underwent NSPT with and without Nd:YAG laser therapy, respectively. Periodontal parameters (plaque index [PI], bleeding on probing [BOP] and probing pocket depth⩾4mm [PPD]) were measured at baseline and after 1 and 3months. Hemoglobin A1c (HbA1c) levels were measured at baseline and after 3months. RESULTS: In Group-1, PI, BOP and PPD⩾4mm were higher at the control-sites (6.4% [P<0.05], 5.5% [P<0.05] and 3.5% [P<0.05], respectively) than test-sites (1.5%, 2.1% and 1.1%, respectively) at 1-month follow-up. In Group-2, PI, BOP and PPD⩾4mm were higher at the control-sites (4.2% [P<0.05], 2.2% [P<0.05] and 2.2% [P<0.05], respectively) than test-sites (1.2%, 1.3% and 1.1%, respectively). At 3-months follow-up, there was no difference in PI, BOP and PPD⩾4mm among test- and control-sites in both groups. At 3-month follow-up, mean HbA1c levels were comparable among patients in groups 1 and 2 (5±0.2% and 4.6±0.1%, respectively). CONCLUSION: These short-term pilot results support our hypothesis that NSPT+Nd:YAG laser therapy is more effective in reducing periodontal inflammation in patients with and without T2DM than when NSPT is used alone. Further long-term randomized controlled clinical trials are needed in this regard.