Effectiveness of novel oral hygiene instruction avoiding inattentional blindness using an application for unique plaque control record calculation: A randomized clinical trial

OBJECTIVE

This study was performed to estimate the effectiveness of novel oral hygiene instruction (OHI) focusing on areas with deep periodontal pockets for reduction of periodontal inflammation.

BACKGROUND DATA DISCUSSING THE PRESENT STATUS OF THE FIELD

Because stained areas on the plaque chart do not always correspond to the areas with deep periodontal pockets, conventional OHI based on O'Leary's plaque control record (PCR) often provides guidance inconsistent with the target area.

METHODS

This randomized clinical trial involved two groups: (1) OHI based on the PCR limited in deep pocket sites (novel OHI group) and (2) OHI based on O'Leary's PCR (conventional OHI group). The unique PCR (aggressive target for PCR [agPCR]; only counting the plaque-stained areas with PD at ≥4 mm sites) for the novel OHI was calculate by dedicated expression program. The probing depth (PD), bleeding on probing (BOP), and periodontal inflamed surface area (PISA) were obtained at the baseline and 5 to 6 months later.

RESULTS

The approximation curve with PISA before and after instruction indicated that the PISA converged to a lower value after instruction in the novel OHI group. The approximation curve with the improvement rate of the PISA and agPCR showed a positive correlation in the novel OHI group but no correlation in the conventional OHI group.

CONCLUSION

Control of inflammation was more effective in the novel OHI group. These results suggest that this novel OHI technique using our developed application could be used as a strategy to improve the effectiveness of brushing instruction.

Efficacy of Laser-assisted Periodontal Therapy vs. Conventional Scaling and Root Planing

Background

This study aimed to compare the effectiveness of laser-assisted periodontal therapy (LAPT) with conventional scaling and root planing (CSRP) in the treatment of periodontal disease. The objective was to assess the outcomes of these two treatments on a sample of 30 patients in each group.

Materials and Methods

In this study, a total of 60 patients diagnosed with periodontal disease were divided into two groups: the LAPT group and the CSRP group, with 30 patients in each group. The LAPT group received periodontal treatment using laser therapy, while the SRP group underwent traditional SRP. The patients were evaluated for periodontal parameters, including probing depth and clinical attachment level before and after the treatments.

Results

After the treatment interventions, both the LAPT group and the CSRP group showed significant improvements in periodontal health. The mean reduction in probing depth was 2.5 mm in the LAPT group and 2.2 mm in the SRP group. In addition, the clinical attachment level increased by 2.8 mm in the LAPT group and 2.5 mm in the SRP group. Statistical analysis using the paired t-test demonstrated a P-value of less than 0.05, indicating the significance of these improvements in both groups.

Conclusion

This study suggests that both LAP and CSRP are effective in improving periodontal health in patients with periodontal disease.

Community Water Fluoridation and its Influence on Periodontal Health in Different Age Groups

Background

Community water fluoridation is a well-recognized public health initiative known for its efficacy in preventing dental cavities. The positive effects of fluoride on tooth enamel have led to widespread implementation of water fluoridation programs.

Materials and Methods

This cross-sectional study involved 1,000 participants from diverse age groups, spanning children, adolescents, adults, and older adults, residing in both fluoridated and non-fluoridated communities. Comprehensive periodontal assessments included measurements of probing depth (PD), clinical attachment level (CAL), and the presence of gingival inflammation. Participants were categorized into "fluoridated" or "non-fluoridated" groups based on their residential history.

Results

Fluoridated communities consistently displayed lower mean PDs, CALs, and rates of gingival inflammation across all age groups. Notably, the reduction in PD and CAL reached approximately 0.5 millimeters and 0.3 millimeters, respectively, while the decrease in gingival inflammation ranged from 3% to 5.

Conclusion

This study suggests a potential link between community water fluoridation and enhanced periodontal health, as evidenced by improved PDs, CALs, and reduced gingival inflammation.

Can Erythropoietin Open a Novel Avenue for Periodontal Regeneration?

INTRODUCTION

Periodontitis is a dramatic inflammatory disease, representing vigorous interactions between specific causative pathogens and host immune responses resulting in the activation of the destructive inflammatory cascade with the subsequent irreversible destruction of the teeth-supporting apparatus.

AIM

This study aims to evaluate the effect of using erythropoietin (EPO) injectable hydrogel, as an additional therapeutic option to scaling and root planing (SRP) in the treatment of stage II periodontitis patients, and to assess its effect on the level of osteocalcin and interleukin (IL)-1β in the gingival crevicular fluid (GCF).

METHODOLOGY

A total number of 40 patients clinically diagnosed with stage II periodontitis were included. The participants were allocated into two equal groups: study and control groups. Patients in the control group received SRP, while those in the study group received SRP followed by injectable hydrogel containing EPO. Clinical parameters such as plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed at baseline and two months post treatment. GCF samples were collected at baseline and two months post treatment from both groups to analyze GCF IL-1β and osteocalcin levels using enzyme-linked immunosorbent assay (ELISA).

RESULTS

Significant reductions in all tested clinical parameters were revealed in both groups in comparison to baseline values. A marked significant reduction in GCF IL-1β level was detected in the study group. However, two months post treatment, the osteocalcin level was decreased significantly in both groups.

CONCLUSION

This preliminary study shows great promise for the local application of EPO hydrogel as an adjunct to SRP for the management of stage II periodontitis.

The natural history of periodontal disease-Part 2: In populations with access to dental care: The Studies of Health in Pomerania (SHIP)

In this descriptive analysis of the 21-year follow-up data from the SHIP-START cohort and the 7-year follow-up data from the SHIP-TREND cohort, we report the progression of clinical attachment levels (CAL), age effects on CAL change, and a detailed description of CAL progression and remission. At baseline, 4307 and 4420 persons participated in SHIP-START and SHIP-TREND, respectively. At the final follow-up, 1181 and 2507 subjects were available for evaluation, respectively. In SHIP-START and SHIP-TREND participants, the mean CAL progressed by 0.04 and 0.02 mm/year, respectively. The older the participants were, the lower the average annual change in mean CAL (from 0.043 to 0.031 mm/year); annual tooth loss was 0.11-0.14 teeth/year. When participants were ranked according to their annual change in mean CAL, remission was more frequently observed in older subjects. To correctly understand the data, it is important to realize that selection bias due to dropouts during follow-up favored younger and more health-conscious persons. In addition, extraction of severely periodontally compromised teeth during follow-up biased the progression towards zero. Another explanation for these low CAL progression rates is that most sites had little or no change in CAL; this means that CAL progression was partly offset by CAL remission. Therefore, changes in mean CAL do not adequately describe the temporal course of periodontitis. Older age was not a risk factor for CAL progression in either cohort.

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

INTRODUCTION

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

Effects of Scaling and Root Planing on Salivary Interleukine-6 Levels in Chronic Periodontitis Patients and Glycemic Controls

BACKGROUND

 Type 2 diabetes mellitus (DM) and periodontitis have a bidirectional relationship that is well documented in many reviews and epidemiological studies. Periodontitis has been referred to as the sixth complication of diabetes mellitus. Various studies showed improvement in Interleukin-6 levels as well as metabolic parameters after non-surgical periodontal therapy in chronic periodontitis patients with type 2 DM.  Objective: To evaluate the effect of scaling and root planing (SRP) on salivary levels of IL-6 and assessment of clinical parameters in CP patients with and without T2DM.

METHODS

We included 50 CP patients with well-controlled T2DM (Group I), and 50 CP patients without T2DM as controls (Group II) with evident clinical inflammation, ≥ 5mm probing depth (PD) and a relative attachment level (RAL) of ≥ 5mm. Following a brief medical and dental history plaque index (PI), gingival index (GI), gingival bleeding index (BI), PD, and RAL were recorded, and an unstimulated saliva was collected. Following SRP therapy, the clinical parameters and IL-6 levels were measured after seven days, 14 days, and 30 days. Intragroup and intergroup comparisons were carried out using a paired t-test and an independent t-test. The statistical significance was set at P < 0.05. Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) v. 22.0 (IBM Corp., Armonk, NY).

RESULTS

Intergroup comparisons of IL-6 levels at different intervals showed a significantly higher reduction in Group II than in Group I (p=0.000). While the mean difference in the GI scores from baseline to 30 days was significantly higher in Group I patients (p=0.000), the difference in the mean PI (p=0.004), mean BI (p=0.000), mean PD (p=0.000) and mean RAL scores (p=0.000) were significantly higher in Group II patients.

CONCLUSION

This study indicates that scaling and root planing is effective in glycemic control and also has a role to play in the level of salivary IL-6 in periodontal health and T2DM with chronic periodontitis. Elevated salivary IL-6 levels indicate periodontal inflammation which is further increased in T2DM patients. Hence, elevated IL-6 can be considered a marker of periodontal destruction.

