Recent Advances in Periodontics and Dental Implantology

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dentistry".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 28343

Special Issue Editor

Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Korea
Interests: bone; bone biology; tissue engineering; stem cells; instrumentation; enzyme kinetics; bone regeneration; dental implants; biomaterials; oral health
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Special Issue Information

Dear Colleagues, 

With the advancement of technology, great progress has been made in the periodontology field. The prevalence of periodontal disease is relatively high and has been reported from 20­–45% or higher. Various treatments and biomaterials have been applied to increase the effectiveness of periodontal treatment. The long-term effects of periodontal treatment have been published. Despite advances in periodontal treatment, tooth extraction and further implant placement are being made. A protocol to increase the success rate of implants has been proposed. Various methods have been proposed that can be used in areas where the placement of dental implants is difficult. Stem cells and growth factors have been used as various biomaterials.

This scope of this Special Issue will serve as a forum for papers addressing the following concepts:

  • Understanding and mechanisms of periodontal disease;
  • Treatment of periodontal disease;
  • Short- and long-term effects of periodontal treatment;
  • Various soft and hard tissue regeneration methods;
  • Clinical outcome of dental implants;
  • Enhancement of efficacy with application of growth factors;
  • Cell therapy in periodontal and implant treatment.

Prof. Dr. Jun-Beom Park
Guest Editor

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Keywords

  • periodontitis
  • inflammation
  • epidemiology
  • oral health
  • bone regeneration
  • bone biology
  • tissue engineering
  • dental implants
  • biomaterials
  • stem cells

Published Papers (12 papers)

