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Kalra J, Dhawan P, Jain N. Implant stability and crestal bone level in osseodensification and conventional drilling protocols: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00524-9. [PMID: 39191537 DOI: 10.1016/j.prosdent.2024.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/29/2024]
Abstract
STATEMENT OF PROBLEM How osseodensification osteotomy affects the implant stability and crestal bone level in patients requiring implant placement in low-density bone compared with conventional osteotomy is unclear. PURPOSE This systematic review and meta-analysis analyzed how implant stability and crestal bone level vary in a low-density bone in osseodensification osteotomy and conventional osteotomy. MATERIAL AND METHODS The SCOPUS, PUBMED, and Google Scholar databases were searched, along with a manual search, for articles published between January 2013 and January 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to select the studies for review. A total of 5 studies were included in this systematic review. The Joanna Briggs Institute (JBI) tools were used to conduct the risk of assessment of the included articles, and forest plots were generated for the included articles (α=.05). RESULTS The data were assimilated from a small sample size of 109 patients and 198 implants. The meta-analysis found that osseodensification resulted in significantly higher implant stability quotient (P<.05) values at baseline and follow-up, while the crestal bone level changes were not found to be significant (P>.05) at baseline or on follow-up visits. CONCLUSIONS The osseodensification drilling protocol displayed an advantage over the conventional drilling protocol regarding higher primary stability and secondary stability, as well as bone expansion in low-density bone. No significant difference in crestal bone loss was found in either technique at baseline or at follow-up.
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Affiliation(s)
- Janvi Kalra
- Postgraduate student, Department of Prosthodontics and Crown & Bridge, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India.
| | - Pankaj Dhawan
- Professor and Department Head, Department of Prosthodontics and Crown & Bridge, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
| | - Neha Jain
- Professor, Department of Prosthodontics and Crown & Bridge, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
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2
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P SM, Rajasekar A. Effectiveness of Surgical Periodontal Therapy in Oral Health-Related Quality of Life. Cureus 2024; 16:e58792. [PMID: 38784346 PMCID: PMC11112134 DOI: 10.7759/cureus.58792] [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: 04/04/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Background and objective The objective of this study is to evaluate and compare the surrogate and true end points following surgical periodontal therapy using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Materials and methods The study included a total of 30 participants, comprising 15 males and 15 females aged between 25 and 50 years. All individuals who had undergone periodontal flap surgery for generalized chronic periodontitis at the Department of Periodontology, Saveetha Dental College and Hospitals were included in the study. The OHIP-14 questionnaire was used to assess the patient-centered outcomes (true end points) pre- and post-flap surgery at baseline and six months. Surrogate end points such as the clinical attachment level (CAL), probing pocket depth (PPD), and gingival index (GI) were recorded at baseline and six months pre- and post-flap surgery. Results Clinical parameters such as the GI (p=0.03*), CAL (p=0.03), and PPD (p=0.02*) showed a statistically significant improvement after surgery. Patient-centered outcomes showed statistically significant differences in terms of taste perception, reduction in pain sensation, improvement in self-consciousness and reduction in anxiety levels, diminution of the feeling of embarrassment and enhancement in the ability to relax due to problems associated with gums, and improvement in the workplace (p<0.05) post-operatively. Conclusion Surgical periodontal therapy plays a pivotal role in improving oral health-related quality of life (OHRQoL) among patients with chronic periodontal disease. Utilizing OHIP-14 as an assessment tool enables a comprehensive evaluation of treatment outcomes, encompassing various dimensions of oral health impact. Patient-centered outcomes such as psychological discomfort and functional limitations can be achieved only by an interdisciplinary approach.
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Affiliation(s)
- Swarna Meenakshi P
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Arvina Rajasekar
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Sindhusha VB, Rajasekar A. Assessment of Clinical and Patient-Centered Outcomes in Nonsurgical Periodontal Therapy. Cureus 2024; 16:e56464. [PMID: 38638755 PMCID: PMC11024879 DOI: 10.7759/cureus.56464] [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] [Received: 02/23/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Aim The study was conducted to assess the clinical and patient-centered outcomes among the patients who had undergone nonsurgical periodontal therapy (NSPT). Methodology The participants for this study were 40 individuals with generalized chronic periodontitis. Numerous clinical parameters including clinical attachment level (CAL), probing pocket depth (PPD), plaque index (PI), and gingival index (GI) were evaluated along with the administration of a customized questionnaire before and after three months of therapy to evaluate patient-centered outcomes. Results Clinical parameters showed significant (p < 0.05) improvement post-NSPT. There was 100% satisfaction in few patient-centered outcomes such as bleeding gums, bad breath, food entrapment, and mobility. Conclusion A significant improvement in the clinical parameters does not guarantee improvement in patient-centered outcomes. Achieving the improvement in patient-centered outcomes can improve the overall quality of life (QOL), marking this a holistic treatment.
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Affiliation(s)
- Vyshnavi B Sindhusha
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Arvina Rajasekar
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Needleman I, Almond N, Leow N, Phillips J. Outcomes of periodontal therapy: Strengthening the relevance of research to patients. A co-created review. Periodontol 2000 2023. [PMID: 36786482 DOI: 10.1111/prd.12483] [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: 07/11/2022] [Revised: 12/09/2022] [Accepted: 01/03/2023] [Indexed: 02/15/2023]
Abstract
Periodontitis is a long-term condition affecting up to half of the population globally and causing significant impacts on life quality. Successful management depends on taking life-long ownership of the condition by those affected. There is a wealth of research to inform on management options. However, most of the research has been designed by professional experts with outcomes to gauge benefits and harms based on parameters that inform on the disease process but which might not be informative to support decision-making in people with lived experience (PWLE) of periodontal ill-health (including both patients and carers). The importance of relevant outcomes is highlighted in the concept of the "expert patient" which aims to strengthen the capacity of PWLE to make health-care choices that are important for them, elements of which are likely to be already familiar to many clinicians delivering periodontal health care. Therefore, the voice and collaboration of PWLE in research are recognised as crucial to developing high quality, relevant evidence especially for long-term conditions. In this paper, we review what is known about the relevance of treatment outcomes to PWLE. We also examine the degree to which PWLE have been involved in identifying outcomes that are important to them as well as the diversity and therefore representativeness of PWLE recruited for studies. We consider why having more relevant outcomes could enhance the expertise of PWLE in managing their periodontitis. We then conclude with key learnings from our review which we hope will encourage more rapid development of these initiatives in periodontology for the benefit of global health and wellbeing.
