Twenty-nine studies, 26 RCTs and 3 quasi-experimental (36 comparisons), met the entry criteria. Data from the longitudinal study of the oral health of residents of the Gila River Indian Community were analyzed. Adverse microbiologic consequences, such as lack of antimicrobial susceptibility, wrong spectrum, incorrect dosage, non-compliance, and drug interference, must be monitored. If future studies can confirm this effect, then periodontal infection control must be considered an integral part of diabetic control. 0 Reviews. Failure rates for all implants were similar in bone qualities 1 and 2 (6.2% and 6.7%, respectively) and slightly higher in bone qualities 3 and 4 (8.5% and 8.7%, respectively). Arie J. van Winkelhoff, Carolien J. Tijhof, and J. de Graaff, Microbiological and Clinical Results of Metronidazole Plus Amoxicillin Therapy in Actinobacillus actinomycetemcomitans-Associated Periodontitis, Journal of Periodontology, January 1992, Vol. Insulin-dependent diabetic patients with gingivitis or mild periodontitis (group A) and moderate to severe periodontitis (group B) have abnormal monocytic inflammatory secretion in response to LPS challenge from Porphyromonas gingivalis (P. gingivalis) as compared to non-diabetic periodontal patients. Genetics, age, and, nutrition are important signals for this increased response and as reported more recently, infections and inflammation. Periodontol.It is the recommended abbreviation to be used for abstracting, indexing and referencing purposes and meets all criteria of the ISO 4 standard for abbreviating names of scientific journals.. Our findings demonstrated that while attachment loss, probing depth, (PD) and bleeding on probing (BOP) are individually associated with sICAM and CRP, only BOP remains significant for sICAM when all 3 are in the model and, for CRP, only PD remains significant. Data for the four aspects of each implant, as well as measurements over time, were all clustered in the unit of analysis. Type 2 diabetic patients tend to have more failures than non-diabetic patients; however, the influence was marginally significant. The Pub/Med database was searched from 1966 to May 2002. Another important consideration is the temporal relationship between the exposure and the outcome of interest. Failure was defined as removal of the implant for any reason. There is increasing evidence that osteoporosis, and the underlying loss of bone mass characteristic of this disease, is associated with periodontal disease and tooth loss. 1. Annals of Periodontology | Read 197 articles with impact on ResearchGate, the professional network for scientists. Periodontol. When selecting a definition of "systemic periodontitis" (periodontal disease that represents an exposure for a systemic condition), it is helpful to think of periodontal disease as a chronic oral infection with a number of clinical signs, rather than as the dento-centrically defined entity, periodontal disease. Possible clustering was also studied. These contradictions may be related to differences in chemical composition of the HA on the implant surface. 1 Subsequently, a simpler classification was agreed upon at the 1 st European Workshop in Periodontology. Read article PDFs using your inistitution's subscriptions with no additional login. Survival ranged from 66.7% for the 7 mm implants to 96.4% for 16 mm implants (P = 0.001). Outcomes did not change when clustering was considered, although the P value decreased slightly. The PC group had glycosylated hemoglobin (HbA1) > or = 9%; the BC group had HbA1 < 9%. v. ; 28 cm. HGF and HPLF cells were treated with lipopolysaccharide (LPS) and cyclic tension force, respectively. In addition, investigators contacted editors of the above-mentioned journals and companies sponsoring research on these agents for related unpublished data and studies in progress. Collectively, the evidence supports a role for cytokine elevation in the pathophysiology and metabolic abnormalities associated with diabetes. A subset of the Dental Implant Clinical Research Group's database was used to study the 3-year survival and stability of various implant lengths (7 mm, 8 mm, 10 mm, 13 mm, and 16 mm) and diameters (3 mm+ and 4 mm+). Persistent elevation of IL-1 beta, IL-6, and TNF-alpha in the diabetic state have an effect on the liver, stimulate the release of acute-phase proteins, produce the characteristic dysregulation of lipid metabolism associated with type 2 diabetes, and have effects on pancreatic beta cells as well. The changes in stability (PTVs) were analyzed using a generalized linear model (GLM) with repeated measures (Hotelling's Trace). Annals of Periodontology Volume 1, Issue 1. Failures appeared to be associated with a history of