Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis.

OBJECTIVE: The aim of this cross-sectional study was to evaluate the dental and periodontal health, as well as the microbiological and salivary conditions, of patients with and without diabetes mellitus (DM) who are receiving haemodialysis. METHODS: One-hundred and fifty-nine haemodialysis patients were included and divided into groups according to the pre-existing diabetes status: DM or no DM. The oral examination included dental findings and assessment of the periodontal situation. The periodontal condition was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were analysed using the polymerase chain reaction. The salivary diagnostics included measurement of unstimulated and stimulated salivary flow, pH and buffer capacity. Statistical analyses used Fisher's test, the t-test and the Mann-Whitney U-test (α = 5%). RESULTS: The dental findings showed no significant difference between patients with and without DM (P = 0.44). The prevalence of periodontitis was high (96% in patients with DM and 97% in patients who did not have DM) and there was no significant difference between the groups (P = 0.71). There was a higher prevalence of Porphyromonas gingivalis, Parvimonas micros, Eubacterium nucleatum and Capnocytophaga spp. in patients without DM (P < 0.05). The salivary pH was significantly higher in patients without DM (P < 0.01). CONCLUSION: While differences in the prevalence of periodontal pathogenic bacteria and in the salivary pH were detected between the groups, the dental and periodontal status was comparable between patients with and without DM. Accordingly, DM appears to have no decisive influence on the oral health in patients treated with haemodialysis who have well-controlled diabetes.

Treatment Outcome of Two Adjacent Implant-Supported Restorations with Different Implant Platform Designs in the Esthetic Region: A Five-Year Randomized Clinical Trial.

PURPOSE: The aim of this study was to evaluate the peri-implant soft and hard tissues and satisfaction in patients with two adjacent implant-supported restorations in the esthetic region, treated with two adjacent implants with a scalloped or flat platform. MATERIALS AND METHODS: The randomized clinical trial consisted of 40 patients allocated to either a scalloped implant group consisting of 20 patients or a flat implant group of 20 patients. Clinical and radiographic examinations were performed during a 5-year followup period, and patient satisfaction during the same period was assessed. RESULTS: The scalloped implant group showed significantly more marginal bone loss (scalloped: 3.2 ± 1.1 mm; flat: 1.5 ± 0.8 mm) and significantly greater bone loss at the interimplant bone crest (scalloped: 2.4 ± 1.0 mm; flat: 1.3 ± 1.0 mm). Furthermore, peri-implant soft tissues showed significantly more bleeding when provided with scalloped implants than with flat implants. Papilla index scores were low in both groups. Patient satisfaction was high in both groups. CONCLUSION: More bone loss and compromised interimplant papilla regeneration were noted around scalloped implants in the first year, and stable results were observed in the subsequent 4 years with both systems. Scalloped implants seem to offer no benefit when compared to conventional flat implants in the esthetic region.

Long-term bonded retention after closure of maxillary midline diastema.

INTRODUCTION: The objectives of this study were to evaluate fixed bonded palatal surface retainers between the maxillary central incisors that were placed to maintain midline diastema closure and record their longevity, proclivity for damage, and periodontal health of the central incisors in patients 5 or more years after treatment. METHODS: Twenty-nine subjects were contacted and interviewed by phone concerning the status of their bonded retainer and midline diastema. Eleven subjects with intact retainers came for a periodontal health evaluation of the maxillary central incisors. The measures used were the plaque index, the periodontal screening and recording score, and the gingival index. A split-mouth design was used. Statistical analyses of retainer duration, damage probability, and gingival health were performed. RESULTS: Of the 29 subjects, 52% of the initial retainers were in place for an average of 23 years. For the total of 34 bonded retainers, the mean longevity was 17 years. The risk of breakage for any particular year the retainer was in place was 2%. The mean differences in scores between the maxillary central incisors and the control teeth were -0.06 for the plaque index, -0.14 for the periodontal screening and recording score, and -0.11 for the gingival index. Statistical tests on the differences indicated no evidence that the long-term presence of the bonded palatal surface retainer adversely affected the periodontal health of the maxillary central incisors. CONCLUSIONS: The study's sample demonstrated that a bonded retainer for maintaining closure of a maxillary midline diastema can last an average of 17 years or more, with a yearly 2% chance of breakage and with no expected adverse effects on the periodontal health of the maxillary central incisors.

