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1.
Arch Oral Biol ; 122: 104982, 2020 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-33276272

RESUMO

OBJECTIVE: Human gingival fibroblasts (hGFs) are involved in inflammatory responses to bacteria by recognizing pathogen-associated molecular patterns. In search of host modulation strategies to increase LPS tolerance, Low level laser therapy (LLLT) has been suggested as an alternative treatment that reduces periodontal tissue inflammation. In this study, we investigate whether 810 nm (diode) and 1064 nm (Nd:YAG) laser wavelengths, modulate pro-inflammatory responses to LPS challenges in hGFs. DESIGN: Primary hGFs were challenged with Porphyromonas gingivalis LPS and irradiated with either Diode (810 nm) or with Nd:YAG (1064 nm) lasers. Cell cultures were examined for cell proliferation by MTT assay and IL-6 and IL-8 expression by qPCR at 24, 48 and 72 h. IL-6 and IL-8 protein levels were detected via ELISA. RESULTS: Naïve hGF populations irradiated with both Diode 810 nm and Nd:YAG 1064 nm lasers demonstrated cellular proliferation (p < 0.05), but LLLT did not affect cellular viability in LPS-challenged cells. IL-6 and IL-8 gene expression levels revealed significant anti-inflammatory effects of irradiation with both examined wavelengths on hGFs challenged with P. gingivalis LPS. Protein levels of these cytokines were increased by LPS challenge. Treatment with LLLT inhibited this increase for both wavelengths evaluated in the study at a statistically significant level particularly for the first 48 h. CONCLUSIONS: The present study demonstrates a modulatory effect of LLLT using both 810 nm diode and Nd:YAG 1064 nm lasers in gingival fibroblasts by decreasing the production of IL-6, IL-8 in response to LPS.

2.
J Periodontol ; 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32846000

RESUMO

BACKGROUND: Peri-implantitis treatments are mainly based on protocols for teeth but have not shown favorable outcomes for implants. The potential role of titanium dissolution products in peri-implantitis necessitate the consideration of material properties in devising treatment protocols. We assessed implant cleaning interventions on (1) bacterial removal from Ti-bound biofilms, (2) Ti surface alterations and related Ti particle dissolution, and (3) cytocompatibility. METHODS: Acid-etched Ti discs were inoculated with human peri-implant plaque biofilms and mechanical antimicrobial interventions were applied on the Ti-bound biofilms for 30 seconds each: (1) rotary nylon brush; (2) Ti brush; (3) water-jet on high and (4) low, and compared to sterile, untreated and Chlorhexidine-treated controls. We assessed colony forming units (CFU) counts, biofilm removal, surface changes via scanning electron microscopy (SEM) and atomic force microscopy (AFM), and Ti dissolution via light microscopy and Inductively-coupled Mass Spectrometry (ICP-MS). Biological effects of Ti particles and surfaces changes were assessed using NIH/3T3 fibroblasts and MG-63 osteoblastic cell lines, respectively. RESULTS: Sequencing revealed that the human biofilm model supported a diverse biofilm including known peri-implant pathogens. WJ and Nylon brush were most effective in reducing CFU counts (P < 0.01 versus control), whereas Chlorhexidine was least effective; biofilm imaging results were confirmatory. Ti brushes led to visible streaks on the treated surfaces, reduced corrosion resistance and increased Ti dissolution over 30 days of material aging as compared to controls, which increase was amplified in the presence of bacteria (all P-val < 0.05). Ti particles exerted cytotoxic effects against fibroblasts, whereas surfaces altered by Ti brushes exhibited reduced osteoconductivity versus controls (P < 0.05). CONCLUSIONS: Present findings support that mechanical treatment strategies selected for implant biofilm removal may lead to Ti dissolution. Ti dissolution should become an important consideration in the clinical selection of peri-implantitis treatments and a necessary criterion for the regulatory approval of instruments for implant hygiene.

