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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 There was no funding for this study SI

Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation.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.Six electronic databases were searched up to 10 February 2022 to identify and select articles in English language only.Twenty-six randomized controlled clinical trials reporting changes amongst 2579 participants about CRP levels at 6 months or more after treatment.Two reviewers independently extracted data and rated the quality of studies. Meta-analyses were performed using random and fixed effect models.Risk of bias (RoB 2.0 tool) and quality of evidence (GRADEpro GDT tool) analyses were completed.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 CRP3 mg/L at baseline.High level of heterogeneity.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.

Immune response leading to increased systemic inflammation is one of the mechanisms linking periodontitis to chronic inflammatory diseases. The aim of this study was to compare the expression of toll-like receptors 2 and 4 in monocytes and neutrophils (TLR2M, TLR2N, TLR4M, and TLR4N) and its endogenous ligands (cellular fibronectin [cFN] and heat shock protein 60 [HSP60]) in patients with and without periodontitis. Additionally, the relationship between cFN and HSP60 expression with innate immunity activation and systemic inflammatory response (interleukin 6 [IL-6]) was also evaluated.A case-controlled study was designed in which 30 patients with periodontitis (cases) and 30 age- and sex-matched participants without periodontitis (controls) were included. Fasting blood samples were collected to determine: (1) expression of TLR2N, TLR2M, TLR4N, and TLR4M by flow cytometry; and (2) serum concentrations of cFN, HSP60, and IL-6 by ELISA technique.Expression of TLR2M (411.5 [314.2, 460.0] vs. 236.5 [204.0, 333.0] AFU), TLR2N (387.0 [332.0, 545.5] vs 230.0 [166.2, 277.7] AFU), TLR4M (2478.5 [1762.2, 2828.0] vs 1705.0 [1274.5, 1951.2] AFU), and TLR4N (2791.0 [2306.7, 3226.2] vs. 1866.0 [1547.5, 2687.2] AFU) as well as serum levels of cFN (301.1 [222.2, 410.9] vs. 156.4 [115.3, 194.0] ng/ml) and IL-6 (10.4 [6.5, 11.5] vs. 3.5 [2.6, 4.9] pg/ml) were significantly higher in periodontitis patients than those without periodontitis. A positive association was found between periodontitis and cFN (odds ratio [OR] = 1.028, p 0.001), TLR2N (OR = 1.026, p 0.001), TLR4M (OR = 1.001, p = 0.002), and IL-6 (OR = 1.774, p 0.001).Periodontitis patients exhibited high expression of TLRs, cFN, and IL-6.

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

Background Several studies seek to prove the relationship between bruxism and periodontal status although it remains unclear and debatable. We aimed to assess the association between self-reported (SR) bruxism with the periodontal status in a large scale survey. Material and methods A total of 1064 individuals from the southern region of the Lisbon Metropolitan Area (Portugal) were enrolled. Patients were interviewed for the SR bruxism assessment through a self-report questionnaire. Full-mouth periodontal status was assessed with probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), and bleeding on probing (BoP) being measured. The American Association of Periodontology/European Federation of Periodontology 2018 case definitions were used. Logistic regression analyses provided information on the influence of SR bruxism towards periodontitis. Results SR bruxers exhibited lower prevalence of periodontitis. Additionally, SR bruxers with periodontitis had PD and CAL significantly lower than patients with only periodontitis. Multivariate analysis suggests that SR bruxism was significantly associated with a lower risk of periodontitis (odds ratio [OR] = 0.42 95% CI: 0.32-0.56). Mean PD and CAL were significantly lower in SR bruxers. When assessing the type of SR bruxism, significant differences among mean PD, CAL, and BoP levels were also identified. Conclusion SR bruxism and periodontal status are negatively associated. SR bruxers exhibit lower odds towards periodontitis and better periodontal clinical characteristics. Further studies are mandatory to clarify these findings.

Aim: To investigate the psychometric properties of the validated Portuguese version of the Brief Illness Perception Questionnaire (Brief‐IPQ) in patients with gingivitis and periodontitis. Material and Methods: This study enrolled 571 patients with periodontal diseases (PDs) (67 gingivitis and 504 periodontitis cases), in a population‐based epidemiologic survey conducted at the health centres in the South Lisbon Metropolitan Area. Brief‐IPQ, a 9‐item self‐reported scale, reliability was evaluated using Cronbach's alpha. Confirmatory factor analysis (CFA) was used to construct validation. Multigroup analysis tested invariance across gender. Results: The Brief‐IPQ showed acceptable reliability (α = .80). Confirmatory factor analysis revealed good model fit (χ2 (16) = 41.236, GFI = 0.982, CFI = 0.985, RMSEA = 0.053). All factors loaded similarly to the original Brief‐IPQ scale, with the exception of the “personal control” domain. Periodontal patients downgrade its illness and likely impact. The “consequences” domain showed significant positive correlations with all factors, except “treatment control” and “understanding” domains. The “concern” and “emotional response” domains had the highest significant correlation. Multigroup analysis findings supported factor invariance across the sex groups. Conclusion: The Brief‐IPQ revealed acceptable reliability, construct factorial validity and invariance across gender. This short instrument may be used as an easily applicable and valuable tool to determine illness perception in patients with PDs. info:eu-repo/semantics/publishedVersion

The European Union (EU) has taken the lead to promote the management of coastal systems. Management strategies are implemented by the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD), as well as the recent Maritime Spatial Planning (MSP) Directive. Most EU directives have a strong focus on public participation; however, a recent review found that the actual involvement of stakeholders was variable. The “Architecture and roadmap to manage multiple pressures on lagoons” (ARCH) research project has developed and implemented participative methodologies at different case study sites throughout Europe. These cases represent a broad range of coastal systems, and they highlight different legislative frameworks that are relevant for coastal zone management. Stakeholder participation processes were subsequently evaluated at 3 case study sites in order to assess the actual implementation of participation in the context of their respective legislative frameworks: 1) Byfjorden in Bergen, Norway, in the context of the WFD; 2) Amvrakikos Gulf, Greece, in the context of the MSFD; and 3) Nordre Alv Estuary, Sweden, in the context of the MSP Directive. An overall assessment of the evaluation criteria indicates that the ARCH workshop series methodology of focusing first on the current status of the lagoon or estuary, then on future challenges, and finally on identifying management solutions provided a platform that was conducive for stakeholder participation. Results suggest that key criteria for a good participatory process were present and above average at the 3 case study sites. The results also indicate that the active engagement that was initiated at the 3 case study sites has led to capacity building among the participants, which is an important intermediary outcome of public participation. A strong connection between participatory processes and policy can ensure the legacy of the intermediary outcomes, which is an important and necessary start toward more permanent resource management outcomes such as ecological and economic improvement. Integr Environ Assess Manag 2016;12:701–710. © 2016 SETAC. © 2016 SETAC