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Mayr A, Ciper N, Wahl G, Wildenhof J, Frede S, Kirschneck C, Jäger A, Götz W, Beisel-Memmert S. Longitudinal analysis of microcirculatory parameters in gingival tissues after tooth extraction in patients with different risk profiles for wound healing disorders - a pilot study. Clin Oral Investig 2024; 28:303. [PMID: 38714559 PMCID: PMC11076346 DOI: 10.1007/s00784-024-05686-3] [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: 02/08/2024] [Accepted: 04/24/2024] [Indexed: 05/10/2024]
Abstract
OBJECTIVES We aimed to establish a risk profile for intraoral wound healing disorders based on measurements of microcirculation in gingival tissues. MATERIALS AND METHODS Oxygen saturation (SO2) and blood flow in gingival tissues were measured with tissue spectrometry and laser doppler spectroscopy in 37 patients before/after tooth extractions. Patients were assigned to four groups: anamnestically and periodontally healthy patients (n = 7), anamnestically healthy but suffering from periodontitis (n = 10), anamnestically healthy but smoking and suffering from periodontitis (n = 10) and suffering from diabetes and periodontitis (n = 10). Measurements were performed at three different time points: Baseline measurement (T0), one day post extractionem (p.e.) (T1) and seven days p.e. (T2). RESULTS Baseline SO2 values were higher in control patients (p = .038). This effect was most evident in comparison to smokers suffering from periodontitis (p = .042), followed by diabetics suffering from periodontitis (p = .09). An opposite trend was seen for blood flow. Patients suffering from periodontitis demonstrated higher blood flow values (p = .012). Five patients, which belonged to the group of smokers suffering from periodontitis, showed clinically a delayed wound healing. CONCLUSION Differences in SO2 and blood flow of gingival tissue could be detected in different groups of patients with existing periodontitis compared to control patients. CLINICAL RELEVANCE Lower baseline SO2 values could be a warning signal for possible wound healing disorders after oral surgery.
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Affiliation(s)
- Alexandra Mayr
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Nadja Ciper
- Center for Dental, Oral and Maxillofacial Medicine, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Gerhard Wahl
- Center for Dental, Oral and Maxillofacial Medicine, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Jan Wildenhof
- Private Clinic Schloss Schellenstein, Olsberg, Germany
| | - Stilla Frede
- Department of Anaesthesiology, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Andreas Jäger
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Werner Götz
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Svenja Beisel-Memmert
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany.
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Katz MS, Ooms M, Winnand P, Heitzer M, Bock A, Kniha K, Hölzle F, Modabber A. Evaluation of perfusion parameters of gingival inflammation using laser Doppler flowmetry and tissue spectrophotometry- a prospective comparative clinical study. BMC Oral Health 2023; 23:761. [PMID: 37838702 PMCID: PMC10576369 DOI: 10.1186/s12903-023-03507-9] [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: 12/11/2022] [Accepted: 10/08/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND The aim of this study was to determine the values of different perfusion parameters- such as oxygen saturation, the relative amount of hemoglobin, and blood flow- in healthy subjects compared to patients with gingivitis as a non-invasive measurement method. METHODS A total of 114 subjects were enrolled in this study and separated into subjects with gingivitis (50) and without gingivitis (64) based on clinical examination. Gingival perfusion was measured at 22 points in the maxilla and mandible using laser Doppler flowmetry and tissue spectrophotometry (LDF-TS) with the "oxygen to see" device. All patients underwent measurement of gingival perfusion, followed by the clinical evaluation (measurement of probing depths, evaluation of bleeding on probing, plaque level, and biotype). Perfusion parameters were compared between the groups, associations between the non-invasive and clinical measurements were analyzed, and theoretical optimal cut-off values for predicting gingivitis were calculated with receiver operating characteristics. RESULTS The mean oxygen saturation, mean relative amount of hemoglobin, and mean blood flow all significantly differed between the groups with and without gingivitis (p = 0.005, p < 0.001, and p < 0.001, respectively). The cut-off value for predicting gingivitis was > 40 AU (p < 0.001; sensitivity 0.90, specificity 0.67). CONCLUSIONS As a non-invasive method, LDF-TS can help determine gingival hyperemia. Flow values above 40 AU indicate a higher risk of hyperemia, which can be associated with inflammation. The LDF-TS method can be used for the objective evaluation of perfusion parameters during routine examinations and can signal the progression of hyperperfusion before any change in clinical parameters is observed. TRIAL REGISTRATION All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional Clinical Research Ethics Committee (Ethik-Kommission der Medizinischen Fakultät der RWTH Aachen, Decision Number 286/20) and retrospectively registered by the German Clinical Trials Register (File Number DRKS00024048, registered on the 15th of October 2021).
