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Restorative

Dentistry Current Awareness Newsletter

NOVEMBER 2015

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Lunchtime Drop-in Sessions

The Library and Information Service provides free specialist information

skills training for all UHBristol staff and students.

To book a place, email: library@uhbristol.nhs.uk

If you’re unable to attend we also provide one-to-one or small group

sessions. Contact library@uhbristol.nhs.uk to arrange a session.

Literature Searching

An in-depth guide on how to

search the evidence base,

including an introduction to

UpToDate and Anatomy.tv.

Useful for anybody who wants to

find the best and quickest way to

source articles.

How to understand an article

How to assess the strengths and

weaknesses of published articles.

Examining bias and validity.

Medical Statistics

A basic introduction to the key

statistics in medical articles.

Giving an overview of statistics

that compare risk, test confidence,

analyse clinical investigations, and

test difference.

November (1pm)

Weds 4th Literature Searching

Thurs 12th Understanding articles

Fri 20th Statistics

Mon 23rd Literature Searching

December (12pm)

Tues 1st Understanding articles

Weds 9th Statistics

Thurs 17th Literature Searching

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Your Friendly Local Librarian… Whatever your information needs, the library is here to help. We offer literature searching services

as well as training and guidance in searching the evidence and critical appraisal – just email us at

library@uhbristol.nhs.uk

Outreach: Your Outreach Librarian can help facilitate evidence-based practice for all in the

restorative dentistry team, as well as assisting with academic study and research. We can help with

literature searching, obtaining journal articles and books. We also offer one-to-one or small group

training in literature searching, accessing electronic journals, and critical appraisal. Get in touch:

library@uhbristol.nhs.uk

Literature searching: We provide a literature searching service for any library member. For those

embarking on their own research it is advisable to book some time with one of the librarians for a 1 to

1 session where we can guide you through the process of creating a well-focused literature research

and introduce you to the health databases access via NHS Evidence. Please email requests to

library@uhbristol.nhs.uk

Your Friendly Local Librarian…

Contents Your Friendly Local Librarian… ................................................................................................................ 3

New from Up-to-Date ............................................................................................................................. 5

New from the Dental Elf ......................................................................................................................... 6

The Cochrane Library of Systematic Reviews ......................................................................................... 7

Current Awareness Database Articles on Restorative Dentistry ............................................................ 9

Peri-implantitis .................................................................................................................................... 9

Bisphosphonate-related osteonecrosis of the jaw ........................................................................... 18

Cleft lip and palate ............................................................................................................................ 21

Periodontal disease and antibiotics .................................................................................................. 24

Head and neck oncology and dentistry ............................................................................................ 25

Dental implants ................................................................................................................................. 27

Journal Tables of Contents .................................................................................................................... 37

British Dental Journal; ....................................................................................................................... 37

Evidence Based Dentistry; ................................................................................................................ 37

International Journal of Oral and Maxillofacial Implants; ................................................................ 38

International Journal of Prosthodontics ........................................................................................... 38

Journal of Clinical Periodontology .................................................................................................... 38

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On Twitter?

Twitter can be a useful CPD tool. Here are some accounts will help you stay on top of new

developments in the Restorative Dentistry field:

@BSPerio – the Twitter account for The British Society of Periodontology

@BSSPD – the Twitter account for The British Society of Prosthodontics

@BESteethforlife – the Twitter account for The British Endodontic Society

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New from Up-to-Date

Medication-related osteonecrosis of the jaw in patients with cancer

Authors: James R Berenson, MD; Alison T Stopeck, MD

Literature review current through: Oct 2015. | This topic last updated: Aug 18, 2015.

INTRODUCTION — Osteonecrosis of the jaw (ONJ), which was first described in 2002, is a relatively uncommon but potentially serious side effect of treatment with antiresorptive agents such as intravenous (IV) high potency bisphosphonates and denosumab, which decrease the risk of skeletal-related events (SREs) in patients with cancer and metastatic bone disease. The increased dose intensity of anti-resorptive therapy typically prescribed for cancer indications places cancer patients at a substantially higher risk for ONJ than are patients who receive them for other conditions such as osteoporosis and Paget’s disease.

ONJ has also been described as a complication of cancer therapies that target angiogenesis; however, this association is more controversial with little confirmatory prospective trial data available in the setting of monotherapy with an antiangiogenic agent alone. Use of antiangiogenic agents is clearly a risk factor for medication-related ONJ (MRONJ) among patients receiving antiresorptive agents for cancer.

This topic review will describe the incidence, risk factors, staging, clinical course, prevention strategies, and management of MRONJ in patients with cancer who are receiving antiresorptive agents. The incidence, risk factors, and management strategies for MRONJ in patients receiving antiresorptive therapy for osteoporosis and other side effects associated with bisphosphonates and denosumab in patients with cancer are addressed elsewhere.

Gingivitis and periodontitis in adults: Classification and dental treatment

Authors: Rebecca S Wilder, BSDH, MS; Antonio J Moretti, DDS, MS

Section Editor Literature review current through: Oct 2015. | This topic last updated: Oct 21, 2015.

INTRODUCTION — Periodontal, or gum disease is a common condition affecting the tissues that comprise the dental supporting structure: gingiva, cementum, periodontal ligament, and the alveolar bone. Periodontal disease is broadly classified as either gingivitis or periodontitis; these conditions are distinguished by the presence of alveolar bone involvement that occurs with periodontitis, and not with gingivitis.

Periodontal disease may be a risk factor for a number of conditions including cardiovascular and pulmonary diseases, and pregnancies resulting in low birth weight [3-5]. Clinicians should encourage regular dental visits and incorporate oral examination into their office practice, inspecting for inflamed gingiva, bleeding, or suppuration around teeth.

This topic will review the classification of gingivitis and conditions associated with gingivitis and periodontitis. The pathogenesis, clinical manifestations, and antibiotic treatment of odontogenic infections are discussed in detail separately.

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New from the Dental Elf

Poorer implant outcomes in periodontitis patients?

Oct 23 2015

The aim of this review was to update a 2008 review of implant survival and success rates, bone loss/bone-level changes and incidence of peri-implantitis for dental implants placed in partially dentate patients with history of treated periodontitis compared to periodontally healthy patients.

Peri-implant disease: Limited evidence for the use of air polishing.

Oct 26 2015

Dental implants require ongoing maintenance care to prevent the complications of peri-

implant disease (mucositis and implantitis). Air polishing was introduced as an approach for

the supra- and sub-mucosal cleansing of titanium implants using repeated application of

either amino acid glycine or sodium bicarbonate powder to effect the removal of plaque.

The aim of this review was to assess the efficacy of air polishing in the management of peri-

implant disease

Root perforation repair: non-surgical approach has good success suggests

Oct 13 2015

Perforation of the tooth root can occur as a result of mechanical, iatrogenic or pathological reasons. Endodontics and restorative treatment are common causes and a range of dental materials have been suggested for perforation repair with various success rates being reported. The aim of this review was to assess the published treatment outcome of repaired root perforation and to identify any preoperative factors that may influence the outcome of perforation repairs.

Infective endocarditis prophylaxis – NICE reaffirms 2008

Oct 12 2015

Infective endocarditis is a rare condition with high morbidity and mortality. In 2008 the UK National Institute for Health and Clinical Excellence (NICE; now the National Institute for Health and Care Excellence) produced new guidance that recommended the complete cessation of antibiotic prophylaxis for patients undergoing dental procedures.

While the incidence of infective endocarditis has been slow increasing with time a 2014 paper Dayer el al reported an apparently higher rate of increase following the publication of the NICE guidance. Consequently, NICE undertook a review of the guideline to assess new evidence published since 2008.

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The Cochrane Library of Systematic Reviews

Management of gag reflex for patients undergoing dental treatment

Eachempati Prashanti, Kumbargere N Sumanth, P Renjith George, Laxminarayan Karanth,

Htoo Htoo Kyaw Soe

Editorial Group: Cochrane Oral Health Group

Published Online: 1 OCT 2015

Abstract

Background:

Gag reflex is an involuntary defence mechanism to protect the pharynx and throat from

foreign objects. Gagging is a common problem encountered during dental treatment, which

makes therapeutic procedures distressing and often difficult or even impossible to perform.

Various interventions can be used to control the gag reflex; for example, anti-nausea

medicines, sedatives, local and general anaesthetics, herbal remedies, behavioural

therapies, acupressure, acupuncture, and prosthetic devices.

Objectives:

To assess the effects of pharmacological and non-pharmacological interventions for the

management of gagging in people undergoing dental treatment.

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Current Awareness Database Articles on

Restorative Dentistry

Below is a selection of articles on restorative dentistry recently added to the healthcare databases,

grouped in the following categories:

Peri-implantitis

Bisphosphonate-related osteonecrosis of the jaw

Dental-related cleft lip and palate

Periodontal disease and antibiotics

Dental-related head and neck oncology

Dental implants

If you would like any of the following articles in full text, or if you would like a more focused

search on your own topic, then get in touch: library@uhbristol.nhs.uk

Peri-implantitis

Title: Bacterial profiles and proteolytic activity in peri-implantitis versus healthy sites

Citation: Anaerobe, October 2015, vol./is. 35/(28-34), 1075-9964;1095-8274

Author(s): Neilands J., Wickstrom C., Kinnby B., Davies J.R., Hall J., Friberg B., Svensater G.

Abstract: Peri-implantitis is a biofilm-induced destructive inflammatory process that, over time, results in loss of supporting bone around an osseointegrated dental implant. Biofilms at peri-implantitis sites have been reported to be dominated by Gram-negative anaerobic rods with a proteolytic metabolism such as, Fusobacterium, Porphyromonas, Prevotella and Tannerella, as well as anaerobic Gram-positive cocci. In this study, we hypothesized that protease activity is instrumental in driving bone destruction and we therefore compared the microbial composition and level of protease activity in samples of peri-implant biofluid (PIBF) from 25 healthy subjects (H group) and 25 subjects with peri-implantitis (PI group). Microbial composition was investigated using culture techniques and protease activity was determined using a FITC-labelled casein substrate. The microbial composition was highly variable in subjects both in the H and PI groups but one prominent difference was the prevalence of Porphyromonas/Prevotella and anaerobic Gram positive cocci which was significantly higher in the PI than in the H group. A subgroup of subjects with peri-implantitis displayed a high level of protease activity in the PIBF compared to healthy subjects. However, this activity could not be related to the presence of specific bacterial species. We

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propose that a high level of protease activity may be a predictive factor for disease progression in peri-implantitis. Further longitudinal studies are however required to determine whether assessment of protease activity could serve as a useful method to identify patients at risk for progressive tissue destruction.

