151
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Preus HR, Gjermo P, Baelum V. A Randomized Double-Masked Clinical Trial Comparing Four Periodontitis Treatment Strategies: 5-Year Tooth Loss Results. J Periodontol 2016; 88:144-152. [PMID: 27767387 DOI: 10.1902/jop.2016.160332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tooth loss is the ultimate negative consequence of periodontitis, and reports of the extent to which different treatment strategies may influence long-term tooth loss are hard to find. This study aims to test the hypothesis that there is no difference in 5-year clinical outcome of therapy in terms of tooth mortality between groups of patients treated with conventional scaling and root planing (SRP) over weeks or same-day full-mouth disinfection (FDIS), with or without adjunctive metronidazole (MET). METHODS One hundred eighty-four patients with moderate-to-severe periodontitis were randomly allocated to one of four treatment groups: 1) FDIS+MET; 2) FDIS+placebo; 3) SRP+MET; and 4) SRP+placebo. Total 161 patients (88%) completed the 5-year follow-up examination, and data on number and timing of tooth extractions as well as pre-extraction diagnoses and reasons for extractions were analyzed. RESULTS No differences were observed between groups with regard to number of, reasons for, or time of extractions in the four groups at baseline and 1, 3, and 5 years after treatment. CONCLUSION If extraction or retention of teeth is regarded as a measure of failure or success 5 years after completion of periodontal therapy, none of the four strategies produced an end result better than the other.
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Affiliation(s)
- Hans R Preus
- Department of Periodontology, Faculty of Dentistry, Institute of Clinical Odontology, University of Oslo, Oslo, Norway
| | - Per Gjermo
- Department of Periodontology, Faculty of Dentistry, Institute of Clinical Odontology, University of Oslo, Oslo, Norway
| | - Vibeke Baelum
- Department of Dentistry Health, Aarhus University, Aarhus, Denmark
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152
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Pretzl B, Eickholz P, Saure D, Pfefferle T, Zeidler A, Dannewitz B. Endodontic status and retention of molars in periodontally treated patients: results after 10 or more years of supportive periodontal therapy. J Clin Periodontol 2016; 43:1116-1123. [PMID: 27570936 DOI: 10.1111/jcpe.12621] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the influence of endodontic status on retention of molars in patients under supportive periodontal treatment (SPT). MATERIAL & METHODS A total of 136 subjects with 1015 molars at baseline were examined retrospectively, including 188 endodontically treated molars in 90 patients. Multilevel Cox regression analysis identified factors contributing to loss of molars. RESULTS Root canal treatments contributed significantly to loss of molars during on average 13.2 years of SPT (Hazard ratio: 2.98, 95% CI: 1.74-5.1, p < 0.001). Endodontic treatment was more frequently present in first molars (p < 0.001) and in the maxilla (p = 0.01). In endodontically treated molars, degree III furcation involvement could be detected more often compared to molars without root canal treatment (p < 0.001). Among the root canal-treated molars, several patient and tooth-related factors showed an impact on tooth retention, but only molars with a periapical index of 4 and 5 (labelled "diseased") were significantly more often lost. CONCLUSION The retention of molars in periodontally compromised patients after periodontal treatment is influenced by periodontal as well as endodontal factors. On a long-term basis, it is feasible to retain these teeth via active periodontal treatment and SPT for more than 10 years.
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Affiliation(s)
- Bernadette Pretzl
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Daniel Saure
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Heidelberg, Germany
| | - Thorsten Pfefferle
- Section of Endodontics and Dental Traumatology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Zeidler
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Bettina Dannewitz
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.,Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany.,Private Dental Practice, Weilburg, Germany
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153
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Renvert S, Persson GR. Treatment of periodontal disease in older adults. Periodontol 2000 2016; 72:108-19. [DOI: 10.1111/prd.12130] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 12/20/2022]
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154
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Heitz-Mayfield LJA, Salvi GE, Mombelli A, Loup PJ, Heitz F, Kruger E, Lang NP. Supportive peri-implant therapy following anti-infective surgical peri-implantitis treatment: 5-year survival and success. Clin Oral Implants Res 2016; 29:1-6. [DOI: 10.1111/clr.12910] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Lisa J. A. Heitz-Mayfield
- International Research Collaborative; Faculty of Science; The University of Western Australia; Perth WA Australia
- Perth Periodontal Specialists; Perth WA Australia
| | | | - Andrea Mombelli
- School of Dental Medicine; The University of Geneva; Geneva Switzerland
| | - Pierre-Jean Loup
- School of Dental Medicine; The University of Geneva; Geneva Switzerland
| | - Fritz Heitz
- Perth Periodontal Specialists; Perth WA Australia
| | - Estie Kruger
- International Research Collaborative; Faculty of Science; The University of Western Australia; Perth WA Australia
| | - Niklaus P. Lang
- Center for Dental Medicine; University of Zurich; Zurich Switzerland
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155
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Avila-Ortiz G, De Buitrago JG, Reddy MS. Periodontal regeneration - furcation defects: a systematic review from the AAP Regeneration Workshop. J Periodontol 2016; 86:S108-30. [PMID: 25644295 DOI: 10.1902/jop.2015.130677] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this review is to present the available evidence regarding the effectiveness of different regenerative approaches for the treatment of furcation defects in specific clinical scenarios compared with conventional surgical therapy to provide clinical guidelines for the therapeutic management of furcation defects and to identify priorities for future research that may advance the understanding of periodontal regenerative medicine. METHODS A comprehensive search based on predetermined eligibility criteria was conducted to identify human original studies and systematic reviews on the topic of periodontal regeneration of furcation defects. Two reviewers independently screened the title and abstract of the entries yielded from the initial search. Subsequently, both reviewers read the full-text version of potentially eligible studies, made a final article selection, and extracted the data of the selected studies considering specific clinical scenarios. The clinical scenarios contemplated in this review included the following: 1) facial and interproximal Class I defects in maxillary molars; 2) facial and lingual Class I defects in mandibular molars; 3) facial and interproximal Class II furcation defects in maxillary molars; 4) facial and lingual Class II furcation defects in mandibular molars; 5) Class III furcation defects in maxillary molars; 6) Class III furcation defects in mandibular molars; and 7) Class I, II, or III furcation defects in maxillary premolars. Endpoints of interest included different clinical, radiographic, microbiologic, histologic, and patient-reported outcomes. RESULTS The initial search yielded a total of 1,500 entries. The final selection consisted of 150 articles, of which six were systematic reviews, 109 were clinical trials, 27 were case series, and eight were case reports. A summary of the main findings of previously published systematic reviews and the available evidence relative to the indication of regenerative approaches for the treatment of furcation defects compared with conventional surgical therapy are presented. Given the marked methodologic heterogeneity and the wide variety of materials and techniques applied in the selected clinical trials, the conduction of a meta-analysis was not viable. CONCLUSIONS On the basis of the reviewed evidence, the following conclusions can be drawn. 1) Periodontal regeneration has been demonstrated histologically and clinically for the treatment of maxillary facial or interproximal and mandibular facial or lingual Class II furcation defects. 2) Although periodontal regeneration has been demonstrated histologically for the treatment of mandibular Class III defects, the evidence is limited to one case report. 3) Evidence supporting regenerative therapy in maxillary Class III furcation defects in maxillary molars is limited to clinical case reports. 4) In Class I furcation defects, regenerative therapy may be beneficial in certain clinical scenarios, although most Class I furcation defects may be successfully treated with non-regenerative therapy. 5) Future research efforts should be primarily directed toward the conduction of clinical trials to test novel regenerative approaches that place emphasis primarily on patient-reported outcomes and also on histologic demonstration of periodontal regeneration. Investigators should also focus on understanding the influence that local, systemic, and technical factors may have on the outcomes of regenerative therapy in furcation defects.