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Affiliation(s)
- Marie Sophie Katz
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany.
| | - Mark Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
| | - Anna Bock
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
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Schulze A, Busse M. Long-term training improves clinical signs of periodontal disease in type 2 diabetic patients: a pilot trial. J Sports Med Phys Fitness 2023; 63:478-484. [PMID: 36321814 DOI: 10.23736/s0022-4707.22.14197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND Systemic inflammation is related to diabetes mellitus. Periodontal disease may be considered a local manifestation of systemic inflammation in association with diabetes mellitus. Physical activity may have a positive effect on inflammatory diseases. We investigated the effects of exercise training on periodontal inflammation in diabetic patients. METHODS Out of 69 diabetic patients with periodontitis, 40 subjects participated in a recreational training, while 29 subjects performed no training. All underwent a periodontal examination before and after 6.14±1.24 months and completed a dental hygiene questionnaire. RESULTS In the long-term training group the following parameters decreased: hemoglobin A1c from 6.7±1.0% to 6.3±0.7% (P<0.007), papillary bleeding score 3 by 60% (P<0.0003), and the mean of all probing pocket depths 4 - 6 mm by 40% (P<0.0001). No significant weight changes and no improvements in oral health behavior were observed in either of the groups. No correlation between hemoglobin A1c or weight and periodontal parameters was found. CONCLUSIONS A six-months recreational training was independently related to improved clinical signs of periodontal disease in diabetic subjects.
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Affiliation(s)
- Antina Schulze
- Department of Sports Dentistry, Institute of Sports Medicine, University of Leipzig, Leipzig, Germany -
| | - Martin Busse
- General Outpatient Clinic of Sports Medicine, University of Leipzig, Leipzig, Germany
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Qi B, Hariri A, Khazaeinezhad R, Fu L, Li Y, Jin Z, Yim W, He T, Cheng Y, Zhou J, Jokerst JV. A miniaturized ultrasound transducer for monitoring full-mouth oral health: a preliminary study. Dentomaxillofac Radiol 2023; 52:20220220. [PMID: 36075610 PMCID: PMC9793456 DOI: 10.1259/dmfr.20220220] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To customize a miniaturized ultrasound transducer to access full-mouth B-mode, color Doppler, and spectral Doppler imaging for monitoring oral health. METHODS A customized periodontal ultrasound transducer SS-19-128 (19 MHz, 128 channels) 1.8-cm wide and 1-cm thick was developed and connected to a data acquisition (DAQ) system. B-mode, color Doppler, and spectral Doppler data could all be collected with SS-19-128. The imaging resolution and penetration capacity of SS-19-128 were characterized on phantoms. The gingival thickness was measured on 11 swine teeth by SS-19-128 for comparison with conventional transgingival probing via Bland-Altman analysis and Pearson correlation. Five human subjects were then recruited to demonstrate B-mode and Doppler imaging by SS-19-128. RESULTS The axial and lateral spatial resolution at 5.5 mm depth is 102.1 µm and 142.9 µm, respectively. The penetration depth in a tissue-mimicking phantom is over 30 mm. In vivo B-mode imaging of all 28 teeth was demonstrated on one human subject, and imaging of tooth #18 was accessed on five human subjects. Gingival thickness measurement compared with transgingival probing showed a bias of -0.015 mm and SD of 0.031 mm, and a r = 0.9235 (p < 0.0001) correlation. In vivo color and spectral Doppler imaging of the supraperiosteal artery in human gingiva was performed to generate hemodynamic information. CONCLUSIONS The small size of SS-19-128 offers important advantages over existing ultrasound technology-more specifically, whole-mouth scanning/charting reminiscent of radiography. This is nearly a two-fold increase in the number of teeth that can be assessed versus conventional transducers.