Treatment of Periodontitis Affecting Human Primary Teeth-A Systematic Review

The aim of this systematic review is to report the treatment options (Intervention) and outcomes (O) for primary teeth affected by periodontitis (Population) and if the treatment of primary teeth can prevent the spread of periodontitis to permanent teeth (Outcomes). The following databases were searched for papers published before December 2022: PubMed, Embase, Web of Science, and Ebscohost. Studies on children affected by periodontitis involving the primary teeth were included and those on children who presented with periodontitis as a manifestation of systemic disease were excluded. Narrative synthesis and methodological quality assessments were performed for the included studies. Three interventional studies (without a control group) that evaluated treatments involving scaling and root planing (SRP with antibiotics) and extraction were included (total n = 60 patients). Additionally, twelve case reports/case series articles (n = 19 patients) were identified. The diagnoses ranged from aggressive periodontitis to juvenile periodontitis and pre-pubertal periodontitis. Based on a limited number of published studies, it was found that the early treatment of periodontitis affecting the primary teeth using SRP and systemic antibiotics resulted in favorable improvements in PD and CAL. Limited evidence suggests that SRP and the extraction of the primary teeth involved have the potential to prevent periodontitis affecting permanent teeth. Future trials are required to standardize the treatment protocols and to confirm these findings.

Delayed and Immediately Loaded Implants Placed in Fresh Extraction Socket - A Clinical and Radiological Study

Purpose

To present the outcomes of immediately loaded single implants placed in the anterior region compared to conventional protocol.

Methodology

10 patients requiring single anterior tooth extraction was randomised either into immediate or delayed loaded group. Implants were positioned immediately after extraction and prosthesis was providing for the immediately loaded group. The cases were followed up for a period of 9 months at regular 3-month interval after the placement of definitive crowns. The parameters taken were probing depth, pain score and crestal marginal bone loss.

Results

A total of 10 AD1N-Touareg Spiral tapered Implant with spiral tap, 5 immediately loaded and 5 delayed loaded were evaluated. For immediate loaded cases, there was 0.93 ± 0.04 mm bone lost after 3 months, 1.26 ± 0.21 mm after 6 months and 1.72 ± 0.13 mm after 9 months. For delayed loading, there was 0.90 ± 0.02 mm bone lost after 3 months, 1.26 ± 0.15 mm after 6 months and 1.80 ± 0.07 mm after 9 months. Pain and probing depth showed gradual reduction in both the groups during the course of treatment.

Conclusion

In the present study, the success rate and radiographic results of immediate loading of implants in freshly extracted sockets in the anterior region where comparable to those obtained from delayed groups.

Clinico-Radiographic Research Evaluating Crestal Bone Level and Bone Density Surrounding Dental Implants

Aim

Planning the surgical operation, choosing the type of implant, and the effectiveness of the implant all heavily rely on the quantity and quality of the accessible bone. This study's goal was to determine how promptly inserted dental implants affected postoperative changes in bone density and crestal bone level by Cone bean computed tomography (CBCT) gray-scale value during a follow-up of three to six months.

Method

A prospective clinical-radiographic investigation was conducted. Twenty participants with a partly edentulous arch who were also systemically healthy were chosen from the OPD of the Department of Periodontics and Oral Implantology. Each patient's oral hygiene status was noted, and a preoperative CBCT was performed to assess bone density. The following clinical parameters were noted before surgical procedures: plaque index (PI) (Silness and Loe, 1964), gingival index (GI) (Loe and Sillness, 1964), probing pocket depth (PPD), and primary stability.

Result

A weak connection between Hounsfield unit (HU) in three months and six months was found. Moreover, a slender positive connection between baseline primary stability and three months was found. PI was shown to have a statistically significant difference between the means at several follow-ups (P value of 0.0001). PI and probing depth were not statistically different between baseline and six months (P values = 0.0001) or between three months and six months (P values = 0.050), respectively.

Conclusion

The main outcome of this study shows that insertion torque is directly proportional to bone density and crestal bone level.

Salivary Soluble CD44 Level in Chronic Periodontitis - A Comparative Assessment between Preoperative and Postoperative Scaling and Root Planing

Background

Salivary biomarkers can be used to diagnose illnesses, track their course, and gauge a patient's response to therapy. Inflammatory circumstances result in higher sCD44 levels. The most typical inflammatory disorder connected to periodontal tissue is called periodontitis. Therefore, the purpose "of the current study was to compare the levels of sCD44 in patients with chronic periodontitis before and after scaling and root planing.

Objectives

1) Determining CD44 concentrations in healthy individuals' spit. 2) To quantify CD44 levels in the saliva of individuals with persistent periodontitis. The third objective is to compare the levels of CD44 that can be dissolved in saliva between those with healthy gums and those with active periodontitis. 4) Assessing CD44 levels in saliva after "scaling and root planing in patients with chronic periodontitis."

Materials and Methods

Half of the study participants were classified as having chronic periodontitis, while the other half had healthy gums. Participants with healthy gums and those with chronic periodontitis had their plaque levels, gingival status, and testing depths measured. All the same, data were calculated in persons with chronic periodontitis one month after they had "scaling and root planing done. Clinical attachment levels were evaluated before scaling and root planing was performed on patients with chronic periodontitis and again one month afterwards. Patients with chronic periodontitis," those whose condition had not improved following scaling and root planing (SRP), and healthy individuals all had spit tests conducted after a month. The concentration of sCD44 in the saliva was determined with a chemically coupled immunosorbent assay.

Results

Salivary sCD44 levels were substantially greater in people with chronic periodontitis than in people without the condition. After one month of scaling and root planing in patients with chronic periodontitis, sCD44 levels drastically dropped (p < 0.0001).

Conclusion

Chronic periodontitis is linked to elevated levels of salivary sCD44. sCD44 can be employed as a possible salivary biomarker for chronic Periodontitis.

Have extraction patterns in German adults with severe periodontitis changed between 2000 and 2010? Results from two cohort studies

AIM

The aim of this study was to evaluate whether extraction thresholds in persons with severe periodontitis have changed between 2000 and 2010 and whether potential shifts have contributed to the reported decrease in tooth extractions in German adults over the last decades.

MATERIALS AND METHODS

Data from two German population-based cohort studies in Northeast Germany (Studies of Health in Pomerania; SHIP-START [baseline 1997-2001; 11-year follow-up] and SHIP-TREND [baseline 2008-2012; 7-year follow-up]) were used. In SHIP-START (SHIP-TREND), 522 (478) participants with severe periodontitis according to the CDC/AAP case definition were included. Patterns of maximum probing depth (PD) and maximum clinical attachment level (CAL) for retained and extracted teeth were compared between SHIP-START and SHIP-TREND participants.

RESULTS

No major differences in patterns of baseline maximum CAL of retained or extracted teeth were detected between SHIP-START and SHIP-TREND. Extraction thresholds were identified at the baseline at maximum CAL ≥6 and ≥9 mm. Tooth-level incidence rates for extraction for baseline maximum CAL of 6 mm were comparable between SHIP-START and SHIP-TREND (17.1 vs. 15.9 events per 1000 person-years).

CONCLUSIONS

After a decade, teeth in persons with severe periodontitis were still undergoing extraction with minor or moderate attachment loss. A change in extraction pattern did not contribute to the higher tooth retention rate.

Association of periodontal disease with oral lichen planus: A systematic review and meta analysis

Background

Gingival lesions in oral lichen planus can indirectly increase the risk of plaque-induced periodontal disease when symptoms associated with such lesions hamper the proper oral hygiene maintenance by the patients and can increase the risk of periodontal tissue destruction. This systematic review analyses the existing evidence on the association between oral lichen planus and periodontal disease.

Aim

This systematic review of case-control studies aimed to analyse the association between periodontal disease and oral lichen planus.

Material and Methods

An electronic database search for randomised controlled trials, experimental studies, case-control studies, and cohort studies published in peer-reviewed Journals in the English language was conducted from the following databases: PubMed, EBSCOHost, Science Open, EMBASE, and Google Scholar.

Results

A total of 12,507 were identified on an electronic database search. Only eight studies fulfilled the eligibility criteria and were included for quantitative analysis. A data extraction sheet was prepared, and studies were analysed.

Conclusion

Bleeding on Probing and Probing depth were seen to be significantly associated with Oral Lichen Planus. The symptoms in Oral Lichen Planus impede efficient oral hygiene maintenance by a patient and predispose them to the occurrence of long-term Periodontal Disease.

Spatial Resolution of Micro-Raman Spectroscopy for Particulate Lithium Iron Phosphate (LiFePO4)

The fast-growing lithium battery industry needs quality control tools. Micro-Raman spectroscopy is a popular technique for structural characterization and can be used for impurity revealing. The problem is that the method resolution can be appropriately quantified for a sample with a simple planar geometry, like a single crystal. Much less studied are powders consisting of particles of irregular shape and sizes close to the wavelengths of the probing laser irradiation. In this work, we have examined a series of single particles of transparent lithium iron phosphate (LiFePO₄) on a Si substrate. This model experiment revealed the significant spread of local optical properties, blocking properties of pores, and abnormal enhancement of Raman response from a bottom Si layer under some of particles. As the result, we can conclude that vertical resolution of micro-Raman spectroscopy for particulate systems with inhomogeneity of shape and structure should be described not quantitative, but qualitative, and the Raman probing of powder samples can be both multilayer and superficial.

Prevalence, extent, and severity of periodontitis among Australian older adults: Comparison of two generations

BACKGROUND

Chronic periodontitis is highly prevalent among older adults. The study aimed to compare periodontal disease among Australian older adults in two generations. We hypothesized that the prevalence and severity of periodontitis would decrease from the previous generation to the recent generation.