Title: 16S rRNA based microarray analysis of ten periodontal bacteria in patients with different forms of periodontitis

Citation: Anaerobe, October 2015, vol./is. 35/(35-40), 1075-9964;1095-8274

Author(s): Topcuoglu N., Kulekci G.

Abstract: DNA microarray analysis is a computer based technology, that a reverse capture, which targets 10 periodontal bacteria (ParoCheck) is available for rapid semi-quantitative determination. The aim of this three-year retrospective study was to display the microarray analysis results for the subgingival biofilm samples taken from patient cases diagnosed with different forms of periodontitis.A total of 84 patients with generalized aggressive periodontitis (GAP,n:29), generalized chronic periodontitis (GCP, n:25), peri-implantitis (PI,n:14), localized aggressive periodontitis (LAP,n:8) and refractory chronic periodontitis (RP,n:8) were consecutively selected from the archives of the Oral Microbiological Diagnostic Laboratory. The subgingival biofilm samples were analyzed by the microarray-based identification of 10 selected species.All the tested species were detected in the samples. The red complex bacteria were the most prevalent with very high levels in all groups. Fusobacterium nucleatum was detected in all samples at high levels. The green and blue complex bacteria were less prevalent compared with red and orange complex, except Aggregatibacter actinomycetemcomitas was detected in all LAP group. Positive correlations were found within all the red complex bacteria and between red and orange complex bacteria especially in GCP and GAP groups.Parocheck enables to monitoring of periodontal pathogens in all forms of periodontal disease and can be alternative to other guiding and reliable microbiologic tests.

Title: Integration of non-oral bacteria into in vitro oral biofilms

Citation: Virulence, October 2015, vol./is. 6/3(258-264), 2150-5594;2150-5608

Author(s): Thurnheer T., Belibasakis G.N.

Abstract: Biofilms are polymicrobial communities that grow on surfaces in nature. Oral bacteria can spontaneously form biofilms on the surface of teeth, which may compromise the health of the teeth, or their surrounding (periodontal) tissues. While the oral bacteria exhibit high tropism for their specialized ecological niche, it is not clear if bacteria that are not part of the normal oral microbiota can efficiently colonize and grow within oral biofilms. By using an in vitro "supragingival" biofilm model of 6 oral species, this study aimed to investigate if 3 individual bacterial species that are not part of the normal oral microbiota (Eschericia coli, Staphylococcus aureus, Enterococcus faecails) and one not previously tested oral species (Aggregatibacter actinomycetemcomitans) can be incorporated into this established supragingival biofilm model. Staphylococcus aureus and A. actinomycetemcomitans were able to grow efficiently in the biofilm, without disrupting the growth of the remaining species. They localized in sparse small aggregates within the biofilm

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mass. Enterococcus faecalis and E. coli were both able to populate the biofilm at high numbers, and suppressed the growth of A. oris and S. mutants. Enterococcus faecalis was arranged in a chain-like conformation, whereas E. coli was densely and evenly spread throughout the biofilm mass. In conclusion, it is possible for selected species that are not part of the normal oral microbiota to be introduced into an oral biofilm, under the given experimental microenvironmental conditions. Moreover, the equilibrated incorporation of A. actinomycetemcomitans and S. aureus in this oral biofilm model could be a useful tool in the study of aggressive periodontitis and peri-implantitis, in which these organisms are involved, respectively.

Title: Twelve-Year Retrospective Follow-Up of Machined Implants in the Posterior Maxilla: Radiographic and Peri-Implant Outcome.

Citation: Clinical implant dentistry and related research, Oct 2015, vol. 17 Suppl 2, p. e343.

Author(s): Simion, Massimo, Gionso, Luca, Grossi, Giovanni Battista, Briguglio, Francesco, Fontana, Filippo

Abstract: To retrospectively evaluate the survival rate of machined implants in sinus-lifted posterior maxilla after 12 years, with special reference to radiographic outcome and peri-implantitis. From 37 possible candidates, 29 patients with 59 implants were evaluated. Implants were placed in the posterior maxilla in combination with a sinus elevation procedure (27 patients) or 6 months after sinus elevation (2 patients). Marginal bone level changes were radiographically evaluated at baseline and 1, 7, and 12 years post-loading. Probing depth was measured; presence/absence of plaque and bleeding on probing were recorded. Four out of 59 implants failed in 4 out of 29 patients (cumulative survival rate = 93.2%). The mean bone loss was 0.78 mm (± 0.88) after 12 years. Changes in the mean bone level were statistically significant between baseline and all the other follow-up intervals (p < .001). Statistically significant differences could be demonstrated for the first- to 12th-year interval (p < .05) and for the seventh- to 12th-year interval (p < 0.001). No statistically significant differences could be demonstrated at the first- to seventh-year interval (p = .32). The mean overall probing depth was 2.9 ± 0.66 mm. Probing depth was moderately correlated with the marginal bone changes at 7 year and after 12 year follow up (p = .05). No signs of peri-implantitis were reported during the 12-year follow-up period. This follow-up demonstrates a very good prognosis when implants with machined surfaces are used. The frequencies of implant failures were very small. Within the limits of the results from this study, the risk of peri-implantitis in the posterior maxilla might be considered a minor problem when implants with machined surfaces are used. © 2014 Wiley Periodicals, Inc.

Title: Clinical and Radiographic Evaluation of Marginal Bone Changes around Platform-Switching Implants Placed in Crestal or Subcrestal Positions: A Randomized Controlled Clinical Trial.

Citation: Clinical implant dentistry and related research, Oct 2015, vol. 17 Suppl 2, p. e364.

Author(s): Kütan, Esma, Bolukbasi, Nilufer, Yildirim-Ondur, Esra, Ozdemir, Tayfun

Abstract: It has been reported in many articles that marginal bone resorptions are prevented by platform-switching design. However, what occurs when these implants are

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placed in the apical position is not completely known. This report describes a randomized controlled clinical trial study that aims to test the hypothesis that less resorption will occur when platform-switching implants are placed 1 mm below bone level. A total of 56 randomly selected implants were inserted bilaterally, either 1 mm below bone level (test group, 28 implants) or at bone level (control group, 28 implants) of the patients' posterior regions. Marginal bone resorptions were examined through periapical radiographies taken with the parallel technique at the time of crown cementation and the third, sixth, 12th, and 36th months after prosthetic loading. The modified plaque index, gingival index, bleeding on probing, and probing depths were used for follow-up periodontal care of the implants. After 3 years, the mean radiographic vertical bone loss in the control group was significantly lower than in the test group (0.56 ± 0.35 mm and 1.21 ± 1.05 mm, respectively) (p < .01). In terms of periodontal indexes, there were no statistically significant differences between the two groups (p > .05). No peri-implantitis or peri-implant mucositis was observed around the test or control implants. More marginal bone resorptions occurred after the third year of loading in implants placed 1 mm below bone level. However, the resorptions did not reach the implants thread. In the control group, the first bone implant contact was placed under the level of the first threads. Therefore, the present randomized clinical trial confirmed the hypothesis that placing platform-switching implants 1 mm below bone level reduced marginal bone loss. It can be noted that to reduce resorption, platform-switching implants should be placed below bone level. © 2014 Wiley Periodicals, Inc.

Title: Peri-Implantitis Associated with Type of Cement: A Retrospective Analysis of Different Types of Cement and Their Clinical Correlation to the Peri-Implant Tissue.

Citation: Clinical implant dentistry and related research, Oct 2015, vol. 17 Suppl 2, p. e434.

Author(s): Korsch, Michael, Walther, Winfried

Abstract: The cementation of fixed implant-supported dental restorations involves the risk of leaving excess cement in the mouth which can promote biofilm formation in the peri-implant sulcus. As a result, an inflammation may develop. The aim of the present study was to investigate the clinical effect of two different luting cements on the peri-implant tissue. Within the scope of a retrospective clinical follow-up study, the prosthetic structures of 22 patients with 45 implants were revised. In all cases, a methacrylate cement (Premier Implant Cement [PIC], Premier® Dental Products Company, Plymouth Meeting, PA, USA) had been used for cementation. In 16 additional patients with 28 implants, the suprastructures were retained with a zinc oxide-eugenol cement (Temp Bond [TB], Kerr Sybron Dental Specialities, Glendora, CA, USA). These patients were evaluated in the course of routine treatment. In both populations, the retention time of the suprastructures was similar (TB 3.77 years, PIC 4.07 years). In the PIC cases, 62% of all implants had excess cement. In the TB cases, excess cement was not detectable on any of the implants. Bleeding on probing was significantly more frequent on implants cemented with PIC (100% with and 94% without excess cement) than on implants cemented with TB (46%). Pocket suppuration was observed on 89% of the PIC-cemented implants with excess cement (PIC without excess cement 24%), whereas implants with TB were not affected by it at all. The peri-implant bone loss was significantly greater in the PIC patients (with excess cement 1.37 mm, without excess cement 0.41 mm) than it was in the TB patients (0.07 mm). The frequency of undetected excess cement depends essentially on the type of cement used. Cements that

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tend to leave more undetected excess have a higher prevalence for peri-implant inflammation and cause a more severe peri-implant bone loss. © 2014 Wiley Periodicals, Inc.

Title: In Vitro Investigation of the Effect of Oral Bacteria in the Surface Oxidation of Dental Implants.

Citation: Clinical implant dentistry and related research, Oct 2015, vol. 17 Suppl 2, p. e562.