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Affiliation(s)
- Baiyan Qi
- Materials Science and Engineering Program University of California San Diego, La Jolla, California, USA
| | - Ali Hariri
- StyloSonic LLC, San Diego, United States
| | | | - Lei Fu
- Department of Nanoengineering, University of California San Diego, La Jolla, California, USA
| | - Yi Li
- Department of Nanoengineering, University of California San Diego, La Jolla, California, USA
| | - Zhicheng Jin
- Department of Nanoengineering, University of California San Diego, La Jolla, California, USA
| | - Wonjun Yim
- Materials Science and Engineering Program University of California San Diego, La Jolla, California, USA
| | - Tengyu He
- Materials Science and Engineering Program University of California San Diego, La Jolla, California, USA
| | - Yong Cheng
- Department of Nanoengineering, University of California San Diego, La Jolla, California, USA
| | - Jiajing Zhou
- Department of Nanoengineering, University of California San Diego, La Jolla, California, USA
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Silva H. Tobacco Use and Periodontal Disease-The Role of Microvascular Dysfunction. BIOLOGY 2021; 10:441. [PMID: 34067557 PMCID: PMC8156280 DOI: 10.3390/biology10050441] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022]
Abstract
Periodontal disease consists in highly prevalent wide-ranging inflammatory conditions that affect the supporting apparatus of teeth. Tobacco use is the most important risk factor for periodontal disease as it increases disease severity and periodontal surgery complications. Tobacco use is harmful for the vasculature by causing microvascular dysfunction, which is known to negatively affect periodontal disease. To the author's knowledge this paper is the first comprehensive review on the mechanisms by which tobacco use affects oral microcirculation and impacts the pathophysiology of periodontal disease. In healthy subjects, acute nicotine administration or tobacco use (smoking/smokeless forms) increases the blood flow in the oral mucosa due to local irritation and increased blood pressure, which overcome neural- and endocrine-mediated vasoconstriction. Chronic tobacco smokers display an increased gingival microvascular density, which is attributed to an increased capillary recruitment, however, these microcirculatory units show higher tortuosity and lower caliber. These morphological changes, together with the repetitive vasoconstrictive insults, contribute to lower gingival perfusion in chronic smokers and do not completely regress upon smoking cessation. In periodontal disease there is considerable gingival inflammation and angiogenesis in non-smokers which, in chronic smokers, are considerably suppressed, in part due to local immune suppression and oxidative stress. Tobacco exposure, irrespective of the form of use, causes long-term microvascular dysfunction that increases the risk of complications due to the natural disease course or secondary therapeutic strategies.
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Affiliation(s)
- Henrique Silva
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam;
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam
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Gregorczyk-Maga I, Szustkiewicz-Karoń A, Kaszuba M, Januszek R, Rahnama M, Jurczak A, Maga P. Prognostic markers of post-traumatic dental external root resorption in children-a pilot study. Dent Traumatol 2021; 37:699-705. [PMID: 33970554 DOI: 10.1111/edt.12682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND External inflammatory root resorption (EIRR) is a frequent complication of traumatic dental injuries (TDI). The aim of this cohort study was to identify novel non-invasive markers of post-traumatic EIRR by assessing the changes in the pulp's blood flow and the composition of gingival sulcus fluid (GCF) in children after dental trauma. MATERIAL AND METHODS Thirty-two children were enrolled and assessed within 48 h of a TDI to their permanent incisors and during an additional three visits over a 6-months follow up period. During each visit, a radiograph and laser Doppler flow (LDF) measurements of the pulp blood flow were performed on the injured tooth, and the GCF was sampled. The permanent first molar tooth of the same subject served as a control for the LDF measurements and the GCF sampling. Concentrations of IL-1α in the GCF were measured using enzyme-linked immunosorbent assays. Radiographs were used to confirm EIRR. RESULTS EIRR occurred in fourteen (43.8%) teeth in 32 patients. The teeth with EIRR showed diminished LDF readings when compared with controls at all visits. The LDF readings of the injured teeth continued to decrease at follow up visits. In the EIRR group, levels of IL-1α in the GCF of teeth with EIRR were increased and significantly higher than those of the control teeth at the visit when EIRR was diagnosed. The IL-1α levels were significantly higher in the EIRR group when compared to the injured teeth of patients without EIRR at the last follow-up visit. CONCLUSIONS The occurrence of EIRR after mechanical trauma of permanent teeth with complete root development is accompanied by a significant reduction in the blood flow of the tooth's pulp. It is accompanied by an increase in concentrations of IL-1α in the GCF of EIRR affected teeth. The results of this pilot study identified the use of IL-1α in GCF and LDF as non-invasive markers of EIRR.