3.
J Evid Based Dent Pract ; 20(2): 101443, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32473794

RESUMO

Periodontal practice has made tremendous progress toward evidence-based treatment over the past decade. Importantly, a new classification scheme for periodontal and peri-implant treatments has recently been devised that is incorporating current evidence and enabling patient-specific periodontal care. However, this important progress can be further accelerated with the availability of patient-perceived outcomes of periodontal and implant interventions. The majority of existing clinical studies assess treatment effects based on clinician-measured surrogate outcomes, such as probing depth and attachment levels which are easily communicated to or perceived by dental patients. As dental patient-reported outcomes (dPROs) gain momentum in dental practice, our understanding of the true outcome of dental therapies is vastly increasing. In periodontal research in particular, the utilization of dPROs has clearly demonstrated that periodontal disease contributes to an individual's burden of disease in a substantial manner. Correspondingly, disease treatment interventions seem to lead to varying levels of patient-perceived improvements. The present editorial aims to highlight the importance of patient communication of treatment outcomes in periodontal and implant research and to review the information on available measures for capturing dPROs.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Doenças Periodontais , Odontólogos , Humanos , Resultado do Tratamento
4.
J Evid Based Dent Pract ; 20(1): 101403, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32381410

RESUMO

OBJECTIVES: Dental research typically targets multiple outcomes. Interdental cleaning devices such as interdental brushes (IB) and water jet devices (WJ) share a sizable portion of the medical device market. However, recommendations for device selection are limited by the conflicting evidence from multiple outcomes in available studies and the lack of an appropriate synthesis approach to summarize evidences taken from multiple outcomes. In particular, both pairwise meta-analyses and single-outcome network meta-analyses can give discordant results. The purpose of this multioutcome, Bayesian network meta-analysis is to introduce this innovative method to the dental research community using data from interdental cleaning device studies for illustrative purposes. METHODS: We reanalyzed a network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation, which included 22 trials assessing 10 interproximal oral hygiene aids. We focused on the primary outcome of gingival inflammation, which was measured by 2 correlated outcome variables, the Gingival Index (GI) and bleeding on probing (BOP). RESULTS: In our previous single-outcome analysis, we concluded that IB and WJ rank high for reducing gingival inflammation while toothpick and flossing rank last. In this multioutcome Bayesian network meta-analysis with equal weight on GI and BOP, the surface under the cumulative ranking curve was 0.87 for WJ and 0.85 for IB. WJ and IB remained ranked as the 2 best devices across different sets of weightings for the GI and BOP. CONCLUSION: In conclusion, multioutcome Bayesian network meta-analysis naturally takes the correlations among multiple outcomes into account, which in turn can provide more comprehensive evidence.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária , Teorema de Bayes , Pesquisa em Odontologia , Humanos , Metanálise em Rede , Escovação Dentária
5.
Int J Oral Maxillofac Implants ; 35(2): 379-385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32142575

RESUMO

PURPOSE: To assess longitudinal volumetric changes during immediate implant placement with simultaneous intentional retention of the buccal aspect of the root. MATERIALS AND METHODS: This study assessed 10 cases drawn from a previously reported cohort that had study casts available pretreatment and at least 2 years after periodontal ligament (PDL)-mediated immediate implant placement. Gypsum casts were scanned using a laser scanner and converted into digital three-dimensional rendered files. The digital casts were superimposed, and semi-automated subtractive assessment was performed via specialized software. RESULTS: Data from 10 patients with a minimum of 3 years follow-up (median follow-up time: 42 months) were analyzed. Each person contributed one implant site in this study. All implants successfully maintained osseointegration during the follow-up period and demonstrated optimal soft tissue stability. Changes during the observation period ranged from 0.19 mm (95% confidence interval [95% CI]: 0.10 to 0.28) in the midfacial region 6 mm apical to the mucosal zenith to -0.06 mm (95% CI: -0.14 to 0.02) at 5 mm apical to the base of the distal papilla. All changes were noninferior to pre-extraction baseline measurements based on a 0.5-mm noninferiority margin. CONCLUSION: The intentional retention of the buccal aspect of the root with its periodontal apparatus during immediate implant placement led to optimal soft tissue dimensional stability in the esthetic zone. This technique holds promise for clinical application, and further controlled clinical studies are warranted to determine the comparative clinical benefit from the use of this procedure.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Carga Imediata em Implante Dentário , Estética Dentária , Humanos , Ligamento Periodontal , Estudos Prospectivos , Resultado do Tratamento
6.
J Endod ; 46(3): 444-448, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31959483

