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Aim: To develop and validate an automated electronic health record (EHR)-based algorithm to suggest a periodontal diagnosis based on the 2017 World Workshop on the Classification of Periodontal Diseases and Conditions., Materials and Methods: Using material published from the 2017 World Workshop, a tool was iteratively developed to suggest a periodontal diagnosis based on clinical data within the EHR. Pertinent clinical data included clinical attachment level (CAL), gingival margin to cemento-enamel junction distance, probing depth, furcation involvement (if present) and mobility. Chart reviews were conducted to confirm the algorithm's ability to accurately extract clinical data from the EHR, and then to test its ability to suggest an accurate diagnosis. Subsequently, refinements were made to address limitations of the data and specific clinical situations. Each refinement was evaluated through chart reviews by expert periodontists at the study sites., Results: Three-hundred and twenty-three charts were manually reviewed, and a periodontal diagnosis (healthy, gingivitis or periodontitis including stage and grade) was made by expert periodontists for each case. After developing the initial version of the algorithm using the unmodified 2017 World Workshop criteria, accuracy was 71.8% for stage alone and 64.7% for stage and grade. Subsequently, 16 modifications to the algorithm were proposed and 14 were accepted. This refined version of the algorithm had 79.6% accuracy for stage alone and 68.8% for stage and grade together., Conclusions: Our findings suggest that a rule-based algorithm for suggesting a periodontal diagnosis using EHR data can be implemented with moderate accuracy in support of chairside clinical diagnostic decision making, especially for inexperienced clinicians. Grey-zone cases still exist, where clinical judgement will be required. Future applications of similar algorithms with improved performance will depend upon the quality (completeness/accuracy) of EHR data., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

To appraise the literature on the prevalence of the JP2 clone of Aggregatibacter actinomycetemcomitans (A.a.) and on its association with presence and progression of periodontitis in different populations. A systematic search of the literature was conducted in Medline, Embase and Cochrane Library for studies reporting data on detection of the JP2 clone of A.a. A total of 56 papers were included in the review, from an initial search of 685 titles. Studies were carried out in populations with a mean age of 26.34 years (range 6.24-53.85 years). Just over 16% of the overall population assessed (n = 13 751) had the JP2 clone detected. Meta-analyses included 16 studies and 1775 patients, and revealed an association between detection of the JP2 clone and diagnosis of periodontitis (RR = 1.86, 95% 1.43-2.42) from saliva and plaque, with high heterogeneity (I 2  = 85%, p < .00001). Meta-analyses included 5 studies and 616 patients, and revealed an association between baseline detection of the JP2 clone and onset of periodontitis over 2 to 5 years (RR = 4.12, 95% 2.42-7.00), with high heterogeneity (I 2  = 81%, p < .0003). From the overall risk of bias score, 29 papers were judged as low risk of bias, whilst the remaining papers were judged to have an overall medium or high risk of bias. Detection of the JP2 clone of A.a. in subgingival plaque and saliva samples is associated with increased odds of diagnosis of periodontitis and may be able to predict onset of periodontitis. This systematic review provides clear evidence that in certain populations, the JP2 clone of A.a. is associated with early-onset periodontitis. Furthermore, detection of this bacterium seems to be predictive of disease onset., (© 2023 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd.)

Aim: This study determined whether higher screen time was associated with the development of 3-year-old children in Taiwan. It also examined whether differences would be found between television and other screen-based media in the probability of lagged development., Methods: We examined 2139 children aged 3 years and their parents. The association between daily screen time was assessed using multiple logistic regression analysis. All the odds ratios (ORs) were calculated using the rates of lagged developmental achievement, with the group who used screens for less than 1 h a day as the reference category. Screen time comprised television and other screen-based media, such as smartphones, touch screens, computers and laptops., Results: Children who used screens for more than 3 h per day had the lowest developmental scores and highest probabilities of lagged development. The children who used other screen-based media for more than 1 h per day had greater probabilities of lagged developmental achievements (ORs 1.85-4.98, all p < 0.05) than those who watched television for the same amount of time (OR 1.41-2.77, all p < 0.05)., Conclusion: Increased screen time was associated with higher probabilities of lagged developmental achievement in multiple development domains in 3-year-old children, particularly other screen-based media., (© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Cemiplimab has been widely recommended by international guidelines to treat patients with locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC). In this study, we conducted a comparative analysis to integrate the efficacy and safety data in the published prospective and retrospective studies for better understanding the application of cemiplimab. The online databases (PubMed, Cochrane CENTRAL, Web of Science, and EMBASE) were searched to find out eligible studies from inception to November 4, 2021. The "R" software and the "meta" package were used to synthesize the objective response rates (ORRs), disease control rates (DCRs), and the incidences of treatment-related adverse events (TRAEs). Overall, three retrospective studies with 398 patients and three prospective studies with 219 patients were enrolled. The pooled ORR and DCR were 53% (95% confidence interval [CI] 46-59) and 70% (95% CI 57-82) for retrospective studies versus 45% (95% CI 39-52) and 68% (95% CI 56-79) for prospective studies. In regard of toxicities, prospective studies reported much higher incidences of any grade (99% vs. 47%) and grade 3-4 TRAEs (43% vs. 15%) against retrospective studies. The most reported TRAE was fatigue, followed by diarrhea and pruritus. In addition, nine treatment-related deaths (four in retrospective studies vs. five in prospective studies) were documented. In both retrospective and prospective clinical practices, cemiplimab could be an effective regimen for locally advanced or metastatic CSCC patients, but toxicities during the treatment deserve further attention., (© 2022 Wiley Periodicals LLC.)

