An assessment of unstimulated salivary flow rate, IgA and clinical oral dryness among active and passive smokers.

OBJECTIVES: The aim of this study was to assess the impact of smoking on the whole salivary flow rate (SFR), IgA levels and clinical oral dryness (COD) among active and passive smokers. MATERIAL AND METHODS: The participants were categorized as active smokers (N = 54) or passive smokers (N = 163). Saliva was collected in tubes and placed in ice storage at -70°C. Salivary IgA levels were assessed in duplication using the enzyme linked immunosorbent assay (ELISA) method. Following the saliva sample collection, the subjects were assessed for COD using the COD score, SFR and caries. Chi-square test, the t-test and ANOVA were employed to compare the clinical impact of the smoking status associated with specific variables (smoking status, number of cigarettes, active caries, gender, age, COD score, IgA level and SFR). A p-value of <0.05 was considered significant. RESULTS: Two hundred and seventeen subjects with the mean age of 32.86±6.30 years, with 145 males (66.8%) and 72 females (33.2%), were included in the study. Among the active smokers, 88.8% were males compared to 11.2% females. The active smokers had the mean age of 32.52 years, a COD score of 1.43, an IgA level of 1.39 g/l, and a SFR of 0.37 ml/min. Among the passive smokers, 59.5% were males and 40.5% were females, with the mean age of 32.97 years, a COD score of 0.87 g/l, an IgA level of 1.47, and a SFR of 0.42 ml/min. Active caries showed a positive correlation with the number of cigarettes, with significance in the >35 years age group (p < 0.05). CONCLUSIONS: The study demonstrated significant differences in SFR, IgA and COD scores among the active and passive smokers. The number of cigarettes had a negative impact on saliva production, IgA levels, the oral health status, and the progression of caries with respect to age and gender. Smoking potentially leads to xerostomia associated with active caries. Int J Occup Med Environ Health. 2022;35(1):39-51.

Clinical, radiographic and restorative parameters for short tuberosity implants placed in smokers: a retrospective study with 5 year follow-up.

This study aimed to estimate and compare the clinical, radiographic, and restorative parameters around short tuberosity implants (STIs) placed in cigarette smokers (CS) and never smokers (NS). In this 60-month follow-up retrospective study, a total of 50 (37 males + 13 females) individuals who had received 82 dental implants were included. These participants were categorized into two groups as follows: (i) Group-1: 25 self-reported systemically healthy CS with 43 STIs; and (ii) Group-2: 25 self-reported systemically healthy NS with 39 STIs. In both groups, peri-implant plaque index (PI), probing depth (PD), bleeding on probing (BOP), and crestal bone loss (CBL) and restorative parameters were measured at 12 and 60 months of follow-up. Group comparisons were performed utilizing the Kruskal-Wallis test. The significance level was set at p < 0.05. In CS and NS, the mean age of participants was 58.5 and 60.7 years, respectively. No statistically significant differences were observed in the overall mean levels of PD and CBL around STIs among CS and NS. However, a statistically significant increase was observed in the mean scores of BOP and PI around STIs in the NS and CS at 12 and 60 months follow-up, respectively. In both groups, the loosening of the implant was the most frequently encountered type of STI failure. The outcomes of the present study suggest that STIs placed in maxillary tuberosity can show reliable clinical, radiographic, and restorative stability among cigarettes smokers and non-smokers. However, the role of smoking status and oral hygiene cannot be disregarded in this scenario.

Evaluation of the implant diameter on the initial-stability of narrow- and standard-diameter implants placed in simulated Type-I and Type-IV bone-blocks.

