3149 articles - 10.09.10
1: J Oral Maxillofac Surg. 2010 Sep 3; [Epub ahead of print]
Lindenmeyer A, Sutcliffe P, Eghtessad M, Goulden R, Speculand B, Harris M.
Research Fellow, Postgraduate Dental Education Unit, Warwick Medical School, Coventry, UK.
PURPOSE: To provide a systematic review of the best available research literature investigating the relation of oral and maxillofacial surgical procedures to the onset or relief of chronic painful temporomandibular disorder (TMD). MATERIALS AND METHODS: A comprehensive review of the databases CINAHL, Cochrane Library, Embase, Medline, NHS Evidence-Oral Health, PsycINFO, Web of Knowledge, and MetaLib was undertaken by 2 authors (P.S., M.H.) up to June 2009 using search terms appropriate to establishing a relation between orofacial surgical procedures and TMD. The search was restricted to English-language publications. RESULTS: Of the 1,777 titles reviewed, 35 articles were critically appraised but only 32 articles were considered eligible. These were observational studies that fell into 2 groups; 9 were seeking to establish a surgical cause for TMD. Of these, only 2 of a series of 3 claimed that there was a significant link, but this claim was based on weak data (health insurance records) and was abandoned in a subsequent report. Twenty-three studies were seeking to achieve relief by orthognathic surgical intervention. These were also negative overall, with 7 articles showing varying degrees of mostly nonsignificant improvement, whereas 16 showed no change or a worse outcome. No published report on the putative effect of implant insertion was found. CONCLUSION: These apparently contradictory approaches underline a belief that oral surgical trauma or gross malocclusion has a causative role in the onset of TMD. However, there was no overall evidence of a surgical causal etiology or orthognathic therapeutic value. This review emphasizes that it is in the patients' best interest to carry out prospective appropriately controlled randomized trials to clarify the situation. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
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PMID: 20822845 [PubMed - as supplied by publisher]2: J Periodontol. 2010 Sep 1; [Epub ahead of print]
Siciliano VI, Andreuccetti G, Siciliano AI, Blasi A, Sculean A, Salvi GE.
University of Naples "Federico II", Department of Dental and Maxillofacial Sciences, Naples, Italy.
Background: To compare the healing of deep non-contained intrabony defects (i.e. with at least an 80% 1-wall component and a residual 2- to 3-wall component in the most apical part) treated with either an enamel matrix derivative (EMD) or guided tissue regeneration (GTR) after 12 months. Methods: In this randomized controlled clinical trial, 40 subjects with 40 defects affecting single-rooted teeth were treated. The defects were treated either with EMD alone or with a non-resorbable titanium-reinforced membrane. No grafting materials were used. At baseline and after 12 months clinical parameters including pocket probing depths (PPD) and clinical attachment levels (CAL) were recorded. The difference in CAL gain was the primary outcome. Results: At baseline, the intrabony component of the defects amounted to 8.5+/-2.2 mm at EMD and 8.6+/-1.7 mm at GTR treated sites, respectively (p=0.47). The mean CAL gain at sites treated with GTR was significantly greater (p<0.001) compared with that at sites treated with EMD (4.1+/-1.4 mm vs. 2.4+/-2.2 mm). GTR therapy significantly (p=0.01) increased the probability of CAL gain >/= 4 mm (79.2% vs. 11.3%) and significantly (p=0.01) decreased the probability of residual PPD >/= 6 mm (3% vs. 79.3%) compared with EMD application alone. Conclusion: Although the outcomes of open flap debridement alone were not investigated, the application of EMD alone appeared to yield less PPD reduction and CAL gain compared with GTR therapy in the treatment of deep non-contained intrabony defects.
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PMID: 20809859 [PubMed - as supplied by publisher]3: J Periodontol. 2010 Sep 1; [Epub ahead of print]
Patel AM, Blanchard SB, Christen AG, Bandy RW, Romito LM.
Graduate Student, Department of Periodontics and Allied Dental Programs, Indiana University, Indianapolis, IN.