RESUMO

Peri-implantitis is becoming a frequent complication observed around dental implants. An endodontic infection of a nearby tooth or an immediate implant placement in an inflamed bone socket from failing endodontic therapy has been associated with retrograde peri-implantitis (RPI), a condition that presents with radiographic lucency at the "apex" of an implant. However, current classification schemes do not capture endodontic lesions that may manifest as coronal or intrabony lesions associated with dental implants. As a result, such cases may be mistreated. Here we present for the first time 2 cases in which peri-implant bone loss occurred in the coronal half of the implant adjacent to a tooth with an endodontic-periodontic lesion and was resolved via endodontic therapy or tooth extraction as indicated. This proof of concept report aimed to introduce endodontic peri-implant ("endo-implant") defects and increase vigilance, which may help prevent overtreatment or mistreatment of such cases.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Assistência Odontológica , Implantes Dentários/efeitos adversos , Humanos , Peri-Implantite/etiologia , Peri-Implantite/terapia , Periodontia , Extração Dentária
7.
Periodontol 2000 ; 81(1): 18-28, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31407431

RESUMO

The field of clinical implant research has been flourishing in recent years. The number of related publications has been on the rise, as has the number of dental journals. However, the information gathered from surveillance studies on the quality of reporting and methodologic quality of published studies is unsettling. An important challenge faced by researchers endeavoring to conduct implant studies is how to factor the differences between implant surfaces and dental surfaces in the study design. Given the considerable experience that has been gained in the research methodology of the study of teeth and periodontal tissues, clinical implant research studies have often been conducted without giving much consideration to the fundamental differences between implants and teeth. This article discusses study design related to implant research in view of these differences. Observational and interventional study design methodology is discussed, and guidelines are provided to inform researchers on how to minimize bias in the design and implementation of these clinical studies when implant-related outcomes are studied.


Assuntos
Implantes Dentários , Humanos , Projetos de Pesquisa
8.
Artigo em Inglês | MEDLINE | ID: mdl-31449581

RESUMO

The objective of this clinical study was to assess the outcomes of autologous tooth structure in alveolar ridge preservation procedures. Extraction sites were grafted with autologous tooth structure prepared from the extracted teeth, and histologic samples were obtained at varying intervals to allow observation of bone-healing dynamics over time. Grafted areas were occupied by dentin particles that had begun to connect via bridges of woven bone at 3 months posthealing, and vital bone was in direct contact with residual particles with no inflammatory infiltrate. Further clinical investigation is warranted on the comparative effectiveness of autologous tooth structure against established bone-substitute biomaterials.


Assuntos
Aumento do Rebordo Alveolar , Alvéolo Dental , Processo Alveolar , Transplante Ósseo , Extração Dentária
10.
PLoS One ; 14(1): e0210530, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30703125

RESUMO

BACKGROUND: Titanium (Ti) and its alloys possess high biocompatibility and corrosion resistance due to Ti ability to form a passive oxide film, i.e. TiO2, immediately after contact with oxygen. This passive layer is considered stable during function in the oral cavity, however, emerging information associate inflammatory peri-implantitis to vast increases in Ti corrosion products around diseased implants as compared to healthy ones. Thus, it is imperative to identify which factors in the peri-implant micro-environment may reduce Ti corrosion resistance. METHODS: The aim of this work is to simulate peri-implant inflammatory conditions in vitro to determine which factors affect corrosion susceptibility of Ti-6Al-4V dental implants. The effects of hydrogen peroxide (surrogate for reactive oxygen species, ROS, found during inflammation), albumin (a protein typical of physiological fluids), deaeration (to simulate reduced pO2 conditions during inflammation), in an acidic environment (pH 3), which is typical of inflammation condition, were investigated. Corrosion resistance of Ti-6Al-4V clinically-relevant acid etched surfaces was investigated by electrochemical techniques: Open Circuit Potential; Electrochemical Impedance Spectroscopy; and Anodic Polarization. RESULTS: Electrochemical tests confirmed that most aggressive conditions to the Ti-6Al-4V alloy were those typical of occluded cells, i.e. oxidizing conditions (H2O2), in the presence of protein and deaeration of the physiological medium. CONCLUSIONS: Our results provide evidence that titanium's corrosion resistance can be reduced by intense inflammatory conditions. This observation indicates that the micro-environment to which the implant is exposed during peri-implant inflammation is highly aggressive and may lead to TiO2 passive layer attack. Further investigation of the effect of these aggressive conditions on titanium dissolution is warranted.