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Research

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12 pages, 2075 KiB  
Article
Clinical and Radiographic Evaluation of Third-Generation Pericardium Membrane for the Treatment of Grade II Furcation Defect in Stage III Periodontitis Patients
by Mohamed O. Elboraey and Eihab A. Mously
Medicina 2023, 59(3), 572; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59030572 - 15 Mar 2023
Cited by 1 | Viewed by 1487
Abstract
Background and Objectives: Guided tissue regeneration, with or without a bone graft, is a modality for the treatment of furcation involvement. Because the direct application of a bone graft into the periodontal defect has drawbacks, such as the risk of microbial contamination and/or [...] Read more.
Background and Objectives: Guided tissue regeneration, with or without a bone graft, is a modality for the treatment of furcation involvement. Because the direct application of a bone graft into the periodontal defect has drawbacks, such as the risk of microbial contamination and/or graft containment, a new modality of directly loading bone graft particles over the barrier membrane is now used. This study aimed to evaluate clinically and radiographically the effects of a two-layered membrane consisting of a layer of nanohydroxyapatite particles on a pericardium membrane in the treatment of stage III periodontitis, compared with direct application of a nanohydroxyapatite bone graft. Materials and Methods: Forty individuals with grade II furcation involvement were divided into two groups. Group I was treated with a two-layered membrane consisting of a pericardium membrane with nanohydroxy particles loaded onto its surface; group II was treated with direct application of a nano bone graft covered with pericardium membrane. Clinical and cone beam computed tomography (CBCT) radiographic assessments of the two groups were carried out after a 6-month follow-up period. Results: Clinically, the results showed a significant reduction in furcation involvement (F). The CBCT assessment also revealed reductions in depth (D), height (H), width (W), and 3D radiographic volume of furcation involvement in all study groups at baseline and at 6 months postoperative (p < 0.05) with no significant differences between groups. Conclusions: According to the results of the current study, a two-layer membrane formed by direct loading of bone graft particles onto a pericardium membrane can be used as an effective, reliable, and easy-to-use substitute for direct bone graft application into periodontal defects. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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13 pages, 2075 KiB  
Article
Effects of Enamel Matrix Derivative on Cell Spheroids Made of Stem Cells Obtained from the Gingiva on Osteogenic Differentiation
by Somyeong Hwa, Hyun-Jin Lee, Youngkyung Ko and Jun-Beom Park
Medicina 2023, 59(2), 377; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59020377 - 15 Feb 2023
Cited by 2 | Viewed by 1326
Abstract
Background and Objectives: A derivative of the enamel matrix was used to speed up periodontal regeneration, including the formation of new cementum, alveolar bone, and periodontal ligament. In this study, human gingiva-derived stem cell–derived cell spheroids were used to assess the effects [...] Read more.
Background and Objectives: A derivative of the enamel matrix was used to speed up periodontal regeneration, including the formation of new cementum, alveolar bone, and periodontal ligament. In this study, human gingiva-derived stem cell–derived cell spheroids were used to assess the effects of an enamel matrix derivative on cell viability, osteogenic differentiation, and mineralization. Materials and Methods: Human gingiva-derived stem cells were used to create spheroids, which were then coupled with unloaded control groups and an enamel matrix derivative at a final concentration of 2.7, 27, 270, and 2700 μg/mL. The morphological examination of the created stem cell spheroids took place on days 1, 3, 5, and 7. The Live/Dead Kit assay was used to determine the qualitative viability of cells on days 3 and 7. Using the Cell Counting Kit-8, the quantitative vitality of the cell spheroids was assessed on days 1, 3, and 5. On days 7 and 14, alkaline phosphatase activity assays and Alizarin Red S staining were carried out to examine the osteogenic differentiation of the cell spheroids. RUNX2 and COL1A1 expression levels on days 7 and 14 were determined using real-time polymerase chain reaction. Results: The added enamel matrix derivative at the tested concentrations did not significantly alter the morphology of the applied stem cells’ well-formed spheroids on day 1. On days 3 and 7, the majority of the spheroids’ cells fluoresced green while they were being cultivated. Alkaline phosphatase activity data revealed a substantial rise in the 2700 μg/mL group on day 7 when compared to the unloaded control (p < 0.05). On days 7 and 14, calcium deposits were distinctly seen in each group. In the 27 and 2700 μg/mL groups, the treatment with the enamel matrix derivative resulted in noticeably higher values for the Alizarin Red S staining (p < 0.05). qPCR results showed that adding an enamel matrix derivative to the culture of the 27 μg/mL group raised the level of RUNX2 mRNA expression. Conclusions: These results lead us to the conclusion that a derivative of the enamel matrix may be used to promote osteogenic differentiation in stem cell spheroids. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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16 pages, 369 KiB  
Article
Reliability and Validity of a Lithuanian Version of the Oral Health Impact Profile—A Study in Patients with Stage III–IV Periodontitis
by Eglė Zasčiurinskienė, Antanas Šidlauskas, Aistė Kavaliauskienė, Jurgita Vazgytė, Agnius Matuzas and Apolinaras Zaborskis