Background: Because of the clear causal relationship between smoking and periodontal disease, as well as the negative effect of smoking on wound healing, it is of great importance to evaluate the tobacco cessation interventions provided by periodontal practices. The use of tobacco cessation interventions in clinical practice can be measured by whether or not the practitioner employs any of the "5 As" defined by the 2008 United States Public Health Services Clinical Practice Guideline. Methods: Surveys were mailed out to 1000 active members of the American Academy of Periodontology. The surveys assessed the periodontists' demographic information, educational and professional background, knowledge and attitudes about tobacco cessation and use of interventions in the daily practice of periodontics. Results: Data were collected from 231 periodontists via a self-administered survey. The vast majority (92%) believed that tobacco cessation is a responsibility of the dental profession. A pattern of declining levels of involvement was seen as the providers moved through the suggested "5 As" for promoting tobacco cessation. Providers with formal tobacco cessation training were more likely to perform interventions. The primary perceived barriers to providing tobacco cessation interventions were low patient acceptance of treatment, lack of time, and lack of training. Conclusions: The findings of this study indicate periodontists believe that tobacco cessation interventions are a responsibility of the dental profession; however, due to several perceived barriers, reported rates of comprehensive tobacco interventions in periodontal practices are low.
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PMID: 20809858 [PubMed - as supplied by publisher]4: J Am Dent Assoc. 2010 Sep;141(9):1097-105.
Cunha-Cruz J, Wataha JC, Zhou L, Manning W, Trantow M, Bettendorf MM, Heaton LJ, Berg J.
Department of Dental Public Health Sciences, School of Dentistry, University of Washington, 1959 NE Pacific St., Box 357475, Seattle, Wash. 98195-7475, USA. silvajcc@u.washington.edu
BACKGROUND: Methods used by dental practitioners to diagnose and treat dentin hypersensitivity are not well documented. The authors conducted a survey of dentists in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) to ascertain the treatment methods they used. Methods. Via an Internet survey, the authors collected data regarding methods used for diagnosis and treatment of dentin hypersensitivity from 209 Northwest PRECEDENT dentists. RESULTS: The PRECEDENT dentists indicated that they most often used fluoride varnishes and gels, advice regarding toothbrushing and diet, bonding agents, restorative materials and glutaraldehyde/2-hydroxyethyl methacrylate (HEMA) to treat dentin hypersensitivity. They reported that the most successful treatments were fluorides, glutaraldehyde/HEMA, bonding agents, potassium nitrates and restorative treatments; they considered observation, advice regarding toothbrushing and diet and laser therapy to be the least successful. Dentists listed fluorides, calcium phosphates, glutaraldehyde/HEMA and bonding agents as the treatments most desirable for inclusion in a future randomized clinical trial of dental hypersensitivity treatments. CONCLUSIONS: Dentists rely on patients to assess the severity of dentin hypersensitivity. Modalities for the diagnosis and treatment of hypersensitivity are diverse. Methods used to diagnose and treat dentin hypersensitivity in practice are challenging to justify. CLINICAL IMPLICATIONS: Practitioners should be aware of the diversity of methods available for diagnosing and treating dentin hypersensitivity as they manage the care of their patients with this condition.
Publication Types: Research Support, N.I.H., Extramural
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PMID: 20807910 [PubMed - in process]5: J Am Dent Assoc. 2010 Sep;141(9):1076-85.
Sala-Perez S, Vazquez-Delgado E, Rodriguez-Baeza A, Gay-Escoda C.
Master of Oral Surgery and Orofacial Implantology program, School of Dentistry, University of Barcelona, Spain.
BACKGROUND: The authors present six cases of mandibular condyle malformation. They also conducted a literature review of bifid mandibular condyle (BMC) to analyze the various hypotheses that have been made regarding the etiopathogenesis of this entity. Type of Studies Reviewed. The authors searched the PubMed database for all instances of BMC and similar anatomical alterations, and they included non-English-language published reports. The inclusion criterion was the presence of a multilobular mandibular condyle. RESULTS: Mandibular condyle may manifest in different anatomical forms; bilobular is the most common, although triple lobular morphology also has been observed. A congenital origin has been suggested as the primary cause. In addition, trauma may alter the growth of the condylar cartilage, inducing an anatomical defect. However, the majority of participants in this study had no history of trauma. The authors reviewed a total of 198 cases in study participants and cadavers. CLINICAL IMPLICATIONS: In the absence of traumatic antecedents or other alterations of the temporomandibular joint, the presence of a BMC may be associated with developmental anomalies.
Publication Types: Research Support, Non-U.S. Gov't
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PMID: 20807906 [PubMed - in process]6: J Am Dent Assoc. 2010 Sep;141(9):1061-74.
