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Taylor A, Burns L. Deep margin elevation in restorative dentistry: A scoping review. J Dent 2024; 146:105066. [PMID: 38740249 DOI: 10.1016/j.jdent.2024.105066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES Deep margin elevation (DME) is a restorative approach offering the possibility of performing stepwise elevation of deep proximal cavities to create more favourable margins for direct or indirect restorations. The objectives of this scoping review were to explore what is known or unknown about DME by describing a wide ranging evidence base including peer reviewed literature and non-traditionally published information on the web. DATA Data were extracted from the included evidence in order to describe the following: the extent and nature of the evidence base; the situations which are appropriate for DME; the materials and techniques which are used; the outcomes which have been measured in empirical studies; the risks which have been reported; and the findings which have been reported in studies which compared DME to surgical crown lengthening. SOURCES This scoping review included a wide range of published evidence and extensive web searching for grey literature, including CPD, training and multimedia information. STUDY SELECTION The findings revealed a range of published literature as well as freely available, online information advising practitioners about DME. Most empirical evidence was based on in vitro studies, and there were few clinical studies comparing DME to crown lengthening. Online information included recent, multimedia sources. CONCLUSIONS DME is a technique that can be used with motivated patients with good oral hygiene if rubber dam isolation is achieved, if there is no invasion of the connective tissue space, and if a strict restorative protocol is adhered to. CLINICAL SIGNIFICANCE With phasing out of amalgam and adhesive dentistry increasing in popularity, DME addresses multiple clinical problems associated with sub-gingival margins prior to restoration.
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Affiliation(s)
- Anna Taylor
- The Treatment Centre, Tinner's Court, Back Quay, Truro, Cornwall TR1 2LL, UK
| | - Lorna Burns
- Peninsula Dental School, John Bull Building, Research Way, Plymouth, Devon PL6 8BU, UK.
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Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J 2022; 55 Suppl 4:1059-1084. [PMID: 35808836 PMCID: PMC9796050 DOI: 10.1111/iej.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has. Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence. However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.
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Affiliation(s)
- Francesco Mannocci
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Kerstin Bitter
- Department of Operative and Preventive DentistryCharité ‐ University Medicine BerlinBerlinGermany
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la SaludUniversidad CEU‐Cardenal Herrera ValenciaAlfara del PatriarcaSpain
| | - Paolo Ferrari
- Department of Operative DentistryUniversity of ParmaParmaItaly
| | - Rupert Austin
- Department of ProsthodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Bhavin Bhuva
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
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Beklen A, Sali N, Yavuz MB. The impact of smoking on periodontal status and dental caries. Tob Induc Dis 2022; 20:72. [PMID: 36118559 PMCID: PMC9423024 DOI: 10.18332/tid/152112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/16/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Investigations to explore the relationship between smoking and its oral manifestations are important to clinicians. Among these oral manifestations, periodontal diseases and dental caries have still a controversial association. This study aims to analyze the effect of smoking on periodontal disease and caries and their relevance to each other. METHODS Data on demographic and clinical features were retrieved from 7028 patients. Smoking status was categorized as a smoker, non-smoker, former smoker and passive smoker. Each patient received a diagnosis according to the new classification system for periodontal disease, in which periodontal disease is divides into stages (PS). The carries status was diagnosed by evaluating the decayed, missing, and filled teeth (DMFT) index. RESULTS Of the patients, 66.6% were non-smoker women, whereas 53.7 % of passive smokers were women. Being a worker and having a Bachelor’s degree was associated with a higher likelihood of getting diagnosed with periodontal disease and caries in smokers. Smoking significantly influences periodontal disease severity and DMFT values (p<0.001). This becomes more evident in former smokers by showing the highest severe periodontal problems (PS3: 29.7% and PS4: 18.9%), and the highest DMFT mean (16.4 ± 7.4) Accordingly, persons having high DMFT had significantly the most severe periodontal disease, namely PS4 (p<0.05). CONCLUSIONS Smoking is associated with higher caries prevalence and more severe periodontal disease, and DMFT tend to increase with the severity of periodontitis in the same subjects.
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Affiliation(s)
- Arzu Beklen
- Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Nichal Sali
- Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - M. Burak Yavuz
- Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
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Baik KM, Dabbagh RAA. Knowledge About Deep Margin Elevation Among Different Practicing Dental Specialists in Saudi Arabia. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/n0yjg9s7lc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gil EG, Åstrøm AN, Lie SA, Rygg M, Fischer J, Rosén A, Bletsa A, Luukko K, Shi XQ, Halbig J, Frid P, Cetrelli L, Tylleskär K, Rosendahl K, Skeie MS. Dental caries in children and adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis. BMC Oral Health 2021; 21:417. [PMID: 34433437 PMCID: PMC8390188 DOI: 10.1186/s12903-021-01758-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore whether caries is more prevalent among children and adolescents with JIA compared to controls; examine presence of caries according to JIA group, socio-behavioral and intraoral characteristics, and the extent to which surface-specific caries varies between and within individuals; assess whether surface-specific caries varies according to JIA group and dentition; and investigate whether disease-specific clinical features of JIA are associated with presence of caries. Methods In this comparative cross-sectional study, calibrated dentists examined index teeth (primary 2. molars, 1. permanent molars) of 4–16-year-olds with JIA (n = 219) and matched controls (n = 224), using a detailed caries diagnosis system (including enamel caries). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-behavioral information collected by questionnaires. Multilevel mixed-effect logistic regressions reporting odds ratios (OR) with 95% confidence interval (CI) were applied (caries at surface level as outcome variable). Potential confounders were adjusted for, and the effect of dependency of surface-specific caries data was estimated by calculating intra-class correlation coefficients (ICC). Results At individual level, no significant difference in caries prevalence was found between individuals with JIA and controls, regardless of inclusion of enamel caries. Proportion of enamel lesions exceeded dentine lesions. JIA was not associated with presence of caries, but in both groups, low maternal educational level was associated with presence of caries (OR: 2.07, 95% CI: 1.24–3.46). Occlusal and mesial surfaces, compared to buccal surfaces, had generally higher OR according to presence of caries than distal and lingual surfaces (ICC = 0.56). Surface-specific caries in the permanent dentition differed significantly according to group affiliation. Some JIA disease-specific variables were suggested to associate with presence of caries. Conclusions No overall difference in caries prevalence between individuals with JIA and controls was observed, but for both groups, low maternal educational level and tooth surface associated with presence of caries. Associations between JIA disease-specific variables and presence of caries cannot be excluded. Due to predominance of enamel lesions, the potential of preventative dental strategies is considerable. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01758-y.