The Effect of Waterpipe Smoking on Periodontal Health.

PURPOSE: To determine the effect of waterpipe smoking on periodontal health. MATERIALS AND METHODS: The study included 190 participants who were categorised into four groups; cigarette smokers, waterpipe smokers, dual smokers and nonsmokers. Intraoral examination included plaque (PI), gingival (GI) and calculus (CI) indices, probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP). RESULTS: The four groups differed significantly in the prevalence and extent of periodontal disease. Pairwise comparison tests showed that the means of percentages of sites with PPD > 3 mm, PPD > 4 mm, CAL > 1 mm and bleeding on probing were significantly higher among smoking groups compared to the nonsmoking group (p < 0.05). After adjusting for age, cigarette smokers (OR = 4.6), waterpipe smokers (OR = 4.3) and dual smokers (OR = 4.9) were significantly more likely to have periodontal disease compared to nonsmokers. When data were analysed according to the smoking method, no significant differences in the odds of periodontal disease were detected between different smoking groups (p > 0.05). CONCLUSION: Waterpipe tobacco smoking is not an alternative, safe way of smoking considering periodontal disease. Thus, global actions against waterpipe smoking are required.

Accuracy of partial-mouth examination protocols for extent and severity estimates of periodontitis: a study in a Chinese population with chronic periodontitis.

BACKGROUND: Partial-mouth periodontal examination (PMPE) has been widely used in periodontal epidemiologic studies. In this study, the authors evaluate the accuracy of extent and severity estimates from PMPE protocols in a Chinese population. METHODS: The study enrolled 200 individuals with periodontitis, ages 22 to 64 years. Full-mouth examination was performed to determine probing depth (PD), attachment loss (AL), and bleeding on probing (BOP) at mesio-buccal (MB), mid-buccal (B), disto-buccal (DB), mesio-lingual (ML), mid-lingual (L), and disto-lingual (DL) sites per tooth. Extent and severity estimates from 15 PMPE protocols were derived from and compared to full-mouth data. Relative bias (RB) and intraclass correlation coefficients (ICCs) were calculated. Bland-Altman plots were used to evaluate the agreement patterns across disease levels. RESULTS: Of the 15 PMPE protocols, the random half-mouth six-sites per tooth (r6sites) protocol performed best in both extent (AL ≥ 2, ≥ 4, or ≥ 6 mm; PD ≥ 4 or ≥ 6 mm; and BOP) and severity (AL and PD) estimates, with RB within 5.0% and ICCs ≥ 0.950 in most cases. MB-B-DB and MB-B-DL protocols generally resulted in RB within 20.0% for extent and within 5.0% for severity. Protocols involving only interproximal sites (MB-DB, MB-DL, and MB-DB-ML-DL) showed good accuracy in AL (RB within 20.0% for extent and within 3.0% for severity), but overestimated PD (RB 12.5% to 54.2% for extent and >10.0% for severity). The community periodontal index teeth protocol caused severe overestimation of up to 110.4% for extent and 14.6% for severity. CONCLUSION: The r6sites protocol is best for assessing extent and severity for AL, PD, and BOP under the study conditions.

Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder.

AIM: To assess dental caries experience and periodontal treatment needs among Libyan children diagnosed with autistic spectrum disorder (ASD). MATERIALS AND METHODS: A cross-sectional, comparative case-control study was used, in which dental caries experience of 50 children with ASD was compared with that of 50 controls. The children with ASD were recruited from Benghazi Centre of Children with ASD, Libya. Controls were recruited from school children and matched for age, gender and socioeconomic status. DMFT, dmft for dental caries experience and CPITN for periodontal treatment needs were calculated according to WHO criteria by a calibrated examiner. Scores for DMFT as well as CPITN indices were compared using bivariate analysis. RESULTS: The data analysed for this study comprised observations from a group of children (cases = 50) diagnosed with ASD matched with healthy children (controls = 50). Consequently, each group consisted of 40 males and 10 females aged between 3 and 14 years (mean 7.29 ± 3.11). The ASD children showed significantly lower means for DMFT and dmft teeth as well as higher periodontal treatment needs (p > 0.05). CONCLUSION: Children with ASD were found to be more likely caries-free and have lower DMFT scores and higher unmet periodontal treatment needs than did the unaffected control children.

Follow-up study of implants with turned or oxidized surfaces placed after sinus augmentation.