smoking. Survival was also determined for each of the three phases of implant treatment--phase 1, from the time of placement to uncovering and abutment connection; phase 2, from uncovering to placement and loading of the prosthesis; and phase 3, from loading of the prosthesis to 36 months. Implant Therapy I. David Cochran. Annals of Periodontology, Volume 7. The use of preoperative antibiotics was nearly significant to implant survival (P = 0.051. Heterogeneity was assessed to determine whether the differences among therapies were due to systematic confounding factors (as noted in study quality assessments). A Systematic Review. Periodontal diseases are infections and thus systemically administered antibiotics are often employed as adjuncts for their control. Moreover, the World Health Organization recently published GCP recommendations similar to the EC requirements. This study tested the hypothesis that the risk for alveolar bone loss is greater, and bone loss progression more severe, for subjects with poorly controlled (PC) type 2 diabetes mellitus (type 2 DM) compared to those without type 2 DM or with better controlled (BC) type 2 DM. Well-controlled diabetic patients as measured by blood glycated hemoglobin levels have less severe periodontal disease than poorly controlled diabetics. 0 Reviews. Home; About. These findings need to be confirmed by other scientific clinical studies with a larger Type 2 diabetic sample size. In addition, oral bacterial products or cytokines in oral/pharyngeal aspirates may stimulate cytokine production from respiratory epithelial cells, resulting in recruitment of inflammatory cells. Conclusions of the study are as follows: 1) PTVs are influenced by bone quality and surface coating of the implant; 2) the PTVs at the time of uncovering provide the best estimate of a clinically acceptable PTV for that bone-implant complex; 3) while the PTVs for any bone-implant complex may fluctuate +/- 1.0 around the uncovering PTV during routine healing and loading of the implant, a consistent shift toward a positive PTV that approaches "0" should be cause for concern that the bone-implant complex may be at risk of failure; 4) HA-coated implants became slightly less stable (more positive PTVs) over time, while the non-coated implants became more stable (more negative PTVs); and 5) until a "critical PTV" can be accurately identified, it is suggested that a consistent shift in recorded PTVs that exceeds the +3.0 value on the PTV scale should be viewed with concern for possible deterioration at the bone-implant complex. Diabetics had significantly higher GCF levels of both PGE2 and IL-1 beta when compared to non-diabetic controls with similar periodontal status. 0 Reviews. Well-designed and well-controlled studies done in the EC, US, and other developed countries are generally accepted throughout the world. Prevention studies of periodontitis require a longer duration than treatment studies. These findings support the use of implants placed in augmented sinuses to support dental prostheses. Survival curves were used to determine differences in survival outcomes for the two methods. Role of Nuclear FactorKappa B NFKB in Inflammation Periodontitis and Atherogenesis . Little information is available concerning the changes in stability of various designs and materials following clinical loading. A Systematic Review, The Design and Implementation of Trials of Host Modulation Agents*, Coagulation and Thrombosis in Cardiovascular Disease: Plausible Contributions of Infectious Agents, Effect of Aging on Functional Changes of Periodontal Tissue Cells. New measurement technologies may offer increased measurement resolution and automated data capture; but, depending on their specific application and level of examiner reproducibility, these technologies may or may not result in lowered thresholds for declaring change. Many devices specifically intended to treat periodontal conditions have progressed through the 510(kappa) process based on their substantial equivalence to predicate devices. Hand searches were performed of the Journal of Clinical Periodontology, Journal of Periodontology, and Journal of Periodontal Research. GFs were also prepared from gingiva of Down's syndrome patients and 60-week-old rats. From inside the book . The approval of pharmaceutical products for the treatment and/or prevention of periodontal diseases requires presentation of evidence that supports the safety and efficacy of the particular drug therapy in question. Overall, the study implants experienced most peri-implant vertical bone loss in the first year after placement, followed by a dramatic decrease in bone loss rate through the subsequent study intervals. The 3+ mm group had a mean stability (PTV) of -3.8 (SD = 2.9), and the 4+ group had a mean PTV of -4.4 (SD = 2.7) (P < 0.05). 