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Affiliation(s)
- Elisabeth G Gil
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.
| | - Anne N Åstrøm
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olav's Hospital, Trondheim, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway-Vestland, Bergen, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Xie-Qi Shi
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Josefine Halbig
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway
| | - Paula Frid
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lena Cetrelli
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Center for Oral Health Services and Research (TKMidt), Trondheim, Norway
| | - Karin Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karen Rosendahl
- Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Marit S Skeie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Center for Oral Health Services and Research (TKMidt), Trondheim, Norway
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Binalrimal SR, Banjar WM, Alyousef SH, Alawad MI, Alawad GI. Assessment of knowledge, attitude, and practice regarding Deep Margin Elevation (DME) among dental practitioners in Riyadh, Saudi Arabia. J Family Med Prim Care 2021; 10:1931-1937. [PMID: 34195127 PMCID: PMC8208217 DOI: 10.4103/jfmpc.jfmpc_1707_20] [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: 08/21/2020] [Revised: 09/25/2020] [Accepted: 10/07/2020] [Indexed: 12/02/2022] Open
Abstract
Objectives: To evaluate Knowledge, Attitude, and Practice (KAP) regarding deep margin elevation (DME) among dental practitioners in Riyadh city. Materials and Methodology: A cross-sectional study that comprised a total number of 535 dental practitioners: 255 (47.7%) were males and 280 (52.3%) females. A self-constructed 21 close-ended self-administered questionnaire was utilized in the study. The data were entered and analyzed by Chi-square test and descriptive analysis using Statistical Package for the Social Sciences (SPSS) software. Results: Although the majority of the respondents have heard about DME, only 30.4% have utilized this technique in their clinical practice by having general practitioners and specialists utilize this technique more often than consultants. Among the participants, 65.4% of them have agreed that adhesion by bonding to deep cervical dentin is predictable and related to the success of the final restoration. Conclusion: The knowledge level of DME among the study participants was adequate. The findings of this study revealed that the total number of dentists who utilize the technique in restoring large subgingival defects of posterior teeth with proximal caries is very minimal. Thus, it is recommended that dental practitioners have this technique introduced in their dental clinics as an alternative to surgical crown lengthening. Although years of experience and dentist rank may influence the clinical decision, in-depth factorial analysis with a greater sample size is necessary.
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Affiliation(s)
| | - Weam M Banjar
- Office of Assistant Deputy for Planning and Organization Excellence, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Mada I Alawad
- Dental Intern, Riyadh Elm University, Riyadh, Saudi Arabia
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West N, Chapple I, Claydon N, D'Aiuto F, Donos N, Ide M, Needleman I, Kebschull M. BSP implementation of European S3 - level evidence-based treatment guidelines for stage I-III periodontitis in UK clinical practice. J Dent 2021; 106:103562. [PMID: 33573801 DOI: 10.1016/j.jdent.2020.103562] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To adapt the supranational European Federation for Periodontology (EFP) S3-Level Clinical Practice Guideline for treatment of periodontitis (stage I-III) to a UK healthcare environment, taking into account the views of a broad range of stakeholders, and patients. SOURCES This UK version is based on the supranational EFP guideline (Sanz et al., 2020) published in the Journal of Clinical Periodontology. The source guideline was developed using the S3-level methodology, which combined the assessment of formal evidence from 15 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 62 clinical recommendations for the treatment of stage I-III periodontitis, based on a step-wise process mapped to the 2017 classification system. METHODOLOGY The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for the adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework and following the S3-process, the underlying systematic reviews were updated and a representative guideline group of 75 delegates from 17 stakeholder organisations was assembled into three working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly. RESULTS AND CONCLUSION Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the dental community in the UK. CLINICAL SIGNIFICANCE The aim of S3-level guidelines is to combine the evaluation of formal evidence, grading and synthesis with the clinical expertise of a broad range of stakeholders to form clinical recommendations. Herein, the first major international S3-level guideline in dentistry, the EFP guideline, was implemented for direct clinical applicability in the UK healthcare system.
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Affiliation(s)
- Nicola West
- Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Trust, Birmingham, UK.
| | - Nick Claydon
- Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Francesco D'Aiuto
- Periodontology, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Nikos Donos
- Periodontology, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University, Turner Street, London E1 2AD, UK.
| | - Mark Ide
- Periodontology, Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London SE1 9RT, UK.
| | - Ian Needleman
- Periodontology, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Moritz Kebschull
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
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Epidemiological trends, predictive factors, and projection of tooth loss in Germany 1997-2030: part I. missing teeth in adults and seniors. Clin Oral Investig 2020; 25:67-76. [PMID: 33219875 PMCID: PMC7785540 DOI: 10.1007/s00784-020-03266-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 03/19/2020] [Indexed: 12/14/2022]
Abstract
Objective This is the first part of a report on tooth loss in Germany 1997–2030. Here, we describe trends in the prevalence of tooth loss in adults and seniors 1997–2014, assess predictive factors for tooth loss and projected it into 2030. Material and methods Data of the cross-sectional, multi-center, nationally representative German Oral Health Studies of 1997, 2005, and 2014 were used. Age, sex, educational level, smoking status, and the cohort were used for ordinary least square regression to assess the association of predictors with tooth loss (missing teeth, MT). The yielded regression coefficients were used to predict tooth loss in 2030. Results Compared with 1997, the mean MT in adults (35–44 years old) in 2030 was predicted to decrease by two-thirds to 1.3. The prevalence of tooth loss (MT > 0) will decrease by 72% from 1997 to 2030. In 2030, half of the population of adults will not exhibit any tooth loss. Compared with 1997, the mean MT among seniors (65–74 years old) will decline to 5.6 teeth (i. e. two-thirds reduction) until 2030. Prevalence of tooth loss will be halved by 2030, and approximately one-third of this age group will not exhibit any tooth loss. Conclusions Based on the model used, the trend of a robust decline in tooth loss will become more dynamic by the year 2030. As a result, every second adult will have experienced no tooth loss at all in 2030, and seniors will possess more teeth than they have previously lost. Clinical relevance This study presents the trends of tooth loss in Germany for a period of three decades. It provides clinically relevant data for health care planning by 2030.
