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Annals of Palliative Medicine Jul 2022The efficacy and safety between connective tissue graft (CTG) and acellular dermal matrix (ADM) remain inconsistent. Meta-analysis is a valuable approach to resolve... (Meta-Analysis)
Meta-Analysis
Efficacy and safety of acellular dermal matrix versus connective tissue graft for root coverage of Miller's Class I and II gingival recession: a systematic review and meta-analysis.
BACKGROUND
The efficacy and safety between connective tissue graft (CTG) and acellular dermal matrix (ADM) remain inconsistent. Meta-analysis is a valuable approach to resolve inconsistencies across studies and provide a high level of evidence to comprehensively evaluate the effect and safety of ADM versus CTG for root coverage of Miller's Class I and II gingival recession. Our study was conducted to comprehensively analyze the efficacy and safety of ADM versus CTG for root coverage in patients with gingival recession.
METHODS
Articles on randomized controlled trials (RCTs) that compared the ADM with CTG for adult patients with the gingival recession in terms of percent root coverage (PRC), clinical attachment level (CAL), keratinized tissue (KT), probing depth (PD), recession width (RW), and recession depth (RD) were identified in PubMed, Embase, Cochrane Library, and Web of Science databases until 15 May 2020. Weighted mean difference (WMD) was used as the statistic for measurement data and the effect sizes were expressed as 95% confidence intervals (CIs).
RESULTS
A total of 24 RCTs were eligible for the final analysis. A total of 587 patients with 1,315 gingival recession sites were involved in the study. There were 724 loci in the ADM group and 591 loci in the CTG group. The patients who underwent ADM had a higher gain in CAL (WMD: 0.25, 95% CI: 0.03 to 0.47, P=0.026) but a smaller gain in KT width (WMD: -0.44, 95% CI: -0.63 to -0.25, P<0.001) than those who underwent CTG. No significant differences were found between the patients who underwent ADM and those who received CTG in PRC (WMD: -1.61, 95% CI: -3.49 to 0.28, P=0.094), PD (WMD: 0.07, 95% CI: -0.01 to 0.14, P=0.067), RW (WMD: 0.07, 95% CI: -0.10 to 0.23, P=0.437), and RD (WMD: 0.11, 95% CI: -0.10 to 0.31, P=0.294).
DISCUSSION
The ADM treatment for patients with gingival recession may be superior to CTG in gaining CAL, but CTG has a significant advantage over ADM for gaining KT width. ADM can be considered in the future as a treatment for root coverage in patients with gingival recession.
Topics: Acellular Dermis; Adult; Connective Tissue; Gingiva; Gingival Recession; Humans; Surgical Flaps; Treatment Outcome
PubMed: 35927781
DOI: 10.21037/apm-22-656 -
BMC Women's Health Feb 2021Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases.
METHODS
This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters.
RESULTS
18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [- 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters.
CONCLUSIONS
The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.
Topics: Contraceptive Agents; Female; Humans; Periodontal Diseases
PubMed: 33526027
DOI: 10.1186/s12905-021-01180-0 -
PloS One 2023Periodontitis is a chronic multifactorial inflammatory disease linked to oral microbiota dysbiosis. This disease progresses to infection that stimulates a host...
CONTEXT
Periodontitis is a chronic multifactorial inflammatory disease linked to oral microbiota dysbiosis. This disease progresses to infection that stimulates a host immune/inflammatory response, with progressive destruction of the tooth-supporting structures.
OBJECTIVE
This systematic review aims to present a robust critical evaluation of the evidence of salivary protein profiles for identifying oral diseases using proteomic approaches and summarize the use of these approaches to diagnose chronic periodontitis.
DATA SOURCES
A systematic literature search was conducted from January 1st, 2010, to December 1st, 2022, based on PICO criteria following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and by searching the three databases Science Direct, Scopus, and Springer Link.
STUDY SELECTION
According to the inclusion criteria, eight studies were identified to analyze the proteins identified by proteomics.
RESULTS
The protein family S100 was identified as the most abundant in patients with chronic periodontitis. In this family, an increased abundance of S100A8 and S100A9 from individuals with the active disease was observed, which strongly relates to the inflammatory response. Moreover, the ratio S100A8/S100A9 and the metalloproteinase-8 in saliva could differentiate distinct periodontitis groups. The changes in protein profile after non-surgical periodontal therapy improved the health of the buccal area. The results of this systematic review identified a set of proteins that could be used as a complementary tool for periodontitis diagnosis using salivary proteins.