2000 - 2009. XRD of the control specimens showed that the samples were predominantly apatite; however, two peaks were detected in the diffraction pattern, which are not characteristic of hydroxyapatite, indicating that small amounts of one or more other crystalline phases were also present. A Systematic Review, Annals of Periodontology, December 2003, Vol. imprint. For the meta-analysis, PD and CAL were expressed as summary mean effects with 95% confidence intervals (CI) for the effect, and analyzed using a standardized difference between SRP alone and experimental agent groups. There was a marked elevation in salivary nicotine concentration from before smoking (mean: 80.8 ng) to after smoking (mean 1,685 ng/mL). Studies were excluded if they: 1) included data from a previously published article; 2) included daily rinsing with chlorhexidine (CHX); or 3) had unclear descriptions of randomization procedures, examiner masking, or concomitant therapies. The Efficacy of Bone Replacement Grafts in the Treatment of Periodontal Osseous Defects. The best characterized of these is the receptor for advanced glycation end products (RAGE), which is expressed by multiple cell types including endothelium and mononuclear phagocytes. Beginning in 1991, 882 prostheses supported by more than 2,900 implants (687 patients) were placed by the Department of Veterans Affairs Dental Implant Clinical Research Group (DICRG). What people are saying - Write a review. The overwhelming amount of evidence which has established a microbial etiology for periodontitis is the basis for developing and testing antimicrobial treatments. Preliminary studies performed in our laboratory suggest that oral bacteria may modulate the adhesion of respiratory pathogens to epithelial cell lines. The concerns about HA-coated implants being associated with adverse periodontal responses for the HA chemical composition included in this study appear to be unfounded for a period of clinical performance up to 36 months. 1, 52-57 Anne D. Haffajee, Systemic Anti-Infective Periodontal Therapy. DOI: 10.1902/annals.2003.8.1.54 Abstract Background: Several recent studies provide evidence that the oral cavity may influence the initiation and/or the progression of lung diseases such as pneumonia and chronic obstructive pulmonary disease (COPD). Many of these studies contained large numbers of subjects and were adjusted for traditional risk factors. Start year: 1996 End year: 2003 Frequency: Irregula Country: United States Language: English Topics: Periodontal Diseases Publisher: Chicago, Ill. Studies suggest that certain pharmacologic agents, which act at a molecular level to block specific inflammatory mediators, appear to attenuate disease progression. The ADA Seal program serves to help dentists and manufacturers meet their ethical obligations to the public by promoting safe and effective health care products. To date, the majority of studies on the relationship between periodontal disease and osteoporosis have been hindered by small sample sizes, limited control of other potential confounding factors, varying definitions of both periodontal disease and osteoporosis, and few prospective studies where the temporality of the association can be established. Many investigators have, however, demonstrated a role for IL-1 in the initiation and progression of periodontitis. Included studies had to report patient-based mean values and measures of variation for probing depth (PD) and/or clinical attachment levels (CAL) for both test and control groups. These induce production of matrix metalloproteinases which destroy the connective tissues of the gingiva and periodontal ligament, and prostaglandins which mediate alveolar bone destruction. 3. The stability of thermally processed hydroxyapatite coatings for oral and orthopedic bioprostheses has been questioned. Annals of Periodontology, Volume 7 Snippet view - 2002. Journal abbreviation: Annals of periodontology. HA-coated implants demonstrated the highest survival rate; 2) the post-loading analysis approach inflated survival; 3) non-HA implants showed increased stability following loading; 4) HA-coated implants showed a slight decrease or no change in stability; and 5) the clinical significance of the changes in implant stability must be determined for the long-term. Richard Ranney. The follow-up began at Stage 2 uncovering and ranged from 5 to 71 months, with a mean of 38.2 and standard deviation of 14.6 months. The augmentation materials were autogenous bone, allogenic bone (demineralized freeze-dried bone allograft, DFDBA), alloplastic bone (HA), combination grafts of HA and DFDBA, and combination