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Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Berglundh T, Sculean A, Tonetti MS. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol 2020; 47 Suppl 22:4-60. [PMID: 32383274 PMCID: PMC7891343 DOI: 10.1111/jcpe.13290] [Citation(s) in RCA: 587] [Impact Index Per Article: 146.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/03/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The recently introduced 2017 World Workshop on the classification of periodontitis, incorporating stages and grades of disease, aims to link disease classification with approaches to prevention and treatment, as it describes not only disease severity and extent but also the degree of complexity and an individual's risk. There is, therefore, a need for evidence-based clinical guidelines providing recommendations to treat periodontitis. AIM The objective of the current project was to develop a S3 Level Clinical Practice Guideline (CPG) for the treatment of Stage I-III periodontitis. MATERIAL AND METHODS This S3 CPG was developed under the auspices of the European Federation of Periodontology (EFP), following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The rigorous and transparent process included synthesis of relevant research in 15 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and consensus, on those recommendations, by leading experts and a broad base of stakeholders. RESULTS The S3 CPG approaches the treatment of periodontitis (stages I, II and III) using a pre-established stepwise approach to therapy that, depending on the disease stage, should be incremental, each including different interventions. Consensus was achieved on recommendations covering different interventions, aimed at (a) behavioural changes, supragingival biofilm, gingival inflammation and risk factor control; (b) supra- and sub-gingival instrumentation, with and without adjunctive therapies; (c) different types of periodontal surgical interventions; and (d) the necessary supportive periodontal care to extend benefits over time. CONCLUSION This S3 guideline informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat periodontitis and to maintain a healthy dentition for a lifetime, according to the available evidence at the time of publication.
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Affiliation(s)
- Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri‐implant Diseases) Research GroupUniversity Complutense of MadridMadridSpain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri‐implant Diseases) Research GroupUniversity Complutense of MadridMadridSpain
| | - Moritz Kebschull
- Periodontal Research GroupInstitute of Clinical SciencesCollege of Medical and Dental SciencesThe University of BirminghamBirminghamUK
- Birmingham Community Healthcare NHS TrustBirminghamUK
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesCollege of Dental MedicineColumbia UniversityNew YorkNYUSA
| | - Iain Chapple
- Periodontal Research GroupInstitute of Clinical SciencesCollege of Medical and Dental SciencesThe University of BirminghamBirminghamUK
- Birmingham Community Healthcare NHS TrustBirminghamUK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity Hospital BonnBonnGermany
| | - Tord Berglundh
- Department of PeriodontologyInstitute of OdontologyThe Sahlgrenska AcademyUniversity of GothenburgGöteborgSweden
| | - Anton Sculean
- Department of PeriodontologySchool of Dental MedicineUniversity of BernBernSwitzerland
| | - Maurizio S. Tonetti
- Division of Periodontology and Implant DentistryFaculty of DentistryThe University of Hong KongHong KongHong Kong
- Department of Oral and Maxillo‐facial ImplantologyShanghai Key Laboratory of StomatologyNational Clinical Research Centre for StomatologyShanghai Ninth People HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina
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TEKBAŞ ATAY M, BÜYÜKGÖZE DİNDAR M, ÖZYURT E, ÇİLİNGİR A, ERDEMİR U. Frequency and Localization of Overhanging Restorations. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.677099] [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] Open
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Kavuncu G, Yilmaz AM, Karademir Yilmaz B, Yilmaz Atali P, Altunok EC, Kuru L, Agrali OB. Cytotoxicity of Different Nano Composite Resins on Human Gingival and Periodontal Ligament Fibroblast Cell Lines: An In Vitro Study. Biomedicines 2020; 8:biomedicines8030048. [PMID: 32121617 PMCID: PMC7148444 DOI: 10.3390/biomedicines8030048] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 12/17/2022] Open
Abstract
The aim of this study is to determine the cytotoxicity of three different nano composite resins (CRs) on human gingival fibroblast (hGF) and periodontal ligament fibroblast (hPDLF) cell lines. These CRs selected were nanohybrid organic monomer-based Admira Fusion (AF), nanohybrid Bis-(acryloyloxymethyl) tricyclo [5.2.1.0.sup.2,6] decane-based Charisma Topaz (CT), and supra nano filled resin-based Estelite Quick Sigma (EQS). MTT assay was performed to assess the cytotoxicity of CRs at 24 h and one week. AF and EQS applied on hGF cells at 24 h and one week demonstrated similar cytotoxic outcomes. Cytotoxicity of CT on hGF cells at one week was higher than 24 h (p = 0.04). Cytotoxicity of CT on hGF cells was higher at 24 h (p = 0.002) and one week (p = 0.009) compared to control. All composites showed higher cytotoxicity on hPDLF cells at one week than the 24 h (AF; p = 0.02, CT; p = 0.02, EQS; p = 0.04). AF and EQS demonstrated lower cytotoxicity on hPDLF cells than the control group at 24 h (AF; p = 0.01, EQS; p = 0.001). CT was found more cytotoxic on hPDLF cells than the control (p = 0.01) and EQS group (p = 0.008) at one week. The cytotoxicity of CRs on hGF and hPDLF cells vary, according to the type of composites, cell types, and exposure time.
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Affiliation(s)
- Gamze Kavuncu
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey; (G.K.); (L.K.)
| | - Ayse Mine Yilmaz
- Department of Biochemistry, Faculty of Medicine, Marmara University, Istanbul 34854, Turkey; (A.M.Y.); (B.K.Y.)
- Genetic and Metabolic Diseases Research and Investigation Center, Marmara University, Istanbul 34854, Turkey
| | - Betul Karademir Yilmaz
- Department of Biochemistry, Faculty of Medicine, Marmara University, Istanbul 34854, Turkey; (A.M.Y.); (B.K.Y.)
- Genetic and Metabolic Diseases Research and Investigation Center, Marmara University, Istanbul 34854, Turkey
| | - Pinar Yilmaz Atali
- Department of Restorative Dentistry, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey;
| | - Elif Cigdem Altunok
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Yeditepe University, Istanbul 34755, Turkey;
| | - Leyla Kuru
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey; (G.K.); (L.K.)
| | - Omer Birkan Agrali
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey; (G.K.); (L.K.)
- Correspondence: ; Tel.: +90-216-421-16-21
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Hong C, Broadbent J, Thomson W, Poulton R. The Dunedin Multidisciplinary Health and Development Study: Oral health findings and their implications. J R Soc N Z 2020; 50:35-46. [PMID: 32226196 PMCID: PMC7100605 DOI: 10.1080/03036758.2020.1716816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
Longitudinal research is needed to better understand the natural history of oral conditions and long-term health and social outcomes. Oral health data has been collected periodically in the Dunedin Multidisciplinary Health and Development Study for over 40 years. To date, 70+ peer-review articles on the Study's oral health-related findings have been published, providing insight into the natural history of oral conditions, risk factors, impacts on quality of life, and disparities in oral health. Some of these report new findings, while others build upon the existing body of evidence. This paper provides an overview of these findings and reflects on their public health implications and policy utility in New Zealand.
