Survival Rate of Implants Placed in Residual Bone Height Less than 4.5 Millimeters with or without Bone Grafting Using Summers Method.

The aim of this retrospective study is to analyze the survival rate of implants placed in residual bone height (RBH) less than 4.5 mm during an overall follow-up of 5 years, by using Straumann and Astra implant designs with or without sinus bone grafting. A total of 77 patients were examined and treated in two private practices in the regions of Hamra and Jounieh, Lebanon, by two periodontists from 2009 to 2019. These patients received 104 implants (83 Straumann implants and 21Astra implants) where 94 implants underwent osteotomy sinus floor elevation with bone graft and 10 implants without bone graft. The radiographic images were analyzed by three examiners: two periodontists and one oral radiologist. Written informed consents were obtained from all patients prior to treatment. All patients had to fulfill the inclusion criteria elaborated hereinafter. A total of 75.96% of implants were placed at the molars sites and 24.04% at the premolars sites. All 104 implants were clinically stable except 2 Straumann implants which suffered early failure (before the implant loading) and 1 Straumann implant late failure (3 months after the implant loading). All the failed implants were placed in a RBH > 4 mm. The cumulative success rate was 97.12% during an overall follow-up of 5 years. The crestal approach for maxillary sinus floor elevation is a viable technique that can be used in patients with minimal RBH < 4.6 mm.

Prevalence of Periodontal Destruction and Putative Periodontal Pathogens in the Same Lebanese Family.

AIM: Periodontal diseases are associated with microorganisms rich in Gram-negative species. Several studies have indicated the presence of few a periodontopathic microorganisms in the same family. A parent with severe adult periodontitis, who is infected with bacteria associated with periodontal disease, may function as a source of infection. Their children may be at a greater risk to become colonized with bacteria. The purpose of this investigation was (1) to explore the presence of three bacteria, such as Porphyromonas gingivalis (PG), Prevotella intermedia (PI), and Aggregatibacter actinomycetemcomitans (AA) in the same Lebanese family and (2) to study the clinical destruction in the same family and their relations as members of this family due to the presence of PG. MATERIALS AND METHODS: A total of 10 families were screened; only 5 (13 females and 5 males) were selected for this study, and at least one member of the family had untreated periodontal disease, chronic or aggressive. Every participant signed an informed consent form. A total of 18 available deoxyribonucleic acid (DNA) samples were taken to analyze the presence of three periodontal bacteria. STATISTICS: Multiple logistic regression was used for the exact methods. RESULTS: All 18 patients showed a positive result for PI. Also, PG. was recognized in 15 patients while AA was not detected in any of the subjects. All couples suffered from periodontitis, chronic or aggressive forms, five children suffered from gingivitis, three children had no clinical manifestation, and only one suffered from localized aggressive periodontitis. The statistical analysis showed with each 1 year of increase in age, the odds of having periodontal disease multiply by 1.39, i.e., age as a risk factor for periodontal disease due to the presence of PG and sharing the same plate. CONCLUSION: This investigation demonstrates a high prevalence of periodontal microorganisms in children and young adults of Lebanese periodontitis parents and a microbiological similarity between the children and their mothers. All these factors could be a high risk of developing periodontal disease in the future. CLINICAL SIGNIFICANCE: This article shows that vertical transmission of microorganisms is a possible risk factor for developing periodontal disease in the offspring.

Prevalence of Periodontal Pathogens in a Group of Participants from the Middle East and North Africa Geographic Region with Minimal Periodontal Disease.

AIM AND OBJECTIVES: To assess the prevalence of the three putative periodontal pathogens such as Aggregatibacter actinomycetemcomitans (A. a), Porphyromonas gingivalis (P. g), and Prevotella intermedia (P. i) in a group of Arab participants from the Middle East and North Africa (MENA) region who had minimal periodontal disease and no history of periodontal treatment and further to analyze the association among these three microorganisms. MATERIALS AND METHODS: Eighty-four participants of varied demographics and oral/dental care habits were screened for this study. Twenty-one participants who eventually gave their consent to fully participate in the study provided a balanced representation of the screened universe. RESULTS: Seventy-eight microbiological samples were taken from the deepest pockets. Twenty-three percent of all samples were found to be A. a positive and so were 79% for P. g and 82% for P. i. A highly remarkable association was observed between the presence of P. i along with P. g (P < 0.00l; Fisher's exact test). Of all samples, merely six cases were P. i positive but not P. g and eight cases were vice versa. There was a statistically significant association between A. a and P. g (P = 0.016). No significant relationship was detected between P. i and A. a. CONCLUSIONS: This qualitative study shows very high frequency of the three periodontal pathogens (A. a, P. g, and P. i) in a group of Arab nationals with minimal periodontal disease. The lack of oral hygiene, minimal use of antimicrobial drugs and antiseptics, and the absence of dental care may partly explain the high prevalence of periodontal pathogens.

Deoxyribonucleic Acid Probes Analyses for the Detection of Periodontal Pathogens.

BACKGROUND: In clinical microbiology several techniques have been used to identify bacteria. Recently, Deoxyribonucleic acid (DNA)-based techniques have been introduced to detect human microbial pathogens in periodontal diseases. Deoxyribonucleic acid probes can detect bacteria at a very low level if we compared with the culture methods. These probes have shown rapid and cost-effective microbial diagnosis, good sensitivity and specificity for some periodontal pathogens in cases of severe periodontitis. MATERIALS AND METHODS: Eighty-five patients were recruited for the study. Twenty-one subjects ranging between 22 and 48 years of age fulfilled the inclusion and exclusion criteria. Seventy-eight samples became available for DNA probe analysis from the deepest pockets in each quadrant. RESULTS: All 21 patients showed positive results for Prevotella intermedia; also, Prevotella gingivalis was identified in 19 subjects, Aggregatibacter actinomycetemcomitans in 6 subjects. P. intermedia was diagnosed positive in 82% of the subgingival samples taken, 79% for P. gingivalis, and 23% for A. actinomycetemcomitans. CONCLUSION: This study shows a high frequency of putative periodontal pathogens by using DNA probe technology, which is semi-quantitative in this study. Deoxyribonucleic acid probes can detect bacteria at very low level about 10(3) which is below the detection level of culture methods. The detection threshold of cultural methods. CLINICAL SIGNIFICANCE: The three types of bacteria can be detected rapidly with high sensitivity by using the DNA probe by general practitioners, and thus can help in the diagnosis process and the treatment.