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Watanabe C, Wada J, Mizutani K, Nagayama T, Uchida H, Shibata Y, Wakabayashi N. Radiographic predictive factors for 10-year survival of removable partial denture abutment teeth: Alveolar bone level and density. J Prosthodont Res 2023; 67:437-443. [PMID: 36418082 DOI: 10.2186/jpr.jpr_d_22_00034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE To determine postoperative periodontal and radiographic factors that predict the survival rates of abutments of removable partial dentures (RPDs). METHODS Patients who wore RPDs for > 10 years and received supportive periodontal therapy were included. Periodontal examinations and radiographic assessments were conducted on 83 abutment teeth in 35 patients at baseline, and five years after RPD insertion. In addition to conventional factors, such as tooth mobility at 5 years, radiographic factors, such as the crown-root ratio (ΔCR ratio) and gray-level changes reflecting changes in alveolar bone density (ΔABD), were evaluated. The impact of the covariables on the 10-year survival of abutment teeth was estimated using a multivariate Cox regression model, considering multicollinearity. RESULTS Patients were classified as having A2-B2 (45.7%) and B3-C2 (54.3%) tooth loss, according to the Eichner classification. A probing depth ≥ 4 mm, tooth mobility ≥ grade 1, and CR ratio ≥ 1 were found in 30.1%, 33.7%, and 51.8% of abutment teeth, respectively. The 10-year survival rate of abutment teeth was 86.7%. Multivariate analysis showed that the 10-year survival of abutment teeth was significantly associated with root canal treatment (P = 0.045, hazard ratio [HR] = 1.23), the 5-year ΔCR ratio (P = 0.022, HR = 3.20), and ΔABD on the edentulous side of the abutment teeth (P = 0.047, HR = 1.08). CONCLUSIONS In addition to root canal treatment, changes in the CR ratio and radiographic alveolar bone density at five years predicted the long-term survival rate of RPD abutments.
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Affiliation(s)
- Chie Watanabe
- Department of Conservative Dentistry, Division of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| | - Junichiro Wada
- Department of Advanced Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomiharu Nagayama
- Department of Advanced Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hirofumi Uchida
- Department of Advanced Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yo Shibata
- Department of Conservative Dentistry, Division of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| | - Noriyuki Wakabayashi
- Department of Advanced Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Naicker M, Ngo LH, Rosenberg AJ, Darby IB. The effectiveness of using the perioscope as an adjunct to non-surgical periodontal therapy: Clinical and radiographic results. J Periodontol 2021; 93:20-30. [PMID: 33909914 DOI: 10.1002/jper.20-0871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/21/2021] [Accepted: 04/03/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND It is well known that following root surface debridement (RSD) residual deposits remain. Periodontal endoscopy has provided a method of directly visualizing root surfaces during periodontal debridement in an intact pocket without the need for surgical incision. The aim of this study was to determine if periodontal debridement using endoscopic visualization was more effective in improving clinical and radiographic parameters as compared to RSD. METHODS Thirty-eight subjects were randomized into RSD with perioscope (n = 19) or RSD only (n = 19) groups. A full-mouth evaluation included probing pocket depths (PPDs), clinical attachment levels (CAL), bleeding on probing (BOP) and plaque scores (PI) recorded at baseline, 3 and 12 months and compared among groups. Radiographs were taken at sites with deepest pockets at baseline and 12-month and the change in radiographic bone levels (RBL) compared. An independent samples T-test was used to assess statistical significance. RESULTS Both groups had significant improvements in clinical outcomes. The test (T) group had a significantly lower percentage of PPDs 7 to 9 mm at three (0.72 ± 1.2%) and 12 months (0.5 ± 1.0%) as compared with the control (C) group (2.25 ± 2.9%; 1.84 ± 2.3%). At 12 months, the test group recorded a significantly lower mean PPD (T: 2.70 + 0.2 mm; C: 2.98 ± 0.4 mm), BOP% (T: 4.3 ± 3.2%; C: 11.95 ± 7.1%), PI% (T: 25.61 ± 3.9%; C: 30.11 ± 6.3%) and less change in gingival recession (T: -0.13 ± 0.2 mm; C: -0.50 ± 0.6 mm) (P < 0.05). More radiographic bone gain was observed in the test group (0.69 ± 0.3 mm) as compared with the control group (0.49 ± 0.2 mm). This was also observed around multi-rooted teeth (T: 0.83 ± 0.45 mm; C: 0.46 ± 0.36 mm). CONCLUSION The adjunctive use of the perioscope provided a slight benefit to the outcomes of non-surgical therapy particularly at deeper probing depths.