grafts of autogenous bone and DFDBA. Mehr Titelinformationen. Twenty-two studies (27 comparisons) were used in the meta-analysis, evaluating if the antibiotics provided a consistent benefit in mean AL change for different patient populations, for different therapies, and for different antibiotics. Survival was examined with respect to patient demographics and health status, implant location, surgical variables, and 2-week post-placement use of chlorhexidine digluconate (0.12%) rinses. Despite widespread use of drugs to arrest preterm labor (tocolytics), there has been no decrease in low birth weight or preterm infants in the last 20 years. The possible influence of clustering on survival was taken into consideration. Data for all 3 mm to 3.9 mm diameter implants were pooled into a "3+" group, and the 4 mm to 4.9 mm diameter implants into a "4+" mm group. For example, the measurement of a change in periodontal disease status, either during progression or in response to therapy, is fundamentally unidimensional and may be only mildly informative when one considers that the disease is multifactorial by nature. MEDLINE, the Cochrane Central Trials Register, and Web of Science were searched. Amounts of PGE2, interleukin (IL)-1 beta, IL-6, and plasminogen activator (PA) in conditioned media were measured. Pathogenetic mechanisms include an ascending route of infection and/or inflammatory process due to microbial products and maternal and/or fetal response(s) with production of prostaglandins and cytokines. In addition, periodontitis and certain systemic diseases, such as cardiovascular disease, share risk factors including tobacco smoking, male gender, race/ethnicity, stress, and aging. Use of electrocardiograms is recommended for the patients with cardiovascular disorders. Several microbiologic and epidemiologic studies have suggested an association between dental plaque, poor oral health, and respiratory diseases such as nosocomial pneumonia and chronic obstructive pulmonary disease (COPD). Narrowing of and increased detail in the phosphate peaks indicated an increase in average crystal size and/or perfection relative to the controls, as did the XRD results. Annals of periodontology : proceedings of the 20th International Conference on periodontal research : molecular determinants of risk : Author: The American Academy of Periodontology and held June 5-9, 2002 at the University of North Carolina, Chapel Hill: Imprint: Illinois : The American Academy of Periodontology, 2002 : Descript: 129 p. : ill: Periodontics -- Congresses. The largest difference in survival was for the commercially pure titanium screw (used in this study only in the maxillary completely edentulous applications), which showed a 21.7% greater survival rate. The DICRG comprised 30 VA medical centers and 2 dental schools at the time of this study. American Academy of Periodontology, 2002. What people are saying - Write a review. The guidance document for premarket approval submissions for dental endosseous implants also provides guidance on clinical trials for dental implants. Periodontitis may enhance susceptibility to systemic diseases in several ways. Microorganisms in blood were collected after anaerobic lysis filtration and cultured anaerobically on blood agar plates. Diabetes is a risk factor for severe periodontal disease. We examined both the unstimulated and stimulated release of 2 oxidative burst products: superoxide (O-2) and hydrogen peroxide (H2O2). Since failures tended to occur in the earlier phases of treatment, the post-loading approach always resulted in more favorable survival data. In the presence of periodontal disease, oral opportunistic pathogens and/or their inflammatory products also may have a role in prematurity via a hematogenous route. In collaboration with interested parties, expert consultants, and Council members, the ADA produces guidelines suggesting appropriate methodologies and submission data to assist manufacturers in voluntarily earning the Seal of Acceptance. With the post-loading approach, valuable information related to implant performance before loading is lost. Placement to uncovering crestal bone loss was also determined. Search for Library Items Search for Lists Search for Contacts Search for a Library. Prevalence of both osteoporosis and tooth loss increase with advancing age in both women and men. Based on these results, we conclude that chemical changes may occur within the coating, with the incorporation of carbonate and concomitant reduction in hydroxyapatite coating thickness. 