Periodontal probing on digital images compared to clinical measurements in periodontitis patients

Vitamin D and Periodontal Health: A Systematic Review

The role of vitamin D in maintaining gum well-being is crucial. However, scientific research reported that the connotations of cholecalciferol and periodontal health have been divested in the present literature. However, there is enormous heterogeneity in the data available. The current review aims to systematically review and appraise the available literature investigating the role of vitamin D in maintaining periodontal health. Studies included randomized controlled trials and clinical trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and cohort studies reporting associations between vitamin D and oral health in systemically healthy patients. Databases such as PubMed, Google Scholar, Scopus, Embase, and other sources, including hand search, were searched until May 2023 using together-equipped search sequences. Altogether, scientific articles that conform to the inclusion principles underwent a thorough eminence evaluation. All papers meeting inclusion criteria were subject to quality assessment, and the method used to assess the risk of bias was the Cochrane risk of bias tool. The search identified 1883 papers, among which 1435 were excluded after title evaluation. After abstract and title screening, 455 were excluded, and six full texts were assessed. After full-text evaluation, two articles were excluded, and only four were included. The data shows vitamin D's association with oral health maintenance. Along with its action on bone metabolism, it has extended function, which provides for its action as an anti-inflammatory agent and production of anti-microbial peptides, which help maintain oral health. Although the literature available is immense, there is enormous heterogenicity in the papers conducted to appraise the association between vitamin D and oral health. This systematic review has filtered all the data to review a few essential aspects of the role of vitamin D in maintaining oral physiology. Vitamin D has a linear relationship with periodontal health; however, the evidence is insufficient, and further studies must be done.

Comparative Assessment of Reliability and Accuracy of Cone-Beam Computed Tomography (CBCT) Over Direct Surgical Measurement for Periodontal Bone Loss: A Prospective, Cross-Sectional Study

INTRODUCTION

Assessing bone condition holds significant value in the diagnosis, treatment planning, and prognosing the periodontal disease; its importance is undeniable. The main aim of the present study was to evaluate the accuracy of alveolar bone measurements due to periodontal disease using cone-beam computed tomography (CBCT), by comparing with surgical measurements, considered as the gold standard.

MATERIALS AND METHODS

A prospective cross-sectional study included a sample of 40 individuals diagnosed with chronic periodontitis who required periodontal surgery. A total of 202 sites were assessed for vertical and horizontal bone loss in the anterior (76 sites) and posterior (126 sites) teeth. Bone loss was measured using CBCT and a UNC 15 periodontal probe during the surgical intervention, and then compared. The statistical analysis involved employing a Student's t-test to compare measurements. Unpaired t-tests and correlation analyses were conducted using Pearson's correlation coefficient test. To establish statistical significance, a threshold of p<0.05 was considered appropriate.

RESULTS

The statistical analysis carried out on the mean values of CBCT and direct surgical measurements for vertical bone loss demonstrated a significant difference (p<0.01). However, the values obtained for horizontal bone loss did not display statistical significance. A strong correlation of 0.94-0.99 existed between surgical and CBCT measurements. A statistically significant distinction was observed between the two methods in measuring bone loss at the distal and palatal sites of the anterior teeth.

CONCLUSION

Both CBCT and direct surgical measurement exhibit comparable accuracy potential in assessing alveolar bone loss. CBCT provides an accessibility advantage by enhancing visual access to challenging sites during surgical interventions, including palatal and distal areas of the teeth.

A pilot study on the association between soft tissue volumetric changes and non-surgical periodontal treatment in stage III periodontitis patients. A case series study

OBJECTIVES

This study investigates the correlation between soft tissue volumetric changes and clinical periodontal parameters for patients suffering from Stage III periodontitis after non-surgical periodontal treatment (NSPT) via intraoral scanning.

METHODOLOGY

The following study is a case series pilot study involving twenty-eight Stage III Periodontitis patients. All subjects received full-mouth periodontal examination and intra-oral scanning cat baseline and re-evaluation. NSPT with bi-weekly oral hygiene reviews were carried out, and re-evaluation was performed after 10-12 weeks. Baseline scanned data of all subjects would be superimposed with the corresponding scanned data obtained during re-evaluation to ensure the teeth are in the correct alignment. Boolean subtraction would be performed with the 3D scanned data after superimposition and transformation into a 3D solid. The association of baseline clinical parameters and changes after NSPT with soft tissue volumetric changes up to tooth surface level would be evaluated.

RESULTS AND CONCLUSION

Mean volumetric reduction after NSPT was 153.45 mm³ ± 185.30 mm³ and 124.06 mm³± 124.17 mm³ for the maxillary and mandibular arch, respectively. A statistically significant correlation was detected between soft tissue volumetric reduction to baseline and post-treatment clinical periodontal parameters. Posterior teeth were found to have the highest reduction in soft tissue volume. According to this pilot study, baseline clinical periodontal parameters (PPD, CAL, BOP) correlate with the soft tissue volumetric reduction after NSPT. Further studies on a larger scale and utilization of digital means on tooth sites would be necessary to strengthen the proof of concept.

CLINICAL SIGNIFICANCE

Intraoral scanning can be a valid non-invasive method to assess soft tissue volumetric changes after initial periodontal treatment, which are correlated to changes in the baseline clinical periodontal parameters.

Gingival shape analysis using surface curvature estimation of the intraoral scans

Background

Despite many advances in dentistry, no objective and quantitative method is available to evaluate gingival shape. The surface curvature of the optical scans represents an unexploited possibility. The present study aimed to test surface curvature estimation of intraoral scans for objective evaluation of gingival shape.

Methods

The method consists of four main steps, i.e., optical scanning, surface curvature estimation, region of interest (ROI) definition, and gingival shape analysis. Six different curvature measures and three different diameters were tested for surface curvature estimation on central (n = 78) and interdental ROI (n = 88) of patients with advanced periodontitis to quantify gingiva with a novel gingival shape parameter (GS). The reproducibility was evaluated by repeating the method on two consecutive intraoral scans obtained with a scan-rescan process of the same patient at the same time point (n = 8).

Results

Minimum and mean curvature measures computed at 2 mm diameter seem optimal GS to quantify shape at central and interdental ROI, respectively. The mean (and standard deviation) of the GS was 0.33 ± 0.07 and 0.19 ± 0.09 for central ROI using minimum, and interdental ROI using mean curvature measure, respectively, computed at a diameter of 2 mm. The method’s reproducibility evaluated on scan-rescan models for the above-mentioned ROI and curvature measures was 0.02 and 0.01, respectively.

Conclusions

Surface curvature estimation of the intraoral optical scans presents a precise and highly reproducible method for the objective gingival shape quantification enabling the detection of subtle changes. A careful selection of parameters for surface curvature estimation and curvature measures is required.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02322-y.