Medicina 2023, 59(1), 69; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59010069 - 28 Dec 2022
Viewed by 1185
Abstract
Background and Objectives: The study aimed to translate the original English version of Oral Health Impact Profile (OHIP) into Lithuanian and to assess reliability and validity of the translated instrument (OHIP-Lt) in patients with advanced stages of periodontitis. Materials and Methods: [...] Read more.
Background and Objectives: The study aimed to translate the original English version of Oral Health Impact Profile (OHIP) into Lithuanian and to assess reliability and validity of the translated instrument (OHIP-Lt) in patients with advanced stages of periodontitis. Materials and Methods: Subjects (N = 67) with stage III–IV periodontitis aged 30–63 years were surveyed by questionnaire and examined clinically. Psychometric analysis included explanatory (EFA) and confirmatory (CFA) factor analyses and psychometric tests. Results: Cronbach’s alpha of the translated OHIP was 0.96. EFA revealed four dimensions which Cronbach’s alpha ranged from 0.75 to 0.96. Construct validity of the four-factor model derived from the OHIP-Lt was supported by findings of CFA (RMSEA = 0.077). The total OHIP-Lt and its subscale scores increased as the patients’ self-rated oral health status changed from healthy to unhealthy. Discriminative validity of the OHIP-Lt was confirmed by its higher scores among patients who had an increased spacing between the maxillary anterior teeth and increased clinical attachment level (CAL ≥ 5 mm) compared to those who did not. Conclusions: The translated Lithuanian version of OHIP-Lt was identified as four-dimension inventory. Good reliability and validity of the OHIP-Lt provide the evidence for its further use in study on advanced periodontal disease burden among Lithuanian patients. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
12 pages, 5223 KiB  
Article
Assessment of the Impacts of Centipeda minima (L.) on Cell Viability, and Osteogenic Differentiation of Mesenchymal Stem Cell Spheroids
by Hyun-Jin Lee, Kyung-Hwan Na, Md. Salah Uddin and Jun-Beom Park
Medicina 2023, 59(1), 43; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59010043 - 26 Dec 2022
Cited by 1 | Viewed by 1280
Abstract
Background and Objectives: Centipeda minima (L.) is a well-known and traditional pharmaceutical that has been utilized to treat different conditions controlling rhinitis, soothe pain, and decrease swelling. We assessed the impacts of Centipeda minima (L.) extricates (CMTs) on the osteogenic differentiation of cell spheroids [...] Read more.
Background and Objectives: Centipeda minima (L.) is a well-known and traditional pharmaceutical that has been utilized to treat different conditions controlling rhinitis, soothe pain, and decrease swelling. We assessed the impacts of Centipeda minima (L.) extricates (CMTs) on the osteogenic differentiation of cell spheroids made of human-bone-marrow-derived mesenchymal stem cells. Materials and Methods: Mesenchymal stem cells (MSCs) in spheroid 3D culture were generated and propagated in the presence of CMTs ranging from 0 to 1 μg/mL. Cell morphology was measured on Days 1, 3, 5, and 7. The quantitative cellular viability was evaluated on Days 1, 3, 5, and 7. Alkaline phosphatase activity assays were designed to measure the osteogenic differentiation of mesenchymal stem cell spheroids on Day 7. Alizarin Red S staining was performed to investigate the mineralization of cell spheroids on Days 7 and 14. Real-time polymerase chain reactions were used to measure the expression levels of RUNX2 and COL1A1 on Day 14. Western blot techniques were performed to identify the protein expression of Runt-related transcription factor 2 and type I collagen. Results: The control group’s mesenchymal stem cells displayed a spheroid shape. There was no noticeable change in morphology with the addition of CMTs at final concentrations of 0.001, 0.01, 0.1, and 1 μg/mL compared with the untreated (control) group. The application of CMTs did not induce a significant change in cell viability. The relative alkaline phosphatase activity values in the 0.001, 0.01, 0.1, and 1 μg/mL CMT groups were 114.4% ± 8.2%, 130.6% ± 25.3%, 87.8% ± 3.4%, and 92.1% ± 6.8%, respectively, considering a control of 100% (100.0% ± 17.9%). On Day 14, calcium deposits were clearly observed in each group. The relative values of Alizarin Red S staining in the 0.001, 0.01, 0.1, and 1 μg/mL CMT groups were 100.1% ± 8.9%, 105.9% ± 0.0%, 109.7% ± 19.1%, and 87.0% ± 40.9%, respectively, considering a control of 100% (100.0% ± 28.7%). The addition of CMT significantly increased RUNX2 expression in the 0.01 μg/mL group and COL1A1 in the 0.001 and 0.01 μg/mL groups. Normalization of protein expression showed that the addition of CMTs significantly increased type I collagen expression in the 0.001, 0.01, and 1 μg/mL groups. Conclusions: In conclusion, CMTs influence the osteogenic differentiation of bone-marrow-derived mesenchymal stem cells and the use of CMTs may positively influence the osteogenic differentiation of cell spheroids. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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12 pages, 1786 KiB  
Article
Assessment of Bone Height Changes Based on the Cone–Beam Computed Tomography Following Intentional Replantation for Periodontally Compromised Teeth
by So-hyun Park, Seung-Heon Paek, Bongju Kim and Jung-Tae Lee
Medicina 2023, 59(1), 40; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59010040 - 25 Dec 2022
Cited by 1 | Viewed by 1563
Abstract
Background and Objectives; This study aimed to evaluate the clinical outcomes and bone changes before and after intentional replantation (IR) for periodontally compromised teeth by using cone–beam computed tomography (CBCT). Materials and Methods; Fourteen periodontally involved teeth were selected for IR. [...] Read more.
