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Mukherjee M, Nair V, Phull T, Jain A, Grover V, Ali ABM, Arora S, Das G, Hassan SAB, Sainudeen S, Saluja P. Biometric analysis of furcation area of molar teeth and its relationship with instrumentation. BMC Oral Health 2024; 24:436. [PMID: 38600486 PMCID: PMC11005133 DOI: 10.1186/s12903-024-04164-2] [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: 11/27/2023] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
The anatomy of furcation favours the bacterial retention and makes periodontal debridement as well as oral hygiene procedures difficult. Teeth that have lost attachment to a level of the furcation are said to have a furcal invasion or furcation involved.Involvement of furcation in a multi-rooted tooth poses a very different type of clinical situation in terms of establishment of diagnosis, determination of prognosis and of course planning the treatment modality.The present study was carried out on 200 selected extracted human first and second permanent molar teeth based on a predefined criteria. Teeth with prosthetic crowns, fused or fractured roots, those not fully developed, grossly carious or heavily restored at the cementoenamel junction (CEJ) were excluded from the study. The morphology of the root trunk was recorded by measuring various dimensions of the root trunk,including furcal angle and root trunk volume was calculated by using a custom made special apparatus. The furcation areas were debrided with different types of curettes in the market in order to see how best the instrument could be maneuvered in the furcation area. The data so obtained was statistically analysed using SPSS version 22. The highest root trunk volume and the longest root trunk length were found to be in the maxillary second molar. 48.60% furcations didn't allow instrument engagementof furcation area with standard area specific curettes. The proposal of inclusion of root trunk length (mm) is suggested in addition to classification of FI to have assess prognosis and appropriate treatment for of the involved tooth.
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Affiliation(s)
| | - Vineet Nair
- Dr. R Ahmed Dental College and Hospital, Kolkata, India
| | - Tanvi Phull
- Department of Oral and Maxillofacial Surgery, Gian Sagar Dental College, Rajpura, Patiala, India
| | - Ashish Jain
- Department of Periodontology and Oral Implantology Dr.H.S.J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Vishakha Grover
- Department of Periodontology and Oral Implantology Dr.H.S.J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Ahmed Babiker Mohamed Ali
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Saudi Arabia
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Saudi Arabia
| | - Gotam Das
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, 61421, Saudi Arabia.
| | - Saeed Awod Bin Hassan
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Saudi Arabia
| | - Shan Sainudeen
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Saudi Arabia
| | - Priyanka Saluja
- Department of Dentistry, University of Alberta, Edmonton, AB, Canada
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Peeran SW, Ramalingam K, Sethuraman S, Thiruneervannan M. Furcation Involvement in Periodontal Disease: A Narrative Review. Cureus 2024; 16:e55924. [PMID: 38601385 PMCID: PMC11004587 DOI: 10.7759/cureus.55924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/12/2024] Open
Abstract
Furcation-involved teeth, commonly seen in dental practice, have a higher likelihood of needing extraction as the severity of periodontal furcation involvement increases. Studies consistently show that periodontitis in teeth with multiple roots significantly increases the risk of tooth loss, especially in the area where the furcation is involved. These furcation defects pose a major problem for dentists because of their location, accessibility issues, and the unpredictable healing process. The biggest hurdle in treating furcation defects is their irregular shape, which makes it hard to achieve complete debridement. While various treatments have been explored, non-surgical methods have not shown much success. This article comprehensively provides a review and discussion on the classification, assessment, and treatment options, including surgical and non-surgical management of furcation-involved molar teeth. Properly understanding the severity of the disease and its confounding factors and managing and treating the lesions appropriately have been shown to impart satisfactory survival rates for these teeth. Enhancing the understanding of managing these teeth can also lead to better outcomes for patients.
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Affiliation(s)
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sathya Sethuraman
- Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Bhatsange A, Kamble SP. Assessment of nutritional status in chronic periodontitis patients: A cross-sectional study. J Indian Soc Periodontol 2024; 28:231-243. [PMID: 39411731 PMCID: PMC11472975 DOI: 10.4103/jisp.jisp_263_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/12/2024] [Accepted: 07/04/2024] [Indexed: 10/19/2024] Open
Abstract
Background This cross-sectional study compared the nutritional status of chronic periodontitis (CP) patients who presented with various degrees of severity with systemically healthy individuals using the Mini Nutritional Assessment (MNA®) tool along with laboratory analysis of macro- and micronutrients. Materials and Methods This research enrolled a total of 84 participants, of which 63 belonged to the CP group while 21 served as healthy controls. The CP patients were divided into three groups of 21 each, based on severity as mild, moderate, and severe. Clinical periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment level/loss, total number of teeth present [NOT-P], furcation involvement, pathological migration, and tooth mobility), biochemical parameters (lipid, protein, iron profiles, and Vitamin D3 and B12), and the MNA® tool were used to assess the nutritional status of all the participants. The results were analyzed statistically. Results NOT-P, MNA score, lipid profile (except very-low-density lipoprotein), iron profile (except total iron-binding capacity), and Vitamin D3 showed high significant differences (P < 0.001) among the groups. However, Vitamin B12 and protein profile except for total protein revealed significant differences (P < 0.05). Conclusion CP can be a contributing risk factor for the development of malnutrition. MNA® tool can be used for assessing the nutritional status of CP patients.