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Affiliation(s)
- Ian Needleman
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | | | - Natalie Leow
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Jim Phillips
- Centre for Empowering Patients and Communities (CEMPAC), Cirencester, UK
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Opšivač D, Musić L, Badovinac A, Šekelja A, Božić D. Therapeutic Manuka Honey as an Adjunct to Non-Surgical Periodontal Therapy: A 12-Month Follow-Up, Split-Mouth Pilot Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1248. [PMID: 36770254 PMCID: PMC9921343 DOI: 10.3390/ma16031248] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/15/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Periodontitis is recognized as one of the most common diseases worldwide. Non-surgical periodontal treatment (NSPT) is the initial approach in periodontal treatment. Recently, interest has shifted to various adjunctive treatments to which the bacteria cannot develop resistance, including Manuka honey. This study was designed as a split-mouth clinical trial and included 15 participants with stage III periodontitis. The participants were subjected to non-surgical full-mouth therapy, followed by applying Manuka honey to two quadrants. The benefit of adjunctive use of Manuka honey was assessed at the recall appointment after 3, 6, and 12 months, when periodontal probing depth (PPD), split-mouth plaque score (FMPS), split-mouth bleeding score (FMBS), and clinical attachment level (CAL) were reassessed. Statistically significant differences between NSPT + Manuka and NSPT alone were found in PPD improvement for all follow-up time points and CAL improvement after 3 and 6 months. These statistically significant improvements due to the adjunctive use of Manuka amounted to (mm): 0.21, 0.30, and 0.19 for delta CAL and 0.18, 0.28, and 0.16 for delta PPD values measured after 3, 6, and 12 months, respectively. No significant improvements in FMPS and FMBS were observed. This pilot study demonstrated the promising potential of Manuka honey for use as an adjunct therapy to nonsurgical treatment.
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Affiliation(s)
- David Opšivač
- School of Medicine, University of Pula, Zagrebačka 30, 52100 Pula, Croatia
| | - Larisa Musić
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| | - Ana Badovinac
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| | | | - Darko Božić
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
- University Dental Clinic, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
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Reuter-Selbach MJ, Su N, Faggion CM. ASSESSMENT OF THE FREQUENCY OF REPORTING DENTAL PATIENT-REPORTED OUTCOMES (dPROs) IN A SAMPLE OF RANDOMIZED CONTROLLED TRIALS ON ROOT COVERAGE PROCEDURES. J Evid Based Dent Pract 2023; 23:101793. [PMID: 36707163 DOI: 10.1016/j.jebdp.2022.101793] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/29/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Dental patient-reported outcomes (dPROs) are important for understanding the impact of proposed therapies on patients' oral health. The aims of the present study were to investigate the frequency of the reporting of dPROs in randomized controlled trials (RCTs) of root coverage procedures and to assess associations between the study/article characteristics and the reporting level of the dPROs. METHODS The PubMed database was searched for RCTs of root coverage procedures in March 16, 2022 and articles published up to March 2022 were included. Information on the types of outcomes and the characteristics of the studies/articles were extracted and reported as frequencies and percentages. Univariate and multivariate binary logistic regression analyses were performed to investigate the associations between the study/article characteristics and the reporting level of dPROs. RESULTS The search initially identified 387 articles, and after applying the eligibility criteria, 135 articles reporting 135 RCTs were included. A combination of dPROs and non-dPROs was reported in 61.5% of the selected trials, while 37.8% of the trials reported only non-dPROs. Pain or discomfort was the most frequently reported dPRO (n = 58, 43% of the RCTs). More recently published RCTs reported more dPROs. The country of the first author (odds ratio [OR]: 4.39; 95% CI: 1.76-10.95; P < .01), protocol registration (OR: 0.36; 95% CI: 0.16-0.83; P = .02), and RCT type (OR: 0.38; 95% CI: 0.17-0.83; P = .02) were significantly associated with the reporting level of the dPROs. CONCLUSIONS Researchers in recent years seem to be paying more attention to the importance of dPROs. RCTs in which the first authors were from developed countries, registered trials, and RCTs with a parallel design were more likely to report dPROs than RCTs with first authors from developing countries, unregistered trials, and RCTs with a split-mouth design.
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Affiliation(s)
- Maximilian J Reuter-Selbach
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany
| | - Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany.
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Hayashi M, Morino K, Harada K, Miyazawa I, Ishikawa M, Yasuda T, Iwakuma Y, Yamamoto K, Matsumoto M, Maegawa H, Ishikado A. Real-world evidence of the impact of obesity on residual teeth in the Japanese population: A cross-sectional study. PLoS One 2022; 17:e0274465. [PMID: 36103495 PMCID: PMC9473396 DOI: 10.1371/journal.pone.0274465] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 08/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Tooth loss is associated with nutritional status and significantly affects quality of life, particularly in older individuals. To date, several studies reveal that a high BMI is associated with tooth loss. However, there is a lack of large-scale studies that examined the impact of obesity on residual teeth with respect to age and tooth positions. OBJECTIVE We assessed the impact of obesity on the number and position of residual teeth by age groups using large scale of Japanese database. METHODS This was a cross-sectional study of 706150 subjects that were included in the database that combined the data from health insurance claims and health check-up, those lacking information about BMI, HbA1c level, smoking status, and the number of residual teeth were excluded. Thus, a total of 233517 aged 20-74 years were included. Subjects were classified into 4 categories based on BMI, and the number of teeth was compared between age-groups. The percentage of subjects with residual teeth in each position was compared between groups with obesity (BMI ≥25.0 kg/m2) and non-obesity. Logistic regression analysis was performed to clarify whether obesity predicts having <24 teeth. RESULTS Higher BMI was associated with fewer teeth over 40s (P for trend <0.0001 when <70s). Obesity was associated with the reduction of residual teeth in the maxillary; specifically, the molars were affected over the age 30. Smoking status further affected tooth loss at positions that were not affected by obesity alone. After adjusting for age, sex, smoking status, and HbA1c ≥6.5%, obesity remained an independent predictive factor for having <24 teeth (ORs: 1.35, 95% CIs: 1.30-1.40). CONCLUSIONS We found that an increase in BMI was associated with a decrease in the number of residual teeth from younger ages independently of smoking status and diabetes in the large scale of Japanese database.
