Management of systemic risk factors ahead of dental implant therapy: A beard well lathered is half shaved

AimsTo report the 6-year incidence of optical coherence tomography (OCT)-derived age-related changes in drusen volume and related systemic and ocular associations.MethodsChinese adults aged 40 years and older were assessed at baseline and 6 years with colour fundus photography (CFP) and spectral domain (SD) OCT. CFPs were graded for age-related macular degeneration (AMD) features and drusen volume was generated using commercially available automated software.ResultsA total of 4172 eyes of 2580 participants (mean age 58.12±9.03 years; 51.12% women) had baseline and 6-year follow-up CFP for grading, of these, 2130 eyes of 1305 participants had gradable SD-OCT images, available for analysis. Based on CFP grading, 136 (3.39%) participants developed incident early AMD and 10 (0.25%) late AMD. Concurrently, retinal pigment epithelial-Bruch’s membrane (RPE-BrC) volumes decreased, remained stable and increased in 6.8%, 78.5% and 14.7%, respectively, over 6 years. In eyes where RPE-BrC volumes were >0 mm3 at baseline, this was associated with two-fold higher prevalence rate of any AMD at baseline (p<0.001). Multivariable analysis showed that when compared with eyes where RPE-BrC volume was unchanged, volume decrease was significantly associated with older age (OR=1.30; p<0.001), smoking (OR=2.21; p=0.001) and chronic kidney disease (OR=3.4, p=0.008), while increase was associated with older age (OR=1.36; p<0.001) and hypertension (OR=1.43; p=0.016).ConclusionAMD incidence detected at 6 years on CFP and correlated OCT-derived drusen volume measurement change is low. Older age and some systemic risk factors are associated with drusen volume change, and our data provide new insights into relationship between systemic risk factors and outer retinal morphology in Asian eyes.

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Should the quality of glycemic control guide dental implant therapy in patients with diabetes? Focus on implant survival

Current Diabetes Reviews ◽

10.2174/1573399817666210806120300 ◽

2021 ◽

Vol 17 ◽

Author(s):

Dalia Nourah ◽

Salwa Aldahlawi ◽

Sebastiano Andreana

Keyword(s):

Risk Factors ◽

Glycemic Control ◽

Dental Implant ◽

Failure Rate ◽

Implant Failure ◽

Diabetic Patients ◽

Marginal Bone Loss ◽

Good Glycemic Control ◽

Implant Therapy

Introduction: Optimal glycemic control is crucial to dental implant long-term functional and esthetic success. Despite HbA1c levels of 7% or lower used as an indicator for good glycemic control, however, this level may not be attainable for all diabetic patients. Most dentists do not consider patients with poor glycemic control candidates for implant therapy due to higher implant failure, infection or other complications. Aim: This review challenges the concept of one size fits all and aims to critically appraise the evidence for the success or failure rate of dental implants and peri-implant health outcomes in patients with less-than-optimal glycemic control. Discussion: Evidence suggests that estimating glycemic control from HbA1c measurement alone is misleading. Moreover, elevated preoperative HbA1c was not associated with increased mortality and morbidity after major surgical procedures. Literature for the survival or success of implants in diabetic patients is inconsistent due to a lack of standardized reporting of clinical data collection and outcomes. While a number of studies report that implant treatment in patients with well-controlled diabetes has a similar success rate to healthy individuals, other studies suggest that the quality of glycemic control in diabetic patients does not make a difference in the implant failure rate or marginal bone loss. This discrepancy could indicate that risk factors other than hyperglycemia may contribute to the survival of implants in diabetic patients. Conclusion: In the era of personalized medicine, the clinician should utilize individualized information and analyze all risk factors to provide the patient with evidence-based treatment options.

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Systemic and Genetic Risk Factors in Diabetic Retinopathy and Diabetic Macular Edema

Güncel Retina Dergisi (Current Retina Journal) ◽

10.37783/crj-0077 ◽

2018 ◽

pp. 102-107

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Systemic Risk ◽

Genetic Effect ◽

Current Treatment ◽

Genetic Studies ◽

Patient Subgroups ◽

Systemic Risk Factors

Diabetic retinopathy (DR) is an increasingly common health problem in our country as it is all over the world. DR is a leading cause of loss of vision patients at a productive age. Current treatment of diabetic macular edema (DME) is distressing, expensive, and not suitable for some patient subgroups. For this reason, the development and progression of DR and DME are affected by many systemic risk factors. It is important to increase the understanding of these responsible risk factors and develop preventive strategies. However, the presence of systemic risk factors is inadequate to predict the progression of the disease on an individual basis. It indicates the presence of a genetic effect. In this review, we have summarized the known systemic risk factors as well as the genetic basis of the disease under the light of genetic studies.

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