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Affiliation(s)
- Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
| | | | - Marek Kaszuba
- Faculty of Health Sciences, Institute of Physiotherapy, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland
| | - Mansur Rahnama
- Faculty of Dentistry, Chair and Department of Dental Surgery, Medical University of Lublin, Lublin, Poland
| | - Anna Jurczak
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Maga
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
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Guo W, Zhao Y, Li H, Lei L. NCOA4-mediated ferritinophagy promoted inflammatory responses in periodontitis. J Periodontal Res 2021; 56:523-534. [PMID: 33533512 DOI: 10.1111/jre.12852] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/02/2021] [Accepted: 01/11/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND/OBJECTIVES Iron homeostasis plays a crucial role in the combat against pathogen invasion. Ferrous iron can trigger generous production of reactive oxygen species (ROS) by Fenton reaction. Nuclear receptor coactivator 4 (NCOA4), a selective cargo receptor to deliver ferritin to lysosome, may trigger release of ferritin-bound iron into the cytosol. The aim of the present study was to explore whether NCOA4-mediated ferritinophagy participated in the pathogenesis of periodontitis, and its role in promoting the periodontal inflammation. METHODS Inflamed and healthy periodontal tissues were harvested for immunobiological staining of ferritinophagy-related genes in the periodontal tissues, while real-time quantitative PCR (qPCR) was utilized to detect mRNA transcription. Periodontal ligament fibroblasts (PDLFs) were isolated and infected with Porphyromonas gingivalis. The mRNA transcription and protein expression of genes involved in the iron metabolism, including NCOA4, transferrin receptor 1 (TFR1), and ferroportin (SLC40A1) were detected by qPCR and western blot. Levels of labile iron pool and ROS production were detected by flow cytometry and confocal endoscopy. Small interference RNA was utilized to knock down NCOA4. RESULTS Elevated expression of NCOA4, ferritin heavy chain, and light chain were observed in the diseased periodontal tissues. P. gingivalis infection promoted expression of TFR1, NCOA4, and microtubule-associated protein 1-light chain 3 B (LC3B), enhanced levels of intracellular labile iron pool and ROS production. NCOA4 knockdown reduced ROS generation in PDLFs in response to P. gingivalis and mitigated production of pro-inflammatory monocyte chemoattractant protein-1 and interleukin 6. P. gingivalis triggered activation of c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase signaling pathway. In addition, inhibitors of JNK, SP600125, and inhibitors of p38, SB203580 blocked NCOA4 transcription. CONCLUSION NCOA4-ferritinophagy participated in the progress of periodontitis progression. P. gingvalis-triggered ferritinophagy aggravated production of ROS and inflammatory responses in PDLFS. These findings suggest iron homeostasis plays an important role in the pathogenesis of periodontitis.
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Affiliation(s)
- Wei Guo
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yunhe Zhao
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.,Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Houxuan Li
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lang Lei
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Yoon MJ, Kim DH, Jung IY, Park SH. A laboratory study to detect simulated pulpal blood flow in extracted human teeth using ultrasound Doppler flowmetry. Int Endod J 2020; 54:231-240. [PMID: 32931061 DOI: 10.1111/iej.13410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Abstract
AIM To develop a laboratory-based tooth model of simulated blood flow in teeth and evaluate it using ultrasound Doppler flowmetry (UDF). METHODOLOGY A laboratory-based tooth model for UDF was created based on a microfluidic experimental model proposed by Kim & Park (2016 a,b). Twenty-one maxillary or mandibular anterior human teeth within 1 month of extraction were used. Four holes were made in each tooth to fit 1.6-mm diameter polytetrafluoroethylene (PTFE) tubes: at the apical foramen, palatal surface in the centre of the crown, palatal surface apical to the cementoenamel junction (CEJ) and the root centre. Fluid mimicking pulsating blood was pumped (pressure range: 0-200 mbar, flow rate range: 0-80 μL min-1 ) into the apical foramen via the PTFE tubes, which exited the tooth through the palatal surface in the centre of the crown (control group), palatal surface below the CEJ (group 1) and the palatal surface at the mid-root level (group 2). An UDF transducer of 20 MHz was placed at a 60° angle to the labial surface of tooth and was used to measure the fluid flow velocity (Vs, Vas, Vm, Vam, Vd, Vad and Vakd). The flow velocity of the different groups was compared using the Wilcoxon signed-rank test, with a 95% confidence level. RESULTS UDF facilitated the detection of the simulated pulpal blood flow in the control group and group 1, but not in group 2. The mean and standard deviations of Vas, Vam and Vakd were 0.921 ± 0.394, 0.479 ± 0.208 and 0.396 ± 0.220 cm s-1 , respectively, in the control group, and 0.865 ± 0.368, 0.424 ± 0.215 and 0.487 ± 0.279 cm s-1 , respectively, in group 1. The pulpal blood flow values of the control group and group 1 were not significantly different (p > 0.05). CONCLUSIONS This laboratory study revealed that ultrasound Doppler flowmetry enabled the detection of simulated blood flow below the level of the CEJ but not at the mid-root level.