METHODS

Data were obtained from the South Australian Dental Longitudinal Study (SADLS) in 1991 to 1992 (SADLS I) and 2013 to 2014 (SADLS II); population-based longitudinal surveys of Australian older adults aged ≥60 years. American Academy of Periodontology, the US Centers for Disease Control and Prevention (AAP/CDC), and the 2018 European Federation of Periodontology (EFP/AAP) classification case definitions were used to define and calculate prevalence of chronic periodontitis. Multivariable log-Poisson regression models were used to identify risk indicators for severe periodontitis after adjusting for other covariates.

RESULTS

There were a total of 801 and 355 participants that underwent a periodontal exam in SADLS I and II, respectively. The prevalence of severe periodontitis was higher in the recent generation (88% and 56%) than the previous generation (75% and 46.7%) under the CDC/AAP and EFP/AAP case definitions, respectively. The mean number of missing teeth was lower in the recent generation (6) than the previous generation (13). The prevalence ratio of severe periodontitis was around two times higher in the younger age group, men, those not born in Australia, and current smokers across both generations.

CONCLUSIONS

Our findings indicated that the recent generation of older adults has higher prevalence and severity of chronic periodontitis than the previous generation. Our findings indicated that aging, being male, born overseas, low household income, no dental insurance, and being a current smoker are significant risk factors associated with severe periodontitis among older Australians.

Prevalence of periodontal disease in young moroccans. A national survey

BACKGROUND

There are few large surveys of periodontal disease in young age cohorts, and national surveys in Africa do not existent. This study assessed the prevalence and severity of periodontal disease in a national survey of adolescents and young adults in Morocco.

METHODS

A multi-stage probability sampling design was used to draw a sample of 14,667 students 12-25 years old attending 87 schools. The sample was representative of approximately 3 million Moroccan students in this age group.

RESULTS

27.9%, 11.9%, and 7.7% of the subjects had ≥1 teeth with ≥4 mm, ≥5 mm, and ≥6 mm probing depth, and the population estimates were approximately 822, 350, and 226 thousand affected subjects, respectively. For attachment loss the prevalences were: 11.6%, 9.5%, and 6.9% (or ≈ 342, 281, and 204 thousand affected subjects) for ≥4 mm, ≥5 mm, and ≥6 mm, respectively. The rates of probing depth and attachment loss increased significantly with the increase in age (p<0.01, p<0.001). Gender and urban status did not show significant effects on the prevalence of periodontal disease (p>0.05). Similarly, the relationship between the occupation status and periodontal status was modest and not statistically significant (p>0.05).

CONCLUSIONS

Children and young adults attending public schools in Morocco have a high prevalence and severity of periodontal disease compared to other populations of similar age. The rate of periodontal disease reported here may be used as baseline population estimates in the surveillance of disease status in this population. This article is protected by copyright. All rights reserved.

Postoperative Analgesic and Anti-inflammatory Effectiveness of Ginger (Zingiber officinale) and NSAIDs as Adjuncts to Nonsurgical Periodontal Therapy for the Management of Periodontitis

PURPOSE

The authors hypothesize that ginger (Zingiber officinale) tablets and non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing postoperative self-rated pain and periodontal parameters (plaque index [PI], gingival index [GI], and probing depth [PD], clinical attachment loss [AL] and marginal bone loss) following non-surgical periodontal therapy (NSPT) in patients with periodontitis. The aim was to compare the postoperative analgesic and anti-inflammatory effectiveness of ginger tablets and NSAIDs as adjuncts to nonsurgical periodontal therapy for the management of periodontitis. Materials and Methods: Patients with periodontitis were included. All patients underwent NSPT. In groups 1 and 2, patients received postoperative ginger (400 mg) and non-steroidal anti-inflammatory drugs (400 mg), respectively. Demographic data were collected, and full-mouth periodontal parameters (PI, GI, PD and CAL) were evaluated at baseline and at 7, 14 and 21 days. Self-rated pain scores were assessed at baseline, and at 24 h, 3 and 7 days of follow-up. In both groups, self-rated pain was assessed pre- and postoperatively using the numeric rating scale (NRS). Power analysis was performed on data from a pilot investigation and group comparisons were done. Statistical significance was set at p < 0.01.

RESULTS

Baseline mean NRS scores in groups 1 and 2 were 4.19 ± 0.12 and 4.13 ± 0.08, respectively. All participants had stage II/grade B periodontitis. At baseline, self-rated pain scores were significantly higher among patients in groups 1 and 2 at 24 h (p < 0.01) and 3 days (p < 0.01) of follow-up. In groups 1 (p < 0.01) and 2 (p < 0.01), self-rated pain scores were significantly higher at 24 h compared with 3 days of follow-up. In both groups, there was a significant reduction in PI (p < 0.01), GI (p < 0.01) and PD (p < 0.01) at 7, 14 and 21 days of follow-up compared with baseline.

CONCLUSION

Ginger and traditional NSAIDs are effective in reducing postoperative pain and inflammation following NSPT in patients with moderate periodontitis.

Type 1 diabetes and periodontal disease: a literature review

OBJECTIVE

This narrative review examines the literature on type 1 diabetes mellitus (T1DM) and periodontitis pathogenesis, seeking to determine the effectiveness of periodontal therapy in improving glycemic control in individuals with T1DM.

METHODS

A detailed search of the literature was conducted in the following electronic databases: PubMed, Google Scholar, Scopus, and Cochrane Library. Inclusion criteria were systematic reviews with meta-analyses published between 2015 and 2020, and human peer-reviewed clinical trials addressing the effectiveness of periodontal treatment on glycemic control in individuals with T1DM published between 1995 and 2020.

RESULTS

The search retrieved 3 systematic reviews and 9 original research papers that included 10 clinical studies.

DISCUSSION

Three systematic reviews on T1DM and periodontal disease suggested that individuals with T1DM have more features of periodontitis than healthy subjects, although long-term data are scarce. Nine of the ten clinical studies showed no impact on glycemic control in individuals with T1DM, while 1 study reported improvement.

CONCLUSION

The selected literature lacked data on long term assessment and adequate randomization with controls. The data perused did not provide sufficient evidence to determine the effectiveness of periodontal therapy in improving glycemic control in type 1 diabetes or to suggest that T1DM is a risk factor for periodontal disease.

Effectiveness of Platelet-Rich Fibrin in the Treatment of Intrabony Defects with or Without Bone Graft: A Clinical Comparative Study

BACKGROUND

Periodontal diseases are a group of inflammatory diseases causing alveolar bone loss and eventually leading to loss of teeth. The present study was evaluated the effectiveness of platelet-rich fibrin (PRF) in the treatment of intrabony defects with or without bone graft.

MATERIALS AND METHODS

Thirty subjects with the presence of intrabony defects were enrolled. All subjects were included irrespective of age and gender. A questionnaire was prepared for extracting demographic and personal details of all the patients. William probe and moth mirror-tweezers set was used for carrying out clinical examination of all subjects. Random and unbiased division of all the subjects was done with ten patients in each group as follows: Group I: Subjects in which treatment was carried out using PRF with demineralized bone matrix, Group II: Subjects in which treatment was carried out using PRF alone, and Group III: Subjects in which treatment was carried in the form of open flap debridement (OFD). Pretreatment and posttreatment clinical variables were assessed which included plaque index (PI), gingival index (GI), probing depth (PD), relative attachment level (RAL), and gingival recession (GR) were assessed at baseline and 9 months postoperatively were calculated.

RESULTS

Mean PI among Group 1, Group 2, and Group 3 at baseline was 0.78, 0.8, and 0.84, respectively. Mean PI among Group 1, Group 2, and Group 3 at 9 months follow-up was 0.56, 0.55, and 0.72, respectively. Significant results were obtained while comparing the PI among the three study groups at follow-up. Mean GI among Group 1, Group 2, and Group 3 at baseline was 0.78, 0.8, and 0.84, respectively. Mean GI among Group 1, Group 2, and Group 3 at 9 months follow-up was 0.56, 0.55, and 0.72, respectively. Significant results were obtained while comparing the GI among the three study groups at follow-up. Significant difference was seen in PD, RAL, and GR from baseline to 9 months in all groups (P < 0.05).

CONCLUSION

PRF leads to significantly better improvement in the clinical parameters on follow-up in comparison to OFD alone in patients with the presence of intrabony defects.

Clinical Evaluation of Dental Implants with a Double Acid-Etched Surface Treatment: A Cohort Observational Study with Up to 10-Year Follow-Up

BACKGROUND AND OBJECTIVES

The main purpose of this study was to evaluate the survival and success rates of dental implants with a double acid-etched surface treatment with evaluation times up to 10 years post-loading. Materials and Methods: This study was conducted at a hospital oral surgery and implantology unit. It included 111 dental implants with a double acid-etched surface. Three groups were created: Group 1 (1-3 years loading), Group 2 (3-5 years loading), and Group 3 (over 5 years loading). Probing depth, resonance frequency analysis (ISQ value), and marginal bone loss were evaluated. Results: The data obtained underwent statistical analysis. Overall, 78 patients were included in the study, who received, in total, 111 dental implants, all replacing single teeth. Mean probing depth was 3.03 mm and mean ISQ was 65.54. Regarding marginal bone loss, in Group 1, 67.6% of implants did not undergo any thread loss, in Group 2, 48.3%, and in Group 3, 59.6%; 59.10% of all implants did not present thread loss with a mean bone loss of 0.552 mm. The implant survival rate was 99.1%, and the success rate was 96.37%. Conclusions: Implants with a double acid-etched surface showed excellent success rates in terms of marginal bone loss, ISQ, and probing depth after up to 10 years of loading, making them a clinically predictable treatment option. Future studies are needed to compare this implant surface with other types in different restorative situations.