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Affiliation(s)
- C.L. Hong
- Department of Oral Sciences, University of Otago
| | | | - W.M. Thomson
- Department of Oral Sciences, University of Otago
| | - R. Poulton
- Department of Psychology, University of Otago
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Collins JR, Elías AR, Brache M, Veras K, Ogando G, Toro M, Rivas-Tumanyan S, Rajendra AB. Association between gingival parameters and Oral health-related quality of life in Caribbean adults: a population-based cross-sectional study. BMC Oral Health 2019; 19:234. [PMID: 31675959 PMCID: PMC6825342 DOI: 10.1186/s12903-019-0931-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 10/21/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Good oral health has been associated with better quality of life and general health. In the Caribbean, there have been no studies regarding the association between oral health conditions and the quality of life of the population. The main purpose of this study was to investigate the association between gingival parameters and oral health-related quality of life (OHRQoL) in Caribbean adults. A secondary aim of the study was to gain more information on factors that impact OHRQoL in this population. METHODS This cross-sectional, epidemiological, population-based study was conducted in community settings. After the participants with missing Oral Health Impact Profile (OHIP) data were excluded, the sample size was 1821 (weighted according to the age and gender distribution in each target population). OHIP-14 standardized questionnaires were used to collect information. In addition, a medical/oral health questionnaire including sociodemographics, general health, dental visits, oral hygiene habits and knowledge, the frequency of dental visits, prosthesis use/hygiene, and smoking was administered. A multivariate model included predictors that showed significant associations in the univariate models. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported; statistical significance was set at 0.05. RESULTS In the multivariate analysis, current smokers (OR = 2.34, 95% CI: 1.74-3.14 vs. never smokers), those who visited the dentist only when problems arose (OR = 1.65, 95% CI: 1.13-2.40 vs. those visiting once a year), and participants with any chronic disease/condition (OR = 1.38, 95% CI: 1.06-1.78) had higher odds of being in the highest tertile for OHIP score (poorer health). CONCLUSIONS The present multicenter study identified potential modifiable risk factors for poor OHRQoL among adults in three Caribbean cities.
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Affiliation(s)
- J R Collins
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM-CSD), Santo Domingo, Dominican Republic.
| | - A R Elías
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, (UPR SDM), San Juan, Puerto Rico
| | - M Brache
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM-CSD), Santo Domingo, Dominican Republic
| | - K Veras
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM-CSD), Santo Domingo, Dominican Republic
| | - G Ogando
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM-CSD), Santo Domingo, Dominican Republic
| | - M Toro
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, (UPR SDM), San Juan, Puerto Rico
| | - S Rivas-Tumanyan
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, (UPR SDM), San Juan, Puerto Rico
| | - A B Rajendra
- Department of Pathology, University of the West Indies Mona, Kingston, Jamaica
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Millar B, Blake K. The influence of overhanging restoration margins on interproximal alveolar bone levels in general dental practice. Br Dent J 2019; 227:223-227. [DOI: 10.1038/s41415-019-0530-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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15
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Bernabé E, Knuuttila M, Suominen AL. Interdental cleaning and periodontal pocketing among finnish adults. J Clin Periodontol 2019; 46:310-320. [PMID: 30734957 DOI: 10.1111/jcpe.13081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Abstract
AIM To investigate the relationship between frequency of interdental cleaning and 11-year change in teeth with periodontal pocketing in Finnish adults. METHODS Data from 1667 dentate adults, aged 30 to 82 years, who participated in the Health 2000 survey and were re-examined in 2004 and/or 2011 were analysed. Participants reported their frequency of interdental cleaning (either dental floss or interdental brush) at baseline. Teeth with periodontal pocketing (PD) ≥4 mm were counted in every survey and treated as a repeated outcome. The association between the frequency of interdental cleaning and the number of teeth with PD ≥4 mm was evaluated in linear mixed effects models, controlling for demographic factors, socioeconomic position, diabetes, smoking status, toothbrushing frequency, dental attendance and number of teeth. RESULTS Twelve per cent of adults reported daily interdental cleaning. Significant inverse linear trends in the number of teeth with PD ≥4 mm were found in every survey according to the frequency of interdental cleaning. However, this association was completely attenuated after adjustment for the full set of confounders. Contrarily, toothbrushing frequency was negatively associated with the baseline number of teeth with PD ≥4 mm and its rate of change over time. CONCLUSION Interdental cleaning was not associated with 11-year change in periodontal pocketing after accounting for other established risk factors for periodontal disease.
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Affiliation(s)
- Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna L Suominen
- Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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García-Cortés JO, Loyola-Rodríguez JP, Monárrez-Espino J. Gingival biotypes in Mexican students aged 17-19 years old and their associated anatomic structures, socio-demographic and dietary factors. J Oral Sci 2019; 61:156-163. [DOI: 10.2334/josnusd.17-0370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- José O. García-Cortés
- Graduate School of Dentistry, Faculty of Dentistry, San Luis Potosi Autonomous University
| | | | - Joel Monárrez-Espino
- Department of Public Health Sciences, Karolinska Institute
- Research Department, Claustro University
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17
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Root caries experience in Germany 1997 to 2014: Analysis of trends and identification of risk factors. J Dent 2018; 78:100-105. [DOI: 10.1016/j.jdent.2018.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 08/24/2018] [Accepted: 08/26/2018] [Indexed: 11/19/2022] Open
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Collares K, Demarco FF, Horta BL, Correa MB. Proximal restoration increases the risk of clinical attachment loss. J Clin Periodontol 2018; 45:832-840. [DOI: 10.1111/jcpe.12919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/19/2018] [Accepted: 05/08/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Kauê Collares
- Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - Flávio F. Demarco
- Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
- Postgraduate Program in Epidemiology; Federal University of Pelotas; Pelotas Brazil
| | - Bernardo L. Horta
- Postgraduate Program in Epidemiology; Federal University of Pelotas; Pelotas Brazil
| | - Marcos B. Correa
- Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
- Postgraduate Program in Epidemiology; Federal University of Pelotas; Pelotas Brazil
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Ferrari M, Koken S, Grandini S, Ferrari Cagidiaco E, Joda T, Discepoli N. Influence of cervical margin relocation (CMR) on periodontal health: 12-month results of a controlled trial. J Dent 2018; 69:70-76. [DOI: 10.1016/j.jdent.2017.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/11/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022] Open
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20
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Sun X, Bernabé E, Liu X, Gallagher JE, Zheng S. Do contextual factors have a role in periodontal disease? J Clin Periodontol 2016; 44:13-21. [DOI: 10.1111/jcpe.12630] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Xiangyu Sun
- Department of Preventive Dentistry; Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology; Beijing China
