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1.
J Appl Oral Sci ; 30: e20220089, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35920448

RESUMO

OBJECTIVE: This study aimed to retrospectively collect clinical data to evaluate the influence of possible risk factors on the long-term success of implant treatment with extra-narrow (2.9 mm diameter) implants in a daily dental practice setting. METHODOLOGY: Data were collected from records of patients who received at least one extra-narrow implant from 2012 to 2017, regarding implant survival, prosthesis survival, patient characteristics, and implant characteristics. The association between the dependent variables "implant survival", "prosthesis survival," and "adverse events" related to patient and implant characteristics was statistically evaluated by chi-square tests. Moreover, implant and prosthesis survival were analyzed by Kaplan-Meier survival curves. RESULTS: The sample was constituted of 58 patients (37 women and 21 men) with a mean age of 54.8 years old (SD: 12.5), followed up for up to eight years. In total, 86 extra-narrow implants were placed within this sample. Four implants were lost, resulting in an implant survival rate of 95.3%. A total of 55 prostheses were inserted and only one (1.8%) was lost, resulting in a prosthesis survival rate of 98.2%. The mean implant and prosthesis survival time was, respectively, 7.1 years and 6.3 years, according to the Kaplan-Meier survival analysis. A correlation was found between smoking and implant loss, which makes implant loss eight times more likely to occur in smokers than non-smokers. A significant association was also found between prosthesis loss and previous need of prosthesis repair. However, it was not considered clinically relevant. No association was found between the occurrence of adverse events and later implant or prosthesis loss. CONCLUSION: High implant and prosthesis survival rates were found in the long term for treatment with extra-narrow implants. Moreover, a significant correlation between smoking and implant loss was observed.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/etiologia , Implantação Dentária Endóssea/métodos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Falha de Prótese , Estudos Retrospectivos , Fatores de Risco
2.
J Appl Oral Sci ; 30: e20220010, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35830122

RESUMO

BACKGROUND: Characterizations of rat mandibular second molar extraction socket with significantly different buccal and lingual alveolar ridge width remain unclear. OBJECTIVE: To observe alterations in the alveolar ridge after extraction of mandibular second molars, and to examine processes of alveolar socket healing in an experimental model of alveolar ridge absorption and preservation. METHODOLOGY: Eighteen Wistar rats were included and divided into six groups regarding healing time in the study. Bilateral mandibular second molars were extracted. The rats with tooth extraction sockets took 0, 1.5, 2, 3, 4 and 8 weeks of healing. Histological observation, tartrate-resistant acidic phosphatase (TRAP) staining, Masson's trichrome staining, immunohistochemical staining and micro-computed tomography (micro-CT) were applied to estimate alterations in the alveolar ridge. RESULTS: Different buccal and lingual alveolar ridge width led to different height loss. Lingual wall height (LH) decreased significantly two weeks after tooth extraction. Buccal wall height rarely reduced its higher ridge width. From two to eight weeks after extraction, bone volume (BV/TV), density (BMD), and trabecular thickness (Tb.Th) progressively increased in the alveolar socket, which gradually decreased in Tb.Sp and Tb.N. LH showed no significant change during the same period. Osteogenic marker OCN and OPN increased during bone repair from two to eight weeks. The reduced height of the lingual wall of the tooth extraction socket was rarely repaired in the later repair stage. Osteoclast activity led to absorption of the alveolar ridge of the alveolar bone wall within two weeks after operation. We observed positive expression of EMMPRIN and MMP-9 in osteoclasts that participated in the absorption of the spire region. CONCLUSION: Extraction of rat mandibular second molars may help the study of alveolar ridge absorption and preservation. The EMMPRIN-MMP-9 pathway may be a candidate for further study on attenuating bone resorption after tooth extraction.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/patologia , Aumento do Rebordo Alveolar/métodos , Animais , Basigina , Metaloproteinase 9 da Matriz , Dente Molar/cirurgia , Ratos , Ratos Wistar , Extração Dentária , Alvéolo Dental , Microtomografia por Raio-X
3.
Int J Oral Maxillofac Implants ; 37(4): 685-689, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35904824