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Affiliation(s)
- Mayu Hayashi
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Katsutaro Morino
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Kayo Harada
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Itsuko Miyazawa
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Miki Ishikawa
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Takako Yasuda
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Yoshie Iwakuma
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Kazushi Yamamoto
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Motonobu Matsumoto
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Hiroshi Maegawa
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Atsushi Ishikado
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
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Smoking Cessation therapy is a cost-effective intervention to avoid tooth loss in Brazilian subjects with periodontitis: an economic evaluation. BMC Oral Health 2021; 21:616. [PMID: 34861866 PMCID: PMC8642876 DOI: 10.1186/s12903-021-01932-2] [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: 02/10/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Smokers present a higher prevalence and severity of periodontitis and, consequently, higher prevalence of tooth loss. Smoking cessation improves the response to periodontal treatment and reduces tooth loss. So, the aim of this study was to evaluate the efficiency in resources allocation when implementing smoking cessation therapy vs. its non-implementation in smokers with periodontitis. Methods We adopted the Brazilian public system perspective to determine the incremental cost-effectiveness (cost per tooth loss avoided) and cost-utility (cost per oral-related quality-adjusted life-year ([QALY] gained) of implementing smoking cessation therapy. Base-case was defined as a 48 years-old male subject and horizon of 30 years. Effects and costs were combined in a decision analytic modeling framework to permit a quantitative approach aiming to estimate the value of the consequences of smoking cessation therapy adjusted for their probability of occurrence. Markov models were carried over annual cycles. Sensitivity analysis tested methodological assumptions. Results Implementing the therapy saved approximately US$ 100 over the time horizon accompanied by a slightly better effect, both in CEA and CUA. Considering uncertainties, the therapy could be cost-effective in the most part of simulated cases, even being cheaper and more effective in 35% of cases in which the oral-health related outcome is used as effect. Considering a willingness-to-pay of US$100 per health effect, smoking cessation therapy was cost-effective, respectively, in 72% and 99% of cases in cost-utility and cost-effectiveness analyses. Conclusions Implementation of smoking cessation therapy may be cost-effective, considering the avoidance of tooth loss and oral health-related consequences to patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01932-2.
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Casarin M, Nolasco WDS, Colussi PRG, Piardi CC, Weidlich P, Rösing CK, Muniz FWMG. Prevalence of tooth loss and associated factors in institutionalized adolescents: a cross-sectional study. CIENCIA & SAUDE COLETIVA 2021; 26:2635-2642. [PMID: 34231676 DOI: 10.1590/1413-81232021267.07162021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/09/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the prevalence of tooth loss and associated factors in institutionalized adolescents. This cross-sectional study included 68 male adolescents incarcerated from Socio-Educational Assistance Center (CASE) aged between 15 and 19 years. Questionnaires were applied individually to assess sociodemographical, economical, medical, behavioral and oral health self-perception variables. All present teeth were evaluated by Decay, Missing, Filling (DMF) Index. The prevalence of tooth loss was analyzed in individuals with ≥1 tooth loss. Associations between tooth loss and exposure variables studied were analyzed by Poisson Regression with robust variance estimation. The prevalence of tooth loss was 47.06%. First molars in the mandible and maxilla and central incisor in the maxilla were the most absent teeth. In the multivariate model, number of decayed teeth, and those that reported daily use of medication were associated with higher tooth loss. Besides, tooth loss was associated with decayed tooth and daily use of medication. Oral health promotion and treatment should be implemented in these institutions to reduce the prevalence of dental loss in these adolescents.
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Affiliation(s)
- Maísa Casarin
- Departamento de Periodontologia, Faculdade de Odontologia, Universidade Federal Pelotas (UFPel). R. Gonçalves Chaves 457, Centro. 96015-560 Pelotas RS Brasil.
| | | | | | - Carla Cioato Piardi
- Departamento de Periodontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Patricia Weidlich
- Departamento de Periodontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Cassiano Kuchenbecker Rösing
- Departamento de Periodontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Francisco Wilker Mustafa Gomez Muniz
- Departamento de Periodontologia, Faculdade de Odontologia, Universidade Federal Pelotas (UFPel). R. Gonçalves Chaves 457, Centro. 96015-560 Pelotas RS Brasil.