4. AGEs accumulate during the process of normal aging in the plasma and tissues, but to an accelerated degree in patients with diabetes. Thermodynamic dissolution-reprecipitation of the coating itself and subsequent surface insult by bacterial and local inflammatory components may be involved with these changes. Systemic loss of bone density in osteoporosis, including that of the oral cavity, may provide a host system that is increasingly susceptible to infectious destruction of periodontal tissue. 0 Reviews. American Academy of Periodontology, 2001 - Periodontics. FDA guidance documents are available which outline the information that should be included in the submissions. This paper reviews the current evidence on the association between periodontal disease and osteoporosis. Fetal rat calvarial osteoblasts were prepared by sequential digestion with collagenase. The FDA is continually developing and updating guidance documents and guidelines to assist manufacturers in gaining clearance/approval to market new products. Abbreviation: Ann Periodontol. All root canals contained anaerobic bacteria. If reliable clinical indicators of adequacy of the bone-implant complex existed, they could stimulate new and innovative early intervention research to arrest of reverse early deterioration of the bone-implant complex. Another important clinical question relates to the influence of periodontal disease on the control of the diabetic state. The use of HA-coated implants improved survival by 13.2% in Type 2 diabetics. What people are saying - Write a review. Although carefully collected, accuracy cannot be guaranteed. The purpose of this epidemiological investigation was to examine whether the risk for chronic obstructive pulmonary disease (COPD) is enhanced among individuals with a history of periodontal disease as assessed by radiographic alveolar bone loss (ABL). Use of antimicrobial irrigants or anti-infective sustained-release systems as an adjunct to SRP does not result in significant patient-centered adverse events. Annals of periodontology : a publication of The American Academy of Periodontology Chicago, Ill. : American Academy of Periodontology 1.1996 - 8.2003; damit … Archived in. 8. When contrasted with subjects with BC type 2 DM, the COR for those in the PC group was 5.3 (95% CI = 0.8, 53.3). Annals of periodontology / the American Academy of Periodontology Frequency: Irregula Country: United States Publisher: Chicago, Ill. : The Academy, c1996-Previous Journal: Etudes irlandaises Abbreviation. Diabetes mellitus is a systemic disease that affects more than 12 million people in the United States and represents a risk factor for periodontitis with odds ratios of 2.1 to 3.0. Severe periodontal disease often coexists with severe diabetes mellitus. The FDA was granted increased authority to regulate drugs in 1938 and devices in 1976. Subjects are not VA patients. Other forms: Also available in print. 2. Department of Periodontics, Health Sciences Center, University of Texas, San Antonio, Texas. In patients with chronic periodontitis, what is the effect of local controlled-release anti-infective drug therapy with or without SRP compared to SRP alone on changes in clinical, patient-centered, and adverse outcomes? Periodontitis has long been defined as an infection-mediated destruction of the alveolar bone and soft tissue attachment to the tooth, responsible for most tooth loss in adult populations. 2 These classification systems have been widely used by clinicians and … The Academy, 2000 - Periodontics. 2. A meta-analysis completed on 19 studies that included SRP and local sustained-release agents compared with SRP alone indicated significant adjunctive PD reduction or CAL gain for minocycline (MINO) gel, microencapsulated MINO, CHX chip and doxycycline (DOXY) gel during SRP compared to SRP alone. Each issue contains proceedings of a meeting or symposium of interest to dental researchers, educators, and students. This has been traditionally accomplished through mechanical means (scaling and root planing [SRP]), which is time-consuming, difficult, and sometimes ineffective. Lipopolysaccharide (LPS) and other substances gain access to the gingival tissues, initiate and perpetuate immunoinflammation, resulting in production of high levels of proinflammatory cytokines. 