OBJECTIVE: A comparison of the initial stability of narrow- and standard-diameter implants (SDIs) placed in Type-I and Type-IV bone-blocks is not yet reported. The aim was to evaluate in-vitro the influence of implant diameter on the initial stability of narrow- and standard-diameter implants (SDIs) placed in simulated Type-I and Type-IV bone-blocks. METHODS: The present experimental in-vitro study was performed between July and September 2020 at the Specialist Dental Practice, Riyadh, Saudi Arabia. Narrow- and standard-diameter implants were placed 3-mm apart in simulated soft (Type-IV) and dense (Type-I) bone blocks by a trained and calibrated investigator. In groups A (Type-IV bone blocks) and B (Type-I bone blocks), implants were inserted using an insertion-torque and drilling-speed of 15-30 Ncm and 1000-1500 rpm, respectively with the implant collar at the crest of simulated bone blocks. In all samples, initial-stability was recorded using resonance frequency analysis (RFA). Sample-size estimation was done and group-comparisons were carried out. A P-value of 0.01 or less reflected statistical significance. RESULTS: In Groups-A and -B, 44 (22 NDIs and 22 SDIs) and 44 (22 NDIs and 22 SDIs) were placed. In group-A, the mean RFA values for NDIs and SDIs were 68.5 ± 3.5 and 69.1 ± 2.4, respectively. In Group-B, the mean RFA values for NDIs and SDIs were 78.06 ± 9.6 and 75.3 ± 5.2. RFA values among NDIs and SDIs in groups A and B were similar. CONCLUSION: The NDIs and SDIs show comparable initial-stability when positioned in simulated Type-I and Type-IV bone blocks.

Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial.

The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF (n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher's exact test were employed to compare periodontal factors between EF and SF groups, considering p ≤ 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase (p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.

Assessment of self-rated pain perception and whole salivary cortisol levels among adolescents with and without temporomandibular disorders.

Objective: To assess the self-perceived pain perception (PP) and whole salivary cortisol levels (CL) among adolescents with and without temporomandibular disorders (TMD).Methods: Adolescents between 15 and 17 years were included. Participants were categorized into three groups: Group 1: patients with TMD; Group 2: nocturnalbruxers without TMD; and Group 3: controls. Demographic data CL and self-rated PP were assessed. A p-value < 0.05 was proposed as statistically significant.Results: Fifty-four patients (18 per group) were included. Scores of self-rated PP in the affected TMJ were higher in Group 1 than Group 2 (p < 0.001). Whole salivary CL were higher in groups 1 and 2 (p < 0.01) than in Group 3. Whole salivary CL were higher in Group 2 than Group 3 (p < 0.05).Conclusion: Whole salivary CL are higher in adolescents with TMD, and there is a direct relationship between self-rated PP in the TMJ area and salivary CL.

Cortisol levels in the peri-implant sulcular fluid among patients with and without peri-implantitis.

BACKGROUND AND OBJECTIVE: Cortisol levels remain uninvestigated in peri-implant sulcular fluid (PISF) of patients with and without peri-implantitis. The present investigation investigated levels of cortisol in PISF among controls (individuals without peri-implantitis) and patients with peri-implantitis. METHODS: The patient population comprised of participants with and without peri-implantitis (groups 1 and 2, respectively). Demographic information and data related to implant characteristics was recorded. Peri-implant radiographic (crestal bone loss [CBL]) and clinical (modified plaque and bleeding on probing indices [PI and BOP], and probing depth [PD]) and parameters were assessed. In all patients, levels of cortisol were measured in the PISF, which was collected using standard methods. Data normality and group comparisons were assessed, and multiple logistic regression was performed. Probability values less than 0.01 were nominated as being significant. RESULTS: Eighty-eight individuals (44 and 44 in groups 1 and 2, correspondingly) were included. In group 1, 24 and 20 participants were males and females, and there were 22 and 22 males and females in group 2. Mean ages were analogous in both groups. Peri-implant BOP (p < .001); CBL (p < .001); PI (p < .001); and PD (p < .001) were higher among patients in group 1 compared with group 2. The volume of PISF (p < .001) collected and its concentrations of cortisol (p < .001) were significantly higher among patients in group 1 compared with group 2. Regression analysis showed that CBL and PD directly correlated with increased PISF levels of cortisol among participants with peri-implantitis. CONCLUSION: Within the limits of the present study, it remains debatable whether or not PISF cortisol levels vary among patients with and without peri-implantitis. Further studies are needed to evaluate the role of PISF levels of cortisol in the diagnosis of peri-implantitis.

Self-perceived competency of the medical faculty for E-Teaching during the COVID-19 pandemic.