- King's College London Dental Institute at Guy's; King's College and St Thomas' Hospitals, Population and Patient Health Division; London UK
| | - Eduardo Bernabé
- King's College London Dental Institute at Guy's; King's College and St Thomas' Hospitals, Population and Patient Health Division; London UK
| | - Xuenan Liu
- Department of Preventive Dentistry; Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology; Beijing China
| | - Jennifer E. Gallagher
- King's College London Dental Institute at Guy's; King's College and St Thomas' Hospitals, Population and Patient Health Division; London UK
| | - Shuguo Zheng
- Department of Preventive Dentistry; Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology; Beijing China
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Bahrami G, Vaeth M, Kirkevang LL, Wenzel A, Isidor F. The impact of smoking on marginal bone loss in a 10-year prospective longitudinal study. Community Dent Oral Epidemiol 2016; 45:59-65. [PMID: 27649930 DOI: 10.1111/cdoe.12260] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/30/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this epidemiologic study was to determine the impact of smoking on marginal bone loss in a subsample derived from an original randomly selected adult sample, after adjusting for oral and general factors. METHODS The number of participants at baseline in this 10-year longitudinal study was 616 (mean age: 42 years, range 21-63 years). The participants underwent a full-mouth radiographic survey. After recall in 2003, 473 (77%) of the participants accepted and completed an identical survey. In 2008, the survey was repeated, and 301 (48.9%) individuals were included in this study. The marginal bone level of each tooth was measured in mm. Age, gender, smoking habits, number of teeth, apical periodontitis, crowns and initial marginal bone level were also recorded for each individual. Only individuals who did not report a change in smoking habits during the 10-year period were included in the study. Multiple regression analyses were used to evaluate crude and adjusted associations between smoking and marginal bone loss. RESULTS At the first, radiographic survey smokers had a statistically significantly more reduced marginal bone level (in average 0.9 mm) than nonsmokers. After 10 years, a progression of a mean marginal bone loss of > 2 mm was statistically significantly more common in smokers than in nonsmokers (7.1% and 0%, respectively). Furthermore, a marginal bone loss of 1-2 mm was observed in 29% of the smokers and 19% of the nonsmokers, and ≤ 1 mm marginal bone loss was found in 69% of smokers and 81% of nonsmokers. Even after adjusting for initial marginal bone level, gender, age, and also presence of apical periodontitis and crowns, the difference in progression of marginal bone loss was still statistically higher in smokers (on average 0.36 mm). CONCLUSIONS The smokers started out with a more reduced marginal bone level than nonsmokers. However, even after adjusting for the initial marginal bone level, the progression of marginal bone loss in smokers was more pronounced than in nonsmokers. This shows that smoking is a factor with significant impact on the marginal bone level and can be assumed to be a true risk factor for marginal bone loss.
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Affiliation(s)
- Golnosh Bahrami
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Michael Vaeth
- Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lise-Lotte Kirkevang
- Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.,Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ann Wenzel
- Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Flemming Isidor
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
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22
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Karimalakuzhiyil Alikutty F, Bernabé E. Long-term regular dental attendance and periodontal disease in the 1998 adult dental health survey. J Clin Periodontol 2016; 43:114-20. [PMID: 26932321 DOI: 10.1111/jcpe.12496] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 12/26/2022]
Abstract
AIM The aim of this study was to explore the association between long-term pattern of dental attendance and periodontal disease among British adults. METHODS We used data from 3272 adults who participated in the 1998 Adult Dental Health Survey in the UK. Participants were classified into four trajectories (current, always, former and never regular attenders) based on their responses to three questions on lifetime dental attendance patterns. The numbers of teeth with pocket depth (PD) ≥4 mm and loss of attachment (LOA) ≥4 mm were the outcome measures. The association between dental attendance patterns and each periodontal measure was assessed in crude and adjusted models using negative binomial regression. RESULTS Never and former regular attenders had more teeth with PD ≥4 mm (Rate Ratios with 95% Confidence Interval: 1.58 [1.28-1.95] and 1.34 [1.12-1.60] respectively) and LOA ≥4 mm (1.34 [1.04-1.72] and 1.37 [1.07-1.75] respectively) than always regular attenders, after adjustments for demographic (sex, age and country of residence) and socioeconomic factors (education and social class). However, no differences in periodontal measures were found between always and current regular attenders. CONCLUSION This analysis of national cross-sectional data shows that adults with different long-term patterns of dental attendance have different periodontal health status.
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Affiliation(s)
- Fazeena Karimalakuzhiyil Alikutty
- King's College London Dental Institute at Guy's, King's College and St Thomas Hospitals, Unit of Dental Public Health, London, United Kingdom
| | - Eduardo Bernabé
- King's College London Dental Institute at Guy's, King's College and St Thomas Hospitals, Unit of Dental Public Health, London, United Kingdom
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Skudutyte-Rysstad R, Tveit AB, Espelid I, Kopperud SE. Posterior composites and new caries on adjacent surfaces - any association? Longitudinal study with a split-mouth design. BMC Oral Health 2016; 16:11. [PMID: 26831336 PMCID: PMC4736652 DOI: 10.1186/s12903-016-0167-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/21/2016] [Indexed: 02/06/2023] Open
Abstract
Background The aim of this longitudinal study was to compare caries incidence in sound approximal surfaces adjacent to newly placed composite restorations with the caries incidence in corresponding surfaces in contralateral teeth without any restorations in contact; and to assess risk factors for dentine caries development on adjacent and control surfaces. Methods Data from a practice-based study, where 4030 posterior approximal restorations placed in permanent teeth by clinicians working in a Public Dental Health Service in Norway, were used. The study was approved by the Regional Committee for Medical Research Ethics. The present study is based on a subsample of patients with a sound surface adjacent to a newly placed composite posterior approximal restoration. All individuals who had intact corresponding contralateral pairs of teeth in the same jaw, were included. At the end of the follow-up period, the study restorations and their adjacent surfaces were evaluated clinically and radiographically. Status of the contralateral tooth pair at baseline and end point was based on recordings from routine dental examinations, retrospectively extracted from the electronic dental records. Results One hundred and ninety three patients (mean age 15.0 years, SD = 3.4) met the inclusion criteria. The surfaces were followed on average for 4.8 years. Follow-up observations revealed that 41 % of adjacent surfaces remained sound, compared with 67 % of the control surfaces (p < 0.001). Restorations were placed in 17 % of adjacent surfaces, compared with 3 % of the control surfaces (p < 0.001). In multivariate logistic regression analysis adjacent surfaces in maxillary teeth had increased risk for dentine caries development (OR 3.1, CI 1.3–7.3). Conclusions Caries incidence in intact approximal surfaces adjacent to newly placed composite posterior approximal restorations was significantly higher compared with the contralateral control surface without a restoration in contact. Adjacent surfaces in maxillary teeth had increased risk for dentine caries development.