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Loos BG, Needleman I. Endpoints of active periodontal therapy. J Clin Periodontol 2021; 47 Suppl 22:61-71. [PMID: 31912527 PMCID: PMC7670400 DOI: 10.1111/jcpe.13253] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/21/2019] [Accepted: 01/04/2020] [Indexed: 01/01/2023]
Abstract
Aim Position paper on endpoints of active periodontal therapy for designing treatment guidelines. The question was as follows: How are, for an individual patient, commonly applied periodontal probing measures—recorded after active periodontal therapy—related to (a) stability of clinical attachment level, (b) tooth survival, (c) need for re‐treatment or (d) oral health‐related quality of life. Methods A literature search was conducted in Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations and Daily <1946 to 07 June 2019>. Results A total of 94 papers were retrieved. From the literature search, it was found that periodontitis patients with a low proportion of deep residual pockets after active periodontal therapy are more likely to have stability of clinical attachment level over a follow‐up time of ≥1 year. Other supporting literature confirms this finding and additionally reports, at the patient level, that probing pocket depths ≥6 mm and bleeding on probing scores ≥30% are risks for tooth loss. There is lack of evidence that periodontal probing measures after completion of active periodontal treatment are tangible to the patient. Conclusions Based on literature and biological plausibility, it is reasonable to state that periodontitis patients with a low proportion of residual periodontal pockets and little inflammation are more likely to have stability of clinical attachment levels and less tooth loss over time. Guidelines for periodontal therapy should take into consideration (a) long‐term tangible patient outcomes, (b) that shallow pockets (≤4 mm) without bleeding on probing in patients with <30% bleeding sites are the best guarantee for the patient for stability of his/her periodontal attachment, (c) patient heterogeneity and patient changes in immune response over time, and (d) that treatment strategies include lifestyle changes of the patient. Long‐term large population‐based and practice‐based studies on the efficacy of periodontal therapies including both clinical and patient‐reported outcomes (PROs) need to be initiated, which include the understanding that periodontitis is a complex disease with variation of inflammatory responses due to environment, (epi)genetics, lifestyle and ageing. Involving people living with periodontitis as co‐researchers in the design of these studies would also help to improve their relevance.
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Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Ian Needleman
- Unit of Periodontology, University College London Eastman Dental Institute, London, UK
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11
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2021. [DOI: 10.1016/s1532-3382(21)00041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2020. [DOI: 10.1016/j.jebdp.2020.101519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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13
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2020. [DOI: 10.1016/s1532-3382(20)30141-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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Pedrazzi V, Figueiredo FATD, Adami LE, Furlaneto F, Palioto DB, Messora MR. Surrogate endpoints: when to use and when not to use? A critical appraisal of current evidences. Braz Oral Res 2020; 34 Suppl 2:e074. [PMID: 32785485 DOI: 10.1590/1807-3107bor-2020.vol34.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/22/2019] [Indexed: 11/21/2022] Open
Abstract
Clinical research needs to formulate a question, which must be answered by obeying ethical precepts with well-defined inclusion/exclusion criteria and approval of the study on platforms of ethical appreciation and clinical trial records. In comparing the results or clinically relevant outcomes should be prioritized in the study of techniques, products, inputs, drugs and therapies. However, it is not always possible to use long study drawings, with many participants, and with many costs, then look for study designs with surrogate outcomes, usually a shorter path, with less sample size and considerably lower costs to the research, with shorter intervention time. Considering these outcomes as major challenges in clinical research, the premise of this work was to examine in relevant research platforms, studies on the feasibility of using surrogate endpoints for clinically relevant parameters in dentistry, with a critical evaluation of the advantages, disadvantages, and need for validation of substitute parameters for clinical studies. After a critical analysis of the results, it could be concluded that surrogate endpoints may have an important role in the initial process of developing new drugs, faster, with less sampling, and lower risk of side effects for the patient. Careful use of the surrogate endpoints is advised because, even if validated, they can provide ambiguous evidence and not be extrapolated to other populations, and may lead to bias due to the individual interpretation of each researcher. The use of unplanned surrogate outcomes that arise during the study requires a lot of caution.
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Affiliation(s)
- Vinicius Pedrazzi
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Larisse Eduardo Adami
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Flávia Furlaneto
- Department of Oral & Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniela Bazan Palioto
- Department of Oral & Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Michel Reis Messora
- Department of Oral & Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2020. [DOI: 10.1016/s1532-3382(20)30094-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2020. [DOI: 10.1016/s1532-3382(20)30051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rösing CK, Cavagni J, Langa GPJ, Mazzetti T, Muniz FWMG. Dental Care and the COVID-19 Pandemic: The Precautionary Principle and the Best Available Evidence. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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18
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2019. [DOI: 10.1016/j.jebdp.2019.101392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2019. [DOI: 10.1016/s1532-3382(19)30247-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2019. [DOI: 10.1016/s1532-3382(19)30183-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Van der Weijden GAF, Dekkers GJ, Slot DE. Success of non-surgical periodontal therapy in adult periodontitis patients: A retrospective analysis. Int J Dent Hyg 2019; 17:309-317. [PMID: 30942938 PMCID: PMC6852011 DOI: 10.1111/idh.12399] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/26/2019] [Accepted: 03/29/2019] [Indexed: 01/02/2023]
Abstract
Objective To evaluate the results of active non‐surgical treatment in patients diagnosed with adult periodontitis treated in a specialized clinic for periodontology. Material & Methods In total, 1182 patients with adult periodontitis received active non‐surgical therapy, which involved professional oral hygiene instruction, scaling and root planing, supragingival polishing and elective systemic antimicrobial medication. The results of this therapy were based on a full‐mouth periodontal chart as assessed at the time of evaluation. Successful treatment as periodontal pocket depth (PPD) ≤5 mm was the main outcome parameter with bleeding on pocket probing as secondary outcome. Patient‐related factors such as smoking and severity of periodontitis at baseline and site‐related factors such as tooth type, furcation involvement and endodontic treatment were analysed. Possible relations with assessed parameters and the success of active periodontal therapy were evaluated. Results Overall 39% of the patients reached the successful treatment objective and a mean bleeding on pocket probing tendency of 14%. Treatment success appeared to be dependent on tooth type where the results at single‐rooted front teeth (85%) and premolar teeth (78%) were more successful than at molar teeth (47%). Analysis revealed that in 55% of the cases furcation involvement at molars was associated with the absence of success. Endodontic treatment was associated with absence of success in 8%‐11% of the cases. Smoking negatively influences successful treatment outcome (P < 0.001). Conclusion Active non‐surgical periodontal therapy in patients with adult periodontitis resulted in approximately one third of the cases in the success endpoint of PPD ≤ 5mm. Sub‐analysis showed that the outcome appeared to be dependent on tooth type, furcation involvement, severity of periodontal disease at intake and smoking status.