Assuntos
Ligas Dentárias/química , Implantes Dentários/normas , Teste de Materiais/métodos , Titânio/química , Ácidos/química , Corrosão , Técnicas Eletroquímicas/métodos , Humanos , Peróxido de Hidrogênio/química , Concentração de Íons de Hidrogênio , Inflamação/induzido quimicamente , Inflamação/complicações , Microscopia Eletrônica de Varredura , Modelos Químicos , Propriedades de Superfície
11.
Implant Dent ; 27(5): 564-574, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30161062

RESUMO

PURPOSE: Immediate implant placement in conjunction with intentional root retention is a recently introduced technique, but the majority of existing documentation is limited to short-term reports with low level of evidence. Hence, the aim of this study was to document the long-term clinical and radiographic results of the root membrane technique. METHODS: This retrospective study reports on clinical results of the root membrane technique for periodontal ligament-mediated immediate implant placement with up to 10 years of follow-up from 3 private dental practices. Anterior implants placed with immediate loading from January 2006 to December 2016 were assessed. Kaplan-Meier estimators were computed for reporting of implant success and survival. RESULTS: A sample of 182 patients (82 men and 100 women, age range: 18-83 years) received 250 immediate implants (230 maxilla, 20 mandible) after the root membrane concept and followed-up for a mean of 49.94 months (±32.5). Overall, 5 implant failures were recorded for a 10-year cumulative patient-level implant survival rate of 96.5%. Considering mechanical and biological complications, the 10-year cumulative implant success rate was 87.9%. CONCLUSIONS: Within the limits of the retrospective design, the root membrane technique showed long-term success rates comparable to those of conventional immediate implants.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Carga Imediata em Implante Dentário/métodos , Ápice Dentário/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Reabsorção Óssea/prevenção & controle , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
12.
Gerodontology ; 35(4): 282-289, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29766564

RESUMO

OBJECTIVE: To conduct a systematic review of randomised trials assessing the association between personal oral hygiene and dental caries in the absence of the confounding effects of fluoride. BACKGROUND: Dental caries continues to affect close to 100% of the global population. There is a century-old conflict on whether dental caries is caused by poor oral hygiene or poorly formed teeth (ie, teeth with dental defects). Resolving this conflict is of significant public health importance as these two hypotheses on dental caries aetiology can lead to different prevention strategies. METHODS: A systematic search for randomised trials was conducted using predefined criteria in 3 databases. The impact of personal oral hygiene interventions on coronal dental caries incidence was evaluated using random-effects models. RESULTS: Three randomised studies involving a total of 743 participants were included. Personal oral hygiene interventions failed to influence the incidence of dental caries (Δ Decayed, Missing and Filled Surfaces (DFMS) = -0.11; 95% confidence interval: (-0.91, 0.69; P-value < .79)) despite meticulous deplaquing of teeth. There was no significant heterogeneity in the trial results (heterogeneity chi-squared = 1.88, P = .39). The findings were robust to sensitivity analyses, including consideration of the results of nonrandomised studies. CONCLUSION: Personal oral hygiene in the absence of fluorides has failed to show a benefit in terms of reducing the incidence of dental caries.