CONCLUSION
Biomarkers in saliva can be used to monitor an early stage of periodontitis and the progression of the disease following therapy.
Topics: Humans; Chronic Periodontitis; Proteomics; Saliva; Periodontium; Periodontal Ligament; Calgranulin A; Calgranulin B
PubMed: 37224160
DOI: 10.1371/journal.pone.0286079 -
Therapeutic Advances in Musculoskeletal... 2019Periodontitis is an inflammatory disease of dental supporting tissues (gingiva, periodontal ligament, and bone) and it has been suggested as a possible etiology for... (Review)
Review
Periodontitis is an inflammatory disease of dental supporting tissues (gingiva, periodontal ligament, and bone) and it has been suggested as a possible etiology for rheumatoid arthritis (RA). In this systematic review, we aim to verify if periodontitis represents a risk factor for RA. Electronic databases were consulted until March 2018 considering eligibility criteria focusing on: (P, participants) adults; (E, exposure) with periodontitis; (C, comparison) without periodontitis; and (O, outcome) development of RA. Quality assessment of studies and risk-of-bias evaluation were also performed. To undertake a quantitative analysis, the number of persons with RA and a total number of participants for the case group (with periodontitis) and control group (without periodontitis) were used to calculate the odds ratio (OR) with a 95% confidence interval (CI). A total of 3888 articles were identified, and nine studies were considered eligible. Seven of 9 articles suggested an association among diseases by the common pro-inflammatory profiles. The pooled analysis of 3 articles showed a higher RA prevalence for persons with periodontitis ( = 1177) than controls ( = 254) (OR 1.97; CI 1.68-2.31; < 0.00001). However, considerable heterogeneity among studies was verified (I = 96%, < 0.00001). Periodontitis may represent a risk factor for RA by heredity, bacterial infection, and the pro-inflammatory profile shared between both diseases. Although most of the elective studies report an association between periodontitis and RA, the quantitative analysis showed a high heterogeneity, leading to the need for further studies.
PubMed: 31316593
DOI: 10.1177/1759720X19858514 -
Journal of Clinical Medicine Mar 2021The course of periodontal disease is affected by many factors; however, the most significant are the dysbiotic microflora, showing different pathogenicity levels. Rapid... (Review)
Review
The course of periodontal disease is affected by many factors; however, the most significant are the dysbiotic microflora, showing different pathogenicity levels. Rapid colonization in the subgingival environment can radically change the clinical state of the periodontium. This systematic review aims to present an innovative technique of loop-mediated isothermal amplification for rapid panel identification of bacteria in periodontal diseases. The decisive advantage of the loop-mediated isothermal amplification (LAMP) technique in relation to molecular methods based on the identification of nucleic acids (such as polymerase chain reaction (PCR or qPCR) is the ability to determine more pathogens simultaneously, as well as with higher sensitivity. In comparison with classical microbiological seeding techniques, the use of the LAMP method shortens a few days waiting time to a few minutes, reducing the time necessary to identify the species and determine the number of microorganisms. The LAMP technology requires only a small hardware base; hence it is possible to use it in outpatient settings. The developed technique provides the possibility of almost immediate assessment of periodontal status and, above all, risk assessment of complications during the treatment (uncontrolled spread of inflammation), which can certainly be of key importance in clinical work.
PubMed: 33809163
DOI: 10.3390/jcm10061189 -
Biomolecules Feb 2022Periodontal ligament (PDL) cells play a pivotal role in periodontal and bone homeostasis and have promising potential for regenerative medicine and tissue engineering.... (Review)
Review
Periodontal ligament (PDL) cells play a pivotal role in periodontal and bone homeostasis and have promising potential for regenerative medicine and tissue engineering. There is compelling evidence that long non-coding RNAs (lncRNAs) are differentially expressed in PDL cells compared to other cell types and that these lncRNAs are involved in a variety of biological processes. This study systematically reviews the current evidence regarding the expression and regulatory functions of lncRNAs in PDL cells during various biological processes. A systematic search was conducted on PubMed, the Web of Science, Embase, and Google Scholar to include articles published up to 1 July 2021. Original research articles that investigated the expression or regulation of lncRNAs in PDL cells were selected and evaluated for a systematic review. Fifty studies were ultimately included, based on our eligibility criteria. Thirteen of these studies broadly explored the expression profiles of lncRNAs in PDL cells using microarray or RNA sequencing. Nineteen studies investigated the mechanisms by which lncRNAs regulate osteogenic differentiation in PDL cells. The remaining 18 studies investigated the mechanism by which lncRNAs regulate the responses of PDL cells to various stimuli, namely, lipopolysaccharide-induced inflammation, tumor necrosis factor alpha-induced inflammation, mechanical stress, oxidative stress, or hypoxia. We systematically reviewed studies on the expression and regulatory roles of lncRNAs in diverse biological processes in PDL cells, including osteogenic differentiation and cellular responses to inflammation, mechanical stress, and other stimuli. These results provide new insights that may guide the development of lncRNA-based therapeutics for periodontal and bone regeneration.
