Long-term stability of gingival margin and periodontal soft-tissue phenotype achieved after mucogingival therapy: A systematic review.

BACKGROUND: The aim of this systematic review was two-fold: (i) to evaluate the long-term (≥5 years) stability of the gingival margin position, keratinized tissue width (KTW) and gingival thickness (GT) in sites that underwent root coverage (RC) or gingival augmentation (GA); and (ii) to assess the influence of different local variables on the long-term stability of dental and gingival tissues. MATERIALS AND METHODS: Randomized controlled trials (RCTs) and non-RCTs reporting short-term (i.e., 6-12 months after baseline surgical intervention) and long-term (≥5 years) follow-up data after surgical treatment of adult patients presenting single or multiple mucogingival deformities, defined as sites presenting gingival recession defects (GRDs) and/or (KTW) deficiency (i.e., <2 mm), were considered eligible for inclusion. MEDLINE-PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases were searched for articles published up to 15 May 2023. Mixed-effects multiple linear regression was used to assess the association between KTW, type of surgical procedure and time (i.e., independent variables) on the stability of the gingival margin in sites that received RC or GA therapy. RESULTS: Of the 2569 potentially eligible records, 41 (reporting 40 studies) met the eligibility criteria. Graphical estimates including data from all RC procedures found an upward trend in recession depth (RD) increase over time. Conversely, it was observed that in 63.63% of RC studies and in 59.32% of RC treatment arms KTW increased over time, particularly in sites treated with subepithelial connective tissue grafts (SCTGs). Conversely, sites that underwent GA procedures generally exhibited an overall reduction of KTW over time. However, sites treated with free gingival grafts (FGGs) showed a decrease in RD after 10 years of follow-up. Three main findings derived from the pooled estimates were identified: (i) Gingival margin stability was associated with the amount of KTW present during short-term assessment (i.e. the greater the KTW at 6-12 months after treatment, the more stable the gingival margin). (ii) The use of autogenous soft-tissue grafts was associated with lower RD increase over time. (iii) Treatment approaches that contribute to the three-dimensional enhancement of the gingival phenotype, as clearly demonstrated by FGG, were associated with gingival margin stability. CONCLUSIONS: The extent of apical migration of the gingival margin appears to be directly related to the amount of KTW and GT upon tissue maturation. Interventions involving the use of autogenous grafts, either SCTG or FGG, are associated with greater short-term KTW gain and lower RD increase over time.

Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies.

AIM: The aim of the study was to evaluate the prevalence of periodontitis in dentate people between 2011 and 2020. MATERIALS AND METHODS: PUBMED, Web of Science, and LILACS were searched up to and including December 2021. Epidemiological studies reporting the prevalence of periodontitis conducted between 2011 and 2020 were eligible for inclusion in this review. Studies were grouped according to the case definition of confidence as confident (Centers for Disease Control [CDC] AAP 2012; CDC/AAP 2007; and Armitage 1999) and non-confident (community periodontal index of 3 or 4, periodontal pocket depth >4 mm, and clinical attachment level ≥1 mm). Random effects meta-analyses with double arcsine transformation were conducted. Sensitivity subgroup and meta-regression analyses explored the effect of confounding variables on the overall estimates. RESULTS: A total 55 studies were included. The results showed a significant difference, with confident case definitions (61.6%) reporting nearly twice the prevalence as non-confident classifications (38.5%). Estimates using confident periodontal case definitions showed a pooled prevalence of periodontitis of 61.6%, comprising 17 different countries. Estimates reporting using the CDC/AAP 2012 case definition presented the highest estimate (68.1%) and the CDC/AAP 2007 presented the lowest (48.8%). Age was a relevant confounding variable, as older participants (≥65 years) had the highest pooled estimate (79.3%). CONCLUSION: Between 2011 and 2020, periodontitis in dentate adults was estimated to be around 62% and severe periodontitis 23.6%. These results show an unusually high prevalence of periodontitis compared to the previous estimates from 1990 to 2010.

Influence of low insertion torque values on survival rate of immediately loaded dental implants: A systematic review and meta-analysis.