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Affiliation(s)
- G A Fridus Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Periodontology Utrecht, Utrecht, The Netherlands
| | - Gijs J Dekkers
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2019. [DOI: 10.1016/s1532-3382(19)30045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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23
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Levels of Evidence—Grading System. J Evid Based Dent Pract 2018. [DOI: 10.1016/s1532-3382(18)30326-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Levels of Evidence—Grading System ∗ ∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2018. [DOI: 10.1016/s1532-3382(18)30209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Needleman I, Garcia R, Gkranias N, Kirkwood KL, Kocher T, Iorio AD, Moreno F, Petrie A. Mean annual attachment, bone level, and tooth loss: A systematic review. J Periodontol 2018; 89 Suppl 1:S120-S139. [DOI: 10.1002/jper.17-0062] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/29/2017] [Accepted: 05/28/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Ian Needleman
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Raul Garcia
- Department of Health Policy and Health Services Research; Boston University Henry M. Goldman School of Dental Medicine; Boston MA USA
| | - Nikos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry; Barts and The London School of Medicine and Dentistry, Queen Mary University of London; London UK
| | - Keith L. Kirkwood
- Department of Oral Biology; University at Buffalo, State University of New York; Buffalo NY USA
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry; Dental School of the University Medicine Greifswald; Greifswald Germany
| | - Anna Di Iorio
- UCL Library Services; University College London; London UK
| | - Federico Moreno
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Aviva Petrie
- Biostatistics Unit; University College London Eastman Dental Institute; London UK
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Needleman I, Garcia R, Gkranias N, Kirkwood KL, Kocher T, Iorio AD, Moreno F, Petrie A. Mean annual attachment, bone level, and tooth loss: A systematic review. J Clin Periodontol 2018; 45 Suppl 20:S112-S129. [DOI: 10.1111/jcpe.12943] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/29/2017] [Accepted: 05/28/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Ian Needleman
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Raul Garcia
- Department of Health Policy and Health Services Research; Boston University Henry M. Goldman School of Dental Medicine; Boston MA USA
| | - Nikos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry; Barts and The London School of Medicine and Dentistry, Queen Mary University of London; London UK
| | - Keith L. Kirkwood
- Department of Oral Biology; University at Buffalo, State University of New York; Buffalo NY USA
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry; Dental School of the University Medicine Greifswald; Greifswald Germany
| | - Anna Di Iorio
- UCL Library Services; University College London; London UK
| | - Federico Moreno
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Aviva Petrie
- Biostatistics Unit; University College London Eastman Dental Institute; London UK
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Levels of Evidence—Grading System ∗ ∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2018. [DOI: 10.1016/s1532-3382(18)30124-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Aoyama N, Suzuki JI, Kobayashi N, Hanatani T, Ashigaki N, Yoshida A, Shiheido Y, Sato H, Kumagai H, Ikeda Y, Akazawa H, Komuro I, Minabe M, Izumi Y, Isobe M. Japanese Cardiovascular Disease Patients with Diabetes Mellitus Suffer Increased Tooth Loss in Comparison to Those without Diabetes Mellitus -A Cross-sectional Study. Intern Med 2018; 57:777-782. [PMID: 29151540 PMCID: PMC5891513 DOI: 10.2169/internalmedicine.9578-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective Tooth loss is an irreversible condition that reflects the end-stage of oral diseases, including periodontitis. Although periodontitis is a major factor in the progression of diabetes mellitus (DM) and cardiovascular disease (CVD), no previous studies have compared tooth loss in CVD patients with and without DM. Methods The subjects included CVD patients with (n=94) and without (n=145) DM who attended Tokyo Medical and Dental University Hospital. Blood examinations and periodontal measurements were performed. Results The oral and periodontal examinations revealed that the numbers of missing teeth in the DM group were increased in comparison to the non-DM group. There was no significant difference between the groups with regard to the incidence of edentulism, the probing pocket depth, the clinical attachment level or the incidence of bleeding on probing. Conclusion We showed that the numbers of missing teeth among CVD patients with DM was significantly higher than that among CVD patients without DM.
