Mansour Al-Askar

Cytokine profile in the gingival crevicular fluid of periodontitis patients with and without type 2 diabetes: a literature review.

BACKGROUND Periodontitis may occur in patients with and without type 2 diabetes (T2D). It may be hypothesized that the gingival crevicular fluid (GCF) cytokine profile in patients with periodontitis with poorly controlled T2D may differ from the GCF cytokine profile in medically healthy individuals with periodontitis. The aim was to review the cytokine profiles in the GCF of patients with periodontitis with and without T2D. METHODS Databases were searched from 1988 to August 2011 using different combinations of various keywords. Titles and abstracts of articles that satisfied the eligibility criteria were screened by the authors and checked for agreement. Only articles published in English were included. RESULTS Ten studies were included. Two studies reported GCF concentrations of interleukin (IL)-6 to be higher in patients with periodontitis with T2D compared to medically healthy patients with periodontitis. Two studies showed GCF IL-6 levels to be higher in periodontitis with T2D compared to medically healthy subjects without periodontitis. In one study GCF levels of IL-17, IL-23, and interferon-γ were higher in patients with periodontitis with T2D compared to medically healthy patients with periodontitis. In one study, GCF concentrations of IL-8 were significantly higher in patients with periodontitis with T2D compared to medically healthy individuals with periodontitis. Three studies reported GCF levels of IL-1α to be significantly higher in patients with periodontitis with T2D compared to medically healthy individuals with periodontitis. CONCLUSION The GCF cytokine profile in patients with and without T2D seems to be governed by the intensity of periodontal inflammation and the role of T2D in this regard is rather secondary.

Periodontal Disease in Habitual Cigarette Smokers and Nonsmokers With and Without Prediabetes

Introduction:Prediabetes and habitual cigarette smoking are significant risk factors contributing to periodontal disease. The aim was to assess the clinical and radiological markers of periodontal disease in habitual cigarette smokers and nonsmokers with and without prediabetes. Methods:Sixty-eight individuals with prediabetes (test group; 34 smokers and 34 nonsmokers) and 68 medically healthy individuals (control group; 34 smokers and 34 nonsmokers) were included. Sociodemographic information, duration of smoking habit and number of cigarettes smoked daily were recorded through a questionnaire. Fasting blood glucose levels and periodontal inflammatory conditions (plaque index [PI], bleeding on probing [BOP] and probing pocket depth [PPD] of 4 to <6 mm and ≥6 mm) were recorded. In both groups, marginal bone loss (MBL) was measured on digital panoramic radiographs. Results:Cigarette smokers and nonsmokers in the test group had significantly higher fasting blood glucose level when compared with cigarette smokers in the control group (P < 0.001). In the test group, there was no significant difference in PI, BOP, PPD (4 to <6 mm and ≥6 mm) and MBL among cigarette smokers and nonsmokers. Cigarette smokers in the control group had significantly higher PI (P < 0.001), PPD (4 to <6 mm; P < 0.001), PPD ≥6 mm (P < 0.01) and MBL (P < 0.05) than nonsmokers. BOP was significantly reduced in smokers when compared with nonsmokers in the control group (P < 0.001). Conclusions:Cigarette smokers without prediabetes exhibit significantly severe periodontal disease than nonsmokers. In subjects with prediabetes, the severity of periodontal disease seems to be over shadowed by the hyperglycemic state, obscuring the effect of habitual smoking.

Comparison of Self-Perceived Oral Health, Periodontal Inflammatory Conditions and Socioeconomic Status in Individuals With and Without Prediabetes

Introduction: The aim was to compare the self-perceived oral health, periodontal inflammatory conditions and socioeconomic status (SES) in patients with and without prediabetes. Methods: Thirty-nine individuals [19 patients with prediabetes (test group) and 20 control individuals (control group)], at least 20 years old were included. Plaque index, bleeding on probing, probing depth (4 to <6 mm and ≥6 mm) and number of missing teeth were recorded. Fasting blood glucose levels were recorded, and marginal bone loss was measured on radiographs. SES, education status, self-perceived oral health, family history of diabetes and tobacco habits were also investigated. Results: Mean ages of individuals in the test and control groups were 40.6 and 42.3 years, respectively. Plaque index, bleeding on probing, probing depth (4 to <6 mm and ≥6 mm) and number of missing teeth were higher in the test group as compared with the control group (P < 0.05). Premolar and molar marginal bone loss was higher in the test group as compared with the control group (P < 0.001). Self-perceived bleeding gums was more often reported by individuals in the test group as compared with the control group. A poor SES and education status was higher among individuals in the test group as compared with the control group (P < 0.001). Conclusions: Self-perceived gingival bleeding and clinical periodontal inflammation were severe in patients with prediabetes as compared with controls. An underprivileged SES aggravated periodontal conditions in patients with prediabetes.