AIM: The aim was to systematically evaluate the effect of low insertion torque values on the survival rate of immediately loaded dental implants. MATERIALS AND METHODS: The protocol was registered with PROSPERO (ID CRD42020189499). An electronic search was performed in PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until June 2022 in English and Spanish. Studies analysing the failure or survival rate of immediately loaded dental implants according to different insertion torque values were included. RESULTS: Five-hundred seventy-three articles were assessed for eligibility, of which seven articles, four randomized clinical trials (RCTs), one controlled clinical trial, and two prospective case series studies were included in the qualitative analysis. The RCTs were classified as having low risk of bias and the non-RCTs as having moderate and serious risk of bias. The mean survival rate for implants with low insertion toque (≤35 Ncm) was 96% (p > .001, 95% confidence interval [CI]: 0.91-0.98) and that for implants with medium or high insertion torque (>35 Ncm) was 92% (p > .001, 95% CI: 0.86-0.96) (incidence rate ratio [IRR] = 1.05, 95% CI: 0.79-1.39, p = .175, I2  = 0.0%). Splinted implants with insertion torque >20 Ncm and single implants with insertion torque >35 Ncm had a higher survival rate than implants with lower insertion torque values (IRR = 1.05, 95% CI: 0.78-1.43, p = .956, I2  = 0.0%, and RR = 0.92, 95% CI: 0.48-1.75, p = .799, I2  = 0.0%, respectively). Different insertion torque values achieved equivalent outcomes. The mean follow-up was 24 months. CONCLUSIONS: Low insertion torque values have no significant effect on survival rates of immediate loading implants at a mean follow-up of 24 months.

Treatment of periodontitis and C-reactive protein: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation. PURPOSE: To comprehensively appraise all the evidence on the effects of the treatment of periodontitis on systemic inflammation assessed by serum C-reactive protein (CRP) levels. DATA SOURCES: Six electronic databases were searched up to 10 February 2022 to identify and select articles in English language only. STUDY SELECTION: Twenty-six randomized controlled clinical trials reporting changes amongst 2579 participants about CRP levels at 6 months or more after treatment. DATA EXTRACTION: Two reviewers independently extracted data and rated the quality of studies. Meta-analyses were performed using random and fixed effect models. RISK OF BIAS: Risk of bias (RoB 2.0 tool) and quality of evidence (GRADEpro GDT tool) analyses were completed. DATA SYNTHESIS: Treatment of periodontitis reduced CRP levels by 0.69 mg/L (95% confidence interval: -0.97 to -0.40) after 6 months, but limited evidence was retrieved from studies with longer follow-ups. Similar findings were observed in participants with other co-morbidities in addition to periodontitis. Greatest reductions were observed in participants with concentrations of CRP >3 mg/L at baseline. LIMITATIONS: High level of heterogeneity. CONCLUSIONS: Treatment of periodontitis reduces serum CRP levels (up to 6 months follow-up) to a degree equivalent to that observed after traditional lifestyle or drug interventions. This evidence supports a causal association between periodontitis and systemic inflammation.

Association of periodontitis with cognitive decline and its progression: Contribution of blood-based biomarkers of Alzheimer's disease to this relationship.

AIM: To assess whether periodontitis is associated with cognitive decline and its progression as well as with certain blood-based markers of Alzheimer's disease. MATERIALS AND METHODS: Data from a 2-year follow-up prospective cohort study (n = 101) was analysed. Participants with a previous history of hypertension and aged ≥60 years were included in the analysis. All of them received a full-mouth periodontal examination and cognitive function assessments (Addenbrooke's Cognitive Examination (ACE) and Mini-Mental State Examination [MMSE]). Plasma levels of amyloid beta (Aß)1-40 , Aß1-42 , phosphorylated and total Tau (p-Tau and t-Tau) were determined at baseline, 12 and 24 months. RESULTS: Periodontitis was associated with poor cognitive performance (MMSE: ß = -1.5 [0.6]) and progression of cognitive impairment (hazard ratio [HR] = 1.8; 95% confidence interval: 1.0-3.1). Subjects with periodontitis showed greater baseline levels of p-Tau (1.6 [0.7] vs. 1.2 [0.2] pg/mL, p < .001) and Aß1-40 (242.1 [77.3] vs. 208.2 [73.8] pg/mL, p = .036) compared with those without periodontitis. Concentrations of the latter protein also increased over time only in the periodontitis group (p = .005). CONCLUSIONS: Periodontitis is associated with cognitive decline and its progression in elderly patients with a previous history of hypertension. Overexpression of p-Tau and Aß1-40 may play a role in this association.

