Exam Flashcards
Smoking
18 light icebergs with 2000 cows on 2 to 15 coats. We can change 21 paddles with 12 to 20 rivers of alfalfa 18 feet high. 22 coasts of 18 bud lights jangled 20 ram 17s. 20 times the great yang scott found 22 greener pastures 11 miles past the 22 darts.
18 light icebergs with 2000 cows on 2 to 15 coats. We can change 21 paddles with 12 to 20 rivers of alfalfa 18 feet high. 22 coasts of 18 bud lights jangled 20 ram 17s. 20 times the great yang scott found 22 greener pastures 11 miles past the 22 darts.
Leite 2018
Bergstrom 2000
Calsina 2002
Kotsakis 2015
Chang 2021
Patel 2012
Ravida 2020
Alfadda 2018
Costa 2022
Buduneli 2018
Jiang 2020
Ramoa 2017
Yang 2020
Scott 2022
Greer 2011
Duarte 2022
Diabetes
There are 2000 positions for 13 tailors working on 18 poles at the opera 22 times in 21 roman villages. 18 songs about 97 gross snails were grazing on 18 rich treats at 91-96 west. The 98 tailors made 22 patties, and all the hats needed for 20 years.
There are 2000 positions for 13 tailors working on 18 poles at the opera 22 times in 21 roman villages. 18 songs about 97 gross snails were grazing on 18 rich treats at 91-96 west. The 98 tailors made 22 patties, and all the hats needed for 20 years.
AAP position paper 2000
Taylor 2013
Polak 2018
Chopra 2022
Romano 2021
Sanz 2018
Grossi 1997
Graziani 2018
Emrich 1991
Westfelt 1996
Taylor 1998
Pattayil 2022
Alqahatani 2020
Pregnancy hormones
17 ions saw 14 figure skaters doing 20-21 bends. 18 of them dropped into Orlando 22 times, 96 times more often back when Robert deler in 1994.
17 ions saw 14 figure skaters doing 20-21 bends. 18 of them dropped into Orlando 22 times, 96 times more often back when Robert deler in 1994.
Ionnidou 2017
Shiau 2014
Figuero 2020
Bendek 2021
Daalderop 2018
Orlandi 2022
Offenbacher 1996
Raber-Durlacher 1994
Leite 2018
smoking increases peridoontitis risk by 85%
positive association
review of studies 12 months or longer, but most studies were shorter than 5 years
Did not stratify between light and heavy smokers
Bergstrom 2000
assessed professional musicians over 20 years
smokers had more diseased sites
non smokers had less diseased sites
former smokers were inbetween
smokers had significant bone loss, where former smokers and non smokers did not
limited smokers in the sample size
Calsina 2002
smokers had a greater likelehood of established periodontal disease, and former smokers were inbetween
1-10 was 2.3X, 11-30 was 4X, 30+ was 12X risk
cross sectional study
population was periodontal private practice patients
Kotsakis 2015
smokers had less favorable reaction to surgical therapy
the differences are not clinically relevant
smokers are still candidates for surgical therapy, however they may have diminished results
Chang 2021
smokers had less reduction in non-surgical therapy, especially in deeper sites
differences are not clinically significant
Patel 2012
smoking had a negative effect on bone regeneration
There was a lot of heterogeneity in the regeneration procedures
smoking was not always the primary focus of the studies
Ravida 2020
The wash out period of smoking cessation before periodontal risks reverted to non smoker is 15 years for tooth loss
retrospective study so some bias expected
Alfadda 2018
smokers have a higher rate of implant failure
systematic review
failure rate of 8.3% vs 4.3%
Costa 2022
peri-implantitis is more frequent in current smokers than non smokers
cumulative smoking exposure and shorter smoking cessation is important
30% rate for smokers vs 19 and 18% for former smokers and non-smokers
cross sectional study
did not evaluate different implant surfaces
Buduneli 2018
oxygen tension decreased which could affect vascular responsiveness
vasoconstriction in the arteries is counteracted by increase in BP, so flow is similar
higher number of micro vessels with lower internal circumference in oral tissues
Jiang 2020
initial studies found no difference in oral microflora, but more recent studies with 16S sequencing did
More periopathogens were found even in areas with no evidence of disease
more established periopathogens are likely responsible for periodontal disease progression and poorer treatment results
Ramoa 2017
waterpipes have similar effect as cigarettes
ecigarettes are very limited studies, and have very heterogenic compounds in them so are challenging to study
different voltages make a very different vapour
Yang 2020
ecigarettes have some health impact such as oral irritation
weak or moderate evidence of deterioration of periodontal tissues
increase in plaque index
Scott 2022
There is some evidence of improvement in periodontal parameters from cannabis, such as improvement in inflammasomes and cannabinoid interactions
Still direct toxicity to the cells, and immune alterations
most studies are confounded with cigarette smoking.