RESUMO

PURPOSE: A new tissue-level implant design with angulations of 17, 30, and 45 degrees has been introduced to allow the use of the existing bone while maintaining the restorative platform at an angle to ensure an optimal functional and esthetic result for treatment of edentulous patients. The aim of this study was to measure implant survival, bone loss, and peri-implant health of the novel tissue-level angled-head dental implant system. MATERIALS AND METHODS: A retrospective analysis of cases from three private offices that were using the new implant system was performed. Data regarding patients' demographics, number and location of implants, restoration type, bone loss, implant failure, bleeding, and pocket depths were collected and analyzed. The data collected were analyzed using mainly descriptive statistics. RESULTS: A total of 29 participants were selected, and 185 dental implants were placed. The average patient age was 61 ± 7 years, and 52% were female. Some of the patients were medically compromised; 7% were diabetic, 20% were smokers, and 7% had osteoporosis. The average time from dental implant placement to the placement of the screw-retained crowns was 6 ± 5 months. Four implants failed with an average time to failure of 18 ± 8 months. Implant survival rate was 97.8%. The average bone loss was 0.014 ± 0.082 mm at 1 year, 0.133 ± 0.306 mm at 5 years, and 0.426 ± 0.903 mm at 10 years. Overall, 18.9% of implants were associated with bleeding, and only one implant had a pocket depth greater than or equal to 5 mm. CONCLUSION: The new tissue-level implant design with angulations of 17, 30, and 45 degrees has demonstrated predictable survival and success rates with minimal bone loss. The long-term follow-up seems highly promising; however, further studies are warranted to validate the results.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Idoso , Perda do Osso Alveolar/etiologia , Implantação Dentária Endóssea/métodos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Estética Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Bucal , Estudos Retrospectivos , Resultado do Tratamento
4.
Int J Oral Maxillofac Implants ; 37(4): 778-783, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35904835

RESUMO

PURPOSE: To primarily evaluate the dimensional changes of bone and soft tissue following ridge augmentation in compromised molar regions. The secondary objective was to evaluate the histologic composition of augmented sites. MATERIALS AND METHODS: The study included 27 patients who underwent augmentation of extraction sites with grafts covered by a collagen membrane. CBCT was taken immediately after augmentation (T2) and after 8 months of healing, before implant placement (T3). The width and height of the extraction sites were recorded at extraction (T1) and reentry surgery (T4). A histomorphometric analysis was performed. Data were evaluated in terms of bone crest level, implant survival rates, and change in mucogingival junction. RESULTS: According to clinical measurement, horizontal and vertical bone gain was 10.15 ± 1.00 mm and 8.80 ± 1.86 mm, respectively. Radiographic measurement showed that the horizontal width changes were 1.46 ± 0.52 mm, 0.98 ± 1.29 mm, and 1.29 ± 0.82 mm, respectively, at 1, 3, and 5 mm apical to the crestal level. Vertical bone change was 2.34 ± 0.90 mm in the center of the socket. Histomorphometric analysis showed that percentages of mineralized bone, nonmineralized tissue, and bone substitute were 32.31% ± 13.25%, 25.36% ± 12.24%, and 42.34% ± 9.54%, respectively. The mucogingival junction shift was 0.6 ± 1.1 mm. Implant survival rates and crestal bone resorption were 100% and 0.78 ± 0.58 mm, respectively, after 1 year of loading. CONCLUSION: Ridge augmentation can be performed successfully to manage extraction sockets. Membrane coverage combined with primary wound closure could be conducive to new bone regeneration and peri-implant tissue health.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/patologia , Perda do Osso Alveolar/cirurgia , Processo Alveolar/cirurgia , Aumento do Rebordo Alveolar/métodos , Humanos , Estudos Prospectivos , Extração Dentária , Alvéolo Dental/patologia , Alvéolo Dental/cirurgia
5.
Int J Implant Dent ; 8(1): 31, 2022 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-35841488

RESUMO

PURPOSE: The collar region of an implant is its connection to the oral cavity. A balance between osseointegration on one hand and the absence of plaque accumulation on the other hand is necessary for successful implantation. It is yet to be determined which implant collar design, polished or rough, is best to stabilize the crestal bone level, avoiding peri-implantitis and subsequent risk of implant loss. The aim of this study was to investigate the influence of the architecture of the collar region on marginal bone and soft tissue response. METHODS: This prospective, randomized, clinically controlled multicenter study included 58 patients undergoing dental implant treatment using a pair of dental implants with either machined or rough-surfaced shoulder regions. Patients were clinically and radiologically examined for bone level height and signs of inflammation after 6, 12 and 24 months. RESULTS: No implant was lost within the 2 years of follow-up (100% survival rate). No significant differences on crestal bone loss (machined neck: 0.61 mm ± 0.28 mm, rough neck 0.58 mm ± 0.24 mm) and on soft tissue response (probing depth 3-6 mm with bleeding on probing 7.6% in machined-neck implants and in 8.3% in rough neck implants) were observed between implants with machined and roughened neck after 2 years. CONCLUSIONS: Machined and roughened neck implants achieved equally good results concerning peri-implant bone loss, the rate of peri-implantitis and implant survival rate/hard and soft tissue integration. None of the two collar designs showed a clear advantage in peri-implant reaction. Trial registration German Clinical Trials Register, DKRS00029033. Registered 09 May 2022-Retrospectively registered, http://www.dkrs.de.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/etiologia , Implantação Dentária Endóssea/efeitos adversos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária/efeitos adversos , Humanos , Peri-Implantite/induzido quimicamente , Estudos Prospectivos , Ombro , Propriedades de Superfície
6.
Biomolecules ; 12(7)2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35883424