Epidemiology of peer cybervictimization and its relationship with health-related quality of life in adolescents: A prospective study.

INTRODUCTION: Research focused on the association between peer cybervictimization and declining health-related quality of life (HRQoL) is scarce. Currently, few longitudinal studies find an association between these phenomena, and none focus on cybervictimization profiles. The main objectives are: (1) to analyze the point and period prevalence, and incidence of cybervictimization profiles (uninvolved, new, ceased, intermittent, and stable cybervictims); (2) to study the relationship between cybervictimization and HRQoL over time; (3) to determine the longitudinal impact on the HRQoL of each type of profile. METHODS: A prospective study was conducted in three waves over 13 months. A total of 1142 adolescents aged 11-18 years participated in all the waves (630 girls, 55.2%). RESULTS: The prevalence of victimization for the three waves was 21.6% (Wave 1; W1), 23.5% (W2), and 19.6% (W3), respectively. The period prevalence was 41.3%, and the accumulated incidence was 25.1%. It was found that 24% of the participants were new victims, 5.9% were intermittent victims, and 6% were stable victims. Being a cybervictim at W1 poses a relative risk of 1.73 [1.29-2.32], that is, a twofold increased risk of presenting a low HRQoL 13 months later compared to those who are not cybervictims. CONCLUSION: One in four adolescents became a new cybervictim during the 13 months of the study. The adolescents who presented poorer HRQoL were the stable cybervictims.

Revisiting Alpha-Synuclein Pathways to Inflammation.

Alpha-synuclein (α-Syn) is a short presynaptic protein with an active role on synaptic vesicle traffic and the neurotransmitter release and reuptake cycle. The α-Syn pathology intertwines with the formation of Lewy Bodies (multiprotein intraneuronal aggregations), which, combined with inflammatory events, define various α-synucleinopathies, such as Parkinson's Disease (PD). In this review, we summarize the current knowledge on α-Syn mechanistic pathways to inflammation, as well as the eventual role of microbial dysbiosis on α-Syn. Furthermore, we explore the possible influence of inflammatory mitigation on α-Syn. In conclusion, and given the rising burden of neurodegenerative disorders, it is pressing to clarify the pathophysiological processes underlying α-synucleinopathies, in order to consider the mitigation of existing low-grade chronic inflammatory states as a potential pathway toward the management and prevention of such conditions, with the aim of starting to search for concrete clinical recommendations in this particular population.

Non-Surgical Periodontal Treatment Impact on Subgingival Microbiome and Intra-Oral Halitosis.

The purpose of this study was to characterize and compare subgingival microbiome before and after periodontal treatment to learn if any changes of the subgingival microbiome were reflected in intra-oral halitosis. We tested the hypothesis that intra-oral halitosis (Volatile sulfur compounds levels) correlates with corresponding subgingival bacterial levels before and after periodontal treatment. Twenty patients with generalized periodontitis completed the study. Subgingival plaque samples were collected at baseline and 6-8 weeks after nonsurgical periodontal therapy. Full-mouth periodontal status assessed probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), bleeding on probing (BoP), PISA and PESA. Halitosis assessment was made using a volatile sulfur compounds (VSC) detector device. Periodontal measures were regressed across VSC values using adjusted multivariate linear analysis. The subgingival microbiome was characterized by sequencing on an Illumina platform. From a sample of 20 patients referred to periodontal treatment, 70% were females (n = 14), with a mean age of 56.6 (±10.3) years; full-mouth records of PD, CAL, BOP (%) allowed to classify the stage and grade of periodontitis, with 45% (n = 9) of the sample having Periodontitis Stage IV grade C and 95% (n = 19) had generalized periodontitis. The correlation of bacterial variation with VSCs measured in the periodontal diagnosis and in the reassessment after treatment were evaluated. Fusobacterium nucleatum, Capnocytophaga gingivalis and Campylobacter showaei showed correlation with the reduction of VSC after periodontal treatment (p-value = 0.044; 0.047 and 0.004, respectively). Capnocytophaga sputigena had a significant reverse correlation between VSCs variation from diagnosis (baseline) and after treatment. Microbial diversity was high in the subgingival plaque on periodontitis and intra-oral halitosis participants of the study. Furthermore, there were correlations between subgingival plaque composition and VSC counting after periodontal treatment. The subgingival microbiome can offer important clues in the investigation of the pathogenesis and treatment of halitosis.