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Affiliation(s)
- Rasa Skudutyte-Rysstad
- Faculty of Dentistry, University of Oslo, Norway, P. O. Box 1109, Blindern, NO-0317, Oslo, Norway.
| | - Anne Bjørg Tveit
- Faculty of Dentistry, University of Oslo, Norway, P. O. Box 1109, Blindern, NO-0317, Oslo, Norway.
| | - Ivar Espelid
- Faculty of Dentistry, University of Oslo, Norway, P. O. Box 1109, Blindern, NO-0317, Oslo, Norway.
| | - Simen E Kopperud
- Faculty of Dentistry, University of Oslo, Norway, P. O. Box 1109, Blindern, NO-0317, Oslo, Norway. .,Nordic Institute of Dental Materials (NIOM), Sognsveien 70A, NO-0855, Oslo, Norway.
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Gomes IA, Filho EMM, Mariz DCBR, Borges AH, Tonetto MR, Firoozmand LM, Kuga CM, De Jesus RRT, Bandéca MC. In vivo Evaluation of Proximal Resin Composite Restorations performed using Three Different Matrix Systems. J Contemp Dent Pract 2015; 16:643-647. [PMID: 26423500 DOI: 10.5005/jp-journals-10024-1735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this in vivo study was to radiographically evaluate the proximal contour of composite resin restorations performed using different matrix systems. MATERIALS AND METHODS Patients with premolars needing class II type resin composite restorations involving the marginal ridge were selected. Thirty premolars were selected and randomly divided into three groups (n = 10 each) to receive restorations using different matrix systems: group 1: metal matrix coupled to a carrier matrix and wood wedge (G1-MMW); group 2: sectioned and precontoured metal matrix and elastic wedge (G2-SME); and group 3: a polyester strip and reflective wedge (G3-PMR). After the restorative procedure, bitewing radiographs were performed and analyzed by three calibrated professionals. The quality of the proximal contact and marginal adaptation of the proximal surfaces was classified as either correct or incorrect (undercontour/overcontour). RESULTS The Pearson Chi-square statistical test (α = 5%) revealed a statistically difference between frequencies of correct and incorrect restorations (α(2) = 6.787, p < 0.05). The group G2 SME produced a higher frequency of correct proximal contours (90%), while G1-MMW and G3-PMR had a ratio of 40% correct and 60% incorrect contours respectively. CONCLUSION None of the matrix systems was able to prevent the formation of incorrect proximal contours; however, the sectioned and precontoured metal matrix/elastic wedge configuration provided better results as compared to the other groups.
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Affiliation(s)
| | | | | | - Alvaro Henrique Borges
- Department of Postgraduate in Integrated Dental Science University of Cuiaba, Cuiaba, MT, Brazil
| | - Mateus Rodrigues Tonetto
- Department of Postgraduate in Integrated Dental Science University of Cuiaba, Cuiaba, MT, Brazil
| | | | - Carlos Milton Kuga
- Department of Restorative Dentistry, Araraquara Dental School, Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
| | | | - Matheus Coelho Bandéca
- Professor, Department of Postgraduate in Dentistry, CEUMA University, Sao Luis, MA, University Rua Jossue Montello, 01, Sao Luis, MA, Brazil, e-mail:
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Shin BM, Ryu JI, Sheiham A, Do LG, Jung SH. Which life course model better explains the association between socioeconomic position and periodontal health? J Clin Periodontol 2015; 42:213-20. [PMID: 25581381 DOI: 10.1111/jcpe.12360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2014] [Indexed: 11/28/2022]
Abstract
AIM To assess whether the relationship between socioeconomic position (SEP) and periodontal health fitted the Critical Period or the Social Mobility life course models. METHODS A nationally representative sample of 5570 Korean adults from KNHANES IV study. Log-binomial regression models adjusting for adulthood or childhood socioeconomic (SES) variables was used to assess independent effects of socioeconomic differences for childhood, adulthood and period of transition from child to adult in periodontal health. RESULTS In the Critical Period model, poorer periodontal status was associated with SES disadvantage in adulthood and not predicted by SES disadvantage in childhood. For the intergenerational Social Mobility model, prevalence of current periodontal disease was only different for females aged 30-39 and 40-49 years, after adjustment. Prevalence of periodontal disease in females was highest in the downwardly mobile group. CONCLUSIONS The Critical Period model was better at explaining association between socioeconomic position and periodontal health, such as the adulthood socioeconomic variables (SEP), had a stronger effect than childhood factors on periodontal disease. The Social Mobility model explained more of the variation in the association between SEP and periodontal health among women than among men.
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Affiliation(s)
- Bo-Mi Shin
- Gangneung-Wonju National University, Gangneung, Korea
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Zimmermann H, Zimmermann N, Hagenfeld D, Veile A, Kim TS, Becher H. Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis. Community Dent Oral Epidemiol 2014; 43:116-27. [PMID: 25255820 DOI: 10.1111/cdoe.12126] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/09/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The epidemiology of periodontitis regarding oral-hygiene practices particularly the frequency of tooth brushing has been the subject of relatively few dedicated studies. This paper provides a systematic review of available relevant epidemiological studies and a meta-analysis of the effect of tooth brushing frequency on periodontitis. To review and to quantify the risk for periodontitis associated with frequency of tooth brushing. METHODS Systematic literature search was conducted in nine online resources (PUBMED, ISI and 7 additional databases). Related and cross-referencing publications were reviewed. Papers published until end of March 2013 reporting associations between tooth brushing frequency and periodontitis were considered. A meta-analysis was performed to quantify this association. RESULTS Fourteen studies were identified. The test of heterogeneity for cross-sectional studies was not significant (P = 0.31). A fixed-effects model yielded a significant overall odds ratio estimate of 1.41 (95%CI: 1.25-1.58, P < 0.0001) for infrequent compared to frequent tooth brushing. For all fourteen studies, there was a slight indication for heterogeneity (I² = 48%, P = 0.02) and the corresponding result with a random-effects model was 1.44 (95%CI: 1.21-1.71, P < 0.0001). CONCLUSIONS There are relatively few studies evaluating the association between tooth brushing frequency and periodontitis. A clear effect was observed, indicating that infrequent tooth brushing was associated with severe forms of periodontal disease. Further epidemiological studies are needed to precisely estimate the effect of key risk factors for periodontitis and their interaction effects.
