Search

Recent demographic developments resulted in an aged society with a rising disease burden of systemic and non-communicable diseases (NCDs). In cardiovascular disease (CVD), a NCD with high morbidity and mortality, recent preventive strategies include the investigation of comorbidities to reduce its significant economic burden. Periodontal disease, an oral bacterial-induced inflammatory disease of tooth-supporting tissue, is regulated in its prevalence and severity by the individual host response to a dysbiotic oral microbiota. Clinically, both NCDs are highly associated; however, shared risk factors such as smoking, obesity, type II diabetes mellitus and chronic stress represent only an insufficient explanation for the multifaceted interactions of both disease entities. Specifically, the crosstalk between both diseases is not yet fully understood. This review summarizes current knowledge on the clinical association of periodontitis and CVD, and elaborates on how periodontitis-induced pathophysiological mechanisms in patients may contribute to increased cardiovascular risk with focus on atherosclerosis. Clinical implications as well as current and future therapy considerations are discussed. Overall, this review supports novel scientific endeavors aiming at improving the quality of life with a comprehensive and integrated approach to improve well-being of the aging populations worldwide. [ABSTRACT FROM AUTHOR]

(1) Background: The in vitro study aimed to investigate mechanical characteristics of resin composites and their suitability in direct restauration of endodontically treated teeth (ETT). (2) Methods: 38 endodontically treated premolars with occlusal access cavities were directly restored using the following resin composites and adhesives: Tetric Evo Ceram® + Syntac classic® (n = 10), Venus Diamond® + iBond Total-Etch® (n = 10), Grandio® + Solobond M® (n = 9), Estelite® Sigma Quick + Bond Force® (n = 9). After thermocycling, the elastic modulus, shear-bond-strength, fracture load (Fmax) and fracture mode distribution were evaluated. Statistical analysis: one-way ANOVA, t-test, Kruskal–Wallis test; p < 0.05. (3) Results: Grandio® showed the highest E-modulus (15,857.9 MPa) which was significant to Venus Diamond® (13,058.83 MPa), Tetric Evo Ceram® (8636.0 MPa) and Estelite® Sigma Quick (7004.58 MPa). The highest shear-bond-strength was observed for Solobond M® (17.28 MPa), followed by iBond® (16.61 MPa), Syntac classic® (16.41 MPa) and Bond Force® (8.37 MPa, p < 0.05). The highest fracture load (Fmax) was estimated for ETT restored with Venus Diamond® (1106.83 N), followed by Estelite® Sigma Quick (1030.1 N), Tetric Evo Ceram® (1029 N) and Grandio® (921 N). Fracture-mode distribution did not show any significant differences. (4) Conclusions: The observed resin composites and adhesives show reliable mechanical characteristics and seem to be suitable for direct restoration of endodontically treated teeth. [ABSTRACT FROM AUTHOR]

Recently, our group showed that additional supplementation of Trolox™ (vitamin E analogue) can significantly enhance the antimicrobial photodynamic effect of the photosensitizer Indocyanine green (ICG). Up to now, the combined effect has not yet been investigated on Enterococcus faecalis in dental root canals. In the present in vitro study, eighty human root canals were inoculated with E. faecalis and subsequently subjected to antimicrobial Photodynamic Therapy (aPDT) using ICG (250, 500, 1000 µg/mL) and near-infrared laser light (NIR, 808 nm, 100 Jcm−2). Trolox™ at concentrations of 6 mM was additionally applied. As a positive control, irrigation with 3% NaOCl was used. After aPDT, root canals were manually enlarged and the collected dentin debris was subjected to microbial culture analysis. Bacterial invasion into the dentinal tubules was verified for a distance of 300 µm. aPDT caused significant suppression of E. faecalis up to a maximum of 2.9 log counts (ICG 250 µg/mL). Additional application of TroloxTM resulted in increased antibacterial activity for aPDT with ICG 500 µg/mL. The efficiency of aPDT was comparable to NaOCl-irrigation inside the dentinal tubules. In conclusion, ICG significantly suppressed E. faecalis. Additional application of TroloxTM showed only minor enhancement. Future studies should also address the effects of TroloxTM on other photodynamic systems. [ABSTRACT FROM AUTHOR]

