Objective To systematically evaluate the clinical effectiveness of platelet-rich plasma (PRP) combined with grafting material for the treatment of periodontal intrabony defects. Methods The following databases such as PubMed, The Cochrane Library, EMbase, CNKI, CBM and WanFang Data were searched on computer from inception to August, 2012 to collect the relevant randomized controlled trials (RCTs) on PRP combined with grafting material versus grafting material alone for periodontal intrabony defects. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies. RevMan 5.2 software was applied for meta-analysis. Results A total of 11 RCTs involving 342 patients were included. The pooled analysis on 7 RCTs showed that there was a significant difference in lower increase of clinical attachment loss (WMD=0.70, 95%CI 0.51 to 0.90, Plt;0.000 01) between the PRP combined with grafting material group and the grafting material alone group. But there was no significant difference in the gingival recession (WMD= −0.01, 95%CI −0.15 to 0.13, P=0.86). The pooled analysis on 9 RCTs showed that there was no significant difference in the reduction of plaque index (WMD= −0.04, 95%CI −0.09 to 0.02, P=0.20) between the two groups. Conclusion PRP combined with grafting material is superior to grafting material alone in the clinical attachment loss. But, there are no significant differences in gingival recession and plaque index. However, given the limited sample size and incomplete measure indexes of included studies, this conclusion still needs to be further proved by conducting more high-quality and large-scale RCTs.
Objective To explore the relationship between periodontitis and postmenopausal osteoporosis.Methods Databases were electronically searched from PubMed (1966 to December, 2010), EMbase (1974 to December, 2010), CBM (1978 to December, 2010), VIP (1989 to December, 2010), CNKI (1979 to December, 2010) and WanFang Data (January, 2007 to December, 2010), and the references listed in all papers were also retrieved. The literature was screened according to the inclusion and exclusion criteria by two reviewers independently; the methodology quality was evaluated after data abstraction; and then the RevMan 5.0 software was used for meta-analyses. Results Four trials were included. Among the total 678 patients involved, 263 were postmenopausal osteoporosis patients, while the other 415 were non-osteoporosis patients. The results of meta-analyses showed that: a) Clinical attachment loss (CAL) of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.60, 95%CI 0.23 to 0.96); b) The level of gingival recession of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.78, 95%CI 0.41 to 1.14); c) There were no significant differences in plaque index (PI), gingival index (GI) and periodontal probing depth (PPD) between the two groups (WMD=0.17, 95%CI 0.00 to 0.35; WMD=0.05, 95%CI –0.09 to 0.19; and WMD=–0.08, 95%CI –0.24 to 0.09); d) The results of one study indicated that the rate of periodontitis in the postmenopausal osteoporosis patients was higher than that of the non-osteoporosis patients (OR=2.45, 95%CI 1.38 to 4.34, Plt;0.01); the severe alveolar crest height loss was related to osteoporosis (OR=4.20, 95%CI 1.57 to 11.22, Plt;0.01). Conclusion Postmenopausal osteoporosis patients are more prone to suffer from periodontitis or turn to the worse stage of periodontitis. In consideration of the factors such as small scales and incomplete measure indexes of the included studies, which have influences on the intensity and comprehensiveness of this conclusion, more high-quality studies are required.
Objective To evaluate the effects of the polypeptide growth factors on the periodontal ligament cell(PDLC) based on a comprehensive review onthe literature concerned. Methods The recent literature related to the effects of the polypeptide growth factors on the PDLC were extensivelyand comprehensively reviewed and a corresponding evaluation was made. Results The proliferation and the multidirectional differentiation of thePDLC were found to be the basis for the regeneration of the periodontal tissues. The effects of the polypeptide growth factors on the function of the PDLC became a hot issue of the research on the regeneration of the periodontal tissues. The polypeptide growth factors were found to play an important role in the migration, growth, proliferation, differentiation, and synthesis of protein and matrixof the PDLC. Conclusion The polypeptide growth factors can beused in the periodontal regeneration treatment, but a further research is stillrequired to improve this kind of treatment.
To review the literature about the development of the periodontal tissue engineering. Methods Based on an extensive review of the latest literature concerned, we analyzed and evaluated themethod of the periodontal tissue engineering. Results The development of the periodontal tissue engineering in the fields of the seed cells, modifier genes, cell factors, and scaffold materials provided a brand-new thinking and method for complete regeneration of the eriodontal tissues. Conclusion The periodontal tissue engineering has an excellent future butmany problems still require a further study and a satisfactory solution.