BACKGROUND: The aim of this study was to evaluate the self-perceived competency (FSPC) of medical faculty in E-Teaching and support received during the COVID-19 pandemic. METHODS: An online well-structured and validated faculty self-perceived competency questionnaire was used to collect responses from medical faculty. The questionnaire consisted of four purposely build sections on competence in student engagement, instructional strategy, technical communication and time management. The responses were recorded using a Likert ordinal scale (1-9). The Questionnaire was uploaded at www.surveys.google.com and the link was distributed through social media outlets and e-mails. Descriptive statistics and Independent paired t-test were used for analysis and comparison of quantitative and qualitative variables. A p-value of ≤0.05 was considered statistically significant. RESULTS: A total of 738 responses were assessed. Nearly 54% (397) participants had less than 5 years of teaching experience, 24.7% (182) had 6-10 years and 11.7% (86) had 11-15 years teaching expertise. 75.6% (558) respondents have delivered online lectures during the pandemic. Asynchronous methods were used by 61% (450) and synchronous by 39% (288) of participants. Moreover, 22.4% (165) participants revealed that their online lectures were evaluated by a structured feedback from experts, while 38.3% participants chose that their lectures were not evaluated. A significant difference (p < 0.01) was found between FSPC scores and online teaching evaluation by experts. The mean score of FSPC scale was 5.62±1.15. The mean score for student's engagement, instructional strategies, technical communication and time management were of 5.18±1.60, 5.67±1.61, 5.49±1.71 and 6.12±1.67 respectively. CONCLUSIONS: Medical faculty members were found somewhat competent in E-teaching for student engagement, instructional strategy, technical communication and time management skills. Faculty receiving feedback was more competent in comparison to peers teaching without feedback.

Assessment of Tumor Angiogenesis by Expression of CD 105 in Ameloblastoma, Odontogenic Keratocyst and Central Giant Cell Lesion.

BACKGROUND: Angiogenesis is critical for tumor growth and reflects the aggressive behavior of invasive odontogenic lesions [like Ameloblastoma (AM), Odontogenic Keratocyst (OKC) and Central giant cell lesion (CGCL)]. Mean vascular density (MVD) shows the angiogenic potential and CD105 is an ideal endothelial biomarker due to its specificity to new blood vessels for MVD detection. The aim of the study was to compare the MVD (angiogenic potential) among AM, OKC and CGCL in comparison to Pyogenic Granuloma (PG) using CD105 biomarker. METHODS: Sixty-four primary cases of odontogenic invasive tumors (AM, OKC and CGCL) and PG, diagnosed clinically and histologically were included in the study, with 16 samples in each group. Tissue samples of peripheral AM, Peripheral GCL of jaws, malignant AM, and specimen with insufficient tissue were excluded. Tissue sections were embedded, processed and stained using Hematoxylin and Eosin (H and E). Immunohistochemistry was performed using antibodies against CD105, with positive brown cytoplasmic staining in the endothelial cells of neo-vasculature. Distinct countable, positively stained endothelial cell or clusters were evaluated under light microscope for identification of MVD. ANOVA and t-test were applied for statistical analysis of data. RESULTS: Highest MVD was displayed in CGCL (32.99±0.77) and the minimum was observed in OKC (7.21± 0.75) respectively. CGCL showed significantly higher MVD to AM, OKC and PG lesions (p <0.05). AM (8.07± 0.36) and Odontogenic Keratocyst (7.21± 0.75) showed comparable MVD, which was lower than PG (14.7± 0.96) and CGCL vascular density (p < 0.01) respectively. CONCLUSION: CGCL was most aggressive, with highest MVD among the investigated odontogenic lesions (OKC, AM and PG). The proliferative aggressive behavior of Odontogenic Keratocyst is comparable to AM due to comparable mean vascular density.
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Comparison of peri-implant soft tissue and crestal bone status of dental implants placed in prediabetic, type 2 diabetic, and non-diabetic individuals: a retrospective cohort study.