Aim: The aim of this analysis was to assess how different tooth-prognosis systems could predict tooth loss in a cohort of periodontitis patients followed up prospectively during supportive periodontal care (SPC)., Materials and Methods: Clinical and radiographic data of 97 patients undergoing regular SPC for 5 years were used to assign tooth prognosis using four different systems (McGuire & Nunn, 1996; Kwok & Caton, 2007; Graetz et al., 2011; Nibali et al., 2017). Three independent examiners assigned tooth prognosis using all four systems, following a calibration exercise. The association between prognostic categories and tooth loss was tested for each prognostic system separately and across prognostic systems., Results: All four systems showed good reproducibility and could identify teeth at higher risk of being lost during 5 years of SPC; the risk of tooth loss increased with the worsening of tooth-prognosis category (p < .0001). Although specificity and negative predictive values were good, low sensitivity and positive predictive values were detected for all systems., Conclusions: Previously published periodontal prognostic systems exhibited good reproducibility and predictive ability for tooth retention. However, low sensitivity was detected, with several teeth in the worst prognosis category being retained at 5 years. Some modifications in the number of categories and their definitions are suggested., (© 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

Background: It is thought that infrabony defect morphology affects the outcome of periodontal regenerative surgery. However, this has not been systematically investigated., Aims: To investigate how well defect morphology is described in papers reporting regenerative therapy of periodontal infrabony defects and to investigate its effect on clinical and radiographic outcomes., Materials and Methods: A search was conducted in 3 electronic databases for publications reporting clinical and radiographic outcomes of periodontal intra-bony defects after regenerative therapy, divided by defect morphology., Results: The initial search resulted in 4487 papers, reduced to 143 after first and second screening. Fifteen of these publications were suitable for a fixed-effects meta-analysis. Initial defect depth was found to influence radiographic bone gain 12 months post-surgery, while narrower angles and increased number of walls influenced both radiographic bone gain and clinical attachment level (CAL) gain at 12 months. These associations seemed to occur irrespective of biomaterials used. Risk of bias ranged from low to high., Conclusion: Deeper defects with narrower angles and increased number of walls exhibit improved CAL and radiographic bone gain at 12 months post-regenerative surgery. More data are needed about other aspects of defect morphology such as extension to buccal/lingual surfaces., (© 2020 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

The mitigation of biofouling has received significant research attention, with particular focus on non-toxic and sustainable strategies. Here, we investigated quorum sensing inhibitor (QSI) bacteria as a means of controlling biofouling in a laboratory-scale system. Approximately, 200 strains were isolated from coral (Pocillopora damicornis) and screened for their ability to inhibit quorum sensing (QS). Approximately, 15% of the isolates exhibited QSI activity, and a typical coral symbiotic bacterium, H12-Vibrio alginolyticus, was selected in order for us to investigate quorum sensing inhibitory activity further. Confocal microscopy revealed that V. alginolyticus extract inhibited biofilm formation from Pseudomonas aeruginosa PAO1. In addition, the secondary metabolites of V. alginolyticus inhibited PAO1 virulence phenotypes by downregulating motility ability, elastase activity and rhamnolipid production. NMR and MS spectrometry suggested that the potential bioactive compound involved was rhodamine isothiocyanate. Quantitative real-time PCR indicated that the bacterial extract induced a significant downregulation of QS regulatory genes (lasB, lasI, lasR, rhlI, rhlR) and virulence-related genes (pqsA, pqsR). The possible mechanism underlying the action of rhodamine isothiocyanate analogue involves the disruption of the las and/or rhl system of PAO1. Our results highlight coral microbes as a bioresource pool for developing QS inhibitors and identifying novel antifouling agents., (© 2018 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.)