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156
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Armitage GC, Xenoudi P. Post-treatment supportive care for the natural dentition and dental implants. Periodontol 2000 2016; 71:164-84. [DOI: 10.1111/prd.12122] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2015] [Indexed: 12/11/2022]
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157
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Chee B, Park B, Fitzsimmons T, Coates AM, Bartold PM. Omega-3 fatty acids as an adjunct for periodontal therapy-a review. Clin Oral Investig 2016; 20:879-94. [PMID: 26885664 DOI: 10.1007/s00784-016-1750-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/10/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this article is to present an overview of omega-3 fatty acids, their anti-inflammatory properties and potential use as an adjunct for periodontal therapy. MATERIALS AND METHODS A general literature search was conducted to provide an overview of omega-3 fatty acids, their metabolism and anti-inflammatory properties. A more specific literature search of PubMed and EMBASE was conducted to identify articles dealing studies investigating the effects of omega-3 fatty acids in the treatment of periodontitis in animals and humans and included cross-sectional, longitudinal and intervention designs. RESULTS To date, there is good emerging evidence that dietary supplementation with fish oil may be of some benefit and this is enhanced if combined with aspirin. All clinical intervention studies to date have been on small sample sizes, and this indicates there is need for larger and more robust clinical trials to verify these initial findings. CONCLUSIONS Dietary supplementation with fish oil could be a cost-effective adjunctive therapy to the management of periodontal disease. CLINICAL RELEVANCE The host modulatory properties of omega-3 fatty acids warrant further assessment of their use as an adjunct in the management of periodontitis.
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Affiliation(s)
- B Chee
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - B Park
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - T Fitzsimmons
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - A M Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - P M Bartold
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia.
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158
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Nibali L, Zavattini A, Nagata K, Di Iorio A, Lin GH, Needleman I, Donos N. Tooth loss in molars with and without furcation involvement - a systematic review and meta-analysis. J Clin Periodontol 2016; 43:156-66. [DOI: 10.1111/jcpe.12497] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Luigi Nibali
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
- Clinical Oral Research Centre; Institute of Dentistry; Queen Mary University London (QMUL); London UK
| | - Angelo Zavattini
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - Kohji Nagata
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC; Institute of Dentistry; University of Turku; Turku Finland
- Department of Removable Partial Prosthodontics Rehabilitation; Tokyo Medical and Dental University; Tokyo Japan
| | - Anna Di Iorio
- Library Services; UCL Eastman Dental Institute; London UK
| | - Guo-Hao Lin
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
| | - Ian Needleman
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - Nikos Donos
- Clinical Oral Research Centre; Institute of Dentistry; Queen Mary University London (QMUL); London UK
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159
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Dannewitz B, Zeidler A, Hüsing J, Saure D, Pfefferle T, Eickholz P, Pretzl B. Loss of molars in periodontally treated patients: results 10 years and more after active periodontal therapy. J Clin Periodontol 2016; 43:53-62. [PMID: 26660235 DOI: 10.1111/jcpe.12488] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2015] [Indexed: 01/17/2023]
Abstract
AIM To identify risk factors for loss of molars during supportive periodontal therapy (SPT). MATERIALS AND METHODS A total of 136 subjects with 1015 molars at baseline were examined retrospectively. The association of risk factors with loss of molars was assessed using a multilevel Cox regression analysis. Furcation involvement (FI) was assessed clinically at start of periodontal therapy and assigned according to Hamp et al. (1975). RESULTS Fifty molars were extracted during active periodontal therapy (APT) and 154 molars over the average SPT period of 13.2 ± 2.8 years. FI degree III (HR 4.68, p < 0.001), baseline bone loss (BL) > 60% (HR 3.74, p = 0.009), residual mean probing pocket depth (PPD, HR 1.43, p = 0.027), and endodontic treatment (HR 2.98, p < 0.001) were identified as relevant tooth-related factors for loss of molars during SPT. However, mean survival time for molars with FI III or BL > 60% were 11.8 and 14.4 years, respectively. Among the patient data, age (HR 1.57, p = 0.01), female gender (HR 1.99, p = 0.035), smoking (HR 1.97, p = 0.034), and diabetes mellitus (HR 5.25, p = 0.021) were significant predictors for loss of molars. CONCLUSION Overall, periodontal therapy results in a good prognosis of molars. Degree III FI, progressive BL, endodontic treatment, residual PPD, age, female gender, smoking, and diabetes mellitus strongly influence the prognosis for molars after APT.
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Affiliation(s)
- Bettina Dannewitz
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.,Private Dental Practice, Weilburg, Germany
| | - Anna Zeidler
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Johannes Hüsing
- Coordination Centre for Clinical Trials (KKS), University of Heidelberg, Heidelberg, Germany
| | - Daniel Saure
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Thorsten Pfefferle
- Section of Endodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Bernadette Pretzl
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
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160
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Tomita S, Uekusa T, Hosono M, Kigure T, Sugito H, Saito A. Periodontist-Dental Hygienist Collaboration in Periodontal Care for Chronic Periodontitis: An 11-year Case Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2016; 58:177-186. [PMID: 28954953 DOI: 10.2209/tdcpublication.2016-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report a case of severe chronic periodontitis treated and longitudinally maintained by a periodontist and dental hygienists. The patient was a 45-year-old woman who presented with the chief complaint of gingival bleeding and tooth mobility. An initial examination revealed generalized gingival inflammation and subgingival calculus in the premolar and molar regions. Premature contact was observed in #14 and 45. Clinical examination revealed 42% of sites with a probing depth (PD) of ≥4 mm and 44% of sites with bleeding on probing. Radiographic examination revealed vertical bone resorption in #35, 36, and 45, and horizontal bone resorption in other regions. Based on a clinical diagnosis of severe chronic periodontitis, initial periodontal therapy consisting of plaque control, scaling and root planing, and removal of an ill-fitting prosthesis was performed. Following suppression of inflammation, occlusal adjustment of premature contact sites was performed. Open flap debridement was performed for teeth with a PD of ≥5 mm. After confirming the stability of the periodontal tissue, final prostheses were placed on #16, 35-37, and 46. Following re-evaluation, the patient was placed on supportive periodontal therapy. It has been 11 years since the patient's first visit, and the periodontal conditions have remained stable. Meticulous periodontal care maintained over a number of years by a periodontist and dental hygienist have yielded a clinically favorable outcome.
