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2.
J Prosthodont Res ; 2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34789636

RESUMO

PURPOSE: The purpose of this study was to investigate the inhibitory effect of night denture (ND) placement on abutment tooth mobility in removable partial denture (RPD) wearers with sleep bruxism (SB). METHODS: The participants were selected from RPD wearers diagnosed with SB using BiteStrip® and randomly allocated to one of the following groups: with ND placement or without ND placement (intervention or control group, respectively). The mobility of the RPD abutment tooth was measured using Periotest® at baseline (T0) and at 1 (T1), 3 (T3), and 6 months (T6). BiteStrip® scores were recorded at T0 and T6. Intragroup comparisons of the Periotest® value (PTV) were performed using analysis of covariance. Intergroup comparisons of PTV and BiteStrip® scores were performed using the linear mixed model and Wilcoxon signed-rank test, respectively. Intragroup comparisons of BiteStrip® scores were performed using the Mann-Whitney U test. RESULTS: At T6, the PTV in the intervention group was significantly lower than that in the control group (p=0.004). PTV was significantly lower at T6 than that at T0 in the intervention group (p=0.030), while PTV was significantly higher at T6 than that at T0 in the control group (p=0.007). There was no significant difference in the BiteStrip® score between the two groups. The BiteStrip® score at T6 was significantly lower than that at T0 only in the intervention group (p=0.011). CONCLUSION: ND placement might inhibit the increase in mobility of RPD abutment teeth and be effective in protecting them in RPD wearers with SB.

3.
J Prosthodont Res ; 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34545008

RESUMO

PURPOSE: This article describes a novel, minimally invasive procedure called Er:YAG laser micro-keyhole surgery (EL-MIKS) that removes metal or amalgam tattoos in the gingiva adjacent to prosthetic teeth without gingival deformity and recession. We aimed to evaluate the clinical efficacy of EL-MIKS for removing metal tattoos and present its long-term treatment outcomes. METHODS: The EL-MIKS procedure consists of several steps that are all performed under a microscope. First, a micro-keyhole (1-2 mm diameter) was prepared using an Er:YAG laser in the center of the metal pigmentation. The connective tissue was evaporated in the deep layer, where metal debris was deposited. Second, within the accessible range, the irradiation angle was changed in various directions to ablate the metal pieces and discolored connective tissue without enlarging the keyhole. Finally, after blood filled the space created by the tissue evaporation, the surface of the blood clot at the entrance of the micro-keyhole was thermally coagulated with defocus laser irradiation. Pigmentation that could not be successfully removed from a single micro-keyhole was treated by forming new micro-keyholes at a distance of 3 mm or more from each previously created hole. Depigmentation over an extended area was completed over a few sessions every 4 weeks without gingival recession after surgery. CONCLUSIONS: EL-MIKS, a novel depigmentation technique, was able to successfully remove an extended area of metal tattoos in the gingiva using a simpler, easier, and less invasive procedure than conventional periodontal plastic surgery. Esthetic restoration was successfully achieved without postoperative alteration of the gingival contour.

4.
J Clin Periodontol ; 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34545600

RESUMO

AIM: To investigate the influence of chronological aging on periodontal regenerative therapy (PRT) outcomes with enamel matrix derivative (EMD). MATERIALS AND METHODS: In total, 253 intra-bony defects (151 patients) including 44 furcation involvement were prospectively investigated for 3 years after regenerative therapy with EMD by evaluating probing pocket depth (PPD), clinical attachment level (CAL), and radiographic bone defect depth (RBD). The influence of age on these outcomes was assessed using multilevel regression analyses adjusting for confounders. RESULTS: Participants' mean age was 55.9 ± 12.3 years (range: 22-85). Baseline PPD, CAL, and RBD were 6.14 ± 1.82, 7.22 ± 2.14, and 5.08 ± 2.04 mm, respectively. Significant improvement was observed with PPD reductions of 2.84 ± 1.73 and 2.87 ± 1.87 mm, CAL gains of 2.40 ± 1.87 and 2.47 ± 1.89 mm, and RBD gains of 1.76 ± 1.98 and 2.39 ± 2.41 mm at 1- and 3-year examinations, respectively. At the 1-year examination, multivariate analysis revealed a significant negative association between age and improvement in PPD and CAL (coefficients: -0.13, -0.23 mm per 10 years). However, by the 3-year examination, no significant association was noted between age and improvement in PPD, CAL, or RBD. CONCLUSION: Although the statistical difference was detected with age at 1-year examination, PRT with EMD significantly improved clinical outcomes on long-term observation, irrespective of the patient's age. CLINICAL TRIAL REGISTRATION NUMBER: UMIN000039846.