RESUMO

Obesity and periodontitis are both common health concerns that have given rise to considerable economic and societal burden worldwide. There are established negative relationships between bone metabolism and obesity, obesity and diabetes mellitus (DM), and DM and periodontitis, to name a few, with osteoporosis being considered a long-term complication of obesity. In the oral cavity, bone metabolic disorders primarily display as increased risks for periodontitis and alveolar bone loss. Obesity-driven alveolar bone loss and mandibular osteoporosis have been observed in animal models without inoculation of periodontopathogens. Clinical reports have also indicated a possible association between obesity and periodontitis. This review systematically summarizes the clinical periodontium changes, including alveolar bone loss in obese individuals. Relevant laboratory-based reports focusing on biological interlinks in obesity-associated bone remodeling via processes like hyperinflammation, immune dysregulation, and microbial dysbiosis, were reviewed. We also discuss the potential mechanism underlying obesity-enhanced alveolar bone loss from both the systemic and periodontal perspectives, focusing on delineating the practical considerations for managing periodontal disease in obese patients.


Assuntos
Perda do Osso Alveolar , Diabetes Mellitus , Osteoporose , Doenças Periodontais , Periodontite , Perda do Osso Alveolar/etiologia , Animais , Obesidade/complicações , Osteoporose/etiologia , Doenças Periodontais/complicações , Periodontite/complicações
8.
J Diabetes Res ; 2022: 8260111, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35845316

RESUMO

Background: The relationship between diabetes and periodontitis is bidirectional, and there is now consensus that periodontitis and diabetes are comorbid. There is a quest for a drug that can be used to treat both conditions simultaneously. This study evaluated the anti-inflammatory and osteoprotective effects of liraglutide (LIRA) on periodontitis in diabetic rats. Methods: Male Wistar rats (n = 46) were randomly divided into four groups: control group (n = 8), LIRA group (n = 8), diabetes-associated periodontitis+0.9% saline group (diabetic periodontitis (DP)+NaCl group, n = 15), and diabetes-associated periodontitis+LIRA group (DP+LIRA group, n = 15). LIRA treatment lasted for 4 weeks (300 µg/kg/d) after establishment of a rat model of DP. The expression of IL-6, TNF-α, and IL-1ß was detected by enzyme-linked immunosorbent assay. The morphological changes of periodontal tissues were observed by hematoxylin-eosin staining. The absorption of alveolar bone and its ultrastructural changes were observed by histomorphometry and microcomputed tomography. The expression of receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) in alveolar bone was detected by immunohistochemistry. The levels of Runx2 mRNA and ALP mRNA in the gingival epithelium were examined by quantitative real-time polymerase chain reaction. Results: LIRA decreased alveolar bone resorption, improved the microstructure of alveolar bone, and reduced periodontal inflammation and damage (P < 0.05). LIRA also reduced blood glucose level and inhibited the secretion of serum IL-6, TNF-α, and IL-1ß (P < 0.05). In addition, after treatment with LIRA, the ratio of RANKL/OPG was reduced, and the expression levels of ALP mRNA and Runx2 mRNA were upregulated (P < 0.05). Conclusions: LIRA not only controls blood glucose level but also reduces inflammation and bone loss and enhances osteogenic differentiation in diabetes-associated periodontitis. Those indicate that LIRA may be used as a potential medicine for the adjunctive therapy of diabetes-periodontitis comorbidity.


