Prevention and treatment of peri‐implant diseases—The EFP S3 level clinical practice guideline

Journal Of Clinical Periodontology, Год журнала: 2023, Номер 50(S26), С. 4 - 76

Опубликована: Июнь 1, 2023

Abstract Background The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I–IV periodontitis provided evidence‐based recommendations treating patients, defined according to 2018 classification. Peri‐implant diseases were also re‐defined in It is well established that both peri‐implant mucositis and peri‐implantitis are highly prevalent. In addition, particularly challenging manage accompanied by significant morbidity. Aim To develop an S3 level CPG prevention diseases, focusing on implementation interdisciplinary approaches required prevent development or their recurrence, treat/rehabilitate patients with dental implants following diseases. Materials Methods This was developed European Federation Periodontology, methodological guidance from Association Scientific Medical Societies Germany Grading Recommendations Assessment, Development Evaluation process. A rigorous transparent process included synthesis relevant research 13 specifically commissioned systematic reviews, evaluation quality strength evidence, formulation specific recommendations, a structured consensus involving leading experts broad base stakeholders. Results culminated recommendation various different interventions before, during after implant placement/loading. Prevention should commence when planned, surgically placed prosthetically loaded. Once loaded function, supportive care programme be structured, including periodical assessment tissue health. If detected, appropriate treatments management must rendered. Conclusion present informs clinical practice, health systems, policymakers and, indirectly, public available most effective modalities maintain healthy tissues, evidence at time publication.

Язык: Английский

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Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases: Consensus report of the Joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA Europe)

Journal Of Clinical Periodontology, Год журнала: 2023, Номер 50(6), С. 819 - 841

Опубликована: Март 20, 2023

Abstract Aim To explore the implications for dentists and family doctors of association between periodontal systemic diseases role in managing non‐communicable (NCDs) promoting healthy lifestyles. Materials Methods The consensus reports previous Focused Workshops on associations periodontitis diabetes (2017) cardiovascular (2019) formed technical reviews to underpin discussions both topics. For with respiratory diseases, a systematic review was specifically commissioned Workshop discussions. Working groups prepared proposals independently, then were discussed approved at plenary meetings. Results Periodontitis is independently associated diabetes, chronic obstructive pulmonary disease (COPD), sleep apnea COVID‐19 complications. Dentists should collaborate NCDs, implementing strategies early detection primary care centres or dental settings. Family be informed about their consequences, oral health professionals (OHPs) relevance NCDs risk factors. Conclusions Closer collaboration OHPs important management Pathways case medicine practices developed evaluated.

Язык: Английский

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Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3‐level clinical practice guideline

International Endodontic Journal, Год журнала: 2023, Номер 56(S3), С. 238 - 295

Опубликована: Сен. 29, 2023

The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only clinical endodontics but also consensus and guideline development processes. In the of inaugural S3-level practice (CPG), a comprehensive systematic methodologically robust consultation process was followed order to produce evidence-based recommendations management patients presenting with pulpal apical disease.

Язык: Английский

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Melatonin Engineering M2 Macrophage‐Derived Exosomes Mediate Endoplasmic Reticulum Stress and Immune Reprogramming for Periodontitis Therapy

Advanced Science, Год журнала: 2023, Номер 10(27)

Опубликована: Июль 14, 2023

Periodontitis is a chronic infectious disease caused by bacterial irritation. As an essential component of the host immunity, macrophages are highly plastic and play crucial role in inflammatory response. An appropriate timely transition from proinflammatory (M1) to anti-inflammatory (M2) indispensable for treating periodontitis. M2 macrophage-derived exosomes (M2-exos) can actively target sites modulate immune microenvironments, M2-exos effectively treat Excessive endoplasmic reticulum stress (ER stress) unfolded protein response (UPR) destructive pathological characteristics during periodontal bone loss. Although melatonin has antioxidant effects, studies focusing on ER modulation remain limited. This study fabricates engineered loading with (Mel@M2-exos) result, drive macrophage reprogramming M1 type, which resolves inflammation accelerated healing. Melatonin released Mel@M2-exos rescues osteogenic cementogenic differentiation capacity human ligament cells (hPDLCs) reducing excessive UPR. Injectable gelatin methacryloyl (GelMA) hydrogels sustained-release accelerate regeneration rats ligation-induced Taken together, engineering promising candidates tissue regeneration.

Язык: Английский

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Local Delivery and Controlled Release Drugs Systems: A New Approach for the Clinical Treatment of Periodontitis Therapy

Pharmaceutics, Год журнала: 2023, Номер 15(4), С. 1312 - 1312

Опубликована: Апрель 21, 2023

Periodontitis is an inflammatory disease of the gums characterized by degeneration periodontal ligaments, formation pockets, and resorption alveolar bone, which results in destruction teeth’s supporting structure. caused growth diverse microflora (particularly anaerobes) releasing toxins enzymes stimulating immune system. Various approaches, both local systemic, have been used to treat periodontitis effectively. Successful treatment depends on reducing bacterial biofilm, bleeding probing (BOP), or eliminating pockets. Currently, use drug delivery systems (LDDSs) as adjunctive therapy scaling root planing (SRP) a promising strategy, resulting greater efficacy fewer adverse effects controlling release. Selecting appropriate bioactive agent route administration cornerstone successful plan. In this context, review focuses applications LDDSs with varying properties treating without systemic diseases identify current challenges future research directions.

