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Nutrients Feb 2022(1) Background: Periodontal diseases are a global health concern. They are multi-stage, progressive inflammatory diseases triggered by the inflammation of the gums in... (Meta-Analysis)
Meta-Analysis Review
The Clinical, Microbiological, and Immunological Effects of Probiotic Supplementation on Prevention and Treatment of Periodontal Diseases: A Systematic Review and Meta-Analysis.
(1) Background: Periodontal diseases are a global health concern. They are multi-stage, progressive inflammatory diseases triggered by the inflammation of the gums in response to periodontopathogens and may lead to the destruction of tooth-supporting structures, tooth loss, and systemic health problems. This systematic review and meta-analysis evaluated the effects of probiotic supplementation on the prevention and treatment of periodontal disease based on the assessment of clinical, microbiological, and immunological outcomes. (2) Methods: This study was registered under PROSPERO (CRD42021249120). Six databases were searched: PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, and Dentistry and Oral Science Source. The meta-analysis assessed the effects of probiotic supplementation on the prevention and treatment of periodontal diseases and reported them using Hedge's g standardized mean difference (SMD). (3) Results: Of the 1883 articles initially identified, 64 randomized clinical trials were included in this study. The results of this meta-analysis indicated statistically significant improvements after probiotic supplementation in the majority of the clinical outcomes in periodontal disease patients, including the plaque index (SMD = 0.557, 95% CI: 0.228, 0.885), gingival index, SMD = 0.920, 95% CI: 0.426, 1.414), probing pocket depth (SMD = 0.578, 95% CI: 0.365, 0.790), clinical attachment level (SMD = 0.413, 95% CI: 0.262, 0.563), bleeding on probing (SMD = 0.841, 95% CI: 0.479, 1.20), gingival crevicular fluid volume (SMD = 0.568, 95% CI: 0.235, 0.902), reduction in the subgingival periodontopathogen count of (SMD = 0.402, 95% CI: 0.120, 0.685), (SMD = 0.392, 95% CI: 0.127, 0.658), and (SMD = 0.341, 95% CI: 0.050, 0.633), and immunological markers MMP-8 (SMD = 0.819, 95% CI: 0.417, 1.221) and IL-6 (SMD = 0.361, 95% CI: 0.079, 0.644). (4) Conclusions: The results of this study suggest that probiotic supplementation improves clinical parameters, and reduces the periodontopathogen load and pro-inflammatory markers in periodontal disease patients. However, we were unable to assess the preventive role of probiotic supplementation due to the paucity of studies. Further clinical studies are needed to determine the efficacy of probiotic supplementation in the prevention of periodontal diseases.
Topics: Biomarkers; Dietary Supplements; Humans; Inflammation; Periodontal Diseases; Probiotics; Randomized Controlled Trials as Topic
PubMed: 35268009
DOI: 10.3390/nu14051036 -
Journal of Dental Research, Dental... 2021It is critical to understand laser-microtextured implant collars' influence on peri-implant pocket depths and marginal bone levels, especially in crucial areas. The... (Review)
Review
It is critical to understand laser-microtextured implant collars' influence on peri-implant pocket depths and marginal bone levels, especially in crucial areas. The present review investigated the peri-implant marginal bone loss (MBL) and pocket depths and failure rates of dental implants with laser-microtextured collars. An electronic search was run in the PubMed and Embase databases until September 15, 2019. Randomized and prospective clinical studies comparing peri-implant MBL and pocket depths and failure rates between implants with laser-microtextured and machined collar surfaces were included. Five studies (two cohort studies and three RCTs) were included in the meta-analysis after the inclusion and exclusion criteria and qualitative assessments were applied. The risk ratio of osseointegrated implant failure and mean differences in peri-implant MBL and pocket depths were calculated using the Comprehensive Meta-Analysis (CMA) software. Implants with laser-microtextured collars exhibited significantly better marginal bone level scores ( < 0.001; MD: 0.54; 95% CI: 0.489‒0.592) and a significant reduction in peri-implant probing depths than implants with machined collars ( < 0.001; MD: 1.01; 95% CI: 0.90‒1.13). The assessed studies showed that 17 out of 516 implants failed (3.29%), comprising nine implants with machined (3.62%) and eight implants with laser-microtextured collars (2.98%). However, no significant differences were detected in the implant neck surface characterization ( = 0.695; RR: 1.205; 95% CI: 0.472‒3.076). This study suggests that laser-microtexturing of implant collar significantly affected the peri-implant MBL and probing depths. Although no significant differences were noted in implant failure rates between implants with laser-microtextured and machined collar surfaces, the peri-implant MBL and probing depths with laser-microtextured collars were significantly lower than the machined collars.