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Affiliation(s)
| | - Tomomi Uekusa
- Section of Dental Hygiene, Tokyo Dental College Chiba Hospital
| | - Meiko Hosono
- Section of Dental Hygiene, Tokyo Dental College Chiba Hospital
| | | | - Hiroki Sugito
- Department of Endodontics and Clinical Cariology, Tokyo Dental College
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161
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Lim HC, Jeon SK, Cha JK, Lee JS, Choi SH, Jung UW. Prevalence of Cervical Enamel Projection and Its Impact on Furcation Involvement in Mandibular Molars: A Cone-Beam Computed Tomography Study in Koreans. Anat Rec (Hoboken) 2015; 299:379-84. [DOI: 10.1002/ar.23301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/06/2015] [Accepted: 11/01/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, School of Dentistry; Kyung Hee University; Seoul South Korea
| | - Seok-Kyun Jeon
- Department of Periodontology; Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University; Seoul South Korea
| | - Jae-Kook Cha
- Department of Periodontology; Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University; Seoul South Korea
| | - Jung-Seok Lee
- Department of Periodontology; Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University; Seoul South Korea
| | - Seong-Ho Choi
- Department of Periodontology; Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University; Seoul South Korea
| | - Ui-Won Jung
- Department of Periodontology; Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University; Seoul South Korea
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162
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Monje A, Aranda L, Diaz KT, Alarcón MA, Bagramian RA, Wang HL, Catena A. Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis. J Dent Res 2015; 95:372-9. [PMID: 26701350 DOI: 10.1177/0022034515622432] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
At the present time, peri-implantitis has become a global burden that occurs with a frequency from 1% to 47% at implant level. Therefore, we aimed herein at assessing the impact of peri-implant maintenance therapy (PIMT) on the prevention of peri-implant diseases. Electronic and manual literature searches were conducted by 3 independent reviewers using several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles up to June 2015 without language restriction. Articles were included if they were clinical trials aimed at demonstrating the incidence of peri-implant diseases under a strict regime or not of PIMT. Implant survival and failure rate were studied as secondary outcomes. A meta-analysis was conducted to evaluate the influence of PIMT and other reported variables upon peri-implant diseases. Thirteen and 10 clinical trials were included in the qualitative and quantitative analysis, respectively. Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. Similarly, significant effects of history of periodontal disease were obtained for peri-implantitis for both implant and patient levels. Furthermore, mean PIMT interval was demonstrated to influence the incidence of peri-implantitis at implant but not patient level. PIMT interval showed significance at both levels. For implant survival, implants under PIMT have 0.958 the incident event than those with no PIMT. Within the limitations of the present systematic review, it can be concluded that implant therapy must not be limited to the placement and restoration of dental implants but to the implementation of PIMT to potentially prevent biologic complications and hence to heighten the long-term success rate. Although it must be tailored to a patient's risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of 5 to 6 mo. Additionally, it must be stressed that even in the establishment of PIMT, biologic complications might occur. Thus, patient-, clinical-, and implant-related factors must be thoroughly explored.
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Affiliation(s)
- A Monje
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - L Aranda
- Department of Periodontology and Implant Dentistry, Cayetano Heredia Peruvian University, Lima, Perú
| | - K T Diaz
- Department of Oral Implantology, Cayetano Heredia Peruvian University, Lima, Perú
| | - M A Alarcón
- Department of Periodontology and Implant Dentistry, Cayetano Heredia Peruvian University, Lima, Perú
| | - R A Bagramian
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - H L Wang
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - A Catena
- Department of Experimental Psychology, University of Granada, Granada, Spain
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163
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Farooqi OA, Wehler CJ, Gibson G, Jurasic MM, Jones JA. Appropriate Recall Interval for Periodontal Maintenance: A Systematic Review. J Evid Based Dent Pract 2015; 15:171-81. [PMID: 26698003 PMCID: PMC4848042 DOI: 10.1016/j.jebdp.2015.10.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES A systematic review of the literature was undertaken to assess the evidence to support a specific time interval between periodontal maintenance (PM) visits. METHODS Relevant articles were identified through searches in MEDLINE, EMBASE and PubMed using specific search terms, until April, 2014, resulting in 1095 abstracts and/or titles with possible relevance. Critical Appraisal Skills Programme (CASP) guidelines were used to evaluate the strength of studies and synthesize findings. If mean recall interval was not reported for study groups, authors were contacted to attempt to retrieve this information. RESULTS Eight cohort studies met the inclusion criteria. No randomized control trials were found. All included studies assessed the effect of PM recall intervals in terms of compliance with a recommended regimen (3-6 months) as a primary outcome. Shorter PM intervals (3-6 months) favored more teeth retention but also statistically insignificant differences between RC and IC/EC, or converse findings are also found. In the 2 studies reporting mean recall interval in groups, significant tooth loss differences were noted as the interval neared the 12 month limit. CONCLUSIONS Evidence for a specific recall interval (e.g. every 3 months) for all patients following periodontal therapy is weak. Further studies, such as RCTs or large electronic database evaluations would be appropriate. The merits of risk-based recommendations over fixed recall interval regimens should be explored.
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Affiliation(s)
| | - Carolyn J Wehler
- VA Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA; Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
| | - Gretchen Gibson
- Veterans Health Care System of the Ozarks, Dental (160), Fayetteville, AR 72703, USA
| | - M Marianne Jurasic
- VA Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA; Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
| | - Judith A Jones
- VA Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA; Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
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164
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Martinez-Canut P. Predictors of tooth loss due to periodontal disease in patients following long-term periodontal maintenance. J Clin Periodontol 2015; 42:1115-25. [PMID: 26498672 PMCID: PMC4737315 DOI: 10.1111/jcpe.12475] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2015] [Indexed: 12/03/2022]
Abstract
AIM To analyse patient-related factors (PRFs) and tooth-related factors (TRFs) associated with tooth loss due to periodontal disease (TLPD) in patients undergoing periodontal maintenance (PM). MATERIAL AND METHODS The sample consisted of 500 patients (mean follow-up of 20 years). The impact of PRFs on TLPD was analysed with Poisson regression and multivariate logistic regression. The simultaneous impact of PRFs and TRFs was analysed with multilevel logistic regression and Cox regression. RESULTS Tooth loss due to periodontal disease was 515 (mean 0.05 patient/year). The significant PRFs were severe periodontitis (p < 0.001), aggressive periodontitis (p < 0.001), smoking (p = 0.018), bruxism (p = 0.022) and baseline number of teeth (p = 0.001). These PRFs allowed characterizing patients losing more teeth. The whole TRFs analysed were significant, depending on the type of tooth and the category of each factor (e.g. mobility 0, 1, 2, and 3). The significant PRFs increased the risk of TLPD by 2 to 3 times while TRFs increased the risk to a higher extent. Mobility was the main TRF. CONCLUSIONS Severe periodontitis, aggressive periodontitis, smoking, bruxism and baseline number of teeth, as well as the whole TRFs analysed, were associated with TLPD.
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Affiliation(s)
- Pedro Martinez-Canut
- Department and institutions, Private practice, Valencia, Spain
- Former Director, Division of Periodontics, Facultad de Medicina y Odontología, University of Valencia, Valencia, Spain
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165
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Kumar Y, Chand P, Arora V, Singh SV, Mishra N, Alvi HA, Verma UP. Comparison of Rehabilitating Missing Mandibular First Molars with Implant- or Tooth-Supported Prostheses Using Masticatory Efficiency and Patient Satisfaction Outcomes. J Prosthodont 2015; 26:376-380. [DOI: 10.1111/jopr.12399] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yogesh Kumar
- Department of Prosthodontics, Faculty of Dental Sciences; King George's Medical University; Lucknow Uttar Pradesh India
| | - Pooran Chand
- Department of Prosthodontics, Faculty of Dental Sciences; King George's Medical University; Lucknow Uttar Pradesh India
| | - Varuni Arora
- Department of Prosthodontics, Faculty of Dental Sciences; King George's Medical University; Lucknow Uttar Pradesh India
| | - Saumyendra V. Singh
- Department of Prosthodontics, Faculty of Dental Sciences; King George's Medical University; Lucknow Uttar Pradesh India
| | - Niraj Mishra
- Department of Prosthodontics, Faculty of Dental Sciences; King George's Medical University; Lucknow Uttar Pradesh India
| | - Habib A. Alvi
- Department of Prosthodontics, Faculty of Dental Sciences; King George's Medical University; Lucknow Uttar Pradesh India
| | - Umesh P. Verma
- Department of Periodontics, Faculty of Dental Sciences; King George's Medical University; Lucknow Uttar Pradesh India
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166
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Graetz C, Schützhold S, Plaumann A, Kahl M, Springer C, Sälzer S, Holtfreter B, Kocher T, Dörfer CE, Schwendicke F. Prognostic factors for the loss of molars - an 18-years retrospective cohort study. J Clin Periodontol 2015; 42:943-50. [DOI: 10.1111/jcpe.12460] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 02/02/2023]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Svenja Schützhold
- Unit of Periodontology; School of Dentistry; University of Greifswald; Greifswald Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Birte Holtfreter
- Unit of Periodontology; School of Dentistry; University of Greifswald; Greifswald Germany
| | - Thomas Kocher
- Unit of Periodontology; School of Dentistry; University of Greifswald; Greifswald Germany
| | - Christof E. Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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167
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Abstract
Periodontal regeneration-treatment that results in new alveolar bone, cementum, and a functional periodontal ligament-is successful in class II furcation defects. This article examines one aspect of periodontal regeneration-alveolar bone growth in furcation defects-in trying to answer the question, Can bone lost from furcations be regenerated? The best evidence for bone growth is histology but there is limited histologic evidence for bone growth in human furcation defects. There is more evidence from intraoperative measurements for hard tissue growth in treated furcation defects, but the nature of the hard tissue needs to be determined histologically.