Author(s): Sridhar, Sathyanarayanan, Wilson, Thomas G, Palmer, Kelli L, Valderrama, Pilar, Mathew, Mathew T, Prasad, Shalini, Jacobs, Michael, Gindri, Izabelle M, Rodrigues, Danieli C

Abstract: Bacteria are major contributors to the rising number of dental implant failures. Inflammation secondary to bacterial colonization and bacterial biofilm is a major etiological factor associated with early and late implant failure (peri-implantitis). Even though there is a strong association between bacteria and bacterial biofilm and failure of dental implants, their effect on the surface of implants is yet not clear. To develop and establish an in vitro testing methodology to investigate the effect of early planktonic bacterial colonization on the surface of dental implants for a period of 60 days. Commercial dental implants were immersed in bacterial (Streptococcus mutans in brain-heart infusion broth) and control (broth only) media. Immersion testing was performed for a period of 60 days. During testing, optical density and pH of immersion media were monitored. The implant surface was surveyed with different microscopy techniques post-immersion. Metal ion release in solution was detected with an electrochemical impedance spectroscopy sensor platform called metal ion electrochemical biosensor (MIEB). Bacteria grew in the implant-containing medium and provided a sustained acidic environment. Implants immersed in bacterial culture displayed various corrosion features, including surface discoloration, deformation of rough and smooth interfaces, pitting attack, and severe surface rusting. The surface features were confirmed by microscopic techniques, and metal particle generation was detected by the MIEB. Implant surface oxidation occurred in bacteria-containing medium even at early stages of immersion (2 days). The incremental corrosion resulted in dissolution of metal ions and debris into the testing solution. Dissolution of metal ions and particles in the oral environment can trigger or contribute to the development of peri-implantitis at later stages. © 2015 Wiley Periodicals, Inc.

Title: Experimental Peri-Implantitis around Different Types of Implants - A Clinical and Radiographic Study in Dogs.

Citation: Clinical implant dentistry and related research, Oct 2015, vol. 17 Suppl 2, p. e661.

Author(s): Fickl, Stefan, Kebschull, Moritz, Calvo-Guirado, José Luis, Hürzeler, Markus, Zuhr, Otto

Abstract: The influence of the implant micro and macrostructure on peri-implantitis is not fully understood. To determine the effect of ligature-induced peri-implantitis on three commercially available implant types. Five beagle dogs were used. Two months following tooth extraction, three different implant types (BIOMET 3i T3, BIOMET 3i, Palm Beach Gardens, FL, USA; Straumann Bone Level, Straumann GmbH, Basel, Switzerland; Nobel

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Replace Tapered, Nobel Biocare, Gothenburg, Sweden) were placed in a randomized fashion in each hemi-mandible. Peri-implantitis was initiated by ligature placement and soft diet. Ligatures were added every 2 weeks for a total of four ligature advancements. After 2 weeks, the ligatures were removed, oral hygiene measures initiated for 3 weeks, and clinical (probing depth, mucosal recession, bleeding on probing), intrasurgical (intrasurgical defect depth, intrasurgical defect width), and radiographic (radiographic bone level) parameters assessed. Nobel Replace Tapered implants showed significantly higher intrasurgical defect depth, intrasurgical defect width, probing depths, and radiographic bone level when compared to BIOMET 3i T3 or Straumann Bone Level implants. Straumann Bone Level implants showed largely similar clinical outcomes to BIOMET 3i T3. No significant differences between the groups were observed for mean mucosal recession. In an experimental peri-implantitis model, Nobel Replace Tapered implants are associated with pronounced tissue loss. © 2015 Wiley Periodicals, Inc.

Title: 10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients.

Citation: Clinical oral implants research, Oct 2015, vol. 26, no. 10, p. 1121-1128

Author(s): van Velzen, Frank J J, Ofec, Ronen, Schulten, Engelbert A J M, Ten Bruggenkate, Christiaan M

Abstract: This prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients. Patients who had dental implant surgery in the period between November 1997 and June 2001, with a follow-up of at least 10 years, were investigated for clinical and radiological examination. Among the 506 inserted dental implants in 250 patients, 10-year data regarding the outcome of implants were available for 374 dental implants in 177 patients. In the current study, peri-implantitis was defined as advanced bone loss (≧1.5 mm. postloading) in combination with bleeding on probing. At 10-year follow-up, only one implant was lost (0.3%) 2 months after implant surgery due to insufficient osseointegration. The average bone loss at 10 year postloading was 0.52 mm. Advanced bone loss at 10-year follow-up was present in 35 dental implants (9.8%). Seven percent of the observed dental implants showed bleeding on probing in combination with advanced bone loss and 4.2% when setting the threshold for advanced bone loss at 2.0 mm. Advanced bone loss without bleeding on probing was present in 2.8% of all implants. In this prospective study, the 10-year survival rate at implant and patient level was 99.7% and 99.4%, respectively. Peri-implantitis was present in 7% of the observed dental implants according to the above-mentioned definition of peri-implantitis. This study shows that SLA implants offer predictable long-term results as support in the treatment of fully and partially edentulous patients. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Title: Is Photodynamic Therapy an Effective Treatment for Periodontal and Peri-Implant Infections?

Citation: Dental clinics of North America, Oct 2015, vol. 59, no. 4, p. 831-858 (October 2015)

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Author(s): Sculean, Anton, Aoki, Akira, Romanos, George, Schwarz, Frank, Miron, Richard J, Cosgarea, Raluca

Abstract: Antimicrobial photodynamic therapy (PDT) has attracted much attention for the treatment of pathogenic biofilm associated with peridontitis and peri-implantitis. However, data from randomized controlled clinical studies (RCTs) are limited and, to some extent, controversial, making it difficult to provide appropriate recommendations. Therefore, the aims of the present study were (a) to provide an overview on the current evidence from RCTs evaluating the potential clinical benefit for the additional use of PDT to subgingival mechanical debridement (ie, scaling and root planing) alone in nonsurgical periodontal therapy; and (b) to provide clinical recommendations for the use of PDT in periodontal practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Title: A Murine Model of Lipopolysaccharide-Induced Peri-Implant Mucositis and Peri-Implantitis.

Citation: The Journal of oral implantology, Oct 2015, vol. 41, no. 5, p. e158. (October 2015)

Author(s): Pirih, Flavia Q, Hiyari, Sarah, Leung, Ho-Yin, Barroso, Ana D V, Jorge, Adrian C A, Perussolo, Jeniffer, Atti, Elisa, Lin, Yi-Ling, Tetradis, Sotirios, Camargo, Paulo M

Abstract: Dental implants are a widely used treatment option for tooth replacement. However, they are susceptible to inflammatory diseases such as peri-implant mucositis and peri-implantitis, which are highly prevalent and may lead to implant loss. Unfortunately, the understanding of the pathogenesis of peri-implant mucositis and peri-implantitis is fragmented and incomplete. Therefore, the availability of a reproducible animal model to study these inflammatory diseases would facilitate the dissection of their pathogenic mechanisms. The objective of this study is to propose a murine model of experimental peri-implant mucositis and peri-implantitis. Screw-shaped titanium implants were placed in the upper healed edentulous alveolar ridges of C57BL/6J mice 8 weeks after tooth extraction. Following 4 weeks of osseointegration, Porphyromonas gingivalis -lipolysaccharide (LPS) injections were delivered to the peri-implant soft tissues for 6 weeks. No-injections and vehicle injections were utilized as controls. Peri-implant mucositis and peri-implantitis were assessed clinically, radiographically (microcomputerized tomograph [CT]), and histologically following LPS-treatment. LPS-injections resulted in a significant increase in soft tissue edema around the head of the implants as compared to the control groups. Micro-CT analysis revealed significantly greater bone loss in the LPS-treated implants. Histological analysis of the specimens demonstrated that the LPS-group had increased soft tissue vascularity, which harbored a dense mixed inflammatory cell infiltrate, and the bone exhibited noticeable osteoclast activity. The induction of peri-implant mucositis and peri-implantitis in mice via localized delivery of bacterial LPS has been demonstrated. We anticipate that this model will contribute to the development of more effective preventive and therapeutic approaches for these 2 conditions.

Title: Increasing the Width of Keratinized Mucosa in Maxillary Implant Areas Using a Split Palatal Bridge Flap: Surgical Technique and 1-Year Follow-Up.

Citation: The Journal of oral implantology, Oct 2015, vol. 41, no. 5, p. e195. (October 2015)

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Author(s): Frisch, Eberhard, Ratka-Krüger, Petra, Ziebolz, Dirk

Abstract: Sufficient soft-tissue coverage of maxillary implant sites may be difficult to achieve, especially after bone augmentation. The use of vestibular flaps moves keratinized mucosa (KM) toward the palate and may be disadvantageous for future peri-implant tissue stability. This study describes a new split palatal bridge flap (SPBF) that achieves tension-free wound closure and increases the KM width in maxillary implant areas. We began SPBF surgery with a horizontal incision in the palatal soft tissue to create a split-thickness flap. The second incision was performed perpendicular to the first, using a bridge design, at a distance of 10 to 15 mm. The superior layer can be moved crestally and sutured to cover the soft-tissue defect. The defect width was measured using a periodontal probe. The inferior layer was left exposed, and secondary wound healing created new KM in this region. This SPBF technique was performed on 37 patients. Of these, 16 patients were included in the assessment of clinical peri-implant outcomes. All of the SPBF procedures successfully resulted in a palatal regeneration of KM through secondary wound healing (mean regeneration width, 4.51 ± 1.17 mm; range, 3-6 mm). The 1-year follow-up of 16 patients revealed a mean pocket probing depth of 3.22 ± 0.6 mm with zero cases of peri-implantitis. The vestibular KM width at the involved implants was 2.82 ± 1.07 mm (range, 1.5-6 mm). Surgery for SPBF may be a promising technique for covering soft-tissue defects and increasing KM width in maxillary implant surgery.

Title: A Regenerative Approach to the Successful Treatment of Peri-implantitis: A Consecutive Series of 170 Implants in 100 Patients with 2- to 10-Year Follow-up.

Citation: International Journal of Periodontics & Restorative Dentistry, 2015, vol./is. 35/6(857-863)

Title: International Brainstorming Meeting on Etiologic and Risk Factors of Peri-implantitis, Montegrotto (Padua, Italy), August 2014.

Citation: International Journal of Oral & Maxillofacial Implants, 2015, vol./is. 30/5(1093-1104)

Abstract: The emerging literature has recently reported an alarming increase in peri-implantitis. This disease is typically described as the result of an imbalance between host response and bacterial load, supported by gram-negative anaerobic microflora. The current literature on the prevention and treatment of peri-implantitis does not allow for the extraction of applicable clinical information. In fact, the lack of efficacy of the current treatment methods may be a result of insufficient understanding of the biology. The aim of this position paper was to try to re-evaluate the etiopathogenesis of peri-implantitis, highlighting the principal clinically induced triggering factors of the disease. The consensus conference provided strong evidence to suggest that a different microbiologic flora (slightly different from that collected around teeth affected by periodontitis) could support peri-implantitis. However, the evidence to support a consensus statement regarding clinically triggering factors (surgical, prosthetic, and biomechanical) for peri-implantitis is only of moderate strength (cohort studies or consistent results from long-term, well-populated case series). Expert opinion led the consensus group to support the following: rectifying the number of peri-implant inflammatory situations caused by surgical, restorative, or material

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complications may lower the number of infections to a more realistic figure and may suggest different and more appropriate treatment plans. At the same time, it can be stated that implant material, shape and surface characteristics, procedures and biomaterials used for bone augmentation, and incorrect prosthetic procedures and biomechanical plans could also be risk factors for the occurrence and progression of peri-implantitis.