PubMed: 35070185
DOI: 10.34172/joddd.2021.048 -
BMC Oral Health Jan 2022This systematic review and meta-analysis aimed to investigate the role of alendronate combined with step 2 of periodontal therapy in reducing probing pocket depth,... (Meta-Analysis)
Meta-Analysis
Added effect of 1% topical alendronate in intra-bony and inter-radicular defects as part of step II periodontal therapy: a systematic review with meta-analysis and trial sequential analysis.
BACKGROUND
This systematic review and meta-analysis aimed to investigate the role of alendronate combined with step 2 of periodontal therapy in reducing probing pocket depth, improving clinical attachment level, and reducing bone defect depth in intra-bony and inter-radicular defects.
METHODS
RCTs with more than 6 months follow-up were included in this study. Risk of bias assessment was performed using the Cochrane collaboration tool. In addition, meta-analysis and trial sequential analysis were used to aggregate the available evidence.
RESULTS
Seven studies met the inclusion criteria and were included in the systematic review. Topical application of alendronate during second step of periodontal therapy significantly improved PD and CAL.
CONCLUSION
Local application of alendronate may confer a beneficial effect when applied during step II of periodontal therapy even if long term studies are needed to confirm these results.
CLINICAL RELEVANCE
Considering the emerging role of host-inflammatory response in treatment of periodontitis and the antiresorptive and osteostimulative properties of bisphosphonates, several studies are focusing on the role of alendronate as an addition to non-surgical periodontal therapy.
Topics: Alendronate; Alveolar Bone Loss; Diphosphonates; Humans; Periodontal Attachment Loss; Periodontitis
PubMed: 35062940
DOI: 10.1186/s12903-022-02044-1 -
Clinical and Experimental Dental... Feb 2022To conduct systematic review applying "preferred reporting items for systematic reviews and meta-analyses statement" and "prediction model risk of assessment bias tool"...
OBJECTIVE
To conduct systematic review applying "preferred reporting items for systematic reviews and meta-analyses statement" and "prediction model risk of assessment bias tool" to studies examining the performance of predictive models incorporating oral health-related variables as candidate predictors for projecting undiagnosed diabetes mellitus (Type 2)/prediabetes risk.
MATERIALS AND METHODS
Literature searches undertaken in PubMed, Web of Science, and Gray literature identified eligible studies published between January 1, 1980 and July 31, 2018. Systematically reviewed studies met inclusion criteria if studies applied multivariable regression modeling or informatics approaches to risk prediction for undiagnosed diabetes/prediabetes, and included dental/oral health-related variables modeled either independently, or in combination with other risk variables.
RESULTS
Eligibility for systematic review was determined for seven of the 71 studies screened. Nineteen dental/oral health-related variables were examined across studies. "Periodontal pocket depth" and/or "missing teeth" were oral health variables consistently retained as predictive variables in models across all systematically reviewed studies. Strong performance metrics were reported for derived models by all systematically reviewed studies. The predictive power of independently modeled oral health variables was marginally amplified when modeled with point-of-care biological glycemic measures in dental settings. Meta-analysis was precluded due to high inter-study variability in study design and population diversity.
CONCLUSIONS
Predictive modeling consistently supported "periodontal measures" and "missing teeth" as candidate variables for predicting undiagnosed diabetes/prediabetes. Validation of predictive risk modeling for undiagnosed diabetes/prediabetes across diverse populations will test the feasibility of translating such models into clinical practice settings as noninvasive screening tools for identifying at-risk individuals following demonstration of model validity within the defined population.
Topics: Diabetes Mellitus, Type 2; Humans; Mass Screening; Oral Health; Prediabetic State; Research Design
PubMed: 34850592
DOI: 10.1002/cre2.515 -
International Journal of Environmental... Oct 2021Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world.... (Review)
Review
Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.