5.
Antioxidants (Basel) ; 10(8)2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34439554

RESUMO

This review investigated whether the adjunctive use of antioxidants with periodontal therapy improves periodontal parameters in patients with type 2 diabetes. A systematic and extensive literature search for randomized controlled trials (RCTs) conducted before April 2021 was performed on the PubMed, Cochrane Library, and Web of Science databases. The risk of bias was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed to quantitatively evaluate the clinical outcomes following periodontal therapy. After independent screening of 137 initial records, nine records from eight RCTs were included. The risk-of-bias assessment revealed that all RCTs had methodological weaknesses regarding selective bias, although other risk factors for bias were not evident. This meta-analysis of two RCTs showed that periodontal pocket depths were significantly reduced in the groups treated with combined non-surgical periodontal therapy and melatonin than in those treated with non-surgical periodontal therapy alone. The present systematic review and meta-analysis suggest that the adjunctive use of melatonin, resveratrol, omega-3 fatty acids with cranberry juice, propolis, and aloe vera gel with periodontal therapy significantly improves periodontal disease parameters in patients with type 2 diabetes, and melatonin application combined with non-surgical periodontal therapy might significantly reduce periodontal pocket depth. However, there are still limited studies of melatonin in combination with non-surgical periodontal therapy in Type 2 diabetic patients, and more well-designed RCTs are required to be further investigated.

6.
J Periodontol ; 2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34427916

RESUMO

BACKGROUND: This study aimed to investigate the effects of metformin on gingival wound healing in insulin-resistant prediabetes. METHODS: C57BL/6J mice were fed normal diet (ND) or high-fat diet (HFD) for 10 weeks; half of the HFD mice were treated with metformin (HFD+ Met) for the last 2 weeks. Insulin and glucose tolerance tests were performed. The palatal gingiva (2.0 × 0.5 mm) was surgically removed adjacent to the maxillary molars. Post-surgical wound closure was histomorphometrically evaluated for 1 week. The mRNA expression of vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) in the tissue were quantified by real-time polymerase chain reaction. In vitro, the proliferation and migration of human gingival fibroblasts (HGFs) cultured under high-glucose or control conditions with/without metformin were analyzed. Akt phosphorylation and VEGF expression following the insulin stimulation were evaluated with/without metformin in high-glucose or control media. RESULTS: HFD mice showed significantly higher plasma glucose levels and insulin resistance than ND mice. Gingival wound healing was delayed in HFD group compared with ND group but significantly improved in HFD + MET group. The decreased expression of VEGF and eNOS in HFD group was significantly elevated in the HFD + MET group. The proliferation and migration of HGFs were significantly impaired in high-glucose conditions compared with control; metformin treatment partially attenuated these effects. Metformin treatment significantly recovered the downregulated Akt phosphorylation and VEGF expression in high-glucose conditions. CONCLUSIONS: Metformin improved delayed gingival wound healing in insulin-resistant prediabetes by accelerating HGFs proliferation and migration via Akt phosphorylation in insulin signaling pathway.

7.
J Periodontal Res ; 56(6): 1037-1045, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34273107

RESUMO

AIMS: The impact of periodontal inflammation on lipid metabolism is controversial. This study aimed to investigate the association between full-mouth periodontal inflammation and serum lipid levels. MATERIALS AND METHODS: In this cross-sectional study, we performed periodontal and bacteriological examinations during medical checkup on 131 subjects. The association between the periodontal inflamed surface area (PISA) and the lipid markers was analyzed by multiple linear regression, adjusting for age, sex, smoking, and body mass index. RESULTS: Overall, 118 medically healthy participants were analyzed. The proportions of none, mild, moderate, and severe periodontitis were 37.3%, 32.2%, 25.4%, and 5.1%, respectively. Multivariate analysis showed that high-density lipoprotein cholesterol was significantly higher in participants with the lowest tertile of PISA values (PISA low, coefficient: 7.94; 95% confidence interval [CI]: 1.63, 14.26, p = .01) compared to those in other tertiles (PISA high). Low-density/high-density lipoprotein cholesterol and total/high-density lipoprotein cholesterol ratios were significantly lower in the PISA-low group than the PISA-high group (coefficient: -0.26 and -0.30; 95% CI: -0.50, -0.02, and -0.59, -0.0002; p = .04 and .0498). Serum high-sensitivity C-reactive protein level, but not serum Porphyromonas gingivalis antibody titer, partly explained the association between PISA and high-density lipoprotein cholesterol. A significant interaction between female sex and PISA values toward high-density lipoprotein cholesterol level was detected. CONCLUSION: Periodontal inflammation was inversely associated with higher high-density lipoprotein cholesterol, especially in females. Elevated serum C-reactive protein partly explained this association.