Purpose: To compare the optical effects of an immediately placed anodized pink-neck implant and abutment vs a conventional gray implant and abutment in relation to soft tissue thickness 6 months after the restoration was completed.Materials and Methods: Forty patients with a hopeless maxillary anterior tooth received an immediate implant and an immediate provisional or custom healing abutment after flapless extraction. Participants were randomized to receive either a conventional titanium implant (control) or a pink-neck implant (test). All patients then received two identical CAD/CAM titanium abutments (one conventional gray, delivered first, and one anodized to appear pink, delivered 3 weeks after) and a zirconia crown. A spectrophotometer was used to record the color of the peri-implant mucosa and gingiva 3 weeks after delivery of each abutment and 6 months after the final restoration was delivered. The color difference between the two sites was calculated (ΔL*, Δa*, Δb*), and correlations with soft tissue thickness, change in ridge dimension, and implant position were assessed.Results: Irrespective of the randomization group, changing the abutments from gray to pink showed a change in color between the peri-implant mucosa and the natural gingiva. Patients with a thin gingival biotype showed a statistically significant color change (P = .00089) in the a* axis, meaning that the gingiva appeared more pink (Δa*). No significant correlation between the soft tissue color and buccolingual collapse, vertical recession, or implant position was observed in either group.Conclusion: The difference in color observed between the peri-implant mucosa and the gingiva was considerable in all groups. Anodized pink implants and abutments could reduce the difference in the red aspect (Δa*) of the peri-implant mucosa compared to the adjacent gingiva in patients with a thin biotype. [ABSTRACT FROM AUTHOR]

This prospective randomized controlled clinical trial aimed to compare changes in the horizontal and vertical soft tissue and the alveolar ridge dimension over the course of 12 months following immediate implant placement and temporization with or without simultaneous augmentation with a deproteinized bovine bone mineral with 10% collagen (DBBM-C). Thirty-two patients with a hopeless maxillary anterior tooth and fully intact sockets received an immediate implant and provisional or custom healing abutment after a flapless extraction. Patients were randomized to a control group (n = 16), which received no graft, or to a test group (n = 16), which received DBBM-C grafts. Horizontal and vertical soft tissue changes as well as soft tissue thickness were compared digitally between groups on casts obtained from impressions made at baseline and 3, 6, and 12 months. The test group showed less horizontal dimensional change than the control group; however, the change between the two groups was not statistically significant. Vertical dimensional soft tissue changes from baseline to 12 months showed a statistically significant difference at the distal papilla, favoring the test group. No statistically significant difference was observed for vertical changes between both groups at mesial papillae and midbuccal soft tissue; however, the test group showed lower values overall. No statistically significant differences in soft tissue thickness between groups were detected. Immediate implant placement and temporization with and without adding DBBM-C demonstrate favorable clinical outcomes regarding horizontal and vertical soft tissue changes. Both groups showed loss of tissue volume. Adding DBBM-C in the gap of immediately placed implants slightly lowered the change in tissue parameters, which was not statistically significant, for the first 12 months after implant placement. [ABSTRACT FROM AUTHOR]

Using tissue graft substitutes in root coverage procedures can avoid complications associated with harvesting an autogenous tissue graft. However, the resulting coverage rate and volume stability are generally lower when using tissue graft substitutes as compared to autogenous tissue grafts. A new volumestable porcine collagen matrix has recently been introduced for soft tissue thickening around dental implants; however, use of this matrix in recession coverage has not been reported. This case series demonstrates a novel surgical technique and reports clinical outcomes (7 to 12 months) of a minimally invasive root coverage procedure that uses vestibular incision subperiosteal tunnel access in combination with a volume-stable collagen matrix (VISTA-X). [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the visual effects of pink-neck implants and pink abutments with respect to the color of natural gingiva. The distribution pattern and magnitude of CIELAB color difference coordinates were studied. Materials and Methods: Forty subjects with a tooth in the maxillary esthetic zone deemed hopeless were recruited. Patients were randomized to either a conventional gray implant or a pink-neck implant. The hopeless tooth was removed, and patients received an immediate implant along with an immediate customized provisional prosthesis. The provisional was maintained for 3 months to allow for complete healing of the implants. Two identical computer-aided design/computer-aided manufacturing (CAD/CAM) titanium abutments only differing in color (gray and pink) were fabricated along with an all-ceramic zirconia crown. The gray abutment was delivered first with a zirconia crown, and it was replaced with the pink abutment 3 weeks later. Three weeks after insertion of each abutment with the zirconia crown, a spectrophotometer was used to collect the color of the peri-implant mucosa and natural gingiva, so the difference between the two sites could be calculated (ΔL* [difference in lightness], Δa* [difference in green-red axis], Δb* [difference in blue-yellow axis]). The natural gingiva measured was the gingiva of a contralateral or adjacent unrestored tooth. The effect of implant color and abutment on the color difference between peri-implant mucosa and natural gingiva was investigated with a linear regression model using a generalized estimating equation approach. Results: Raw data demonstrated statistically insignificant smaller ΔL*, Δa*, and Δb* between peri-implant soft tissue and natural gingiva when the implant was pink vs gray. Further, there were statistically insignificant smaller ΔL* and Δb* between peri-implant soft tissue and natural gingiva when the abutment was pink vs gray. Δa* between peri-implant soft tissue and natural gingiva was significantly smaller when using a pink abutment regardless of the implant type (P < .05). Conclusion: Using an anodized pink abutment and/or a pink-neck implant minimizes the color difference observed between the peri-implant mucosa and the natural gingiva in the redness spectrum. These advances in technology assist in helping the peri-implant mucosa appear more natural by minimizing the color variance. [ABSTRACT FROM AUTHOR]