PURPOSE: To compare long-term survival and clinical outcomes of endosseous implants with different surface characteristics in patients with sinus elevation procedures, autologous bone grafting, and delayed implant placement. MATERIALS AND METHODS: Implant survival, peri-implant soft tissue conditions, marginal bone level, intrasinus apical bone level, and sinus health were studied in patients subjected to autologous bone graft and delayed placement of implants with turned or oxidized surfaces. After a minimum of 5 years of functional loading, all patients were clinically examined regarding gingival pocket depth (PD) and bleeding on probing (BoP). The marginal bone level (MBL) was measured in intraoral radiographs. Cone beam computed tomography was used to evaluate the apical bone level (ABL) of the implants and intrasinus conditions. RESULTS: Twenty-eight patients received sinus elevation and a total of 92 dental implants. Thirteen patients received 47 implants with a turned surface, and 15 patients received 45 implants with an oxidized surface. Mean follow-up was 10 years (range, 5 to 19 years). No significant difference was found between the two implant surfaces in terms of PD, BoP, MBL, or ABL. Four patients (14%) exhibited radiographic signs of sinus pathology, with opacification, polyp-like structures, and thickening of the sinus membrane. Radiographic signs of sinus pathology were not correlated to implant survival or to the investigated parameters. CONCLUSION: Grafting of the maxillary sinus floor with intraorally harvested bone and delayed placement of either turned or oxidized implants results in equally high long-term survival rates, stable marginal and apical bone levels, and good peri-implant soft tissue health.

Single crowns in the resorbed posterior maxilla supported by either 6-mm implants or by 11-mm implants combined with sinus floor elevation surgery: a 1-year randomised controlled trial.

PURPOSE: The aim of this randomised controlled trial was to assess the clinical performance of single crowns in the posterior maxilla supported by either 6-mm or 11-mm implants combined with maxillary sinus floor elevation. MATERIALS AND METHODS: 41 consecutive patients with one missing premolar or molar in the posterior maxilla and with an estimated bone height of 6 to 8 mm in that area were included. Each patient was randomly allocated to one of the two treatment groups, namely to receive an 11-mm implant (Osseo Speed 4.0 S, Dentsply Implants, Mölndal, Sweden) in combination with maxillary sinus floor elevation surgery or to receive a 6-mm implant (Osseo Speed 4.0 S) without any grafting. After a 3-month osseointegration period, all implants were restored with custom-made titanium abutments and cemented zirconia-based porcelain crowns. Outcome measures were: implant survival; radiographic bone changes; plaque accumulation; bleeding tendency; peri-implant inflammation; presence of dental calculus; biological and technical complications; and patients' satisfaction. Clinical and radiographic examinations were performed at placement of the crown and 12 months thereafter. Patients' satisfaction was scored before treatment and after 12 months of functioning of the crown. RESULTS: One patient of the 11 mm implant group died during the follow-up. No implant failed and no biological or technical complications occurred. From loading to the 12 months follow-up, no difference was found in mean marginal bone changes between the groups (bone resorption in both groups 0.1 ± 0.3 mm). Clinical items revealed very healthy peri-implant soft tissues in both groups. Patients' satisfaction scores were high in both groups. CONCLUSIONS: 6-mm implants and 11-mm implants combined with sinus floor elevation surgery are equally successful to support a single crown in the resorbed posterior maxilla after 1-year follow-up.

Platform switching vs regular platform implants: nine-month post-loading results from a randomised controlled trial.

PURPOSE: To compare the clinical outcome of platform switching (PS) and regular platform (RP) implants in bilateral single molar replacements. MATERIAL AND METHODS: This study was designed as a randomised, controlled, split-mouth trial. Eighteen patients, with bilaterally missing single molars had one site randomly assigned to a PS implant or a RP implant. A total of 36 implants were bilaterally installed. Both implants were loaded with screw retained temporary crowns 3 months after implant insertion and with screw retained definitive crowns 3 months later. Outcome measures were implant/crown failure, complications, radiographic marginal bone-level changes, pocket probing depth (PPD) and bleeding on probing (BOP). Clinical data were collected at baseline 6 and 12 months after implant placement. RESULTS: No patients dropped out and no implant failed. No prosthetic or major biological complications were observed. One year after implant placement, mean marginal bone level was 0.93 ± 0.26 mm (95% CI 0.81 to 1.05) in RP group and 0.84 ± 0.23 mm (95% CI 0.73 to 0.95) in the PS group and no statistically significant differences between the two groups were observed (P = 0.18). Mean PPD and BOP values were, 6 and 12 months after implant placement, 2.74 ± 0.49 mm (95% CI 2.51 to 2.97) and 1.28 ± 0.75 (95% CI 0.93 to 1.63) in the RP group, and 2.70 ± 0.38 mm (95% CI 2.53 to 2.88) and 1.39 ± 0.78 (95% CI 1.03 to 1.75) in the PS group respectively, with no statistical differences between groups (P = 0.81 and P = 0.16, respectively). CONCLUSIONS: No statistically significant difference was observed between platform switched and non-platform switched implants.