BACKGROUND: Clinicoradiographic status of narrow-diameter implants (NDIs) among patients with prediabetes and type 2 diabetes mellitus (DM) is scarce. The aim was to address the clinicoradiographic status of NDIs placed prediabetic, type 2 diabetic, and non-diabetic individuals. In this retrospective cohort study, patients having undergone oral rehabilitation with NDI were included. The participants were divided into the following: (a) patients with prediabetes; (b) patients with poorly controlled type 2 DM; (c) patients with well-controlled type 2 DM; and (d) normoglycemic individuals. Demographic data was collected. In all groups, peri-implant plaque index (PI), gingival index (GI), probing depth (PD), and mesiodistal CBL were measured in all groups. Information related to implant dimensions, surface characteristics, insertion torque, implant geometry, duration of NDI in function, and jaw location of NDI was also recorded. Data normality was assessed and group comparisons were performed. A probability value under 0.01 was considered statistically significant. RESULTS: Eighty-three patients (20 patients had prediabetes, 22 with poorly controlled type 2 DM, 20 with well-controlled type 2 DM, and 20 self-reported non-diabetic individuals) were included. The mean HbA1c levels were significantly higher among patients with prediabetes (P < 0.01) and poorly controlled type 2 DM (P < 0.01) than patients with well-controlled type 2 DM and non-diabetic controls. Peri-implant PI, GI, PD, and mesiodistal CBL levels were significantly higher among patients with pre-diabetes (P < 0.01) and poorly controlled type 2 DM (P < 0.01) than patients with well-controlled type 2 DM and non-diabetic controls. Peri-implant PI, GI, PD, and mesiodistal CBL levels were significantly higher among patients with poorly controlled type 2 DM (P < 0.01) than patients with prediabetes. CONCLUSION: Chronic hyperglycemia increases the risk of peri-implant diseases around NDIs.

Efficacy of Scaling and Root Planing with Photobiomodulation for Treating Periodontitis in Gutka Chewers: A Randomized Controlled Trial.

Objective: To explore the influence of photobiomodulation (PBMT) as an adjuvant to scaling and root planing (SRP) for treating periodontitis among gutka chewers. Materials and methods: Self-reported smokeless-tobacco (gutka) users were enrolled; and underwent SRP with (test group) and without (control group) PBMT. Full-mouth plaque index (P-I), bleeding upon probing (BUP), probing depth (P-D) clinical attachment loss (CAL), marginal bone loss (MBL) (on mesial and distal surfaces of the teeth), and number of missing teeth were recorded before treatment and at 3 and 6 months. Group comparisons were performed and p < 0.05 was referred significant. Results: In the control group, P-I (p < 0.013), BUP (p < 0.001), and P-D (p < 0.012) were high at baseline compared with 3 months follow-up. P-I, BUP, and P-D were higher in the test group, at baseline in comparison with the 3-month (p < 0.001) and 6-month (p < 0.01) follow-up. At 3 and 6 months, scores of P-I, BUP, and P-D were high in the control compared with the test group. No difference in CAL, and mesial and distal MBL was found among patients of both groups at 3 and 6 months. Conclusions: Among gutka chewers, SRP with PBMT is more efficient than SRP alone in the management of periodontitis.

Clinical efficacy of photodynamic therapy as an adjunct to mechanical debridement in the treatment of per-implantitis with abscess.

AIM: The aim of the present clinical trial was to evaluate the efficacy of photodynamic therapy (PDT) as an adjunct to mechanical debridement (MD) in the treatment of severe peri-implantitis (PI) with abscess. MATERIALS AND METHODS: Selected individuals with severe PI were divided into two groups: Group A: received methylene blue mediated (PDT) using diode laser as an adjunct to MD, whereas, Group B received thrice daily application of 500 mg amoxicillin and 400 mg metronidazole with adjunctive MD. Peri-implant plaque scores (PS), probing depth (PD), bleeding on probing (BOP) and clinical attachment loss (CAL) were reported. Microbial counts of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia were analyzed using polymerase chain reaction. The assessment of pain was done with the help of numeric pain rating scale (NPRS). All assessments were done at baseline and repeated at 6 and 12 months, respectively. RESULTS: A total of 40 individuals completed the clinical trial. Both Group A and Group B comprised of 20 patients respectively. A significant improvement was observed in BOP in Group A at 12 months compared to Group B. No statistically significant changes were seen for NPRS scores between both groups (p > 0.05). Statistically significant differences were observed in values for P. gingivalis, T. denticola and T. forsythia at 6 months follow-up period in comparison to baseline for both Group A and Group B (p < 0.05). Whereas, the values observed at 6 months follow-up period for Porphyromonas gingivalis also reported a statistically significant difference in between the groups (p < 0.05). CONCLUSION: PDT was equally effective in reducing severe peri-implant symptoms compared to antimicrobial therapy as an adjunct to mechanical debridement.