Aim: Therapeutic modulation of bacterial‐induced inflammatory host response is being investigated in gingival inflammation and periodontal disease pathology. Therefore, dietary intake of the monounsaturated fatty acid (FA) oleic acid (OA (C18:1)), which is the main component of Mediterranean‐style diets, and saturated FA palmitic acid (PA (C16:0)), which is a component of Western‐style diets, was investigated for their modifying potential in an oral inoculation model of Porphyromonas gingivalis. Materials and Methods: Normal‐weight C57BL/6‐mice received OA‐ or PA‐enriched diets (PA‐ED, OA‐ED, PA/OA‐ED) or normal standard diet for 16 weeks and were inoculated with P. gingivalis/placebo (n = 12/group). Gingival inflammation, alveolar bone structure, circulating lipid mediators, and in vitro cellular response were determined. Results: FA treatment of P. gingivalis‐lipopolysaccharide‐incubated gingival fibroblasts (GFbs) modified inflammatory activation, which only PA exacerbated with concomitant TNF‐α stimulation. Mice exhibited no signs of acute inflammation in gingiva or serum and no inoculation‐ or nutrition‐associated changes of the crestal alveolar bone. However, following P. gingivalis inoculation, OA‐ED improved oral trabecular bone micro‐architecture and enhanced circulating pro‐resolving mediators resolvin D4 (RvD4) and 4‐hydroxydocosahexaenoic acid (4‐HDHA), whereas PA‐ED did not. In vitro experiments demonstrated significantly improved differentiation in RvD4‐ and 4‐HDHA‐treated primary osteoblast cultures and reduced the expression of osteoclastogenic factors in GF. Further, P. gingivalis infection of OA‐ED animals led to a serum composition that suppressed osteoclastic differentiation in vitro. Conclusions: Our results underline the preventive impact of Mediterranean‐style OA‐EDs by indicating their pro‐resolving nature beyond anti‐inflammatory properties. [ABSTRACT FROM AUTHOR]

Purpose: Maxillary sinus augmentation has been a predictable procedure. However, in-depth analysis of tissue healing after sinus grafting with simultaneous implant placement is limited. This study aimed to compare histologic outcomes after sinus grafting with a synthetic bone graft compared with a xenograft. Materials and Methods: A randomized controlled split-mouth study was conducted to compare bone formation around microimplants (2.00 mm, Dentium) placed at the time of maxillary sinus augmentation with a synthetic material (Osteon, Dentium) (OST) and deproteinized bovine bone (Bio-Oss) (BIO) as the control group. Four microimplants per subject (n = 13) were placed bilaterally for intrasubject comparison (two implants per side/patient). Bone cores with osseointegrated microimplants were harvested for histomorphometric analysis 6 to 8 months after sinus augmentation surgery. Results: Histologic analysis revealed newly formed bone deposited on the microimplant surface and bridging to bone graft material in both groups. Further, there was no histologic evidence of signs of inflammation in all specimens. In general, bone-to-implant contact was comparable and ranged from 6.1% to 67.0% with a mean of 38.4% ± 11.61% in OST and from 10.5% to 57.0% with a mean of 34.58% ± 12.55% in BIO. However, a significantly higher percentage of bone-to-implant contact in the first four threads of the grafted area was noted in OST compared with BIO (P = .016). Conclusion: The synthetic OST was found to be equivalent to BIO in new bone formation and clinical success after sinus augmentation in conjunction with microimplant placement. Although there are some statistically significant differences in the histologic outcomes, the clinical relevance of these needs to be further evaluated. Nevertheless, the findings of this study indicate that this synthetic alloplast would be a viable alternative to an allograft material. [ABSTRACT FROM AUTHOR]

Implant placement in the edentulous maxilla often represents a clinical challenge because of insufficient bone height after crestal bone resorption and maxillary sinus pneumatization. In this study, tissue engineering techniques were used to increase bone height in the posterior maxilla before implant placement. Periosteal biopsies were harvested, and osteoblast precursor cells were isolated and cultured on three-dimensional fleeces (nonwoven polyglactin-910 fibers connected by poly-p-dioxanon bonding sites) in vitro. Tissue-engineered bone chips were implanted into the sinus cavity using a lateral window approach. Four months post-sinus augmentation, implants were placed and subsequently restored. During a 12-month follow-up period, no implant failure was observed. [ABSTRACT FROM AUTHOR]