Five-year outcome of a retrospective cohort study on the rehabilitation of completely edentulous atrophic maxillae with immediately loaded zygomatic implants placed extra-maxillary.

PURPOSE: To report retrospectively on the 5-year follow-up results of the rehabilitation of complete edentulous atrophied maxillae, using extra-maxillary zygomatic implants alone or in combination with conventional implants. MATERIALS AND METHODS: This retrospective report includes an initial cohort of 39 patients (30 women and 9 men), with a mean age of 53 years, followed for 5 years. The patients were rehabilitated with 39 fixed prostheses and 169 implants (92 zygomatic implants inserted extra-maxillary and 77 conventional dental implants). A provisional prosthesis was manufactured and attached via multiunit abutments secured to the implants on the same day as implant placement. According to patient desires and each clinical situation, either an acrylic resin, a metal-acrylic or metal-ceramic final prosthesis was inserted approximately 6 months after implant placement. Outcome measures were: prosthesis success; implant success; complications; probing pocket depths; marginal bleeding; and marginal bone levels (only for conventional implants). Data were analysed with descriptive statistics. RESULTS: Two patients died after 8 and 30 months of follow-up due to causes unrelated to their oral rehabilitations, and 5 patients dropped out of the study. No prosthesis was lost; one zygomatic implant was removed after 46 months of follow-up, giving cumulative success rates of 97% and 98.8% (patient and implant related, respectively). Twelve complications occurred in 12 patients: 5 sinus infections in 5 patients, all with a previous history of sinusitis and whose sinus membrane was disrupted during surgery; one oroantral communication (leading to removal of the implant), 2 all acrylic resin prostheses fractures, 1 ceramic crown fracture (on a metal-ceramic prosthesis); and 3 screw loosenings. Bleeding on probing was recorded in 6 patients (13 implants). Probing pocket depths >4 mm were present in 13 patients (23 implants) at 5 years of follow-up. The average (standard deviation) marginal bone loss on conventional implants was 1.16 mm (0.77 mm) in those 9 patients having the intraoral radiographs. CONCLUSIONS: The long term outcome (5 years) of rehabilitations performed on patients with completely edentulous, severely atrophic maxillae supported by immediately loaded zygomatic implants alone, or in combination with conventional implants, is satisfactory.

Implant- and patient-centred outcomes of guided surgery, a 1-year follow-up: An RCT comparing guided surgery with conventional implant placement.

AIM: To assess, in a randomized study, the implant (clinical and radiological) and patient outcomes of guided implant placement at 1-year follow-up, compared to conventional implant treatment. MATERIAL AND METHODS: A total of 314 were placed in 59 patients, randomly assigned to one of the treatment groups. Radiographic and clinical parameters were recorded at the time of implant placement, prosthesis instalment (baseline) and at 1-year follow-up. Patient satisfaction was measured with the oral health-related quality of life instrument (OHIP-49). RESULTS: No implants were lost. The mean marginal bone loss after the first year of loading was 0.04 mm (SD 0.34) for the guided surgery and 0.01 mm (SD 0.38) for the control groups. In the guided surgery groups, the mean number of surfaces with BOP and plaque at 1-year follow-up was 1.41 (SD 1.25) and 1.10 (SD 1.22), for the control groups this was, respectively, 1.37 (SD 1.25) and 1.77 (SD 1.64). The mean pocket probing depth was 2.81 mm (SD 1.1) for the guided, and 2.50 mm (SD 0.94) for the control groups. For all treatment groups, a significant improvement in quality of life was observed at 1-year follow-up (p ≤ 0.01), no differences between groups were observed. CONCLUSION: Within the limitations of this study, no difference could be found at 1-year follow-up between the implant and patient outcome variables of guided or conventional implant treatment.