Expression of HER-2/neu in Oral Squamous Cell Carcinoma.

BACKGROUND: HER-2/neu is a member of the human epidermal growth factor (HER) family of transmembrane tyrosine kinases, which is significantly associated with the pathogenesis of various cancer types. The aim was to evaluate the expression of HER-2/neu in oral squamous cell carcinoma (OSCC) as a potential biomarker to target antigens for specific immunotherapy in OSCC. METHODS: One hundred and forty histologically diagnosed OSCC cases were identified. Four to five-micrometer thick formalin-fixed, paraffin-embedded tumor sections were stained with Haematoxylin and Eosin (H and E). Histological grade was assessed according to WHO/Broders classification, while tumors were staged according to the American Joint Committee on Cancer (AJCC) TNM classification from stage I to IV. Immunohistochemistry was performed by using Rabbit monoclonal antibody against HER-2/neu (EP700Y, cell marquee and diluted 1:50). FISH was performed on positive cases using Vysis PathVysion HER-2 DNA probe (Abbott USA). Probes consist of LSI HER gene spectrum orange and control probe CEP 17 spectrum green. RESULTS: In this study, males were mostly effected (64.3%) with buccal mucosa (49%) to be the commonly involved site for OSCC. Majority of cases were moderately differentiated (62.1%) and 50.7% tumors were Stage IV. HER-2/neu was found to be positive (2+) in one case of OSCC, however weak to moderate complete membrane staining was observed in >10% of the tumor cells. One hundred and thirty nine cases were HER-2/neu negative. FISH analysis of HER-2/neu positive cases also showed gene amplification (Her2-neu/ CEp 17 = 225/33 = 7.2). CONCLUSIONS: The study showed disparity in the expression of HER-2/neu in OSCC, which is due to multiple reasons. Therefore therapy against HER-2/neu in OSCC is debatable.

Influence of body fat in patients with dental implant rehabilitation treated with adjunctive photodynamic therapy.

BACKGROUND: Obesity appears to govern peri-implant hard and soft tissue health. We hypothesized that adjunctive photodynamic therapy (aPDT), improves clinical peri-implant perimeters and alleviates peri-implant crevicular fluid (PICF) levels of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and high sensitivity C-reactive protein (hsCRP) in obese with moderate peri-implantitis. The current clinic-laboratory study aimed to determine whether obesity influences the outcomes of aPDT in patients with moderate peri-implantitis. METHODS: A total of 49 patients (24 obese and 25 non-obese) with moderate periodontitis receiving aPDT were included. Clinical characteristics including peri-implant probing depth (PIPD), peri-implant bleeding on probing (PIBOP), and peri-implant plaque index (PIPI) were measured. PICF levels of TNF-a, IL-6 and hsCRP were assessed using enzyme-linked immunosorbent assay (ELISA). Both clinical and cytokine assessments were performed at baseline, three months and six months, respectively. Intra-group comparisons of changes in clinical parameters pre and post PDT was performed using Friedman test. Comparison of changes of TNF-a, IL-6 and hsCRP levels within group was performed using Kruskal-Wallis test. RESULTS: When compared with the baseline, a considerable reduction in PIPI, PIBOP and PIPD was observed in obese as well as non-obese patients at three- and six-months follow-up. At three months follow-up, a statistically significant difference was observed in PIPI (p < 0.05), PIBOP (p < 0.05) and PIPD (p < 0.05) among obese and non-obese individuals. Additionally, when compared with the baseline, a statistically significant difference was noticed in PICF volume (p < 0.05) and levels of TNF-α (p < 0.05) and IL-6 (p < 0.05) in non-obese as well as obese at three- and six-months follow-up. CONCLUSION: With the application of aPDT, considerable improvement was observed in peri-implant inflammatory parameters among obese and non-obese patients with moderate peri-implantitis. Obesity did not appear to influence aPDT outcome in patients with moderate peri-implantitis.

Oral Candida carriage among cigarette- and waterpipe-smokers, and electronic cigarette users.