Evidence of Age Estimation Procedures in Forensic Dentistry: Results from an Umbrella Review.

Background and objective: Age estimation is an important tool when dealing with human remains or undocumented minors. Although the skull, the skeleton or the hand-wrist are used in age estimation as maturity indicators, they often present a lack of good conditions for a correct identification or estimation. Few systematic reviews (SRs) have been recently published; therefore, this umbrella review critically assesses their level of evidence and provides a general, comprehensive view. Materials and methods: Considering the review question "What is the current evidence on age determination approaches in Forensic Dentistry?" an electronic database search was conducted in four databases (PubMed, Cochrane, WoS, LILACS) up to December 2022, focusing on SRs of age estimation through forensic dentistry procedures. The methodological quality was analyzed using the measurement tool to assess SRs criteria (AMSTAR2). Results: Eighteen SRs were included: five of critically low quality, six of low quality, three of moderate quality and four of high quality. The SRs posited that Willems' method is more accurate and less prone to overestimation; most methods seem to be geographically sensitive; and 3D-imaging and artificial intelligence tools demonstrate high potential. Conclusions: The quality of evidence on age estimation using dental approaches was rated as low to moderate. Well-designed clinical trials and high-standard systematic reviews are essential to corroborate the accuracy of the different procedures for age estimation in forensic dentistry.

Periodontitis and Systemic Lupus Erythematosus: A systematic review and meta-analysis.

This systematic review and meta-analysis evaluated the association between periodontitis (PD) and systemic lupus erythematosus (SLE). A systematic search was conducted through the following electronic databases: Cochrane Library, MEDLINE, EMBASE, Scopus, LILACS, CINAHL and SIGLE (System for Information on Grey Literature in Europe) for relevant publications up to September 2020 with no language restriction. The association between PD and SLE was assessed by the prevalence of PD in SLE patients (both sex and females only) as the primary outcome. Secondary outcomes included differences in common gingival parameters including probing pocket depth (PPD), clinical attachment level (CAL), disease activity index (SLEDAI) scores of SLE patients with or without PD. A total of 1183 citations and 22 full text articles were screened. Eighteen articles were included in the qualitative synthesis, and 13 in the quantitative analysis. SLE diagnosis was associated with greater odds of PD (OR = 1.33, 95% Confidence Interval [CI]: 1.20-1.48), but these were non-significant when examined in females (OR = 3.20, 95%CI: 0.85-12.02). Patients with SLE exhibited no differences in PPD (SMD: -0.09 mm, 95%CI: -0.45-0.27) and CAL (SMD: 0.05 mm, 95%CI: -0.30-0.40) when compared with systemically healthy controls. PD diagnosis was, however, associated with higher SLEDAI scores in patients suffering from SLE (SMD: 0.68, 95% CI: 0.03-1.32). PD and SLE are both inflammatory diseases and their association could be bi-directional. This review suggested that the patients with SLE have greater odds of suffering with PD. Further investigations are required to assess the association between PD and SLE.

Epicardial placement of human MSC-loaded fibrin sealant films for heart failure: Preclinical efficacy and mechanistic data.

Mesenchymal stromal cell (MSC) transplantation has been investigated as an advanced treatment of heart failure; however, further improvement of the therapeutic efficacy and mechanistic understanding are needed. Our previous study has reported that epicardial placement of fibrin sealant films incorporating rat amniotic membrane-derived (AM)-MSCs (MSC-dressings) could address limitations of traditional transplantation methods. To progress this finding toward clinical translation, this current study aimed to examine the efficacy of MSC-dressings using human AM-MSCs (hAM-MSCs) and the underpinning mechanism for myocardial repair. Echocardiography demonstrated that cardiac function and structure were improved in a rat ischemic cardiomyopathy model after hAM-MSC-dressing therapy. hAM-MSCs survived well in the rat heart, enhanced myocardial expression of reparative genes, and attenuated adverse remodeling. Copy number analysis by qPCR revealed that upregulated reparative genes originated from endogenous rat cells rather than hAM-MSCs. These results suggest hAM-MSC-dressing therapy stimulates a secondary release of paracrine factors from endogenous cells improving myocardial repair ("secondary paracrine effect"), and cardiac M2-like macrophages were identified as a potential cell source of repair. We demonstrated hAM-MSCs increased M2-like macrophages through not only enhancing M2 polarization but also augmenting their proliferation and migration capabilities via PGE2, CCL2, and TGF-ß1, resulting in enhanced cardiac function after injury.