Assuntos
Perda do Osso Alveolar , Diabetes Mellitus Experimental , Periodontite , Perda do Osso Alveolar/tratamento farmacológico , Animais , Glicemia , Comorbidade , Subunidade alfa 1 de Fator de Ligação ao Core , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/tratamento farmacológico , Inflamação , Interleucina-6/metabolismo , Liraglutida/farmacologia , Liraglutida/uso terapêutico , Masculino , Osteogênese , Osteoprotegerina/genética , Osteoprotegerina/uso terapêutico , Periodontite/complicações , Periodontite/tratamento farmacológico , Periodontite/genética , Ligante RANK , RNA Mensageiro , Ratos , Ratos Wistar , Fator de Necrose Tumoral alfa/metabolismo , Microtomografia por Raio-X
9.
J Appl Oral Sci ; 30: e20220076, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35830121

RESUMO

OBJECTIVE: The purpose of this study is to investigate the pathogenic role of PPARα in periodontal antigen treated gingival cells in vitro and in experimental periodontitis in vivo . METHODOLOGY: Gingival fibroblasts, gingival epithelial cells and splenocytes were isolated from C57BL/6J wild type (WT) mice and treated with fixed P. gingivalis at for 48 hours. The mRNA levels of PPARs, TNFα, IL-1ß and IL-10 were detected by Real-time quantitative PCR. Silk ligatures after being soaked in the P.gingivalis suspension were tied around both maxillary second molars of WT mice or PPARα knock-out (KO) mice for two weeks. PPARα agonist fenofibrate and vehicle control were injected into the different side of the palatal gingiva on days 3, 6, and 9. At day 14, bone resorption and gingival mRNA expression levels of PPARs, TNFα, IL-1ß and IL-10 were measured by micro-computed tomography and RT-qPCR respectively. RESULTS: P. gingivalis treatment downregulated the expression of PPARα, but not PPARß or PPARγ, and increased the expression of TNF-α and IL-1ß in Gingival fibroblasts, gingival epithelial cells and splenocytes from WT mice. Gingival mRNA levels of PPARα were significantly decreased in experimental periodontitis in WT mice. The bone loss of PPARα KO mice in experimental periodontitis was significantly higher than WT mice and was not reduced by fenofibrate treatment. Gingival TNFα protein expressions were significantly increased by P. gingivalis associated ligation and decreased by fenofibrate treatment in WT mice but not in PPARα KO mice. CONCLUSION: This study suggests that PPARα plays an essential role in periodontitis.


Assuntos
Perda do Osso Alveolar , Fenofibrato , PPAR alfa , Periodontite , Perda do Osso Alveolar/patologia , Animais , Fenofibrato/farmacologia , Gengiva/patologia , Interleucina-10/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , PPAR alfa/metabolismo , Periodontite/metabolismo , Periodontite/patologia , Porphyromonas gingivalis/metabolismo , RNA Mensageiro/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Microtomografia por Raio-X
10.
Artigo em Inglês | MEDLINE | ID: mdl-35830312

RESUMO

This study evaluated the radiographic alterations that occur in immediate postextraction implants and in delayed implants inserted in a preserved ridge. In group A, an implant was placed immediately after tooth extraction, grafting the bone-to-implant gap. In group B, alveolar ridge preservation was performed after tooth extraction, and delayed implant placement was performed 4 months later. The final follow-up was 1 year after prosthetic loading in both groups. The marginal bone level (MBL) was measured at implant insertion (T1), at loading (T2), and at the final follow-up, 12 months after prosthetic loading (T3). At tooth extraction (T0) and T3, the horizontal ridge width (HW) was measured on CBCT scans at three different levels. No statistically significant differences in MBL or HW were found between the two study groups. The outcomes suggest that it is possible to maintain MBL and alveolar bone volumes regardless of whether the procedure is performed through immediate postextraction implant placement or through delayed implant placement in a preserved ridge.


Assuntos
Perda do Osso Alveolar , Implantes Dentários para Um Único Dente , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Implantação Dentária Endóssea/métodos , Humanos , Extração Dentária/métodos , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia , Resultado do Tratamento
11.
Artigo em Inglês | MEDLINE | ID: mdl-35830316