The aim of this systematic review was to compare the root-coverage outcomes of using a partially exposed connective tissue graft (CTG) technique with a fully covered CTG technique for root coverage. An electronic search up to February 28 th , 2017, was performed to identify human clinical studies with data comparing outcomes of root coverage using CTG, with and without a partially exposed graft. Five clinical studies were selected for inclusion in this review. For each study, the gain of keratinized gingiva, reduction of recession depth, number of surgical sites achieving complete root coverage, percentage of root coverage, gain of tissue thickness, and changes of probing depth and clinical attachment level were recorded. Meta-analysis for the comparison of complete root coverage between the two techniques presented no statistically significant differences. A statistically significant gain of keratinized tissue in favor of the sites with an exposed CTG and a tendency of greater reduction in recession depth were seen at the sites with a fully covered CTG. Based on the results, the use of a partially exposed CTG in root-coverage procedures could achieve greater gain in keratinized gingiva, while a fully covered CTG might be indicated for procedures aiming to reduce recession depth., (© 2018 Eur J Oral Sci.)

Background: Recent research is increasingly showing that host genetic variants can affect the colonization by specific microbes. The aim of this study was to systematically investigate the associations between host genetic variants and subgingival microbial detection and counts., Materials and Methods: A systematic search of the literature was conducted in Ovid Medline, Embase, LILACS and Cochrane Library for studies reporting data on host genetic variants and detection of microbes subgingivally., Results: A total of 43 studies were included in the review, from an initial search of 3887 titles. Studies consisted mainly of candidate gene studies and of one genome-wide analysis. Some promising associations were detected between single nucleotide polymorphisms and microbial detection. The only feasible meta-analysis failed to show any association between Interleukin 1 (IL1) genetic variants and detection of periodontopathogenic bacteria subgingivally., Conclusions: There is no evidence yet that neither IL1 genetic polymorphisms nor other investigated genetic polymorphisms are associated with presence and counts of subgingival bacteria. Further studies on large populations with replication samples should clarify the possible effects of other genetic variants on the subgingival microbiota., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The aim of this study was to investigate risk of tooth loss in molars with furcation involvement (FI) based on initial diagnosis., Materials and Methods: A systematic search of the literature was conducted in Ovid Medline, Embase, LILACS and Cochrane Library for longitudinal studies with at least 3 years follow-up including measures of FI and data on tooth loss., Results: A total of 21 studies were included in the review, from an initial search of 1207 titles. The relative risk of tooth loss during maintenance therapy attributable to FI was 1.46 (95% CI = 0.99-2.15, p = 0.06) for studies up to 10 years and 2.21 (95% CI = 1.79-2.74, p < 0.0001) for studies with a follow-up of 10-15 years. A gradual increase in the risk of tooth loss was observed for molars with degree II and III FI., Conclusions: The presence of FI approximately doubles the risk of tooth loss for molars maintained in supportive periodontal therapy for up to 10-15 years. However, most molars, even with grade III FI respond well to periodontal therapy, suggesting that every effort should be made to maintain these teeth when possible. Long-term studies reporting patient-reported outcomes are needed to substantiate this conclusion., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The aim was to evaluate the effects of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human fibroblast growth factor-2 (rhFGF-2) on treating periodontal intra-bony defects, compared to the control (carrier alone)., Methods: Electronic and hand searches were performed to identify eligible studies. The weighed mean differences of linear defect fill (LDF), probing depth (PD) reduction, clinical attachment level (CAL) gain and gingival recession (GR) were calculated using random effect meta-analysis., Results: The searches yielded 1018 articles, of which seven studies were included. Only one included study was considered at low risk of bias. The outcomes that reached statistical significance in comparison to carriers alone included: LDF (0.95 mm, 95% CI: 0.62-1.28 mm or 20.17%, 95% CI: 11.81-28.54%) and CAL gain (0.34 mm, 95% CI: 0.03-0.65 mm) for PDGF, and LDF (21.22%, 95% CI: 5.82-36.61%) for FGF-2., Conclusions: Within the limits of this review, rhPDGF-BB demonstrated significantly more LDF and CAL gain; rhFGF-2 resulted in significantly higher percentage of LDF., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)