Periodontal Status and Whole Salivary Cytokine Profile Among Smokers and Never-Smokers With and Without Prediabetes

BACKGROUND Whole salivary interleukin (IL)-1β and IL-6 in smokers and never-smokers with prediabetes remains uninvestigated. The aim of this study is to assess the periodontal status and whole salivary IL-1β and IL-6 levels among smokers and never-smokers with and without prediabetes (controls). METHODS Ninety-five males (45 with prediabetes and 50 systemically healthy controls) were included. Twenty-seven controls and 29 patients with prediabetes were smokers. Periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment loss, and marginal bone loss) were measured, and the number of missing teeth were recorded. Fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded. Unstimulated whole saliva samples were collected, unstimulated whole salivary flow rate (UWSFR) was determined, and IL-1β and IL-6 levels were measured. P values <0.05 were considered statistically significant. RESULTS FBG (P <0.05) and HbA1c (P <0.05) levels were higher among patients with prediabetes than controls. All patients with prediabetes were hyperglycemic. UWSFR was significantly higher among controls than among patients with prediabetes (P <0.05). Periodontal parameters and whole salivary IL-1β and IL-6 levels were comparable among smokers and never-smokers with prediabetes. Among controls, periodontal parameters and whole salivary IL-1β and IL-6 levels were higher among smokers than never-smokers (P <0.05). CONCLUSIONS Among controls, periodontal inflammation was worse, and whole salivary IL-1β and IL-6 levels are higher in smokers than never-smokers. Among patients with prediabetes, periodontal inflammation and whole salivary IL-1β and IL-6 levels were comparable between smokers and never-smokers.

Effect of Single and Contiguous Teeth Extractions on Alveolar Bone Remodeling: A Study in Dogs

BACKGROUND Tooth extraction is associated with dimensional changes in the alveolar ridge. The aim was to examine the effect of single versus contiguous teeth extractions on the alveolar ridge remodeling. MATERIAL AND METHODS Five female beagle dogs were randomly divided into three groups on the basis of location (anterior or posterior) and number of teeth extracted - exctraction socket classification: group 1 (one dog): single-tooth extraction; group 2 (two dogs): extraction of two teeth; and group 3 (two dogs): extraction of three teeth in four anterior sites and four posterior sites in both jaws. The dogs were sacrificed after 4 months. Sagittal sectioning of each extraction site was performed and evaluated using microcomputed tomography. RESULTS Buccolingual or palatal bone loss was observed 4 months after extraction in all three groups. The mean of the alveolar ridge width loss in group 1 (single-tooth extraction) was significantly less than those in groups 2 and 3 (p < .001) (multiple teeth extraction). Three-teeth extraction (group 3) had significantly more alveolar bone loss than two-teeth extraction (group 2) (p < .001). The three-teeth extraction group in the upper and lower showed more obvious resorption on the palatal/lingual side especially in the lower group posterior locations. CONCLUSION Contiguous teeth extraction caused significantly more alveolar ridge bone loss as compared with when a single tooth is extracted.

Tissue reactions to various suture materials used in oral surgical interventions.

A variety of suture materials are available for primary wound closure following oral surgical procedures. The aim was to review the tissue reactions to the various suture materials used in oral surgical interventions. Databases were searched using the following keywords: cotton, nylon, polyglecaprone 25, polytetrafluoroethylene (ePTFE), Polyglactin 910, polyglycolic acid (PGA), polylactic acid, silk, surgery, suture, and tissue reaction. Articles published only in English language were included. Seventeen studies were included. Two studies reported that polyglecaprone 25 had positive effects on wound-healing as compared to silk. Six studies reported that silk elicits more intense tissue inflammatory response and delayed wound healing as compared to other suture materials (including ePTFE, polyglecaprone-25, PGA, and nylon). Polyglactin 910 sutures were associated with the development of stitch abscess in one clinical study. Eight studies reported that tissue reactions are minimal with nylon sutures. Tissue reactions to suture materials used for oral surgical interventions may vary depending on the surface properties and bacterial adherence properties of the material.

Alveolar bone remodeling around immediate implants placed in accordance with the extraction socket classification: a three-dimensional microcomputed tomography analysis.