Assuntos
Inflamação , Periodontite , HDL-Colesterol , Estudos Transversais , Feminino , Humanos , Lipídeos
8.
Int J Periodontics Restorative Dent ; 41(4): e137-e175, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34328480

RESUMO

In order to achieve favorable ridge preservation (RP) or ridge augmentation (RA) in substantial vertical and/or horizontal bone defects and extraction sockets, a barrier membrane is usually employed. Recently, it was reported that a novel surgical technique for periodontal regenerative surgery applying Er:YAG laser (ErL) irradiation to form blood coagulation on the grafted bone surface, without using a membrane, resulted in sufficient bone regeneration in bone defects. This case series aims to present clinical and radiographic outcomes of ErL-assisted bone regenerative therapy (Er-LBRT), without use of membranes, for RP/RA before or after implant placement. In 10 cases, ErL irradiation was applied (50 mJ/pulse and 20 Hz without water spray in noncontact, defocused mode for approximately 60 seconds) to enhance the blood clot on the entire surface of the grafted bovine bone mineral before suturing. Wound healing was favorable without any postoperative complications such as wound gaping or infection of the grafted material. In all cases, dramatic bone regeneration was observed. After prosthetic treatment, peri-implant tissue and regenerated bone were stable and well-maintained during the follow-up period in each case. This novel technique of Er-LBRT without using a membrane resulted in favorable and stable RP/RA with sufficient bone regeneration for implant therapy.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Lasers de Estado Sólido , Animais , Regeneração Óssea , Bovinos , Implantação Dentária Endo-Óssea , Humanos
9.
Clin Oral Investig ; 2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34278521

RESUMO

OBJECTIVES: Recently, the application of erbium-doped yttrium aluminum garnet (Er:YAG) laser has been increasing in periodontal therapy. In this retrospective study, we evaluated the safety and effectiveness of a novel pocket therapy using Er:YAG laser in combination with conventional mechanical scaling and root planing treatment (Er:YAG laser-assisted comprehensive periodontal pocket therapy). METHODS: Forty sites in 29 elderly patients having residual periodontal pockets of ≥ 5 mm depth were treated by curette and Er:YAG laser from 2006 to 2009. After root debridement by curette, laser irradiation was performed on the root surfaces. Then, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided by curette and laser. Furthermore, in most cases, removal of the outer epithelium and coagulation of the blood clot in the pocket entrance were additionally performed with laser. Clinical parameters were evaluated before and 3, 6, and 12 months after treatment. RESULTS: With Er:YAG laser-assisted pocket therapy, debridement of pockets was thoroughly and safely performed, and favorable clinical improvements were observed in most cases, without any adverse side effects and complications. After 1 year, probing pocket depth significantly decreased from 6.4 ± 1.4 to 3.5 ± 1.3 mm (p < 0.001, 3.0 mm reduction), and clinical attachment level significantly decreased from 7.5 ± 1.6 to 5.2 ± 1.9 mm (p < 0.001, 2.3 mm gain). CONCLUSION: The results of this study indicate that Er:YAG laser-assisted therapy is useful for the treatment of residual pockets as a minimally invasive flapless surgery. CLINICAL RELEVANCE: Er:YAG laser-assisted comprehensive pocket therapy reduces the necessity of more conventional surgical therapies.