Maupome G, Shulman JD, Medina-Solis CE, Ladeinde O.
Department of Preventive and Community Dentistry, School of Dentistry, Indiana University, 415 Lansing Street, Indianapolis, Ind. 46202-2876, USA. gmaupome@iupui.edu
BACKGROUND: The authors conducted a critical review of the literature to ascertain the strength of the scientific and professional evidence supporting an association between dental caries and the experience and severity of asthma. TYPES OF STUDIES REVIEWED: In March 2010, the authors searched Medline (1976-2010) by using the Ovid Web Gateway for the terms "asthma" and ["dental caries" or "dental caries susceptibility"] appearing in studies of humans published in English. The authors eliminated conference proceedings and abstracts, opinion pieces and unpublished studies; they included case series, cross-sectional, case-control and cohort studies and clinical trials. RESULTS: The review yielded 27 studies described in 29 articles. The authors found that researchers have investigated the hypothesized relationship between asthma and caries by means of diverse strategies, often using asthma cases clustered in pools of patients seeking clinical care. The strongest methodological designs were more likely to reveal little support for a positive association. The authors found no strong evidence suggesting that a causal link exists. Future research incorporating better-defined covariates and longitudinal designs is needed. CLINICAL IMPLICATIONS: Asthma per se may not be a risk factor for caries. Patients who have extreme dryness of the mouth, whose use of nebulizers is persistent, whose consumption of carbohydrates is frequent, and who have used multiple medications or have used medications over the long term necessitate cautious dental health care.
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PMID: 20807905 [PubMed - in process]7: J Clin Periodontol. 2010 Aug 26; [Epub ahead of print]
Torres J, Tamimi F, Alkhraisat MH, Manchon A, Linares R, Prados-Frutos JC, Hernandez G, Lopez Cabarcos E.
Ciencias de la Salud III, Universidad Rey Juan Carlos, Alcorcon, Spain.
Torres J, Tamimi F, Alkhraisat MH, Manchon A, Linares R, Prados-Frutos JC, Hernandez G, Lopez Cabarcos E. Platelet-rich plasma may prevent titanium-mesh exposure in alveolar ridge augmentation with anorganic bovine bone. J Clin Periodontol 2010; doi: 10.1111/j.1600-051X.2010.01615.x. Abstract Objective: Bone augmentation with the titanium-mesh (Ti-mesh) technique is susceptible to a large rate of complications such as morbidity of bone graft donor site, and mesh exposure to the oral cavity. The purpose of this study was to evaluate the effectiveness of anorganic bovine bone (ABB) in alveolar bone augmentation with the Ti-mesh technique. In addition, we investigated the effect of platelet-rich plasma (PRP) in preventing mesh exposure by using it to cover the Ti-mesh. Patients and Methods: Patients included in the clinical trial were randomly allocated by a blinded assistant into two groups. The 30 patients recruited for this study underwent 43 alveolar bone augmentation with the Ti-mesh technique using ABB as graft material in all of them. In 15 patients, the Ti-meshes were covered with PRP (PRP group) whereas in the other 15 the Ti-meshes were not (control group). After 6 months, patients were called for clinical, radiographic, and histological evaluation, and implant placement surgery. A total of 97 implants were placed in the augmented bone and their evolution was followed up for a period of 24 months. Results: Significant differences were found between the two study groups in terms of complications and bone formation. In the control group, 28.5% of the cases suffered from mesh exposure, while in the PRP group, no exposures were registered. Radiographic analysis revealed that bone augmentation was higher in the PRP group than in the control group. Overall, 97.3% of implants placed in the control group and 100% of those placed in the PRP group were successful during the monitoring period. We suggest that the positive effect of PRP on the Ti-mesh technique is due to its capacity to improve soft tissue healing, thereby protecting the mesh and graft material secured beneath the gingival tissues. Conclusions: Alveolar bone augmentation using ABB alone in the Ti-mesh technique is sufficient for implant rehabilitation. Besides, covering the Ti-meshes with PRP was a determining factor in avoiding mesh exposure. Ti-mesh exposure provoked significant bone loss, but in most cases it did not affect the subsequent placement of implants.
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PMID: 20796106 [PubMed - as supplied by publisher]8: J Clin Periodontol. 2010 Aug 25; [Epub ahead of print]
Duss C, Lang NP, Cosyn J, Persson GR.