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Affiliation(s)
- Norio Aoyama
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Japan
| | - Jun-Ichi Suzuki
- Department of Advanced Clinical Science and Therapeutics, The University of Tokyo, Japan
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Japan
| | - Naho Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Tomoya Hanatani
- Department of Periodontology, Kyushu Dental University, Japan
| | | | - Asuka Yoshida
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Yuka Shiheido
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Hiroki Sato
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Hidetoshi Kumagai
- Department of Advanced Clinical Science and Therapeutics, The University of Tokyo, Japan
| | - Yuichi Ikeda
- Department of Cardiovascular Medicine, The University of Tokyo, Japan
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine, The University of Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Japan
| | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Japan
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Levels of Evidence—Grading System ∗ ∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2018. [DOI: 10.1016/s1532-3382(18)30031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bidra AS, Nguyen V, Manzotti A, Kuo CL. Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population - Part 3: Unblinded and Discriminatory Subjective Analysis. J Prosthodont 2018; 27:22-28. [DOI: 10.1111/jopr.12635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2017] [Indexed: 12/01/2022] Open
Affiliation(s)
- Avinash S. Bidra
- Department of Reconstructive Sciences; University of Connecticut Health Center; Farmington CT
| | - Viensuong Nguyen
- Department of Restorative Dentistry; University of Colorado School of Dental Medicine; Denver CO
| | - Anna Manzotti
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry; Chicago IL
| | - Chia-Ling Kuo
- Department of Community Medicine and Health Care; University of Connecticut Health Center; Farmington CT
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Levels of Evidence—Grading System ∗ ∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2017. [DOI: 10.1016/s1532-3382(17)30336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Aoyama N, Suzuki J, Kobayashi N, Hanatani T, Ashigaki N, Yoshida A, Shiheido Y, Sato H, Minabe M, Izumi Y, Isobe M. Associations among tooth loss, systemic inflammation and antibody titers to periodontal pathogens in Japanese patients with cardiovascular disease. J Periodontal Res 2017; 53:117-122. [DOI: 10.1111/jre.12494] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 11/29/2022]
Affiliation(s)
- N. Aoyama
- Division of Periodontology Department of Oral Interdisciplinary Medicine Graduate School of Dentistry Kanagawa Dental University Yokosuka Japan
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - J.‐I. Suzuki
- Department of Advanced Clinical Science and Therapeutics The University of Tokyo Tokyo Japan
- Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan
| | - N. Kobayashi
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - T. Hanatani
- Division of Periodontology Kyushu Dental University Kitakyushu Fukuoka Japan
| | - N. Ashigaki
- Department of Oral Microbiology Tsurumi University Yokohama Japan
| | - A. Yoshida
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - Y. Shiheido
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - H. Sato
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - M. Minabe
- Division of Periodontology Department of Oral Interdisciplinary Medicine Graduate School of Dentistry Kanagawa Dental University Yokosuka Japan
| | - Y. Izumi
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - M. Isobe
- Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan
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Levels of Evidence—Grading System ∗ ∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2017. [DOI: 10.1016/s1532-3382(17)30219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Shah EB, Modi BB, Shah MA, Dave DH. Patient Centered Outcomes in Periodontal Treatment-An Evidenced Based Approach. J Clin Diagn Res 2017; 11:ZE05-ZE07. [PMID: 28571299 DOI: 10.7860/jcdr/2017/24260.9631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/31/2016] [Indexed: 11/24/2022]
Abstract
Transformation of research into clinical practice is the most challenging step in evidence based dental practice. Designing the most reliable research with applicable endpoint evaluation is very important as it can lead to successful research outcomes that can be accepted in clinical practice. In the periodontal research few accepted endpoints are used frequently as they are believed to be the gold standard in measuring the periodontal disease and the treatment outcomes. However, a wide range of endpoints used are surrogate endpoints and these endpoints have no direct correlation with the patient centered outcomes. Hence, a direct relationship of surrogate endpoints with true endpoints needs to be established. This review highlights the importance of true endpoints and challenges in implementing these in clinical research. Importance of patient's centered outcomes are also reviewed and duly discussed here. Need for conducting research which includes the true endpoints or the surrogate endpoints with clinical applicability and tangible outcomes, was also suggested in this review.
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Affiliation(s)
- Ekta Bharatbhai Shah
- Senior Lecturer, Department of Periodontology, K.M.Shah Dental College, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India
| | - Bhavesh Bhupendrabhai Modi
- Senior Lecturer, Department of Periodontology, K.M.Shah Dental College, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India
| | - Monali Amit Shah
- Professor, Department of Periodontology, K.M.Shah Dental College, Sumandeep Vidhyapeeth University, Vadodara, Gujarat, India
| | - Deepak Harishbhai Dave
- Professor and Head, Department of Periodontology, K.M.Shah Dental College, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India
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Aoyama N, Suzuki JI, Kobayashi N, Hanatani T, Ashigaki N, Yoshida A, Shiheido Y, Sato H, Kumagai H, Ikeda Y, Akazawa H, Komuro I, Izumi Y, Isobe M. Periodontitis deteriorates peripheral arterial disease in Japanese population via enhanced systemic inflammation. Heart Vessels 2017; 32:1314-1319. [PMID: 28567552 DOI: 10.1007/s00380-017-1003-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/26/2017] [Indexed: 12/27/2022]
Abstract
Peripheral arterial disease (PAD) is a common manifestation of arterial stenosis of the extremity that reduces arterial flow. While patients with periodontitis are at a high risk of PAD, little causal information has been provided to date. To clarify the relationship, we conducted this cross-sectional study. The oral condition of patients with or without PAD, who attended Tokyo Medical and Dental University Hospital, was evaluated. Blood examinations and dental clinical measurements, including number of teeth, probing pocket depth (PPD), bleeding on probing (BOP) and clinical attachment level (CAL) were performed. Chi-square test was performed to compare gender, smoker rate, prevalence of DM, hypertension and dyslipidemia and edentulous rate. Wilcoxon test was used to compare bacterial counts and anti-bacterial antibodies and Student's t test was used to compare the other numerical values. The subjects were patients with (n = 34) or without (n = 956) PAD. We revealed that the PAD patients had more missing teeth (17.5 ± 11.0), a higher rate of edentulism (18%), and higher serum inflammatory factor levels than non-PAD patients (10.9 ± 8.7, 5%, respectively). On the other hand, there was no significant difference between hypertension, dyslipidemia, smoking status, HbA1c, bacterial antibody titers, and bacterial counts between the groups. In conclusion, we clarified that PAD patients had decreased tooth number and worsened oral and periodontal condition with enhanced systemic inflammation.
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Affiliation(s)
- Norio Aoyama
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Jun-Ichi Suzuki
- Department of Advanced Clinical Science and Therapeutics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Cardiovascular Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Naho Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Tomoya Hanatani
- Educational Cooperation Center, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka, 803-8580, Japan
| | - Norihiko Ashigaki
- Department of Oral Microbiology, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, 230-8501, Japan
| | - Asuka Yoshida
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yuka Shiheido
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroki Sato
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hidetoshi Kumagai
- Department of Advanced Clinical Science and Therapeutics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yuichi Ikeda
- Department of Cardiovascular Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Faggion CM, Pachur T, Giannakopoulos NN. Patients' Values in Clinical Decision-Making. J Evid Based Dent Pract 2017; 17:177-183. [PMID: 28865814 DOI: 10.1016/j.jebdp.2017.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Shared decision-making involves the participation of patient and dental practitioner. Well-informed decision-making requires that both parties understand important concepts that may influence the decision. This fourth article in a series of 4 aims to discuss the importance of patients' values when a clinical decision is made. METHODS We report on how to incorporate important concepts for well-informed, shared decision-making. Here, we present patient values as an important issue, in addition to previously established topics such as the risk of bias of a study, cost-effectiveness of treatment approaches, and a comparison of therapeutic benefit with potential side effects. RESULTS We provide 2 clinical examples and suggestions for a decision tree, based on the available evidence. CONCLUSION The information reported in this article may improve the relationship between patient and dental practitioner, resulting in more well-informed clinical decisions.