Chronological age range estimation of cervical vertebral maturation using Baccetti method: a systematic review and meta-analysis.

BACKGROUND: The timing of growth is a key factor for correct orthodontic treatment planning. Cervical vertebrae maturation (CVM) is no exception, although the reported chronological ages vary in the literature. OBJECTIVE: We aimed to estimate the average chronological age for each Baccetti's CVM staging. SEARCH METHODS: Search on MEDLINE-PubMed, Scopus, LILACS, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) was conducted until July 2021. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. SELECTION CRITERIA: Observational or interventional studies reporting chronological age classified through Baccetti's CVM method were included. DATA COLLECTION AND ANALYSIS: Methodological quality was assessed, and pooled estimates were carried out through random-effects meta-analysis of single means. The impact of sex and continent were also investigated through subgroup analyses. RESULTS: Forty-one studies were included (9867 participants, 4151 men, and 5716 women). The average chronological age was 9.7 years old (95% confidence interval [CI]: 9.4 to 10.1) in CS1, 10.8 years old (95% CI: 10.5 to 11.1) in CS2, 12.0 years old (95% CI: 11.7 to 12.2) in CS3, 13.4 years old (95% CI: 13.2 to 13.6) in CS4, 14.7 years old (95% CI: 14.4 to 15.1) in CS5, and 15.8 years old (95% CI: 15.3 to 16.3) in CS6. A significant difference was found between the sexes in all CVM stages. We also found significant differences across continents. CONCLUSIONS: For each CVM staging a chronological age range was successfully estimated. Girls presented an earlier skeletal maturation compared to boys. The skeletal maturation differs also according to continents, except for CMV stage 1, pointing to the need for personalized ranges according to each region. REGISTRATION: Registration number: PROSPERO: CRD42021225422.

Knowledge, perception, and clinical experiences on molar incisor hypomineralization amongst Portuguese dentists.

AIM: Molar incisor hypomineralization (MIH) is a prevalent oral health condition whose knowledge by dentists is key to the best clinical outcome. This study aimed to evaluate the knowledge, perceptions and clinical experiences of MIH among Portuguese dentists. METHODS: A cross-sectional structured questionnaire was distributed nationally through a web-based survey platform. Data concerning demographic variables, years of experience, dental specialty, MIH prevalence, diagnosis, severity, training demands and clinical management of MIH were collected. We calculated a knowledge score (KS), and compared data between Pediatric Dentists (PDs), General Dental Practitioners (GDPs) and other dental specialties (ODS). RESULTS: Overall, 2.2% of Portuguese dentists (n = 257) answered the questionnaire. Most participants reported having identified MIH in their practice (82.5%), with PD reporting the prevalence appeared to have increased, and practically all (91.7%) considered it a public health problem. Resin composite was often the used material to restore MIH teeth (56.0%), however PDs indicated glass ionomer cements as the preferred and preformed crowns a better option. The average KS on MIH was 41.3 (± 5.7), with GDPs having a similar score than PDs. Most respondents (94.9%) reported a lack of information about MIH and were willing to receive appropriate clinical training. CONCLUSIONS: The average knowledge on MIH was considered low among Portuguese dentists. Respondents perceived an increased incidence of MIH, despite the lack of prevalence data in Portugal. The material of choice was Glass Ionomer and performed crowns, by PDs, while GDPs and ODS reported poor confidence to manage MIH. These results may serve future programs to increase knowledge, perceptions and clinical experiences towards MIH.

The associations of use of social network sites with perceived social support and loneliness.

