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Aim: To develop and internally validate a nomogram built on a multivariate prediction model including parameters from the new classification of periodontal diseases, able to predict, at baseline, the occurrence of tooth loss due to periodontal reason (TLP)., Materials and Methods: A total of 315 individuals diagnosed with periodontal disease and receiving a minimum of one annual supportive periodontal therapy visit were included in the study. Patients were staged and graded based upon baseline data. The population was divided into a development (254 patients) and a validation (61 patients) cohort to allow subsequent temporal validation of the model. According to the TLP at the 10-year follow-up, patients were categorized as "low tooth loss" (≤ 1 TLP) or "high tooth loss" (≥ 2 TLP). Bootstrap internal validation was performed on the whole data set to calculate an optimism-corrected estimate of performance., Results: The generated nomogram showed a strong predictive capability (AUC = 0.81) and good calibration with an intercept = 0 and slope = 1. These findings were confirmed by internal validation using bootstrapping (average bootstrap AUC = 0.83)., Conclusions: The clinical implementation of the present nomogram guides the prediction of patients with high risk of disease progression and subsequent tooth loss for personalized care., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: The aim of this systematic review was to analyse current evidence regarding differences in early and late implant failure as well as in marginal bone level (MBL) changes between submerged and non-submerged healed dental implants., Methods: PUBMED, SCOPUS, EMBASE and Web of Science databases were searched for prospective randomized and non-randomized controlled studies addressing direct comparison between submerged and non-submerged implant healing, without performing immediate loading. Early and late implant failure (before or after 6 months from implant placement, respectively) together with MBL were the investigated outcomes. Risk of bias assessment was performed using the Cochrane Collaboration Tool for Randomized clinical trials. Meta-analysis was performed and the power of the meta-analytic findings determined by trial sequential analysis (TSA)., Results: Eleven studies met the inclusion criteria and were included in the review. Results of this systematic review revealed a small higher rate (2%) of early implant failure when a non-submerged healing approach is performed. Late implant failure appears not to be different in submerged or non-submerged healing, but the power of evidence, as determined by TSA, is not high. If we consider MBL changes at 1 year from implant load, it seems that non-submerged healing may better preserve marginal bone, although with a small effect size (0.13 mm)., Conclusions: Implants placed with a non-submerged technique have a higher risk (2%) of early failure. The power of the evidence about the effects on MBL is low, but present results seem to favour non-submerged healing, although with a very small effect size., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: In order to enhance clinical improvement of intrabony defects, the addition of enamel matrix derivatives (EMD) to bone substitues (BS) has been investigated. The aim of this systematic review is to figure out whether such a combination, in comparison to the treatment with BS alone has beneficial effects on the following outcomes: clinical attachment level (CAL) gain, probing depth (PD) reduction and recession (REC)., Methods: Electronic databases (PUBMED, SCOPUS, EBSCO Host Research Databases and Web of Knowledge) were searched for randomized controlled trials in humans addressing the use of a combination of BS and EMD versus a control group with BS alone for the treatment of intrabony defects, with a minimum of 6 months of follow-up; meta-analysis and trial sequential analysis were then performed., Results: From a total of 1,197 records screened by title and abstract, nine studies were read full-text and five out of them included in the meta-analysis. No significant differences have been demonstrated both for CAL gain, PD reduction and REC between test and control groups., Conclusions: In the treatment of intrabony defects, the addition of EMD to BS seems to be not beneficial in terms of CAL gain, PD reduction and REC changes. However, such results should be considered with caution because of the small number of studies included in the meta-analysis and their heterogeneity., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Oral lichen planus (OLP) is one of the most common oral mucosa disorders. OLP gingival involvement is very frequently observed, and it is characterized by wide variations in clinical appearance and symptoms, leading, in many cases, to misdiagnosis or undiagnosis. This can be potentially harmful since OLP patients require appropriate management in oral and periodontal care, together with an adequate systemic evaluation., Objective: In this paper, we have analysed the prevalence and clinical aspects of gingival lesions in our series of 700 patients affected by OLP. Furthermore, we have discussed the possible periodontal implications on the basis of the available literature., Patients and Methods: Data from 700 patients affected by OLP, clinically and histologically assessed, have been studied; the location and morphology of lesions, the symptoms and the progression of the disease have been considered, with particular attention given to gingival involvement., Results: Gingival lesions have been diagnosed in 48% of cases, usually associated with diffuse oral involvement. Only 7.4% of patients had OLP lesions confined to the gingiva. The morphology of lesions included all the forms originally described for OLP (reticular, papular, plaque, atrophic, erosive and bullous). The symptoms, if present, varied from mild discomfort to severe oral pain, with the general trend increasing from the keratotic to the erosive forms. The gingiva was involved in four out of 21 of our oral cancer cases, which developed from pre-existing OLP lesions., Conclusion: OLP is a very proteiform disorder; considering the high frequency of gingival involvement and its influence on oral health, it is our opinion that periodontologists should be involved in OLP management and should become familiar with its clinical aspects and related themes.

Background: Gorham's disease is a rare disorder characterized by spontaneous and progressive osteolysis of one or more skeletal bones. The radiographic findings associated with Gorham's disease are particularly dramatic, as in some cases a complete resorption of the involved bone can occur, leading to the definition of phantom bone, vanishing bone, or disappearing bone disease., Material and Methods: A 24-year-old female patient with a previous diagnosis of periodontal disease and progressive mandibular alveolar bone loss was referred to our Oral Medicine section. The initial radiographic picture showed infrabony defects and horizontal bone loss., Results: After further extensive local and systemic evaluation, including histopathological, laboratory and imagine techniques investigations, the patient was diagnosed to be affected by Gorham's disease. Meanwhile the progression of the osteolytic process had caused the loosening of all the left mandibular teeth and a pathologic fracture. Appropriate medical therapy was successful in stabilizating the resorptive process, with no evidence of further progressive disease., Conclusions: When Gorham's disease involves the mandible, the role of the periodontologist is extremely important in diagnosing promptly the disorder and preventing the functional and aesthetic consequences of advanced and extensive bone loss. Gorham's disease should be included among the pathologic entities mimicking periodontal disease on radiograph, such as inflammatory disease (e.g. osteomyelitis), endocrine disease (e.g. hyperparathyroidism), intra-osseous malignancies or metastases, lymphoma, histiocytosis X, mainly eosinophilic granuloma, infective process (e.g. tuberculosis and actinomycosis), odontogenic tumours.