Assuntos
Cárie Dentária/prevenção & controle , Fluoretos/uso terapêutico , Higiene Bucal , Criança , Feminino , Fluoretação , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
J Periodontol ; 89(5): 558-570, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29520910

RESUMO

BACKGROUND: A wide selection of Interdental Oral Hygiene (IOH) aids is available to consumers. Recommendations for selection are, however, limited by the lack of direct comparisons in available studies. We aimed to assess the comparative efficacy of IOH aids using Bayesian Network Meta-Analysis (BNMA). METHODS: Two independent reviewers performed a systematic literature review of randomized clinical trials assessing IOH aids, based on a focused question. Gingival inflammation (Gingival Index (GI), Bleeding-on-probing (BOP)) was the primary outcome and plaque and probing depth were secondary outcomes A random-effects arm-based BNMA model was run for each outcome; posterior medians and 95% credible-intervals (CIs) summarized marginal distributions of parameters. RESULTS: A two-phase selection process identified 22 trials assessing 10 IOH aids as brushing adjuncts. Interdental brushes (IB) yielded the largest reduction in GI (0.23 [95% CI: 0.09, 0.37]) as toothbrushing adjuncts, followed by water-jet (WJ) (0.19 [95% CI: 0.14, 0.24]). Rankings based on posterior probabilities revealed that IB and WJ had the highest probability of being "best" (64.7% and 27.4%, respectively) for GI reduction, whereas the probability for toothpick and floss being the "best" IOH aids was near zero. Notably, except for toothpicks, all IOH aids were better at reducing GI as compared with control. CONCLUSIONS: BNMA enabled us to quantitatively evaluate IOH aids and provide a global ranking of their efficacy. Interdental brushes and water-jets ranked high for reducing gingival bleeding, whereas toothpicks and floss ranked last. The patient-perceived benefit of IOH aids is not clear because gingival inflammation measures are physical indicators of periodontal health.


Assuntos
Gengivite , Higiene Bucal , Teorema de Bayes , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Humanos , Inflamação , Escovação Dentária
14.
J Biomed Mater Res B Appl Biomater ; 106(7): 2645-2652, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29405560

RESUMO

Bacterial peri-implant biofilms, and the chemotherapeutics for their removal alter titanium surface cytocompatibility. In this study we aimed to assess the adjunctive use of an osteostimulative biomaterial utilizing a peri-implantitis model under the hypothesis that it will increase cell migration towards treated titanium surfaces. Acid-etched titanium surfaces were inoculated with a multi-species biofilm model and treated with 1.5% NaOCl in a previously characterized in vitro peri-implantitis model. Cell migration of MG63 cells towards the treated titanium surface (CTRL) was significantly reduced following inoculation with biofilm and chemotherapeutic treatment as compared to sterile controls. Addition of a tricalcium phosphate biomaterial (TCP) as a control for Ca+2 had a small non-significant effect, while BG significantly increased MG63 chemotaxis to titanium to levels comparable to sterile (STE). Similarly, cell viability at 5 days was increased in BG and TCP as compared to CTRL. SEM imaging confirmed the improved cytocompatibility of BG and TCP surfaces as compared to CTRL. Osteostimulative BG exhibited a strong chemotactic effect to osteoblasts, which was stronger than what was expected due to the chemotactic effect of Ca+2 alone (TCP). In addition, substantially increased cell attachment and viability was found on treated implant surfaces as compared to CTRL. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2645-2652, 2018.


Assuntos
Compostos de Cálcio , Fosfatos de Cálcio , Movimento Celular/efeitos dos fármacos , Materiais Revestidos Biocompatíveis , Teste de Materiais , Osteoblastos/metabolismo , Silicatos , Compostos de Cálcio/química , Compostos de Cálcio/farmacologia , Fosfatos de Cálcio/química , Fosfatos de Cálcio/farmacologia , Adesão Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Materiais Revestidos Biocompatíveis/química , Materiais Revestidos Biocompatíveis/farmacologia , Humanos , Silicatos/química , Silicatos/farmacologia , Titânio/química , Titânio/farmacologia
15.
Clin Nutr ; 37(4): 1306-1312, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28633943