OBJECTIVE: The aim of this cross-sectional study was to compare oral Candida carriage among cigarette- and waterpipe-smokers, electronic cigarette (E-Cig) users, and never-smokers. METHODS: Demographic data and information regarding smoking and vaping were collected using a questionnaire. Number of missing teeth and unstimulated whole salivary flow rate (UWSFR) were recorded. Oral Candida samples were collected and identified using concentrated oral rinse culture technique and PCR, respectively. Level of significance was set at p < 0.05. RESULTS: Thirty-four cigarette-smokers (Group-1), 33 waterpipe-smokers (Group-2), 30 E-Cig users (Group-3), and 32 never-smokers (Group-4) were included. All were male participants with comparable mean ages. In groups 1, 2, 3, and 4, oral Candida carriage rate was 100%, 100%, 83.3% and 50%, respectively. The most commonly isolated oral yeast species in all groups was C. albicans. C. albicans carriage was significantly higher in groups 1 (p < 0.05), 2 (p < 0.05), and 3 (p < 0.05) than Group-4. Data stratification for age, missing teeth, and UWSFR showed no significant difference in oral yeasts carriage in groups 1, 2, and 3. CONCLUSIONS: Oral C. albicans carriage was significantly higher among cigarette- and waterpipe-smokers and E-Cig users than never-smokers. No significant differences were identified among groups in the oral carriage of other Candida species.

Peri-implant soft tissue status and crestal bone levels around adjacent implants placed in cigarette smokers and never smokers: Five-year follow-up results.

BACKGROUND: It is hypothesized that peri-implant soft tissue inflammation and crestal bone loss (CBL) are higher around adjacent implants placed in cigarette smokers compared with never smokers. The aim of the present 5-years follow-up retrospective clinical study was to compare the peri-implant soft tissue status and CBL around adjacent implants placed in cigarette smokers and never smokers. METHODS: Cigarette smokers (group 1) and never smokers (group 2) with adjacent dental implants were included. Demographic information regarding age, sex, duration of smoking (pack-years), daily frequency of toothbrushing and most recent visit to a dentist or dental hygienist were recorded using a questionnaire. Information regarding implant dimensions (length × diameter), duration of implants in function, loading protocol (and type of restoration was recorded. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD), and mesial and distal CBL were measured. P <0.05 were considered statistically significant. RESULTS: Seventy-two male participants (37 in group 1 and 35 in group 2) were included. The mean age of individuals in groups 1 and 2 were 50.3 ± 5.4 and 48.5 ± 3.8 years, respectively. In group 1, the mean duration of cigarette smoking was 22.3 ± 1.6 pack years. A family history of smoking was more often reported by individuals in group 1 compared with group 2. In groups 1 and 2, 54 and 70 adjacent implants, respectively were placed in the regions of missing premolars and molars. All implants were delayed loaded and were fixed with non-splinted screw-retained restorations. In groups 1 and 2, toothbrushing twice daily was reported by 78.3% and 74.2% individuals, respectively. There was no statistically significant difference in peri-implant PI, BOP, PD, and mesial and distal CBL among individuals in groups 1 and 2. CONCLUSION: Peri-implant soft tissue status and crestal bone levels were comparable around adjacent dental implants placed in cigarette smokers and never smokers.

Proinflammatory cytokine levels and peri-implant parameters among cigarette smokers, individuals vaping electronic cigarettes, and non-smokers.

BACKGROUND: Tobacco smoking compromises the prognosis of dental implant treatment and is associated with increased risk of peri-implant bone loss and increased implant failure rate. There is a dearth of studies that have compared clinical, radiographic, and immunological peri-implant parameters among cigarette smokers (CS), individuals vaping e-cigarettes (e-cigs), and non-smokers (NS). This study aimed to compare clinical and radiographic peri-implant parameters and levels of matrix metalloproteinase (MMP)-9 and interleukin (IL)-1ß levels among CS, individuals' vaping e-cigs, and NS. METHODS: Thirty-two CS (group 1), 31 individuals vaping e-cigs (group 2), and 32 NS (group 3) were included. Demographic- and implant-related data were collected using a structured baseline questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded and marginal bone loss (MBL) were assessed using standardized digital radiographs. Enzyme-linked immunosorbent assay was used to assess levels of MMP-9 and IL-1ß in peri-implant sulcular fluid. Pearson correlation coefficient was used to analyze for correlations of MMP-9 and IL-1ß levels with peri-implant parameters. RESULTS: BOP showed significantly higher values in group 3 as compared with groups 1 and 2 (P < 0.01). PI (P < 0.01), PD ≥ 4 mm (P < 0.01), and mean concentrations of MMP-9 (P < 0.001) and IL-1ß (P < 0.01) were significantly higher in groups 1 and 2 than group 3. MBL was significantly higher in group 1 as compared with group 2 and group 3 (P < 0.01). Significant positive correlations were found between MMP-9 (P = 0.0198) and IL-1ß (P = 0.0047) levels and MBL in group 1; and a significant positive correlation between IL-1ß and MBL in group 2 (P = 0.0031). CONCLUSIONS: Peri-implant health was compromised among CS than vaping individuals and NS. Increased levels of proinflammatory cytokines in CS and vaping individuals may suggest greater peri-implant inflammatory response.

