Long-Term Comparison of Survival and Marginal Bone of Implants with and without Sinus Augmentation in Maxillary Molars within the Same Patients: A 5.8- to 22-Year Retrospective Study.

Maxillary sinus floor augmentation (MSFA) is widely used and considered a predictable procedure for implant placement. However, the influence of MSFA on implant survival and marginal bone loss (MBL) is still inconclusive. The purpose of this retrospective observational study is to evaluate the long-term genuine influence of MSFA on the survival and MBL of implants by comparing those with and without MSFA only in maxillary molars within the same patients. Thirty-eight patients (28 male and 10 female), with a total of 119 implants, received implants with and without MSFA, and were followed up for 5.8 to 22 years. Patient- and implant-related factors were assessed with a frailty model for implant survival and with generalized estimation equations (GEE) for MBL around the implant. No variables showed a statistical significance for implant failure in the frailty model. In GEE analysis for MBL, MSFA did not show any statistical significance. In conclusion, MSFA demonstrated no significant influence on implant failure and MBL in posterior maxilla in this study.

Expression of Phospholipase D in Periodontitis and Its Role in the Inflammatory and Osteoclastic Response by Nicotine- and Lipopolysaccharide-Stimulated Human Periodontal Ligament Cells.

BACKGROUND: The aim of the present study is to investigate the expression of phospholipase D (PLD) 1 and PLD2 in periodontal patients and in human periodontal ligament cells (HPDLCs) exposed to nicotine plus lipopolysaccharide (LPS) from Porphyromonas gingivalis (Toll-like receptor 2 ligand). Furthermore, the effects of PLD isoform inhibition on the inflammatory response and osteoclast differentiation and its mechanisms were determined. METHODS: Proinflammatory mediators were examined by reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay. To silence the gene expression of the PLD isoforms, cells were transfected with small interfering RNA (siRNA) targeting PLD1 or PLD2. Mouse bone marrow-derived macrophages (BMMs) were used as osteoclast precursor cells for in vitro osteoclastogenesis. Western blot analysis and immunofluorescence were used to assess signaling pathways. RESULTS: Chronic smokers with periodontitis exhibited significantly higher PLD1 and PLD2 messenger RNA (mRNA) expression than non-smokers with periodontitis and healthy controls. Nicotine and LPS upregulated PLD1 and PLD2 mRNA expression in a dose-dependent manner in HPDLCs. Pharmacologic and siRNA-mediated inhibition of PLD1 and PLD2 attenuated the nicotine- and LPS-induced upregulation of inducible nitric oxide (NO) synthase and cyclooxygenase-2, production of NO, and prostaglandin E2, and mRNA expression and secretion of tumor necrosis factor-α, interleukin (IL)-1ß, and IL-8. The conditioned media from HPDLCs treated with PLD isoform inhibitors or siRNA against PLD inhibited receptor activator of nuclear factor-κB (NF-κB) ligand-mediated osteoclast differentiation, as well as protein expression of nuclear factor of activated T cells c1 and c-Fos, in BMMs. In addition, PLD isoform inhibitors and siRNA inhibited the nicotine- and LPS-induced activation of phosphoinositide 3-kinase, protein kinase C, p38, extracellular signal-regulated kinase, c-Jun N-terminal protein kinase, mitogen-activated protein kinase, and NF-κB. CONCLUSION: To the best of the authors' knowledge, this study is the first to demonstrate that PLD isoform inhibition has anti-inflammatory and antiosteoclastogenic effects and thus may be a therapeutic target for the treatment of periodontitis.