Greer 2011
smokeless tobacco has a limited cancer risk
risk of periodontitis, gingival and alveolar bone damage, delayed wound healing, keratosis
Duarte 2022
smoking cessation does benefit the outcome of non-surgical therapy, however it takes 15 years to reach the end of the wash out period
AAP position paper 2000
diabetic patients are more likely to have periodontal disease and bone loss
PMN function is reduced, with reduced chemotaxis, adherence, and phagocytosis
fibroblast proliferation is reduced with less collagen
doxycycline is the preferred abx
long lasting insulin (bovine) vs short acting insulin (human)
Taylor 2013
IL1beta, TNF alpha, IL6, OPG, RANKL are altered in poor diabetic control
does not seem to alter microbiota
AGEs are inflammatory too, and when bound to RAGE alter phenotype, enhancing oxidative stress
Polak 2018
periodontitis control can affect HbA1c
uncertain mechanism
treatment does have a limited short term effect
Chopra 2022
AGE levels in the GCF are higher in individuals with DM and periodontitis compared to healthy controls.
periodontitis itself dose contribute to AGE
cross sectional design study
Romano 2021
bidirectional evidence of glycemic control and periodontitis.
cross sectional study
data calculated both ways
Sanz 2018
patients with periodontitis have elevated HbA1c prior to developing diabetes
tehreapy is safe and effective in reducing HbA1c
the difference is mostly gone at 6 months
Grossi 1997
study showing that periodontal therapy can improve HbA1c.
Very short trial
Doxycycline may be beneficial
Graziani 2018
AAP-EFP position paper
individuals with periodontitis have poorer glycemic control, and diabetic patients with periodontitis have poorer glycemic control
most evidence for T2DM
Emrich 1991
Pima Indian cross sectional study
diabetes increases the risk of periodontal disease
severity of periodontal disease is related to T2DM
panoramic images used for study, and % bone loss rather than mm
Westfelt 1996
very poorly controlled HbA1c initially (10+)
clinical parameters improved in both diabetic and non-diabetic groups
Taylor 1998
more severe bone loss progression in T2DM patients over 2 years
based off quartile categorization which may be misleading
Pattayil 2022
the periodontally inflamed surface was correlated with HbA1c level
insulin group had better glycemic control than the diabetic medication group
Alqahtani 2020
peri-implant parameters were worse among patients with T2DM than without, and that poor glycemic control was a greater risk mediator for implant inflammation than smoking
Ionnidou 2017
differences between males and females is genetic or hormonal
males are more prone to infection, women to autoimmune
testosterone and progesterone are anti-inflammatory, estrogen pro-inflammatory
women are more likely to be depressed, smoke, diabetes, HTTN, but have better OH
microbiome is different
Shiau 2014
estrogen deficiency with early menopause associated with rapid bone loss
post-menopausal women on estrogen are half as likely to have periodontal disease then those not on estrogen
Tamoxifen (estrogen blocker) can reduce bone healing and osseointegration
Figuero 2020
review of periodontitis and adverse pregnancy outcoems
unclear if it is a direct pathway of bacteria or inflammatory mediator driven
preterm birth, pre-eclampsea, low birth weight, spontaneous abortion are more likely with periodontal disease
Bendek 2021
high rate of gingivitis during pregnancy, that can lead to CAL
pregnancy granulomas are prevalent
periodontitis leads to a signfiicant increase in gestational diabetes, which increases T2Dm risk in the future
extracellular vessicles transmit information from the periodontum to the placenta
Daalderop 2018
review of systematic reviews
consistent positive association between periodontal disease and preterm birth, possibly with a dose dependent relationship
inconsistency in definitions between reviews
Orlandi 2022
periodontal therapy improved many health parameters, reduced pro-inflammatory mediators
There did seem to he an effect on preterm deliveries
data was very homogenous
Offenbacher 1996
mothers who had preterm birth, preeclampsia, low birth weight had significantly more periodontitis than matched controls
unclear what the periodontal status was throughout pregnancy or prior to. no inflammatory information
Raber-Durlacher 1994
during pregnancy experimentally created gingivitis persisted much longer than post partum in the same patients
this suggests hormones play a signifciant role, not just bacteria