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Affiliation(s)
- Heiko Zimmermann
- Unit of Epidemiology and Biostatistics, Institute of Public Health, University of Heidelberg, Germany
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Walter MH, Marré B, Vach K, Strub J, Mundt T, Stark H, Pospiech P, Wöstmann B, Heydecke G, Kern M, Hartmann S, Luthardt R, Huppertz J, Wolfart S, Hannak W. Management of shortened dental arches and periodontal health: 5-year results of a randomised trial. J Oral Rehabil 2014; 41:515-22. [PMID: 24673467 DOI: 10.1111/joor.12160] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2014] [Indexed: 11/28/2022]
Abstract
In a multicentre randomised trial (German Research Association, grants DFG WA 831/2-1 to 2-6, WO 677/2-1.1 to 2-2.1.; controlled-trials.com ISRCTN97265367), patients with complete molar loss in one jaw received either a partial removable dental prosthesis (PRDP) with precision attachments or treatment according to the SDA concept aiming at pre-molar occlusion. The objective of this current analysis was to evaluate the influence of different treatments on periodontal health. Linear mixed regression models were fitted to quantify the differences between the treatment groups. The assessment at 5 years encompassed 59 patients (PRDP group) and 46 patients (SDA group). For the distal measuring sites of the posterior-most teeth of the study jaw, significant differences were found for the plaque index according to Silness and Löe, vertical clinical attachment loss (CAL-V), probing pocket depth (PPD) and bleeding on probing. These differences were small and showed a slightly more unfavourable course in the PRDP group. With CAL-V and PPD, significant differences were also found for the study jaw as a whole. For CAL-V, the estimated group differences over 5 years amounted to 0.27 mm (95% CI 0.05; 0.48; P = 0.016) for the study jaw and 0.25 mm (95% CI 0.05; 0.45; P = 0.014) for the distal sites of the posterior-most teeth. The respective values for PPD were 0.22 mm (95% CI 0.03; 0.41; P = 0.023) and 0.32 mm (95% CI 0.13; 0.5; P = 0.001). It can be concluded that even in a well-maintained.patient group statistically significant although minor detrimental effects of PRDPs on periodontal health are measurable.
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Affiliation(s)
- M H Walter
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Iwasaki M, Taylor GW, Nakamura K, Yoshihara A, Miyazaki H. Association Between Low Bone Mineral Density and Clinical Attachment Loss in Japanese Postmenopausal Females. J Periodontol 2013; 84:1708-16. [DOI: 10.1902/jop.2013.120613] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Demarco FF, Correa MB, Horta B, Barros AJ, Peres KG, Peres MA. Multilevel analysis of the association between posterior restorations and gingival health in young adults: a population-based birth cohort. J Clin Periodontol 2013; 40:1126-31. [PMID: 24102545 DOI: 10.1111/jcpe.12168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the association of direct posterior restorations with gingival bleeding and dental calculus in young adults from a birth cohort. METHODS A representative sample (n = 720) of 5914 infants born live in Pelotas, Brazil, in 1982, were prospectively investigated, and posterior restorations and periodontal health outcomes assessed when they were 24 years of age. Tooth-level exploratory variables included the presence and number of restoration's surfaces. Demographic and socio-economic characteristics, oral health instructions, dental floss usage, dental caries presence and smoking were also considered whilst gingival bleeding and dental calculus were the outcomes. Multilevel logistic regression was carried out. RESULTS Class I cavities were found in 15.2% (95% CI 14.5-15.9) of the teeth and class II in 3.6% (3.3-4.0). Percentage of teeth with gingival bleeding was 6.1% (5.6-6.6) and that with dental calculus 22% (21.2-22.8). Even after all the individual variables were controlled for, the presence of a class I [OR1.51 (1.14-2.00)] and class II [OR 1.76 (1.04-2.97)] cavities was positively associated with gingival bleeding. Class I [OR1.36 (1.13-1.65)] and Class II [OR1.80 (1.28-2.53)] cavities were associated with dental calculus also. CONCLUSIONS Posterior restoration and higher number of restored surfaces was associated with a higher prevalence of gingival bleeding and dental calculus around the restoration.
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Affiliation(s)
- Flávio Fernando Demarco
- Post-graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil; Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Thomson WM, Shearer DM, Broadbent JM, Foster Page LA, Poulton R. The natural history of periodontal attachment loss during the third and fourth decades of life. J Clin Periodontol 2013; 40:672-80. [PMID: 23656174 DOI: 10.1111/jcpe.12108] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2013] [Indexed: 11/26/2022]
Abstract
AIM To describe changes in the occurrence of periodontal attachment loss (AL) through ages 26, 32 and 38 in a complete birth cohort. MATERIALS AND METHODS Systematic periodontal examinations conducted at ages 26, 32 and 38 in a longstanding New Zealand cohort study (N = 1037). Periodontitis extent data were used to assign participants to periodontitis trajectories using group-based trajectory analysis. RESULTS Eight hundred and thirty-one individuals were periodontally examined at all three ages; the prevalence and extent of AL increased as the cohort aged. Between 26 and 32, one in nine participants had 1+ sites showing new or progressing AL; that proportion almost doubled between ages 32 and 38. Four periodontitis trajectory groups were identified, comprising 55.2%, 31.5%, 10.7% and 2.5% of the cohort; these were termed the "Very low", "Low", "Moderately increasing" and "Markedly increasing" trajectory groups respectively. Those who had smoked tobacco at all ages from 15 through 38 were at higher risk of being in the "Moderately increasing" or "Markedly increasing" trajectory groups. There was a similar risk gradient for those who were in the highest 20% of cannabis usage. CONCLUSIONS Periodontitis commences relatively early in adulthood, and its progression accelerates with age, particularly among smokers.
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Affiliation(s)
- W Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand.
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Zaruba M, Göhring TN, Wegehaupt FJ, Attin T. Influence of a proximal margin elevation technique on marginal adaptation of ceramic inlays. Acta Odontol Scand 2013; 71:317-24. [PMID: 23004362 DOI: 10.3109/00016357.2012.680905] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Evaluating the effect of a proximal margin elevation technique on marginal adaptation of ceramic inlays. METHODS Class II MOD-cavities were prepared in 40 human molars and randomly distributed to four groups (n = 10). In group EN (positive control) proximal margins were located in enamel, 1 mm above the cementoenamel junction, while 2 mm below in groups DE-1In, DE-2In and DE. The groups DE-1In, DE-2In and DE simulated subgingival location of the cervical margin. In group DE-1In one 3 mm and in group DE-2In two 1.5 mm composite layers (Tetric) were placed for margin elevation of the proximal cavities using Syntac classic as an adhesive. The proximal cavities of group DE remained untreated and served as a negative control. In all groups, ceramic inlays (Cerec 3D) were adhesively inserted. Replicas were taken before and after thermomechanical loading (1.200.000 cycles, 50/5°C, max. load 49 N). Marginal integrity (tooth-composite, composite-inlay) was evaluated with scanning electron microscopy (200×). Percentage of continuous margin (% of total proximal margin length) was compared between groups before and after cycling using ANOVA and Scheffé post-hoc test. RESULTS After thermomechanical loading, no significant differences were observed between the different groups with respect to the interface composite-inlay and tooth-composite with margins in dentin. The interface tooth-composite in enamel of group EN was significantly better compared to group DE-2In, which was not different to the negative control group DE and DE-1In. CONCLUSION Margin elevation technique by placement of a composite filling in the proximal box before insertion of a ceramic inlay results in marginal integrities not different from margins of ceramic inlays placed in dentin.