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Affiliation(s)
- Anuradha Bhatsange
- Department of Periodontology and Oral Implantology, JMF’s ACPM Dental College, Dhule, Maharashtra, India
| | - Sanika Prakash Kamble
- Department of Periodontology and Oral Implantology, JMF’s ACPM Dental College, Dhule, Maharashtra, India
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Alotaibi RA, Abdulaziz R, Bery N, Alotaibi MA, Kolarkodi SH. Assessing the Accuracy and Reliability of Cone-Beam Computed Tomography (CBCT) in Diagnosing Grade II and III Furcation Involvement Compared to Traditional Clinical Examination Methods. Cureus 2024; 16:e55117. [PMID: 38558584 PMCID: PMC10979309 DOI: 10.7759/cureus.55117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Chronic periodontal diseases can lead to bone defects and tooth loss, making accurate diagnosis essential for treatment. Various methods are used for diagnosing furcation involvement, with clinical examination and cone-beam computed tomography (CBCT) being the most effective. CBCT produces reliable images with submillimeter resolution, revealing marginal bone contours and furcation defects. Limited studies show that CBCT is more precise than clinical detection for diagnosing furcation involvement. Therefore, CBCT technology can be considered as an adjunct method for furcation involvement detection. This study tests the accuracy and efficiency of CBCT and clinical examination in detecting furcation involvement. Material and methods The study included 25 patients (68 molars) with generalized periodontitis of stage II to IV, Grade B and C. Inclusion criteria required at least two intrabony defects with probing depth > 6mm in both jaws and criteria of periodontitis in at least 30% of the teeth present. Results The study compared clinical examination and CBCT readings for measuring maxillary and mandibular teeth furcation involvement. The results show significant differences between clinical and CBCT measurements of maxillary teeth furcation involvement, particularly in specific areas and types of furcation involvement. In contrast, there were significant differences between clinical and CBCT readings for only a few measurements of mandibular teeth furcation involvement. Therefore, the study suggests that CBCT imaging may be beneficial for accurate diagnosis and treatment planning in cases of furcation involvement in maxillary teeth. Conclusion CBCT imaging is a reliable adjunct method for detecting furcation involvement in maxillary teeth, while clinical examination alone may not be sufficient. Therefore, the use of CBCT technology should be considered in cases where accurate detection of furcation involvement is necessary for successful treatment outcomes. However, further studies with larger sample sizes are needed to confirm these findings.
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Affiliation(s)
- Renad A Alotaibi
- Medicine, College of Dentistry, Qassim University, Buraydah, SAU
| | - Rehab Abdulaziz
- Diagnostic Radiology, King Fahad Specialist Hospital, Buraydah, SAU
| | - Nancy Bery
- Periodontology, College of Dentistry, Qassim University, Buraydah, SAU
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Mišković I, Kuiš D, Špalj S, Pupovac A, Prpić J. Periodontal Health Status in Adults Exposed to Tobacco Heating System Aerosol and Cigarette Smoke vs. Non-Smokers: A Cross-Sectional Study. Dent J (Basel) 2024; 12:26. [PMID: 38392230 PMCID: PMC10887685 DOI: 10.3390/dj12020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Tobacco heating systems (THS) are new products on the market, advertised as a less harmful alternative for smokers, in which tobacco is heated and not burned like in conventional cigarettes. This research explored the effect on periodontal tissues in contact with heating and burning tobacco residual products (smoke and tobacco). METHODS The sample included 66 subjects, patients of the Clinic of Dentistry in Rijeka, Croatia, aged 26-56 (median 38), 64% females. Three age- and gender-matched groups were formed (each N = 22): non-smokers, classic cigarettes smokers and THS smokers. Probing depth (PD) and clinical attachment loss (CAL) were primary research parameters. RESULTS Three groups differed in average PD and CAL (p ≤ 0.002), with cigarette smokers having the highest and non-smokers the lowest values (p ≤ 0.002). THS consumers generally had lower values of periodontal indices than smokers, but only CAL differed significantly (p = 0.011). Periodontal indices CAL and PD were worse in THS consumers than non-smokers, but they did not reach a level of statistical significance. Cigarette smoking was the only predictor of periodontitis (average CAL ≥ 4 mm) in logistic regression models, with an odds ratio of 4.7 (95% confidence interval 1.2-18.3; p = 0.027). CONCLUSIONS Exposure to nicotine-containing aerosol of THS in adults has a less harmful effect on periodontal tissues, measurable through periodontal indices (PD and CAL), compared to burning tobacco of conventional cigarettes. THS, presented as an alternative product to classic cigarettes, also has a detrimental effect on the periodontium.