Objective To investigate the effect of astragalus polysaccharides(AP) on chitosan／polylactic acid(AP／C／PLA)scaffolds and marrow stromal cells(MSCs)tissue engineering on periodontal regeneration of horizontal alveolar bone defects in dogs． Methods MSCs were isolatedfrom the bone marrow and then cultured in conditioned medium to be induced to become osteogenic．The MSCs were harvested and implanted into AP／C／PLA and C／PLA scaffolds．A horizontal alveolar bone defect(5 mm depth, 2 mm width)were produced surgically in the buccal side of the mandibular premolar 3 and 4 of 10 dogs．The defects were randomly divided into 4 groups(n=10)：Group A, root planning only(blank contro1); group B, AP／C／PLA with conditioned medium(medium contro1);group C, C／PLA with MSCs(scaffolds contro1); and group D, AP／C／PLA with MSCs(experimental group)．Eight weeks after surgery， block sections of the defects were collected for gross, histological and X-ray analysis. Results MSCs induced in vitro exhibited an osteogenic phenotype with expressingcollagen I and alkaline phosphatase． X-ray film observation showed that the bone density and height had no changes in group A; in group B, the bone density was increased to a certain extent and furcation area reached a few height, but no height was increased in interdental septum; in group C，the bone density was increased and furcation area nearly reached the native height,but interdental septum reached a few height;in group D,the bone density was increased significantly and furcation area and interdental septum reached the native height. Histological evaluation showed that there was greater tissue formation in group D than that in groups A, B and C, in which new alveolar bone, new cementum, periodontal ligament with Sharpey’s fibers, and new bone tissue was similar to native periodontal tissues. Ingroup A，B, C and D respectively, the amount of new alveolar bone regeneration was 0.83±0.30, 1.46±0.55, 2.67±0.26 and 2.90±0.41 mm; new cementum regeneration was 0.78±0.45，1.30±0.60，2.29±0.18 and 2.57±0.22 mm; the amount of connective tissue adhesion was 0.80±0.22，1.33±0.34，2.23±0.42 and 2.64±0.27 mm; all showing significant differenecs between group D and groups A, Band C (Plt;0.05)．Conclusion The technology of tissue engineering with AP／C／PLAscaffolds and induced MSCs may contribute to periodontal regeneration．
Objective To study the biocompatibility of tendon mixedextraction of bovine collagen(tMEBC) and to explore the feasibility of using the threedimensional framework as periodontal tissue engineering scaffold. Methods After being prepared, the tMEBC were cultured with the P4P6 of human periodontal ligament fibroblasts (HPDLFs) in vitro. Threedimensional framework was prepared from bovine tendon. The P4-P6 of HPDLFs (with an initial density of 5×106 cells／ml) were cultured in vitro. Cell attachment andproliferation were measured by cell counting 1 day, 3,5, and 10 days after cell seeding. Histological examination was performed with light microscope and scanning electron microscope 5 and 10 days after cell seeding. Results Porous structure, which supported the proliferation and attachment of HPDLFs, was found in tMEBC. The density of cell increased from 0.556×104 cells／ml 24 hours after cell seeding to 3.944×104 cells／ml 10 days after seeding. Light and scanning electron microscope examinationindicated that HPDLFs were attached and extended on the three-dimensional scaffolds and were well embedded in the newly formed tissue matrix. ConclusiontMEBC has good biocompatibility with the HPDLFs, and can be used as scaffold for cell transplantation in periodontal tissue engineering.
ObjectiveTo systematically evaluate the clinical efficacy of systemic antibiotic combined with non-surgical periodontal therapy for aggressive periodontitis. MethodsWe searched PubMed, EMbase, The Cochrane Library, WanFang Data, CBM, VIP and CNKI databases from inception to January, 2016, to collect randomized controlled trials (RCTs) about non-surgical periodontal therapy combined with systemic antibiotics for aggressive periodontitis. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 8 RCTs involving 236 patients were included. The results of meta-analysis showed, compared with non-surgical periodontal therapy alone, non-surgical periodontal therapy combined with systemic antibiotics showed a significant additional probing depth reduction at 3-, 6- and 12 months follow-up (MD=0.33, 95%CI 0.25 to 0.41, P<0.00001; MD=0.53, 95%CI 0.44 to 0.62, P<0.00001; MD=0.52, 95%CI 0.23 to 0.81, P=0.0004), and a significant clinical attachment gain at 3-, 6- and 12 months follow-up (MD=0.43, 95%CI 0.30 to 0.56, P<0.00001; MD=0.44, 95%CI 0.33 to 0.55, P<0.00001; MD=0.43, 95%CI 0.20 to 0.65, P=0.0002). ConclusionCurrent evidence shows that the treatment of patients with aggressive periodontitis, systemic antibiotic (Metronidazole and Amoxicillin) combined with non-surgical periodontal therapy has a significant additional effect than non-surgical therapy alone. However, because of the limitation of quality and quantity of included studies, the above conclusion still needs to be further proved by conducting more high-quality and large-scale RCTs.
Objective To systematically review the relationship between periodontal disease and gastric cancer risk. Methods We retrieved PubMed, EMbase, CNKI, WanFang Data, VIP, and CBM databases to collect studies about the correlation between periodontal disease and gastric cancer from inception to January 31st, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results Five studies were included. The results of meta-analysis showed that there was no significant correlation between periodontal disease and gastric cancer (RR=0.99, 95%CI 0.83 to 1.19, P=0.93). Sensitivity analysis showed good stability. Subgroup analysis showed that the type of study, race and type of effect size have no statistically impact on the outcome, there was no significant correlation between periodontal disease and gastric cancer. Conclusion According to the current evidence, periodontal disease probably is not a risk factor of gastric cancer. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
ObjectiveTo systematically review the association between periodontal disease and the incidence risk of colorectal cancer (CRC).MethodsPubMed, EMbase, WanFang Data and CNKI databases were searched to collect cohort studies and case-control studies for the association between periodontal disease and the incidence risk of CRC from inception to February 28th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 5 prospective cohort studies were included. The results from adjusted data based meta-analysis showed that the periodontal disease was not associated with the incidence risk of CRC (RR=1.14, 95%CI 0.88 to 1.49, P=0.32).ConclusionsThe current evidence suggests that periodontal disease is not associated with the risk of CRC.
Periodontal disease is a common chronic infectious disease targeting the connective tissue supporting the dentition. In recent years, the research on periodontal disease and cerebral infarction has been increasing. However, the causal relationship between periodontal disease and cerebral infarction remains unclear. Periodontal disease may be associated with atherosclerosis, which is one of the major causes of cerebral infarction. Regular dental care can reduce the risk of cardiovascular disease. Therefore, investigating the above association and its underlying mechanisms is of great clinical significance, which may help clinicians to make appropriate treatment and prevention measures. In this paper, the research progress and possible mechanism of the relationship between periodontal disease and cerebral infarction were reviewed.