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The prevalence of approximal caries in patients after fixed orthodontic treatment and in untreated subjects: a retrospective, cross-sectional study on bitewing radiographs. J Orofac Orthop 2013; 74:64-72. [PMID: 23307177 DOI: 10.1007/s00056-012-0111-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 07/23/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this retrospective, cross-sectional study was to investigate the prevalence of approximal carious lesions in patients after fixed multibracket therapy and in subjects without orthodontics on bitewing radiographs. MATERIAL AND METHODS Bitewing radiographs of 104 orthodontically treated patients with fixed multibracket appliances were compared to those of 111 untreated subjects. The individuals in both groups were between 15 and 16.25 years of age when radiographs were taken. The test group with orthodontics was recruited from the archive of the Department of Orthodontics at the University of Zürich. The untreated control group was selected randomly from 16 communities in the Canton of Zürich. The approximal surfaces of the permanent premolars and molars of all subjects were assessed by two calibrated investigators. RESULTS The average number of enamel lesions in the test group after fixed orthodontic treatment was lower than in the control group (0.57 vs. 1.85, p < 0.001). The same was found for dentin lesions (0.06 vs. 0.49, p < 0.001). The distribution of lesions was similar in both groups. CONCLUSION Fewer approximal carious lesions were detected in the test group after fixed multibracket appliances than in the age-matched control group without orthodontic treatment.
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Walter MH, Hannak W, Kern M, Mundt T, Gernet W, Weber A, Wöstmann B, Stark H, Werner D, Hartmann S, Range U, Jahn F, Passia N, Pospiech P, Mitov G, Brückner J, Wolfart S, Busche E, Luthardt RG, Heydecke G, Marré B. The randomized shortened dental arch study: tooth loss over five years. Clin Oral Investig 2012; 17:877-86. [DOI: 10.1007/s00784-012-0761-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 05/22/2012] [Indexed: 11/30/2022]
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Peres MA, Thomson WM, Peres KG, Gigante DP, Horta BL, Broadbent JM, Poulton R. Challenges in comparing the methods and findings of cohort studies of oral health: the Dunedin (New Zealand) and Pelotas (Brazil) studies. Aust N Z J Public Health 2011; 35:549-56. [DOI: 10.1111/j.1753-6405.2011.00736.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Vasconcelos FSQ, Neves ACC, Silva-Concílio LRD, Cunha LG, Rode SDM. Influence of anatomic reference on the buccal contour of prosthetic crowns. Braz Oral Res 2009; 23:230-5. [DOI: 10.1590/s1806-83242009000300002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 05/28/2009] [Indexed: 11/22/2022] Open
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Hermann P, Gera I, Borbély J, Fejérdy P, Madléna M. Periodontal health of an adult population in Hungary: findings of a national survey. J Clin Periodontol 2009; 36:449-57. [DOI: 10.1111/j.1600-051x.2009.01395.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Julihn A, Barr Agholme M, Modéer T. Risk factors and risk indicators in relation to incipient alveolar bone loss in Swedish 19-year-olds. Acta Odontol Scand 2008; 66:139-47. [PMID: 18568472 DOI: 10.1080/00016350802087024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate incipient alveolar bone loss and subgingival calculus on a subject-based level in Swedish 19-year-olds, with special reference to risk factors and risk indicators. MATERIAL AND METHODS Subjects (n=686) with different socio-economic profiles enrolled at seven public dental clinics in suburban Stockholm answered a questionnaire on general health, tobacco habits, oral hygiene habits, and their parents' socio-economic background. The clinical and radiographic examination included registration of plaque, bleeding on probing (GBI), supra- and subgingival calculus, caries, and restorations. Incipient alveolar bone loss was recorded when the distance from the cemento-enamel junction to the alveolar crest was > or =2.0 mm. RESULTS The prevalence of incipient alveolar bone loss was 5.1%; multivariate analysis disclosed the associated variables to be "subgingival calculus" (odds ratio (OR) 4.2) and "proximal restoration > or =1" (OR 2.1). The cumulative probability of exhibiting incipient alveolar bone loss was 19.6%. The prevalence of subgingival calculus was 14.3% and subgingival calculus was associated with "GBI > 25%" (OR 6.0), "supragingival calculus" (OR 4.6), and "father born abroad" (OR 2.8). The cumulative probability of exhibiting subgingival calculus was estimated to be 65.3%. CONCLUSIONS Adolescents with subgingival calculus as well as proximal restorations are at higher relative risk of exhibiting incipient alveolar bone loss than are those without subgingival calculus. In contrast to incipient alveolar bone loss, immigrant background was significantly associated with subgingival calculus among Swedish adolescents.
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Konradsson K, Claesson R, van Dijken JWV. Dental biofilm, gingivitis and interleukin-1 adjacent to approximal sites of a bonded ceramic. J Clin Periodontol 2007; 34:1062-7. [PMID: 17941884 DOI: 10.1111/j.1600-051x.2007.01146.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to investigate in vivo the influence of aged, resin-bonded, ceramic restorations on approximal dental biofilm formation and gingival inflammatory response, associated with and without customary oral hygiene. MATERIAL AND METHODS In a cross-sectional and in a 10-day experimental gingivitis study, Quigley-Hein plaque index, gingival index (GI), crevicular fluid and its levels of interleukin (IL)-1alpha, -1beta and receptor antagonist were measured at appoximal surfaces of leucite-reinforced bonded ceramic coverages, resin composite restorations and enamel and compared intra-individually in 17 participants. RESULTS No differences were found between the ceramic, composite and enamel regarding plaque index, GI, levels of IL-1alpha, -1beta and the receptor antagonist. Throughout, higher crevicular fluid amounts were observed at ceramic sites compared with the enamel (p<0.05). In the experimental gingivitis, plaque index, GI, crevicular fluid and its IL-1alpha levels increased significantly. CONCLUSION The need for optimal oral hygiene and professional preventive oral health care does not seem to be reduced with regard to approximal surfaces of aged, resin-bonded, leucite-reinforced ceramic restorations in comparison with those of a hybrid, resin composite and enamel.
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Affiliation(s)
- Katarina Konradsson
- Dental Hygienist Education, Department of Odontology, Dental School, Umeå University, Umeå, Sweden.
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Merijohn GK. The Evidence-Based Clinical Decision Support Guide: Mucogingival/Esthetics. J Evid Based Dent Pract 2007; 7:93-101. [DOI: 10.1016/j.jebdp.2007.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dental restorations: a risk factor for periodontal attachment loss? Br Dent J 2007. [DOI: 10.1038/bdj.2007.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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