BACKGROUND Previous studies assessed bone remodeling after a single tooth extraction; however, the effect of multiple contiguous teeth extractions around immediate implant remains unknown. The aim of this microcomputed tomographic investigation is to analyze the alveolar bone remodeling around immediate implants placed in accordance with the extraction socket classification (ESC). METHODS Under general anesthesia, 10 beagle dogs underwent atraumatic tooth extractions. Animals were randomly divided into three groups, with 16 sites per group: 1) ESC-1, single tooth extraction; 2) ESC-2, two contiguous teeth extraction; and 3) ESC-3, more than two contiguous teeth extractions. Immediate implants were inserted in each socket, and postoperative plaque control measures were undertaken. After euthanasia, the jaw segments were evaluated for bone thickness, marginal bone loss (MBL), and bone-to-implant contact (BIC) using microcomputed tomography. RESULTS The mean buccal bone thickness (P <0.05) and MBL (P <0.05) was compromised in jaws in ESC-3 compared to those in ESC-1 and ESC-2. The BIC was significantly higher among jaws in ESC-1 compared to those in ESC-2 and ESC-3 (P <0.05). There was no significant difference in the buccal bone thickness, MBL, and BIC among the groups in the maxilla and mandible. Lingual bone remodeling did not reveal any significant differences among the groups in either jaw. CONCLUSION Buccal bone remodeling is significantly more extensive around immediate implants placed in multiple contiguous tooth extraction sites compared to immediate implants placed in single tooth extraction sites.

Characteristics of newly-formed cementum following Emdogain application.

Periodontal regenerative techniques have been proposed; however, the outcomes remain debatable. The present investigation assessed the regenerated cementum following enamel matrix derivative application in dehiscence‐type defects. Buccal osseous dehiscences were surgically created on the maxillary cuspid, and the second and fourth premolars in five female beagle dogs. The treatment group (n=15 sites) received the enamel matrix derived application, whereas the control groups (n=15) did not. The dogs were sacrificed 4 months following treatment and the specimens were histologically and histometrically examined. The newly formed cementum was uneven in thickness and mineralization, overlapped the old cementum and exhibited functional orientation, cementocyte lacunae and collagen fibril bundles. Most of the histological specimens showed the presence of a gap between the newly formed cementum and the underlying dentin. Control sites did not exhibit any cementum formation. The present study concluded that newly formed cementum is of cellular type and exhibits multiple characteristics.

Comparison of self-perceived oral symptoms and periodontal parameters among habitual shamma-chewers, gutka-chewers, and non-chewers.

OBJECTIVE There are no studies that have (a) compared self-perceived oral symptoms and clinical and radiographic periodontal parameters (plaque index [PI], bleeding on probing [BoP], clinical attachment loss [CAL], and marginal bone loss [MBL]) among shamma-chewers (SC) and gutka-chewers (GC); and (b) assessed periodontal parameters among SC. The aim of the present study was to compare the self-perceived oral symptoms and periodontal parameters among SC, GC, and controls. METHOD AND MATERIALS Information regarding demographic characteristics and self-perceived oral symptoms was gathered using a structured questionnaire. Odds ratios were computed for self-perceived oral symptoms and periodontal parameters and compared between the groups. For multiple comparisons, the Bonferroni post-hoc test was used. Level of significance was set at P < .05. RESULTS Forty-seven SC, 45 GC, and 41 control individuals were included. Group comparisons for pain in teeth, pain on chewing, bleeding gums, and burning sensation in the mouth showed no statistically significant difference among SC and GC. These symptoms were significantly higher in SC (P < .01) and GC (P < .01) than controls. PI, BoP, PD (4-6 mm and > 6 mm), and CAL were significantly higher in SC (P < .05) and GC (P < .05) than controls. There was no statistically significant difference in PI, BoP, PD (4-6 mm and > 6 mm), and CAL among SC and GC. There was no statistically significant influence of daily frequency of smokeless tobacco consumption and duration of placement in the mouth on the severity of periodontal parameters. CONCLUSION Self-perceived oral symptoms and periodontal parameters were worse among SC and GC than controls, with no statistically significant difference when comparing these findings between SC and GC.

Oral squamous cell carcinoma arising around osseointegrated dental implants.

Purpose:This literature review investigates the occurrence of oral squamous cell carcinoma (OSCC) around osseointegrated dental implants (DI). Methods:Databases were searched from 1989 up to and including November 2011. The eligibility criteria were as follows: (1) original studies, (2) clinical studies and case reports, (3) reference lists of the relevant original and review articles, (4) intervention: occurrence of OSSC around osseointegrated DI, and (5) articles published only in English language. Results:Fourteen studies were included. In nine studies, the dental implant patients with diagnosed OSCC had previously been exposed to cancer. In five studies, the patients presented with a history of habitual tobacco smoking and alcohol consumption. Conclusion:OSCC is more likely to arise around osseointegrated DI in patients with a previous history of cancer. However, the role of other factors including tobacco and alcohol usage cannot be disregarded.