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Citterio F, Kanmaz B, Baima G, Romano F, Buduneli N, Aimetti M. Pocket closure in stage III-IV grade C periodontitis: A multilevel analysis following non-surgical periodontal therapy. Int J Dent Hyg 2024; 22:547-553. [PMID: 37154234 DOI: 10.1111/idh.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/30/2023] [Accepted: 04/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Risk of disease progression and tooth loss is higher in cases where deep probing pocket depths (PPDs) and bleeding on probing (BOP) persist after active periodontal treatment. This study aimed to investigate the efficacy of non-surgical periodontal therapy on pocket closure (PC), defined as PPD ≤4 mm without BOP (PC1) or PPD ≤4 mm solely (PC2) 3 months after non-surgical periodontal treatment and to compare PC between smokers and non-smokers. METHODS This cohort study is a secondary analysis from a controlled clinical trial consisting of systemically healthy patients with stage III or IV grade C periodontitis. All the sites with baseline PPD ≥5 mm are included as diseased sites and PC at 3 months after completion of non-surgical periodontal treatment was calculated. PC was compared between smokers and non-smokers at site and patient levels. Multilevel analysis is used to investigate factors at patient, tooth and site levels affecting PPD changes and the probability of PC. RESULTS A total of 1998 diseased sites in 27 patients were included in the analysis. The rates of PC1 and PC2 were 58.4% and 70.2% and were significantly correlated to smoking habits at site level (r (1) = 7.03, p = 0.008; r (1) = 36.17, p < 0.001). Tooth type, mobility, clinical attachment level (CAL) and PPD at baseline significantly affected PC. CONCLUSIONS The present findings indicate that non-surgical periodontal treatment is effective in PC, but its performance is influenced by baseline PPD and CAL and residual pockets may remain.
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Affiliation(s)
- Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Burcu Kanmaz
- Department of Periodontology, School of Dentistry, İzmir Demokrasi University, İzmir, Turkey
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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Herz MM, Hoffmann N, Braun S, Lachmann S, Bartha V, Petsos H. Periodontal pockets: Predictors for site-related worsening after non-surgical therapy-A long-term retrospective cohort study. J Clin Periodontol 2024; 51:680-690. [PMID: 38385991 DOI: 10.1111/jcpe.13957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/23/2024]
Abstract
AIM To evaluate site-related changes in periodontal pocket depth (PPD) after non-surgical periodontal therapy and to identify predictors for PPD changes in a retrospective patient data analysis. MATERIALS AND METHODS PPD, clinical attachment level, bleeding on probing, tooth mobility (TM), furcation involvement (FI), abutment status, adherence to supportive periodontal care (SPC) and SPC follow-ups were obtained from fully documented patient data before periodontal therapy (baseline, T0), after active periodontal therapy (APT, T1) and during SPC (T2). PPD changes were classified into deteriorated or unchanged/improved at the site level. Multi-level logistic regression analysis was performed to identify factors influencing PPD changes during SPC. RESULTS This retrospective study included 51 females and 65 males (mean T0 age: 54.8 ± 10.1 years, 25 smokers, 12 diabetics) suffering from Stage III/IV periodontitis. Evaluation outcome: T0/16,044 sampling sites/2674 teeth; T1/15,636/2606; T2/14,754/2459. During 9.0 ± 2.3 years SPC, PPD decreased (-1.33 ± 0.70 mm) by 21.8% of the sites, remained unchanged by 41.4% and increased (1.40 ± 0.78 mm) by 36.8%. Distopalatal FI (p < .001, odds ratio [OR]: 0.252, 95% confidence interval [CI] for OR: 0.118-0.540), residual pockets (p < .001, OR: 0.503, 95% CI: 0.429-0.590) and TM Degrees I-III (Degree I: p = .002, OR: 0.765, 95% CI: 0.646-0.905; Degree II: p = .006, OR: 0.658, 95% CI: 0.489-0.886; Degree III: p = .023, OR: 0.398, 95% CI: 0.180-0.879) correlated significantly with increasing PPD. CONCLUSIONS Over 75% of PPD remained unchanged or increased during SPC. Distopalatal FI, TM Degrees I-III and residual pockets after APT lead to worsening of periodontal pockets.