RESUMO

The Modified Minimally Invasive Surgical Technique (M-MIST) was designed to improve wound stability and reduce patient morbidity. This case series aimed to evaluate clinical outcomes of periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 with M-MIST for the treatment of intrabony defects. Following initial periodontal therapy, nine intrabony defects in seven patients received rhFGF-2 therapy. Using M-MIST, a buccal incision was made to gain access to the defect without interdental and lingual incisions. After debridement, rhFGF-2 was applied to the defect. Periodontal parameters were evaluated at baseline and at 3, 6, and 12 months postoperatively. Composite Outcome Measure (COM) and patient-reported outcome measure (PROM, recorded using an oral health-related quality of life [QoL] instrument) were also used for evaluation. At 12 months postoperative, mean probing depth reduction was 4.2 ± 0.8 mm and clinical attachment gain was 4.7 ± 0.7 mm. The mean value for gingival recession was -0.3 ± 0.5 mm. According to COM, the outcomes of the treated sites were successful. An improvement in oral health-related QoL was noted at 12 months compared to after the initial periodontal therapy. This case series shows that rhFGF-2 therapy with M-MIST yields favorable clinical outcomes in the treatment of intrabony defects.


Assuntos
Perda do Osso Alveolar , Retração Gengival , Perda do Osso Alveolar/cirurgia , Seguimentos , Retração Gengival/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Humanos , Perda da Inserção Periodontal/cirurgia , Qualidade de Vida , Resultado do Tratamento
12.
Artigo em Inglês | MEDLINE | ID: mdl-35830320

RESUMO

This study clinically and histologically evaluated the performance of implants with different crestal morphologies: tissue-level implants and bone-level implants. Nine patients received at least two adjacent implants in an edentulous area: one bone-level implant (EO) and one tissue-level implant (TG) (total: 23 implants), placed beside each other using a single-stage delayed loading protocol. The implants were rehabilitated with screw-retained fixed partial dentures. Plaque Index (PI), bleeding on probing (BOP), probing depth (PD), and peri-implant bone level were recorded at various postsurgical follow-ups, including 2 and 6 months as well as 1 and 4 years. At 3 months postsurgery, soft tissue biopsy samples were taken from all implant sites and histologically analyzed. Longitudinal assessment of the results (TG vs EO implants) was performed using a linear mixed model with random intercept and by using Spearman correlation or chi-square after visual inspection of the probability distribution. Student t test was used to compare means, and chi-square test was used for dichotomic variables. P < .05 was considered statistically significant. All implants were functional at 4 years. Peri-implant bone resorption was limited, with means of 1.20 ± 0.71 mm and 1.24 ± 0.82 mm for TG and EO implants, respectively. No significant differences in clinical parameters were identified between EO and TG implants. Histologic analysis revealed normal peri-implant soft tissue healing with poor inflammatory infiltrate. Differences in the histologic appearance of soft tissues were more related to patients than implant type. Both implants appeared to be suitable for partial rehabilitation of edentulous arches without differences in the investigated clinical and histologic parameters. However, TG implants showed a greater risk of implant collar exposure.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Boca Edêntula , Índice de Placa Dentária , Seguimentos , Humanos , Projetos Piloto
13.
Artigo em Inglês | MEDLINE | ID: mdl-35805792

RESUMO

BACKGROUND: to evaluate the association between type 2 diabetes and periodontal disease severity using the rate of alveolar bone loss (ABL) and high-sensitivity C-reactive protein (hs-CRP) value as indices. METHODS: In this cross-sectional study of 372 patients (mean age ± SD, 53.2 ± 11.8 years) from a Japanese hospital, we measured ABL and number of teeth on either panoramic radiographs or intraoral dental radiographs of all teeth. Periodontal disease severity was classified into nine groups by combining ABL and hs-CRP. RESULTS: 48 subjects had type 2 diabetes; 324 did not. Univariate analysis showed that type 2 diabetes was significantly associated with age, sex, body mass index, number of teeth, ABL, hs-CRP, and periodontal disease severity. Multivariate analysis showed significant associations between type 2 diabetes and the groups with high severity of periodontal disease. In receiver operating characteristic (ROC) curve analysis, predicting the presence of diabetes, area under the ROC curve was 0.762 (95%CI = 0.688-0.835) for ABL, and 0.709 (95%CI = 0.635-0.784) for hs-CRP, which was significant. CONCLUSIONS: this study showed that diabetes can be associated with a periodontal disease severity classification using the combination of ABL and hs-CRP.