Topics: Cell Differentiation; Cells, Cultured; Humans; Inflammation; Osteogenesis; Periodontal Ligament; RNA, Long Noncoding
PubMed: 35204802
DOI: 10.3390/biom12020304 -
Clinical Oral Investigations Oct 2020Inflammation is an integral part of the pathogenesis of periodontitis and sleep disorders. The aim of the present study was to review systematically the current evidence...
OBJECTIVES
Inflammation is an integral part of the pathogenesis of periodontitis and sleep disorders. The aim of the present study was to review systematically the current evidence relating to the association between periodontal diseases and non-apnea sleep disorder.
MATERIALS AND METHODS
Systematic searches were performed in MEDLINE, PsycINFO, Cochrane library, Web of Science, and Scopus without any limitation. Following preliminary screening, the quality of the remaining selected papers was appraised using the Newcastle-Ottawa Scale. Due to substantial heterogeneity among the selected articles, main outcomes were reported in a qualitative manner.
RESULTS
Following screening and evaluation, a final set of 13 studies was selected for inclusion. These studies examined the association between periodontal disease and short sleep duration, long sleep duration, poor sleep quality, or non-specific sleep disorders. The majority (N = 12/13) reported an association or trend between one type of sleep abnormality and periodontal or gingival parameters.
CONCLUSION
Despite the respective limitations of the articles included in this systematic review, an association between periodontal diseases and sleep disturbances was apparent.
CLINICAL RELEVANCE
Adequate management of periodontal disease requires that a patient's lifestyle factors be taken into consideration in treatment planning. One such factor is sleep initiation and maintenance. An obvious association between sleep disturbances and periodontitis exists. Sleep disorders may induce systemic inflammation, which, in turn, could influence the development of periodontitis.
Topics: Gingiva; Humans; Periodontal Diseases; Sleep Wake Disorders
PubMed: 32734481
DOI: 10.1007/s00784-020-03475-2 -
Dentistry Journal Jun 2023The periodontium is a unique organ from the standpoint of building an organ-on-a-chip (OoC) since it is a system that is continually threatened by microorganisms, their... (Review)
Review
The periodontium is a unique organ from the standpoint of building an organ-on-a-chip (OoC) since it is a system that is continually threatened by microorganisms, their noxious compounds, and antigenic components. At the same time, periodontal health depends on a balanced connection between the host and the bacteria in the oral cavity, which is a complex micro-ecological environment. The objective of this systematic review of in vitro studies is to revise the potential clinical application of OoC in periodontal diseases. PRISMA was used to guide this analysis. The review framework made use of several databases, including SCOPUS, PubMed/MEDLINE, SCIELO, and LILACS as well as the gray literature. This systematic review comprised seven studies. The clinical efficacy of OoC in periodontal diseases was observed in models of the gingival crevice for the research of periodontitis, periodontal medication analysis, the interaction of multiple microbial species, pH measurements in in situ-grown biofilm, testing antimicrobial reagents, evaluation of mucosal interactions with microorganisms, and a device for quantitative exploration of microorganisms. OoC has the potential to advance our understanding of periodontal diseases by providing a more accurate representation of the oral microenvironment and enabling the development of new treatments.