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Affiliation(s)
- Meloshini Naicker
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
- The Perio Centre, East Malvern, Victoria, Australia
| | - Luan H Ngo
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | | | - Ivan B Darby
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
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Trombelli L, Simonelli A, Minenna L, Vecchiatini R, Farina R. Simplified procedures to treat periodontal intraosseous defects in esthetic areas. Periodontol 2000 2018; 77:93-110. [DOI: 10.1111/prd.12213] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Watanabe C, Wada J, Mizutani K, Watanabe H, Wakabayashi N. Chronological grey scale changes in supporting alveolar bone by removable partial denture placement on patients with periodontal disease: A 6-month follow-up study using digital subtraction analysis. J Dent 2017; 63:8-13. [PMID: 28478215 DOI: 10.1016/j.jdent.2017.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/27/2017] [Accepted: 05/02/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The purpose was to assess the early effects of removable partial denture (RPD) placement on abutment teeth in patients with periodontal disease. METHODS Fifteen distal-extension RPDs and 19 abutment teeth were evaluated in 13 patients with moderate-to-severe periodontal diseases. Clinical periodontal records and grey level (GL) score based on digital subtraction radiography were measured on the day of denture placement (baseline) and at 1day, 1 week, 1 month, 3 months, and 6 months after the placement. Occlusal force on total dentition (Ft) and abutment tooth (Fa) were recorded with (baseline) and without denture on the day of the placement, and with denture in the follow-up examinations. RESULTS No statistically significant difference between a follow-up period and the baseline was found in the clinical periodontal and occlusal force records, except for Ft with denture on the day of the placement, which was significantly lower than the baseline (p<0.05). The GL at distal crestal of the abutment was significantly higher at 1 week after the placement than at the baseline (p<0.05), while the scores of following examinations returned to the baseline level. CONCLUSIONS The distal crestal bone of the abutment tooth transitorily reacts to mechanical stress due to the denture placement, while this does not suggest a detrimental effect within the limitation of the study design with a short-term observation period. CLINICAL SIGNIFICANCE The RPDs can be safely used for patients with periodontal diseases for at least 6 months if they are properly placed and maintained by professional care.
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Affiliation(s)
- Chie Watanabe
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Junichiro Wada
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroshi Watanabe
- Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Noriyuki Wakabayashi
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
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Nibali L, Pometti D, Chen TT, Tu YK. Minimally invasive non-surgical approach for the treatment of periodontal intrabony defects: a retrospective analysis. J Clin Periodontol 2015; 42:853-859. [DOI: 10.1111/jcpe.12443] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Luigi Nibali
- Periodontology Unit and Department of Clinical Research; UCL Eastman Dental Institute; London UK
- Private practice; London and Bishop's Stortford UK
| | | | - Tzu-Ting Chen
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Yu-Kang Tu
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
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Nibali L, Pelekos G, Onabolu O, Donos N. Effect and timing of non-surgical treatment prior to periodontal regeneration: a systematic review. Clin Oral Investig 2015; 19:1755-61. [DOI: 10.1007/s00784-015-1493-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/04/2015] [Indexed: 01/31/2023]
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Abstract
Periodontitis can lead to vertical bone loss with the creation of 'intrabony defects', associated with higher risk of progression if left untreated. Intrabony defects are considered candidates for periodontal surgical procedures, in order to arrest disease progression and achieve bone regeneration. This paper brings forward anecdotal and scientific evidence from the literature to describe how even non-surgical periodontal treatment can result in clinical and radiographic resolution of periodontal intrabony defects.
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de Barros FC, Braga FF, Fischer RG, Figueredo CMDS. Effects of nonsurgical periodontal treatment on the alveolar bone density. Braz Dent J 2014; 25:90-5. [PMID: 25140711 DOI: 10.1590/0103-6440201302308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 09/22/2013] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the effects of nonsurgical periodontal treatment on alveolar bone density (ABD) and bone height (BH) using direct digital radiography. Nineteen patients (mean age: 36 ± 7.3 years) with generalized chronic periodontitis were examined at baseline, 90 (90 AT) and 180 (180 AT) days after nonsurgical periodontal therapy. Radiographs were taken from two sites with specific characteristics: 39 sites with probing pocket depth (PPD) ≤ 3 mm and clinical attachment level (CAL) ≤ 1 mm (shallow sites); and 62 sites with PPD ≥ 5 mm and CAL ≥ 3 mm (deep sites). The ABD was assessed considering the bone regions of interest at the alveolar bone crest (ROI I) and at the medullar bone (ROI II). The BH was assessed considering the distance from the alveolar bone crest to the cementoenamel junction. Mann-Whitney test was used for the overall demographic data, Wilcoxon test was used to compare the baseline, 90 AT and 180 AT data as well as to compare the groups and subgroups within the same evaluation period. The significance level was set at 5%. The deep sites showed a significant increase of ABD in ROI I at 90 AT (p<0.007) and at 180 AT (p<0.005). ABD decrease was seen in ROI II at 180 AT (p<0.04) while BH reduced only in shallow sites at 90 AT. In conclusion, an increase in ABD was observed in deep sites of patients with generalized chronic periodontitis. However, no significant change in alveolar BH was observed in these sites.