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Affiliation(s)
- M J Yoon
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - D H Kim
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - I Y Jung
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - S H Park
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
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Kanorskiy SG, Polischuk LV. [Control of ventricular rate in permanent atrial fibrillation: cardio-protec-tion and tissue hemodynamics]. KARDIOLOGIIA 2020; 60:30-36. [PMID: 32375613 DOI: 10.18087/cardio.2020.3.n870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/19/2019] [Indexed: 06/11/2023]
Abstract
Objective To evaluate myocardial injury and tissue hemodynamics in elderly patients with permanent atrial fibrillation (AF) based on the achieved range of ventricular contraction rate (VCR).Materials and Methods This prospective, randomized, blind study included 75 patients aged ≥60 with permanent AF. All patients were prescribed bisoprolol as a VCR-reducing therapy. Patients were randomized to two groups according to the permuted-block design based on the range of resting VCR goal: group 1, 60-79 bpm (n=38) and group 2, 80-100 bpm (n=37). All patients also received perindopril and apixaban. Troponin I concentration was measured using the high-sensitivity assay (hsTn); parameters of tissue hemodynamics, including the mean blood flow velocity (Vm) and pulsatility index (PI), were measured using high-frequency ultrasound doppler flowmetry; echocardiographic indexes of left heart remodeling were recorded at baseline and after 6 month of VCR monitoring.Results Mean age of patients was 74±7 years. Medians [25th percentile; 75th percentile] of baseline hsTn concentrations were 10.2 [5.25; 21.2] ng / l in group 1 and 10.3 [5.4; 20.4] ng / ml in group 2 (p=0.91). 89.5 % of patients in group 1 and 100 % of patients in group 2 achieved the VCR range goal. At 6 month, resting VCRs were 70±4 bpm in group 1 (n=34) and 88±5 bpm in group 2 (n=37) (p1, p2<0.001). According to echocardiographic data significant progression of myocardial remodeling was not observed. Concentrations of hsTn significantly decreased in both groups but the decrease was more pronounced in group 1, to 8.0 [4.13; 17.23; p1<0.001] ng / l vs. 9.2 [4.8, 17.5] ng / l in group 2 (р1, p2<0.001). A weak direct correlation was found between the VCR decrease and hsTn concentration (rs=0.44; p=0.009 in group 1, and rs=0.41; p=0.01 in group 2); regression coefficient was 0.78 at 95 % confidence interval (CI), from 0.21 to 1.3 (p=0.009) in group 1, and 0.14 at 95 % CI, from 0.04 to 0.24 (p=0.007) in group 2. Vm values were increased to 2.93±0.10 (p<0.001) and 3.21±0.09 cm / sec (p<0.001) and PIs were decreased to 1.42±0.03 conv. units (p<0.01) and to 1.34±0.02 conv. units (p<0.001) in groups 1 and 2, respectively.Conclusion The treatment aimed at VCR control in patients older than 60 with permanent AF was associated with a positive dynamics of myocardial injury (hsTn) and tissue hemodynamics indexes (Vm и РI). This indicates a possibility for using these indexes for further improvement of managing such patients.
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Affiliation(s)
- S G Kanorskiy
- Kuban State Medical University, Ministry of Health of the Russian Federation
| | - L V Polischuk
- Kuban State Medical University, Ministry of Health of the Russian Federation
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Jain D, Mohan R, Singh VD. Comparison of microsurgical and macrosurgical technique using bioactive synthetic bone graft and collagen membrane for an implant site development: A randomized controlled clinical trial. J Indian Soc Periodontol 2019; 23:448-460. [PMID: 31543619 PMCID: PMC6737851 DOI: 10.4103/jisp.jisp_738_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Implant site development can be effective in minimizing postextraction alveolar ridge resorption in the esthetic region. Microsurgical approach has demonstrated substantial improvement in soft-tissue architecture. Aim and Objectives: The aim of the present study was to evaluate and compare the efficacy of microsurgical technique with conventional one for implant site development utilizing biphasic hydroxyapatite/beta-tricalcium phosphate bone graft substitute and collagen membrane. Materials and Methods: Thirty extraction sites were planned for implant placement and randomly divided into control (macrosurgical/conventional) and test (microsurgery) sites. Clinical measurements were recorded at four different points of extraction socket, i.e., mesiobuccal, midbuccal, distobuccal, and midlingual/palatal at baseline, 3, 6, and 9 months. Postoperative neovascularization at control and test site was evaluated by ultrasound Doppler flowmetry at baseline, 10th day, and 1 month. Radiological assessment of bone density (Hounsfield units) was measured at control and test sites at baseline, 6 and 9 months by computed tomography. Data was subjected to statistical analysis. Results: Significant socket fill at all the four different sites was observed and found to be statistically significant at test as compared to control group with better tissue contour after 3, 6, and 9 months. Test group demonstrated better neovascularization (P < 0.05) with significantly higher bone density (P = 0.000) at different time intervals. Conclusions: The results indicate that the augmentation of extraction sockets, not only improved the quality of bone in both the techniques but the utilization of microsurgical instruments and microsutures under magnification definitely enhanced the quality of soft tissues which is imperative for successful implant placement and its survival.