Assuntos
Perda do Osso Alveolar , Diabetes Mellitus Tipo 2 , Doenças Periodontais , Adulto , Idoso , Proteína C-Reativa/análise , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/epidemiologia
14.
Int J Mol Sci ; 23(13)2022 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-35806105

RESUMO

This study aimed to evaluate the effects of hesperidin (HE) on in vitro osteoclastogenesis and dietary supplementation on mouse periodontal disease and femoral bone phenotype. RAW 264.7 cells were stimulated with RANKL in the presence or absence of HE (1, 100 or 500 µM) for 5 days, and evaluated by TRAP, TUNEL and Western Blot (WB) analyses. In vivo, C57BL/6 mice were given HE via oral gavage (125, 250 and 500 mg/kg) for 4 weeks. A sterile silk ligature was placed between the first and second right maxillary molars for 10 days and microcomputed tomography (µCT), histopathological and immunohistochemical evaluation were performed. Femoral bones subjected or not to dietary HE (500 mg/kg) for 6 and 12 weeks were evaluated using µCT. In vitro, HE 500 µM reduced formation of RANKL-stimulated TRAP-positive(+) multinucleated cells (500 µM) as well as c-Fos and NFATc1 protein expression (p < 0.05), markers of osteoclasts. In vivo, dietary HE 500 mg/kg increased the alveolar bone resorption in ligated teeth (p < 0.05) and resulted in a significant increase in TRAP+ cells (p < 0.05). Gingival inflammatory infiltrate was greater in the HE 500 mg/kg group even in the absence of ligature. In femurs, HE 500 mg/kg protected trabecular and cortical bone mass at 6 weeks of treatment. In conclusion, HE impaired in vitro osteoclastogenesis, but on the contrary, oral administration of a high concentration of dietary HE increased osteoclast numbers and promoted inflammation-induced alveolar bone loss. However, HE at 500 mg/kg can promote a bone-sparing effect on skeletal bone under physiological conditions.


Assuntos
Perda do Osso Alveolar , Reabsorção Óssea , Hesperidina , Perda do Osso Alveolar/patologia , Animais , Reabsorção Óssea/metabolismo , Diferenciação Celular , Hesperidina/farmacologia , Homeostase , Camundongos , Camundongos Endogâmicos C57BL , Fatores de Transcrição NFATC/metabolismo , Osteoclastos/metabolismo , Osteogênese , Ligante RANK/metabolismo , Microtomografia por Raio-X
15.
Dent Med Probl ; 59(2): 309-318, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35791819

RESUMO

The aim of this literature review was to present minimally invasive surgical techniques (MISTs) for the regeneration of intrabony defects and the impact of these surgical procedures on clinical outcomes. Less invasive surgical procedures lead to a more uneventful postoperative healing and reduce patient morbidity. The introduction of these techniques together with the use of magnification tools enables gentle tissue manipulation with performing minimal incisions and flap elevations in the field of surgical treatment of intrabony defects. Minimally invasive surgical techniques induce minor surgical trauma and improve the wound stability with favorable results in terms of clinical outcomes and the patient's comfort. The defect anatomy, patient-centered factors and the various biomaterials applied are considered. Recent evidence concludes that the adjunctive use of regenerative materials seems to have a less determinant effect on the clinical performance of minimally invasive surgical techniques. In addition, more studies are required to investigate the clinical efficacy of these surgical techniques in the treatment of intrabony defects in comparison with the conventional papilla preservation flap techniques.


Assuntos
Perda do Osso Alveolar , Regeneração Tecidual Guiada Periodontal , Perda do Osso Alveolar/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Retalhos Cirúrgicos/cirurgia , Resultado do Tratamento
16.
J Contemp Dent Pract ; 23(1): 100-104, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35656666

RESUMO

Edentulousness affects the mental health of most patients. Missing teeth in the anterior esthetic zones is a matter of concern, especially for young adults. Various replacement options such as fixed partial dentures, removable partial dentures, and dental implants are available to treat edentulousness. Dental implants have been a booming treatment option in modern-day dentistry as they more closely mimic the natural tooth. The most important criterion for placement of the implant in the esthetic zone is the conservation of alveolar bone, especially in the anterior region which is usually compromised due to tooth extraction or resorption of the ridge. The root membrane concept or the socket shield technique is a recently introduced concept in implant dentistry where a portion of the root acts as a shield to protect against alveolar bone resorption and maintain bone integrity, especially in the esthetic area. This case report describes the clinical management of fractured upper anterior teeth using a dental implant and the root membrane technique. Keywords: Anterior zone, Esthetics, Immediate implants, Implant, Missing teeth, Root membrane technique, Socket shield.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Boca Edêntula , Fraturas dos Dentes , Estética Dentária , Humanos , Carga Imediata em Implante Dentário/métodos , Fraturas dos Dentes/terapia , Alvéolo Dental , Adulto Jovem
17.
Oral Health Prev Dent ; 20(1): 233-242, 2022 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-35695693