Department of Periodontology, Faculty of Medicine, University of Berne, Berne, Switzerland.
Duss C, Lang NP, Cosyn J, Persson GR. A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery. J Clin Periodontol 2010; doi: 10.1111/j.1600-051X.2010.01609.x. Abstract Background: Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods: In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p<0001 to declare significance at 80% power). Results: At weeks 4 and 12, more staining was found in the control group (p<0.05 and p<0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p<0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p<0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions: The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.
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PMID: 20738456 [PubMed - as supplied by publisher]9: J Clin Periodontol. 2010 Aug 24; [Epub ahead of print]
Casarin RC, Del Peloso Ribeiro E, Nociti FH Jr, Sallum AW, Ambrosano GM, Sallum EA, Casati MZ.
Department of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, Campinas State University, Sao Paulo, Brazil.
Casarin RCV, Ribeiro EDP, Nociti Jr FH, Sallum AW, Ambrosano GMB, Sallum EA, Casati MZ: Enamel matrix derivative proteins for the treatment of proximal class II furcation involvements: a prospective 24-month randomized clinical trial. J Clin Periodontol 2010; doi: 10.1111/j.1600-051X.2010.01614.x. Abstract Objective: This study aimed to evaluate the response of proximal furcations treated with enamel matrix derivative proteins (EMD) in a 24-month follow-up. Materials and Methods: Twelve patients presenting bilateral class II proximal furcation with vertical probing depth (PD)>/=5 mm and bleeding on probing were selected. The furcations were assigned to: a control group (n=12), open flap debridement (OFD)+EDTA and a test group (n=12) - OFD+EDTA+EMD. The gingival margin position, PD, relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated before treatment and after 6, 12 and 24 months. Results: After follow-up, no statistical difference could be seen between groups. At 24 months, the test group showed 1.9 +/- 1.6 mm PD reduction whereas the control group showed 1.0 +/- 1.3 mm PD reduction. RHCAL gains of the control and the test group were 0.7 +/- 1.3 and 1.4 +/- 0.9 mm, respectively. However, at 24 months, the test group only presented five remaining class II furcations versus 10 furcations in the control group (p<0.05). Conclusion: It could be concluded that EMD therapy promoted a reduction in the number of proximal furcations presenting a diagnosis of class II after 24 months of treatment compared with OFD therapy.
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PMID: 20735795 [PubMed - as supplied by publisher]10: J Periodontol. 2010 Aug 23; [Epub ahead of print]
Chung JE, Koh SA, Kim TI, Seol YJ, Lee YM, Ku Y, Rhyu IC, Chung CP, Koo KT.
Background: The aims of this study were to evaluate the efficacy of Eutectic Mixture of Local Anesthetics (EMLA) cream on pain perception during scaling and to compare the intensities of pain provoked by hand and ultrasonic instruments. Methods: Forty subjects with chronic gingivitis or periodontitis were enrolled in the study. In this randomized split-mouth controlled blind clinical trial, each of the four quadrants in the subjects was randomly assigned to receive one of the following protocols: scaling by ultrasonic scaler with or without EMLA cream, scaling by Gracey curette with or without EMLA cream. Pain levels after each quadrant of scaling were assessed with a visual analog scale (VAS ; 0 approximately 100mm) and verbal rating score (VRS ; 0 approximately 4). All subjects were recalled to detect any complications after 24 hours. Results: The mean VAS and VRS when EMLA cream was applied (18.39+/-14.47 and 0.95+/-0.69) were significantly lower (P <0.001 for VAS and VRS) compared to when EMLA cream was not used (26.54+/-16.46 and 1.30+/-0.75). The mean VAS and VRS of the ultrasonic scaler group (20.43+/-16.40 and 0.98+/-0.76) were significantly lower (P=0.024 for VAS, P=0.003 for VRS) than the Gracey curette group (24.50+/-15.17 and 1.28+/-0.69). None of the subjects showed adverse effects after EMLA cream application. Conclusion: Although most patients experienced limited pain during scaling, a significant reduction of pain was achieved by EMLA cream and the use of ultrasonic scaler.
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PMID: 20731585 [PubMed - as supplied by publisher]11: J Oral Maxillofac Surg. 2010 Aug 18; [Epub ahead of print]
Kyzas PA.