Research shows that use of social network sites is associated with loneliness and this may be amplified in tertiary students by their transition from home life, especially if they struggle to integrate with peers. The buffering effects of social support may offer a solution and the online dimension may offer a suitable outlet for lonely and isolated students. In this study, N = 111 university students, aged 18-40, completed a frequency assessment of Instagram and WhatsApp, the Spanish version of the UCLA loneliness scale and the Multidimensional Scale of Social Support in an online survey. The statistical analysis was completed by Structural Equation Modeling using AMOS 25.0. The construct validity of social network sites was established by good factor loadings for WhatsApp and Instagram, but Facebook was excluded as it did not load adequately on to the latent measurement model, in keeping with the diminishing trend for Facebook use in young students. Loneliness emerged as pivotal in a mediation model, and online social support from friends/significant others, emerged as salient in the predictive model in contrast to family. However, these associations may not have the same advantageous weight for mature students given the observed negative associations with age. Results may have implications for policy and planning through highlighting the psychological variables that are operative in the dynamics of integration, retention, and adjustment to tertiary level experience.

Predictors of tooth loss during long-term periodontal maintenance: An updated systematic review.

AIM: To evaluate the risk factors / predictors of tooth loss in patients with periodontitis who underwent periodontal therapy and long-term periodontal maintenance (PM). MATERIAL AND METHODS: PubMed, CENTRAL, EMBASE, Web of Science, LILACS and Scholar were searched up to and including September 2020. Studies limited to periodontitis patients who underwent active periodontal therapy (APT) and followed a regular PM programme with 5 years follow-up minimum were eligible for inclusion in this review. Studies were included if they reported data on tooth loss during PM. Random effects meta-analyses of number of tooth loss per patient per year were conducted. RESULTS: Thirty-six papers regarding thirty-three studies were included in this review, with three prospective 30 retrospective trials. Subgroup meta-analysis showed no differences between prospective and retrospective studies, with an average of 0.1 tooth loss per year per patient (p < 0.001). Maxillary and molar teeth were more susceptible to be extracted during long-term PM. Baseline characteristics (smoking, diabetes mellitus, cardiovascular disease, being male and teeth with furcation lesions) showed no significance as predictor of tooth loss through meta-regression. The percentage of tooth loss due to periodontal reasons ranged from 0.45% to 14.4%. The individual outcomes in each study evidenced different patient-related factors (age and smoking) and tooth-related factors (i.e. tooth type and location) were associated with tooth loss during PM. CONCLUSION: The majority of patients undergoing long-term PM have not lost teeth. On average, long-term PM effectively causes the loss of 1 tooth per patient every 10 years. Additional prospective trials may confirm these results.

Autogenous Mineralized Dentin versus Xenograft granules in Ridge Preservation for Delayed Implantation in Post-extraction Sites: A Randomized controlled clinical trial with an 18 months follow-up.

OBJECTIVES: To test primary stability of delayed implants placed in post-extraction ridges preserved with autogenous mineralized dentin matrix (MDM) versus xenograft granules. Clinical, histological and pain experience outcomes were further assessed. MATERIAL AND METHODS: From March 2018 to July 2020, patients requiring ridge preservation in preparation for delayed implant placement in post-extraction sites were included. Participants were randomly allocated to either the test (MDM) or control group (xenograft granules) prior to ridge preservation. Visual analogue scale and analgesic consumption were measured every day for a week. Six months after preservation, trephine cores were harvested for histomorphometry prior to implant placement. Implants were then placed, and implant stability was measured immediately as well as two months after placement. Marginal bone loss and presence of mucositis/peri-implantitis were registered up to 18 months after prosthetic loading. RESULTS: Fifty-two patients (66 implants) completed the study. MDM and xenograft groups presented similar primary (77.1 ± 6.9 versus. 77.0 versus. 5.9) and secondary (81.8 ± 5.1 versus. 80.1 ± 3.8) implant stabilities. The percentage of newly formed bone in MDM (47.3%) was significantly higher than xenograft (34.9%) (p < .001), and the proportion of residual graft was significantly lower (12.2% in MDM and 22.1% in xenograft) (p < .001). No significant differences were found as far as clinical, radiographic and patient-related outcomes. CONCLUSIONS: Implants placed in sites preserved with MDM had similar primary stability in comparison to xenograft granules. MDM showed a significantly higher quantity of newly formed bone and lower amount of residual graft in histomorphometry results and equal clinical and patient-related outcomes.