Clinical and radiographic periodontal status and whole salivary cotinine, IL-1ß and IL-6 levels in cigarette- and waterpipe-smokers and E-cig users.

The aim was to compare the clinical (plaque index [PI], bleeding on probing [BOP], probing pocket depth [PPD] and clinical attachment loss [CAL]) and radiographic (marginal bone loss [MBL]) periodontal parameters and whole salivary cotinine, interleukin (IL)-1ß and IL-6 levels among cigarette-smokers, waterpipe-smokers, E-cig users and never-smokers. In total, 154 male individuals (39 cigarette-smokers, 40 waterpipe-smokers, 37 E-cig users and 38 never-smokers) were included. Full mouth PI, BOP, PPD and CAL were measured on all teeth (excluding third molars); and MBL was measured in digital intra-oral radiographs. Unstimulated whole salivary flow rate (UWSFR) and whole salivary cotinine, IL-1ß and IL-6 levels were measured. Group comparisons were performed using one way analysis of variance and Bonferroni post-hoc tests. P-values less than 0.05 were considered statistically significant. There was no difference in UWSFR among the groups. Cotinine levels were significantly higher among cigarette- (P < 0.001) and waterpipe-smokers (P < 0.001) and E-cig users (P < 0.001) than never-smokers. IL-1ß (P < 0.01) and IL-6 (P < 0.01) levels were significantly higher among cigarette- and waterpipe-smokers than E-cig users and never-smokers. There was no difference in PPD, CAL, mesial and distal MBL and whole salivary IL-1ß and IL-6 levels among E-cig users and never-smokers. In conclusion, clinical and radiographic parameters of periodontal inflammation were poorer in cigarette and waterpipe smokers than E-cig users and never-smokers; and whole salivary cotinine levels were similar in all groups. Whole salivary IL-1ß and IL-6 levels were higher in cigarette- and waterpipe-smokers than E-cig users and never-smokers.

Peri-implant soft tissue status and crestal bone levels around adjacent implants placed in patients with and without type-2 diabetes mellitus: 6 years follow-up results.

BACKGROUND: The long-term success and survival of dental implants type-2 diabetic subjects is debatable. PURPOSE: The present 6 years' follow-up prospective clinical study compared the peri-implant soft tissue status and crestal bone loss (CBL) around adjacent implants placed among type-2 diabetic and nondiabetic subjects. MATERIALS AND METHODS: Type-2 diabetic (Group-1) and nondiabetic individuals (Group-2) with adjacent dental implants were included. Hemoglobin A1c (HbA1c) levels were recorded; and a questionnaire was used to collect demographic information. Information regarding implant dimensions, duration in function, loading protocol, and type of restoration was recorded. Peri-implant bleeding-on-probing (BOP), plaque index (PI), probing depth (PD), and mesial and distal CBL were measured. P < .05 were considered statistically significant. RESULTS: Eighty-six male participants (44 in Group-1 and 42 in Group-2) were included. The mean age of individuals in groups 1 and 2 were 57.6 ± 5.5 and 61.6 ± 4.3 years, respectively. In Group-1, the mean duration of type-2 diabetes was 10.1 ± 3.5 years. A family history of diabetes was more often reported by individuals in Group-1 than Group-2. In groups 1 and 2, 44 and 42 pairs of adjacent implants, respectively were placed in the regions of missing premolars and molars in both arches. All implants were delayed loaded and were fixed with non-splinted screw-retained restorations. In groups 1 and 2, tooth-brushing twice daily was reported by 79.5% and 85.7% individuals, respectively. There was no difference in peri-implant PI, BOP, PD, mesial and distal CBL and HbA1c levels among individuals in groups 1 and 2. CONCLUSION: Adjacent implants can remain esthetically and functionally stable in type 2 diabetic patients in a manner similar to healthy individuals provided glycemic levels are strictly controlled and maintained.