Title: Characterization of Cement Particles Found in Peri-implantitis-Affected Human Biopsy Specimens.

Citation: International Journal of Oral & Maxillofacial Implants, 2015, vol./is. 30/5(1168-1173)

Language: English

Abstract: Purpose: Peri-implantitis is a disease characterized by soft tissue inflammation and continued loss of supporting bone, which can result in implant failure. Peri-implantitis is a multifactorial disease, and one of its triggering factors may be the presence of excess cement in the soft tissues surrounding an implant. This descriptive study evaluated the composition of foreign particles from 36 human biopsy specimens with 19 specimens selected for analysis. The biopsy specimens were obtained from soft tissues affected by peri-implantitis around cement-retained implant crowns and compared with the elemental composition of commercial luting cement. Materials and Methods: Nineteen biopsy specimens were chosen for the comparison, and five test cements (TempBond, Telio, Premier Implant Cement, Intermediate Restorative Material, and Relyx) were analyzed using scanning electron microscopy equipped with energy dispersive x-ray spectroscopy. This enabled the identification of the chemical composition of foreign particles embedded in the tissue specimens and the composition of the five cements. Statistical analysis was conducted using classification trees to pair the particles present in each specimen with the known cements. Results: The particles in each biopsy specimen could be associated with one of the commercial cements with a level of probability ranging between .79 and 1. TempBond particles were found in one biopsy specimen, Telio particles in seven, Premier Implant Cement particles in four, Relyx particles in four, and Intermediate Restorative Material particles in three. Conclusion: Particles found in human soft tissue biopsy specimens around implants affected by peri-implant disease were associated with five commercially available dental cements.

Title: Peri-implantitis Treatment with a Regenerative Approach : Clinical Outcomes on Reentry.

Citation: International Journal of Periodontics & Restorative Dentistry, 2015, vol./is. 35/5(624-636)

Title: Reentry After Combined Surgical Resective and Regenerative Therapy of Advanced Peri-implantitis : A Retrospective Analysis of Five Cases.

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Citation: International Journal of Periodontics & Restorative Dentistry, 2015, vol./is. 35/5(646-653), 01987569

Bisphosphonate-related osteonecrosis of the jaw

Title: Jaw Bone Samples From Bisphosphonate-Treated Patients: A Pilot Cohort Study.

Citation: Clinical implant dentistry and related research, Oct 2015, vol. 17 Suppl 2, p. e679.

Author(s): Cardemil, Carina, Thomsen, Peter, Larsson Wexell, Cecilia

Abstract: Osteonecrosis of the jaw (ONJ) is a severe complication of bisphosphonate treatment. A detailed characterization of sampled peri-necrotic jawbone from bisphosphonate-treated patients was performed at tissue and cellular level (histological analyses and gene expression). Alveolar bone samples were collected from patients with (n = 5) and without ONJ (n = 5). Healthy patients served as controls (n = 10). The histological analysis demonstrated low to moderate inflammation, displaying areas of inflammatory infiltrate in the bone marrow. Multinuclear giant cells and osteoclasts were found in both groups. Markers of bone formation (alkaline phosphatase, Col1a1, and osteocalcin), bone resorption (receptor activator of NF-kappaB ligand [RANKL], osteoprotegerin [OPG], tartrate-resistant acid phosphatase, and cathepsin K), inflammation (tumor necrosis factor-alpha, interleukin [IL]-1β, and IL-6), angiogenesis (vascular endothelial growth factor A), and apoptosis (Casp3, Casp8, p53, and Smac) were evaluated. Nonparametric statistical tests were used to identify differences between the groups. In patients with ONJ, the expression level of the proinflammatory marker IL-1β was strongly up-regulated compared with controls (p = .040). A down-regulated expression of Casp8 compared with controls was observed (p = .014) in patients treated with bisphosphonates. The RANKL/OPG ratios were similar in the three groups. The results indicate a need to further investigate the molecular mechanisms involved in the course of ONJ related to antiresorptive treatment. © 2015 Wiley Periodicals, Inc.

Title: Intraindividual comparison of preoperative (99m)Tc-MDP SPECT/CT and intraoperative and histopathological findings in patients with bisphosphonate- or denosumab-related osteonecrosis of the jaw.

Citation: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, Oct 2015, vol. 43, no. 8, p. 1461-1469

Author(s): Assaf, Alexandre T, Zrnc, Tomislav A, Remus, Chressen C, Adam, Gerhard, Zustin, Jozef, Heiland, Max, Friedrich, Reinhard E, Derlin, Thorsten

Abstract: Bisphosphonate- or denosumab-related osteonecrosis of the jaw (BRONJ/DRONJ) requires reliable preoperative assessment of the extent of disease for surgical planning. The

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aim of this study was to compare the extent of BRONJ/DRONJ as detected by Tc-99m-methylene diphosphonate (MDP) bone scintigraphy with intraoperative and histopathological findings, and to assess the additional value of hybrid single photon emission computed tomography/computed tomography (SPECT/CT) for evaluation of disease. Twenty-one patients with BRONJ/DRONJ underwent three-phase bone scintigraphy including SPECT/CT. The diagnostic certainty using conventional SPECT or fused SPECT/CT imaging was compared. Location and extent of disease on scintigraphic imaging and pre- and intra-operative clinical assessment were compared. Intraoperative and histopathological findings served as reference standard. A total of 29 sites of BRONJ/DRONJ were histopathologically confirmed in 21 patients. Bone scintigraphy demonstrated increased perfusion in 57.1% of patients, increased blood pool in 76.2%, and increased tracer accumulation at the metabolic phase in all patients. The intensity of tracer accumulation at the metabolic phase correlated significantly with clinical stage of disease (rs = 0.47, p = 0.03). Clinical examination (p < 0.0001), but not SPECT (p = 0.19), underestimated the extent of disease as determined by surgical evaluation. SPECT/CT offered a significantly higher diagnostic certainty (p < 0.0001). In patients with BRONJ/DRONJ, the true extent of osseous lesions as determined by surgery is significantly underestimated by clinical examination. Tc-99m-MDP bone scintigraphy can reliably predict the extent of disease. Hybrid SPECT/CT may significantly increase the diagnostic certainty of anatomical localization. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Title: Bisphosphonate-Related Osteonecrosis of the Jaw in an 80-Year-Old Woman with Diabetes Mellitus: Case Report.

Citation: Journal of the American Geriatrics Society, Oct 2015, vol. 63, no. 10, p. 2221-2222

Author(s): Valenzuela, Lizette, Alonso-Bouzón, Cristina, Mañas, Leocadio Rodriguez

Title: Genetic association between VEGF polymorphisms and BRONJ in the Korean population.

Citation: Oral diseases, Oct 2015, vol. 21, no. 7, p. 866-871

Author(s): Choi, H, Lee, J H, Lee, J-H, Kim, J-H

Abstract: The purpose of this study was to evaluate the association between vascular endothelial growth factor (VEGF) polymorphisms and bisphosphonate-related osteonecrosis of the jaw (BRONJ) in the Korean population. Forty-five individuals (2 men, 43 women; mean age: 68.7 ± 12.3 years) were recruited for this study. All visited the Yonsei University Dental Hospital for surgical intervention from January 2012 to January 2013 and had a history of bisphosphonate (BP) administration (oral and/or intravenous). Patients were allocated to case (n = 26) or control (n = 19) groups according to the patients' selection criteria. Association between three VEGF single nucleotide polymorphisms (rs699947 (-2578 C>A), rs2010963 (-634 G>C) and rs3025039 (+936 C>T)) and BRONJ were investigated using multiple logistic regression analysis and Fisher's exact test where appropriate (α = 0.05). The CC homozygotes of rs2010963 and rs3025039 of VEGF gene were associated with an increased risk of BRONJ (P = 0.04, 0.03, respectively). In haplotype analysis, no differences in

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haplotype C-C (-2578/-634) and haplotype C-C-C (-2578/-634/+936) were observed. The CC homozygotes of rs2010963 and rs3025039 polymorphisms in the VEGF gene were associated with an increased risk of BRONJ in the Korean population. Further epidemiological cohort studies with a larger sample size would be required to confirm the suggestive correlations. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Title: Treatment of Osteonecrosis of the Jaw.

Citation: The Journal of craniofacial surgery, Oct 2015, vol. 26, no. 7, p. e575.

Author(s): Yamachika, Eiki, Matsubara, Masakazu, Ikeda, Atsushi, Matsumura, Tatsushi, Moritani, Norifumi, Iida, Seiji

Abstract: The definition of bisphosphonate-related osteonecrosis of the jaw (BRONJ) was recently broadened and it is now known as medication-related osteonecrosis of the jaw (MRONJ). To date, the management of MRONJ is controversial. Conservative treatment is recommended, but it is difficult to successfully treat stage 3 MRONJ. Administration of teriparatide for the MRONJ treatment has only been documented in independent case reports and there are few reports on men with MRONJ treated with teriparatide. An 81-year-old man was referred in May 2014 for treatment of an unhealed tooth extraction wound in the mandible. He took minodronic acid hydrate (1 mg/d orally) for 2 years because of osteoporosis cure. On clinical examination, soft tissue swelling in the left mandibular first molar region extended to the inferior border of the mandible with extraoral fistula. Computed tomography (CT) revealed osteolysis extending to the inferior border resulting in pathologic fracture of mandibular bone. Based on these findings, a diagnosis of stage 3 MRONJ was made. We performed conservative treatment, including amoxicillin, but his symptoms did not improve. He was then treated with once-weekly subcutaneous injection of teriparatide. Although teriparatide injections were started without antibiotics, after 1 week, swelling, erythema, and purulent discharge from the extraoral fistula increased rapidly. Therefore, we combined the once-weekly teriparatide injection with amoxicillin administration. Three months later, the osteonecrosis had healed and CT showed significant bone regeneration and healing of the mandibular pathologic fracture. In addition, the mandibular fistula showed healing and the intraoral fistula was covered with normal mucosa

Title: Bisphosphonate-Related Osteonecrosis of the Jaw After Tooth Extraction.