Background and Objectives; This study aimed to evaluate the clinical outcomes and bone changes before and after intentional replantation (IR) for periodontally compromised teeth by using cone–beam computed tomography (CBCT). Materials and Methods; Fourteen periodontally involved teeth were selected for IR. A preoperative orthodontic procedure was performed to apply luxation, and the tooth was then gently extracted. Retrograde filling of the root-end canal was performed. Once the tooth was repositioned in the socket, it was splinted with the adjacent tooth. After three months, prosthetic restoration was performed. Results; Clinical parameters and CBCT images were obtained before and after the IR procedure. The height of the alveolar bone was measured on the CBCT images by using software. Most preoperative symptoms, including pain, mobility, probing depth (PD) and bleeding on probing (BOP), significantly decreased after IR (pain: 4.71 to 1.00; mobility: 1.36 to 0.29; PD: 5.60 to 2.85; BOP: 3.50 to 0.79). CBCT analysis indicated an increase in bone height after IR (the amount of change: maxilla, 4.00; mandible, 1.95). Conclusions; A previous study reported that IR for periodontally involved teeth is quite limited. However, in this study, IR of periodontally compromised teeth showed favorable results in clinical and radiographic evaluations, suggesting that IR may be an alternative to extraction of teeth with periodontal disease. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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18 pages, 7062 KiB  
Article
Non-Destructive Removal of Dental Implant by Using the Cryogenic Method
by Burak AK, Emre Gürkan Eroğlu, Abdullah Seckin Ertugrul, Ayla Batu Öztürk and Şakir Necat Yılmaz
Medicina 2022, 58(7), 849; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58070849 - 25 Jun 2022
Viewed by 1850
Abstract
Background and Objectives: The gold standard for a successful prosthetic approach is the osseointegration of an implant. However, this integration can be a problem in cases where the implant needs to be removed. Removing the implant with minimal damage to the surrounding [...] Read more.
Background and Objectives: The gold standard for a successful prosthetic approach is the osseointegration of an implant. However, this integration can be a problem in cases where the implant needs to be removed. Removing the implant with minimal damage to the surrounding tissues is important. Osteocytes cannot survive below −2 °C, but epithelial cells, fibroblasts, and other surrounding tissue cells can. Remodeling can be triggered by cryotherapy at temperatures that specifically affect osteocyte necrosis. In this study, we aimed to develop a method for reversing the osseointegration mechanism and for protecting the surrounding tissues by bone remodeling induced by CO2 cryotherapy. Materials and Methods: In this study, eight 2.8 mm diameter, one-piece mini implants were used in New Zealand rabbit tibias. Two control and six implants were tested in this study. After 2 months of osseointegration, a reverse torque force method was used to remove all osseointegrated implants at 5, 10, 20, and 30 Ncm. The osseointegration of the implants was proven by periotest measurements. Changes in bone tissue were examined in histological sections stained with toluidine blue after rabbit sacrifice. The number of lacunae with osteocyte, empty lacunae, and lacunae greater than 5 µm and the osteon number in a 10,000 µm2 area were calculated. Cryotherapy was applied to the test implants for 1 min, 2 min, and 5 min. Three implants were subjected to cryotherapy at −40 °C, and the other implants were subjected to cryotherapy at −80 °C. Results: Empty lacunae, filled osteocytes, lacunae >5 µm, and the osteon count around the implant applied at −40 °C were not significantly different from the control implants. The application of −40 °C for 1 min was found to cause minimal damage to the bone cells. The implants, which were applied for 1 min and 2 min, were successfully explanted on the 2nd day with the 5 Ncm reverse torque method. Test implants, which were applied cold for 5 min, were explanted on day 1. Tissue damage was detected in all test groups at −80 °C. Conclusions: The method of removing implants with cryotherapy was found to be successful in −40 °C freeze–thaw cycles applied three times for 1 min. To prove implant removal with cryotherapy, more implant trials should be conducted. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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10 pages, 733 KiB  
Article
Co-Infection of Oral Candida albicans and Porphyromonas gingivalis Is Associated with Active Periodontitis in Middle-Aged and Older Japanese People
by Iori Oka, Hideo Shigeishi and Kouji Ohta
Medicina 2022, 58(6), 723; https://doi.org/10.3390/medicina58060723 - 28 May 2022
Cited by 5 | Viewed by 1638
Abstract
Background and Objectives: Candida albicans can be detected in subgingival sites of patients with periodontitis. However, the association between oral Candida albicans and periodontitis has not been fully elucidated in Japanese adults. The aim of this study is to clarify the relationship between [...] Read more.