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Affiliation(s)
- Joseph J Zambon
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY 14214, USA.
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168
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Abstract
Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory diseases. Gingivitis affects the majority of people, and advanced periodontitis is estimated to affect 5-15% of adults. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. All patients should undergo periodontal assessment as part of routine oral examination. Periodontal screening using methods such as the Basic Periodontal Examination/Community Periodontal Index or Periodontal Screening Record should be performed for all new patients, and also on a regular basis as part of ongoing oral health care. If periodontitis is identified, full periodontal assessment is required, involving recording of full mouth probing and bleeding data, together with assessment of other relevant parameters such as plaque levels, furcation involvement, recession and tooth mobility. Radiographic assessment of alveolar bone levels is driven by the clinical situation, and is required to assess bone destruction in patients with periodontitis. Risk assessment (such as assessing diabetes status and smoking) and risk management (such as promoting smoking cessation) should form a central component of periodontal therapy. This article provides guidance to the oral health care team regarding methods and frequencies of appropriate clinical and radiographic examinations to assess periodontal status, to enable appropriate detection and diagnosis of periodontal conditions.
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169
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Tadinada A, Fung K, Thacker S, Mahdian M, Jadhav A, Schincaglia GP. Radiographic evaluation of the maxillary sinus prior to dental implant therapy: A comparison between two-dimensional and three-dimensional radiographic imaging. Imaging Sci Dent 2015; 45:169-74. [PMID: 26389059 PMCID: PMC4574054 DOI: 10.5624/isd.2015.45.3.169] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 06/03/2015] [Accepted: 06/09/2015] [Indexed: 02/01/2023] Open
Abstract
PURPOSE This study was performed to evaluate the diagnostic efficacy of panoramic radiography and cone-beam computed tomography (CBCT) in detecting sinus pathology. MATERIALS AND METHODS This study was based on a retrospective evaluation of patients who had undergone both a panoramic radiograph and a CBCT exam. A total of 100 maxillary sinuses were evaluated. Four examiners with various levels of expertise evaluated the images using a five-point scoring system. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of the two modalities. The image analysis was repeated twice, with at least two weeks between the evaluation sessions. Interobserver reliability was assessed using Cronbach's alpha, and intraobserver reliability was assessed using Cohen's kappa. RESULTS Maxillary sinus pathology was detected in 72% of the patients. High interobserver and intraobserver reliability were observed for both imaging modalities and among the four examiners. Statistical analyses using ROC curves demonstrated that the CBCT images had a larger area under the curve (0.940) than the panoramic radiographs (0.579). CONCLUSION Three-dimensional evaluation of the sinus with CBCT was significantly more reliable in detecting pathology than panoramic imaging.
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Affiliation(s)
- Aditya Tadinada
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Karen Fung
- Department of Periodontics, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Sejal Thacker
- Department of Periodontics, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Mina Mahdian
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Aniket Jadhav
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Gian Pietro Schincaglia
- Department of Periodontics, University of Connecticut School of Dental Medicine, Farmington, CT, USA
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170
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Bailey DL, Barrow SY, Cvetkovic B, Musolino R, Wise SL, Yung C, Darby I. Periodontal diagnosis in private dental practice: a case-based survey. Aust Dent J 2015; 61:244-51. [PMID: 26308865 DOI: 10.1111/adj.12369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite the prevalence of periodontitis in Australia, there are few reports regarding periodontal diagnosis and therapies in the general dental practice setting. This study aimed to assess the degree of diagnostic accuracy in periodontal cases of Victorian general dental practitioners. METHODS Following ethics approval, dentists were invited to complete a scenario-based questionnaire on the Australian Dental Association Victorian Branch (ADAVB) website. Five text-based clinical scenarios (from a total of 10) were randomly presented, representing patients with a range of disease levels from periodontal health/gingivitis to severe periodontitis, and respondents were asked what examinations they would usually perform. Based upon the presented results of periodontal and radiographic examinations, a periodontal diagnosis was requested. RESULTS One hundred and thirty-five dentists attempted the survey. Most were in group practice and based in Melbourne; 22.5% of respondents worked in a practice employing a hygienist. The clinical parameters most commonly measured to diagnose periodontal disease were pocket depth and mobility. The majority of respondents diagnosed health, gingivitis and mild periodontitis correctly compared to American Academy of Periodontology guidelines. However, moderate periodontitis tended to be diagnosed as severe. CONCLUSIONS Dentists in Victoria used appropriate clinical parameters when assessing periodontal disease and were generally accurate in their diagnoses. There is a need for consensus regarding diagnostic definitions.
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Affiliation(s)
- D L Bailey
- Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia
| | - S-Y Barrow
- Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia
| | - B Cvetkovic
- eviDent Foundation, South Yarra, Victoria, Australia
| | - R Musolino
- eviDent Foundation, South Yarra, Victoria, Australia
| | - S L Wise
- eviDent Foundation, South Yarra, Victoria, Australia
| | - C Yung
- eviDent Foundation, South Yarra, Victoria, Australia
| | - I Darby
- Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia
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171
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Affiliation(s)
- SJ Fokkema
- Dental Hygiene School; University of Applied Sciences Utrecht; Utrecht The Netherlands
- Periodontal Practice Fokkema; ‘s-Hertogenbosch The Netherlands
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172
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Kalsi HJ, Bomfim DI, Darbar U. An Update on Crown Lengthening. Part 2: Increasing Clinical Crown Height to Facilitate Predictable Restorations. ACTA ACUST UNITED AC 2015; 42:230-2, 235-6. [PMID: 26076541 DOI: 10.12968/denu.2015.42.3.230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This is the second paper in this two-part series. Paper one provided an overview of managing gingival tissue excess and paper two will focus on increasing clinical crown height to facilitate restorative treatment. Crown lengthening is a surgical procedure aimed at the removal of gingival tissue with or without adjunctive bone removal. The different types of procedure undertaken will be discussed over the two papers. In order to provide predictable restorations, care must be taken to ensure the integrity of the margins. If this is not taken into account it can lead to an impingement on the biologic width, which may in turn lead to chronic inflammation resulting in recession or the development of periodontal problems which can be hard to manage. Clinical Relevance: This paper aims to reinforce the need for thorough diagnosis and treatment planning and provides an overview of the various procedures that can be undertaken.