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Affiliation(s)
- Ivana Mišković
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Davor Kuiš
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Stjepan Špalj
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Aleksandar Pupovac
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Jelena Prpić
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
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Yang X, Liu P, Fan X, Yu S, Chen C, Pan Y, Lin L, Tang X, Li C. Distribution and influencing factors on residual pockets of the teeth in patients with periodontitis following non-surgical periodontal treatment: a retrospective observational study. BMC Oral Health 2023; 23:736. [PMID: 37814304 PMCID: PMC10561464 DOI: 10.1186/s12903-023-03248-9] [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: 03/07/2023] [Accepted: 07/23/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Periodontitis is a chronic and multi-factorial infectious disease. A notable difference exists in the prognosis of patients with severe periodontitis after non-surgical periodontal treatment. Thus, a retrospective study was conducted to identify common and specific factors that impact the prognosis of patients with periodontitis stage III-IV following non-surgical periodontal treatment at different tooth sites. METHODS A total of 977 teeth were included in the study, comprising 266 patients diagnosed with periodontitis stage III-IV. This sample included 330 anterior teeth, 362 maxillary posterior teeth, and 285 mandibular posterior teeth. Following treatment, the teeth were categorized into two groups based on residual pocket depth [probing depth (PD) ≥ 5 mm] at 3 months post-treatment. The prognosis of periodontitis stage III-IV was assessed through multivariate analysis employing logistic regression to determine the association of various risk factors. RESULTS The PD values of each site and the deepest PD values of each tooth significantly decreased at 3 months post-treatment. Residual pockets were predominantly found in the mesio/disto-buccal and mesio/disto-lingual regions. Multivariate analysis revealed that gender, PD, sulcus bleeding index (SBI) and plaque index (PLI) at baseline, and crown-root ratio in anterior teeth had a significant influence on periodontitis stage III-IV (P < 0.05). Smoking, PD, PLI and furcation involvement (FI) at baseline, PLI at 3 months post-treatment, grades of periodontitis, and crown-root ratio were prediction factors for maxillary posterior teeth. Factors such as PD, PLI and FI at baseline, PLI at 3 months post-treatment, and crown-root were significant in mandibular posterior teeth. CONCLUSIONS The outcome of non-surgical treatment varies depending on the tooth positions for patients with periodontitis stage III-IV. Dentists must accurately identify the affected teeth that have periodontal pockets of more than 5 mm, taking into consideration the positions of the affected teeth, as well as various local and systemic factors. This comprehensive assessment will enable dentists to develop a customized and effective treatment plan.
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Affiliation(s)
- Xue Yang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
- School of Stomatology, Dalian Medical University, Dalian, Liaoning, China
| | - Peicheng Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
- Department of Stomatology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaomiao Fan
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Shiwen Yu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Chen Chen
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Yaping Pan
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Li Lin
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Xiaolin Tang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Chen Li
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China.
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Patel B, Joshi S, Nagrani T, Girdhar GA, Patel H, Sinha S, Haque M, Kumar S, Haq MA. Clinical and Radiographic Evaluation of Autologous Platelet-Rich Fibrin With or Without Demineralized Bone Matrix in the Treatment of Grade II Furcation Defects. Cureus 2023; 15:e44394. [PMID: 37654905 PMCID: PMC10468150 DOI: 10.7759/cureus.44394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction This study aims to differentiate the employment of demineralized bone matrix (DMBM; Osseograft, Advanced Biotech Products (P) Ltd, Chennai, India) and platelet-rich fibrin (PRF) alone to a composite graft consisting of both materials in the surgical actions toward the anomalies of the human periodontal furcation imperfection. Methods In a split-mouth study, 30 patients with mandibular molars affected by the furcation were allocated without conscious choice to test (PRF + DMBM, n = 30) or control (PRF, n = 30) categories. At the starting point, three months after surgery, and six months later, the following modifiable factors were evaluated: probing pocket depth (PPD), full-mouth plaque scores, full-mouth gingival scores, radiographic defect depth, relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). Results Results at three and six months demonstrated substantial differences between baseline values for both treatment methods in clinical and X-ray imaging appraisal. Nonetheless, the PRF/DMBM group manifests statistically significantly soaring changes observed in comparison to the PRF group. Overall, the probing depth (PD) in the test site was significantly lower than that in the control site, showing a reduction of 68% (95% CI=41%, 95%, p<0.001). Conclusion Clinical indications significantly improved with PRF and DMBM combined instead of PRF alone. On radiographs, the test group also showed higher bone fill.
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Affiliation(s)
- Bhavin Patel
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Surabhi Joshi
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Tanya Nagrani
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Gaurav A Girdhar
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Heli Patel
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Susmita Sinha
- Physiology, Khulna City Medical College Hospital, Khulna, BGD
| | - Mainul Haque
- Karnavati Scientific Research Center, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Santosh Kumar
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Md Ahsanul Haq
- Biostatistics, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB), Dhaka, BGD
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Lalla RV, Hodges JS, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Lin A, Brennan MT. Tooth-level predictors of tooth loss and exposed bone after radiation therapy for head and neck cancer. J Am Dent Assoc 2023; 154:519-528.e4. [PMID: 37236706 PMCID: PMC10664022 DOI: 10.1016/j.adaj.2023.03.009] [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: 12/09/2022] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND The objective of this study was to identify tooth-level risk factors for use during preradiation dental care management to predict risk of tooth failure (tooth lost or declared hopeless) and exposed bone after radiation therapy (RT) for head and neck cancer (HNC). METHODS The authors conducted a prospective observational multicenter cohort study of 572 patients receiving RT for HNC. Participants were examined by calibrated examiners before RT and then every 6 months until 2 years after RT. Analyses considered time to tooth failure and chance of exposed bone at a tooth location. RESULTS The following pre-RT characteristics predicted tooth failure within 2 years after RT: hopeless teeth not extracted pre-RT (hazard ratio [HR], 17.1; P < .0001), untreated caries (HR, 5.0; P < .0001), periodontal pocket 6 mm or greater (HR, 3.4; P = .001) or equaling 5 mm (HR, 2.2; P = .006), recession over 2 mm (HR, 2.8; P = .002), furcation score of 2 (HR, 3.3; P = .003), and any mobility (HR, 2.2; P = .008). The following pre-RT characteristics predicted occurrence of exposed bone at a tooth location: hopeless teeth not extracted before RT (risk ratio [RR], 18.7; P = .0002) and pocket depth 6 mm or greater (RR, 5.4; P = .003) or equaling 5 mm (RR, 4.7; P = .016). Participants with exposed bone at the site of a pre-RT dental extraction averaged 19.6 days between extraction and start of RT compared with 26.2 days for participants without exposed bone (P = .21). CONCLUSIONS Individual teeth with the risk factors identified in this study should be considered for extraction before RT for HNC, with adequate healing time before start of RT. PRACTICAL IMPLICATIONS The findings of this trial will facilitate evidence-based dental management of the care of patients receiving RT for HNC. This clinical trial was registered at Clinicaltrials.gov. The registration number is NCT02057510.