Specialist Registrar, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Blackburn Royal Infirmary, East Lancashire NHS Trust, Blackburn, United Kingdom.
PURPOSE: The use of prophylactic antibiotics in the treatment of mandible fractures is common practice. The evidence supporting this practice has not been formally assessed for quality. The purpose of this study was to evaluate this empirically. MATERIALS AND METHODS: Randomized and nonrandomized trials evaluating the possible impact of the prophylactic use of antibiotics in patients with mandible fractures were identified. Data were extracted on characteristics of studies and patients, including treatment, fracture location, time from injury to treatment, antibiotics used (type, route, dosage, duration), and complications (infection, malunion, reoperation). Randomized controlled trials (RCTs) were further evaluated for issues of reported methodological quality. RESULTS: There were 31 eligible studies (5,437 patients). Of these, 9 were prospective RCTs; the remaining 22 were retrospective case series. Information about the time between injury and definite treatment was provided by 10 studies (31%). The type of antibiotic used was not defined in 13 of 31 studies (42%). Half of the studies (15 of 31 [48%]) did not describe the route of administration and did not comment on the duration of the antibiotic course. The vast majority (23 of 31 [74%]) did not describe the dosage of the antibiotics used. Most of the RCTs were small, had not adequately described the mode of randomization, and did not present intention-to-treat analyses. None of them presented power calculations or ensured allocation concealment. There was not a single mention about number needed to treat. The amount and quality of the available data precluded formal quantitative synthesis, despite scattered signals that prophylactic antibiotics may be better than nothing in preventing infection. CONCLUSION: The overall evidence to support the use of prophylactic antibiotics in mandible fractures is of poor quality. Large RCTs are needed to guide clinical practice. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
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PMID: 20727642 [PubMed - as supplied by publisher]12: J Oral Maxillofac Surg. 2010 Aug 18; [Epub ahead of print]
Fritz GW, Gunsolley JC, Abubaker O, Laskin DM.
Formerly, Chief Resident, Department of Oral and Maxillofacial Surgery; and Currently, Private Practice, Apex, NC.
PURPOSE: There is still considerable controversy regarding whether hyperbaric oxygen (HBO) therapy used preoperatively and postoperatively will prevent osteoradionecrosis in previously irradiated patients undergoing tooth extraction. The purpose of this systematic review was to evaluate the best evidence available in an attempt to find an answer to this question. MATERIALS AND METHODS: The literature search on Medline covered the period from January 1948 to March 2008. Included were randomized clinical trials, prospective studies without randomization, case-control studies, retrospective studies, and observational studies with and without control groups. This search retrieved 696 citations, which was reduced to 14 acceptable publications based on an assessment of methodologic quality. They included 1 randomized clinical trial, 8 cohort-controlled studies, and 5 observational studies. These were analyzed for radiation dose, type of radiation, use of adjunctive cancer treatments, number and location of extractions, method of extraction, HBO protocol, and use of adjunctive therapy besides HBO. RESULTS: Most of the studies had a small sample size, lacked specific inclusion and exclusion criteria, did not report the interval between radiation and extraction, and provided limited information on the method of extraction. There was also variation in HBO protocols, radiation dosage, the use of antibiotics, and the use of adjunctive cancer therapy. CONCLUSION: On the basis of the best available evidence, there is currently insufficient information to show that the use of HBO reduces the incidence of osteoradionecrosis in irradiated patients requiring tooth extraction. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
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PMID: 20727635 [PubMed - as supplied by publisher]13: J Clin Periodontol. 2010 Aug 18; [Epub ahead of print]
Listl S, Tu YK, Faggion CM Jr.
Department of Conservative Dentistry, University of Heidelberg, Heidelberg, Germany.