Topics: Humans; Periodontal Diseases; Periodontal Pocket; Risk Factors; Smokers; Smoking
PubMed: 34769523
DOI: 10.3390/ijerph182111003 -
International Journal of Molecular... Nov 2021To compare the results of periodontal infrabony lesions treated using nanohydroxyapatite (NcHA) graft with other bone grafts (BGs). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To compare the results of periodontal infrabony lesions treated using nanohydroxyapatite (NcHA) graft with other bone grafts (BGs).
METHODS
Four electronic databases were searched including PubMed (NLM), Embase (Ovid), Medline, and Dentistry and Oral Sciences (EBSCO). The inclusion criteria included randomised controlled clinical trials (RCTs) and controlled clinical trials (CCTs). The clinical results of NcHA were compared with other BGs. For clinical attachment level (CAL) gain, probing pocket depth (PPD) decrease, and gingival recession (REC) change, weighted averages and forest plots were computed.
RESULTS
Seven RCTs fulfilled the selection criteria that were included. When NcHA was compared to other BGs, no clinically significant differences were found in terms of each outcome assessed, except the REC change for synthetic BGs as compared to NcHA.
CONCLUSIONS
The use of an NcHA graft showed equivalent results compared to other types of BGs. To further validate these findings, future studies are required to compare the NcHA and various BGs over longer time periods and in furcation deficiencies.
Topics: Alveolar Bone Loss; Animals; Bone Regeneration; Bone Substitutes; Bone Transplantation; Durapatite; Guided Tissue Regeneration, Periodontal; Humans; Periodontitis; Randomized Controlled Trials as Topic
PubMed: 34769451
DOI: 10.3390/ijms222112021 -
Journal of Oral Biology and... 2022Host modulation therapy has emerged as a new concept for the treatment of periodontal disease. Recently, a lot of research is being done in product containing... (Review)
Review
BACKGROUND
Host modulation therapy has emerged as a new concept for the treatment of periodontal disease. Recently, a lot of research is being done in product containing docosahexaenoic acid (DHA) and eicosapentanoic acid (EPA). Omega-3 PUFA have therapeutic, anti-inflammatory and protective properties. This systematic review analysed the adjunctive use of omega-3 fatty acids in periodontal therapy of periodontitis patients
METHODS
PICO question (patient, intervention, comparison, and outcome) was formed. Keywords were generated and were fed in databases. The databases were Pubmed, Cochrane library and LIVIVO. Studies selected are Randomized clinical trial, clinical studies, and longitudinal studies. Meta -analysis were performed for Pocket depth (PD), Clinical attachment level (CAL), Gingival index (GI) and Plaque Index (PI). Risk of bias was also assessed.
RESULTS
On analysis of all the 8 studies at 3 months showed significant effect of omega -3 fatty acid on clinical attachment level (CAL), Pocket depth (PD). There was significant effect of omega-3 fatty acids in 4 studies at 6 months.
CONCLUSION
Within the limitation of the review, omega- 3 polyunsaturated fatty acids seems to have a positive effect on periodontal healing following periodontal therapy. Chronic periodontitis patient should be counselled to incorporate omega -3 fatty acid in their diet along with standard periodontal therapy.
PubMed: 34760614
DOI: 10.1016/j.jobcr.2021.10.005 -
Asian Pacific Journal of Cancer... Oct 2021Individual studies conducted in Asian countries have reported higher risk of periodontitis among smokeless tobacco (SLT) users in comparison to non-users. Therefore, a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Individual studies conducted in Asian countries have reported higher risk of periodontitis among smokeless tobacco (SLT) users in comparison to non-users. Therefore, a systematic review was conducted to summarize the available evidence on this topic.
METHODS
Prominent electronic databases were searched using pre-decided MeSH terms and keywords. Screening of titles and abstracts, full text reading, quality assessment and data extraction was done by two investigators independently. The Newcastle-Ottawa scale was used for risk of bias assessment of eligible studies. Meta-analysis was performed for four periodontal outcomes (periodontal pocket depth, loss of attachment, clinical attachment level and gingival recession). A sensitivity analysis was also performed.