Citation: The Journal of craniofacial surgery, Oct 2015, vol. 26, no. 7, p. e606.

Author(s): Bezerra Ribeiro, Ney Robson, de Freitas Silva, Leonardo, Matos Santana, Diego, Maia Nogueira, Renato Luiz

Abstract: Bisphosphonates are widely used for treatment or prevention of bone diseases characterized by high osteoclastic activity. Among the oral medicines used to treat osteoporosis, alendronate has been often used. Despite of the low rate of complications on its use, cases of osteonecrosis of the jaw have been reported on literature after tooth extractions. The main symptoms include pain, tooth mobility, swelling, erythema, and ulceration. The risk factors related to osteonecrosis of the jaw associated with

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bisphosphonate are exposition time to the medicine, routes of administration, and oral surgical procedures performed. The aim of this work is to report a case of a patient showing osteonecrosis of the jaw associated with the use of oral bisphosphonates after tooth extractions. The patient was treated through the suspension of the alendronate with the removal of the necrotic tissue and the foci of infection. After a year's follow-up, the patient showed no recurrence signs. From the foregoing, the interruption of the alendronate use and the surgical treatment associated to antibiotic therapy showed effective on the patient's treatment.

Title: New cancer therapies and jaw necrosis.

Citation: British dental journal, Sep 2015, vol. 219, no. 5, p. 203-207 (September 11, 2015)

Author(s): Patel, V, Kelleher, M, Sproat, C, Kwok, J, McGurk, M

Abstract: Osteonecrosis of the jaw (ONJ) has a number of causes, the most familiar being radiation or bisphosphonate induced. Various other novel anti-neoplastic and bone-targeting therapies that can also cause jaw necrosis have recently become available. This has led to the suggested acronym MRONJ for medication-related osteonecrosis of the jaw. This article summarises the available information on these drugs and their implications for the dental surgeon.

Cleft lip and palate

Title: Systemic connective tissue features in women with fibromuscular dysplasia

Citation: Vascular Medicine (United Kingdom), October 2015, vol./is. 20/5(454-462),

Author(s): Oconnor S., Kim E.S., Brinza E., Moran R., Fendrikova-Mahlay N., Wolski K., Gornik H.L.

Abstract: Fibromuscular dysplasia (FMD) is a non-atherosclerotic disease associated with hypertension, headache, dissection, stroke, and aneurysm. The etiology is unknown but hypothesized to involve genetic and environmental components. Previous studies suggest a possible overlap of FMD with other connective tissue diseases that present with dissections and aneurysms. The aim of this study was to investigate the prevalence of connective tissue physical features in FMD. A total of 142 FMD patients were consecutively enrolled at a single referral center (97.9% female, 92.1% of whom had multifocal FMD). Data are reported for 139 female patients. Moderately severe myopia (29.1%), high palate (33.1%), dental crowding (29.7%), and early-onset arthritis (15.6%) were prevalent features. Classic connective features such as hypertelorism, cleft palate, and hypermobility were uncommon. The frequency of systemic connective tissue features was compared between FMD patients with a high vascular risk profile (having had 3/41 dissection and/or 3/42 aneurysms) and those with a standard vascular risk profile. A history of spontaneous pneumothorax (5.9% high risk vs 0% standard risk) and atrophic scarring (17.6% high risk vs 6.8% standard risk)

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were significantly more prevalent in the high risk group, p<0.05. High palate was observed in 43.1% of the high risk group versus 27.3% in the standard risk group, p=0.055. In conclusion, in a cohort of women with FMD, there was a prevalence of moderately severe myopia, high palate, dental crowding, and early-onset osteoarthritis. However, a characteristic phenotype was not discovered. Several connective tissue features such as high palate and pneumothorax were more prominent among FMD patients with a high vascular risk profile.

Title: Maxillary sinus volumes of patients with unilateral cleft lip and palate

Citation: International Journal of Pediatric Otorhinolaryngology, October 2015, vol./is. 79/10(1741-1744)

Author(s): Erdur O., Ucar F.I., Sekerci A.E., Celikoglu M., Buyuk S.K.

Abstract: Background and objective: Studies about maxillary sinuses of cleft lip-palate patients have increased since sinusitis is commonly observed in these patients. It is evident that maxillary sinus will be morphologically affected in these patients. And anatomic differences may be a cause or at least a contributor of sinusitis. The aim of this study was to compare maxillary sinus volumes of the non-syndromic patients with unilateral cleft lip-palate and control group by using Cone-Beam computed tomography. Methods: Tomography scans of 44 unilateral cleft lip-palate patients (18 right and 26 left) with age and gender matched 45 control patients were evaluated for the study. The images used in the study were part of the diagnostic records collected due to dental treatment needs. All tomographs were obtained in supine position by using Cone-Beam computed tomography (NewTom 5G, QR, Verona, Italy). The patient-specific Hounsfield values were set to include the largest amount of voxels in the sinuses volume calculation individually. All data were measured in mm³. Results: There was no statistically difference between the gender and age distributions of the groups. No statistically significant difference was found on the cleft and non-cleft side, the right and left side of the unilateral cleft lip-palate patients and the control group (P>0.05). For the inter group comparison, mean maxillary sinus volumes volume of unilateral cleft lip-palate patients (9894.55+/-4171.44mm³) was statistically smaller than the control group (11,977.90+/-4484.93mm³) (P<0.05). Conclusion: Maxillary sinus volumes were effected negatively in unilateral cleft lip-palate patients when compared with the healthy control group. No difference was found on the cleft, non-cleft side and the right-left side of the unilateral cleft lip-palate patients.

Title: Interdisciplinary treatment of an adult with bilateral cleft lip and palate with missing premaxilla: The prosthodontic perspective.

Citation: The Journal of prosthetic dentistry, Oct 2015, vol. 114, no. 4, p. 609-613

Author(s): Abreu, Amara, Levy-Bercowski, Daniel, Yu, Jack, Salgueiro, Martin, Kalathingal, Sajitha, Ferreira Susin, Lisiane, Baker, Phil

Abstract: Conventional orthognathic surgery and orthodontic techniques occasionally fail to completely correct the occlusal relationship and esthetic deficits of patients with cleft lip and palate and severe midface deficiency. Prosthodontic rehabilitation is often required to

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establish adequate occlusion and provide a more proportional facial appearance. This clinical report describes the interdisciplinary management of an adult with complete bilateral cleft lip and palate who was treated with distraction osteogenesis using a rigid external distraction device for maxillary advancement and his prosthodontic rehabilitation with a dual path removable partial overdenture to develop definitive facial and dental esthetic form. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Title: Maxillary sinus volumes of patients with unilateral cleft lip and palate.

Citation: International journal of pediatric otorhinolaryngology, Oct 2015, vol. 79, no. 10, p. 1741-1744

Author(s): Erdur, Omer, Ucar, Faruk Izzet, Sekerci, Ahmet Ercan, Celikoglu, Mevlut, Buyuk, Suleyman Kutalmıs

Abstract: Studies about maxillary sinuses of cleft lip-palate patients have increased since sinusitis is commonly observed in these patients. It is evident that maxillary sinus will be morphologically affected in these patients. And anatomic differences may be a cause or at least a contributor of sinusitis. The aim of this study was to compare maxillary sinus volumes of the non-syndromic patients with unilateral cleft lip-palate and control group by using Cone-Beam computed tomography. Tomography scans of 44 unilateral cleft lip-palate patients (18 right and 26 left) with age and gender matched 45 control patients were evaluated for the study. The images used in the study were part of the diagnostic records collected due to dental treatment needs. All tomographs were obtained in supine position by using Cone-Beam computed tomography (NewTom 5G, QR, Verona, Italy). The patient-specific Hounsfield values were set to include the largest amount of voxels in the sinuses volume calculation individually. All data were measured in mm(3). There was no statistically difference between the gender and age distributions of the groups. No statistically significant difference was found on the cleft and non-cleft side, the right and left side of the unilateral cleft lip-palate patients and the control group (P>0.05). For the inter group comparison, mean maxillary sinus volumes volume of unilateral cleft lip-palate patients (9894.55±4171.44mm(3)) was statistically smaller than the control group (11,977.90±4484.93mm(3)) (P<0.05). Maxillary sinus volumes were effected negatively in unilateral cleft lip-palate patients when compared with the healthy control group. No difference was found on the cleft, non-cleft side and the right-left side of the unilateral cleft lip-palate patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Title: Nasopharyngeal airway volume for different GOSLON scores in patients with unilateral cleft lip and palate

Citation: Cleft Palate-Craniofacial Journal, September 2015, vol./is. 52/5(e176-e179)

Author(s): Olmez Gurlen S., Aras I., Dogan S.

Abstract: Objective: The aim of this study is to evaluate the nasopharyngeal airway volumes of patients with unilateral cleft lip and palate (UCLP) with different GOSLON scores. Methods: The study sample consisted of 34 patients with UCLP and 20 controls with no cleft history. In the UCLP group, three experienced examiners used the GOSLON Yardstick to rate

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dental arch relationships, and the sample was divided into three groups as GOSLON 2 (G2) (n = 13), GOSLON 3 (G3) (n = 10), and GOSLON 4 (G4) (n = 11). Airway volumes were constructed using three-dimensional computed tomography data and divided into four compartments named the nasal airway, and superior, middle, and inferior pharyngeal airways. Results: No statistically significant difference was detected among G2, G3, and G4 between the constitutive airway departments of the nasopharyngeal region. However, nasal airway volumes were significantly higher in the control group when compared with the UCLP group. Discussion: Although there was no correlation among the investigated parameters, it is also a fact that airway capacities display a great variability among patients when investigated three dimensionally. Conclusion: Although the severity of GOSLON scores might predetermine the extent of which the airways are affected from the cleft, a larger sample size is needed in future studies.

Periodontal disease and antibiotics

Title: Dental Procedures and the Risk of Infective Endocarditis.

Citation: Medicine, Oct 2015, vol. 94, no. 43, p. e1826.