Listl S, Tu Y-K, Faggion CM Jr. A cost-effectiveness evaluation of enamel matrix derivatives alone or in conjunction with regenerative devices in the treatment of periodontal intra-osseous defects. J Clin Periodontol current year; doi: 10.1111/j.1600-051X.2010.01611.x. Abstract Purpose: To identify the most cost-effective approach to treatment of infrabony lesions with enamel matrix derivatives (EMD). Methods: We incorporated costs and clinical outcomes of 12 different treatment techniques (including flap operation, EMD alone, and EMD in association with other reconstructive devices) within a decision tree model in which costs were based on insurance regulations in Germany and health outcomes followed a recent meta-analysis. The most cost-effective treatment option was identified on the basis of the maximum net benefit criterion. Results: Treatment techniques using EMD were cost-efficient if the decision maker's willingness-to-pay (WTP) was at least euro150-175 per incremental mm of pocket probing depth reduction and clinical attachment level gain, respectively (1-year perspective). When EMD was affordable, the maximum net benefit was achieved by treatment with EMD in conjunction with bioactive glass or bovine bone substitutes. Additional application of platelet-rich plasma (PRP) or a resorbable membrane came at relatively high costs. Conclusions: If EMD use is indicated, EMD in conjunction with either bioactive glass or bovine bone substitutes is more cost-effective than EMD alone. The additional use of PRP or a resorbable membrane may only be justifiable when monetary resources for treatment are very generous.
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PMID: 20727057 [PubMed - as supplied by publisher]14: J Periodontol. 2010 Aug 19; [Epub ahead of print]
Chaffee BW, Weston SJ.
Graduate student, University of California Berkeley, School of Public Health, Division of Epidemiology.
Background: Obesity is increasing in prevalence and is a major contributor to worldwide morbidity. One consequence of obesity might be an increased risk for periodontal disease, although periodontal inflammation might in turn exacerbate the metabolic syndrome, of which obesity is one component. Objective: This review aims to systematically compile the evidence of an obesity-periodontal disease relationship from epidemiologic studies and to derive a quantitative summary of the association between these disease states. Methods: Systematic searches of the MEDLINE, SCOPUS, BIOSIS, LILACS, Cochrane Library, and Brazilian Bibliography of Dentistry databases were conducted with the results and characteristics of relevant studies abstracted to standardized forms. Meta-analysis was performed to obtain a summary measure of association. Results: The electronic search identified 554 unique citations, and 70 studies met a priori inclusion criteria, representing 57 independent populations. Nearly all studies matching inclusion criteria were cross sectional in design with the results of 41 suggesting a positive association. The fixed-effects summary odds ratio was 1.35 (Shore corrected 95% confidence interval: 1.23-1.47), with some evidence of a stronger association found among younger adults, women, and non-smokers. Additional summary estimates suggested greater mean clinical attachment loss among obese individuals, a higher mean body mass index (BMI) among periodontal patients, and a trend of increasing odds of prevalent periodontal disease with increasing BMI. While these results are highly unlikely due to chance, unmeasured confounding has a credible but unknowable influence on these estimates. Conclusions: This positive association is consistent and coherent with a biologically plausible role for obesity in the development of periodontal disease. Absent future quality longitudinal studies, however, the inability to distinguish the temporal ordering of events limits the evidence that obesity is a risk factor for periodontal disease or that periodontitis might increase the risk of weight gain. In clinical practice, a higher prevalence of periodontal disease should be expected among obese adults.
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PMID: 20722533 [PubMed - as supplied by publisher]15: J Dent. 2010 Aug 12; [Epub ahead of print]
Meireles SS, Santos IS, Bona AD, Demarco FF.
Sonia Saeger Meireles, DDS, PhD, Adjunct Professor, Department of Operative Dentistry, Federal University of Paraiba, Joao Pessoa, PB, Brazil.
OBJECTIVES: This double-blind randomized clinical trial aimed to evaluate the whitening effect of two at-home tooth bleaching agents and the effect of dietary habits after two years. The patients' view about bleaching longevity was also investigated. METHODS: Ninety-two subjects with mean shade of C1 or darker for the six maxillary anterior teeth were randomized into two groups (n= 46) according to the carbamide peroxide (CP) concentration: 10% (CP10) or 16% (CP16). The treatment was performed using the whitening agent in a tray for two hours/day during three weeks. Shade evaluations were done with a shade guide and a spectrophotometer at baseline, 1-month, 6-month, 1-year and 2-year post-bleaching. RESULTS: Eighty-one (88%) of the original 92 subjects enrolled in the study were recalled at 2-year follow-up and, the tooth shade remained significantly lighter than at baseline, in both treatment groups, considering the tooth shade median values (p< 0.001) or the color parameters: L*a* (p< 0.001) for CP10 and, L*b* for CP16 group (p< 0.001). Subjects from CP10 and CP16 reported a consumption of beverage and food stains as high as at 6-month and 1-year recalls and, more than 66% of the participants from each group reported a tooth shade relapse from mild to moderate (p= 0.6). SIGNIFICANCE: At 2-year post-bleaching, tooth shade remained lighter than at baseline for both CP concentrations tested. Tooth shade relapse associated to increasing of a* and b* color parameters were observed for both groups when compared to the end of the treatment. (CEP # 37/05). Copyright (c) 2010. Published by Elsevier Ltd.