Язык: Английский

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Primordial and primary prevention of peri‐implant diseases: A systematic review and meta‐analysis

Journal Of Clinical Periodontology, Год журнала: 2023, Номер 50(S26), С. 77 - 112

Опубликована: Фев. 20, 2023

Abstract Aim This systematic review and meta‐analysis aims to assess the efficacy of risk factor control prevent occurrence peri‐implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or with implants surrounded by healthy tissues (primary prevention). Materials Methods A literature search was performed without any time limit on different databases up August 2022. Interventional observational studies at least 6 months follow‐up were considered. The mucositis and/or peri‐implantitis primary outcome. Pooled data analyses using random effect models according type Results Overall, 48 selected. None assessed primordial preventive interventions for PIDs. Indirect evidence prevention PID indicated that diabetic good glycaemic have a significantly lower (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03–0.96; I 2 : 0%), marginal bone level (MBL) changes (OR –0.36 mm; CI: −0.65 −0.07; 95%) compared poor control. Patients attending supportive periodontal/peri‐implant care (SPC) regularly overall PIDs 0.42; 0.24–0.75; 57%) irregular attendees. failure 3.76; 1.50–9.45; 0%) appears be greater under no SPC than regular SPC. Implants sites augmented keratinized mucosa (PIKM) show inflammation (SMD –1.18; −1.85 −0.51; 69%) MBL (MD –0.25; −0.45 −0.05; 62%) PIKM deficiency. Studies smoking cessation oral hygiene behaviors inconclusive. Conclusions Within limitations available evidence, present findings indicate diabetes, should promoted avoid development. involve augmentation procedures, where deficiency exists, may favour stability MBL. Further are needed impact behaviours, as well implementation standardized protocols

Язык: Английский

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Fit and forget: The future of dental implant therapy via nanotechnology

Advanced Drug Delivery Reviews, Год журнала: 2023, Номер 199, С. 114900 - 114900

Опубликована: Май 30, 2023

Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at bone-implant interface and soft-tissue integration transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents very challenging environment for early acceptance long-term survival especially compromised patient conditions, including aged, smoking diabetic patients. Enabling advanced local therapy from surface titanium-based via novel nano-engineering strategies is emerging. includes anodized nano-engineered eluting growth factors, antibiotics, therapeutic nanoparticles biopolymers to achieve maximum localized action. An important criterion balancing bioactivity enhancement (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need be addressed enable clinical translation these implants. review informs latest developments, challenges future directions this domain successful fabrication clinically-translatable that would allow success, even conditions.

Язык: Английский

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Periodontal diseases and cardiovascular diseases, diabetes, and respiratory diseases: Summary of the consensus report by the European Federation of Periodontology and WONCA Europe

European Journal of General Practice, Год журнала: 2024, Номер 30(1)

Опубликована: Март 21, 2024

Periodontitis is a chronic inflammatory non-communicable disease (NCD) characterised by the destruction of tooth-supporting apparatus (periodontium), including alveolar bone, presence periodontal pockets, and bleeding on probing.

Язык: Английский

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Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability

International Journal of Oral Science, Год журнала: 2024, Номер 16(1)

Опубликована: Янв. 5, 2024

The reduction of nitrate to nitrite by the oral microbiota has been proposed be important for health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies bacterial composition subgingival plaque suggest nitrate-reducing bacteria are associated with periodontal health, but impact periodontitis on capacity (NRC) and, therefore, availability not evaluated. current study aimed evaluate how affects NRC microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing significantly lower patients compared healthy individuals (P < 0.05 all datasets n = 20-82 samples per dataset). Secondly, plaque, saliva, plasma obtained 42 before after treatment. was determined vitro incubating saliva 8 mmol/L (a concentration found nitrate-rich vegetable intake) 15 individuals. Salivary diminished treatment 0.05) recovered levels 90 days post-treatment. Additionally, increased correlated negatively periodontitis-associated 0.01). No significant effect baseline found, indicating differences may only revealed intake. Our an impaired could limit dietary nitrate-derived levels, systemic should explored future studies.

Язык: Английский

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Periodontitis: etiology, conventional treatments, and emerging bacteriophage and predatory bacteria therapies

Frontiers in Microbiology, Год журнала: 2024, Номер 15

Опубликована: Сен. 26, 2024

Inflammatory periodontal diseases associated with the accumulation of dental biofilm, such as gingivitis and periodontitis, are very common pose clinical problems for clinicians patients. Gingivitis is a mild form gum disease when treated quickly properly completely reversible. Periodontitis an advanced irreversible periodontium periods exacerbations, progressions remission. chronic inflammatory condition that damages tissues supporting tooth in its socket, i.e., gums, ligaments, root cementum bone. Periodontal inflammation most commonly triggered by bacteria present excessive accumulations plaque (biofilm) on surfaces. This driven disproportionate host immune responses induced imbalance composition oral changes their metabolic activities. microbial dysbiosis favors establishment conditions ultimately results destruction tooth-supporting tissues. Apart shift response, environmental factors genetics also important etiology In addition to destruction, can result significant systemic complications. Conventional methods treatment (improving hygiene, biofilm control, mechanical removal, using local or antimicrobial agents) not fully effective. All this prompts search new therapy. Advanced periodontitis multiple abscesses often antibiotics, amoxicillin, tetracycline, doxycycline, minocycline, clindamycin, combined therapy amoxicillin metronidazole. However, due growing problem antibiotic resistance, does always achieve desired therapeutic effect. review summarizes pathogenesis, current approaches treatment, limitations state research possibility application bacteriophages predatory combat responsible periodontitis. We landscape potential applications alternative therapies based phages bacteria, highlight gaps existing knowledge need be addressed before trials utilizing these strategies seriously considered.

Язык: Английский

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