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173
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Reich KM, Huber CD, Heimel P, Ulm C, Redl H, Tangl S. A quantification of regenerated bone tissue in human sinus biopsies: influences of anatomical region, age and sex. Clin Oral Implants Res 2015; 27:583-90. [PMID: 26037688 DOI: 10.1111/clr.12627] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Sinus augmentation is a standard procedure to increase vertical bone supply for dental implants in the atrophic posterior maxilla. Despite the longstanding application of this method, information about some basic factors that could potentially influence bone regeneration after sinus augmentation is rare. The objective of this study was therefore to quantify the impact of the maxillary region (premolar/molar) and patients' age and sex on bone regeneration after sinus grafting. MATERIAL AND METHODS Sinus augmentation procedures were performed in 107 patients (66 female: 52.8 ± 11.0 years, 41 male: 50.6 ± 11.3 years). After 6 ± 1 months, 201 sinus biopsies were harvested and histomorphometrically analysed. Height (oldHt) and bone volume fraction of pristine bone (oldBV/TV), as well as the amount of new bone (newBV/TV) and bone-to-bone substitute contact (BBSC) in the augmentation area, were assessed. RESULTS In women, newBV/TV in the augmented sinus decreased significantly by 0.22 ± 0.08% per year. In men, no similar trend was observed. There were strong influences of the maxillary region and the dimensions of the host bone. In the premolar region, newBV/TV was 23.1 ± 7.9% and 25.1 ± 10.1%; in the molar region, newBV/TV averaged 20.4 ± 9.4% and 17.8 ± 8.8% for women and men, respectively. The greater the thickness of the wall of the sinus floor (mainly in the former premolar region), the greater was the amount of new bone tissue formed in the spaces in-between bone substitute particles. CONCLUSIONS These empirical results derived from a large human sample, link factors that influence the quality of biomaterial integration to the known clinical risks for the success of dental implants.
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Affiliation(s)
- Karoline Maria Reich
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Christian Domitian Huber
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in the Trauma Research Center of AUVA, Vienna, Austria
| | - Christian Ulm
- Department of Oral Surgery, Medical University of Vienna, Vienna, Austria
| | - Heinz Redl
- Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in the Trauma Research Center of AUVA, Vienna, Austria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
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174
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Saminsky M, Halperin-Sternfeld M, Machtei EE, Horwitz J. Variables affecting tooth survival and changes in probing depth: a long-term follow-up of periodontitis patients. J Clin Periodontol 2015; 42:513-9. [PMID: 25970318 DOI: 10.1111/jcpe.12419] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2015] [Indexed: 11/29/2022]
Abstract
AIM To retrospectively assess tooth-survival rate and its association with patient and oral variables in periodontal office patients, followed up to 18 years. MATERIAL AND METHODS Patients in a private periodontal office whose files included initial examination (T0 ), reevaluation (TRe ) and ≥ 10 years after T0 (TF ) chartings, and received periodontal therapy and supportive periodontal therapy (SPT) after TRe were included. General health, plaque scores (PI), probing depth (PPD), bleeding on probing (BOP) at six points/tooth, tooth extractions, and SPT visits were extracted from patient files at T0 , TRe , and TF . Descriptive statistics and Cox regression analysis were performed. RESULTS Fifty patients (mean 26 ± 4 teeth/patient, 1301 teeth) fulfilled inclusion criteria. About 20 and 129 teeth respectively were extracted before/after TRe , 96 of them for periodontal causes. PPD>7 mm at TRe (HR = 17.7, 95%CI 8.6, 36.6), age above 60 years (HR = 3.3, 95%CI 1.5, 7.2), multi-rooted teeth (HR = 1.9, 95%CI 1.2, 3.1) and SPT<3 times/year (HR = 1.8, 95%CI 1.1, 2.9), were the best prognostic factors for tooth loss during follow-up. (p < 0.05, Cox regression analysis). A continuous, statistically significant reduction was observed in mean PPD among teeth that survived follow-up [4.3 ± 1.8 mm, 3.5 ± 1.4 mm, 3.2 ± 1.3 mm, at T0 , TRe , TF , respectively. (p < 0.001, Repeated-measures test)]. CONCLUSION Regular SPT was associated with low tooth-loss rates and continuous reductions in probing depth. PPD after initial therapy, age above 60, multi-rooted teeth and infrequent SPT were strong negative prognostic factors for long-term tooth survival among periodontal patients.
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Affiliation(s)
- Michael Saminsky
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel
| | | | - Eli E Machtei
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel
| | - Jacob Horwitz
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.,Private Periodontal Practice, Tel-Aviv, Israel
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175
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Kornman KS. Commentary: Periodontitis severity and progression are modified by various host and environmental factors. J Periodontol 2015; 85:1642-5. [PMID: 25434780 DOI: 10.1902/jop.2014.140430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kenneth S Kornman
- Chief Executive Officer, President, and Chief Scientific Officer, Interleukin Genetics, Inc., Waltham, MA
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176
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Elkhatat EI, Elkhatat AE, Azzeghaiby SN, Tarakji B, Beshr K, Mossa H. Clinical and radiographic evaluation of periodontal intrabony defects by open flap surgery alone or in combination with Biocollagen(®) membrane: A randomized clinical trial. J Int Soc Prev Community Dent 2015; 5:190-8. [PMID: 26236678 PMCID: PMC4515801 DOI: 10.4103/2231-0762.159956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Guided tissue regeneration (GTR) is often incorporated in regenerative periodontal surgical procedures. However, the actual benefits of adding GTR to such a procedure remain undocumented. The purpose of this randomized controlled trial was to investigate the contribution of GTR to the outcomes of open flap debridement (OFD) in the treatment of intrabony defects. MATERIALS AND METHODS A total of 16 patients of both sexes satisfying the criteria of chronic periodontitis and each of whom displayed one intrabony defect were randomly assigned to two groups, i.e. either treated with open flap surgery and GTR (group 1) or with open flap surgery alone (group 2), in this parallel-arm study. The soft tissue and hard tissue measurements, including probing pocket depth (PD), clinical attachment level (CAL), and bone mineral density were recorded at baseline and 3,6 and 12 months after surgery. The differences with a P < 0.05 were considered significant. RESULTS Results showed that the membrane group showed significant difference when compared with open flap surgery alone, in relation to the degree of periodontal pocket, clinical attachment loss, and bone density. CONCLUSION The findings of this study suggest that biocollagen membrane could be considered as an option in the treatment of intrabony defects. Biocollagen membrane alone gives favorable clinical results in the treatment of intrabony defects. Open flap debridement resulted in acceptable clinical results in the treatment of intrabony defects.
