Peri-implantitis management by resective surgery combined with implantoplasty and Er:YAG laser irradiation, accompanied by free gingival graft: a case report.

The optimal method for decontamination of implant surfaces for peri-implantitis treatment remains controversial. In recent years, erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation and implantoplasty (IP) (i.e. mechanical modification of the implant) have been reported to be effective in decontaminating implant surfaces during the surgical treatment. Also, a lack of adequate keratinized mucosa (KM) around the implant is known to be associated with more plaque accumulation, tissue inflammation, attachment loss, and mucosal recession, increasing the risk of peri-implantitis. Therefore, free gingival graft (FGG) has been recommended for gaining adequate KM around the implant. However, the necessity of acquiring KM for the treatment of peri-implantitis using FGG remains unclear. In this report, we applied the apically positioned flap (APF) as resective surgery for peri-implantitis treatment in conjunction with IP and Er:YAG laser irradiation to polish/clean the implant surface. Furthermore, FGG was conducted simultaneously to create additional KM, which increased the tissue stability and contributed to the positive results. The two patients were 64 and 63 years old with a history of periodontitis. The removal of granulation tissue and debridement of contaminated implant surfaces were performed with Er:YAG laser irradiation post flap elevation and then modified smooth surfaces mechanically using IP. Er:YAG laser irradiation was also utilized to remove the titanium particles. In addition, we performed FGG to increase the width of KM as a vestibuloplasty. Peri-implant tissue inflammation and progressive bone resorption were not observed, and both patients maintained good oral hygiene conditions until the 1-year follow-up appointment. Bacterial analysis via high-throughput sequencing revealed proportional decreases in bacteria associated with periodontitis (Porphyromonas, Treponema, and Fusobacterium). To the best of our knowledge, this study is the first to describe peri-implantitis management and bacterial change before and after procedures by resective surgery combined with IP and Er:YAG laser irradiation for peri-implantitis treatment, accompanied by FGG for increasing KM around the implants.

Correlation between changes of oral bacterial flora and radiation-induced oral mucositis during radiotherapy for head and neck / 中华放射肿瘤学杂志

Objective:To investigate the correlation between the changes of oral bacterial flora during head and neck radiotherapy and radiation-induced oral mucositis (ROM).Methods:The oral bacterial samples of patients with nasopharyngeal carcinoma and accompanying family members were obtained before and at the end of radiotherapy and subjected to high-throughput sequencing. C57BL/6 mice were used to establish the ROM models. On the 9 th day after radiotherapy, oral bacterial samples were collected in the radiotherapy group and the negative control group. On the 3 rd, 5 th, 7 th, and 9 th days post-radiotherapy, the tongue tissues were obtained from another batch of mice in the negative control and radiotherapy groups. Inflammatory factors were detected with PCR and HE staining was performed. Results:The oral bacterial diversity of patients after radiotherapy significantly differed from that of patients before radiotherapy and their accompanying family members before and after radiotherapy in Observed species, Chao1, Simpson index (all P<0.05). There was a significant difference in Shannon index between the severe and mild ROM patients ( P=0.036). LEfSe analysis showed that patients with severe ROM had higher levels of g_ Streptococcus and f_ Streptococcus, and lower levels of f_ Familyxl, g_ Gemini and o_ Bacillus. The Simpson index and PCoA results in the oral bacterial samples significantly differed between the negative control and radiotherapy groups (all P<0.05). Conclusions:Radiotherapy can disrupt the balance of bacterial flora. The dysregulated oral bacterial flora is closely associated with the aggravation of ROM.

[Relationship of consequences of anastomotic insufficiency and bacterial flora of oral cavity in patients with esophageal and cardia cancer]. / A szájüreg baktériumflórájának összefüggése az anastomosiselégtelenség következményeivel nyelocso- és cardiatumoros betegeknél.

INTRODUCTION: In the course of anastomotic insufficiency following resection of esophageal cancers the bacterial compound of the esophageal substance has a remarkable, presumable role in the outcome of complications. AIM: The purpose of this study is to compare the consequences of the anastomotic leak with the bacterial flora of patients' oral cavity. METHOD: In this prospective study a total of 131 patients were investigated directly before the surgical intervention taking a bacterial sample. Bacterial flora of patients' oral cavity was analysed; and the correlation between the consequences of the anastomotic leak and the content of the bacterial flora was examined. RESULTS: Pathogenic bacteria in the oral microflora in 50 cases (38.2%) was found. Statistically significant, moderate correlation was found between the severity of the complication and the incidence of pathogenic bacteria (rs = 0.553; p≤0.05). CONCLUSIONS: Pathogenic agent in the microbial flora might induce higher risk and more severe outcome in case of anastomotic leakage and it might be evaluated as a determinative factor. Consideration of the bacterial flora of the oral cavity requires more attention in the preoperative preparation than before and it demands the change of the current practice. Orv. Hetil., 2017, 158(1), 25-30.

