Objectives Periodontitis and diabetes are known to have a bidirectional relationship. Diabetic macular edema is a complication of diabetes that is strongly influenced by inflammatory pathways. However, it remains to be established whether inflammation at other locations, such as periodontitis, affects diabetic macular edema. Here, we investigated the prevalence of periodontitis in patients treated for diabetic macular edema. Materials and methods Patients with diabetic macular edema were recruited for this cross-sectional study at the Medical University of Graz. Macular edema was documented by optical coherence tomography. Periodontal status was assessed by computerized periodontal probing and panoramic X-ray imaging. Bleeding on probing, clinical attachment level, probing pocket depth, and plaque index were compared between different stages of diabetic retinopathy. Results Eighty-three eyes of 45 patients with diabetic macular edema were enrolled. Forty-four eyes (53.0%) had early stages of diabetic retinopathy (mild and moderate), and 39 eyes (47.0%) had late stages (severe and proliferative). Patients with mild or moderate DR were more likely to have more severe periodontal conditions than patients with severe or proliferative DR. Fourteen patients with mild DR (82.4%), 7 patients with moderate DR (87.5%), 4 patients with severe DR (100.0%), and 15 patients with proliferative DR (93.8%) had some degree of PD. The periodontal inflamed surface areas and the percentages of tooth sites that bled on probing were significantly higher in patients with early stages of diabetic retinopathy than in those with late stages of the disease (p < 0.05). Patients with periodontal inflamed surface areas of more than 500 mm2 required significantly more intravitreal injections in the last year than those with milder forms of periodontitis (n = 6.9 ± 3.1 versus n = 5.0 ± 3.5, p = 0.03). Conclusion In patients with diabetic macular edema, periodontitis is more prevalent in early stages of diabetic retinopathy. We suggest regular dental check-ups for diabetic patients, especially when diabetic macular edema is already present. Clinical relevance Patients with diabetic macular edema should be screened for periodontitis and vice versa, particularly early in the course of diabetes.

Background and aims:Observational studies support an association between periodontitis and cardiovascular diseases. The study objective was to assess vascular inflammation after periodontal treatment in patients with peripheral arterial disease. Methods: Ninety patients with peripheral arterial disease (PAD) and severe periodontitis were enrolled in a randomized, controlled trial. Thirty patients underwent non-surgical periodontal therapy and received additional systemic antibiotics (PT1 group), while 30 patients received the same therapy without antibiotics (PT2 group). The remaining thirty patients did not receive periodontal therapy (CG, control group). The primary outcome of this treatment was a reduction in vascular inflammation three months after periodontal treatment as determined by 18 F-FDG PET/CT values. Secondary outcomes were changes in the inflamed periodontal surface area (PISA) and other periodontal parameters, changes in vascular biomarkers, and adverse cardiovascular events. Results: After three months of treatment, a significant improvement in periodontal health was observed in the treatment groups. However, no difference in the primary outcome in the aorta was observed in the three study groups (median target to background ratio follow-up/baseline, PT1 1.00; 95% CI 0.97-1.10, PT2 1.00; 95% CI 0.98-1.1, CG 1.1; 95% CI 0.99-1.1, p = 0.75). No significant differences were detected in most diseased segments and active segments. In addition, no differences were observed in 18 F-FDG uptake in the carotid, iliac, femoral, and popliteal arteries. No differences with regard to relative changes in vascular biomarkers were noted, and no serious cardiovascular adverse events occurred. Conclusions: Periodontal treatment was effective and safe but did not reduce vascular inflammation in patients with PAD.

Objectives Periodontal disease occurs frequently in patients with limited cutaneous systemic sclerosis (lcSSc) while data about underlying pathways contributing to periodontal changes are scarce. The aim of this study was to evaluate periodontal disease and to investigate its association with endothelial dysfunction and clinical changes in patients with lcSSc. Methods In 38 lcSSc patients and 38 controls, periodontal status was evaluated by disease‐specific questionnaire, dental examination including bleeding on probing (BOP), pocket depth, and plaque index, and dental panoramic radiograph. Periodontopathogen bacteria were collected subgingivally using paper points and interleukin‐1 (IL‐1) gene polymorphisms were evaluated using buccal swabs. Endothelial dysfunction was measured by flow‐mediated dilatation, pulse‐wave velocity and biochemical analysis, including arginine metabolites and endothelial microparticles. Additionally, lcSSc‐specific clinical changes and parameters were recorded. Results Periodontitis was present in 31 patients with lcSSc (81.6%) and in 27 controls (71.1%) (p = .280). LcSSc patients had a lower teeth number (p = .039) and Eikenella corrodens was to a higher degree detectable in patients with lcSSc (p = .041) while the remaining periodontal parameters revealed no differences between both cohorts. Significant correlations between parameters of arterial stiffness, EUSTAR index, number of teeth and BOP were observed (all p < .05). Detection of Prevotella intermedia was associated with selected IL‐1 gene polymorphisms (p = .032) and Porphyromonas gingivalis was associated with severe periodontitis (p = .041). Conclusion Periodontal disease may occur frequently in patients with lcSSc and may be associated with arterial stiffness and with SSc activity.

Background : Several studies have compared different materials with each other in order to find suitable materials for dental implants, abutments, healing abutments, and fixed dentures. Many of these have focused on biological complications and have compared titanium (Ti) and zirconia (ZrO2) as material. In addition to ZrO2-based and Ti-based materials, research is increasingly being conducted on polymethylmethacrylate (PMMA) as a material for fixed dentures or healing abutments.Aim/Hypothesis : Aim of this prospective study was to compare the effect of different abutments materials (Ti, Zr, PMMA) on marginal bone loss (MBL) one-year post-loading. The hypothesis was that there is no difference in MBL.Material and Methods : 30 subjects received two-piece titanium implants in single-tooth gaps and were randomized into 3 groups. After a submerged healing period of 3 months, healing abutments made of titanium, zirconia or PMMA (group 1-3) were placed. 3 months after implant exposure, Ti and Zr group received permanent all-ceramic restoration with Ti or Zr abutments. The PMMA group received a provisional PMMA restoration. 3 and 15 months after implant exposure (baseline), intraoral digital radiographs (Sirona D3507, Sirona Dental Systems GmbH, Bensheim, Germany) with rectangular collimation were obtained to measure the mesial and distal bone loss around each implant. All radiographs were investigated in twofold magnification for evaluability by two experienced investigators, not involved in the clinical procedure, and statistically analysed. MBL was calculated as the difference between the bone levels, where negative MBL values indicate a bone loss.Results : The titanium group (group 1) had a mean MBL of -0.09 ± 0.33 mm, whereas the bone losses of PMMA (group 3) resulted in -0.16 ± 0.22 mm and MBL of the Zr group (group 2) showed the highest results -0.38 ± 0.33 mm. MBL values showed differences between Ti group (group 1) and the two other groups. PMMA (group 3) showed slightly better values than Zr (group 2), whereby this difference is not significant (one-factorial analysis of variance with P = 0.106 for the change from 3 to 15 months). Marginal bone loss 12 month after loading is displayed as a boxplot graph, too. Conclusion and Clinical Implications: Only studies comparing Ti and Zr abutments exist. 1-year results of Hosseini et al. showed similar MBL for Ti and Zr abutments; De Albornoz et al. found minimal mean peri-implant bone level changes at 1 year. Our results showed that MBL were comparable to the results of other publications. Thus, all materials seem appropriate as healing abutments and abutments concerning MBL.Further long-term investigations are necessary prior to application of PMMA as abutment material.