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Limiroli E, Calò A, Cortellini P, Eickholz P, Katayama A, Majzoub J, Wong J, McClain P, Cortinovis I, Rasperini G. The influence of interradicular anatomy on the predictability of periodontal regenerative therapy of furcation defects: a retrospective, multicenter clinical study. Clin Oral Investig 2023:10.1007/s00784-023-04995-3. [PMID: 37052671 DOI: 10.1007/s00784-023-04995-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND The relationship between the anatomy of the interradicular space and success in regenerative therapy of furcation defects is discussed in this paper. The goal of this retrospective, multicenter clinical study is to clinically evaluate the relationship between the interradicular conformation and regenerative therapy success with the use of a novel measurement method. METHODS One hundred thirty-eight radiographs of mandibular molars with furcation defects that had been treated with regenerative therapy were collected from six clinical centers. Data on the type of therapy and clinical parameters before and after treatment (follow-up of at least 12 months) were collected. The radiographs (before surgery and at least 12 months postoperatively) were measured with a visual evaluation method by a blind operator using graphics software. RESULTS Success, defined as a reduction in horizontal and vertical furcation involvement, decrease in probing depths, and increase in clinical attachment level, was statistically assessed on 138 regenerated molars sites and were related to clinical variables such as age, sex, center, and treatment. No correlation was found between success in regenerative therapy and the conformation of the interradicular space, measured with a visual ratio method and a standard linear measurement. At the univariate analysis, the parameters that had a correlation with success were center, extent of furcation involvement, treatment, and sex. The use of enamel matrix derivative (EMD) seemed to be the most favorable therapy, with increase in CAL gain and reduction of vertical or horizontal furcation involvement. CONCLUSIONS The regenerative outcome was not significantly influenced by the anatomy of furcation. The center, the degree of furcation involvement, sex, and treatment (EMD) were significantly associated with higher success of periodontal regeneration.
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Affiliation(s)
- Enrico Limiroli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
- Foundation IRCCS Ca' Granda Polyclinic, Via Della Commenda 10, 20122, Milan, Italy.
| | - Andrea Calò
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Foundation IRCCS Ca' Granda Polyclinic, Via Della Commenda 10, 20122, Milan, Italy
| | | | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt Am Main, 60596, Frankfurt Am Main, Germany
| | | | - Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer Wong
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology at the Harvard School of Dental Medicine, Boston, MA, USA
| | | | - Ivan Cortinovis
- Laboratory G.A. Maccacaro, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Foundation IRCCS Ca' Granda Polyclinic, Via Della Commenda 10, 20122, Milan, Italy
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Limiroli E, Calò A, Limiroli A, Cortinovis I, Rasperini G. Radiographic ratios for classifying furcation anatomy: proposal of a new evaluation method and an intra-rater and inter-rater operator reliability study. Clin Oral Investig 2023; 27:1541-1546. [PMID: 36781478 PMCID: PMC10102072 DOI: 10.1007/s00784-022-04774-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/06/2022] [Indexed: 02/15/2023]
Abstract
OBJECTIVES Even if it seems to be an important anatomical parameter for tissue regeneration, few studies in literature evaluate the "mean measure" of root divergence. Most of them are linear measurements, which hardly describe the dental furcation conformation in its entirety. It is left to the subjectivity of the operator deciding whether a furcation is convergent or divergent. The goal of this study is to create a visual evaluation method using specific measurements applied on endo-oral X-rays to overcome these problems, giving a conformation of the entire interradicular space and its divergence. MATERIAL AND METHODS A user-friendly software (Paint®, Windows10®) was used to take three different measurements on endo-oral radiographs of upper and lower molars. Three blind operators measured 20 radiographs, to analyze the intra- and inter-operator reproducibility of the measurements. Then, the technique was repeated on 250 radiographic images to identify an average value and define a main conformation of the interradicular space. The ratio of these three measurements allowed to develop a new visual evaluation method of the interradicular space. RESULTS Intra and inter-operator reproducibility was statistically confirmed on a sample of 20 anonymous endo-oral radiographs measured by 3 blind operators, indicating that the measurement technique was not operator dependent. Measurement made on 250 X-rays obtained with this technique permitted to subdivide in five groups the conformation of the interradicular space and define a mean value of the interradicular space. CONCLUSIONS A new anatomical evaluation of the interradicular space in its entirety, which could help the clinicians in diagnostic and decisional phase in the therapy of furcated molars, can be obtained. CLINICAL RELEVANCE A pre-operative evaluation of interradicular space conformation could affect therapy treatment choice.