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Affiliation(s)
- Marco M Herz
- Department for Conservative Dentistry, University Hospital of Tuebingen, Tuebingen, Germany
| | | | | | | | - Valentin Bartha
- Department for Conservative Dentistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Hari Petsos
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt am Main, Germany
- Private Practice, Butzbach, Germany
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Sonnenschein SK, Kilian S, Ruetters M, Ciardo A, Kim TS. Changes in periodontal parameters of splinted versus non-splinted posterior teeth during ten years of supportive periodontal therapy - A retrospective evaluation. Clin Oral Investig 2024; 28:283. [PMID: 38683397 PMCID: PMC11058677 DOI: 10.1007/s00784-024-05679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES To compare periodontal parameters of splinted posterior teeth versus control teeth over ten years of supportive periodontal therapy (SPT) and to assess the survival rate of splints. MATERIAL AND METHODS Retrospective data of 372 SPT-patients was screened for splints (composite/fiberglass-reinforced composite) in the posterior (molars/premolars) which were inserted at least ten years before due to increased tooth mobility. For each splinted tooth (test), a corresponding control tooth had to be present at the first SPT-session after splint insertion (T1). Data was assessed at T1 and ten years later (T2). Possible influencing covariates for splint survival (mobility degree/Eichner class) were tested by Cox regression. The change in clinical attachment level (ΔCAL), probing pocket depth (ΔPPD) and the testing of possible influencing covariates was analyzed by using mixed linear regression. RESULTS Twenty-four patients (32 splints, 58 splinted teeth) were included. Ten test and two control teeth were lost. No differences were observed between ΔCAL and ΔPPD of test teeth compared to control teeth (ΔCAL -0.38 ± 1.90 vs. 0.20 ± 1.27 mm; ΔPPD -0.17 ± 1.18 vs. 0.10 ± 1.05 mm). Twenty-two splints fractured during the observation period (survival-rate: 31%). Mobility degree and Eichner class did not influence time until fracture. CONCLUSIONS Splinting of periodontally compromised and mobile posterior teeth does not have any disadvantage regarding the clinical periodontal situation when regular SPT is applied. However, splint fractures occur very often. CLINICAL RELEVANCE Splinting of posterior teeth is a treatment option in addition to active periodontal therapy when patients are disturbed by tooth mobility but splints have a high susceptibility to fracture.
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Affiliation(s)
- Sarah K Sonnenschein
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Samuel Kilian
- Heidelberg University, Institute of Medical Biometry, Heidelberg, Germany
| | - Maurice Ruetters
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Antonio Ciardo
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Ti-Sun Kim
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Chanthavisouk P, Ingleshwar A, Theis-Mahon N, Paulson DR. The oral health impact of dental hygiene and dental therapy populations: a systematic review. J Evid Based Dent Pract 2024; 24:101949. [PMID: 38401949 DOI: 10.1016/j.jebdp.2023.101949] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/09/2023] [Accepted: 10/29/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVES Oral health-related quality of life (OHRQoL) is pivotal in patient care, reflecting oral health through dental patient-reported outcomes (dPROs). This systematic review aims to outline the 4-dimensional (4-D) impact of OHRQoL within patient populations routinely treated by dental hygiene and/or dental therapy providers, as there is limited literature present for these oral health care professionals. METHODS The study extracted and analyzed characteristics and multidimensional impact of OHRQoL, using the Oral Health Impact Profile (OHIP) as the primary dental patient-reported outcome measure (dPROM). The search strategy spanned 7 databases: Medline via the Ovid interface (Ovid MEDLINE(R) ALL), Embase via Ovid, Cinahl, APA PsycINFO via Ovid, Dentistry and Oral Sciences Search, Scopus, and Web of Science (Core Collection). It commenced September 2, 2022, with a refinement search on July 5, 2023. English language criteria yielded 645 articles postduplication removal. A screening procedure involving 3 reviewers encompassed title, abstract, and full-text review. RESULTS After application of inclusion and exclusion criteria, 5 articles were subjected to data extraction, capturing domain-specific information including baseline and follow-up OHRQoL data. An additional set of 13 articles containing summarized OHRQoL data underwent separate analysis. The Joanna Briggs Institute (JBI) critical appraisal tools were utilized for risk bias assessment of the included articles. The 4-D impact scores reported for baseline OHRQoL data, ranged from 3.10 to 4.20 for Oral Function, 0.84-2.70 for Orofacial Pain, 1.70-4.50 for Orofacial Appearance, and 0.44-2.50 for Psychosocial Impact. In follow-up OHRQoL data, the range for Oral Function was 1.52-3.60, Orofacial Pain 0.60-2.10, Orofacial Appearance 0.91-2.25, and Psychosocial Impact 0.10-0.60. CONCLUSIONS This review highlights a critical call for standardization in OHRQoL data collection for dental hygiene and dental therapy patient populations as only 26% of the predetermined distinct populations were found to have studies completed with 4-D impact of OHRQoL. Moreover, the presence of limited research in describing the multi-dimensional impact in patients routinely treated by these providers shows the urgency of substantive research in this area.
