Serum creatinine and alkaline phosphatase levels are associated with severe chronic periodontitis.

BACKGROUND AND OBJECTIVE: Periodontitis may alter systemic homeostasis and influence creatinine and alkaline phosphatase levels. Therefore, the aim of this study was to evaluate the relationship between severe chronic periodontitis and serum creatinine and alkaline phosphatase levels. MATERIAL AND METHODS: One hundred patients were evaluated, 66 with severe chronic periodontitis (test group) and 34 periodontally healthy controls (control group). Medical, demographic and periodontal parameters were registered. Blood sample was collected after an overnight fast and serum creatinine and alkaline phosphatase levels were determined. RESULTS: There were significant differences between test and control groups in ethnicity, gender and educational level (p < 0.05). Patients with periodontitis showed a lower mean creatinine level (p < 0.05) and higher mean alkaline phosphatase level (p < 0.001) than the control group. There were significant correlations between periodontal parameters and serum creatinine and alkaline phosphatase levels. CONCLUSION: Severe chronic periodontitis was associated to lower creatinine and higher alkaline phosphatase levels.

Apical extrusion of bacteria when using reciprocating single-file and rotary multifile instrumentation systems.

AIM: To evaluate ex vivo, apical bacterial extrusion associated with two reciprocating single-file systems (WaveOne and Reciproc) compared with a conventional multifile rotary system (BioRace). METHODOLOGY: Forty-five human single-rooted mandibular incisors were used. Endodontic access cavities were prepared, and root canals were contaminated with an Enterococcus faecalis suspension. Following incubation at 37 °C for thirty days, the contaminated teeth were divided into three groups of 15 specimens each (G1 - Reciproc, G2 - WaveOne and G3 - BioRace). Positive and negative controls consisted of 5 infected teeth and 3 uninfected incisors that were instrumented with one of the tested NiTi systems, respectively. Bacteria extruded from the apical foramen during instrumentation were collected into vials containing 0.9% NaCl. The microbiological samples were taken from the vials and incubated in brain heart agar medium for 24 h. The resulting bacterial titre, in colony-forming units (CFU) per mL, was determined, and these data were analysed by Wilcoxon matched-pairs signed rank test and Kruskal-Wallis H-test. The level of significance was set at α = 0.05. RESULTS: No significant difference was found in the number of CFU between the two reciprocating systems (P = 0.41). The conventional multifile rotary system group was associated with significantly higher CFU than both of the two reciprocating groups (P = 0.01). CONCLUSIONS: All instrumentation systems extruded bacteria beyond the foramen. However, both reciprocating single-file systems extruded fewer bacteria apically than the conventional multifile rotary system.

Tomographic evaluation of iliac crest bone grafting and the use of immediate temporary implants to the atrophic maxilla.

Sixteen consecutive patients with atrophic maxillae, who had been referred for bone augmentation using iliac bone grafting before the placement of dental implants, received a full clinical examination and underwent a CT scan before and after surgery. Linear vertical and horizontal measurements were made before and 6 months after surgery. Differences in mean bone gain or loss for each area were compared between a group that received an immediate total provisional prosthesis on temporary immediate implants (test group, 12 patients) and a control group (four patients). Both groups showed significant horizontal bone gain in all regions and vertical bone augmentation in the posterior regions. The test group showed no significant difference for bone gain compared to the control group, but half the test group had problems during treatment. Bone augmentation of the atrophic maxilla with iliac crest bone grafting resulted in sufficient vertical and horizontal bone augmentation to install six or eight implants in all patients and successfully rehabilitate them. The results suggest that the use of total provisional prostheses on temporary immediate implants meets the aesthetic demands required, but should be used with care and in special cases.