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Affiliation(s)
- Deepali Jain
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Ranjana Mohan
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Vikram Deep Singh
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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Sameera S, Aravind Kumar P, Nagasri M, Indeevar P, Raviraj K. ENAP vs LANAP: assessment of revascularization using ultrasound Doppler flowmetry-a split-mouth randomized controlled clinical trial. Lasers Med Sci 2018; 33:1181-1188. [PMID: 29392530 DOI: 10.1007/s10103-018-2451-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022]
Abstract
Laser-assisted new attachment procedure (LANAP) is a new protocol that has been proposed for the treatment of periodontitis. However, there is little evidence regarding the rate of revascularization and the clinical efficacy of LANAP over conventional periodontal therapies. Hence, this study is done to evaluate and compare the clinical efficacy of LANAP vs Excisional new attachment procedure (ENAP) and also to assess the blood flow in both the techniques using ultrasound Doppler flowmetry. A split-mouth double-blinded controlled clinical trial was carried out in 15 subjects with chronic periodontitis. In every patient, 2 quadrants were treated with ENAP and the other 2 quadrants with LANAP. Clinical parameters like plaque index (PI), gingival index (GI), pocket depth (PD), clinical attachment level (CAL), and radiographic measurements (RBL) were recorded at baseline and 6, 9, and 12 months, postoperatively. Gingival blood flow assessment was done at baseline and on the ninth day postoperatively. Both the groups showed statistically significant reduction in all the clinical parameters when compared from baseline to subsequent follow-up visits. There was greater reduction in all the parameters in LANAP group than that of ENAP group. The rate of revascularization was higher in ENAP group than that of LANAP group when compared from baseline to the ninth day postoperatively. Although there is a delay in the rate of revascularization in the LANAP group, there was significant improvement in all the clinical and radiographic parameters than that of the ENAP group when compared from baseline to follow-up visits.
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Affiliation(s)
- Shaik Sameera
- Department of Periodontics and Implantology, St. Joseph Dental College, Eluru, India.
| | | | - Medandrao Nagasri
- Department of Periodontics and Implantology, St. Joseph Dental College, Eluru, India
| | - Pantareddy Indeevar
- Department of Periodontics and Implantology, St. Joseph Dental College, Eluru, India
| | - Kalapala Raviraj
- Department of Periodontics and Implantology, St. Joseph Dental College, Eluru, India
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12
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Kouadio AA, Jordana F, Koffi NJ, Le Bars P, Soueidan A. The use of laser Doppler flowmetry to evaluate oral soft tissue blood flow in humans: A review. Arch Oral Biol 2017; 86:58-71. [PMID: 29182953 DOI: 10.1016/j.archoralbio.2017.11.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 11/17/2017] [Accepted: 11/19/2017] [Indexed: 02/07/2023]
Abstract
The objective of this work is to define the conditions for improving the use of laser Doppler flowmetry (LDF) and to determine the limits for the use of this technique. This article systematically reviews the literature on the evaluation of oral soft tissue blood microcirculation by LDF. We analysed the available literature through October 2016 using the database resources Medline/PubMed, the Cochrane Oral Health Group Specialist Trials Register and the ISI Web of Knowledge. Several points emerged from this literature review The use of LDF involves specific constraints; however, the influence of different factors (temperature, tobacco, pressure etc.) must be adequately controlled when using LDF. LDF measurements of soft tissue within the oral cavity vary depending on the anatomical site. In dentistry, LDF can be used to track healing progress in periodontal surgery and to diagnose vascular flow changes in the connective tissue of mucosae covered by a removable prosthesis at an early stage prior to the onset of clinical inflammation signs.
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Affiliation(s)
- Ayepa Alain Kouadio
- Department of Prosthetic, UIC Odontology, Nantes Dental school 1, Place Alexis-Ricordeau, 44042 Nantes Cedex 1, France; UFR d'Odonto-stomatologie, Université Félix Houphouët Boigny, 22 BP 612 Abidjan 22, Cote d'Ivoire.
| | - Fabienne Jordana
- Department of Prosthetic, UIC Odontology, Nantes Dental school 1, Place Alexis-Ricordeau, 44042 Nantes Cedex 1, France.
| | - N'goran Justin Koffi
- UFR d'Odonto-stomatologie, Université Félix Houphouët Boigny, 22 BP 612 Abidjan 22, Cote d'Ivoire.
| | - Pierre Le Bars
- Department of Prosthetic, UIC Odontology, Nantes Dental school 1, Place Alexis-Ricordeau, 44042 Nantes Cedex 1, France.
| | - Assem Soueidan
- Department of Periodontology, UIC Odontology, Nantes Dental School 1, Place Alexis-Ricordeau, 44042 Nantes Cedex 1, France.