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Affiliation(s)
- Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany.
| | - Thorsten Pachur
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
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Levels of Evidence—Grading System ∗ ∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2017. [DOI: 10.1016/s1532-3382(17)30051-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Levels of Evidence—Grading System∗∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2016. [DOI: 10.1016/s1532-3382(16)30198-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Levels of Evidence—Grading System∗∗Originally published in Newman MG, Weyant R, Hujoel P: JEBDP improves grading system and adopts strength of recommendation taxonomy grading (SORT) for guidelines and systematic reviews. J Evid Based Dent Pract 2007;7:147-150. J Evid Based Dent Pract 2016. [DOI: 10.1016/s1532-3382(16)30150-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Levels of Evidence—Grading System∗. J Evid Based Dent Pract 2016. [DOI: 10.1016/s1532-3382(16)30086-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Listl S, Faggion CM. Valuing the Clinical Effectiveness of Therapeutics. J Evid Based Dent Pract 2016; 16:86-9. [DOI: 10.1016/j.jebdp.2016.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/03/2016] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
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Madianos P, Papaioannou W, Herrera D, Sanz M, Baeumer A, Bogren A, Bouchard P, Chomyszyn-Gajewska M, Demirel K, Gaspersic R, Giurgiu M, Graziani F, Jepsen K, Jepsen S, O′Brien T, Polyzois I, Preshaw PM, Rakic M, Reners M, Rincic N, Stavropoulos A, Sütcü S, Verner C, Llodra JC. EFP Delphi study on the trends in Periodontology and Periodontics in Europe for the year 2025. J Clin Periodontol 2016; 43:472-81. [DOI: 10.1111/jcpe.12551] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Phoebus Madianos
- School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - William Papaioannou
- School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Amelie Baeumer
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral; Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
| | - Anna Bogren
- Specialistkliniken för Parodontologi; Folktandvården Västra Götaland Göteborg; Göteborg Sweden
| | - Philippe Bouchard
- Department of Periodontology; Rothschild Hospital (AP-HP); UFR of Odontology; University of Paris Diderot; Paris France
- EA 2496; UFR of Odontology; University of Paris Descartes; Montrouge France
| | - Maria Chomyszyn-Gajewska
- Department of Periodontology and Oral Medicine; Jagiellonian University; Collegium Medicum Cracow Poland
| | - Korkud Demirel
- Department of Periodontology; Istanbul University; Istanbul Turkey
| | - Rok Gaspersic
- Department of Oral Medicine and Periodontology; Faculty of Medicine; University of Ljubljana; Ljubljana Slovenia
| | - Marina Giurgiu
- Department of Periodontology; Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - Filippo Graziani
- Department of Surgical; Medical and Molecular Pathology and Critical Care Medicine; Section of Dentistry; University of Pisa; Pisa Italy
| | - Karin Jepsen
- Department of Periodontology; Operative and Preventive Dentistry; University of Bonn; Bonn Germany
| | - Sören Jepsen
- Department of Periodontology; Operative and Preventive Dentistry; University of Bonn; Bonn Germany
| | | | - Ioannis Polyzois
- Department of Restorative Dentistry and Periodontology; Dublin Dental University Hospital; Trinity College; Dublin Ireland
| | - Philip M. Preshaw
- Centre for Oral Health Research and Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - Mia Rakic
- Department for Periodontology and Oral Medicine; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | | | | | - Andreas Stavropoulos
- Department of Periodontology; Faculty of Odontology; Malmö University; Malmö Sweden
| | | | - Christian Verner
- Department of Periodontolgy; University of Nantes; Nantes France
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Taylor TD, Bidra AS, Nazarova E, Wiens JP. Clinical significance of immediate mandibular lateral translation: A systematic review. J Prosthet Dent 2016; 115:412-8. [PMID: 26723093 DOI: 10.1016/j.prosdent.2015.09.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Immediate mandibular lateral translation (IMLT) has been widely described in theory, but its clinical significance in prosthodontics and restorative dentistry is not clear. PURPOSE The purpose of this study was to systematically review the existing literature to identify the clinical significance of IMLT (immediate side shift). MATERIAL AND METHODS An electronic search for articles in the English language literature was performed independently by multiple investigators using a systematic search process with the PubMed search engine. After applying predetermined inclusion and exclusion criteria, the final list of studies was analyzed to identify the clinical significance of IMLT. RESULTS The initial electronic search yielded 858 titles. The systematic application of the inclusion and exclusion criteria eventually produced 23 studies addressing IMLT in 914 human participants. Eleven studies reported use of voluntary movements, 5 articles reported use of only induced movements, 2 studies reported use of both voluntary and induced movements, and 5 articles did not report the recording method. The amount of IMLT reported ranged from 0 to 3 mm with minimal clarity among authors on the exact description of IMLT. No studies reported on any clinical implication (harm or benefit to patients or clinicians) of incorporating IMLT in diagnosis and treatment planning. CONCLUSIONS This systematic review did not identify any scientific evidence on the clinical implications of IMLT. Furthermore, there is a lack of clear terminology related to IMLT and the timing of the side shift, occurrence of IMLT on the working versus nonworking condyle, and induced versus noninduced methods of recording and measuring. Current scientific evidence does not support the need to include IMLT as a factor when prosthodontic or restorative treatment is planned and executed.