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Affiliation(s)
- Phonsuda Chanthavisouk
- Division of Dental Therapy, Department of Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
| | - Aparna Ingleshwar
- Department of Diagnostic & Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | | | - Danna R Paulson
- Division of Dental Hygiene, Department of Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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Zhang Y, Kang N, Xue F, Duan J, Chen F, Cai Y, Luan Q. Survival of nonsurgically splinted mandibular anterior teeth during supportive maintenance care in periodontitis patients. J Dent Sci 2023; 18:229-236. [PMID: 36643235 PMCID: PMC9831790 DOI: 10.1016/j.jds.2022.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/29/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose Splinting mobile teeth is a choice to improve the patient's oral comfort. The purpose of this study was to assess the survival and stability of mobile anterior mandibular teeth after splinting in patients with periodontitis undergoing supportive periodontal therapy (SPT). Materials and methods Patients with splinted mobile anterior mandibular teeth were assessed retrospectively. Periodontal statuses were recorded at baseline and follow-up visits. Tooth and splint survival as well as splint repairs were recorded. Multilevel Cox regression analyses were performed to evaluate patient- and tooth-related factors that might have influenced the survival rates of splints. Results Sixty-one patients, collectively having 161 splints, were followed for an average of 5.44 years. On average, probing depth (PD) of splinted teeth decreased from 4.31 mm to 2.93 mm and clinical attachment loss (CAL) decreased from 5.02 mm to 4.58 mm. Alveolar bone was stable in the follow-up period. None of the splinted teeth were extracted, The overall survival rate of the splints was 65.2%. Splints made of composite resin alone were associated with a higher risk of breakage when compared to splints composed of composite resin with mesh grid strips. Conclusion Splinting showed long-term survival and splinting combined with periodontal supportive treatment is a feasible option to maintain mobile mandibular anterior teeth.
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Affiliation(s)
- Yong Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Ni Kang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China,Central Laboratory, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Fei Xue
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Jinyu Duan
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Fan Chen
- Department of Stomatology, People's Hospital of Peking University, Beijing, 100044, PR China
| | - Yu Cai
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China,Central Laboratory, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China,Corresponding author. Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22 South Avenue Zhongguancun, Beijing 100081, PR China.
| | - Qingxian Luan
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China,Corresponding author. Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22 South Avenue Zhongguancun, Beijing 100081, PR China.
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6
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Herrera D, Sanz M, Kebschull M, Jepsen S, Sculean A, Berglundh T, Papapanou PN, Chapple I, Tonetti MS. Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. J Clin Periodontol 2022; 49 Suppl 24:4-71. [PMID: 35688447 DOI: 10.1111/jcpe.13639] [Citation(s) in RCA: 112] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND The recently published clinical practice guideline (CPG) for the treatment of periodontitis in stages I-III provided evidence-based recommendations for the treatment of periodontitis patients, defined according to the 2018 classification. Stage IV periodontitis shares the severity and complexity characteristics of stage III periodontitis, but includes the anatomical and functional sequelae of tooth and periodontal attachment loss (tooth flaring and drifting, bite collapse, etc.), which require additional interventions following completion of active periodontal therapy. AIM To develop an S3 Level CPG for the treatment of stage IV periodontitis, focusing on the implementation of inter-disciplinary treatment approaches required to treat/rehabilitate patients following associated sequelae and tooth loss. MATERIALS AND METHODS This S3 Level CPG was developed by the European Federation of Periodontology (EFP), following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and a structured consensus process with leading experts and a broad base of stakeholders. RESULTS The S3 Level CPG for the treatment of stage IV periodontitis culminated in recommendations for different interventions, including orthodontic tooth movement, tooth splinting, occlusal adjustment, tooth- or implant-supported fixed or removable dental prostheses and supportive periodontal care. Prior to treatment planning, it is critically important to undertake a definitive and comprehensive diagnosis and case evaluation, obtain relevant patient information, and engage in frequent re-evaluations during and after treatment. The periodontal component of therapy should follow the CPG for the treatment of periodontitis in stages I-III. CONCLUSIONS The present S3 Level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat patients with stage IV periodontitis and to maintain a healthy dentition over lifetime, according to the available evidence at the time of publication.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Moritz Kebschull