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PMID: 20709137 [PubMed - as supplied by publisher]16: J Oral Maxillofac Surg. 2010 Aug 11; [Epub ahead of print]
Joss CU, Joss-Vassalli IM, Berge SJ, Kuijpers-Jagtman AM.
Orthodontist and PhD Student, Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Orthodontics, University of Geneva, Switzerland.
PURPOSE: To evaluate the ratio of soft tissue to hard tissue in bilateral sagittal split setback osteotomy with rigid internal fixation or wire fixation. MATERIALS AND METHODS: A literature search was performed using PubMed, Medline, CINAHL, Web of Science, the Cochrane Library, and Google Scholar Beta. From the original 766 articles identified, 8 articles were included. Two articles were prospective and 6 retrospective. The follow-up period ranged from 1 year to 12.7 years for rigid internal fixation. Two articles on wire fixation were found to be appropriate for inclusion. RESULTS: The differences between short- and long-term ratios of the lower lip to lower incisors for bilateral sagittal split setback osteotomy with rigid internal fixation or wire fixation were quite small. The ratio was 1:1 in the long term and by trend slightly lower in the short term. No distinction was seen between the short- and long-term ratios for mentolabial fold. The ratio was found to be 1:1 for the mentolabial fold to point B. In the short term, the ratio of the soft tissue pogonion to the pogonion showed a 1:1 ratio, with a trend to be lower in the long term. The upper lip showed mainly protrusion, but the amount was highly variable. CONCLUSIONS: This systematic review shows that evidence-based conclusions on soft tissue changes are difficult to draw. This is mostly because of inherent problems of retrospective studies, inferior study designs, and the lack of standardized outcome measurements. Well-designed prospective studies with sufficient samples and excluding additional surgery, ie, genioplasty or maxillary surgery, are needed. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20708321&dopt=ExternalLink
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PMID: 20708321 [PubMed - as supplied by publisher]17: J Periodontol. 2010 Aug 3; [Epub ahead of print]
Shibly O, Patel N, Albandar JM, Kutkut A.
Background: This 2-year randomized clinical trial compared bone regeneration and esthetic outcome between immediate and conventional loading of dental implants placed immediately after extraction in patients with a past history of periodontal disease. Methods: Patients were randomly assigned to receive immediate implants with either immediate loading or conventional loading after 3 months. Both groups received a periodontal flap, tooth extraction, implant placement, allograft bone, and membrane placement. The immediate loading group received a temporary crown. In the conventional loading group primary closure was achieved. All patients were followed up 3, 6, 12, and 24 months. Evaluation included radiographic bone changes, papillary esthetic outcome, and implant survival rate. Results: Seventy-two patients were recruited into the study. However, 60 patients received immediate implant placement after extraction: 30 in each group. In the immediate loading group the implant survival rate at 2 years was 96.7%, and the mean bone gain was 1.19 mm. The corresponding figures in the conventional loading group were 93.3% and 1.00 mm. The gain in bone level occurred mainly from baseline to 1 year postoperatively in both groups (p<0.001). The papilla index decreased from baseline to 1 year in both groups (p<0.001) and changed only slightly thereafter. There were no significant differences between the 2 groups in the amount of bone gain or papilla index change during 2 years. Conclusions: Immediate loading of a single implant placed in a fresh extraction site in periodontally compromised patients resulted in similar bone gain and soft tissue esthetic outcomes compared to delayed loading. Primary closure and delayed loading to ensure bone regeneration around implants were not critical in this study.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20681808&dopt=ExternalLink
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PMID: 20681808 [PubMed - as supplied by publisher]18: J Am Dent Assoc. 2010 Aug;141(8):967-78.
Markou N, Pepelassi E, Kotsovilis S, Vrotsos I, Vavouraki H, Stamatakis HC.
Periodontal Department, 401 Athens Military Hospital, Athens, Greece.