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Affiliation(s)
- Enrico Limiroli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Della Commenda 10, 20122, Milan, Italy.,Foundation IRCCS Ca' Granda Polyclinic, Via Della Commenda 10, 20122, Milan, Italy
| | | | | | - Ivan Cortinovis
- Laboratory G.A. Maccacaro, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Della Commenda 10, 20122, Milan, Italy. .,Foundation IRCCS Ca' Granda Polyclinic, Via Della Commenda 10, 20122, Milan, Italy.
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Jeong YJ, Jung JI, Kim Y, Kang CH, Imm JY. Effects of Lactobacillus reuteri MG5346 on Receptor Activator of Nuclear Factor-Kappa B Ligand (RANKL)-Induced Osteoclastogenesis and Ligature-Induced Experimental Periodontitis Rats. Food Sci Anim Resour 2023; 43:157-169. [PMID: 36789196 PMCID: PMC9890358 DOI: 10.5851/kosfa.2022.e68] [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: 10/06/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022] Open
Abstract
Effects of culture supernatants of Lactobacillus reuteri MG5346 (CS-MG5346) on receptor activator of nuclear factor-kappa B ligand (RANKL)-induced osteoclastogenesis were examined. CS-MG5346 treatment up to 400 μg/mL significantly reduced tartrate-resistant acid-phosphatase (TRAP) activity, the phenotype biomarker of osteoclast, without affecting cell viability. CS-MG5346 inhibited the expression of osteoclast specific transcriptional factors (c-fos and nuclear factor-activated T cells c1) and their target genes (TRAP, cathepsin, and matrix metallo-proteinase-9) in a dose-dependent manner (p<0.05). The administration of L. reuteri MG5346 (2×108 CFU/day) for 8 wks significantly improved furcation involvement, but no difference was observed in alveolar bone loss in ligature-induced experimental periodontitis rats. The elevated RANKL/ osteoprotegerin ratio, the biomarker of periodontitis, was significantly lowered in the gingival tissue by administration of L. reuteri MG5346 (p<0.05). L. reuteri MG5346 showed excellent stability in simulated stomach and intestinal fluids and did not have antibiotic resistance. Based on the results, L. reuteri MG5346 has the potential to be a promising probiotic strain for oral health.
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Affiliation(s)
- Yu-Jin Jeong
- Department of Foods and Nutrition, Kookmin
University, Seoul 02707, Korea
| | - Jae-In Jung
- Department of Foods and Nutrition, Kookmin
University, Seoul 02707, Korea
| | | | | | - Jee-Young Imm
- Department of Foods and Nutrition, Kookmin
University, Seoul 02707, Korea,Corresponding author: Jee-Young
Imm, Department of Foods and Nutrition, Kookmin University, Seoul 02707, Korea,
Tel: +82-2-910-4772, Fax: +82-2-910-5249, E-mail:
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12
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Gill T, Bahal P, Nibali L. Furcation-involved molar teeth - part 1: prevalence, classification and assessment. Br Dent J 2022; 233:847-852. [DOI: 10.1038/s41415-022-5202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
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13
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Zacher A, Marretta SM. Diagnosis and Management of Furcation Lesions in Dogs - A Review. J Vet Dent 2022; 39:151-172. [PMID: 35234060 DOI: 10.1177/08987564221076908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The furcation is the anatomic area where the roots divide on a multirooted tooth. Periodontal disease causing alveolar bone loss can lead to furcation lesions of various stages. Once furcation involvement has occurred, the area can be more difficult to clean or treat due to the complex anatomy and morphology of furcations. Teeth with short root trunks, longer tooth roots, and roots with wide furcation entrance areas/degrees of separation and wide root divergence are considered better candidates for long term maintenance. Dog teeth possess many of these advantageous anatomic features compared to human teeth. Treatment options for teeth with furcation lesions include: closed debridement, open debridement, furcation plasty, tunneling, partial tooth or root resection, root separation (hemisection or trisection), regenerative therapies, or exodontia. There are many factors to consider in determining treatment options. The favorable and unfavorable characteristics for maintenance of teeth with furcation lesions are summarized. Home care and ongoing professional care are important aspects of periodontal disease control for any patient. Studies of systemic and local antibiotic therapies in human patients have not demonstrated reduction of furcation stages, and probiotic effects at furcation sites have not been specifically examined. Human review studies show that most molar teeth once deemed "hopeless" due to stage 3 furcation lesions can be maintained for at least 5 to 15 years with supportive periodontal therapy. Similar long term studies in dogs are needed to improve the evidence-based management of canine patients with furcation lesions.