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Affiliation(s)
- Thomas D Taylor
- Professor and Head, Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, Conn
| | - Avinash S Bidra
- Program Director, Post-Graduate Prosthodontics, Department of Reconstructive Sciences, University of Connecticut Health Center, Department of Reconstructive Sciences, Farmington, Conn.
| | - Elena Nazarova
- Associate Professor, Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, Conn
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Baelum V, López R. Defining and predicting outcomes of non-surgical periodontal treatment: a 1-yr follow-up study. Eur J Oral Sci 2015; 124:33-44. [PMID: 26714428 DOI: 10.1111/eos.12240] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2015] [Indexed: 12/28/2022]
Abstract
This study reports on 1-yr outcomes of non-surgical periodontal therapy and compares predictive models resulting from different definitions of treatment success. A total of 149 participants, 30-70 yr of age, provided clinical periodontal data and data on sociodemographic status, health status, symptoms, and oral health-care behaviors at baseline. One week later, clinical attachment level and probing pocket depth were recorded again in 148 patients. Participants underwent non-surgical periodontal therapy, including scaling and root planing, during three to four clinical sessions. Three and 12 months later, clinical attachment level, probing pocket depth, and bleeding on probing (BOP) were recorded in 141 and 137 participants, respectively. Using test-retest data, patients were classified as having 'downhill', 'stable', or 'improved' results on three clinical attachment level and three probing pocket depth outcomes, and their classification was found to vary considerably according to outcome. Although the predictors of treatment outcome varied depending on the variable chosen to represent the treatment outcome, some predictors were more commonly noted as predicting improvement, namely a high baseline percentage of sites with subgingival calculus and the presence of suppuration at baseline. The latter was, however, also predictive for tooth loss during the study. Our findings underline the need for uniformity in defining the outcomes in trials of periodontal therapy.
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Affiliation(s)
- Vibeke Baelum
- Department of Dentistry, Section for Oral Epidemiology & Public Health, Aarhus University, Aarhus C, Denmark
| | - Rodrigo López
- Department of Dentistry, Section for Periodontology, Health, Aarhus University, Aarhus C, Denmark
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An overview of systematic reviews of the use of systemic antimicrobials for the treatment of periodontitis. Br Dent J 2014; 217:443-51. [DOI: 10.1038/sj.bdj.2014.909] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2014] [Indexed: 12/24/2022]
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Romanos GE, Javed F, Delgado-Ruiz RA, Calvo-Guirado JL. Peri-implant diseases: a review of treatment interventions. Dent Clin North Am 2014; 59:157-78. [PMID: 25434564 DOI: 10.1016/j.cden.2014.08.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The ideal management of peri-implant diseases focuses on infection control, detoxification of implant surfaces, regeneration of lost tissues, and plaque-control regimens via mechanical debridement (with or without raising a surgical flap). However, a variety of other therapeutic modalities also have been proposed for the management of peri-implantitis. These treatment strategies encompass use of antiseptics and/or antibiotics, laser therapy, guided bone regeneration, and photodynamic therapy. The aim of this article was to review indexed literature with reference to the various therapeutic interventions proposed for the management of peri-implant diseases.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, 106 Rockland Hall, Stony Brook, NY 11794-8700, USA.
| | - Fawad Javed
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Derriyah, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, 1103 Westchester Hall, Stony Brook, NY 11794-8712, USA
| | - José Luis Calvo-Guirado
- Faculty of Medicine and Dentistry, Hospital Morales Meseguer, University of Murcia, 2° Planta Clínica Odontológica Calle Marques de los Velez S/n, Murcia 30007, Spain
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Santillo PMH, Gusmão ES, Moura C, Soares RDSC, Cimões R. [Factors associated with tooth loss among adults in rural areas in the state of Pernambuco, Brazil]. CIENCIA & SAUDE COLETIVA 2014; 19:581-90. [PMID: 24863834 DOI: 10.1590/1413-81232014192.20752012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 01/13/2012] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to estimate the prevalence of tooth loss and associated factors among Brazilian adults aged 20 to 59 years in rural areas in the state Pernambuco, Brazil. A cross-sectional study was conducted on a random sample of 568 participants. The number of lost teeth (d" 12 and > 12) was the outcome investigated. The independent variables were as follows: sociodemographic characteristics, subjective oral health conditions, impact of oral health on quality of life using the short version of the Oral Health Impact Profile (OHIP-14), and the use of dental services. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. The prevalence of subjects with at least one tooth lost was 91.4%. Tooth loss was strongly associated with age group, self-perceived oral health and oral health impact on quality of life. The high prevalence of tooth loss among Brazilian adults in rural areas shows a need for a reorientation of public dental services aimed at this population group.
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Faggion CM. Are there guidelines for reporting clinical research findings in oral lectures and seminars in dental meetings? Br Dent J 2014; 214:281-3. [PMID: 23518971 DOI: 10.1038/sj.bdj.2013.272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/09/2022]
Abstract
Dental meetings are one of the most important resources for disseminating knowledge to dental practitioners. Therefore, the information provided in such meetings should be as unbiased as possible. This paper assessed whether major general dentistry and periodontology/implant dentistry meetings have guidelines for reporting scientific evidence in oral lectures and seminars. The homepages of seven dental meetings (EUROPERIO, AAP, EAO, AO, IADR, ADA, and FDI) were assessed to check for guidelines for presenting scientific data in oral lectures and seminars, according to defined criteria. Only three of these dental meetings reported information for presentations on their homepages, although these guidelines were related to technical issues rather than recommendations for the presentation of scientific data. The present paper suggests guidelines for reporting scientific evidence in oral lectures and seminars in dental meetings to improve the current standards of reporting. High standards of reporting may provide less biased information, which is necessary for dental practitioners and clinicians to make accurate judgements on the efficacy/effectiveness of therapies.
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Affiliation(s)
- C M Faggion
- Department of Oral Sciences, University of Otago, 310 great King Street, Dunedin, 9016, New Zealand.
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