Author(s): Chen, Pei-Chun, Tung, Ying-Chang, Wu, Patricia W, Wu, Lung-Sheng, Lin, Yu-Sheng, Chang, Chee-Jen, Kung, Suefang, Chu, Pao-Hsien

Abstract: Infective endocarditis (IE) is an uncommon but potentially devastating disease. Recently published data have revealed a significant increase in the incidence of IE following the restriction on indications for antibiotic prophylaxis as recommended by the revised guidelines. This study aims to reexamine the basic assumption behind the rationale of prophylaxis that dental procedures increase the risk of IE.Using the Longitudinal Health Insurance Database of Taiwan, we retrospectively analyzed a total of 739 patients hospitalized for IE between 1999 and 2012. A case-crossover design was conducted to compare the odds of exposure to dental procedures within 3 months preceding hospitalization with that during matched control periods when no IE developed.In the unadjusted model, the odds ratio (OR) was 0.93 for tooth extraction (95% confidence interval [CI] 0.54-1.59), 1.64 for surgery (95% CI 0.61-4.42), 0.92 for dental scaling (95% CI 0.59-1.42), 1.69 for periodontal treatment (95% CI 0.88-3.21), and 1.29 for endodontic treatment (95% CI 0.72-2.31). The association between dental procedures and the risk of IE remained insignificant after adjustment for antibiotic use, indicating that dental procedures did not increase the risk of IE.Therefore, this result may argue against the conventional assumption on which the recommended prophylaxis for IE is based

Title: Histologic Analysis of the Influence of a Gelatin-based Scaffold in the Repair of Immature Dog Teeth Subjected to Regenerative Endodontic Treatment.

Citation: Journal of endodontics, Oct 2015, vol. 41, no. 10, p. 1619-1625

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Author(s): Londero, Clacir de Lourdes Dotto, Pagliarin, Claudia Medianeira Londero, Felippe, Mara Cristina Santos, Felippe, Wilson Tadeu, Danesi, Cristiane Cademartori, Barletta, Fernando Branco

Abstract: Regenerative endodontic treatment is a new and promising approach to manage immature teeth with necrotic pulps and apical periodontitis. The use of scaffolds is essential to treatment success, but many materials are difficult to acquire and have a high cost. This study assessed tissue repair in immature dog teeth with necrotic pulps and apical periodontitis after using a gelatin-based scaffold (Gelfoam; Pharmacia & Upjohn Co, Kalamazoo, MI). Apical periodontitis was induced in 20 immature dog teeth. After disinfection with triple antibiotic paste for 2 weeks, canals were irrigated, dried, and filled with a blood clot alone (10 teeth) or combined with Gelfoam (10 teeth). Another 10 teeth were used as negative controls (no intervention). After 7 months, the dogs were euthanized. Histologic sections were stained with hematoxylin-eosin and analyzed in relation to tissue repair. Categoric data were analyzed using the Fisher exact test (P < .05), numeric data (histomorphometric analysis), and the Mann-Whitney U test. Histologic analysis revealed a higher percentage of roots with new cementumlike mineralized tissue and connective tissue inside the canal in the blood clot + Gelfoam group (P < .001). Histomorphometric analysis showed a higher area of mineralized tissue in the same group (P = .029). Apical extension of root and inflammation were similar between the experimental groups. The new tissue formed onto canal walls and in the root canal space showed characteristics of cementum and periodontal ligament, respectively. The use of a gelatin-based scaffold (Gelfoam) combined with a blood clot improved repair in immature dog teeth with apical periodontitis subjected to regenerative endodontic treatment. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Title: Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?

Citation: Dental clinics of North America, Oct 2015, vol. 59, no. 4, p. 919-933 (October 2015)

Author(s): Walters, John, Lai, Pin-Chuang

Abstract: Although scaling and root planing is a cost-effective approach for initial treatment of chronic periodontitis, it fails to eliminate subgingival pathogens and halt progressive attachment loss in some patients. Adjunctive use of systemic antibiotics immediately after completion of scaling and root planing can enhance the degree of clinical attachment gain and probing depth reduction provided by nonsurgical periodontal treatment. This article discusses the rationale for prescribing adjunctive antibiotics, reviews the evidence for their effectiveness, and outlines practical issues that should be considered before prescribing antibiotics to treat chronic periodontitis. Copyright © 2015 Elsevier Inc. All rights reserved.

Head and neck oncology and dentistry

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Title: Association between tobacco waterpipe smoking and head and neck conditions: A systematic review. Citation: Journal of the American Dental Association (1939), Oct 2015, vol. 146, no. 10, p. 760-766 Author(s): Munshi, Teja, Heckman, Carolyn J, Darlow, Susan Abstract: With the growing popularity of waterpipe smoking (WPS), it is important to understand how WPS may impact health. The aim of this study was to systematically review the literature to identify potential health effects of WPS, specifically on the head and neck region. The authors systematically reviewed published articles that focused on WPS and head and neck conditions identified from the following databases: PubMed and MEDLINE, PsycInfo, and Google Scholar. The authors included 20 articles in the review. Ten of the articles pertained to oral tissue outcomes, 7 to head and neck cancer, and 3 to the voice and middle ear. The authors found that WPS was associated with greater inflammation, Candida, periodontitis, dry socket, blood chromium and nickel levels, premalignant lesions, oral cancer, esophageal squamous cell carcinoma, attic retraction, edema in the vocal cords, and lower habitual vocal pitch and voice turbulence index. WPS is associated with various head and neck conditions. Educational and policy approaches may be required to limit the spread of WPS and its potentially deleterious effects. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Title: Advances in Supportive Care for Late Effects of Head and Neck Cancer. Citation: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Oct 2015, vol. 33, no. 29, p. 3314-3321 Author(s): Murphy, Barbara A, Deng, Jie Abstract: As the population of head and neck cancer survivors increases, it has become increasingly important for health care providers to understand and manage late complications of therapy. Functional deficits can be categorized as general health deficits resulting in frailty or debility, head and neck-specific functional deficits such as swallowing and speech, and musculoskeletal impairment as a result of tumor and treatment. Of critical importance is the growing data indicating that swallow therapy and physical therapy may prevent or ameliorate long-term functional deficits. Oral health complications of head and neck therapy may manifest months or years after the completion of treatment. Patients with hyposalivation are at high risk for dental caries and thus require aggressive oral hygiene regimens and routine dental surveillance. Swallowing abnormalities, xerostomia, and poor dentition may result in dietary adaptations that may cause nutritional deficiencies. Identification and management of maladaptive dietary strategies are important for long-term health. Follow-up with primary care physicians for management of comorbidities such as diabetes and hyperlipidemia may help to limit late vascular complications caused by radiation therapy. Herein, we review late effects of head and neck cancer therapy, highlighting recent advances. © 2015 by American Society of Clinical Oncology.

Title: Reliability and validity of the Head and Neck Cancer Inventory (HNCI) in Japanese patients. Citation: Palliative & supportive care, Oct 2015, vol. 13, no. 5, p. 1373-1380

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Author(s): Yamashita, Aya, Ichikura, Kanako, Sugimoto, Taro, Kishimoto, Seiji, Shimozuma, Kojiro, Matsushima, Eisuke Abstract: This project evaluated the psychometric properties of a translated version of the Head and Neck Cancer Inventory (HNCI) for use with Japanese patients. The HNCI is a measure for assessing the quality of life (QoL) of head and neck cancer patients and survivors. The present study was aimed at investigating the reliability and validity of this translated instrument. Some 165 patients with head and neck cancer (HNC) were enrolled at the Tokyo Medical and Dental University Hospital. The instrument's internal consistency and test-retest reliability were evaluated. Criterion-related validity was assessed by correlations between the HNCI and the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) scales. Some 29 of the 30 items in the original version were selected to comprise the Japanese version of the HNCI (Japanese HNCI). Investigation of criterion-related validity using the FACT-H&N demonstrated significant correlations (Spearman's ρ = 0.47-0.63). The value of Cronbach's α for each subscale ranged from 0.84 to 0.87. Test-retest reliability showed an intraclass correlation coefficient (ICC) of 0.62-0.79. The reliability and validity of the Japanese HNCI were evaluated. Although its classification is different from the original U.S. version, the Japanese HNCI is a self-administered questionnaire that can assess quality of life (QoL) in patients with head and neck cancer.

Dental implants

Title: Bacterial profiles and proteolytic activity in peri-implantitis versus healthy sites

Citation: Anaerobe, October 2015, vol./is. 35/(28-34), 1075-9964;1095-8274

Author(s): Neilands J., Wickstrom C., Kinnby B., Davies J.R., Hall J., Friberg B., Svensater G.

Abstract: Peri-implantitis is a biofilm-induced destructive inflammatory process that, over time, results in loss of supporting bone around an osseointegrated dental implant. Biofilms at peri-implantitis sites have been reported to be dominated by Gram-negative anaerobic rods with a proteolytic metabolism such as, Fusobacterium, Porphyromonas, Prevotella and Tannerella, as well as anaerobic Gram-positive cocci. In this study, we hypothesized that protease activity is instrumental in driving bone destruction and we therefore compared the microbial composition and level of protease activity in samples of peri-implant biofluid (PIBF) from 25 healthy subjects (H group) and 25 subjects with peri-implantitis (PI group). Microbial composition was investigated using culture techniques and protease activity was determined using a FITC-labelled casein substrate. The microbial composition was highly variable in subjects both in the H and PI groups but one prominent difference was the prevalence of Porphyromonas/Prevotella and anaerobic Gram positive cocci which was significantly higher in the PI than in the H group. A subgroup of subjects with peri-implantitis displayed a high level of protease activity in the PIBF compared to healthy subjects. However, this activity could not be related to the presence of specific bacterial species. We propose that a high level of protease activity may be a predictive factor for disease

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progression in peri-implantitis. Further longitudinal studies are however required to determine whether assessment of protease activity could serve as a useful method to identify patients at risk for progressive tissue destruction.

Title: Antibiotic prescribing habits of oral and maxillofacial surgeons in conjunction with routine dental implant placement

Citation: Journal of Oral and Maxillofacial Surgery, October 2015, vol./is. 73/10(1926-1931), 0278-2391;1531-5053 (01 Oct 2015)

Author(s): Deeb G.R., Soung G.Y., Best A.M., Laskin D.M.