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Affiliation(s)
| | - Sandra Manfra Marretta
- 14589Professor Emerita University of Illinois College of Veterinary Medicine, Champaign-Urbana, IL, USA
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14
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Pei QG, Wang HC, Li L, Wang ZL. Triggering Receptor Expressed On Myeloid cells-2 Stimulates Osteoclast Differentiation and Bone Loss in Periodontitis. Oral Dis 2021; 28:1652-1661. [PMID: 34387017 DOI: 10.1111/odi.14004] [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: 01/12/2021] [Revised: 06/09/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the expression of triggering receptor expressed on myeloid cells 2 (TREM-2) in the healthy and diseased tissue, including gingivitis or periodontitis, and then to assess if it has an impact on the development of periodontitis. METHODS AND MATERIALS The gingival tissues from healthy controls, gingivitis and periodontitis underwent haematoxylin-eosin and immunohistochemical staining, and the association of TREM-2 expression or TREM-2+ cell counts with clinical parameters was assessed. An anti-TREM-2 antibody was used to block the osteoclastogenesis in vitro and during the experimental periodontitis by injection into the gingiva. The relative gene expression of TREM-2 in different gingival tissues was analysed by quantitative PCR. RESULTS In the gingival tissues of periodontitis, TREM-2 expression and TREM-2+ cell counts were significantly higher than those of gingivitis and healthy controls (P<0.05). In the group of periodontitis showing moderate signs, the gingival tissues displayed significantly lower TREM-2 expression, in contrast with the group with advanced periodontal symptoms (P<0.05). Consistently, blocking TREM-2 significantly decreased osteoclast formation both in vitro and in vivo (P<0.05). CONCLUSION Increased TREM-2 expression and TREM-2+ cells were positively associated with the development of periodontitis. Osteoclast differentiation and stimulating alveolar bone loss were partly relied on TREM-2, which could be a target to be blocked for attenuating osteoclastogenesis in periodontitits.
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Affiliation(s)
- Qing-Guo Pei
- Department of Oral Implant, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, 399 Yanchang Road, Shanghai, 200072, China
| | - Hai-Cheng Wang
- Department of Pathology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, 200072, China
| | - Lin Li
- Department of Endodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, 399 Middle Yanchang Road, Shanghai, 200072, China
| | - Zuo-Lin Wang
- Department of Oral Implant, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, 399 Yanchang Road, Shanghai, 200072, China
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15
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Morphometric Analysis of Furcation Areas of Multirooted Teeth in a Tunisian Population. Int J Dent 2020; 2020:8846273. [PMID: 33014061 PMCID: PMC7512087 DOI: 10.1155/2020/8846273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 11/17/2022] Open
Abstract
Aims The aim of the study was to evaluate the morphological characteristics of furcation of permanent molars in Tunisian population. Materials and Methods One hundred and four extracted maxillary and mandibular permanent molars were included in this study; comprising 34 maxillary first molars, 18 maxillary second molars, 33 mandibular first molars, and 19 mandibular second molars. For each tooth, the vertical dimension of the root trunk, root length, and interradicular space width were assessed with a micrometer caliber. Different types of root trunk in maxillary and mandibular molars were also analyzed. Statistical analysis was performed using a t-test. Results Root length decreased from the first to the second molars. This decrease seems to be pronounced at mandibular molars. The most observed root trunk type was type B, with a prevalence of 67.30% in maxillary molars and 51.92% in mandibular molars. The root trunk length increased from the first to the second molars in both maxillary and mandibular. The average width of the interradicular spaces varied on the same tooth and between the teeth. Conclusion This study provides epidemiological data about molars root length, interradicular space, and root trunk vertical dimension in a Tunisian population that could help clinicians in periodontal and endodontic therapy.
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Farook FF, Alnasyan B, Almohammadi D, Alshahrani A, Alyami M, Alharbi R, Alodwene H, Aboelmaaty W. Reliability Assessment of the Clinical and Radiographic Diagnosis of Furcation Involvement. Open Dent J 2020. [DOI: 10.2174/1874210602014010403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
The aim of the present study was to compare and assess the relationship and agreement between the clinical and radiographic detection of Furcation Involvement (FI) in the mandibular molars of patients with periodontitis.
Materials and Methods:
The sample size included 360 molars from 283 participants with a total of 180 molars involved with furcation clinically and 180 without. The inclusion criteria involved records of patients in the age range 35-76 years, diagnosed with generalized periodontitis, Stage II to IV, Grade B and C, and existing periapical radiographs/dental panoramic radiographs. The periodontal charts (Hamp’s classification) and radiographs were used to evaluate furcation on the buccal and lingual sites of first and second mandibular molars.
Results:
Of the 360 molars, half of the molars (50%, n=180) had clinical FI. Of the clinical FI group, the majority (73%, n=131) demonstrated FI in the radiological assessment with the periapical radiographs. In the not-clinically detected FI group, just less than half (49%, n=89) demonstrated FI in the radiological assessment. The sensitivity of the radiographic detection of FI as a diagnostic marker was 50.6%, and the specificity was 72.8%. Of the 180 sites analyzed with FI clinically, a slight agreement was found between the clinical assessment and radiographic findings using the kappa analysis (k=0.18). The first mandibular molars showed a fair agreement (k= 0.21) compared to the second mandibular molars (k=0.15). In terms of the individual sites, the lingual sites (k=0.24) had a fair agreement compared to the buccal sites with a slight agreement. The Spearman Correlation analysis for the first mandibular molar showed a moderate positive correlation (r=0.4, p<0.001) compared to the second mandibular molar with no or negligible relationship (r=0.19, p<0.001). Comparatively, the DPT radiograph showed a weak correlation and poor agreement.
Conclusion:
Both diagnostic tools, intraoral radiography and clinical assessment should be used for diagnosing FI in mandibular molars.