RESUMO

PURPOSE: The aim of the present systematic review with meta-analysis was to investigate the clinical effectiveness of EMD (enamel matrix derivative) using a minimally invasive surgical technique (MIST) or flapless approach for the treatment of severe periodontal probing depths. MATERIALS AND METHODS: A systematic review of the literature including searches in PubMed/Medline, Cochrane Library, Google Scholar, and Grey Literature databases as well as manual searches was performed on September 1st, 2021. Studies utilising EMD in a non-surgical or minimally invasive approach were included. The eligibility criteria comprised randomised controlled trials (RCTs) comparing minimally-invasive/flapless approaches with/without EMD for the treatment of probing depths >5 mm. RESULTS: From 1525 initial articles, 7 RCTs were included and 12 case series discussed. Three studies investigated a MIST approach, whereas 3 studies utilised a flapless approach. One study compared EMD with either a MIST or a flapless approach. The RCTs included ranged from 19-49 patients with at least 6 months of follow-up. While 5 of the studies included smokers, patients smoking >20 cigarettes/day were excluded from the study. The meta-analysis revealed that EMD with MIST improved recession coverage (REC) and bone fill (BF) when compared to MIST without EMD. However, no difference in CAL or PD was observed between MIST + EMD vs MIST without EMD. No statistically significant advantage was found for employing the EMD via the flapless approach. CONCLUSIONS: Implementing EMD in MIST procedures displayed statistically significant improvement in REC and BF when compared to MIST alone. These findings suggest that MIST in combination with EMD led to improved clinical outcomes while EMD employed in nonsurgical flapless therapy yielded no clinical benefits when compared to nonsurgical therapy alone without EMD. More research is needed to substantiate these findings.


Assuntos
Perda do Osso Alveolar , Proteínas do Esmalte Dentário , Retração Gengival , Perda do Osso Alveolar/terapia , Transplante Ósseo/métodos , Proteínas do Esmalte Dentário/uso terapêutico , Seguimentos , Retração Gengival/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Humanos , Perda da Inserção Periodontal , Resultado do Tratamento
18.
J Evid Based Dent Pract ; 22(2): 101713, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35718427

RESUMO

OBJECTIVE: To systematically evaluate the application of stem cells in tissue engineering for regeneration of periodontal defects and to provide a basis for clinical application. METHODS: PubMed, The Cochrane Library, EMbase, SinoMed, CNKI and Wanfang database were searched for randomized controlled trial (RCT) studies on periodontal defect regeneration using bone marrow mesenchymal stem cells, adipose tissue-derived stem cells, periodontal ligament stem cells (PDLSCs), dental pulp stem cells (DPSCs), gingival mesenchymal stem cells, stem cells from apical papilla and other odontogenic stem cells. Chinese and English literature as of May 9, 2021 (without limitation on retrieve starting date) were searched, and included RCT studies were followed for at least 3 months. Two reviewers independently screened the literature, extracted basic research information, the situation of the research object and outcome measures including probing depth (PD), clinical attachment level (CAL), bone defect depth (BDD) and gingival recession (GR). Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0) was used to evaluate bias risk in included studies and Meta-analysis was performed using RevMan 5.4 software. RESULTS: A total of 182 teeth were included in 7 RCT studies. The experimental group was treated with stem cell tissue engineering technology (87 cases), and the control group was treated with conventional periodontal regeneration therapy without stem cell (95 cases). In the meta-analysis, a significant difference between experimental and control groups was found for PD [mean difference (MD) = -0.66, 95% CI (-1.11, -0.22), P = .004], CAL [MD = -1.11, 95% CI (-1.45, -0.77), P < .00001], BDD [MD = -0.99, 95% CI (-1.42, -0.57), P < .00001] and GR [MD = -0.35, 95% CI (-0.62, -0.07), P = .01]. By observing the 4 outcome indicators of periodontal tissue regeneration, the improvement of CAL was the best, while the improvement of GR was poor. In the subgroup analysis of follow-up time, PD improved best at 6 months compared with other follow-up times [MD = -1.07, 95% CI (-1.58, -0.55), P < .0001]. However, in the subgroup analysis of CAL, BDD and GR, there was no statistical significance among follow-up time. CONCLUSIONS: Compared with conventional periodontal regeneration therapy, the application of stem cells in tissue engineering exhibits a significant advantage in promoting periodontal defect regeneration and allows for complete periodontal regeneration possibly. Due to limitations related to the number and quality of the included studies, additional large-sample and high-quality clinical studies are needed to support future meta-analyses.