Levels of HIV-1 in subgingival biofilm of HIV-infected patients.

AIM: The aims of the current study were to compare the levels of HIV-1 in the subgingival biofilm (SHVL) between detectable and undetectable plasmatic HIV-1 viral load (PHVL) in HIV-infected patients as well as to determine the association of SHVL with PHVL and clinical periodontal parameters. MATERIAL AND METHODS: Forty-one HIV-infected individuals were divided into two groups: detectable (21) and undetectable (20) PHVL. Subgingival biofilm samples were obtained for detection and quantification of HIV-1 by real-time RT-PCR. To estimate the effect of co-variables on the outcome undetectable SHVL, the Generalized Estimation Equation (GEE) was employed. RESULTS: Detectable SHVL was observed only in the detectable PHVL group and the detection of the HIV-1 was observed in 40% of these individuals. In the bivariate analysis between co-variables from the individual level and the outcome SHVL, significant difference was observed only for the CD4+ T lymphocytes levels (p = 0.017). The multiple logistic model demonstrated that only CD4+ T lymphocytes levels had a significant effect on the outcome undetectable SHVL [OR 8.85 (CI 3.6-9.2), p = 0.002]. CONCLUSION: HIV-1 can be detected and quantified in the subgingival biofilm of HIV-infected individuals, but these findings are not associated with PHVL and periodontal clinical parameters.

Periodontal findings in individuals with newly identified pre-diabetes or diabetes mellitus.

AIM: To assess the periodontal status and number of missing teeth in patients with newly identified pre-diabetes or diabetes mellitus. METHODS: A total of 1097 subjects with previously undiagnosed diabetes were available for study, and were categorized into normoglycaemic, potentially pre-diabetes or potentially diabetes groups based on a point-of-care (POC) HbA1c test. RESULTS: In fully adjusted models, significant differences were observed between all groups for the per cent of teeth with at least one site with a probing depth of ≥5 mm. For bleeding on probing, there were significant differences between diabetes and pre-diabetes (p = 0.001), and between diabetes and normoglycaemic groups (p = 0.002). For missing teeth, there were significant differences between the pre-diabetes and normoglycaemic groups (p = 0.034), and the diabetes and normoglycaemic groups (p = 0.004). CONCLUSIONS: Individuals with previously unidentified pre-diabetes demonstrate a level of periodontal destruction between that observed for normoglycaemic individuals and persons with diabetes. These data emphasize the association of oral findings to dysglycaemia, and suggest that periodontal disease and tooth loss can be early complications of diabetes mellitus.

The impact of handicap severity on oral and periodontal status of patients with mental retardation.

AIM: Mental retardation (MR) subjects comprise a considerable amount of the community and are susceptible to oral and periodontal problems due to insufficient oral care. The aim of this cross-sectional study was to determine the oral health and periodontal status of MR patients in Turkey with regard to periodontal indices and Decay missed filling teeth (DMFT) scores and compare findings according to severity of the MR. MATERIALS AND METHODS: One hundred and five MR patients were included to the study and divided into 3 groups according to MR severity diagnoses. Demographic variables like age, gender, disabled sibling, BMI, living an institution and clinical parameters like plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), missing teeth and DMFT scores were recorded from all subjects. Appropriate statistical analyses were used to compare the findings. RESULTS: There were no statistically significant differences between groups according to age, gender, disabled sibling, living status and DMFT scores. Clinical periodontal indices and the number of missing teeth were showed a statistically significant increasing trend with the severity of MR (p < 0.05). Correlation analysis showed significant positive correlations between PI and periodontal disease measures like GI, PD, CAL and BOP and also between PI and DMFT (p < 0.05). CONCLUSION: The deteriorated teeth condition and deprived periodontal health of MR patients may be most likely caused by the poor oral hygiene and may be worsen with the severity of the MR. Clinical significance: Knowledge of oral and periodontal status of mental retardation patients has great importance for public health and family education.

Saliva viscosity as a potential risk factor for oral malodor.