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Affiliation(s)
- Essam I. Elkhatat
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Amr E. Elkhatat
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Saleh N. Azzeghaiby
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Bassel Tarakji
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Khaled Beshr
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Hossam Mossa
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
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177
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Sanz M, Jepsen K, Eickholz P, Jepsen S. Clinical concepts for regenerative therapy in furcations. Periodontol 2000 2015; 68:308-32. [DOI: 10.1111/prd.12081] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2014] [Indexed: 11/26/2022]
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178
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Graziani F, Gennai S, Karapetsa D, Rosini S, Filice N, Gabriele M, Tonetti M. Clinical performance of access flap in the treatment of class II furcation defects. A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol 2015; 42:169-81. [DOI: 10.1111/jcpe.12327] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Filippo Graziani
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Stefano Gennai
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Dimitra Karapetsa
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Stefano Rosini
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Natalia Filice
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Mario Gabriele
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
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179
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Bao K, Papadimitropoulos A, Akgül B, Belibasakis GN, Bostanci N. Establishment of an oral infection model resembling the periodontal pocket in a perfusion bioreactor system. Virulence 2015; 6:265-73. [PMID: 25587671 PMCID: PMC4601317 DOI: 10.4161/21505594.2014.978721] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Periodontal infection involves a complex interplay between oral biofilms, gingival tissues and cells of the immune system in a dynamic microenvironment. A humanized in vitro model that reduces the need for experimental animal models, while recapitulating key biological events in a periodontal pocket, would constitute a technical advancement in the study of periodontal disease. The aim of this study was to use a dynamic perfusion bioreactor in order to develop a gingival epithelial-fibroblast-monocyte organotypic co-culture on collagen sponges. An 11 species subgingival biofilm was used to challenge the generated tissue in the bioreactor for a period of 24 h. The histological and scanning electron microscopy analysis displayed an epithelial-like layer on the surface of the collagen sponge, supported by the underlying ingrowth of gingival fibroblasts, while monocytic cells were also found within the sponge mass. Bacterial quantification of the biofilm showed that in the presence of the organotypic tissue, the growth of selected biofilm species, especially Campylobacter rectus, Actinomyces oris, Streptococcus anginosus, Veillonella dispar, and Porphyromonas gingivalis, was suppressed, indicating a potential antimicrobial effect by the tissue. Multiplex immunoassay analysis of cytokine secretion showed that interleukin (IL)-1 β, IL-2, IL-4, and tumor necrosis factor (TNF)-α levels in cell culture supernatants were significantly up-regulated in presence of the biofilm, indicating a positive inflammatory response of the organotypic tissue to the biofilm challenge. In conclusion, this novel host-biofilm interaction organotypic model might resemble the periodontal pocket and have an important impact on the study of periodontal infections, by minimizing the need for the use of experimental animal models.
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Affiliation(s)
- Kai Bao
- a Oral Translational Research; Institute of Oral Biology; Center of Dental Medicine; University of Zürich ; Zürich , Switzerland
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180
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Kolakovic M, Held U, Schmidlin PR, Sahrmann P. An estimate of pocket closure and avoided needs of surgery after scaling and root planing with systemic antibiotics: a systematic review. BMC Oral Health 2014; 14:159. [PMID: 25529408 PMCID: PMC4531502 DOI: 10.1186/1472-6831-14-159] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 12/09/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Relevant benefits of adjunctive medication of antibiotica after conventional root surface debridement in terms of enhanced pocket depth (PD) reduction have been shown. However, means and standard deviations of enhanced reductions are difficult to translate into clinical relevant treatment outcomes such as pocket resolution or avoidance of additional surgical interventions. Accordingly, the aim of this systematic review was to calculate odds ratios for relevant cut-off values of PD after mechanical periodontal treatment with and without antibiotics, specifically the combination of amoxicilline and metronidazol, from published studies. As clinical relevant cut-off values "pocket closure" for PD ≤ 3mm and "avoidance of surgical intervention" for PD ≤ 5 mm were determined. METHODS The databases PubMed, Embase and Central were searched for randomized clinical studies assessing the beneficial effect of the combination of amoxicillin and metronidazole after non-surgical mechanical debridement. Titles, abstracts and finally full texts were scrutinized for possible inclusion by two independent investigators. Quality and heterogeneity of the studies were assessed and the study designs were examined. From published means and standard deviations for PD after therapy, odds ratios for the clinically relevant cut-off values were calculated using a specific statistical approach. RESULTS Meta-analyses were performed for the time points 3 and 6 month after mechanical therapy. Generally, a pronounced chance for pocket closure from 3 to 6 months of healing was shown. The administration of antibiotics resulted in a 3.55 and 4.43 fold higher probability of pocket closure after 3 and 6 months as compared to mechanical therapy alone. However, as the estimated risk for residual pockets > 5 mm was 0 for both groups, no odds ratio could be calculated for persistent needs for surgery. Generally, studies showed a moderate to high quality and large heterogeneity regarding treatment protocol, dose of antibiotic medication and maintenance. CONCLUSION With the performed statistical approach, a clear benefit in terms of an enhanced chance for pocket closure by co-administration of the combination of amoxicillin and metronidazole as an adjunct to non-surgical mechanical periodontal therapy has been shown. However, data calculation failed to show a benefit regarding the possible avoidance of surgical interventions.
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Affiliation(s)
- Mirela Kolakovic
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Ulrike Held
- Horten Center, University Hospital Zurich, Pestalozzistrasse 24, 8091, Zurich, Switzerland.
| | - Patrick R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Philipp Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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181
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Darby I, Sanelli M, Shan S, Silver J, Singh A, Soedjono M, Ngo L. Comparison of clinical and cone beam computed tomography measurements to diagnose furcation involvement. Int J Dent Hyg 2014; 13:241-5. [PMID: 25511014 DOI: 10.1111/idh.12116] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2014] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to determine the degree of discrepancy between clinical measurement of furcation involvement (FI) and cone beam computed tomography image analysis of multirooted teeth. METHODS FI measurements obtained from clinical records were compared to CBCT images of the same teeth to determine the degree of discrepancy between CBCT FI grading and clinical FI grading. RESULTS Of the hundred and fifty-four sites analysed, 22% of FI measurements from probing and CBCT were in agreement. Fifty-eight percent of clinical FI recordings were overestimated, and 20% were underestimated when compared to CBCT analysis. CONCLUSION Clinical recording of FI is both over and underestimated compared to CBCT analysis. This was highest for probing recording grade I furcation involvement where it was highly overestimated. The occurrence of over and under estimation of FI will affect the assignment of prognosis to multirooted teeth, which can influence treatment planning for periodontal therapy and may result in inappropriate treatment.
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Affiliation(s)
- I Darby
- Periodontics, Melbourne Dental School, Carlton, Vic., Australia
| | - M Sanelli
- Periodontics, Melbourne Dental School, Carlton, Vic., Australia
| | - S Shan
- Periodontics, Melbourne Dental School, Carlton, Vic., Australia
| | - J Silver
- Periodontics, Melbourne Dental School, Carlton, Vic., Australia
| | - A Singh
- Periodontics, Melbourne Dental School, Carlton, Vic., Australia
| | - M Soedjono
- Periodontics, Melbourne Dental School, Carlton, Vic., Australia
| | - L Ngo
- Periodontics, Melbourne Dental School, Carlton, Vic., Australia
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182
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Ioannou AL, Kotsakis GA, Hinrichs JE. Prognostic factors in periodontal therapy and their association with treatment outcomes. World J Clin Cases 2014; 2:822-827. [PMID: 25516855 PMCID: PMC4266828 DOI: 10.12998/wjcc.v2.i12.822] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/22/2014] [Accepted: 10/16/2014] [Indexed: 02/05/2023] Open
Abstract
During the incipient steps of periodontal treatment, clinicians are usually asked to predict the prognosis of teeth with compromised periodontium. The aim of this literature review was to investigate the association between periodontal Prognosis, Tooth Loss and risk indicators, such as smoking and genetics. Results showed that the definition of good prognosis has much higher predictability than the one for questionable prognosis. Several risk indicators for periodontal prognosis and tooth loss are discussed as well as different definitions of questionable prognosis and their success in predicting tooth loss. In conclusion, the major focus of future studies should be to construct simplified prognostic models with high predictability that will increase the confidence of dentists and periodontists when assigning teeth prognosis.