BACKGROUND: On the basis of systematic reviews and randomized controlled trials, the authors provide reports of two cases in which platelet-rich plasma (PRP) combined with demineralized freeze-dried bone allograft (DFDBA) was used to treat periodontal endosseous defects. CASE DESCRIPTION: Clinicians treated two circumferential endosseous defects with a probing pocket depth of 5 and 8 millimeters, respectively (case 1), and a combined 1-2-3-wall endosseous defect with a probing pocket depth of 6 mm (case 2) by using the combination of PRP and DFDBA. At six months, complete periodontal pocket resolution occurred in all defects, and clinical attachment level and radiographic defect fill in all defects exhibited significant improvement compared with presurgical values. CLINICAL IMPLICATIONS: The combination of PRP and DFDBA may be clinically and radiographically efficacious in the treatment of periodontal endosseous defects.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20675422&dopt=ExternalLink
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PMID: 20675422 [PubMed - in process]19: J Am Dent Assoc. 2010 Aug;141(8):954-65.
Kuijpers MA, Vissink A, Ren Y, Kuijpers-Jagtman AM.
Division d'orthodontie, Faculte de Medecine Dentaire, Universite de Geneve, 19, rue Barthelemy-Menn, 1211 Geneve 4, Switzerland. mette.kuijpers@unige.ch
BACKGROUND: The authors conducted a literature review to assess whether there is a reduction of salivation with the use of antisialogogues, whether the use of antisialogogues reduces the chair time needed for dental procedures and whether the use of antisialogogues reduces bond failure in orthodontics. METHODS: The authors conducted a search for original articles published from 1950 to April 2010 by using the following databases: Cochrane Collaboration, PubMed, Scopus, EMBASE and ISI Web of Knowledge. They included in their review only human studies in which antisialogogues were used. They validated methodological quality and evidence grade. RESULTS: Twenty-six studies met the inclusion criteria. Twenty-five of these studies were related to the effect of antisialogogues on salivation, and one study to bond failure. The authors found that there is evidence that antisialogogues work, inconclusive evidence that they reduce bond failure, and no evidence that they reduce chair time for dental procedures. CLINICAL IMPLICATIONS: Taking into account the systemic effects of antisialogogues, which exceed the time needed for bracket bonding, the use of antisialogogues for dental procedures in general is questionable.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20675421&dopt=ExternalLink
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PMID: 20675421 [PubMed - in process]20: J Oral Maxillofac Surg. 2010 Jul 29; [Epub ahead of print]
Yu SH, Beirne OR.
Dental Student, Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA.
PURPOSE: The purpose of the present study was to determine whether, in patients undergoing general anesthesia, those provided with a laryngeal mask airway (LMA) have a lower risk of airway-related complications than those undergoing endotracheal intubation. MATERIALS AND METHODS: A systematic review of randomized prospective controlled trials was done to compare the risk of airway complications with an LMA versus an endotracheal tube (ETT) in patients receiving general anesthesia. Two independent reviewers identified 29 randomized prospective controlled trials that met the predetermined inclusion and exclusion criteria. The data for each individual outcome measure were combined to analyze the relative risk ratios (RRs). The Cochrane RevMan software was used for statistical analysis. RESULTS: When an ETT was used to protect the airway, a statistically significant greater incidence of hoarse voice (RR 2.59, 95% confidence interval [CI] 1.55 to 4.34), a greater incidence of laryngospasm during emergence (RR 3.16, 95% CI 1.38 to 7.21), a greater incidence of coughing (RR 7.12, 95% CI 4.28 to 11.84), and a greater incidence of sore throat (RR 1.67, 95% CI 1.33 to 2.11) was found compared with when an LMA was used to protect the airway. The differences in the risk of regurgitation (RR 0.84, 95% CI 0.27 to 2.59), vomiting (RR 1.56, 95% CI 0.74 to 3.26), nausea (RR 1.59, 95% CI 0.91 to 2.78), and the success of insertion on the first attempt (RR 1.08, 95% CI 0.99 to 1.18) were not statistically significant between the 2 groups. CONCLUSIONS: For the patients receiving general anesthesia, the use of the LMA resulted in a statistically and clinically significant lower incidence of laryngospasm during emergence, postoperative hoarse voice, and coughing than when using an ETT. The risk of aspiration could not be determined because only 1 study reported a single case of aspiration, which was in the group using the ETT. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20674126&dopt=ExternalLink
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PMID: 20674126 [PubMed - as supplied by publisher]