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Affiliation(s)
- Fabiana Cervo de Barros
- Department of Periodontology, Dental School, UERJ - Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Flávia Farah Braga
- Department of Periodontology, Dental School, UERJ - Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Ricardo Guimarães Fischer
- Department of Periodontology, Dental School, UERJ - Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
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Armitage GC. Learned and unlearned concepts in periodontal diagnostics: a 50-year perspective. Periodontol 2000 2014; 62:20-36. [PMID: 23574462 DOI: 10.1111/prd.12006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the past 50 years, conceptual changes in the field of periodontal diagnostics have paralleled those associated with a better scientific understanding of the full spectrum of processes that affect periodontal health and disease. Fifty years ago, concepts regarding the diagnosis of periodontal diseases followed the classical pathology paradigm. It was believed that the two basic forms of destructive periodontal disease were chronic inflammatory periodontitis and 'periodontosis'- a degenerative condition. In the subsequent 25 years it was shown that periodontosis was an infection. By 1987, major new concepts regarding the diagnosis and pathogenesis of periodontitis included: (i) all cases of untreated gingivitis do not inevitably progress to periodontitis; (ii) progression of untreated periodontitis is often episodic; (iii) some sites with untreated periodontitis do not progress; (iv) a rather small population of specific bacteria ('periodontal pathogens') appear to be the main etiologic agents of chronic inflammatory periodontitis; and (v) tissue damage in periodontitis is primarily caused by inflammatory and immunologic host responses to infecting agents. The concepts that were in place by 1987 are still largely intact in 2012. However, in the decades to come, it is likely that new information on the human microbiome will change our current concepts concerning the prevention, diagnosis and treatment of periodontal diseases.
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Resolution of Localized Chronic Periodontitis Associated with Longstanding Calculus Deposits. Case Rep Dent 2014; 2014:391503. [PMID: 24876977 PMCID: PMC4026880 DOI: 10.1155/2014/391503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/28/2014] [Accepted: 04/11/2014] [Indexed: 11/22/2022] Open
Abstract
This report, which is based on nonstandardized serial radiographs obtained over a period of 15 years, documents a case of localized chronic periodontitis associated with progressive deposition of calculus on the distal aspect of a mandibular second molar. The site was treated by scaling and root planing, followed by a course of adjunctive systemic azithromycin. Treatment yielded favorable reductions in probing depth and clinical inflammation, leaving only few isolated sites with pockets no deeper than 4 mm. Two years after completion of active treatment, there was radiographic evidence of increased bone density distal to the second molar.
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Nibali L, Pometti D, Tu YK, Donos N. Clinical and radiographic outcomes following non-surgical therapy of periodontal infrabony defects: a retrospective study. J Clin Periodontol 2010; 38:50-7. [DOI: 10.1111/j.1600-051x.2010.01648.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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12
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Tu YK, Donos N, Pometti D, Nibali L. Latent variable approach to correct errors in radiographic measurements. Eur J Oral Sci 2010; 118:642-8. [DOI: 10.1111/j.1600-0722.2010.00781.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Alves LS, Fontanella V, Damo AC, Ferreira de Oliveira E, Maltz M. Qualitative and quantitative radiographic assessment of sealed carious dentin: a 10-year prospective study. ACTA ACUST UNITED AC 2010; 109:135-41. [PMID: 20123388 DOI: 10.1016/j.tripleo.2009.08.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 08/11/2009] [Accepted: 08/11/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study was to assess radiographic outcomes after partial carious dentin removal performed in deep caries lesions over a 10-year period. STUDY DESIGN Baseline image was compared to 3 follow-up radiographs (at 6-7 months, 3 years, and 10 years). Tertiary dentin deposition and lesion depth were qualitatively assessed. Radiographic density changes in the radiolucent zone (RZ) beneath the restoration were quantitatively compared to the control areas (CA) using digital subtraction radiography (Friedman repeated-measures analysis of variance). RESULTS A total of 13 teeth were evaluated. In most cases, lesion depth remained unchanged or decreased (12/13) and tertiary dentin formation was observed (10/13) after the 10-year follow-up. Differences between RZ and CA at the 6- to 7-month and 3-year follow-up periods were similar but significantly lower than those at the 10-year assessment. CONCLUSIONS Sealing of carious dentin arrested the caries process, promoted deposition of tertiary dentin, and induced mineral gain in the radiolucent zone.
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Affiliation(s)
- Luana Severo Alves
- Department of Social and Preventive Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Borges GJ, Novaes AB, de Moraes Grisi MF, Palioto DB, Taba M, de Souza SLS. Acellular dermal matrix as a barrier in guided bone regeneration: a clinical, radiographic and histomorphometric study in dogs. Clin Oral Implants Res 2009; 20:1105-15. [DOI: 10.1111/j.1600-0501.2009.01731.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Corbet EF, Ho DKL, Lai SML. Radiographs in periodontal disease diagnosis and management. Aust Dent J 2009; 54 Suppl 1:S27-43. [DOI: 10.1111/j.1834-7819.2009.01141.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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