OBJECTIVES: The objective of this study was to assess whether saliva viscosity, measured by a viscometer, was a predictor of oral malodor. MATERIALS AND METHODS: The subjects were 617 patients who visited an oral malodor clinic. The organoleptic test (OT) was used for diagnosis of oral malodor. An oral examination assessed the numbers of teeth present and decayed teeth as well as the presence or absence of dentures. Further, periodontal pocket depths (PD), gingival bleeding, dental plaque and tongue coating were investigated. Unstimulated saliva were collected for 5 min. Saliva viscosity was measured with a viscometer. Logistic regression analysis with oral malodor status by OT as a dependent variable was performed. Possible confounders including age, gender, number of teeth present, number of decayed teeth, number of teeth with PD ≥ 4 mm, number of teeth with bleeding on probing, presence or absence of dentures, plaque index, area of tongue coating, saliva flow rate, saliva pH and saliva viscosity were used as independent variables. RESULTS: Saliva viscosity (p = 0.047) along with the number of teeth with PD ≥4 mm (p = 0.001), plaque index (p = 0.037) and area of tongue coating (p < 0.001) were significant variables for oral malodor. Subjects with a higher number of teeth with PD ≥ 4 mm (OR = 1.32), plaque index (OR = 2.13), area of tongue coating (OR = 3.17) and saliva viscosity (OR = 1.10) were more likely to have oral malodor compared to those with lower values. CONCLUSIONS: The results suggested that high saliva viscosity could be a potential risk factor for oral malodor.

Periodontitis in coronary heart disease patients: strong association between bleeding on probing and systemic biomarkers.

AIM: Few studies have examined the relationship of individual periodontal parameters with individual systemic biomarkers. This study assessed the possible association between specific clinical parameters of periodontitis and systemic biomarkers of coronary heart disease risk in coronary heart disease patients with periodontitis. MATERIALS AND METHODS: Angiographically proven coronary heart disease patients with periodontitis (n = 317), aged >30 years and without other systemic illness were examined. Periodontal clinical parameters of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) and systemic levels of high-sensitivity C-reactive protein (CRP), fibrinogen (FIB) and white blood cells (WBC) were noted and analyzed to identify associations through linear and stepwise multiple regression analyses. RESULTS: Unadjusted linear regression showed significant associations between periodontal and systemic parameters; the strongest association (r = 0.629; p < 0.001) was found between BOP and CRP levels, the periodontal and systemic inflammation marker, respectively. Stepwise regression analysis models revealed that BOP was a predictor of systemic CRP levels (p < 0.0001). BOP was the only periodontal parameter significantly associated with each systemic parameter (CRP, FIB, and WBC). CONCLUSION: In coronary heart disease patients with periodontitis, BOP is strongly associated with systemic CRP levels; this association possibly reflects the potential significance of the local periodontal inflammatory burden for systemic inflammation.

Periodontal status and serum biomarkers levels in haemodialysis patients.

AIM: To investigate the association between periodontal status and serum biomarkers levels in haemodialysis patients. METHODS: This cross-sectional study included 96 haemodialysis patients. The periodontal evaluation was realized using clinical attachment level (CAL), probing depth (PD), gingival bleeding index (GBI), visible plaque index (VPI) and gingival index (GI). Biochemical and haematological data - serum albumin, phosphorus, creatinine, transferrin, ferritin, iron, alkaline phosphatase, calcium, potassium and haemoglobin - were collected from the medical records. The subject was diagnosed with periodontitis if he/she had at least two inter-proximal sites in different teeth with CAL ≥4 mm and/or at least two inter-proximal sites in separate teeth with PD ≥5 mm. RESULTS: The study population consisted of 45 men and 51 women, with mean time under haemodialysis of 45.6 ± 33.1 months. Periodontitis was observed in 59.4% of the subjects. The periodontitis group had albumin (p = 0.021) and phosphorus (p = 0.024) serum levels lower than the no periodontitis group. Thus, there was a positive association of periodontitis with hypoalbuminaemia (OR = 9.10, p = 0.006) and a negative association with hyperphosphataemia (OR = 0.21, p = 0.010). CONCLUSIONS: These findings suggest that periodontitis is associated with albumin and phosphorus serum levels in haemodialysis patients.

Evaluation of periodontal pathogens of the mandibular third molar pericoronitis by using real time PCR.