Molar-incisor hypomineralization: an umbrella review.

OBJECTIVE: In recent years, Molar Incisor Hypomineralization (MIH) has become a subject that concerns the Paediatric Dentistry Community. The aim of the present umbrella review was to analyse previously published systematic reviews (SRs) on MIH in children and adolescents. METHODS: Electronic database search was conducted (including PubMed, Embase, Scopus, Cochrane, Web of Science, and LILACS) until July 2020. Studies were included, if they were SR on MIH in children and adolescents. The methodological quality of SRs was judged by use of the MeaSurement Tool to Assess systematic Reviews 2. The primary outcomes included prevalence, aetiology, and clinical management of MIH. Data extraction and methodological quality assessment were performed. RESULTS: Eighteen systematic reviews were included for data extraction. Among these, two were focussing on prevalence, five addressed aetiology, one highlighted the mechanical and chemical characteristics of enamel in MIH, one underlined the association between MIH and dental caries, six addressed the treatment, and one focussed on hypomineralization of primary teeth as a predictor of MIH. The results showed a high worldwide prevalence of MIH and an unknown aetiology of MIH, but reporting that the aetiology is most likely multifactorial. Different treatment approaches used were desensitizing and remineralizing products, resin infiltration, fissure sealant, atraumatic restorative treatment, resin composite restoration, and stainless steel crown (SSC), but also extraction associated with orthodontic treatment of the permanent first molars (PFMs) was reported on. The AMSTAR criteria 2 was applied, where six studies were assessed as having critically low quality, two studies as having low quality, and nine studies as having moderate quality. CONCLUSIONS: MIH is highly prevalent worldwide and has most likely a multifactorial aetiology. Different treatment approaches according to the degree of severity of lesion(s) are reported on. The quality of evidence produced by the available SRs was not favourable. More well-designed clinical trials and high standard systematic reviews are necessary to elucidate better MIH characteristics and treatment outcomes.

Validity of the association between periodontitis and female infertility conditions: a concise review.

Hormones and inflammatory mechanisms are implicated with female reproductive function, including follicle maturation, ovulation, embryo implantation, and pregnancy. Periodontitis is a chronic inflammatory disease due to a polymicrobial disruption of the homeostasis and may be considered as a potential risk factor that affect female fertility. The role of periodontitis is becoming meaningful, with significant associations with polycystic ovary syndrome, endometriosis and bacterial vaginosis. Further, periodontitis is linked with known risk factors towards female infertility, such as age, obesity, and chronic kidney disease. This review aims to summarize the available evidence on the association between periodontitis and female infertility-associated conditions, and to discuss warranting steps in future research.

Self-reported illness perception and oral health-related quality of life predict adherence to initial periodontal treatment.

AIM: To investigate the impact of periodontal disease perception and oral health-related quality of life (OHRQoL), towards the initial periodontal treatment adherence (IPTA). MATERIAL AND METHODS: This prospective study included 571 patients (274 males and 297 females, mean age 63.1 ± 14.5) with periodontal disease, from the Study of Periodontal Health in Almada-Seixal (SoPHiAS). We assessed the potential connections, between sociodemographic characteristics, oral hygiene behaviours, periodontal measures, the Brief Illness Perception Questionnaire (IPQ) and the Oral Health Impact Profile (OHIP-14), through a structural equation modelling (SEM). Multivariate logistic regression assessed significant oral health-related variables towards IPTA. RESULTS: Overall, 265 participants had IPTA (46.4%). The SEM had a good fit to the data on all six latent variables (χ2  = 2.221, CFI = 0.921, RMSEA = 0.0.046). Multivariate analysis for IPTA indicated Treatment Control (Odds Ratio [OR] = 1.07) and Identity domains of Brief-IPQ (OR = 1.10) and Functional Limitation domain of OHIP-14 (OR = 1.60) as significant predictors. The obtained tool had a satisfactory prediction of IPTA (61.1%). CONCLUSIONS: Initial periodontal treatment adherence is influenced by patient's perception on periodontal disease treatment and identity domains and by functional impact domain of OHRQoL. Future studies shall investigate the effect of modelling these domains on therapeutic success and public health strategies.