RESUMO

BACKGROUND & AIMS: The deleterious effect of cariogenic dietary patterns on tooth loss is well characterized, but the contribution of diet-borne systemic inflammation to loss of teeth remains uncharted. Recent efforts have unveiled a protective role of single nutrients to periodontal health. However, the assessment of overall diet as a modifiable risk factor for oral health remains elusive. Thus, the aim of this study was to assess the association between diet-borne systemic inflammation and tooth loss in a representative sample of the US adult non-institutionalized population. METHODS: A cross-sectional analysis of a sample of participants of the 2009-2010 and 2011-2012 continuous NHANES receiving an oral exam and providing dietary recall data was performed. Dietary inflammatory potential was assessed by the Dietary Inflammatory Index (DII), a composite measure computed based on the association between nutrients and systemic pro-inflammatory cytokine levels. The outcome measure was prevalent tooth loss. Numbers of missing teeth were regressed across quartiles of the DII using multivariable linear regression models. RESULTS: 6887 eligible NHANES participants were included in the analysis; participants in the highest quartile of the DII index (pro-inflammatory diet) had an average [95% CI] of 0.84 [0.24, 1.45] additional more teeth lost as compared to those in the lowest quartile of DII (anti-inflammatory diet) (p = 0.015), after adjusting for known confounders. This significant association remained in subgroup analyses, including the lowest tertiles of energy-adjusted carbohydrate intake, and in persons aged ≥50 years. CONCLUSIONS: Adherence to an anti-inflammatory diet is associated with fewer missing teeth. These results suggest protective dietary patterns as a modifiable protective factor for tooth loss in the US adult population and support the incorporation of tooth loss prevention in the agenda of dietary public health interventions to prevent chronic inflammatory diseases.


Assuntos
Dieta/estatística & dados numéricos , Inflamação/epidemiologia , Estado Nutricional/fisiologia , Perda de Dente/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , Fatores Socioeconômicos , Estados Unidos/epidemiologia
16.
Implant Dent ; 26(4): 613-620, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28574857

RESUMO

OBJECTIVES: The aim of this study was to assess whether growth hormone (GH) replacement therapy can enhance implant osseointegration. MATERIALS AND METHODS: A systematic literature search was conducted from 1982 to March 2016. A structured search using the keywords "growth hormone," "implants," and "osseointegration" was performed to identify preclinical and clinical in vivo controlled studies and was followed by a 2-phase search strategy. Initially, 31 potentially relevant articles were identified. After removal of duplicates and screening by title and abstract, 10 potential studies were included. Studies were assessed for bias and data were synthesized using a random-effects meta-analysis model. RESULTS: All studies were preclinical animal trials, and the follow-up period ranged from 2 to 16 weeks. Seventy percent of the included studies reported an increase in bone-to-implant contact in animals receiving GH compared with controls. Meta-analysis showed a significant mean difference for bone to implant between GH groups versus controls (no GH supplementation) of 10.60% (95% confidence interval: 3.79%-17.41%) favoring GH administration. CONCLUSION: GH treatment seems to promote osseointegration around implants in preclinical studies; however, these findings must be assessed in highly controlled human clinical trials as a number of confounding factors may have influenced the outcomes of the included studies.


Assuntos
Implantes Dentários , Hormônio do Crescimento/farmacologia , Osseointegração/efeitos dos fármacos , Animais , Implantação Dentária Endo-Óssea , Humanos
17.
Int J Cardiol ; 240: 409-413, 2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28487151