Purpose: This prospective, randomised, controlled clinical trial evaluated the relationship between alveolar ridge dimensional change and recession with the implant position (horizontal and vertical) and tissue phenotype in immediately placed and provisionalised implants without the use of bone grafting. Materials and methods: Patients (n = 40) with a hopeless maxillary anterior tooth received an immediate implant and immediate provisional or customised healing abutment after flapless extraction. Implants were finally restored 3 months after placement and followed up for 6 months after delivery of the restoration. The alveolar ridge dimensional change and recession were measured using cone beam computed tomography (CBCT) scans and digitalised dental casts. Alveolar contour changes were correlated to implant position and tissue phenotype. Results: The tissue phenotype showed no significant correlation to the alveolar ridge dimensional change. At 6 months, the average alveolar ridge dimensional change was approximately 0.7 mm in the buccolingual dimension independent of tissue phenotype. A statistically significant difference was observed on the recession values comparing tissue phenotypes, with more recession observed in the thin phenotype (1.96 mm) than in the thick phenotype (1.18 mm). A significant correlation was observed between horizontal implant position and buccolingual alveolar ridge change. A positive correlation was observed between the horizontal implant position and the dimensional change measured in the casts at the level of the free gingival margin. A statistically significant negative correlation was observed between the horizontal implant position and the resorption measured by the CBCT scans. Conclusions: Patients with thin tissue phenotype had a more marked recession. The horizontal implant position showed a relationship to the alveolar ridge dimensional changes observed. The greater the buccal gap distance between the implant and the buccal plate, the lesser the radiographic changes observed in the alveolar bone, however, the greater the changes observed in the buccal aspect of the casts at the level of the free gingival margin. [ABSTRACT FROM AUTHOR]

Implant placement in the edentulous maxilla often represents a clinical challenge due to insufficient bone height after crestal bone resorption and maxillary sinus pneumatization. Several graft materials have been evaluated for augmenting the maxillary sinus to compensate for the lost vertical dimension. Allografts are readily available without the risk of disease transmission and the need for a second site surgery. The aim of this case series was to systematically evaluate the development and maturation of augmented bone in the maxillary sinus using beta-tricalcium phosphate. In 21 to 40 weeks post-sinus elevation, bone biopsies were taken and implants placed simultaneously. All specimens were demineralized and subjected to staining procedures (ie, Hematoxylin and Eosin [H&E], Goldner's staining, and tartrate-resistant acid phosphatase [TRAP]). Total bone increased over time, whereas the amount of graft material diminished. A lack of inflammatory reaction was noticed with the use of this graft material. In addition, TRAP staining revealed the presence of osteoclasts surrounding the remaining particles. During a 12-month follow-up, no implant failure or complications were observed. [ABSTRACT FROM AUTHOR]

Background: Excessive intake of fatty acids is a key factor contributing to metabolic dysfunction-associated steatotic liver disease (MASLD). However, the effects of saturated fatty acids (SFA) and unsaturated fatty acids (UFA) on the development of MASLD are uncertain. Therefore, we conducted two-sample Mendelian randomization studies and animal experiments to explore the effects of SFA, monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) on the risk of developing MASLD., Methods: The genetic summary data of exposures and outcome were retrieved from genome-wide association studies (GWASs) and used for five Mendelian randomization methods. A comprehensive sensitivity analysis was performed to verify the robustness of the results. Mice were subjected to different diets followed by assessment of severity of steatosis based on a histological score and determination of hepatic triglyceride levels to investigate the relationships between SFA, MUFA, PUFA and MASLD., Results: The Mendelian randomization results showed that MUFA (odds ratio: 1.441, 95% confidence interval: 1.078-1.927, P = 0.014) was causally associated with the incidence of MASLD. SFA and PUFA were not causally associated with the incidence of MASLD. Sensitivity analysis did not identify any significant bias in the results. The animal experiment results showed that a MUFA-enriched diet significantly contributed to the development of hepatic steatosis (P < 0.001)., Conclusion: SFA and PUFA did not have a significant causal effect on MASLD, but MUFA intake is a risk factor for MASLD. A MUFA-enriched diet increased the incidence of macrovesicular steatosis and the hepatic triglyceride levels. Therefore, replacing MUFA intake with a moderate intake of PUFA might help reduce the risk of MASLD., Competing Interests: Declarations. Ethical approval: We used summary data from a publicly available database (OpenGWAS) that had obtained participant consent and ethical approval. In our animal experiment, all procedures were performed in accordance with the German Law on the Protection of Animals/European Communities Council Directive (86/609/EEC) and approved by the Thuringia State Office for Food Safety and Consumer Protection (Approval number: UKJ-17/036). Conflict of interest: All authors declare no conflict of interest., (© 2024. The Author(s).)