5. EDAX scans of the retrieved specimens demonstrated evidence of hydroxyapatite coating loss reflected by increasing titanium and aluminum signals. Understanding the association between these common diseases and the mechanisms underlying those associations will aid health professionals to provide improved means to prevent, diagnose, and treat these very common diseases. The Academy, 1997 - Periodontics. However, it must be borne in mind that these data are for a special population. Proceeding of the Sunstar‐Chapel Hill Symposium ′97 on Periodontal Disease and Human Health: New Direction in Periodontal Medicine. An essential component of therapy is to eliminate or control these pathogens. In BQ-3, the stability of the implants decreased over time (-3.6 at uncovering to -2.9 at 60 months), with similar changes recorded for BQ-4 (-2.5 at uncovering to -1.0 at 60 months). American scientists cannot expect to conduct studies in other countries as principal investigators, but many are associated with national clinicians. Monitoring of ventilations along with the assessment of oxygen saturation via a pulse oximeter is significant in preventing hypoxemia. Preterm birth with its subsequent morbidity and mortality is the leading perinatal problem in the United States. In addition, TNF-alpha, a potent inhibitor of the tyrosine kinase activity of the insulin receptor, has been implicated as an etiologic factor for insulin resistance. Stratified analysis of data up to 72 months after implant uncovering indicates different bone loss patterns by: 1) arch; 2) jaw region; 3) case type; 4) bone quality; 5) surface type; 6) implant design; 7) smoking status; and 8) postoperative antibiotic treatment. Search for more papers by this author. ;] Home. The phenotypic methods used for characterization and tracing of microorganisms in blood and root canals were: biochemical and antimicrobial susceptibility test, SDS-PAGE of whole-cell soluble proteins, and gas chromatography of cellular fatty acids. Much of the statistical machinery to handle this complexity was developed in the plant and animal breeding context, where crosses between inbred lines selected for trait differences could be conducted. The influence of stresses transmitted to various bone densities, by different prosthetic appliances as well as the method used to determine failures, needs to be clearly understood. Hand searches were performed on the International Journal of Periodontics and Restorative Dentistry, Journal of Clinical Periodontology, Journal of Dental Research, Journal of Periodontology, and Journal of Periodontal Research. In BQ-1, the mean PTVs increased from -4.7 at uncovering to -4.9 at 60 months. The recommended prosthesis designs investigated in this study proved to be reliable, with encouraging success rates for an observation period of 36 months following placement. The Dental Branch continues to gather information to address these issues. From inside the book . Read article PDFs using your inistitution's subscriptions with no additional login. In hyperglycemic states found in diabetics, a nonenzymatic glycation and oxidation of proteins and lipids occurs. These findings suggest that aging in both HGF and HPLF may be an important factor in the severity of periodontal disease through higher production of inflammatory mediators in response to both LPS and mechanical stress. Gingivitis patients and mild periodontitis patients represented one low response group, and the moderate and severe periodontitis subjects the high response group. Sponsors need to carefully consider each step in the overall development plan beginning with an Investigational New Drug Application and concluding with submission of a New Drug Application for pre-market approval. Evidence is conclusive (Table 2) that periodontal regeneration in humans is possible following the use of bone grafts, guided tissue regeneration procedures, both without and in combination with bone grafts, and root demineralization procedures. Longer implants demonstrated higher survival than shorter implants. 1999 - Volume 4; 1998 - Volume 3; 1997 … The majority of the remaining papers had a low evidence rating. Because the life expectancy of individuals continues to increase, dentists providing dental implant treatment can expect to see an increasing number of patients with diabetes mellitus. 8, Nr. Diabetes was a possible exclusion criterion; however, the final decision on Type 2 patients was left to the dental implant team at the research center. Current Coverage. On the one hand, numerous reports indicate a high prevalence of periodontal disease in diabetics compared to healthy controls, while others fail to show such a relationship. Post-Loading approach, valuable information related to differences in survival was always better non-HA! Tracing microorganisms in the usual places of 30 VA medical centers and 2 dental schools combined form! Marginal ( P = 0.046 ) data and studies in progress syndrome patients and 255 ( %... This 3 year period, 6 implants were removed due to peri-implantitis were examined selected study. But also their actions and interactions depend on nongenetic factors were surgically placed, restored, and followed goal! Il-I genotype with severe diabetes mellitus: Type 1 ( insulin dependent ) and! 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