ABSTRACT
PURPOSE: Short implants are a potential alternative to long implants for use with bone augmentation in atrophic jaws. This meta-analysis investigated the survival rate and marginal bone level (MBL) of surface-modified short vs. long implants. METHODS: Electronic and manual searches were performed for articles published between January 2010 and June 2021. Twenty-two randomized controlled trials (RCTs) comparing surface-modified short and long implants that reported the survival rate with at least 1 year of follow-up were selected. Two reviewers independently extracted the data, and the risk of bias and quality of evidence were evaluated. A quantitative meta-analysis was performed regarding survival rate and MBL. RESULTS: The failure rates of surface-modified short and long implants differed significantly (risk ratio, 2.28; 95% confidence interval [CI], 1.46, 3.57; P<0.000). Long implants exhibited a higher survival rate than short implants (mean follow-up, 1-10 years). A significant difference was observed in mean MBL (mean difference=-0.43, 95% CI, -0.63, -0.23; P<0.000), favoring the short implants. Regarding the impact of surface treatment in short and long implants, for hydrophilic sandblasted acid-etched (P=0.020) and titanium oxide fluoride-modified (P=0.050) surfaces, the survival rate differed significantly between short and long implants. The MBL differences for novel nanostructured calcium-incorporated, hydrophilic sandblasted acid-etched, and dual acid-etched with nanometer-scale calcium phosphate crystal surfaces (P=0.050, P=0.020, and P<0.000, respectively) differed significantly for short vs. long implants. CONCLUSIONS: Short surface-modified implants are a potential alternative to longer implants in atrophic ridges. Long fluoride-modified and hydrophilic sandblasted acid-etched implants have higher survival rates than short implants. Short implants with novel nanostructured calcium-incorporated titanium surfaces, hydrophilic sandblasted acid-etched surfaces, and dual acid-etched surfaces with nanometer-scale calcium phosphate crystals showed less marginal bone loss than longer implants. Due to high heterogeneity, the MBL results should be interpreted cautiously, and better-designed RCTs should be assessed in the future. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42020160185.
ABSTRACT
BACKGROUND: Bone morphogenetic proteins have a powerful osteoinductive capacity and have been used as a new adjunct to graft materials for bone regeneration. The objectives of this systematic review are to assess the amount of radiographic bone fill, clinical attachment level (CAL) gain, and reduction in pocket depth (PD) in patients with intrabony defects in periodontitis patients following the use of recombinant human bone morphogenetic protein-2 (rhBMP-2). MATERIALS AND METHODS: Electronic bibliographic databases search of Medline, Science Direct, and Google Scholar was made from January 1980 to December 2017. Studies using rhBMP-2 to treat periodontal intrabony defects of the maxillary or mandibular region with follow-up period of at least 6 months were searched. Two reviewers performed the systematic review using the PRISMA Statement for reporting and the Cochrane risk-of-bias tool was used for quality assessment. RESULTS: It was found that rhBMP-2 showed statistically significant results with respect to radiographic defect resolution, CAL, and PD reduction at 9 months compared to open-flap debridement but showed statistically significant results only with respect to radiographic bone fill when compared with platelet-rich fibrin at 6 months. CONCLUSION: The rhBMP-2 may provide a promising alternative to traditional grafting procedures therapy that can enhance periodontal regeneration in patients having intrabony defects. Due to limited human studies, it can be concluded that no definitive evidence exists to ascertain the effectiveness of rhBMP-2 in the treatment of intrabony defects in periodontal diseases.
ABSTRACT
BACKGROUND AND AIM: Periodontopathogens require iron constituents for their growth and metabolism in subgingival crevice. In this study, C.rectus was detected and quantified by using 16s rDNA based PCR in chronic periodontitis and compared with the levels of serum iron, total iron binding capacity and transferrin in chronic periodontitis and healthy sites. MATERIALS AND METHODS: One hundred twenty subjects divided into chronic periodontitis and healthy controls. Deep subgingival plaque was collected and genomic DNA was extracted from each sample analysed for C.rectus using 16s rRNA based PCR analysis. Blood samples were collected from both groups for estimation of serum iron, serum total iron binding capacity and serum transferrin levels. The quantified bacterial count was compared with blood samples. C. rectus was detected in both groups. RESULTS: There was significant increase in bacterial count in chronic periodontitis (p<0.05). Serum iron level was significantly raised in healthy group. TIBC and transferrin levels were elevated in periodontitis. Although these differences were non-significant. Regression analysis showed significant linear relationship between C.rectus counts and decreasing iron levels and consequently increasing serum transferrin and TIBC (p<0.05). CONCLUSION: The preliminary in vivo findings suggests C.rectus requires iron as a significant source of nutrition for its survival and growth form its hosts in deeper subgingival sites.
ABSTRACT
BACKGROUND AND AIM: Selenomonas species have been associated with chronic periodontitis and have been implicated in converting periodontal health to disease. Scanty literature is available in Indian population. Hence, the objective of the study was to detect the prevalence of Selenomonas sputigena in healthy and chronic periodontitis by polymerase chain reaction (PCR) in Indian population and to check whether smoking affects the subgingival microflora of this organism in chronic periodontitis. MATERIALS AND METHODS: A total of 60 subjects with severe chronic periodontitis with or without smoking and periodontal healthy subjects underwent clinical and microbiological assessment. A deep subgingival plaque sample was collected and genomic DNA was extracted from each sample and analysed for detection of Selnomonas sputigena using PCR. The frequency and quantification of bacteria were also estimated. RESULTS: All groups differed statistically significant in the frequency of detection of Selenomonas sputigena. On comparison of patients with chronic periodontitis in smokers and non-smokers, there was no statistically significant difference. When the results were quantified, statistically non-significant results were seen among all groups. Plaque index, gingival index, probing pocket depth and clinical attachment level were statistically non-significant in chronic periodontitis with smokers and non-smokers. CONCLUSION: Prevalence of Selenomonas sputigena showed significant differences with respect to the frequency of detection when comparing the disease group to the healthy population. But no significant difference was seen when the results were quantified. Smoking has no influence on number of Selenomonas sputigena. This study highlights presence as well as quantity of the organism is very important in elucidating its role in causation and progression of the disease.