10.
J Prosthodont Res ; 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34108298

RESUMO

PURPOSE: This retrospective study evaluated the periodontal tissues of the abutment teeth of removable partial dentures (RPDs) with rigid retainers and major connectors in patients with and without type 2 diabetes mellitus (T2D). METHODS: A total of 313 patients who had been treated with RPDs, including rigid retainers and major connectors, were divided into two groups: T2D and non-T2D. The periodontal parameters and radiographic bone heights of the abutment teeth were evaluated at baseline and at a 5-year examination during supportive periodontal therapy (SPT). For patients with accessible standardized radiographs, bone density was analyzed based on the gray level (GL) using digital subtraction radiography (n = 83). RESULTS: Overall, 739 abutment teeth (86 in the T2D group) of 235 patients (25 in the T2D group) were analyzed, and 95.0% (94.2% in the T2D group, and 95.2% in the non-T2D group) were maintained. The mean probing pocket depth significantly increased in both groups ( p < 0.001). There were significant changes in the radiographic bone height (p = 0.038) and GL on the side of the denture base area (p = 0.048) in the T2D group compared to those in the non-T2D group. CONCLUSIONS: Regardless of T2D, RPDs with rigid retainers and major connectors could prevent the progression of periodontal disease and successfully maintain most of the abutment teeth during 5-years of SPT. However, T2D may be significantly associated with loss of bone height reduction and density on the side of the denture base area.

11.
J Periodontol ; 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33856713

RESUMO

BACKGROUND: Porphyromonas gingivalis is a key pathogen in microbiota associated with periodontitis. The purpose of the present study was to assess the association between salivary counts of red-complex bacteria and clinical periodontal status in a Japanese population. METHODS: A total of 977 subjects who visited a general dental clinic in Japan from 2003 to 2006 were enrolled in the study. Stimulated saliva was obtained, and the amounts of major periodontal bacteria were measured using real-time polymerase chain reaction. Probing pocket depth (PPD), bleeding on probing (BOP), and each subject's average proximal bone crest level (BCL) on dental radiographs were measured. RESULTS: The number of P. gingivalis strongly associated with percentage of 4 mm or more PPD sites, BOP positive percentage, and 1.5 mm or more BCL sites. The detection of P. gingivalis with Treponema denticola and/or Tannerella forsythia showed a high rate of three positive clinical parameters, whereas the only P. gingivalis detected group and those without P. gingivalis had a low rate of three positive clinical parameters. CONCLUSION: Among red-complex bacteria, the amount of P. gingivalis showed the strongest association with the severity of periodontal condition, and co-occurrence of P. gingivalis with T. denticola and/or T. forsythia showed heightened progression of periodontitis.

12.
Artigo em Inglês | MEDLINE | ID: mdl-33879517

RESUMO

INTRODUCTION: The aim was to investigate the relationship of full-mouth inflammatory parameters of periodontal disease with diabetes and obesity. RESEARCH DESIGN AND METHODS: This cross-sectional study conducted diabetes-related examinations and calculated periodontal inflamed and epithelial surface area (PISA and PESA) of 71 Japanese patients with type 2 diabetes. Multiple linear regression analyses were performed to evaluate associations between PISA or PESA and diabetes and obesity parameters. RESULTS: Median value of body mass index (BMI), hemoglobin A1c (HbA1c) level, fasting plasma glucose (FPG) level, and visceral fat area (VFA) were 25.7 kg/m2, 9.1%, 151 mg/L, and 93.3 cm2, respectively. PISA and PESA were significantly associated with HbA1c after adjusting for age, sex, BMI, smoking status, and full-mouth plaque control level (PISA: coefficient=38.1, 95% CI 8.85 to 67.29, p=0.001; PESA: coefficient=66.89, 95% CI 21.44 to 112.34, p=0.005). PISA was also significantly associated with the highest FPG tertile (>175 mg/dL) after adjusting for confounders (coefficient=167.0, 95% CI 48.60 to 285.4, p=0.006). PISA and PESA were not significantly associated with BMI or VFA. CONCLUSION: PISA was associated with FPG and HbA1c, but not with obesity parameters, independent from confounders such as full-mouth plaque control level in patients with type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobina A Glicada/análise , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Bolsa Periodontal
13.
J Esthet Restor Dent ; 33(4): 550-559, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33565693