Background and Objectives: Candida albicans can be detected in subgingival sites of patients with periodontitis. However, the association between oral Candida albicans and periodontitis has not been fully elucidated in Japanese adults. The aim of this study is to clarify the relationship between oral Candida albicans infection/co-infection of oral C. albicans and Porphyromonas gingivalis and periodontitis among middle-aged and older Japanese people. Materials and Methods: Eighty-six patients (mean age 70.4 years) who visited the Hiroshima University Hospital from April to September 2021 were investigated in this study. Oral swab samples were collected from the tongue surface. C. albicans and P. gingivalis DNA was detected by real-time PCR using specific DNA primer sets. C. albicans-positive participants were classified into two groups according to the presence or absence of intron insertion of C. albicans DNA by PCR analysis. Results: C. albicans was detected in 22 (25.6%) of the 86 patients. Patients in their 80s recorded a higher C. albicans-positive rate (35.3%) compared with other participants. However, there was no significant association between the C. albicans positivity rate and clinical parameters such as sex, age, systemic disease, denture use, or oral health status. Of the 22 C. albicans-positive participants, 10 participants (45.5%) had C. albicans with intron insertion; 70% of participants who had C. albicans with intron insertion exhibited ≥6 mm probing depth. C. albicans/P. gingivalis co-infection was found in 12 patients (14%). Importantly, binomial logistic regression analysis revealed that C. albicans/P. gingivalis co-infection was significantly associated with ≥6 mm periodontal pockets with bleeding on probing (p = 0.02). Conclusions: Co-infection of C. albicans and P. gingivalis is involved in active periodontitis in middle-aged and older people. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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11 pages, 1425 KiB  
Article
Vitamin D3 Serum Levels in Periodontitis Patients: A Case–Control Study
by Iwona Olszewska-Czyz and Elena Firkova
Medicina 2022, 58(5), 585; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58050585 - 24 Apr 2022
Cited by 5 | Viewed by 2372
Abstract
Background: Periodontitis is a multifactorial disease characterized by bacterial-dysbiosis-associated, host-mediated inflammation, which results in the loss of the tooth-supporting tissues. Vitamin D3 plays an important role in the tissue homeostasis and its deficiency might have a negative effect on the periodontitis progression [...] Read more.
Background: Periodontitis is a multifactorial disease characterized by bacterial-dysbiosis-associated, host-mediated inflammation, which results in the loss of the tooth-supporting tissues. Vitamin D3 plays an important role in the tissue homeostasis and its deficiency might have a negative effect on the periodontitis progression and treatment outcomes. Objectives: The aim of the study was to evaluate the vitamin D3 serum levels among patients with periodontitis and healthy subjects. Materials and Methods: A total of 100 generally healthy adult participants (50 diagnosed with periodontitis, 50 with healthy periodontium) were enrolled in the study. The periodontal clinical parameters were measured, radiographs were performed and the 25-hydroxy vitamin D (25(OH)D) test was used to assess vitamin D3 levels. Results: Vitamin D3 levels were found to be statistically significantly lower among periodontitis patients (31.34; SD = 5.62) compared with healthy controls (39.64; SD = 8.77). Vitamin D3 deficiency was corresponding to the stage and grade of the disease as well as the clinical attachment and bone loss. Conclusion: Adequate monitoring of the vitamin D3 serum levels and supplementation could be of benefit in periodontitis treatment. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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13 pages, 2654 KiB  
Article
Vitamin D Enhanced the Osteogenic Differentiation of Cell Spheroids Composed of Bone Marrow Stem Cells
by Hyun-Jin Lee, Young-Min Song, Seunghoon Baek, Yoon-Hee Park and Jun-Beom Park
Medicina 2021, 57(11), 1271; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57111271 - 19 Nov 2021
Cited by 8 | Viewed by 1849
Abstract
Background and Objectives: Vitamin D is a bone modulator widely used in regenerative medicine. This study aimed to analyze the effects of vitamin D on the osteogenic differentiation and mineralization of human mesenchymal stem cells. Materials and Methods: Spheroids were fabricated using human [...] Read more.
Background and Objectives: Vitamin D is a bone modulator widely used in regenerative medicine. This study aimed to analyze the effects of vitamin D on the osteogenic differentiation and mineralization of human mesenchymal stem cells. Materials and Methods: Spheroids were fabricated using human bone marrow-derived stem cells, and were cultured in the presence of vitamin D at concentrations of 0, 0.1, 1, 10, and 100 nM. Stem cell spheroids were fabricated and the morphological evaluation was conducted on days 1, 3, 7 and 14. Determination of qualitative cellular viability was performed with Live/Dead Kit assay on days 1 and 7. Quantitative cellular viability was evaluated with Cell Counting Kit-8 on days 1, 3, 7, and 14. To analyze the osteogenic differentiation of cell spheroids, alkaline phosphatase activity assays were performed with commercially available kit on days 7 and 14. Real-time polymerase chain reaction was used to determine the expression levels of RUNX2, BSP, OCN, and COL1A1 on days 7 and 14. Results: The stem cells produced well-formed spheroids, and addition of vitamin D did not result in any noticeable changes in the shape. The addition of vitamin D did not significantly change the diameter of the spheroids at 0, 0.1, 1, 10, or 100 nM concentrations. Quantitative cell viability results from days 1, 3, 7 and 14 showed no significant difference between groups (p > 0.05). There was significantly higher alkaline phosphatase activity in the 0.1 nM group when compared with the control group on day 14 (p < 0.05). Real-time polymerase chain reaction results demonstrated that the mRNA expression levels of RUNX2, OCN, and COL1A1 were significantly increased when vitamin D was added to the culture. Conclusions: Based on these findings, we concluded that vitamin D could be applied to the increased osteogenicity of stem cell spheroids. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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Review