Abstract: Purpose Although various prophylactic systemic antibiotic regimens have been suggested to minimize failure after dental implant placement, the role of antibiotics in implant dentistry is still controversial. The purpose of the present survey was to determine the current antibiotic prescribing habits of oral and maxillofacial surgeons in conjunction with routine dental implant placement to determine whether any consensus has been reached among such practitioners. Materials and Methods An electronic survey was sent by electronic mail to all members of the American College of Oral and Maxillofacial Surgeons. The questions asked were related to whether antibiotics were routinely prescribed either pre- or postoperatively during routine dental implant placement, and, if so, what antibiotics, dosage, frequency, and duration were used. The survey participants were also asked to specify whether they were in solo private practice, group private practice, academia, military, or "other." The results were tabulated and analyzed using SAS software. Descriptive statistics and chi² analyses were used. Results A total of 217 members responded to the survey. Overall, 112 of 217 (51.6%) prescribed antibiotics preoperatively (95% confidence interval [CI] 50.0 to 58.2%) and 152 of 213 (71.4%) prescribed antibiotics postoperatively (95% CI 65.0 to 77.0%) during routine dental implant placement. Also, 72 (34%) indicated that they prescribed antibiotics both pre- and postoperatively. The most common preoperative regimen used was amoxicillin 2 g given 1 hour before the procedure (32%, n = 36). The most common postoperative regimen used was amoxicillin 500 mg 3 times daily for 5 days (53%, n = 81). Conclusions We found no consensus among oral and maxillofacial surgeons regarding the use of antibiotics in association with routine dental implant placement, the type of regimen to use, or whether such use is even effective in preventing early implant loss. Furthermore, most of the antibiotic regimens being used are not in accordance with the recommendations current in the published data.

Title: Tetracycline tethered to titanium inhibits colonization by Gram-negative bacteria

Citation: Journal of Biomedical Materials Research - Part B Applied Biomaterials, October 2015, vol./is. 103/7(1381-1389)

Author(s): Davidson H., Poon M., Saunders R., Shapiro I.M., Hickok N.J., Adams C.S.

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Abstract: As peri-prosthetic infection is one of the most devastating complications associated with implant placement, we have reasoned that such infection can be largely subverted by development of antibacterial implants. Our previous work demonstrated that covalent coupling of vancomycin to titanium alloy prevented colonization by the Gram-positive pathogens, Staphylococcus aureus and Staphylococcus epidermidis. Some orthopedic devices, including permanent prosthesis anchors, and most dental implants are transcutaneous or transmucosal and can be prone to colonization by Gram-negative pathogens. We report here the successful covalent coupling of the broad-spectrum antibiotic, tetracycline (TET), to titanium surfaces (Ti-TET) to retard Gram-negative colonization. Synthetic progress was followed by changes in water contact angle, while the presence of TET was confirmed by immunofluorescence. Ti-TET actively prevented colonization in the presence of bathing Escherichia coli, both by fluorescence microscopy and direct counting. Finally, the Ti-TET surface supported osteoblastic cell adhesion and proliferation over a 72-h period. Thus, this new surface offers a powerful means to protect transcutaneous implants from adhesion of Gram-negative pathogens, decreasing the need for replacement of this hardware.

Title: Immediate and delayed implantation of front teeth: Comparison of periodontal tissue health degree and success rate

Citation: Chinese Journal of Tissue Engineering Research, March 2015, vol./is. 19/12(1958-1962)

Author(s): Yao X., Zhang N., Li Y.-S., Li H.-M.

Abstract: BACKGROUND: Numerous studies have demonstrated that the use of periodontal tissue-guided regeneration technique significantly elevated success rate of immediate technical planting. No significant difference is detected as compared with the delayed planting success rate in the clinic. OBJECTIVE: To compare the clinical effects of immediate implant and delayed implant in the restoration of anterior teeth. METHODS: A total of 100 cases with former dental implants, who had 160 diseased teeth, were enrolled in this study. They were divided into experimental and control groups according to the principle of random pairing. In the experimental group, the implant was put into the extraction sockets after minimally invasive tooth extraction with the use of periodontal guided tissue regeneration technique. In the control group, at 3 months after minimally invasive tooth extraction, implant was implanted in the sockets. Delayed planting repair of denture in the missing teeth area was performed with the use of periodontal guided tissue regeneration technique. Crown restoration was conducted in both groups at 3 months after implantation. Aesthetics, periodontal pocket depth and implant success rate were compared after repair in both groups. RESULTS AND CONCLUSION: Gingival esthetics score was better at 1, 3, 6 and 12 months after repair in the experimental group than in the control group (P < 0. 05). Periodontal pocket depth was less at 1, 3, 6 and 12 months after repair in the experimental group than in the control group (P < 0. 05). No significant difference in success rate of implants was detected at 12 months after repair between both groups (P > 0. 05). Above findings confirmed that aesthetic effect, treatment cycle, and the health of periodontal tissue were better in the immediate implanting group than in the delayed implanting group. However, no significant difference in success rate was detected between immediate implanting and delayed implanting groups.

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Title: Etiology and clinical characteristics of symptomatic unilateral maxillary sinusitis: A review of 174 cases

Citation: Journal of Cranio-Maxillofacial Surgery, October 2015, vol./is. 43/8(1522-1529)

Author(s): Pache C., Troeltzsch M., Kaeppler G., Ehrenfeld M., Otto S., Probst F.

Abstract: The purpose of the study was to analyze the causative pathology associated with symptomatic unilateral maxillary sinusitis requiring surgical treatment. A retrospective review of all patients that have been treated surgically for unilateral symptomatic maxillary sinusitis between 2006 and 2013 at a single institution was performed. Demographic, anamnesis, clinical, radiological, microbiological and histological data were gathered and analyzed. The patients were allocated into groups depending on the underlying cause of the disease. Descriptive and inferential statistics were computed (level of significance: p < 0.05). The study sample was composed of 174 patients (72 female; 102 male) with a mean age of 52.7 years (SD 16.9). Most cases (130; 75%) were triggered by odontogenic pathology following dentoalveolar surgical interventions (83/130 patients; 64%). Other etiological factors for odontogenic unilateral sinusitis were periapical (23/130 cases; 18%) and periodontal pathology (13/130 cases; 10%). Rhinogenic factors for sinusitis were detected in 13 patients (7.5%) and dental implant-associated unilateral maxillary sinusitis was diagnosed in nine patients (5.2%). Four patients (2.3%) had undergone previous sinus augmentation surgery. A leading cause for the sinus infection could not be identified in 18 patients (10%) who all had a history of midfacial surgery. Medication-related osteonecrosis of the jaw (8) and squamous cell carcinoma (2) were incidental findings. There were no differences in the clinical appearance of the disease with respect to its etiology. Odontogenic causes for maxillary sinusitis must be considered especially in unilateral cases. Maxillary dental implants may induce symptomatic unilateral maxillary sinusitis.

Title: A bar-retained overdenture as an external fixator device in a three-dimensional CAD/CAM-based surgical reconstruction of the mandible

Citation: Journal of Cranio-Maxillofacial Surgery, October 2015, vol./is. 43/8(1447-1451)

Author(s): Koch F.P., Gotze E., Kumar V.V., Schulz P., Wentaschek S., Wagner W.

Abstract: Large defects of the human face often cause esthetic as well as functional disorders. We present a new technique for reconstruction of the mandible with prosthodontic rehabilitation in a single surgery, using the implant-supported, bar-retained overdenture as an external fixator. A 58-year-old patient presented with a near total defect of the mandible after cancer resection. For rehabilitation, the mandibular condyles were virtually positioned in the centre of the fossae, and four dental implants were planned. The position of the fibula segments as well as their angulation and lengths were adapted to the implant position. To transfer this plan into surgery, a combined cutting/implant drilling guide was computer-aided printed. To provide the correct angulation of the fibula segments, a CAD/CAM dental arch-bar was made from titanium, fulfilling three functions: to bear the provisional prosthesis; to stabilize the molded fibula as an external fixator; and to position the complete fibula with the prosthesis in a correct relation to the upper jaw and occlusion, as indicated by the prosthesis. This innovative approach of combined

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prosthodontic and reconstructive rehabilitation could shorten the total reconstruction/rehabilitation time and avoid the need for additional extended surgeries.

Title: Continuity resection of the mandible after ameloblastoma - Feasibility of oral rehabilitation with rhBMP-2 associated to bovine xenograft followed by implant installation

Citation: Journal of Cranio-Maxillofacial Surgery, October 2015, vol./is. 43/8(1553-1560)

Author(s): Lustosa R.M., Macedo D.D.V., Iwaki L.C.V., Tolentino E.D.S., Hasse P.N., Marson G.B.D.O., Iwaki Filho L.

Abstract: Recombinant human morphogenetic protein (rhBMP) is a graft alternative for extensive mandibular reconstruction after tumor resections. However, the feasibility of rhBMP-2 to receive osseointegrated implants and prosthetic rehabilitation has been rarely reported. This study reports on a case of an extensive solid ameloblastoma along the mandibular body. The treatment consisted of resection followed by off-label use of rhBMP type 2 associated with bovine bone xenograft. Eleven months postoperatively, the patient was prosthetically rehabilitated with dental implants, without evidence of resorption or complications. The literature on mandibular reconstructions using rhBMP and their feasibility for future osseointegrated implant placement was also reviewed. Based on the presented case, the association between rhBMP-2 and a bovine bone xenograft could be considered a feasible option for the reconstruction and rehabilitation of large mandibular defects after tumor resection. According to the literature, the use of rhBMP as a graft material is encouraging, with good clinical outcome. However, there are no long-term studies demonstrating success and survival rates of implants placed in these grafts. Future investigations will be required to ascertain the long-term survival of implants in areas grafted with rhBMP. Also, there is a lack of information regarding the prosthetic rehabilitation of these patients.

Title: Finite element simulation of ultrasonic wave propagation in a dental implant for biomechanical stability assessment

Citation: Biomechanics and Modeling in Mechanobiology, October 2015, vol./is. 14/5(1021-1032)

Author(s): Vayron R., Nguyen V.-H., Bosc R., Naili S., Haiat G.

