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    Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: A randomized clinical trial. Montero Eduardo,López Mercedes,Vidal Honorato,Martínez María,Virto Leire,Marrero Jorge,Herrera David,Zapatero Antonio,Sanz Mariano Diabetes, obesity & metabolism AIM:To determine the impact of periodontal treatment on systemic markers of inflammation in patients with metabolic syndrome (MetS) and periodontitis. MATERIALS AND METHODS:In this parallel-arm, double-blind, randomized controlled clinical trial, 63 patients with MetS and severe periodontitis were randomly assigned to receive either intensive periodontal treatment (IPT; scaling and root planing plus azithromycin 500 mg every day for 3 days) or minimal periodontal treatment (MPT; supragingival professional mechanical plaque removal plus a placebo). The primary outcome was the impact of the tested interventions on high-sensitivity C-reactive protein (hs-CRP) serum levels at 6 months. As secondary outcomes, differences in the levels of cytokines, markers of prothrombotic states, carbohydrate and lipid metabolism, as well as blood pressure, were measured at 3 and 6 months after therapy. RESULTS:The intention-to-treat population consisted of 63 subjects randomly assigned to either the MPT (n = 31) or the IPT (n = 32) group. At baseline, mean hs-CRP was 3.9 mg/L (standard deviation [SD] = 2.9) and 3.9 mg/L (SD = 3.4), respectively, and no significant differences in cardiometabolic risk profiles were detected between the groups. Adjusting for baseline hs-CRP, sex, age, smoking status and body mass index, hs-CRP at 6 months was 1.2 mg/L (95% CI 0.4; 2.0; P = .004) lower in the IPT group than in the MPT group. In the secondary outcomes, significant reductions in IL-1β, TNF-α, HbA1c and blood pressure were observed in the IPT group at 3 months compared with the MPT group. CONCLUSION:Effective periodontal treatment significantly reduced hs-CRP after 6 months in patients with MetS and severe periodontitis. Periodontal therapy might be useful to reduce cardiovascular risk in these patients. 10.1111/dom.14131
    Periodontitis and cardiovascular diseases: Consensus report. Sanz Mariano,Marco Del Castillo Alvaro,Jepsen Søren,Gonzalez-Juanatey Jose R,D'Aiuto Francesco,Bouchard Philippe,Chapple Iain,Dietrich Thomas,Gotsman Israel,Graziani Filippo,Herrera David,Loos Bruno,Madianos Phoebus,Michel Jean-Baptiste,Perel Pablo,Pieske Burkert,Shapira Lior,Shechter Michael,Tonetti Maurizio,Vlachopoulos Charalambos,Wimmer Gernot Journal of clinical periodontology BACKGROUND:In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. MATERIAL AND METHODS:There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations RESULTS AND CONCLUSIONS: The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices. 10.1111/jcpe.13189
    Secular trends in severe periodontitis incidence, prevalence and disability-adjusted life years in five Asian countries: A comparative study from 1990 to 2017. Luo Li-Sha,Luan Hang-Hang,Wu Lan,Shi Yu-Jie,Wang Yong-Bo,Huang Qiao,Xie Wen-Zhong,Zeng Xian-Tao Journal of clinical periodontology AIMS:To investigate secular trends in severe periodontitis incidence, prevalence and disability-adjusted life year (DALY) rates in China, India, Japan, South Korea and Thailand from 1990 to 2017. MATERIALS AND METHODS:Data were obtained from the "Global Burden of Disease Study" 2017. The annual percentage change and average annual percentage change were calculated using Joinpoint regression analysis. The independent age, period and cohort effects were estimated by age-period-cohort analysis. RESULTS:From 1990 to 2017, the overall age-standardized incidence, prevalence and DALY rates increased in China, Japan and India, while decreasing in South Korea and Thailand. The highest incidence, prevalence and DALY rates were in India. By APC analysis, the age effect presented increase in 20-59 years in China, Japan and South Korea, 20-54 years in India and 20-64 years in Thailand; the period effect showed progressive increases in five countries, with the most significant increase shown in China; the cohort effect showed monotonic decreases with birth cohort in five countries. CONCLUSIONS:Severe periodontitis poses a serious burden in Asian countries, especially China and India. We suggest raising people's awareness of periodontal health and providing professional interventions in these countries, especially for high-risk groups, such as younger people aged ≤65 years. 10.1111/jcpe.13447
    [Multidisciplinary treatment for generalized severe periodontitis with malocclusion: a case report]. Cai X,Zhou M Q,Tan L,Cao G F,Wang X F,Chen Z H,Chen X P Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 10.3760/cma.j.cn112144-20200604-00317
    [Consensus of Chinese experts on surgical treatment of severe periodontitis]. Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology According to needs of clinical diagnosis and treatment of periodontal disease in China, the Chinese Stomatological Association initiated the workshop of consensus of Chinese experts on treatment of severe periodontitis by the specialized committee expert group. In February 2017, the first part of the consensus was released [Chin J Stomatol, 2017, 52(2): 67-71]. The present report is the second part of the consensus, regarding the surgical treatment of severe periodontitis. The group believes that after initial treatment and reevaluation, some patients with severe periodontitis, can be considered to be performed with surgical treatment. When clinicians choose surgical treatment, the design of surgical methods should be guided by the objective of the operation. Therefore, in this consensus, Chinese experts put forward the objectives of surigical treatment into two kinds of objective, periodontal debridement and augmentation of periodontal tissue. 10.3760/cma.j.issn.1002-0098.2018.08.002
    [State of the art diagnostic criteria of severe periodontitis]. Ouyang X Y Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology Periodontitis could be categorized as mild, moderate, and severe according to the severity of the disease. This categorizing system could also be used together with other classification systems. The present article introduced the status about the case definition of severe periodontitis, including the standard of case definitions for surveillance of periodontitis reported by the Centers for Disease Control and Prevention (CDC) in partnership with the American Academy of Periodontology (AAP) and the consensus report on the definition of periodontitis case for use in risk factor research by Europe workshop. A consensus on the state of the art definition of severe periodontitis for use in clinical work was gained base on the expertise of Chinese Society of Periodontology, Chinese Association of Stomatology. The background of this consensus and the significance of the criteria for the case definition were discussed. 10.3760/cma.j.issn.1002-0098.2017.02.003