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183
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Osteotome Sinus Floor Elevation Procedure for First Molar Single-Gap Implant Rehabilitation. IMPLANT DENT 2014; 23:760-7. [DOI: 10.1097/id.0000000000000177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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184
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An overview of systematic reviews of the use of systemic antimicrobials for the treatment of periodontitis. Br Dent J 2014; 217:443-51. [DOI: 10.1038/sj.bdj.2014.909] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2014] [Indexed: 12/24/2022]
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185
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Grover V, Malhotra R, Kapoor A, Mankotia CS, Bither R. Correlation of the interdental and the interradicular bone loss: A radiovisuographic analysis. J Indian Soc Periodontol 2014; 18:482-7. [PMID: 25210264 PMCID: PMC4158591 DOI: 10.4103/0972-124x.138701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 12/09/2013] [Indexed: 11/22/2022] Open
Abstract
Background: Presence of furcation involvement indicates advanced periodontitis, and a potentially less-favorable prognosis, for the affected tooth and its diagnosis has always been an enigma. The present study was carried out to measure and correlate the interdental and interradicular bone loss in patients suffering from periodontitis using radiovisuography (RVG) for the purpose of early furcation diagnosis. Materials and Methods: A total of 50 patients suffering from chronic generalized periodontitis and with furcation involvement in mandibular molars were selected. Under standardized conditions, RVGs were taken and the morphologic measurements defining the furcation areas were recorded and analyzed. Result: Interradicular bone loss of about 0.8 mm or more, was observed in the study subjects only when the bone loss at the interdental area was minimal of 3.7 mm. The correlation between the interradicular and the interdental bone loss was statistically highly significant (T-test, P < 0.001). A stronger correlation was observed in subjects above 40 years of age as compared with the younger subjects. There was not much difference in the degree of correlation between the interradicular and the interdental bone loss when compared in the context of gender. Conclusion: The very first millimeter of interradicular bone loss was seen when the interdental bone loss was around 4 mm. Therefore, to detect the earliest lesions of furcations, the interdental bone loss can be kept as an approximate guide for the comprehensive diagnosis and management of such sites/patients. The current investigation paves the path for future longitudinal studies with larger samples to ascertain these findings.
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Affiliation(s)
- Vishakha Grover
- Department of Periodontics and Oral Implantology, National Dental College and Hospital, Gulabgarh, Derabassi, Punjab, India
| | - Ranjan Malhotra
- Department of Periodontics and Oral Implantology, National Dental College and Hospital, Gulabgarh, Derabassi, Punjab, India
| | - Anoop Kapoor
- Department of Periodontics and Oral Implantology, M.N.D.A.V Dental college and Hospital, Solan, Himachal Pradesh, India
| | - Chahat Singh Mankotia
- Department of Periodontics and Oral Implantology, National Dental College and Hospital, Gulabgarh, Derabassi, Punjab, India
| | - Rupika Bither
- Department of Periodontics and Oral Implantology, Laxmi Bai Dental College, Patiala, Punjab, India
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186
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Frisch E, Ziebolz D, Vach K, Ratka-Krüger P. Supportive post-implant therapy: patient compliance rates and impacting factors: 3-year follow-up. J Clin Periodontol 2014; 41:1007-14. [DOI: 10.1111/jcpe.12298] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | - Dirk Ziebolz
- Department of Operative Dentistry and Periodontology; University Medical Centre Leipzig
| | - Kirstin Vach
- Center for Medical Biometry and Medical Informatics; Institute for Medical Biometry and Statistics; University Medical Center Freiburg; Freiburg Germany
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology; University of Freiburg; Freiburg Germany
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187
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Woodman AJ. Using risk assessment in periodontics. Prim Dent J 2014; 3:51-6. [PMID: 25198640 DOI: 10.1308/205016814812736709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Risk assessment has become a regular feature in both dental practice and society as a whole, and principles used to assess risk in society are similar to those used in a clinical setting. Although the concept of risk assessment as a prognostic indicator for periodontal disease incidence and activity is well established in the management of periodontitis, the use of risk assessment to manage the practical treatment of periodontitis and its sequelae appears to have less foundation. A simple system of initial risk assessment - building on the use of the Basic Periodontal Examination (BPE), clinical, medical and social factors - is described, linked to protocols for delivering care suited to general dental practice and stressing the role of long-term supportive care. The risks of not treating the patient are considered, together with the possible causes of failure, and the problems of successful treatment are illustrated by the practical management of post-treatment recession.
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188
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Esfahanian V, Farhad S, Sadighi Shamami M. Comparison of ADM and Connective Tissue Graft as the Membrane in Class II Furcation Defect Regeneration: A Randomized Clinical Trial. J Dent Res Dent Clin Dent Prospects 2014; 8:101-6. [PMID: 25093054 PMCID: PMC4120901 DOI: 10.5681/joddd.2014.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 05/17/2014] [Indexed: 11/17/2022] Open
Abstract
Background and aims. Furcally-involved teeth present unique challenges to the success of periodontal therapy and influence treatment outcomes. This study aimed to assess to compare use of ADM and connective tissue membrane in class II furcation defect regeneration. Materials and methods. 10 patient with 2 bilaterally class II furcation defects in first and/or second maxilla or man-dibular molar without interproximal furcation involvement, were selected. Four weeks after initial phase of treatment, before and thorough the surgery pocket depth (PD), clinical attachment level to stent (CAL-S), free gingival margin to stent(FGM-S) , crestal bone to stent (Crest-S), horizontal defect depth to stent (HDD-S) and vertical defect depth to stent (VDD-S) and crestal bone to defect depth measured from stent margin. Thereafter, one side randomly treated using connective tissue and DFDBA (study group) and opposite side received ADM and DFDBA (control group). After 6 months, soft and hard tissue parameters measured again in re-entry. Results. Both groups presented improvements after therapies (P & 0.05). No inter-group differences were seen in PD re-duction (P = 0.275), CAL gain (P = 0.156), free gingival margin (P = 0.146), crest of the bone (P = 0.248), reduction in horizontal defects depth (P = 0.139) and reduction in vertical defects depth (P = 0.149). Conclusion. Both treatments modalities have potential of regeneration without any adverse effect on healing process. Connective tissue grafts did not have significant higher bone fill compared to that of ADM.