Association between proton pump inhibitors and periodontal disease severity

Objectives

Proton pump inhibitors (PPIs) are commonly prescribed for the management of acid‐related gastrointestinal disorders. PPIs modulate osteoclast function, reduce gastric acid secretion, and are associated with the establishment of a more diverse gastrointestinal microbiota. Periodontitis is characterized by microbe‐associated host‐mediated inflammation that results in loss of periodontal attachment. The aim of this study was to assess whether a relationship exists between PPIs and periodontal disease.

Materials and methods

A retrospective analysis was performed using patient records from a faculty periodontal practice. The proportion of elevated probing depths was used to measure periodontitis severity. Statistical analysis was performed using independent sample t‐tests, and Chi‐square tests of independence.

Results

Records from 1093 patients were initially assessed. Fourteen percent of teeth were associated with ≥6 mm probing depths among PPI users, in contrast to 24% for patients not using PPIs (P = 0.030). Similarly, 27% of teeth exhibited ≥5 mm probing depths among PPI users versus 40% for non‐PPI users (P = 0.039).

Conclusions

The results suggest that PPIs are associated with a reduced proportion of elevated probing depths. Future prospective studies are indicated to elucidate possible mechanisms through which PPIs might affect, and potentially be used in the treatment of, periodontitis.

Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis

BACKGROUND AND OBJECTIVE

The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis.

METHODS

Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant.

RESULTS

At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up.

CONCLUSION

PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

Estimation of fluorescence probing depth dependence on the distance between source and detector using Monte Carlo modeling

Photosensitizer fluorescence emission during photodynamic therapy (PDT) can be used to estimate for in vivo photosensitizer concentration. We built a surface contact probe with 405nm excitation light source to obtain Photofrin fluorescence signal during clinical PDT. The probe was equipped with multiple detector fibers that were located at distances between 0.14 to 0.87 cm laterally from the excitation source fiber. In this study, we investigated the probing depth of fluorescence in biological tissue with different source-detector separation using our contact probe setup. We used Monte Carlo method to simulate the 405nm excitation light and 630nm fluorescence probing depth at various source and detector (SD) separations. The results provided insight to the most probable depth of origin of detected fluorescence at each SD separation and help to understand the in vivo depth distribution of clinically measured Photofrin concentration.

Cortisol levels in the peri-implant sulcular fluid among patients with and without peri-implantitis

BACKGROUND AND OBJECTIVE

Cortisol levels remain uninvestigated in peri-implant sulcular fluid (PISF) of patients with and without peri-implantitis. The present investigation investigated levels of cortisol in PISF among controls (individuals without peri-implantitis) and patients with peri-implantitis.

METHODS

The patient population comprised of participants with and without peri-implantitis (groups 1 and 2, respectively). Demographic information and data related to implant characteristics was recorded. Peri-implant radiographic (crestal bone loss [CBL]) and clinical (modified plaque and bleeding on probing indices [PI and BOP], and probing depth [PD]) and parameters were assessed. In all patients, levels of cortisol were measured in the PISF, which was collected using standard methods. Data normality and group comparisons were assessed, and multiple logistic regression was performed. Probability values less than 0.01 were nominated as being significant.

RESULTS

Eighty-eight individuals (44 and 44 in groups 1 and 2, correspondingly) were included. In group 1, 24 and 20 participants were males and females, and there were 22 and 22 males and females in group 2. Mean ages were analogous in both groups. Peri-implant BOP (p < .001); CBL (p < .001); PI (p < .001); and PD (p < .001) were higher among patients in group 1 compared with group 2. The volume of PISF (p < .001) collected and its concentrations of cortisol (p < .001) were significantly higher among patients in group 1 compared with group 2. Regression analysis showed that CBL and PD directly correlated with increased PISF levels of cortisol among participants with peri-implantitis.

CONCLUSION

Within the limits of the present study, it remains debatable whether or not PISF cortisol levels vary among patients with and without peri-implantitis. Further studies are needed to evaluate the role of PISF levels of cortisol in the diagnosis of peri-implantitis.

Regular maintenance appointments after non-surgical scaling and root planing support periodontal health in patients with or without dry mouth: A retrospective study

Objective

Non‐surgical scaling and root planing (SRP), as an initial form of periodontal treatment, followed by ongoing periodontal maintenance appointments is necessary to manage periodontal disease and prevent tooth loss. Saliva also has an essential role in oral health though the relationship between low salivary flow and periodontal outcomes has not been extensively investigated. This study determined if patients with dry mouth have similar clinical outcomes as patients without dry mouth when receiving regular periodontal maintenance after SRP.

Materials and methods

This is a retrospective study that investigated clinical periodontal outcomes in patients with (n = 34) or without (n = 85) dry mouth who had undergone SRP 1 to 5 years prior and had routine periodontal maintenance. The presence of dry mouth was established based on a patient's unstimulated salivary flow rate.

Results

Probing depth for both patients with or without dry mouth was similar between groups and maintained 1 to 5 years following initial SRP. Improved probing depth achieved post‐SRP was sustained regardless of dry mouth status.

Conclusion

Patients with or without dry mouth did not exhibit different probing depths.

Effect of Switching to the Tobacco Heating System Versus Continued Cigarette Smoking on Chronic Generalized Periodontitis Treatment Outcome: Protocol for a Randomized Controlled Multicenter Study

BACKGROUND

Smoking is a significant risk factor for periodontal disease and tooth loss, as shown in several clinical studies comparing smokers and nonsmokers. Although only a few longitudinal studies have assessed the outcome of periodontal disease after smoking cessation, they indicated that recovery after nonsurgical treatment was more successful in those who had quit smoking. As part of tobacco harm reduction strategies, substituting cigarettes with alternative, less harmful tobacco products is an approach complementary to cessation for smokers who would otherwise continue to smoke. The Tobacco Heating System (THS), developed by Philip Morris International (commercialized as IQOS), is part of the heat-not-burn product category. The IQOS device electrically heats tobacco instead of burning it, at much lower temperatures than cigarettes, thereby producing substantially lower levels of harmful and potentially harmful constituents, while providing the nicotine, taste, ritual, and a sensory experience that closely parallel those of cigarettes. Phillip Morris International has published the results from a broad clinical assessment program, which was established to scientifically substantiate the harm reduction potential of the THS among adult healthy smokers switching to the THS. The program is now progressing toward including adult smokers with smoking-related diseases.

OBJECTIVE

The goal of this study is to demonstrate favorable changes of periodontal endpoints in response to mechanical periodontal therapy in patients with generalized chronic periodontitis who completely switched to THS use compared with continued cigarette smoking.

METHODS

This is a randomized controlled two-arm parallel-group multicenter Japanese study conducted in patients with chronic generalized periodontitis who switch from cigarettes to THS compared with smokers continuing to smoke cigarettes for 6 months. The patients were treated with mechanical periodontal therapy as per standard of care in Japan. The primary objective of the study is to demonstrate the beneficial effect of switching to THS use compared with continued cigarette smoking on pocket depth (PD) reduction in all sites with an initial PD≥4 mm. The secondary objectives include evaluation of other periodontal parameters (eg, clinical attachment level or gingival inflammation) and overall oral health status upon switching to THS. Safety was monitored throughout the study.

RESULTS

In total, 172 subjects were randomized to the cigarette (n=86) or THS (n=86) groups, and all 172 completed the study. The conduct phase of the study is completed, while data cleaning and analyses are ongoing.

CONCLUSIONS

This study is the first to test a heat-not-burn tobacco product in smokers with an already established disease. The results should further strengthen the evidence that switching to THS can significantly reduce the risk of smoking-related diseases if favorable changes in the evolution of chronic generalized periodontitis after mechanical therapy are found when compared with continued cigarette smoking.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03364751; https://clinicaltrials.gov/ct2/show/NCT03364751.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/15350.

Comparison of Peri-Implant Clinicoradiographic Parameters among Non-Smokers and Individuals Using Electronic Nicotine Delivery Systems at 8 Years of Follow-up

PURPOSE

It is hypothesised the peri-implant soft-tissue inflammatory parameters (plaque index [PI], gingival index [GI], and probing depth [PD]) are poorer and crestal bone loss (CBL) higher around dental implants placed in electronic nicotine delivery systems (ENDS)-users than controls (individuals that had never consumed any form of tobacco). The aim of this study was to assess the peri-implant clinicoradiographic parameters among non-smokers and individuals using ENDS at 8 years of follow-up.

MATERIALS AND METHODS

Self-reported non-smokers and individuals habitually using ENDS were included. A questionnaire was used to gather information about age in years, sex (female or male), daily frequency and duration of use of ENDS, family history of smoking and/or vaping, daily toothbrushing and flossing and most recent visit to a dentist or dental hygienist. These patients were evaluated for peri-implant CBL, PD, PI, BOP. The mesial and distal CBL was measured on digital bitewing radiographs that were taken using the long-cone paralleling technique. Group comparisons were statistically assessed and the level of significance was set at p < 0.05.