Association of advanced glycation end products with peri-implant inflammation in prediabetes and type 2 diabetes mellitus patients.

BACKGROUND: It is postulated that peri-implant sulcular fluid (PISF) levels of advanced glycation end products (AGEs) are higher with high glycemic levels. PURPOSE: In the present clinico-biochemical study, we explored the clinical and radiographic peri-implant parameters and levels of AGEs among prediabetic, type 2 diabetic (T2DM), and non-diabetic patients and to evaluate the correlation of AGEs with clinical peri-implant parameters. MATERIALS AND METHODS: Ninety patients were divided into three groups of 30 patients each; group 1: patients with prediabetes; group 2: patients with T2DM; and group 3: non-diabetic individuals. Clinical and radiographic peri-implant parameters assessed included plaque index (PI), bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL). PISF was collected and analyzed for AGEs levels using enzyme-linked immunosorbent assay. Between-group comparison of means was verified with Kruskal-Wallis test and Pearson correlation coefficient for correlations of AGE levels with peri-implant parameters. RESULTS: Mean peri-implant PI, BOP, PD, and MBL was significantly higher in group 1 and 2 as compared with non-diabetic patients (P < .05). Mean PI, BOP, PD, and MBL were comparable between group 1 and group 2 patients (P > .05). Mean levels of AGEs in PISF were significantly higher among prediabetic and T2DM patients as compared with non-diabetic patients (P < .05). Between group 1 and group 2, mean levels of AGEs was significantly higher in group 2 (P < .05). A significant positive correlations were found between levels of AGEs and PD (P = .0371) and MBL (P = .0117) in T2DM patients, respectively. CONCLUSION: Clinical and radiographic peri-implant parameters were worse and levels of AGEs in PISF were increased in individuals with prediabetes and T2DM. AGEs may play an important role in peri-implant inflammation in prediabetes and T2DM.

Effectiveness of adjunctive antimicrobial photodynamic therapy in reducing peri-implant inflammatory response in individuals vaping electronic cigarettes: A randomized controlled clinical trial.

BACKGROUND: There are no studies that have assessed the effectiveness of antimicrobial photodynamic therapy (aPDT) in reducing peri-implant inflammatory response in individuals vaping electronic cigarettes (e-cigs). This study explored the effectiveness of aPDT as an adjunct to mechanical debridement (MD) in the treatment of peri-implant mucositis (p-iM) in individuals vaping e-cigs. METHODS: Vaping individuals with p-iM were divided into 2 groups: (a) Group-I: receiving MD with aPDT (test group); and (b) Group-II: MD only (control group). Peri-implant inflammatory parameters including plaque index (PI), bleeding on probing (BoP), and pocket depth (PD) were assessed at baseline and 12-weeks follow-up. Inter- and intra-group comparisons were made using Mann-Whitney U test and Wilcoxon signed ranks test. P-value < 0.05 was considered significant. RESULTS: Thirty-eight male patients (20 in Group-I and 18 in Group-II) were included. The mean age of vaping individuals in groups I and II were 33.6 ±â€¯2.8 and 35.4 ±â€¯2.1 years, respectively. Mean daily frequency of vaping e-cigs in groups I and II was 7.3 ±â€¯0.9 and 5.9 ±â€¯1.0 whereas mean duration of vaping e-cigs was 4.8 ±â€¯1.5 and 4.1 ±â€¯1.3 years respectively. There was no significant difference between groups at baseline. There was significant improvement in PI (p < 0.001) and PD (p < 0.001) at 12-weeks follow-up with respect to the baseline visit in both groups. There was a significant reduction in PI (p < 0.001) and PD (p < 0.001) for group-I as compared to group-II at follow-up. There was no statistically significant difference for BoP between groups at follow-up. CONCLUSION: Antimicrobial PDT is more effective compared to MD alone in the treatment of p-iM in individuals vaping e-cigs. The findings of the present study should be considered preliminary and interpreted with caution. Further randomized clinical trials should be performed in order to obtain strong conclusions.