Analysis in saliva microbiome composition in patients with NAFLD and normal subjects / 实用医学杂志

Objective To analyze the diversity of salivary bacteria in patients with nonalcoholic fatty liv-er disease(NAFLD group)and healthy control group(HC group). Methods Saliva samples were collected from 24 patients with nonalcoholic fatty liver disease and 22 healthy control.Genomic DNA of the samples was extracted and extended to 16S rRNA V4-V5 hypervariable region after PCR with Illumina high-throughput sequencing tech-nology.All the data,including operational taxonomic units,diversity indexes and species annotation,etc.was ana-lyzed. Results 39118 optimized sequences in the saliva of each group were obtained,including nonalcoholic fatty liver group clustering OTUs about 308 ± 48 and healthy control group clustering OTUs about 305 ± 53.The diversi-ty analysis of NAFLD group and HC group showed that there was little difference in diversity of the whole salivary bacteria.The data of the species analysis of the saliva bacteria in two group indicate that the composition was simi-lar and the relative abundance was different in phylum and genus.In NAFLD group,the ratio of the abundance of firmicutes(20.42%)increased and the proportion of bacteroides(36.75%)decreased in phylum. Genus of the NAFLD group,the ratio of fusobacterium,porphyromonas and veillonella increased significantly,and the ratio of prevotella and[Prevotella]decreased.Conclusion In the NAFLD group,the abundance of firmicutes increased, and the abundance of the bacteria decreased.It was speculated that the imbalance of the salivary bacteria is associ-ated with nonalcoholic fatty liver disease.

Retrospective health-care associated infection surveillance in oral and maxillofacial reconstructive microsurgery.

In polymorbid or anaemic patients who receive preoperative radiotherapy or undergo long duration surgery involving potentially infectious sites, perioperative antibiotic prophylaxis (PAP) that is effective against normal oral bacterial flora is mandatory and plays an important role in preventing postoperative infection. In a four-year retrospective analysis, the incidence, outcome, and the efficacy of PAP were evaluated in patients treated at the Department of Oral and Maxillofacial Surgery and Otorhinolaryngology at Kecskemét Hospital. The results were compared with data from the literature to determine if the use of PAP was adequate at the Department.During the study period (between 01/09/2007 and 31/01/2011) 108 patients were evaluated. The mean duration of prophylactic antibiotic treatment was 8.3 ± 5.2 days, with cefotaxime+metronidazole being the most commonly used combination. Surgical site infection occurred in 8 patients (7.5%) in the clean-contaminated category.Our results showed that the perioperative antibiotic prophylaxis administered at our Department was efficient and effective against the oral bacterial flora of patients. Its use is recommended in head and neck microsurgery. To avoid development of antibiotic resistance and to reduce costs, it seems that the duration of antibiotic regimen for primary surgery can be reduced from 8.3 ± 5.2 days to 3 days.

Oral Nitrate Reductase Activity Is Not Associated with Development of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH): A Pilot Study.

BACKGROUND NAFLD/NASH is a manifestation of metabolic syndrome and is associated with obesity/overweight. Not all obese/overweight individuals develop NASH. Gastro-esophageal reflux disease (GERD) is considered a gastrointestinal manifestation of the metabolic syndrome and is associated with obesity/overweight. Again not all obese/overweight individuals develop GERD. Recent data show association of dietary nitrate content and oral nitrate reductase activity (NRA) with GERD. Nitrates need to be converted to nitrite (done in human beings by nitrate reductase of oral bacteria exclusively) to be active in metabolic pathways. OBJECTIVE To assess the relation between NASH/NAFLD and oral NRA. METHODS Oral NRA was measured in individuals with NASH (compatible abdominal ultrasound and two elevated ALT/AST levels over six months) and was compared with that of those without NASH. Oral NRA was measured according to a previously reported protocol. RESULTS Eleven NASH patients and twelve controls were enrolled. Mean oral NRA activity were 2.82 vs. 3.51 µg nitrite-N formed per person per minute for cases and controls respectively (p=0.46). CONCLUSION According to our data, oral nitrite production is not different between individual swith and without NASH.