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.

Effect of laser-assisted scaling and root planing on the expression of pro-inflammatory cytokines in the gingival crevicular fluid of patients with chronic periodontitis: A systematic review.

BACKGROUND: The aim of the present systematic review was to assess the efficacy of laser-assisted (low level laser therapy [LLLT], high intensity laser therapy [HILT], or antimicrobial photodynamic therapy [aPDT]) scaling and root planing (SRP) compared with SRP alone on the expression of inflammatory cytokines in the gingival crevicular (GCF) of patients with chronic periodontitis (CP). METHODS: In order to address the focused question: "What is the efficacy of SRP with and without laser and/or aPDT on the expression of pro-inflammatory cytokines in the GCF of patients with CP?" an electronic search without time or language restrictions was conducted up to and including February 2017 in indexed databases using various key words. RESULTS: Twenty-two randomized control trials were included in the present systematic review. Nine studies and six studies assessed the efficacy of LLLT and HILT, as adjunct to SRP, respectively. Seven studies assessed the efficacy of aPDT as adjunct to SRP on down-regulating the expression of pro-inflammatory cytokines in the GCF among patients with CP. The outcomes of the studies included based upon the reduction in the levels of pro-inflammatory cytokines were inconsistent. CONCLUSION: The role of laser-assisted SRP on the expression of pro-inflammatory cytokines in the GCF of patients with CP remains unclear. Further long term and well-designed randomized clinical trials are needed in this regard.

"Low Testosterone Levels in Body Fluids Are Associated With Chronic Periodontitis".

There is a debate over the association between low testosterone levels in body fluids and the occurrence of chronic periodontitis (CP). The aim of the present systematic review was to assess whether low testosterone levels in body fluids reflect CP. In order to identify studies relevant to the focus question: "Is there a relationship between low testosterone levels in body fluids and CP?" an electronic search without time or language restrictions was conducted up to June 2016 in indexed databases using different keywords: periodontitis, chronic periodontitis, periodontal diseases, testosterone, and gonadal steroid hormones. A total of eight studies were included in the present systematic review. The number of study participants ranged from 24 to 1,838 male individuals with ages ranging from 15 to 95 years. Seven studies measured testosterone levels in serum, two studies in saliva, and one study in gingiva. Four studies reported a negative association between serum testosterone levels and CP. Two studies reported a positive association between decreased testosterone levels in serum and CP. Increased levels of salivary testosterone among patients with CP were reported in one study; whereas one study reported no significant difference in the concentration of salivary testosterone between patients with and without CP. One study identified significant increase in the metabolism of testosterone in the gingiva of patients with CP. Within the limits of the evidence available, the relationship between low testosterone levels and CP remains debatable and further longitudinal studies and control trials are needed.

Does incorporating zinc in titanium implant surfaces influence osseointegration? A systematic review.

STATEMENT OF PROBLEM: Titanium implant surfaces have been modified to improve osseointegration; however, the evidence for incorporating zinc into titanium implants to improve new bone formation and osseointegration is not clear. PURPOSE: The purpose of this systematic review was to assess the efficacy of treating titanium surfaces with zinc on the osseointegration of implants. MATERIAL AND METHODS: The focused question addressed was, "Does incorporating zinc in titanium implant surfaces influence osseointegration?" Indexed databases were searched up to January 2016 using the key words "Bone to implant contact"; "implant"; "zinc"; "osseointegration." Letters to the editor, case reports/case series, historic reviews, and commentaries were excluded. The pattern of the review was customized to summarize the pertinent data. RESULTS: Ten experimental studies were included, all of which were performed in animals (5 in rabbits, 4 in rodents, and 1 in goats). The number of titanium implants placed ranged from 10 to 78. The results from all studies showed that incorporating zinc into titanium implants enhanced new bone formation and/or bone-to-implant contact around implants. One study reported that zinc enhanced the removal torque on implants. CONCLUSIONS: The current available evidence on adding zinc to titanium implants surfaces to enhance osseointegration remains unclear. Further investigation is necessary to assess its effectiveness and safety in humans and to establish a standard methodology and ideal compound for incorporating zinc ion into titanium implant surfaces in a clinical setting.

Comparison of peri-implant clinical and radiographic inflammatory parameters and whole salivary destructive inflammatory cytokine profile among obese and non-obese men.

The aim of the present cross-sectional retrospective study was to compare the peri-implant clinical and radiographic inflammatory parameters and whole salivary destructive inflammatory cytokine profile among obese and non-obese men. Thirty-five obese and 37 non-obese men were included. Information regarding age, obesity, systemic health status, and habits was collected using a questionnaire. Clinical examination to evaluate peri-implant parameters and radiographic examination to assess marginal bone loss were conducted. Levels of interleukin (IL)-6 and IL-1ß in collected un-stimulated whole saliva were measured using enzyme-linked immunosorbent assay. Data was statistically analyzed using Kruskal Wallis test. The mean scores of peri-implant bleeding on probing (P<0.05) and peri-implant probing depth (P<0.05) were significantly higher among obese compared with non-obese individuals. The mean marginal bone loss was also statistically significantly higher among individuals in the test-group compared with the control-group (P<0.05). Whole salivary IL-1ß (P<0.001) and IL-6 (P<0.001) levels were significantly higher among individuals in the test-group compared with the control-group. Clinical and radiographic peri-implant inflammatory parameters were worse, and whole salivary IL-6 and IL-1ß were higher in obese than non-obese subjects. Obese patients are at greater risk of peri-implant inflammation than non-obese healthy subjects. It is highly recommended that clinicians should educate obese patients seeking implant treatment regarding the association between obesity and peri-implant inflammation. In addition, obese patients with osseointegrated implants must follow strict oral hygiene regimen to prevent inflammation and maintain optimum peri-implant tissue health.