Assuntos
Perda do Osso Alveolar , Retração Gengival , Perda do Osso Alveolar/cirurgia , Regeneração Tecidual Guiada Periodontal , Humanos , Perda da Inserção Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto , Células-Tronco , Engenharia Tecidual , Resultado do Tratamento
19.
Cell Physiol Biochem ; 56(3): 270-281, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35712829

RESUMO

BACKGROUND/AIMS: Interleukin 33 (IL-33) plays a significant role in immunity but its role in bone physiology and periodontitis needs to be further investigated. The aim of this study was to decipher the contribution of IL-33 to bone homeostasis under physiological conditions, and to alveolar bone loss associated with experimental periodontitis (EP) in IL-33 knockout (KO) mice and their wildtype (WT) littermates. METHODS: The bone phenotype of IL-33 KO mice was studied in the maxilla, femur, and fifth lumbar vertebra by micro-computed tomography (micro-CT). EP was induced by a ligature soaked with the periopathogen Porphyromonas gingivalis (Pg) around a maxillary molar. Alveolar bone loss was quantified by micro-CT. The resorption parameters were assessed via toluidine blue staining on maxillary sections. In vitro osteoclastic differentiation assays using bone marrow cells were performed with or without lipopolysaccharide from Pg (LPS-Pg). RESULTS: First, we showed that under physiological conditions, IL-33 deficiency increased the trabecular bone volume/total volume ratio (BV/TV) of the maxillary bone in male and female mice, but not in the femur and fifth lumbar vertebra, suggesting an osteoprotective role for IL-33 in a site-dependent manner. The severity of EP induced by Pg-soaked ligature was increased in IL-33 KO mice but in female mice only, through an increase in the number of osteoclasts. Moreover, osteoclastic differentiation from bone marrow osteoclast progenitors in IL-33-deficient female mice is enhanced in the presence of LPS-Pg. CONCLUSION: Taken together, our data demonstrate that IL-33 plays a sex-dependent osteoprotective role both under physiological conditions and in EP with Pg.


Assuntos
Perda do Osso Alveolar , Interleucina-33 , Periodontite , Perda do Osso Alveolar/microbiologia , Animais , Feminino , Interleucina-33/deficiência , Interleucina-33/genética , Lipopolissacarídeos , Masculino , Camundongos , Camundongos Knockout , Osteoclastos , Periodontite/microbiologia , Porphyromonas gingivalis/patogenicidade , Microtomografia por Raio-X
20.
Int J Oral Maxillofac Implants ; 37(3): 455-463, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35727235

RESUMO

PURPOSE: To assess the cumulative failure rate of 4,842 implants comprising six commercial implant brands in a university setting, and to evaluate the influence of different risk factors on the implant failure rate. MATERIALS AND METHODS: A retrospective chart review was conducted in patients receiving dental implants at the School of Dentistry of the International University of Catalonia (Barcelona, Spain) from 2011 to 2018. The inclusion criterion was patients presenting at least one failed implant. RESULTS: The cohort study included 1,510 patients who received a total of 4,842 implants. The cumulative failure rate was 4.9% and 10.8% at the implant and patient levels, respectively. The multiple regression analysis showed that for the same number of implants per patient, variables such as age and sex were not associated with higher implant failure rates. Furthermore, in considering the combination of arch-sector, a statistically significant reduction in failure rate was observed in the posterior maxilla (OR = 0.66, P = .038) and in the posterior mandible (OR = 0.64, P = .037). The results showed all implant brands offering high implant survival rates (> 91%). Nobel Biocare and Straumann implants significantly reduced the risk of implant failure (OR = 0.37, P = .021 and OR = 0.53, P = .024, respectively), while no significant differences were recorded among Klockner (2.8%), MIS (5.4%), Biomet 3i (7.1%), and Astra Tech (8.4%; P ≥ .05). No association was found between implant loss and bone augmentation, time of implant placement, smoking, and history of periodontal disease. CONCLUSION: The implant failure rates obtained in a university setting resulted in overall cumulative rates of 4.9% and 10.8% at the implant and patient levels, respectively, over a 7-year period. Male sex and implants placed in the anterior mandible may be associated with a higher risk of implant failure. Nobel Biocare and Straumann implants seem to positively affect implant survival rate.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Estudos de Coortes , Implantação Dentária Endóssea/efeitos adversos , Implantação Dentária Endóssea/métodos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Universidades
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