RESUMO

BACKGROUND: Dietary guidelines are a key tool in the public health quiver. Single nutrients have been linked to cardiovascular diseases, but existing metrics do not capture the overall effect of diet on inflammatory diseases. The aim of this study was to examine the association between dietary inflammatory potential and cardiovascular diseases risk factors (CVD-RFs) in a nationally-representative sample of non-institutionalized US adults using data from the continuous National Health and Nutrition Examination Survey (NHANES) (2007-2012). METHODS AND RESULTS: A sample of 7880 non-institutionalized US adults aged ≥20years provided data on dietary habits and CVD-RFs (obesity; diabetes mellitus; hypertension; hypercholesterolemia). The total number of CVD-RFs was summed for each individual to create a CVD-RF morbidity index (range 0-4) as the outcome variable, used both as ordinal and dichotomous (no CVD-RFs versus at least one CVD-RF) variables. The association between the Dietary Inflammatory Index (DII) and at least one CVD-RF was dose-dependent, with participants in the 3rd and 4th quartile of DII (i.e., more pro-inflammatory dietary habits) being 1.37 (95%CI=1.11-1.68) and 1.50 (95%CI=1.19-1.90) times more likely, respectively, to have at least one CVD-RF, as compared to participants in the 1st quartile of DII scores. Similar results were obtained for the ordinal logistic regression using the CVD-RF morbidity index as the outcome. CONCLUSIONS: Among US adults aged ≥20years, pro-inflammatory dietary patterns, as assessed by the DII, were associated with increased odds for CVD-RFs. Dietary guidelines aimed at lowering the DII may reduce the CVD-RF burden in US adults.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Efeitos Psicossociais da Doença , Comportamento Alimentar , Inquéritos Nutricionais/métodos , Adulto , Doenças Cardiovasculares/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Hipercolesterolemia/complicações , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/epidemiologia , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Inflamação/complicações , Inflamação/diagnóstico , Inflamação/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , Vigilância da População/métodos , Distribuição Aleatória , Fatores de Risco , Estados Unidos/epidemiologia
18.
J Am Dent Assoc ; 148(6): 353-356, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28550842

Assuntos
Saúde Bucal , Humanos
19.
J Clin Periodontol ; 44(6): 603-611, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28370333

RESUMO

AIM: The recent ADA-commissioned Clinical Practice Guideline on the nonsurgical treatment of chronic periodontitis has provided the most exhaustive library of clinical trials on scaling and root planing (SRP) with or without adjuncts. This network meta-analysis (NMA) compared the adjuncts against each other. MATERIALS AND METHODS: A star-shaped NMA was performed based on 36 indirect comparisons of clinical attachment-level (CAL) gains among nine adjuncts in 74 studies from the Clinical Practice Guideline. RESULTS: All pairwise differences were accompanied by wide confidence intervals, and none of the adjuncts were statistically significantly superior to another. Local doxycycline hyclate and photodynamic therapy with a diode laser had the highest probabilities for ranking first and second, respectively. Publication bias was evident, with fewer than expected studies with small effects. The lack of these studies inflated the treatment effects by an estimated by 20%. CONCLUSIONS: Adjuncts improve CAL gain by about a third of a mm over 6-12 months compared with SRP alone, but no significant differences were found among the adjuncts. The patient-perceived benefit of this gain is unclear because CAL is a physical measure made by the clinician and not a patient-oriented outcome. Publication bias inflated the observed treatment effects.


Assuntos
Periodontite Crônica/terapia , Profilaxia Dentária/normas , Anti-Infecciosos/normas , Anti-Infecciosos/uso terapêutico , Bases de Dados Factuais , Profilaxia Dentária/métodos , Raspagem Dentária/métodos , Raspagem Dentária/normas , Doxiciclina/uso terapêutico , Odontologia Baseada em Evidências , Humanos , Terapia a Laser/normas , Lasers Semicondutores , Metanálise em Rede , Fotoquimioterapia/métodos , Guias de Prática Clínica como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Aplainamento Radicular/métodos , Aplainamento Radicular/normas
20.
Int J Periodontics Restorative Dent ; 37(5): 751­757, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28355311

RESUMO

Current techniques using autogenous soft tissue in periodontal plastic surgery have limitations in the number of teeth that can be treated and may result in suboptimal esthetic results. The innovative use of single, contoured grafts reported in this article overcomes the drawbacks associated with these techniques by more efficient use of available donor tissue. Autogenous tissue is used to graft each individual tooth, leaving the interdental areas uncovered. Multiple teeth-in some cases an entire arch-can be treated in one session, providing consistent and predictable reestablishment of the normal scalloped gingival architecture and convex root eminence.

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