RESULTS

One hundred twenty-seven individuals (92 males and 35 females) were included. Sixty-three individuals (46 males and 17 females) had used ENDS for 9.2 ± 0.8 years (group 1) and 64 (46 males and 18 females) did not use any nicotinic products (group 2). The mean ages of individuals in groups 1 and 2 were 34.2 ± 1.3 and 35.1 ± 0.5 years, respectively. In all patients, platform-switched dental implants with moderately rough surfaces were placed at bone level using an insertion torque of 30--35 Ncm. In both groups, implants had a diameter of 4.1 mm and the lengths ranged between 11 and 14 mm. In groups 1 and 2, implants were in function for 8.8 ± 0.4 and 8.5 ± 0.2 years, respectively. There was no statistically significant difference in mPI, mBoP, PD, and mesial and distal CBL around implants in groups 1 and 2 at 8 years of follow-up.

CONCLUSION

Dental implants can demonstrate stable clinicoradiographic status and can remain functionally stable in non-smokers and ENDS users, provided that strict home oral hygiene measures are adopted.

The impact of supportive periodontal treatment on the outcome of regenerative surgical therapy in aggressive periodontitis patients

Objective: The aim was to evaluate the efficacy of periodontal regenerative therapy using enamel matrix derivatives (EMDs) in aggressive periodontitis patients, and to determine the contribution of maintenance via periodic supportive periodontal treatment. Method and materials: In total, 28 patients were evaluated, comprising 74 intrabony sites. In 50 sites EMD gel was applied, and in 24 sites EMD was combined with deproteinized bovine xenograft. Patients were assigned to a supportive periodontal treatment program; 18 patients fulfilled the program, defined as the well-maintained (WM) group; 10 did not comply, defined as the nonmaintained (NM) group. Probing depth (PD), clinical attachment level (CAL), and radiographic bone level (BL) were recorded. Data were compared presurgically (T0), 6 months postsurgery (T1), and 3 to 10 years posttreatment (T2). Results: Both surgical modalities achieved similar PD reduction, CAL gain, and BL gain, maintained over time. T1 to T2 showed a mean gain/loss of 0.21 ± 0.5 mm and 0.04 ± 1.1 mm, and -0.65 ± 3.0 mm and -0.73 ± 3.0 mm for PD and CAL, respectively, at the WM/NM groups, respectively. BL gain was 21.6% and 11.5% for the WM/NM groups, respectively (P < .05). The courses of the PD, CAL, and BL differed between the WM and NM groups during the observation periods (P < .05). Conclusion: Periodontal regeneration via EMD with/without the combination of deproteinized bovine xenograft can be maintained in aggressive periodontitis cases. It appears that periodic supportive periodontal treatment is a determinant factor in achieving this task.

Effect of Reinforced Oral Hygiene on Periodontally Healthy Dental Students: A Four-year Follow-up Clinical Trial

PURPOSE

In periodontally healthy individuals, mean crevicular depth ranges from 1 to 3 mm. This depth threshold has been used as an indicator to differentiate a physiological dentoalveolar sulcus from a periodontal pocket needing further treatment. Because many studies have shown the important contribution of oral hygiene status to periodontal health, the purpose of this study was to explore the clinical effect of reinforced oral hygiene on the periodontal status of periodontitis-free dental students.

MATERIALS AND METHODS

In our longitudinal observational clinical study, we assessed the periodontal status of healthy individuals attending the dental school by measuring the periodontal pocket depth, bleeding on probing, and plaque index. The follow-up reassessment was carried out four years later at the end of the dental curriculum.

RESULTS

The study showed that oral hygiene improvement led to a slight but significant reduction in the mean sulcus depth (-0.049 mm; p<0.0001).

CONCLUSIONS

Reinforcement of oral hygiene contributes to the reduction of probing depth even in periodontally healthy patients.

Periodontal Conditions and Whole Salivary IL-17A and -23 Levels among Young Adult Cannabis sativa (Marijuana)-Smokers, Heavy Cigarette-Smokers and Non-Smokers

In the United States, prevalence of marijuana-use has doubled in the past 2 decades. The aim was to compare the periodontal conditions and whole-salivary IL-17A and IL-23 levels among young adult marijuana-smokers, heavy cigarette-smokers and non-smokers. Self-reported marijuana-smokers, heavy-cigarette-smokers, non-smokers with periodontitis and periodontally-healthy non-smokers were included. Demographic data was recorded and full-mouth plaque index (PI), bleeding on probing (BoP), probing depth (PD) and clinical attachment loss (AL), marginal bone loss (MBL) and missing teeth were recorded. Levels of IL-17A and IL-23 levels were measured in the whole saliva. p < 0.01 was considered statistically significant. Fifteen-marijuana-smokers, 15 heavy-cigarette-smokers, 16 non-smokers-with-periodontitis and 15 periodontally-healthy-non-smokers) were included. The clinicoradiographic parameters were worse among marijuana-smokers (p < 0.01), cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01) than periodontally-healthy-non-smokers. Marijuana- and cigarette-smokers had Stage-IV/Grade C and non-smokers with periodontitis had Stage-III/Grade-C. Salivary IL-17A and IL-23 levels were higher in marijuana-smokers than cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01). Whole salivary IL-17A and IL-23 levels were higher among cigarette-smokers than non-smokers with periodontitis (p < 0.01) and periodontally-healthy-individuals (p < 0.01). Marijuana- and heavy cigarette-smokers have comparable clinicoradiographic periodontal statuses. This rejects hypothesis-1. However, whole salivary immunoinflammatory response may be moderately worse in marijuana-smokers compared with heavy cigarette-smokers and non-smoker with periodontitis thereby supporting hypothesis-2.

Comparison of an Herbal- and a 0.12% Chlorhexidine-based Oral Rinse as Adjuncts to Nonsurgical Mechanical Debridement in the Management of Peri-implant Mucositis: A Randomised Controlled Trial

PURPOSE

In the present randomised controlled trial (RCT), the authors hypothesise that herbal-based oral rinses are as effective as 0.12% chlorhexidine when used as adjuncts to non-surgical mechanical debridement (MD) in the management of peri-implant mucositis. The aim of the present RCT was to compare the efficacy of an herbal oral rinse with a 0.12% chlorhexidine-based oral rinse when used as adjuncts to non-surgical MD in the treatment of peri-implant mucositis.

MATERIALS AND METHODS

Adult patients with peri-implant mucositis were included. Participants were randomly allocated into 3 groups. In group 1, patients only underwent non-surgical MD. In groups 2 and 3, patients underwent non-surgical MD with adjunct rinsing with an herbal- and 0.12% CHX-based oral rinse, respectively. Peri-implant plaque index (PI) and bleeding-on-probing (BOP) and probing-depth (PD) were assessed at baseline and at 3, 6, and 12 weeks. Group comparisons were done and p < 0.01 was considered statistically significant.

RESULTS

Forty-eight patients with peri-implant mucositis (16, 16, and 16 in groups 1, 2 and 3, respectively) were included. At baseline, there was no difference in PI, PD, BOP in all groups. In group 1, there was no statistically significant difference in PI and BOP at 6, and 12 weeks of follow-up compared with baseline. In groups 2 and 3, PI (p < 0.01) and BOP (p < 0.01) were statistically significantly higher at baseline than 3, 6, and 12 weeks of follow-up. In group 1, there was no statistically significant difference in PD at all time intervals. In groups 2 and 3, PD was statistically significantly higher at baseline than 3, 6, and 12 weeks of follow-up. In groups 2 and 3, there was no statistically significant difference in PI, BOP and PD at all intervals.

CONCLUSION

Herbal- and 0.12% CHX-based oral rinses are useful adjuncts to MD for the treatment of peri-implant mucositis.

Higher intakes of flavonoids are associated with lower salivary IL-1β and maintenance of periodontal health 3-4 years after scaling and root planing

Aims

Higher intakes of fruits and vegetables, and vitamin C are associated with improved periodontal healing post‐scaling and root planing (SRP). This study determined if this association was sustained at 3–4 years post‐SRP, and if flavonoid intake is associated with periodontal health. Whether reduced probing depth (PD) is sustained and whether PD is correlated with salivary IL‐1β, IL‐6 and CRP at 3–4 years post‐SRP were also studied.

Materials and Methods

Clinical periodontal outcomes, dietary intakes and salivary markers of inflammation were measured in patients (n = 43, 23 females, 37–93 years) who had undergone SRP 3–4 years earlier and had been part of a periodontal maintenance programme.

Results

Flavonoid intake was inversely associated with PD (p = .042) and salivary IL‐1β concentration (p = .015) after adjustment for multiple confounders. When changes in PD were considered, the association of flavonoid intake with reduced PD became borderline significant (p = .051) but persisted for IL‐1β (p = .018). PD at 3–4 years and 2–4 months post‐SRP was similar. There was a positive correlation between PD and salivary IL‐1β (p = .005) but not with salivary CRP and IL‐6.

Conclusion

Higher flavonoid intake is associated with lower IL‐1β. Also, regular supportive periodontal therapy maintained the improved PD at 3–4 years post‐SRP regardless of smoking status.

Evaluation of periodontal status in different phenotypes of polycystic ovary syndrome in untreated patients of early reproductive age: A case-control study

AIM

A few studies demonstrated an increased risk of periodontal disease in patients with polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the periodontal status in women of reproductive age who were recently diagnosed with different phenotypes of PCOS.