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13 pages, 1051 KiB  
Review
Efficacy of Systemic Amoxicillin–Metronidazole in Periodontitis Patients with Diabetes Mellitus: A Systematic Review of Randomized Clinical Trials
by Maryam Hassan Mugri
Medicina 2022, 58(11), 1605; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58111605 - 07 Nov 2022
Cited by 2 | Viewed by 6188
Abstract
Systemic amoxicillin–metronidazole was proven to be effective in managing periodontitis in systemically healthy patients. It was demonstrated that systemic antibiotic therapy can effectively improve clinical periodontal parameters and reduce periodontopathogenic organisms in the subgingival biofilm. However, the evidence for prescribing this drug combination [...] Read more.
Systemic amoxicillin–metronidazole was proven to be effective in managing periodontitis in systemically healthy patients. It was demonstrated that systemic antibiotic therapy can effectively improve clinical periodontal parameters and reduce periodontopathogenic organisms in the subgingival biofilm. However, the evidence for prescribing this drug combination to patients with diabetes remains insufficient. This systematic review was designed to evaluate the effectiveness of a systemic amoxicillin–metronidazole combination as an adjunct to nonsurgical periodontal therapy in patients with diabetes presenting with chronic periodontitis. The PubMed, Scopus, and Web of Science databases were electronically searched for randomized clinical trials in January 2022. Randomized clinical trials evaluating systemic amoxicillin–metronidazole therapy as an adjunct to nonsurgical periodontal therapy in patients with type 2 diabetes presenting with periodontitis were selected for screening. The qualities of the studies were assessed using the Cochrane Collaboration’s Tool for Assessing Risk of Bias Version 2.0 (ROB-2), and a GRADE assessment was applied to estimate the overall certainty of the evidence. Using predefined eligibility criteria, four clinical trials examining 209 patients were selected from the 611 articles identified in the search. Two studies reported a better reduction in clinical parameters when SRP was combined with systemic amoxicillin–metronidazole. Systemic amoxicillin–metronidazole was found to be as effective as clindamycin. Surgical therapy with systemic amoxicillin–metronidazole was more effective than nonsurgical therapy with systemic amoxicillin–metronidazole, even though both resulted in reduced clinical parameters. Combined amoxicillin–metronidazole was observed to reduce periodontal probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) compared to no treatment or NSPT alone. However, the effect was not greater when compared to NSPT with clindamycin or surgical therapy with amoxicillin–metronidazole. Further randomized trials are required before clinical guidelines can be established for the use of systemic amoxicillin–metronidazole. Future randomized controlled clinical trials with long-term follow-ups are required to assess the efficacy of systemic antibiotic therapy in managing periodontitis in patients with diabetes. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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Other