RESUMO

OBJECTIVE: Few effective and established treatment methods can remove gingival metal or amalgam tattoos. With this case series, we aimed to demonstrate the use of a novel minimally invasive technique to remove metal tattoos using an erbium-doped yttrium aluminum garnet (Er:YAG) laser. MATERIALS AND METHODS: We retrospectively collected clinical data from 18 patients who had undergone Er:YAG laser treatment to remove metal tattoos. Minimal gingival ablation using an Er:YAG laser directed towards the pigmented area was performed, which exposed metal debris within the connective tissue that was carefully removed. A dental microscope was employed to identify the metal debris, for accurate irradiation, and to minimize wounding by reducing invasion. Postoperative gingival color and morphology, and visual analog scale as a patient-reported outcome assessing postoperative pain were evaluated. RESULTS: All patients' metal tattoos were removed completely and safely during short procedures. Considerable esthetic improvements and favorable wound healing were achieved with almost no postoperative pain or complications. CONCLUSION: The findings from this case series suggest that this novel minimally invasive therapy for metal tattoo removal that involved the Er:YAG laser is effective and safe, is associated with successful outcomes, and contributes greatly to patients' esthetic satisfaction. CLINICAL SIGNIFICANCE: Metal tattoo removal using an Er:YAG laser safely and successfully improved gingival esthetics. This novel technique is much simpler and less invasive than conventional periodontal plastic surgery, and it may be more reliable regarding esthetic gingival improvements as it is associated with favorable wound healing, and it could offer significant benefits to patients by alleviating physical and mental stresses via reduced chair time and postoperative pain.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Tatuagem , Gengiva , Humanos , Estudos Retrospectivos
14.
Heart Vessels ; 36(6): 799-808, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33411012

RESUMO

The Clinical Frailty Scale (CFS) is a simple tool to assess patients' frailty and may help to predict adverse outcomes in elderly patients. The aim of the present study was to examine the impact of CFS on clinical outcomes and bleeding events after successful percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). We enrolled 266 consecutive patients with STEMI who underwent primary PCI in between January 2015 and June 2018. Patients were categorized into two groups based on the CFS stages: CFS 1-3 and CFS ≥ 4. We collected the data and evaluated the relationship between the CFS grade and the incidence of major adverse cardiovascular events (MACE) and Bleeding Academic Research Consortium 3 or 5 bleeding events. Of these patients, CFS ≥ 4 was present in 59 (22.2%). During the follow-up, 37.3% in the CFS ≥ 4 group and 8.2% in the CFS 1-3 group experienced MACE. In Kaplan-Meier analysis, the proportion of MACE-free survival for 4 years was significantly lower in the CFS ≥ 4 group (log-rank P < 0.001). Additionally, the proportion of bleeding event-free survival was significantly lower in the CFS ≥ 4 group (log-rank P < 0.001). The CFS (per 1-grade increase) remained an independent significant predictor of MACE on multivariate Cox proportional hazard analysis [hazard ratio 1.39 (95% confidence interval: 1.08 to 1.79, P = 0.01)]. In conclusion, CFS was an independent predictor of future adverse cardiac events in patients with STEMI. Therefore, the assessment of CFS is crucial in this population.


Assuntos
Fragilidade/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Hemorragia Pós-Operatória/epidemiologia , Sistema de Registros , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Idoso , Feminino , Seguimentos , Fragilidade/epidemiologia , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/etiologia , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Fatores de Tempo
15.
Cardiovasc Interv Ther ; 36(4): 514-522, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33128695

RESUMO

Low skeletal muscle mass is one of the components of sarcopenia. However, the prognostic impact of skeletal muscle mass on clinical outcomes in patients after transcatheter aortic valve replacement (TAVR) remains unclear. Therefore, we assessed the impact of skeletal muscle mass on future cardiovascular events in patients undergoing TAVR. We enrolled 71 consecutive patients who underwent TAVR for symptomatic severe aortic stenosis. We applied bilateral psoas muscles as an indicator of skeletal muscle mass. Psoas muscle volumes were measured from the origin of psoas at the level of the lumbar vertebrae to its insertion in the lesser trochanter on three-dimensional computed tomography datasets. Psoas muscle mass index (PMI) was calculated as psoas muscle volume/height2 (cm3/m2). According to the median value of PMIs (79.8 and 60.0 cm3/m2 for men and women), the enrolled patients were divided into two groups. During the follow-up, 11 (31.4%) patients in low PMI group and 4 (11.1%) in high PMI group experienced major adverse cardiovascular events (MACE) defined as a composite of death from any cause, myocardial infarction, heart failure hospitalization, and stroke. The proportion of MACE-free survival was significantly lower in low PMI group (log-rank P = 0.033), mainly due to the difference of hospital readmission for congestive heart failure. On multivariate Cox proportional hazard analysis, PMI remained an independent negative predictor of MACE [hazard ratio 0.95 (95% confidence interval 0.92-0.98, P = 0.002)]. In conclusion, low skeletal muscle mass independently predicted MACE in patients undergoing TAVR.