METHODS

This prospectively designed cross-sectional case-control study included 116 consecutive subjects with PCOS and 90 healthy volunteers, aged between 18 and 24, who were admitted to the gynecology polyclinic between April 2018 and December 2018. All subjects of PCOS diagnosed using the Rotterdam criteria were subdivided into four phenotypes based on clinical, biochemical and ultrasonographic parameters according to the guidelines of the National Institutes of Health. The same dentist investigated periodontal parameters including plaque index, gingival index, bleeding on probing (%), probing depth, clinical attachment loss and the decayed, missing, filled teeth index.

RESULTS

Probing depth, a periodontal parameter, was higher in all sub-phenotypes of the PCOS group compared to the control group. There was no difference in other periodontal parameters.

CONCLUSION

Periodontal probing depth, which is an important parameter in the diagnosis of periodontal diseases, was higher in all phenotypic subgroups of PCOS in early reproductive age.

Horizontal continuous and apical stretching sutures does not reduce FGG shrinkage: a split-mouth randomized controlled clinical trial

Purpose:

This study aimed to evaluate whether horizontal continuous and apical stretching sutures could reduce FGG shrinkage.

Materials and methods:

In this randomized controlled clinical trial ten patients (20 sites, seven females and three males) ranging from 18 to 53 years (average 39 years) with insufficient keratinized and attached gingiva received FGG in two quadrants of mandible (splitmouth design). Horizontal continuous and apical stretching sutures were used in test sites in addition to common suturing techniques. Clinical parameters including probing depth (PD), the width of keratinized and attached gingiva (KG, AG), the horizontal and vertical dimension of the graft (HD, VD), and graft area (GA) were recorded at baseline and 1, 3, and six months after the operation.

Results:

PD did not differ significantly for six months. The average change of other parameters in test and control sites respectively was as follows: KG increased 5.5 mm and 5.1 mm, AG increased 5.3 mm and 5.1 mm, HD shrinkage was 21.6% and 15.8%, VD shrinkage was 33.7% and 33.2%, GA shrinkage was 47.3% and 43.3%. There were no significant differences between test and control sites in clinical parameters six months after surgery.

Conclusion:

Application of horizontal continuous and apical stretching sutures does not reduce FGG shrinkage.

Self-rated peri-implant oral symptoms and clinicoradiographic characteristics in Narghile-smokers, cigarette-smokers, and nonsmokers with peri-implantitis

BACKGROUND

The hypothesis is that self-rated peri-implant oral symptoms (OS) and clinical (plaque index [PI] and probing depth [PD]) and radiographic (crestal bone loss [CBL]) are higher in (cigarette-smokers [CS]) and (waterpipe-users) than (nonsmokers [NS]). The aim was to relate peri-implant self-perceived OS with clinico-radiographic parameters among CS, waterpipe-users, and NS.

MATERIALS AND METHODS

This study was performed on self-reported CS, waterpipe-users, and NS with peri-implantitis. A questionnaire was used to record peri-implant self-perceived OS (pain in gums, bleeding gums, bad breath, and loose implant) and demographic data (age, sex, duration of smoking and waterpipe usage, duration of implants in function, duration since diagnosis of peri-implantitis). Clinico-radiographic parameters (CBL, PD, PI, and bleeding on probing [BOP]) were also measured; and compared with the self-perceived OS. Group comparisons were done for perceived OS and clinico-radiographic variables, and significant differences were deemed when P-values were under .05.

RESULTS

One hundred male participants (35 CS, 33 waterpipe-users, and 32 NS) with peri-implantitis were included. Pain in gums (P < .05) and bad breath (P < .05) were more frequently perceived by CS and waterpipe-users than NS. There was no significant difference in perceived bleeding gums around the implant or loose implant among all groups. The CBL (P < .01), PI (P < .001), and PD (P < .01) were significantly high in CS and waterpipe-users than NS. NS (P < .05) had significantly higher BOP than waterpipe-users and CS. There was no significant difference in CBL, PI, PD, and BOP among waterpipe-users and CS.

CONCLUSION

Tobacco-smokers present with worse peri-implant perceived OS and clinicoradiograhic parameters than nonsmokers with peri-implantitis.

[Occlusal changes before and after orthodontic treatment in patients with aggressive periodontitis]

OBJECTIVE

To evaluate the efficacy of occlusal improvement in the labial fixed orthodontic treatment in aggressive periodontitis patients and to explore the relationship between occlusal improvement and inflammation control.

METHODS

Twenty-two aggressive periodontitis patients who underwent combined periodontal-orthodontic treatment were included in this study. The patient's photos were matched to the dental models and digital three dimentional models were acquired using 3Shape R700 laser scanner. The occlusal force distribution maps were generated in the OrthoAnalyzer software. The newly established occlusal force distribution score (OFDS) and proximal contact score (PCS) were used to evaluate the occlusal distribution changes before and after labial fixed orthodontic treatment for assessing the effectiveness of orthodontic treatment. The multi-level linear regression analysis was used to explore the relationship between the probing depth changes and OFDS or PCS changes to screen out the favorable orthodontic strategy for inflammation control, which would provide clinical strategy for combined periodontal-orthodontic treatment in aggressive periodontitis patients.

RESULTS

At the patient level, OFDS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (84.5±20.9 vs.105.3±22.6, P <0.001) and PCS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (68.9±9.1 vs. 83.7±6.3, P <0.001).At the tooth level, the OFDS was significantly increased in the maxillary anterior teeth (P <0.001) while the PCS of the anterior teeth in both maxillary and mandible arches were significantly increased significantly (P <0.01). No significant changes were found in other tooth positions. The multilevel linear regression model showed that no significant correlation was found between age and gender and probing depth decrease (P >0.05). The baseline probing depth,OFDS improvements and PCS improvements (P <0.001) were positively correlated with probing depth decrease.

CONCLUSION

This study showed that the distribution of occlusal force was more reasonable and the proximal contacts were more ideal in aggressive periodontitis patients. Orthodontic treatment was effective in improving occlusal force distribution by the above two ways. Especially, the OFDS and PCS improvements were both positively correlated with probing depth decrease, indicating that in the combined periodontal-orthodontic treatment for aggressive periodontitis patients, occlusal force distribution and proximal contact should be improved in order to facilitate periodontal improvement.

Efficacy of an All-Natural Polyherbal Mouthwash in Patients With Periodontitis: A Single-Blind Randomized Controlled Trial

Aim: This study aimed to evaluate the anti-inflammatory effect and the incidence of adverse effects of an all-natural polyherbal mouthwash in patients with periodontitis, after 3 months of use. These aims were accomplished by using full mouth bleeding score (FMBS), full mouth plaque score (FMPS), probing depth (PD) clinical attachment level (CAL) and a questionnaire recording any adverse events.

Methods: The present randomized controlled clinical study considered 40 patients with moderate or severe periodontitis, randomized in two groups: a test group (TG) and a control group (CG). TG was instructed to use a polyherbal mouthwash composed of Propolis resin extract, Plantago lanceolata, Salvia officinalis leaves extract, and 1.75% of essential oils and the CG was given a placebo mouthwash. Both groups were instructed to rinse for 2 min, twice daily after their routine oral home care with the different mouthwashes. Clinical measurements of FMBS, FMPS, PD and CAL were recorded at baseline (T0) and after 3 months (T1). The incidence of adverse outcomes was recorded at every follow-up. Mann–Whitney U test and Wilcoxon signed-rank test were used for the statistical analysis (p < 0.05).

Results: The final study sample consisted of 34 healthy individuals, 17 individuals in each of the two groups. TG and CG showed a statistically significant reduction in FMBS (p = 0.001 TG; p = 0.002 CG), FMPS (p = 0.001 TG; p = 0.003 CG), PD (p = 0.001 TG; p = 0.011 CG) and CAL (p < 0.001 TG; p = 0.020 CG) values from baseline to 3 months. The TG showed a statistically significant decrease in FMBS and FMPS compared with the CG. No adverse events or side effects were reported or observed in both groups.

Conclusion: The use of polyherbal mouthwash in patients with moderate or severe periodontitis has proved safe and effective in reducing bleeding score and plaque accumulation, after 3 months, compared with placebo, although no difference between the two groups were reported on PD and CAL (both improving at T1).

Presence of Candida species in the subgingival oral biofilm of patients with peri-implantitis

BACKGROUND

There are no studies that have investigated the presence of Candida species in the subgingival oral biofilm (OB) of patients with peri-implantitis.

PURPOSE

The aim was to assess the presence of Candida species in the subgingival OB of patients with peri-implantitis.

MATERIALS AND METHODS

Individuals with (group A) and without (group B) peri-implantitis were included. Life style related and demographic data were collected using a questionnaire. In both groups, peri-implant plaque-index (PI), bleeding-on-probing (BOP), and probing-depth (PD) were evaluated and crestal bone loss (CBL) were measured on digital bitewing radiographs. In both groups, subgingival OB samples were collected using sterile paper points. Identification of Candida species was performed using ChromAgar medium and colony forming units per milliliter (CFU/mL) were determined. Statistical analysis was performed, and level of significance was set at P < 0.05.

RESULTS

The mean age of individuals in groups A (n = 43) and B (n = 41) were 52.2 ± 4.4 and 55.1 ± 2.3 years, respectively. All participants were male. In groups A and B, implants were in function for 7.4 ± 1.3 and 6.8 ± 0.6 years, respectively. Scores of peri-implant PI (P < 0.001), BOP (P < 0.001), PD (P < 0.001), and CBL (P < 0.001) were significantly higher in group A than group B. Subgingival Candida was isolated from the OB of 33 (76.7%) patients in group A and 5 (12.2%) individuals in group B. The most common yeast species was Candida albicans, which was isolated from 67.4% to 60% individuals in groups A and B, respectively. The number of subgingival oral yeasts CFU/mL were significantly higher in group A (3147.54 ± 1052.6 CFU/mL) compared with group B (496.68 ± 100.2 CFU/mL; P < 0.01).