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13
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Lenasi H, Potočnik N, Petrishchev N, Papp M, Egorkina A, Girina M, Skedina M, Kovaleva A. The measurement of cutaneous blood flow in healthy volunteers subjected to physical exercise with ultrasound Doppler imaging and laser Doppler flowmetry. Clin Hemorheol Microcirc 2017; 65:373-381. [DOI: 10.3233/ch-16204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Helena Lenasi
- Institute of Physiology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Nejka Potočnik
- Institute of Physiology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Nikolaj Petrishchev
- Saint-Petersburg I.P. Pavlov State Medical University (PSPbGMU), St. Petersburg, Russia
| | - Marina Papp
- North-West State Medical University, L.G. Sokolov Clinical Hospital N 122, St. Petersburg, Russia
| | | | | | - Marina Skedina
- State Scientific Center of the Russian Federation Institute of Biomedical Problems RAS, Moscow, Russia
| | - Anna Kovaleva
- State Scientific Center of the Russian Federation Institute of Biomedical Problems RAS, Moscow, Russia
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14
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Krechina EK, Smirnova TN. [Modern approaches to periodontal microcirculatory parameters assessment]. STOMATOLOGII︠A︡ 2017; 96:28-32. [PMID: 28317826 DOI: 10.17116/stomat201796128-32] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The article presents comprehensive functional study of periodontal tissues in 62 patients aged 20-45 with periodontal disease by laser Doppler flowmetry, Doppler ultrasound and computer capillaroscopy. All patients were divided into 5 groups depending on the severity of inflammation in the periodontium (chronic gingivitis, light, moderate and severe chronic periodontal disease). The relationship between microcirculatory indexes was evaluated by Pearson Product Moment Correlation or PPMC. The study shows high correlation between blood flow velocity measurement, diameter of microvessels and oxygen saturation in periodontal tissues that establish a direct relationship between studied parameters.
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Affiliation(s)
- E K Krechina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - T N Smirnova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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15
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Siraeva Z, Đặng T, Yergeshov A, Salikhova T, Lopukhov L, Abdullin T. Evaluation of skin irritation in rats using simultaneous laser Doppler flowmetry and oxygenation monitoring. BIONANOSCIENCE 2016. [DOI: 10.1007/s12668-016-0242-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Kim D, Park SH. Effects of age, sex, and blood pressure on the blood flow velocity in dental pulp measured by Doppler ultrasound technique. Microcirculation 2016; 23:523-529. [DOI: 10.1111/micc.12302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/10/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Dohyun Kim
- Department of Conservative Dentistry and Oral Science Research Center; Yonsei University College of Dentistry; Seoul Korea
| | - Sung-Ho Park
- Department of Conservative Dentistry and Oral Science Research Center; Yonsei University College of Dentistry; Seoul Korea
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17
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Pilot Study of Laser Doppler Measurement of Flow Variability in the Microcirculation of the Palatal Mucosa. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5749150. [PMID: 27340663 PMCID: PMC4908244 DOI: 10.1155/2016/5749150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 01/19/2016] [Accepted: 01/21/2016] [Indexed: 11/18/2022]
Abstract
Background. Histopathological alterations can arise when the denture-supporting mucosa experiences microbial and mechanical stress through the denture base and diagnosis of these diseases usually follows microvascular changes. Microcirculation measurement could allow for detection of such dysfunction and aid in the early diagnosis of palatal mucosa pathologies. Materials and Methods. We tested the sensitivity of laser Doppler for measuring the microcirculation of the palatal mucosa, assessing the median raphe (MR), Schroeder area (SA), and retroincisive papilla (RP). A Doppler PeriFlux 5000 System, containing a laser diode, was used. 54 healthy participants were recruited. We compare the measurements of PU (perfusion unit) using ANOVA test. Results. The numerical values for palatal mucosa blood flow differed significantly among the anatomical areas (p = 0.0167). The mean value of Schroeder area was 92.6 (SD: 38.4) and was significantly higher than the retroincisive papilla (51.9) (SD: 20.2) (p < 0.05), which in turn was higher than that of median raphe (31.9) (SD: 24.2) (p < 0.0001). Conclusion. Schroeder area appeared to have the greatest sensitivity, and vascular flow variability among individuals was also greatest in this region. We suggest that analysis of blood stream modification with laser Doppler of the palatal mucosa can help to detect onset signs of pathological alterations.