RESULTS
Of the 546 citations, 367 were screened for eligibility. Finally, 89 studies were shortlisted for full text reading, of which, 36 were found eligible for qualitative analysis. Most of the studies were conducted in India (n=22), were of cross-sectional design (n=33), utilized purposive sampling and 24 studies were included for meta-analysis (n=28) and done on hospital-based population (n=26). Only 13 (37.1%) studies achieved a score of more than 50% (5/10 stars) on quality assessment scale. SLT users had higher odds of greater periodontal pocket depth greater than 4 mm (OR=3.64), gingival recession (OR=1.71) and loss of attachment 4-5 mm (OR=2.83) and mean difference of 1.7 mm for Clinical Attachment Level compared to non-users.
CONCLUSION
The studies included in this review suggests that SLT users have poorer periodontal health in comparison to non-users. But most of this evidence comes from cross-sectional studies. Longitudinal studies with rigorous methodology are required to support this elucidation. Registration: This systematic review protocol has been registered in PROSPERO (CRD42019122964).
Topics: Asia; Bias; Cross-Sectional Studies; Gingival Recession; Humans; India; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Risk; Tobacco, Smokeless
PubMed: 34710980
DOI: 10.31557/APJCP.2021.22.10.3061 -
Antibiotics (Basel, Switzerland) Sep 2021The aim of this systematic review is to compare the clinical efficacy of repeated applications of local drug delivery and adjunctive agents (LDAs) in nonsurgical... (Review)
Review
The aim of this systematic review is to compare the clinical efficacy of repeated applications of local drug delivery and adjunctive agents (LDAs) in nonsurgical periodontal therapy (NSPT) compared to subgingival mechanical debridement (SMD) alone. The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, EMBASE, Web of Science, hand-searched literature and grey literature databases were searched for randomized controlled clinical trials (RCTs) with a minimum of 6-month follow-up. The outcomes of interest were changes in probing pocket depth and clinical attachment level as well as patient-centred outcomes. Of 1094 studies identified, 16 RCTs were included in the qualitative analysis. Across 11 different adjuncts analysed, only two studies utilizing minocycline gel/ointment and antimicrobial photodynamic therapy (aPDT) with indocyanine green photosensitizer had statistically significant differences in primary outcomes when compared to their control groups. Only one study on aPDT methylene blue 0.005% had compared single versus multiple applications against its control group. A mean range of 0.27-3.82 mm PD reduction and -0.09-2.82 mm CAL gain were observed with repeated LDA application. Considerable clinical heterogeneity and methodological flaws in the included studies preclude any definitive conclusions regarding the clinical efficacy of repeated LDA applications. Future RCTs with a direct comparison between single and repeated applications should be conducted to confirm or refute the clinical advantages of repeated LDA application in the nonsurgical management of periodontitis.
PubMed: 34680759
DOI: 10.3390/antibiotics10101178 -
Journal of Prosthodontic Research Jul 2022To evaluate the effect of overdenture (OD) attachment type and the number of implants supporting mandibular ODs on peri-implant health. (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate the effect of overdenture (OD) attachment type and the number of implants supporting mandibular ODs on peri-implant health.
STUDY SELECTION
From inception to October 2020, electronic databases (Medline/PubMed, Embase, Cochrane Library, and Scopus) were systematically searched. The outcomes of interest were marginal bone loss (MBL), pocket probing depth (PPD), plaque index, bleeding index, and implant survival rate. Bayesian network meta-analysis was performed using the GeMTC package supported by R. The weighted mean difference and 95% credible interval were estimated.
RESULTS
Twenty-eight studies with a total of 1166 participants who received 2666 dental implants were included. Except for 4 bar and 4 telescopic, which showed a statistically lower MBL than the 2 locator, all other interventions showed insignificant differences in MBL (P > 0.05). The difference in periodontal probing depth was not statistically significant when comparing the different groups. The pooled implant survival rates of the different interventions ranged from 88.9% to 100%. The rank probability test showed that 4 bar and 4 telescopic had the lowest MBL, 2 magnet and 2 bar had the highest PI, whereas 4 locator showed the least PPD.
CONCLUSION
Except for 4 implants+bar, or telescopic, and 4 locator that, respectively, showed less MBL and PPD compared to some interventions, it seemed that different attachment types and number of implants supporting mandibular ODs have no clear superiority over the other in terms of peri-implant health outcomes.
Topics: Bayes Theorem; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Network Meta-Analysis
PubMed: 34588403
DOI: 10.2186/jpr.JPR_D_21_00073