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Affiliation(s)
- Vahid Esfahanian
- Assistant Professor, Department of Periodontology, Faculty of Dentistry, Islamic Azad University Khorasgan (Isfahan) Branch, Isfahan, Iran
| | - Shirin Farhad
- Assistant Professor, Department of Periodontology, Faculty of Dentistry, Islamic Azad University Khorasgan (Isfahan) Branch, Isfahan, Iran
| | - Mehrnaz Sadighi Shamami
- Assistant Professor, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
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189
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Sahrmann P, Ronay V, Schmidlin PR, Attin T, Paqué F. Three-Dimensional Defect Evaluation of Air Polishing on Extracted Human Roots. J Periodontol 2014; 85:1107-14. [DOI: 10.1902/jop.2014.130629] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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190
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Schallhorn RA, McClain PK. Periodontal Regeneration: Management of Periodontal Osseous Defects by the Periodontist-Dental Hygienist Team. J Evid Based Dent Pract 2014; 14 Suppl:42-52.e1. [DOI: 10.1016/j.jebdp.2014.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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191
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Salvi GE, Mischler DC, Schmidlin K, Matuliene G, Pjetursson BE, Brägger U, Lang NP. Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. J Clin Periodontol 2014; 41:701-7. [PMID: 24766602 DOI: 10.1111/jcpe.12266] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2014] [Indexed: 11/27/2022]
Abstract
AIM To investigate risk factors for the loss of multi-rooted teeth (MRT) in subjects treated for periodontitis and enrolled in supportive periodontal therapy (SPT). MATERIAL AND METHODS A total of 172 subjects were examined before (T0) and after active periodontal therapy (APT)(T1) and following a mean of 11.5 ± 5.2 (SD) years of SPT (T2). The association of risk factors with loss of MRT was analysed with multilevel logistic regression. The tooth was the unit of analysis. RESULTS Furcation involvement (FI) = 1 before APT was not a risk factor for tooth loss compared with FI = 0 (p = 0.37). Between T0 and T2, MRT with FI = 2 (OR: 2.92, 95% CI: 1.68, 5.06, p = 0.0001) and FI = 3 (OR: 6.85, 95% CI: 3.40, 13.83, p < 0.0001) were at a significantly higher risk to be lost compared with those with FI = 0. During SPT, smokers lost significantly more MRT compared with non-smokers (OR: 2.37, 95% CI: 1.05, 5.35, p = 0.04). Non-smoking and compliant subjects with FI = 0/1 at T1 lost significantly less MRT during SPT compared with non-compliant smokers with FI = 2 (OR: 10.11, 95% CI: 2.91, 35.11, p < 0.0001) and FI = 3 (OR: 17.18, 95% CI: 4.98, 59.28, p < 0.0001) respectively. CONCLUSIONS FI = 1 was not a risk factor for tooth loss compared with FI = 0. FI = 2/3, smoking and lack of compliance with regular SPT represented risk factors for the loss of MRT in subjects treated for periodontitis.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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192
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Kim SY, Lee JK, Chang BS, Um HS. Effect of supportive periodontal therapy on the prevention of tooth loss in Korean adults. J Periodontal Implant Sci 2014; 44:65-70. [PMID: 24778900 PMCID: PMC3999354 DOI: 10.5051/jpis.2014.44.2.65] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/27/2014] [Indexed: 01/26/2023] Open
Affiliation(s)
- Sang-Yul Kim
- Department of Periodontology, Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Jae-Kwan Lee
- Department of Periodontology, Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Beom-Seok Chang
- Department of Periodontology, Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Heung-Sik Um
- Department of Periodontology, Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
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193
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Heitz-Mayfield LJA, Lang NP. Surgical and nonsurgical periodontal therapy. Learned and unlearned concepts. Periodontol 2000 2014; 62:218-31. [PMID: 23574468 DOI: 10.1111/prd.12008] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This review aims to highlight concepts relating to nonsurgical and surgical periodontal therapy, which have been learned and unlearned over the past few decades. A number of treatment procedures, such as gingival curettage and aggressive removal of contaminated root cementum, have been unlearned. Advances in technology have resulted in the introduction of a range of new methods for use in nonsurgical periodontal therapy, including machine-driven instruments, lasers, antimicrobial photodynamic therapy and local antimicrobial-delivery devices. However, these methods have not been shown to offer significant benefits over and above nonsurgical debridement using hand instruments. The method of debridement is therefore largely dependent on the preferences of the operator and the patient. Recent evidence indicates that specific systemic antimicrobials may be indicated for use as adjuncts to nonsurgical debridement in patients with advanced disease. Full-mouth disinfection protocols have been proven to be a relevant treatment option. We have learned that while nonsurgical and surgical methods result in similar long-term treatment outcomes, surgical therapy results in greater probing-depth reduction and clinical attachment gain in initially deep pockets. The surgical technique chosen seems to have limited influence upon changes in clinical attachment gain. What has not changed is the importance of thorough mechanical debridement and optimal plaque control for successful nonsurgical and surgical periodontal therapy.
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194
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Martin JA, Fardal Ø, Page RC, Loeb CF, Kaye EK, Garcia RI, Linden GJ. Incorporating Severity and Risk as Factors to the Fardal Cost-Effectiveness Model to Create a Cost–Benefit Model for Periodontal Treatment. J Periodontol 2014; 85:e31-9. [DOI: 10.1902/jop.2013.130237] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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195
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Laky M, Majdalani S, Kapferer I, Frantal S, Gahleitner A, Moritz A, Ulm C. Periodontal Probing of Dental Furcations Compared With Diagnosis by Low-Dose Computed Tomography: A Case Series. J Periodontol 2013; 84:1740-6. [DOI: 10.1902/jop.2013.120698] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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196
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Fardal Ø, Fardal P, Persson GR. Periodontal and General Health in Long-Term Periodontal Maintenance Patients Treated in a Norwegian Private Practice: A Descriptive Report From a Compliant and Partially Compliant Survivor Population. J Periodontol 2013; 84:1374-81. [DOI: 10.1902/jop.2012.120416] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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197
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Short-Term Evaluation of Bioactive Glass Using the Modified Osteotome Sinus Elevation Technique. IMPLANT DENT 2013; 22:491-8. [DOI: 10.1097/id.0b013e31829d1a0b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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198
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199
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Graetz C, Ehrenthal JC, Senf D, Semar K, Herzog W, Dörfer CE. Influence of psychological attachment patterns on periodontal disease - a pilot study with 310 compliant patients. J Clin Periodontol 2013; 40:1087-94. [PMID: 24111819 DOI: 10.1111/jcpe.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Psychosocial variables have received increased attention in periodontology. Attachment theory adds to known risk factors by linking early interactional experiences with adult tendencies of stress-regulation, health behaviour, symptom reporting, and healthcare utilization. The study investigates associations between attachment patterns and periodontal parameters. METHODS Within the context of a longitudinal study on periodontal diseases, 310 patients with aggressive (AgP) and chronic periodontitis (CP) filled out questionnaires on psychological attachment patterns. The influence of attachment style on health behaviour, treatment attendance and utilization, and periodontal variables was tested. RESULTS We found associations between psychological attachment anxiety on smoking and higher number of session use, independent of disease severity, which was more pronounced for women. Patients with higher attachment avoidance attended periodontal treatment later when diagnosed with CP and earlier with AgP. For men, we found differential associations for attachment avoidance and anxiety and number of teeth at beginning of treatment. CONCLUSION Psychological attachment patterns are a promising target for understanding periodontal disease in addition to known psychosocial risk factors.
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Affiliation(s)
- Christian Graetz
- Department of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
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200
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Bural C, Bilhan H, Cilingir A, Geçkili O. Assessment of demographic and clinical data related to dental implants in a group of Turkish patients treated at a university clinic. J Adv Prosthodont 2013; 5:351-8. [PMID: 24049578 PMCID: PMC3774951 DOI: 10.4047/jap.2013.5.3.351] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 07/01/2013] [Accepted: 07/08/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This retrospective study analyzed the distribution of the dental implants with regards to age and gender of the patients and type of indication for the implant therapy, as well as the location, dimension and type of the implants. MATERIALS AND METHODS The data of demographics (age and gender), type of indication for implant therapy, anatomical location, dimensions (length and diameter) and type (bone and tissue level) of 1616 implants were recorded from patient charts between January 2000 and January 2010. Descriptive statistics were analyzed using a chi-squared test for demographic parameters, type of indication, tooth position, anatomical location, implant dimensions and type (α=.05). RESULTS The patient pool comprised of 350 women and 266 men, with a mean age of 52.12 ± 13.79 years. The difference in n% of the implants of the age groups was statistically significant between the types of indications. The difference in the position of the implants was statistically significant between the n% of the implants of all age groups. Gender did not significantly vary, except that the diameter of the implants was significantly higher for the standard diameter implants in males. The difference between the implant positions was statistically significant when considered according to indication. The relationship between implant length and anatomical location was statistically significant. CONCLUSION The indication for dental implant use is age dependent and the type and size of the implant seems to be strongly related to the location of the implant.
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Affiliation(s)
- Canan Bural
- Istanbul University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
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