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Atarbashi-Moghadam F, Talebi M, Mohammadi F, Sijanivandi S. Recurrence of periodontitis and associated factors in previously treated periodontitis patients without maintenance follow-up. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2020; 12:79-83. [PMID: 35919754 PMCID: PMC9327454 DOI: 10.34172/japid.2020.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/02/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND Preventive dentistry, including supportive periodontal therapy (SPT), is one of the most critical areas of attention. Despite SPT's importance in the long-term success of periodontal treatment, the patients' adherence to it is weak. The present study aimed to evaluate of periodontal disease's recurrence rate and its related factors in periodontal patients without regular follow-up. METHODS A cross-sectional study was set in a specialized periodontics clinic in Tehran, Iran. Patients with periodontitis who completed periodontal therapy during 2005-2014 and did not adhere to the maintenance phase were evaluated. The periodontal history of the patients was updated. The previous diagnoses of patients according to their previous periodontal charts were revised by AAP 2015 criteria. Then, periodontal parameters were assessed, and current periodontal status was evaluated. Statistical analyses consisted of Fisher's exact test, t-test, Man-Whitney test, and Kruskal-Wallis test. Spearman's correlation coefficient was used to assess the relationship between factors and variables. RESULTS Fifty patients were evaluated, including 29 males and 21 females. There was a significant relationship between the initial diagnosis and recurrence rate of periodontitis (P=0.017). There was also a significant relationship between the recurrence of periodontitis and the years elapsed since the initial treatment (P=0.027, r = 0.353). Smoking significantly affected tooth loss (P=0.001). CONCLUSION Patients with severe periodontitis need more attention to participate in supportive periodontal care. The patients must be aware of the disadvantages of neglecting this phase and be reminded of regular follow-up.
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Affiliation(s)
- Fazele Atarbashi-Moghadam
- Department of Periodontics, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Talebi
- Department of Periodontics, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Mohammadi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soran Sijanivandi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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18
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Pilloni A, Montanaro L, Dell'olmo F, Fonzar A, Cairo F, Rojas MA. A retrospective pilot study of correlation of first maxillary premolar root trunk length with age and gender: a cone beam computed tomography study. MINERVA STOMATOLOGICA 2020; 69:27-36. [PMID: 32181606 DOI: 10.23736/s0026-4970.19.04228-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Root trunk length (RTL) plays an important role in the diagnosis, prognosis and treatment of periodontitis. The aim of this retrospective pilot study was to evaluate the RTL of first maxillary premolar and to study the correlation with age and sex in this value. METHODS The sample included 110 cone beam computed tomography (CBCT) images comprising 220 maxillaries first premolars from systemically healthy patients aged between 18 and 70 years. The tooth length (TL), root length (RL) and RTL were measured (dependent variables). Age and sex were considered as independent variables. RESULTS No statistically significant correlation was found between the RTL and the TL. Longer RL and longer RTL were observed in younger patients than older subjects only in the left maxillary premolars. On the other hand, the sex of the patients had no effect on either of the dependent variables. The single rooted maxillary premolars were more frequent (relative to those with two roots) in woman and in elderly patients. CONCLUSIONS A correlation between the age and the RTL and RL has been found but only in left premolars. Sex seemed to have only a slight correlation on the frequency of single-rooted teeth of the right side of the mouth. Further studies should be addressed to clarify the significance of the asymmetries observed in the present study between the two sides of the mouth with the aim of deepening the knowledge and understanding of the different variables that could be correlated with the RTL.
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Affiliation(s)
- Andrea Pilloni
- Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, Sapienza University, Rome, Italy
| | - Lorenza Montanaro
- Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, Sapienza University, Rome, Italy
| | - Fabiola Dell'olmo
- Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, Sapienza University, Rome, Italy
| | | | - Francesco Cairo
- Department of Periodontology, School of Dentistry, University of Florence, Florence, Italy
| | - Mariana A Rojas
- Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, Sapienza University, Rome, Italy -
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Atarbashi-Moghadam F, Moallemi-Pour S, Atarbashi-Moghadam S, Sijanivandi S, Baghban AA. Effects of raw vegan diet on periodontal and dental parameters. Tzu Chi Med J 2020; 32:357-361. [PMID: 33163381 PMCID: PMC7605299 DOI: 10.4103/tcmj.tcmj_161_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/12/2019] [Accepted: 11/17/2019] [Indexed: 11/08/2022] Open
Abstract
Objectives: Macronutrients and micronutrients present in different types of diet could influence different aspects of both inflammatory and immune responses; thereby, diets could influence oral health and the periodontal condition. The raw vegan diet is a subset of vegetarianism in which only uncooked plant-derived foods are consumed. The present study's aim was to evaluate the effect of the raw vegan diet on periodontal and dental health parameters. Materials and Methods: A total of 118 participants (59 raw vegans and 59 controls) were interviewed about their level of education and oral health habits. Samples of unstimulated whole saliva were collected for pH analysis, and dental and periodontal parameters were examined. Then, statistical analysis was performed. Results: Raw vegans had better oral hygiene (P = 0.001). The decayed-missing-filling indices were relatively equal in both groups. The probing depth, bleeding on probing (BOP), and simplified oral hygiene index were significantly lower in raw vegans (P = 0.047, P = 0.017, and P = 0.001, respectively). Multiple regression analyses disclosed that probing depth and BOP were significantly related to debris index. Conclusion: Based on this study's results, it can be presumed that the better periodontal condition in raw vegans is a result of their better oral care and lifestyle.