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8 pages, 4972 KiB  
Case Report
Bone Regenerative Potential of Cross-Linked Collagen Membrane in Peri-Implant Osseous Defect: Case Series with Histologic/Micro-Computed Tomographic Findings
by Won-Bae Park, Gazelle Jean Crasto, Ji-Young Han, Philip Kang and Hyun-Chang Lim
Medicina 2023, 59(1), 176; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59010176 - 15 Jan 2023
Cited by 3 | Viewed by 1620
Abstract
The role of a barrier membrane is crucial in guided bone regeneration (GBR) for space creation and cell occlusiveness. Those properties of the membrane should be sustained for a sufficient period. For such purpose, several cross-linked collagen membranes were introduced and demonstrated favorable [...] Read more.
The role of a barrier membrane is crucial in guided bone regeneration (GBR) for space creation and cell occlusiveness. Those properties of the membrane should be sustained for a sufficient period. For such purpose, several cross-linked collagen membranes were introduced and demonstrated favorable clinical outcomes. However, histologic data were not sufficient to support the effect of cross-linked collagen membranes. In the present case series, healing after GBR using a cross-linked collagen membrane was investigated in-depth via histologic and micro-computed tomographic (micro-CT) analyses. 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide cross-linked collagen membrane was used in GBR for treating various peri-implant bone defects in seven patients. After 4–7 months of healing, newly formed tissue of hard consistency was observed over the implant platform. This tissue was carefully harvested and assessed. In micro-CT and histological analyses, evident new bone formation was revealed, especially in the vicinity of the collagen membrane. Moreover, it was histologically found that some newly formed bone was in intimate contact with the membrane. Although the exact mechanism of bone regeneration in the present cases was not clearly elucidated, the cross-linked collagen membrane appeared to contribute to ossification in GBR. Further studies are needed to confirm the findings of the present case series. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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15 pages, 7338 KiB  
Case Report
Large Grafting Void Resembling a Surgical Ciliated Cyst following Maxillary Sinus Augmentation. Four Case Reports with Histological Observation
by Won-Bae Park, Meghan Pandya, Ji-Young Han and Philip Kang
Medicina 2022, 58(9), 1300; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58091300 - 18 Sep 2022
Viewed by 1703
Abstract
The cause and pathogenicity of grafting voids following lateral maxillary sinus augmentation (MSA) have not yet been elucidated. The first purpose of this case series is to introduce an unusually large grafting void that radiologically resembles a surgical ciliated cyst (SCC) at the [...] Read more.
The cause and pathogenicity of grafting voids following lateral maxillary sinus augmentation (MSA) have not yet been elucidated. The first purpose of this case series is to introduce an unusually large grafting void that radiologically resembles a surgical ciliated cyst (SCC) at the sinus augmented site; the second is to observe the histological findings of these grafting voids. In four patients, MSA was performed using the lateral window technique. An unusually large grafting void appeared on cone-beam-computed tomography (CBCT) taken one week after surgery and except for one patient, there were no clinical symptoms. On CBCT taken six months after surgery, the grafting voids were slightly smaller in size but showed radiographic findings similar to those of SCC. During uncovering, grafting voids were removed through the lateral window site. Histologically, the grafting void was empty or filled with dense connective tissue, and no ciliated columnar epithelium or inflammatory cells were observed. Within the limitations of this case series, the large grafting voids generated after MSA was not converted to SCCs. Rather, they remained scar tissue, which could infringe the sinus bone graft and affect the apical bone support of the implant. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology)
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