Abstract: Dental implant stability, which is an important parameter for the surgical outcome, can now be assessed using quantitative ultrasound. However, the acoustical propagation in dental implants remains poorly understood. The objective of this numerical study was to understand the propagation phenomena of ultrasonic waves in cylindrically shaped prototype dental implants and to investigate the sensitivity of the ultrasonic response to the surrounding bone quantity and quality. The 10-MHz ultrasonic response of the implant was calculated using an axisymetric 3D finite element model, which was validated by comparison with results obtained experimentally and using a 2D finite difference numerical model. The results show that the implant ultrasonic response changes significantly when a liquid layer is located at the implant interface compared to the case of an interface fully bounded with bone tissue. A dedicated model based on experimental measurements was developed in order to account for the evolution of the bone

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biomechanical properties at the implant interface. The effect of a gradient of material properties on the implant ultrasonic response is determined. Based on the reproducibility of the measurement, the results indicate that the device should be sensitive to the effects of a healing duration of less than one week. In all cases, the amplitude of the implant response is shown to decrease when the dental implant primary and secondary stability increase, which is consistent with the experimental results. This study paves the way for the development of a quantitative ultrasound method to evaluate dental implant stability.

Title: Potential mechanism for osseointegration of dental implants in Zucker diabetic fatty rats

Citation: British Journal of Oral and Maxillofacial Surgery, October 2015, vol./is. 53/8(748-753)

Author(s): Liu Z., Zhou W., Tangl S., Liu S., Xu X., Rausch-Fan X.

Abstract: Our aim was to investigate the impact of diabetes mellitus and different durations of glycaemic control on early osseointegration of dental implants, and to explore possible mechanisms by measuring the expression of integrin alpha5beta1 and fibronectin in bone around the implant. We divided 33 male Zucker diabetic fatty (ZDF) rats aged 3 months into 3 groups. The first group comprised diabetic rats with dental implants (controls); the second group was treated with insulin and implants were placed simultaneously (exenatide alone group); and the third group was treated with insulin until the serum glucose was at a constant concentration (< 16 mmol/L), and implants were then inserted (exenatide+normal glucose group). Rats were killed 7, 14, 30, and 60 days after implants had been inserted. The expression of integrin alpha5beta1 and fibronectin in bone around the implants was detected by immunohistochemical analysis in each group. The expression in the exenatide+normal glucose group was stronger than in the other 2 groups. Fourteen days after implantation, expression of integrin alpha5beta1 in the exenatide alone group was significantly stronger than that in the control group (p=0.027), and 60 days after implantation the expression of fibronectin in the exenatide alone group was also significantly stronger than that among the controls (p=0.001). Both fibronectin and integrin alpha5beta1 participate in the adhesion of osteoblasts and act as signals at the bone/implant interface. Diabetes interferes with the osseointegration of implants by deferring expression of fibronectin and integrin alpha5beta1.

Title: The nasal lift technique for augmentation of the maxillary ridge: Technical note

Citation: British Journal of Oral and Maxillofacial Surgery, October 2015, vol./is. 53/8(771-774)

Author(s): Camargo I.B., Oliveira D.M., Fernandes A.V., Van Sickels J.E.

Abstract: Placement of dental implants in a severely resorbed anterior maxillary alveolar ridge is limited by the fact that implants may penetrate the nasal cavity. However, when the maxilla shows unusual anatomical changes, reconstruction with implants can be a challenge. Options to increase the bone in this region to permit placement of implants include: maxillary onlay bone graft, Le Fort I interpositional bone graft, and augmentation of the

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nasal floor, which is a procedure where only the piriform rim and the anterior nasal spine are exposed through an intraoral approach. In our case we modified this to what we call the nasal lift technique, which is a combination of turbinectomy followed by lifting of the anteroposterior nasal floor through a lateral window using autogenous bone or bone substitutes to augment the space.

Title: Heat generation and drill wear during dental implant site preparation: Systematic review

Citation: British Journal of Oral and Maxillofacial Surgery, October 2015, vol./is. 53/8(679-689)

Author(s): Mohlhenrich S.C., Modabber A., Steiner T., Mitchell D.A., Holzle F.

Abstract: To identify factors that minimise damage during the drilling of sites for dental implants, we reviewed published papers on the amount of heat that is generated. We systematically searched English language studies published between January 2000 and February 2014 on MEDLINE/PubMed and found 41 articles, of which 27 related to an increase in temperature during preparation of the site. We found only basic research with a low level of evidence. Most of the studies were in vitro, and osteotomies were usually made in non-vital bone from cows or pigs. To measure heat in real time, thermocouples were used in 18 studies and infrared thermographs in 7. Three studies reported the use of immunohistochemical analysis to investigate immediate viability of cells. The highest temperature measured was 64.4degreeC and the lowest 28.4degreeC. Drill wear was reported after preparation of 50 sites, and there was a significant increase in temperature and a small change in the physiological balance of the proteins in the bone cells. Differences in the study designs meant that meta-analysis was not appropriate. For future work, we recommend the use of standard variables: an axial load of 2 kg, drilling speed of 1500 rpm, irrigation, standard artificial bone blocks, and the use of infrared thermography.

Title: Impact of type 2 diabetes on the gene expression of bone-related factors at sites receiving dental implants

Citation: International Journal of Oral and Maxillofacial Surgery, October 2015, vol./is. 44/10(1302-1308)

Author(s): Conte A., Ghiraldini B., Casarin R.C., Casati M.Z., Pimentel S.P., Cirano F.R., Duarte P.M., Ribeiro F.V.

Abstract: This study evaluated the influence of type 2 diabetes mellitus (T2DM) on the gene expression of bone-related factors in alveolar bone tissue from sites designated to receive dental implants. Bone biopsies were harvested from sites of planned implants for 19 systemically healthy patients and 35 patients with T2DM (17 with better-controlled T2DM (glycated haemoglobin (HbA1c) levels <8%) and 18 with poorly controlled T2DM (HbA1c levels >8%)). The mRNA levels of tumour necrosis factor alpha, transforming growth factor beta, receptor activator of the nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), runt-related transcription factor 2, alkaline phosphatase, bone sialoprotein (BSP), type I collagen (COL-I), and osteocalcin were evaluated by quantitative real-time polymerase

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chain reaction. T2DM up-regulates RANKL levels and the ratio of RANKL/OPG, whereas it down-regulates COL-I and BSP expression (P < 0.05). Higher mRNA levels of RANKL/OPG were observed in the poorly controlled T2DM patients compared to those with better-controlled T2DM and systemically healthy patients (P < 0.05). A lower amount of COL-I and BSP was detected in the biopsies from individuals with poorly controlled T2DM compared to systemically healthy patients (P < 0.05). In conclusion, RANKL, RANKL/OPG, COL-I, and BSP are negatively affected in diabetics. Additionally, the patient's glycaemic status appears to modulate bone-related genes in a different manner.

Title: The efficacy of a tissue-engineered xenograft in conjunction with sodium hyaluronate carrier in maxillary sinus augmentation: A clinical study

Citation: International Journal of Oral and Maxillofacial Surgery, October 2015, vol./is. 44/10(1287-1294)

Author(s): Emam H.A., Behiri G., El-Alaily M., Sharawy M.

Abstract: PepGen P-15 Putty comprises anorganic bovine bone matrix (ABM) coupled with a synthetic cell-binding peptide, suspended in a sodium hyaluronate carrier. The P-15 portion exhibits a similar structure and properties to the cell-binding region of type I collagen. This study was performed to evaluate ABM/P-15 putty as the sole graft in sinus augmentation. Ten patients for whom both a sinus augmentation and two implants were indicated in the posterior maxilla were enrolled. Bone cores were harvested at 8 and 16 weeks, followed by placement of one implant at 8 weeks and the second at 16 weeks. Twenty collected bone cores were evaluated histologically and by micro-computed tomography. Results showed a significant increase (P < 0.05) in bone mineral density at 8 weeks (0.70 +/- 0.13 g/cm³) and 16 weeks (0.97 +/- 0.08 g/cm³) in the graft compared to native (control) bone (0.04 +/- 0.02 g/cm³). There was no significant difference (P > 0.05) in the percentage bone volume at the two time intervals (PBV 21.14 +/- 4.56 at 8 weeks and 26.33 +/- 5.60 at 16 weeks). The average increase in bone height at 16 weeks was 10.55 +/- 0.53 mm. It is concluded that PepGen P-15 Putty is capable of conducting and accelerating new bone formation and can successfully support dental implants.

Title: Effect of UV-photofunctionalization on oral bacterial attachment and biofilm formation to titanium implant material

Citation: Biomaterials, October 2015, vol./is. 67/(84-92)

Author(s): de Avila E.D., Lima B.P., Sekiya ., Torii Y., Ogawa ., Shi W., Lux R.

Abstract: Bacterial biofilm infections remain prevalent reasons for implant failure. Dental implant placement occurs in the oral environment, which harbors a plethora of biofilm-forming bacteria. Due to its trans-mucosal placement, part of the implant structure is exposed to oral cavity and there is no effective measure to prevent bacterial attachment to implant materials. Here, we demonstrated that UV treatment of titanium immediately prior to use (photofunctionalization) affects the ability of human polymicrobial oral biofilm communities to colonize in the presence of salivary and blood components. UV-treatment

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of machined titanium transformed the surface from hydrophobic to superhydrophilic. UV-treated surfaces exhibited a significant reduction in bacterial attachment as well as subsequent biofilm formation compared to untreated ones, even though overall bacterial viability was not affected. The function of reducing bacterial colonization was maintained on UV-treated titanium that had been stored in a liquid environment before use. Denaturing gradient gel-electrophoresis (DGGE) and DNA sequencing analyses revealed that while bacterial community profiles appeared different between UV-treated and untreated titanium in the initial attachment phase, this difference vanished as biofilm formation progressed. Our findings confirm that UV-photofunctionalization of titanium has a strong potential to improve outcome of implant placement by creating and maintaining antimicrobial surfaces.

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Journal Tables of Contents

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British Dental Journal;

Vol. 219, iss. 8, October 2015

http://www.nature.com/bdj/journal/v219/n8/index.html

Evidence Based Dentistry;

Vol. 16, iss. 3, 2015

http://www.nature.com/ebd/journal/v16/n3/index.html

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International Journal of Oral and Maxillofacial Implants;

Vol. 30, iss. 5 Sept./Oct 2015

http://www.quintpub.com/journals/omi/journal_contents.php?journal_name=OMI&current=1#.VgEBwtJVhBc

International Journal of Prosthodontics

Vol. 28, iss. 5, September/October 2015

http://www.quintpub.com/journals/ijp/journal_contents.php?journal_name=IJP&current=1#.VgECbNJVhBe

Journal of Clinical Periodontology

October 2015, Volume 219 No 7 http://onlinelibrary.wiley.com/doi/10.1111/jcpe.2015.42.issue-9/issuetoc

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