PubMed: 37504224
DOI: 10.3390/dj11070158 -
Journal of Tissue Engineering and... Dec 2021The use of bioactive agents combined with osteoconductive scaffolds for the regeneration of periodontal intrabony defects has been the subject of intensive research in... (Meta-Analysis)
Meta-Analysis
The use of bioactive agents combined with osteoconductive scaffolds for the regeneration of periodontal intrabony defects has been the subject of intensive research in the past 20 years. Most studies reported that such agents, used in different concentrations, doses and combined with various scaffolds, might promote periodontal tissue regeneration, but evidence for the most effective combination of such agents is lacking. The objective of this study 13 was to rank the different combinations of recombinant human-derived growth and differentiation factors with/without scaffold biomaterial in the treatment of periodontal intrabony defects, through network meta-analysis of pre-clinical studies. The systematic review and network meta-analysis protocol was registered on the PROSPERO Systematic Review database with reference number: CRD42021213673. Relevant published articles were obtained after searching five electronic databases. A specific search strategy was followed by using keywords related to intrabony defects, regenerative materials, scaffolds and recombinant factors, and animal studies. All pre-clinical studies used for periodontal regeneration were included. The primary outcomes were: regeneration of junctional epithelium (mm), new cementum, connective tissue attachment, percentage of new bone formation (%), bone area (mm ), bone volume density (g/cm ) and bone height (mm) data was extracted. The analysis was carried out using network meta-analysis methods, that is illustrating network plots, contribution plots, predictive and confidence interval plot, surface under the cumulative ranking (SUCRA), multidimensional scale ranking and net funnel plots using STATA IC statistical software. An SYRCLE's tool for assessing risk of bias was used for reporting risk of bias among individual studies. A total of N = 24 for qualitative and N = 21 studies for quantitative analysis published till 2020 were included. The cumulative total number of animals included in the control and test groups were N = 162 and N = 339, respectively. The duration of the study was between 3 and 102 weeks rhBMP-2 ranked higher in SUCRA as the agent associated with the best performance for bone volume density. rhGDF-5/TCP ranked best in the bone area (mm2), rhPDGF-BB/Equine ranked best in bone height (mm), rhBMP-2 ranked best in the percentage of new bone fill, rhBMP-2/ACS ranked best in new cementum formation, and rhGDF-5/b- TCP/PLGA ranked best in connective tissue attachment and junctional epithelium. There were no adverse effects identified in the literature that could affect the different outcomes for regeneration in intrabony defects. Various recombinant factors are effective in promoting the regeneration of both soft and hard tissue supporting structures of the periodontium. However, when considering different outcomes, different agents, associated or not with biomaterials, ranked best. Keeping into account the limited transferability of results from animal studies to the clinical setting, the choice of the most appropriate formulation of bioactive agents may depend on clinical needs and purpose.
Topics: Animals; Becaplermin; Bone Morphogenetic Protein 2; Bone Regeneration; Horses; Humans; Periodontium; Recombinant Proteins; Transforming Growth Factor beta
PubMed: 34585856
DOI: 10.1002/term.3250 -
Journal of Applied Biomaterials &... 2023Polycaprolactone (PCL) is a highly recognized synthetic polymer for its biocompatibility, ease of fabrication and mechanical strength in bone tissue engineering. Its...
BACKGROUND
Polycaprolactone (PCL) is a highly recognized synthetic polymer for its biocompatibility, ease of fabrication and mechanical strength in bone tissue engineering. Its applications have extended broadly, including regeneration of oral and maxillofacial lost tissues. Its usefulness has brought attention of researchers to regenerate periodontal lost tissues, including alveolar bone, periodontal ligament and cementum. The aim of this systematic review was to obtain an updated analysis of the contribution of PCL-based scaffolds in the alveolar bone regeneration process.
METHODS
This review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews. A computerized search of the PubMed, EBSCO, Scielo and Web of Science databases was performed, restricting literature search to published studies in English or Spanish between January 2002 and March 2023. Database search returned 248 studies which were screened based on title, author names and publication dates.
RESULTS
Data from 17 studies were reviewed and tabulated. All studies combined PCL with other biomaterials (such as Alginate, hydroxyapatite, bioactive glass, poly (lactic-co-glycolic acid)), growth factors (BMP-2, rhCEMP1), and/or mesenchymal stromal cells (adipose-derived, bone marrow, periodontal ligament or gingiva mesenchymal stromal cells). PCL scaffolds showed higher cell viability and osteoinductive potential when combined with bioactive agents. Complementary, its degradation rates were affected by the addition or exposure to specific substances, such as: Dopamine, Cerium Oxide, PLGA and hydrogen peroxide.
CONCLUSIONS
PCL is an effective biomaterial for alveolar bone regeneration in periodontally affected teeth. It could be part of a new generation of biomaterials with improved regenerative potential.
Topics: Biocompatible Materials; Bone Regeneration; Guided Tissue Regeneration; Tissue Engineering; Tissue Scaffolds
PubMed: 37978859
DOI: 10.1177/22808000231211416