CONCLUSION

Candida species (predominantly C. albicans) are present in the subgingival OB of patients with peri-implantitis. Community-based efforts toward routine oral hygiene maintenance are needed to improve oral health and minimize the risks of peri-implant diseases in populations.

A comparative study of synbiotic as an add-on therapy to standard treatment in patients with aggressive periodontitis

Context:

The role of synbiotic in the management of aggressive periodontitis (AP) is not well established.

Aim:

We designed this study to evaluate the efficacy and safety of synbiotic as an add-on therapy in the management of AP.

Settings and Design:

This was a randomized, double-blind, placebo-controlled study.

Materials and Methods:

Sixty patients with AP were randomized to two groups of 30 each. Study group received standard treatment, i.e., scaling and root planing along with doxycycline 100 mg twice daily for the 1^st day (loading dose) followed by 100 mg once daily for 1 week and synbiotic lozenge twice daily for 8 weeks, whereas control group received standard treatment for 1 week and placebo lozenge for 8 weeks. Clinical parameters were recorded at baseline, 4^th, 8^th, and 12^th weeks.

Statistical Analysis Used:

Pearson's Chi-square test and one-way analysis of variance were used to analyze distribution of sex and age, respectively. Differences within the groups were analyzed by Student's paired t-test. Pearson's Chi-square test was applied to measure gingival bleeding index.

Results:

On comparison at 12 weeks, there was a statistically significant reduction (P < 0.01) in probing depth, clinical attachment loss, oral hygiene index, and bleeding on probing in study group. No Adverse drug reactions were noted.

Conclusion:

Co-administration of synbiotic lozenge along with standard therapy is highly efficacious in improving periodontal health in patients with AP.

Incidence of periodontal compromise in teeth indicated for undergoing endodontic treatment: A clinical study

Objective

The aim of this study was to evaluate the periodontal status of teeth indicated for undergoing endodontic treatment.

Materials and Methods

Two hundred and nine teeth were evaluated using probing depth tests at three vestibular and three palatine/lingual sites before the patients underwent treatment. Teeth that presented up to 3-mm probing depth were considered as healthy. Those that presented at least one site with probing depth >3 mm were considered periodontally compromised. The data were statistically analyzed by means of applying the Chi-square test, with a level of significance of 5%.

Results

Of the total of 209 teeth evaluated, 40 (19.10%) presented periodontal compromise. There was statistically significant difference related to the compromised teeth of patients of the female gender (22.80%) compared with teeth of patients of the male gender (12.30%) (P < 0.05).

Conclusions

Fewer than 20% of the teeth evaluated presented a periodontal compromise. Patients of the female gender presented a higher number of periodontally compromised teeth than patients of the male gender.

[Effect of the treatment of periodontal disease on the outcome of pregnancy]

INTRODUCTION

Correlations between periodontitis and its effects on the outcome of pregnancies are actually more focused topics. Maternal motivation for a good oral hygiene and preventive dental treatment must be highlighted tasks during pregnancy care.

AIM

The authors analysed the effect of the preventive dental treatment during pregnancy and its obstetrical effects.

METHOD

In a prospective randomised study, including pregnant women observed for threatening preterm deliveries, patients with dental examination (n = 71) were compared with patients undergoing dental treatment at the same time (n = 79).

STATISTICAL ANALYSIS

Univariate comparisons for categorical variables were assessed by χ2 tests and independent Student's t-tests for continuous variables. ORs were compared with Mantel-Haenszel tests. Multivariable logistic regression was performed to evaluate the factors determining the poor periodontal parameters and gingivitis separately. The two-tailed statistical significance level was set at 5%.

RESULTS

In the dental treatment group, the neonatal birth weight was significantly higher than in the non-treated group, in case of patients with periodontitis (2990 ± 582.3 g vs 2568.1 ± 699.1 g, p = 0.005). Also the average age at delivery was significantly higher in the treated vs non-treated groups (37.3 ± 1.9 vs 36.0 ± 2.9 weeks, p = 0.027), and the treatment had a beneficial effect on the prolongation of pregnancy, with a higher level of significance in the gingivitis group vs patients with periodontitis groups (p = 0.02 vs p = 0.043).

CONCLUSIONS

Dental treatment of expecting women has a beneficial effect on the prolongation of pregnancy by decreasing the rate of prematurity and perinatal complications. Orv Hetil. 2018; 159(24): 978-984.

Evaluation of the Effect of Platelet-Rich Fibrin on the Alveolar Osteitis Incidence and Periodontal Probing Depth after Extracting Partially Erupted Mandibular Third Molars Extraction

Aims

To evaluate whether the alveolar osteitis (AO) incidence after extracting partially erupted third molars differs when platelet-rich fibrin (PRF) is administered in the alveolar socket and to assess the influence of PRF on postoperative pain levels and periodontal probing depth.

Settings and Design

In this split-mouth randomized study, 50 patients (17 men/ 33 women; mean age, 23.96 years) with bilateral symmetric partially erupted mandibular third molars were enrolled.

Material and Methods

PRF was randomly placed in one extraction socket, whereas the other socket was left empty. A verbal rating scale was used to evaluate postoperative pain levels. AO development was evaluated on the 7th postoperative day. At 3 months postoperatively, periodontal probing depth was measured on the distal surface of the second molars.

Results

In total, 8% of patients in the PRF group and 18% of the patients in the control group were diagnosed with AO. None of the smokers in the PRF group and 37.5% smokers in the control group were diagnosed with AO. Mean postoperative pain levels were lower in the PRF group than in the control group at all time points. At 3 months postoperatively, periodontal probing depths were found to be ≤3 mm in both groups.

Conclusions

PRF significantly reduced the AO incidence among smokers and had a positive effect on postoperative pain levels but not on periodontal healing.

Peri-implant soft tissue status and crestal bone levels around adjacent implants placed in patients with and without type-2 diabetes mellitus: 6 years follow-up results

BACKGROUND

The long-term success and survival of dental implants type-2 diabetic subjects is debatable.

PURPOSE

The present 6 years' follow-up prospective clinical study compared the peri-implant soft tissue status and crestal bone loss (CBL) around adjacent implants placed among type-2 diabetic and nondiabetic subjects.

MATERIALS AND METHODS

Type-2 diabetic (Group-1) and nondiabetic individuals (Group-2) with adjacent dental implants were included. Hemoglobin A1c (HbA1c) levels were recorded; and a questionnaire was used to collect demographic information. Information regarding implant dimensions, duration in function, loading protocol, and type of restoration was recorded. Peri-implant bleeding-on-probing (BOP), plaque index (PI), probing depth (PD), and mesial and distal CBL were measured. P < .05 were considered statistically significant.

RESULTS

Eighty-six male participants (44 in Group-1 and 42 in Group-2) were included. The mean age of individuals in groups 1 and 2 were 57.6 ± 5.5 and 61.6 ± 4.3 years, respectively. In Group-1, the mean duration of type-2 diabetes was 10.1 ± 3.5 years. A family history of diabetes was more often reported by individuals in Group-1 than Group-2. In groups 1 and 2, 44 and 42 pairs of adjacent implants, respectively were placed in the regions of missing premolars and molars in both arches. All implants were delayed loaded and were fixed with non-splinted screw-retained restorations. In groups 1 and 2, tooth-brushing twice daily was reported by 79.5% and 85.7% individuals, respectively. There was no difference in peri-implant PI, BOP, PD, mesial and distal CBL and HbA1c levels among individuals in groups 1 and 2.

CONCLUSION

Adjacent implants can remain esthetically and functionally stable in type 2 diabetic patients in a manner similar to healthy individuals provided glycemic levels are strictly controlled and maintained.

Platelet-Rich Fibrin in Regeneration of Intrabony Defects: A Randomized Controlled Trial

BACKGROUND

Platelet-rich fibrin (PRF) is an autologous non-transfusional hemo-component with a high concentration of platelets. It incorporates leukocytes, platelets, and growth factors within the dense fibrin matrix and can be used as healing biomaterial. This study assesses the adjunctive use of PRF in regenerative management of intrabony defects in comparison with open flap debridement (OFD).

METHODS

Twenty-six bilateral defects (13 per group) in 13 patients were randomized as either PRF (test group) or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and bone PD were recorded. Reduction in defect depth and percentage of bone fill was assessed radiographically. Primary outcomes assessed were changes in PD, CAL, and percentage of bone fill, and they were assessed at 6, 9, and 12 months. Secondary outcome was assessment of wound healing using a wound healing index (WHI).

RESULTS

The PRF group showed significant improvement in clinical parameters compared with the control group at 6, 9, and 12 months. The PRF group showed a bone fill of 45.18% ± 7.57%, which was statistically significant compared with 21.6% ± 9.3% seen in the control group at the end of the study period. The PRF group also showed significant soft tissue healing and reduction in PD. WHI also showed significant advantages for the PRF group.

CONCLUSION

The adjunctive use of PRF to conventional OFD may be potentially used in the treatment of intrabony defects.

