Periostin level in gingival crevicular fluid in periodontal disease: a systematic review and meta-analysis.

BACKGROUND: Periostin, a secreted adhesion molecule, is a matricellular protein secreted most in periodontal ligament and periosteum. Periostin is also needed for integrity and maturation of periodontal tissue. This meta-analysis was conducted to compare the gingival crevicular fluid (GCF) periostin levels in subjects having periodontal disease and healthy periodontium. METHODS: In this meta-analysis, three international database including PubMed, Scopus and Web of Science were searched and 207 studies retrieved. Also, the Google Scholar was searched to find more related studies (two studies were found). To assess the risk of bias of included studies, the Newcastle-Ottawa assessment scale adapted for case-control was used. Finally, required data was extracted and included into analysis. All statistical analysis were done using Stata software. RESULTS: Eight studies were included in this meta-analysis. Results showed that GCF periostin level is significant lower in chronic periodontitis group compare to healthy people (the standardized mean difference (SMD) = -3.15, 95% CI = -4.45, -1.85, p < 0.001). The syntheses of studies shown a significant decrease in the periostin level of chronic periodontitis patients compared to the gingivitis patients (SMD = -1.50, 95%CI = -2.52, -0.49, P = 0.003), while the mean level of periostin between the gingivitis patients and healthy group has no significant difference (SMD = -0.88, 95%CI = -2.14, 0.38, P = 0.173). CONCLUSION: The mean concentration of GCF periostin in people with chronic periodontitis significantly decreased compared to people with gingivitis and also compared to healthy people, while no significant difference was observed between the two groups with gingivitis and healthy people. Therefore, this marker may be used as a diagnostic criterion for the disease, which requires further studies.

Comparative evaluation of the effects of different methods of post space preparation in primary anterior teeth on the fracture resistance of tooth restorations.

Background. Severely damaged teeth do not have adequate structure to support the composite crown; therefore, use of the canal space has been suggested to increase retention. Furthermore, the effect of post space irrigation protocols on the fracture resistance of the primary anterior teeth has not definitely been studied in postoperative modalities. This study compared the fracture resistance of restorations of primary anterior teeth following irrigation of the post space with sodium hypochlorite and chlorhexidine with and without application of burs. Methods. Ninety-four extracted primary anterior teeth were selected. Root canal treatments were carried out, 4 mm of the post space was left empty and 1 mm was regarded as a bed. The post space was prepared with and without a bur and the irrigation procedures were carried out with 0.2% chlorhexidine and 2.5% sodium hypochlorite solutions. Composite posts were inserted into the canals and the crowns were restored. Following composite etching and light-curing, the fracture resistance of the restored teeth was determined by a universal testing machine. Results. In the sodium hypochlorite group, fracture resistance of the teeth was 376.8±107.29 N and 475.5±186.89 N without and with bur preparation, respectively. For chlorhexidine protocol, the values were 370.88±175.46 N and 430.85±178.22 N without and with bur preparation, respectively. The effect of irrigating material was not significant; however, the bur and irrigating preparation significantly increased the fracture resistance of the restored teeth (P=0.02). Conclusion. Post space irrigation with 0.2% chlorhexidine or 2.5% sodium hypochlorite did not significantly affect the fracture resistance of primary anterior teeth in the post treatment modality.

Is leukocytosis a predictor for recurrence of ischemic events after coronary artery bypass graft surgery? A cohort study.

Objective. Studies have shown that inflammation plays an important role in pathogenesis of coronary artery disease. The present study was designed to evaluate the role of high WBC count before CABG in predicting the risk of ischemic events after CABG. Methods and Results. This prospective study was carried out on 380 patients who underwent CABG surgery. Ninety seven patients (25.5%) had recurrent ischemic event. Mean WBC count before CABG surgery in patients with recurrent ischemic event was 7267 mic/lit ± 1863, which was significantly higher than the others, with a mean WBC count of 6721 mic/lit ± 1734 (P = 0.011). Patients with a WBC count more than 6000 mic/lit were at the highest risk for recurrent ischemic event (OR = 2.11, 95% CI = 1.18-3.44, P = 0.009). After adjustment for age, sex, family history, smoking, hyperlipidemia, Logestic Euro score, post opretive enzyme release (CK.mb), arterial graft and BMI, the relationship between the group with WBC count higher than 6000 mic/lit and recurrent of ischemic event remained significant (OR = 2.25, 95% CI = 1.2 to 4, P = 0.005). Conclusions. High WBC count before CABG surgery is an independent risk factor for ischemic events one year after the surgery.