16.
Clin Exp Nephrol ; 25(1): 58-65, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32816134

RESUMO

BACKGROUND: High levels of tumor necrosis factor (TNF) receptors (TNFRs; TNFR1 and TNFR2), markers of inflammation, have been reported as significant predictors of mortality in hemodialysis patients. Porphyromonas gingivalis is a major pathogenic bacterium involved in periodontitis, which induces systemic inflammation. We investigated the association between the abundance of P. gingivalis in saliva and serum TNFR levels in hemodialysis patients. METHODS: A cross-sectional study was conducted on 121 hemodialysis patients visiting a clinic in the Tokyo metropolitan area. Medical interviews and examinations, comprehensive dental examinations, bacterial examinations for P. gingivalis in saliva, and measurements of circulating TNFR levels were conducted. Multiple linear regression analysis was performed to evaluate the association between the number of P. gingivalis and circulating TNFR levels. RESULTS: TNFR1 and TNFR2 were positively correlated with high-sensitivity C-reactive protein (hsCRP). Severe periodontitis was significantly associated with the number of P. gingivalis in saliva but not serum TNFR levels. The number of P. gingivalis was significantly associated with both TNFR1 and TNFR2 levels in sera after adjusting for age, sex, body mass index, smoking status, history of diabetes, prior cardiovascular disease events, serum levels of hsCRP and albumin, and severity of periodontitis [for TNFR1: coefficient 0.76, 95% confidence interval (CI) 0.14-1.37, p = 0.02; for TNFR2: coefficient 0.95, 95% CI 0.09-1.80, p = 0.03]. CONCLUSION: Circulating TNFR levels are associated with the number of P. gingivalis in saliva after adjusting for relevant clinical factors.


Assuntos
Falência Renal Crônica/sangue , Porphyromonas gingivalis , Receptores Tipo II do Fator de Necrose Tumoral/sangue , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Saliva/microbiologia , Idoso , Proteína C-Reativa/metabolismo , Estudos Transversais , Feminino , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Boca/microbiologia , Periodontite/sangue , Periodontite/microbiologia , Diálise Renal
17.
J Periodontol ; 92(9): 1262-1273, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33301187

RESUMO

BACKGROUND: Information regarding periodontal regenerative therapy in patients with diabetes mellitus (DM) is limited. This pilot study compared the regenerative outcomes of minimally invasive periodontal surgery using enamel matrix derivative (EMD) between DM and non-DM patients. METHODS: This prospective study included deep intrabony defects in patients with or without type 2 DM. Minimally invasive surgical technique (MIST) or modified MIST (M-MIST) using EMD, without bone graft materials, was performed. Periodontal examination and intraoral radiography were performed at baseline, 6 months, and 1 and 3 years after surgery. RESULTS: Ten sites of 10 subjects in the DM group, and 20 sites of 18 subjects in non-DM group were evaluated (mean age; 67.5 ± 7.6 and 63.1 ± 9.7, respectively). Probing depth significantly decreased from 7.1 ± 1.6 and 7.0 ± 1.3 mm to 2.2 ± 0.9 and 2.3 ± 1.1 mm at the 1-year examination in the DM and non-DM groups, respectively. Clinical attachment level (CAL) gain and radiographical defect fill at the 3-year examination were 3.8 ± 1.1 mm and 58.3% ± 10.4%, respectively, in the DM group, and 4.1 ± 1.1 mm and 65.5% ± 18.8%, respectively, in the non-DM group, showing no significant differences between the groups. Multiple regression analysis showed no significant association of CAL gain with DM or age after adjustments for relevant confounders. CONCLUSIONS: This is the first documented study of successful periodontal tissue regeneration in patients with DM. Minimally invasive surgery combined with EMD yielded significant clinical attachment gain and bone fill in the DM and non-DM groups at comparable levels.