Clinical Characteristics of Abutment Teeth with Gingival Discoloration

PURPOSE

The grey-bluish discoloration of gingiva (known as "amalgam tattoo") does not appear only in the presence of amalgam restorations. It may also be seen in cases of teeth restored with cast dowels and porcelain-fused-to-metal (PFM) restorations. The aim of this article was to determine the clinical characteristics of abutment teeth with gingival discoloration.

MATERIALS AND METHODS

This research was conducted on 25 patients referred for cast dowel and PFM restorations. These restorations were manufactured from Ni-Cr alloys. Ninety days after cementing the fixed prosthodontic restorations, the abutment teeth (n = 61) were divided into a group with gingival discoloration (GD) (n = 25) and without gingival discoloration (NGD) (n = 36). The control group (CG) comprised the contralateral teeth (n = 61). Plaque index, gingival index, clinical attachment level, and probing depth were assessed before fabrication and also 90 days after cementation of the PFM restorations.

RESULTS

The gingival index, clinical attachment level, and probing depths of the abutment teeth that had GD were statistically higher before restoration, in comparison with the abutment teeth in the NGD and control groups. Ninety days after cementation, the abutment teeth with GD had significantly lower gingival indexes and probing depths, compared to the abutment teeth in the NGD group. Both abutment teeth groups (GD and NGD) had significantly higher values of clinical attachment levels when compared to the control group. There were no statistically significant differences in plaque index values between the study groups.

CONCLUSIONS

The results of this study indicated that impairment of periodontal status of abutment teeth seemed to be related to the presence of gingival discolorations. Therefore, fabrication of fixed prosthodontic restorations requires careful planning and abutment teeth preparation to minimize the occurrence of gingival discolorations.

CLINICAL RELEVANCE

With careful preparation of abutment teeth for cast dowels and crown restorations it may be possible to decrease the frequency of gingival discolorations adjacent to abutment teeth.

Comparative evaluation of probing depth and clinical attachment level using a manual probe and Florida probe

Background:

To compare and evaluate the intra- and inter-examiner efficacy and reproducibility of the first-generation manual (Williams) probe and the third-generation Florida probe in terms of measuring pocket probing depth (PD) and clinical attachment level (CAL).

Materials and Methods:

Forty subjects/4000 sites were included in this comparative, cross-sectional study. Group- and site-wise categorizations were done. Based on gingival index, PD, and CAL, patients were divided into four groups, i.e., periodontally healthy, gingivitis, mild to moderate periodontitis, and severe periodontitis. Further, based on these parameters, a total of 4000 sites, with 1000 sites in each category randomly selected from these 40 patients, were taken. Full mouth PD and CAL measurements were recorded with two probes, by Examiner 1 and on Ramfjord teeth by Examiner 2.

Results:

Full mouth and Ramfjord teeth group- and site-wise PD obtained with the manual probe by both the examiners were statistically significantly deeper than that obtained with the Florida probe. The full mouth and Ramfjord teeth mean CAL measurement by Florida probe was higher as compared to manual probe in mild to moderate periodontitis group and sites, whereas in severe periodontitis group and sites, manual probe recorded higher CAL as compared to Florida probe.

Conclusion:

Mean PD and CAL measurements were deeper with the manual probe as compared to the Florida probe in all the groups and sites, except for the mild-moderate periodontitis group and sites where the CAL measurements with the manual probe were less than the Florida probe. Manual probe was more reproducible and showed less interexaminer variability as compared to the Florida probe.

Prevalence of periodontitis according to Hispanic or Latino background among study participants of the Hispanic Community Health Study/Study of Latinos

BACKGROUND

Hispanics and Latinos are an ethnically heterogeneous population with distinct oral health risk profiles. Few study investigators have examined potential variation in the burden of periodontitis according to Hispanic or Latino background.

METHODS

The authors used a multicenter longitudinal population-based cohort study to examine the periodontal health status at screening (2008-2011) of 14,006 Hispanic and Latino adults, aged 18 to 74 years, from four U.S. communities who self-identified as Cuban, Dominican, Mexican, Puerto Rican, Central American or South American. The authors present weighted, age-standardized prevalence estimates and corrected standard errors of probing depth (PD), attachment loss (AL) and periodontitis classified according to the case definition established by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC-AAP). The authors used a Wald χ(2) test to compare prevalence estimates across Hispanic or Latino background, age and sex.

RESULTS

Fifty-one percent of all participants had exhibited total periodontitis (mild, moderate or severe) per the CDC-AAP classification. Cubans and Central Americans exhibited the highest prevalence of moderate periodontitis (39.9 percent and 37.2 percent, respectively). Across all ages, Mexicans had the highest prevalence of PD across severity thresholds. Among those aged 18 through 44 years, Dominicans consistently had the lowest prevalence of AL at all severity thresholds.

CONCLUSIONS

Measures of periodontitis varied significantly by age, sex and Hispanic or Latino background among the four sampled Hispanic Community Health Study/Study of Latinos communities. Further analyses are needed to account for lifestyle, behavioral, demographic and social factors, including those related to acculturation.

PRACTICAL IMPLICATIONS

Aggregating Hispanics and Latinos or using estimates from Mexicans may lead to substantial underestimation or overestimation of the burden of disease, thus leading to errors in the estimation of needed clinical and public health resources. This information will be useful in informing decisions from public health planning to patient-centered risk assessment.

Is there a relationship between periodontal conditions and number of medications among the elderly?

OBJECTIVE

To investigate possible correlations of clinical attachment level and pocket depth with number of medications in elderly individuals.

METHODS

Intra-oral examinations for 139 patients visiting Tufts dental clinic were done. Periodontal assessments were performed with a manual UNC-15 periodontal probe to measure probing depth (PD) and clinical attachment level (CAL) at 6 sites. Complete lists of patients' medications were obtained during the examinations. Statistical analysis involved Kruskal-Wallis, chi square and multivariate logistic regression analyses.

RESULTS

Age and health status attained statistical significance (p< 0.05), in contingency table analysis with number of medications. Number of medications had an effect on CAL: increased attachment loss was observed when 4 or more medications were being taken by the patient. Number of medications did not have any effect on periodontal PD. In multivariate logistic regression analysis, 6 or more medications had a higher risk of attachment loss (>3mm) when compared to the no-medication group, in crude OR (1.20, 95% CI:0.22-6.64), and age adjusted (OR=1.16, 95% CI:0.21-6.45), but not with the multivariate model (OR=0.71, 95% CI:0.11-4.39).

CONCLUSION

CAL seems to be more sensitive to the number of medications taken, when compared to PD. However, it is not possible to discriminate at exactly what number of drug combinations the breakdown in CAL will happen. We need to do further analysis, including more subjects, to understand the possible synergistic mechanisms for different drug and periodontal responses.

Correlation of gingival thickness with gingival width, probing depth, and papillary fill in maxillary anterior teeth in students of a dental college in Navi Mumbai

Context:

The gingival biotype is of utmost importance for esthetics and biologic function. Anatomical characteristic of periodontium such as gingival thickness (GT), width of keratinized gingiva, and alveolar bone morphology will determine the behavior of periodontium when subjected to physical, chemical, or bacterial insult or during therapeutic procedure.

Aims:

The aim of this study was to correlate the GT with gingival width (GW), probing depth (PD), and papillary fill (PF) in relation to maxillary anterior region.

Settings and Design:

Undergraduate dental students and interns from a dental college in Navi Mumbai were enrolled in the study according to the inclusion criteria. Six teeth per subject were assessed; a total of 2178 maxillary anterior teeth were examined.

Subjects and Methods:

Subjects were examined clinically for GT, width of keratinized gingiva, pocket depth, and interdental PF. The data obtained was tabulated and subjected to statistical analysis.

Statistical Analysis Used:

Spearman's correlation analysis test was performed to find the correlation of GT with GW, PD, and PF.

Results:

Positive correlation was found between GT and GW (r = 0.241). No significant correlation could be found between GT and PD; and between GT and PF.

Conclusions:

The present study confirmed a positive correlation between GT and GW. A weak negative correlation was found between GT and PD.

Trends of periodontal conditions in two different randomly selected Swiss (Bernese) cohorts 25 years apart

AIM

To assess the periodontal conditions of two randomly selected Swiss cohorts 25 years apart.

MATERIAL AND METHODS

Standardized examinations were performed to assess the periodontal conditions of two randomly selected populations of the Canton of Bern; oral cleanliness was evaluated using the plaque index (PlI) and the retention index (RI). Gingival health was scored according to the gingival index (GI). Periodontal conditions were evaluated by pocket probing depth (PPD) and loss of attachment (LA).

RESULTS

At the first examination in 1985, 206 out of 350 subjects were evaluated, while in the second examination in 2010, 134 out of 490 subjects attended the examinations. In 1985, subjects showed a mean PlI of 1.16, and 0.77 in 2010. RI was 0.81 and 0.36 in 1985 and 2010 respectively. Mean GI was 1.34 and 0.6. The mean proportion of PPD ≤3 mm was 72% in 1985 and 97.3% in 2010. PPD ≥ 6 mm affected 2.0% in 1985 and 0.3% in 2010. In 1985, subjects had an average of 20.7 teeth, while in 2010, the average was 24.6. In 1985, 7.3% of the subjects were edentulous, while in 2010, 4.5% had no teeth.

CONCLUSIONS

Trends to improvements resulting in more teeth in function and better periodontal conditions were recognized.