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Affiliation(s)
- Fazele Atarbashi-Moghadam
- Department of Periodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soofieh Moallemi-Pour
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saede Atarbashi-Moghadam
- Department of Oral and Maxillofacial Pathology, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soran Sijanivandi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Komšić S, Plančak D, Kašaj A, Puhar I. A Comparison of Clinical and Radiological Parameters in the Evaluation of Molar Furcation Involvement in Periodontitis. Acta Stomatol Croat 2019; 53:326-336. [PMID: 32099258 PMCID: PMC6993470 DOI: 10.15644/asc53/4/3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Objective The aim of this study was to compare clinical, intra-surgical, 2D (panoramic) and 3D (CBCT)-based parameters in assessing molar furcation involvement (FI). Materials and Methods Six patients with generalized periodontitis Stage II to IV, Grade B and C who were scheduled for the periodontal flap surgical treatment were recruited in the study. In total, 38 molar teeth with 93 furcation sites were analysed. All subjects had comprehensive periodontal examination, which included an assessment of molar FI using Naber’s probe according to modified Glickman’s classification. Periodontal surgery was performed in patients with at least one maxillary molar with probing depth of ≥6 mm. This probing demonstrated lower grade of FI compared with intra-surgical findings. Results Periodontal probing, intra-surgical measurement and measurements based on CBCT significantly correlated with each other regarding the assessment of FI, with r values ranging between 0.81 to 1.00 (p<0.01). The correlation of panoramic radiograph with periodontal probing is 0.49, with CBCT 0.39 and with intra-surgical measurements 0.36. The results showed an excellent agreement and higher accuracy between intra-surgical measurements and CBCT (0.96), in contrast to clinical examination and panoramic radiography- 0.87 and 0.63 respectively. Different clinical and radiological modalities showed a correlation among each other. They are accurate and have their own benefits, which makes (renders) them useful in establishing periodontal diagnosis and treatment planning. Conclusion However, CBCT offers significant advantages including excellent agreement and higher accuracy and can be used as justified as excellent diagnostic tool in detecting and locating FI to provide a more reliable diagnosis and basis for treatment decisions.
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Affiliation(s)
- Sanja Komšić
- Dental Office Michael Wolf and Colleagues, Patrickstrasse 2, 65191 Wiesbaden
| | - Darije Plančak
- Department of Periodontology, School of Dental Medicine, University of Zagreb, and Clinical Department of Periodontology, Clinical Hospital Center
| | - Adrian Kašaj
- Department of Periodontology, Department of operative Dentistry and Periodontology, University Medical Center Mainz, Germany
| | - Ivan Puhar
- Department of Periodontology, School of Dental Medicine, University of Zagreb, and Clinical Department of Periodontology, Clinical Hospital Center
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21
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Iwasaki H. Loss of a tooth during diabetic ketoacidosis. BMJ Case Rep 2019; 12:12/7/e230153. [DOI: 10.1136/bcr-2019-230153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Panda S, Karanxha L, Goker F, Satpathy A, Taschieri S, Francetti L, Das AC, Kumar M, Panda S, Fabbro MD. Autologous Platelet Concentrates in Treatment of Furcation Defects-A Systematic Review and Meta-Analysis. Int J Mol Sci 2019; 20:ijms20061347. [PMID: 30884920 PMCID: PMC6470588 DOI: 10.3390/ijms20061347] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/21/2022] Open
Abstract
Background: The aim of this review was to evaluate the adjunctive effect of autologous platelet concentrates (APCs) for the treatment of furcation defects, in terms of scientific quality of the clinical trials and regeneration parameters assessment. Methods: A systematic search was carried out in the electronic databases MEDLINE, SCOPUS, CENTRAL (Cochrane Central Register of Controlled Trials), and EMBASE, together with hand searching of relevant journals. Two independent reviewers screened the articles yielded in the initial search and retrieved the full-text version of potentially eligible studies. Relevant data and outcomes were extracted from the included studies. Risk of bias assessment was also carried out. The outcome variables, relative to baseline and post-operative defect characteristics (probing pocket depth (PPD), horizontal and vertical clinical attachment loss (HCAL, VCAL), horizontal and vertical furcation depth (HFD, VFD) were considered for meta-analysis. Results: Ten randomized trials were included in this review. Only one study was judged at high risk of bias, while seven had a low risk, testifying to the good level of the evidence of this review. The meta-analysis showed a favorable effect regarding all outcome variables, for APCs used in adjunct to open flap debridement (p < 0.001). Regarding APCs in adjunct to bone grafting, a significant advantage was found only for HCAL (p < 0.001, mean difference 0.74, 95% CI 0.54, 0.94). The sub-group analysis showed that both platelet-rich fibrin and platelet-rich plasma in adjunct with open flap debridement, yielded significantly favorable results. No meta-analysis was performed for APCs in combination with guided tissue regeneration (GTR) as only one study was found. Conclusion: For the treatment of furcation defects APCs may be beneficial as an adjunct to open flap debridement alone and bone grafting, while limited evidence of an effect of APCs when used in combination with GTR was found.
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Affiliation(s)
- Sourav Panda
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Lorena Karanxha
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
| | - Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
| | - Anurag Satpathy
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy.
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy.
| | - Abhaya Chandra Das
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Manoj Kumar
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Sital Panda
- Department of Public Health, Regional Medical Research Center, Bhubaneswar 751003, India.
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy.
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