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK.,Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.,Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK.,Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Centre for Oral Diseases, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Dommisch H, Walter C, Difloe-Geisert JC, Gintaute A, Jepsen S, Zitzmann NU. Efficacy of tooth splinting and occlusal adjustment in patients with periodontitis exhibiting masticatory dysfunction: A systematic review. J Clin Periodontol 2021; 49 Suppl 24:149-166. [PMID: 34854115 DOI: 10.1111/jcpe.13563] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/15/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the efficacy of tooth splinting (TS) and occlusal adjustment (OA) compared to no TS or OA in patients with periodontitis exhibiting masticatory dysfunction. MATERIAL The primary outcome criterion was tooth loss (TL), and the secondary outcome parameters were change in probing pocket depth (PPD), change in clinical attachment level (CAL), tooth mobility (TM), and patient-reported outcome measures (PROMs). Literature search was performed on three electronic databases (from 01/1965 to 04/2021) and focused on clinical studies with at least 12 months follow-up. RESULTS From a total of 1515 publications, 51 articles were identified for full-text reading, of which 2 retrospective case series on TS with low risk of bias and 1 randomized and 2 prospective studies on OA with unclear risk of bias were included. For TS, synthesis of data showed that in 72 patients, 26 out of 311 teeth (weighted mean incidence of TL 8.4%) and 156 out of 1541 teeth with no TS (weighted mean incidence of TL 10.1%) were lost over 2 years following non-surgical periodontal therapy. The randomized controlled clinical trial (RCT) indicated CAL gain for teeth with OA compared to no OA. For the effect of OA on TL, PPD, and TM, heterogeneous data were retrieved from the included studies. CONCLUSIONS Within the limitations of this review and based on a low level of evidence, it is concluded that TS does not improve survival of mobile teeth in patients with advanced periodontitis. OA on teeth with mobility and/or premature contacts may lead to improved CAL, while the effect of OA on the remaining periodontal parameters remains unclear.
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Affiliation(s)
- Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Periodontology, Health Science Center, University of Washington, Seattle, Washington, USA
| | - Clemens Walter
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Germany
| | - Julia C Difloe-Geisert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
| | - Aiste Gintaute
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
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8
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Sonnenschein SK, Ciardo A, Kilian S, Ziegler P, Ruetters M, Splindler M, Kim TS. The impact of splinting timepoint of mobile mandibular incisors on the outcome of periodontal treatment-preliminary observations from a randomized clinical trial. Clin Oral Investig 2021; 26:921-930. [PMID: 34309736 PMCID: PMC8311063 DOI: 10.1007/s00784-021-04075-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/08/2021] [Indexed: 11/27/2022]
Abstract
Objectives To compare the outcome of periodontal parameters in mobile mandibular incisors which were splinted before or after full-mouth disinfection (FMD). Materials and methods Thirty-four periodontitis patients with ≥ 1 mobile mandibular incisor (mobility degree II/III, clinical attachment loss (CAL) ≥ 5 mm, relative bone loss ≥ 50%) were randomly allocated to group A or B. Patients received periodontal treatment (PT) including splinting of teeth 33–43 before (A) or after FMD (B). Patient (age/sex/smoking status/systemic diseases/number of teeth) and tooth-related parameters (mean probing pocket depth (PPD)/CAL/oral hygiene indices; for the overall dentition and region 33–43) were assessed prior to PT and 12 months after FMD by a blinded examiner. Therapy-related information was added (group/antibiotic therapy/surgical intervention). Results Twenty-six patients (A: 12; B:14) were re-examined. Two patients of group B did not need splinting after FMD because of reduction in mobility after FMD. Regression analysis revealed a positive association of antibiotic therapy with CAL_overall, PPD_overall, and PPD_33-43 (p ≤ 0.01). There is a trend toward a higher reduction of periodontal parameters at teeth 33–43 in group A (PPD_33-43: − 0.91 vs. − 0.27 mm; CAL_33-43: − 1.02 vs. − 0.47 mm). Conclusions Teeth splinted before or after FMD show a significant improvement in periodontal parameters 12 months after FMD. Splinting after FMD offered the option to detect reduction in mobility. Clinical relevance Despite a higher, but not statistically significant, improvement in periodontal parameters on teeth splinted before FMD, the results do not indicate which timepoint of splinting is more beneficial. The decision for the therapeutic procedure should therefore be made individually.
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Affiliation(s)
- Sarah K Sonnenschein
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral-, Dental- and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Antonio Ciardo
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral-, Dental- and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Samuel Kilian
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Philipp Ziegler
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral-, Dental- and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Maurice Ruetters
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral-, Dental- and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Marcia Splindler
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral-, Dental- and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral-, Dental- and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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