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18
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Park M, Jeong S, Na H, Chung J. Porphyromonas gingivalisinduces autophagy in THP-1-derived macrophages. Mol Oral Microbiol 2016; 32:48-59. [DOI: 10.1111/omi.12153] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2016] [Indexed: 12/30/2022]
Affiliation(s)
- M.H. Park
- Department of Oral Microbiology; School of Dentistry; Pusan National University; Yangsan South Korea
| | - S.Y. Jeong
- Department of Oral Microbiology; School of Dentistry; Pusan National University; Yangsan South Korea
| | - H.S. Na
- Department of Oral Microbiology; School of Dentistry; Pusan National University; Yangsan South Korea
| | - J. Chung
- Department of Oral Microbiology; School of Dentistry; Pusan National University; Yangsan South Korea
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Taşdemir Z, Alkan BA, Albayrak H. Effects of Ozone Therapy on the Early Healing Period of Deepithelialized Gingival Grafts: A Randomized Placebo-Controlled Clinical Trial. J Periodontol 2016; 87:663-71. [PMID: 26777769 DOI: 10.1902/jop.2016.150217] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study evaluates the effects of ozone therapy (OT) on the early healing period of deepithelialized gingival grafts (DGG) placed for non-root coverage gingival augmentation by laser Doppler flowmetry (LDF). METHODS Thirty-three patients were assigned to study groups: 1) test: DGG + OT; or 2) control group: DGG alone. Thirty patients completed the study. Ozone was applied on DGGs placed in the recipient bed and donor site immediately after surgery and at days 1 and 3 post-surgery. Blood perfusion in the recipient site was measured by LDF on the day of surgery and at 1, 2, 3, 6, 8, 10, and 13 days after surgery. Quality of life (assessed by the Oral Health Impact Profile-14) and pain at donor/recipient sites (assessed by visual analog scale) were also investigated. RESULTS Increase in blood perfusion units in the test group was significantly higher than control group at 1, 2, 3, 6, and 8 days post-surgery (P <0.001). Significant differences occurred between test and control groups in terms of visual analog scale values during the first week post-surgery for both donor and recipient sites (P <0.05). The ozone-treated group showed significantly higher quality of life than control group on postoperative day 6 (P = 0.002). CONCLUSIONS OT enhanced blood perfusion units in the first postoperative week. This outcome is also consistent with improvement in wound healing, accompanied by an increase in quality of life and decrease in postoperative pain in the test group.
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Affiliation(s)
- Zekeriya Taşdemir
- Department of Periodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Banu Arzu Alkan
- Department of Periodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Haydar Albayrak
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University
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Rechmann P, Liou SW, Rechmann BMT, Featherstone JDB. Performance of a light fluorescence device for the detection of microbial plaque and gingival inflammation. Clin Oral Investig 2015; 20:151-9. [PMID: 25914048 DOI: 10.1007/s00784-015-1481-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 04/15/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The hypothesis to be tested was that using the SOPROCARE system in fluorescence perio-mode allows scoring of microbial plaque that is comparable to the Turesky modification of the Quigley Hein plaque index (T-QH) and scoring of gingival inflammation comparable to the Silness and Löe gingival inflammation index (GI). MATERIALS AND METHODS Fifty-five subjects with various amounts of microbial plaque were recruited. The T-QH and GI index were recorded. SOPROCARE pictures were recorded in fluorescence perio-mode and in daylight mode. Finally, conventional digital photographs were taken. All pictures were assessed using the same criteria as described for the clinical indices. RESULTS The average T-QH was 1.1 ± 1.2 (mean ± SD). Scoring with SOPROCARE perio-mode led to a slightly higher average than the T-QH scores. SOPROCARE daylight mode and digital photography showed the highest plaque scores. The average GI index was 0.7 ± 0.9. SOPROCARE in perio-mode scored slightly lower. Linear regression fits between the different clinical indices and SOPROCARE scores were significantly different from zero demonstrating high goodness of fit. CONCLUSIONS The study demonstrated that the SOPROCARE fluorescence assessment tool in perio-mode allows reliable judgment of microbial plaque and gingival inflammation levels similar to the established Turesky-modified Quigley Hein index and the Silness and Löe gingival inflammation index. Training on plaque-free teeth will actually reduce scoring errors. CLINICAL RELEVANCE The SOPROCARE fluorescence tool in perio-mode provides reliable evaluation of microbial plaque and gingival inflammation for the dental clinician.
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Affiliation(s)
- Peter Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA.
| | - Shasan W Liou
- Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA
| | - Beate M T Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA
| | - John D B Featherstone
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA
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