18.
Int J Dent Hyg ; 19(1): 93-98, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33029896

RESUMO

OBJECTIVES: This study aimed to evaluate the plaque removal efficacy of a newly developed electric-powered ionic toothbrush vs. a manual toothbrush. MATERIALS AND METHODS: Manual or electric-powered ionic toothbrushes were randomly assigned to 30 healthy volunteers divided into two groups (Phase I). After 2 min of brushing, all tooth surfaces were stained with a plaque staining solution, and blinded examiners performed scoring using the Rustogi Modification of the Navy Plaque Index. Plaque removal rate was calculated at the central incisors, first premolar and first molar, as representative teeth, in the maxilla and mandibula. One week following Phase I, the same examinations were repeated in all subjects using another toothbrush (Phase II), as a crossover design. RESULTS: Electric ionic toothbrushes demonstrated a significantly higher plaque removal rate than manual toothbrushes in the premolar and molar areas (p < .05). However, in the central incisor area, no statistically significant difference was observed. CONCLUSIONS: Compared with manual toothbrushes, electric-powered ionic ones were significantly efficient in removing plaque in the premolar and molar areas.


Assuntos
Placa Dentária , Escovação Dentária , Estudos Cross-Over , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Desenho de Equipamento , Humanos , Método Simples-Cego
19.
Photobiomodul Photomed Laser Surg ; 39(2): 100-112, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33347788

RESUMO

Objective: This study evaluated the comprehensive and sequential gene expression in laser-ablated bone compared with that in nontreated control bone. Background: Bone ablation by Er:YAG laser has shown positive effects on bone healing; however, the gene expression responses that occur during bone healing remain unclear. Materials and methods: The calvarial bone of male, 10-week-old Wistar rats was ablated by Er:YAG laser. Gene expression in the laser-ablated bone and nontreated control bone was evaluated at 6, 24, and 72 h using microarray analysis. Messenger RNA (mRNA) expression levels were validated by quantitative reverse transcription-polymerase chain reaction. Results: Gene expression of BCAR1/p130Cas (breast cancer anti-estrogen resistance 1/p130 Crk-associated substrate), a mechanotransducer, was gradually increased. Additionally, upstream of the Hippo signaling pathway was enriched according to Kyoto Encyclopedia of Genes and Genomes pathway analysis at 6 h. F-actin mRNA expression was also gradually increased, whereas the Hippo signaling pathway was downregulated from 6 to 24 h. Enrichment of bone formation-related Gene Ontology (GO) terms was observed from an early stage, whereas inflammation-related GO terms, gene sets, and mRNA expression of Nfkb1, Tnf, and Il1b were gradually enriched after 24 h. Conclusions: Bone ablation by Er:YAG laser regulated the expression of Bcar1 and Actg1, the main regulators of mechanotransduction in the bone tissue. Additionally, inflammation was gradually increased up to 72 h following bone ablation with Er:YAG laser. Laser influences the expression of genes associated with bone formation immediately after irradiation. Therefore, mechanical stress and the biological effects caused by Er:YAG laser irradiation potentially contribute to wound healing in the laser-ablated bone tissue.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Animais , Expressão Gênica , Masculino , Mecanotransdução Celular , Ratos , Ratos Wistar , Cicatrização/genética
20.
J Oral Sci ; 63(1): 114-118, 2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33298640

RESUMO

Few prospective studies have reported the effects of periodontal therapy on patients who attempted to quit smoking. This study aimed to assess how smoking cessation affects periodontal therapy. Twenty-five smokers with periodontitis were investigated by dividing them into two groups, a smoking cessation support group and a continued smoking group. Those in the support group received counseling and nicotine replacement therapy, followed by periodontal treatment conducted by dentists who had completed an e-learning course on smoking cessation. Clinical parameters were measured at baseline, 3, and 6 months. Most clinical parameters improved for those in the smoking cessation support group. There were no significant improvements in bleeding on probing (BOP) or the number of severe periodontal disease sites in the continued smoking group. Probing pocket depth (PPD) and clinical attachment levels (CAL) at sites that received scaling and root planing (SRP) significantly improved in all subjects. BOP did not improve at reevaluation in the smoking relapse subgroup. Patients in the smoking cessation support program led by dental professionals showed more improvement in BOP than those in the continued smoking group.


Assuntos
Abandono do Hábito de Fumar , Raspagem Dentária , Humanos , Japão , Perda da Inserção Periodontal , Bolsa Periodontal , Estudos Prospectivos , Aplainamento Radicular , Fumar , Dispositivos para o Abandono do Uso de Tabaco , Resultado do Tratamento
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