OBJECTIVES: The aim of this study was to investigate the mandibular third molar pericoronitis flora by using real-time polymerase chain reaction (PCR). MATERIALS AND METHODS: The quantitative values of Aggregatibacter actinomycetemcomitans (Aa), Campylobacter rectus (Cr), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Tannerella forsythia (Tf) were evaluated in comparison with the healthy third molar flora by using real time PCR. RESULTS: Aa, Cr, Pg, and Pi were not statistically significant but numerically higher than the pericoronitis group. In contrast to samples from control subjects, statistically significant higher numbers of Tf were detected in samples from pericoronitis patients. The study revealed the strong relation between risk of pericoronitis and the presence of Tf. Individuals who have Tf in their samples present with an almost eight times relative risk of pericoronitis as the individuals with an absence of Tf in their samples. CONCLUSION: Tf plays an important role in the development of clinical symptoms related to pericoronitis.

Association between metabolic syndrome and periodontal disease measures in postmenopausal women: the Buffalo OsteoPerio study.

BACKGROUND: The objective of this study is to characterize the association between metabolic syndrome (MetS) and periodontitis in women, for which there is limited evidence. METHODS: Cross-sectional associations between MetS and periodontitis were examined in 657 postmenopausal women aged 50 to 79 years enrolled in a periodontal disease study ancillary to the Women's Health Initiative Observational Study. Whole-mouth measures of alveolar crest height (ACH), clinical attachment level (CAL), probing depth (PD), gingival bleeding, and supragingival plaque and measures to define MetS using National Cholesterol Education Program criteria were from a clinical examination. Study outcomes were defined as: 1) mean ACH ≥3 mm, two sites ≥5 mm, or tooth loss to periodontitis; 2) ≥2 sites with CAL ≥6 mm and ≥1 site with PD ≥5 mm; 3) gingival bleeding at ≥50% of sites; and 4) supragingival plaque at ≥50% of sites. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: In unadjusted analyses, MetS (prevalence: 25.6%) was significantly associated with supragingival plaque (OR = 1.74; 95% CI: 1.22 to 2.50) and non-significantly associated with periodontitis defined by ACH (OR = 1.23; 95% CI: 0.81 to 1.85) and gingival bleeding (OR = 1.20; 95% CI: 0.81 to 1.77). Adjustment for age, smoking, and other confounders attenuated observed associations, though supragingival plaque remained significant (OR = 1.47; 95% CI: 1.00 to 2.16; P = 0.049). MetS was not associated with periodontitis defined by CAL and PD. CONCLUSIONS: A consistent association between MetS and measures of periodontitis was not seen in this cohort of postmenopausal women. An association between MetS and supragingival plaque requires further investigation.

Vitamin D status and 5-year changes in periodontal disease measures among postmenopausal women: the Buffalo OsteoPerio Study.

BACKGROUND: Vitamin D is hypothesized to prevent periodontal disease progression through its immune-modulating properties and its role in maintaining systemic calcium concentrations. The authors investigated associations between plasma 25-hydroxyvitamin D [25(OH)D] (collected 1997 to 2000) and the 5-year change in periodontal disease measures from baseline (1997 to 2000) to follow-up (2002 to 2005) among 655 postmenopausal women in a Women's Health Initiative Observational Study ancillary study. Exploratory analyses were conducted in 628 women who also had 25(OH)D measures at follow-up. METHODS: Four continuous measures of the 5-year change in periodontal disease were assessed using alveolar crest height (ACH), clinical attachment level (CAL), probing depth (PD), and percentage of gingival sites that bled on assessment. Linear regression was used to estimate ß-coefficients, standard errors, and P values corresponding to change in periodontal disease (a 1-mm change in ACH, CAL, or PD or a 1-unit change in the percentage of gingival sites that bled) for a 10-nmol/L difference in 25(OH)D. Models were adjusted for age, education, dental visit frequency, smoking, diabetes status, current medications affecting bone health, baseline measures of periodontal disease, body mass index, and recreational physical activity. RESULTS: No statistically significant associations were observed between baseline 25(OH)D and change in periodontal disease measures, overall or in a subset (n = 442) of women with stable 25(OH)D concentrations [25(OH)D change <20 nmol/L from baseline to follow-up]. RESULTS also did not vary significantly in analyses that were stratified by baseline periodontal disease status. CONCLUSIONS: No association between baseline 25(OH)D and the subsequent 5-year change in periodontal disease measures was observed. Vitamin D status may not influence periodontal disease progression. More studies are needed to confirm these results.