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Vaira LA, Biglio A, Roy M, Salzano G, Troise S, Abbate V, Mayo-Yanez M, Lechien JR, Piombino P, De Riu G. Full-arch rehabilitation of severely atrophic maxilla with additively manufactured custom-made subperiosteal implants: A multicenter retrospective study. J Craniomaxillofac Surg 2024; 52:991-998. [PMID: 38871617 DOI: 10.1016/j.jcms.2024.06.016] [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: 02/24/2024] [Revised: 04/08/2024] [Accepted: 06/08/2024] [Indexed: 06/15/2024] Open
Abstract
The aim of this retrospective study was to analyze a series of patients who underwent full-arch rehabilitation of the atrophic maxilla using additively manufactured subperiosteal implants, between August 2018 and January 2023, at the Universities of Sassari and Poznan. In total, 36 patients and 72 implants were included, with no implants lost during follow-up, and a success rate of 90.3%. Seven (9.7%) of the implants showed class 1 exposure. Bleeding on probing was detected in 10.4% of the abutments at 6 months, 7.9% at 1 year, 10% at 2 years, 7% at 3 years, and 11.4% at 4 years. No significant bone resorption under the abutments was detected during the whole observation period. Based on the findings from this study, additively manufactured subperiosteal implants could represent a safe and reliable technique for full-arch rehabilitation in patients with severe maxillary atrophy.
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy; PhD School of Biomedical Science, Biomedical Sciences Department, University of Sassari, Sassari, Italy.
| | - Andrea Biglio
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Marco Roy
- Poznan University of Medical Sciences Department of Prosthodontics and Gerostamotology, Poznan, Poland
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples 'Federico II', Naples, Italy
| | - Stefania Troise
- Maxillofacial Surgery Operative Unit, University Hospital of Naples 'Federico II', Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit, University Hospital of Naples 'Federico II', Naples, Italy
| | - Miguel Mayo-Yanez
- Otorhinolaryngology, Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - Pasquale Piombino
- Maxillofacial Surgery Operative Unit, University Hospital of Naples 'Federico II', Naples, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
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Vaira LA, Biglio A, Favro A, Salzano G, Abbate V, Lechien JR, De Riu G. Implant-prosthetic rehabilitation of the atrophic posterior mandible with additively manufactured custom-made subperiosteal implants: a cohort study. Int J Oral Maxillofac Surg 2024; 53:533-540. [PMID: 38272739 DOI: 10.1016/j.ijom.2024.01.003] [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: 04/24/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024]
Abstract
The aim of this study was to retrospectively analyse a series of patients with posterior mandibular atrophy rehabilitated with custom-made subperiosteal implants. The study included patients with severe posterior mandibular atrophy who had undergone rehabilitation with subperiosteal implants between September 2018 and August 2022 in the Maxillofacial Surgery Operative Unit of the University Hospital of Sassari. Complications and the success rate were reviewed. Data from 30 implants placed in 17 patients were included and analysed. There were no major complications during the surgeries. The main postoperative sequela was oedema, which was reported as moderate by most patients and had completely regressed within 10 days of surgery. No partial or complete exposures, infections, or loss of the implants were detected during follow-up (average follow-up 22.5 months). Control computed tomography scans, performed at 6 months and then annually in all cases, did not show significant bone loss below the abutments, displacement of the implants, or loss or loosening of the osteosynthesis screws. Subperiosteal implants may represent a safe and reliable technique for the rehabilitation of severe atrophy of the posterior mandible. Prospective studies with a long follow-up will be needed to establish the long-term results of this type of implant-prosthetic rehabilitation.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy; School of Biomedical Science, Biomedical Sciences Department, University of Sassari, Sassari, Italy.
| | - A Biglio
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - A Favro
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - G Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - V Abbate
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - J R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - G De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
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Raittio E, Baelum V. Justification for the 2017 periodontitis classification in the light of the Checklist for Modifying Disease Definitions: A narrative review. Community Dent Oral Epidemiol 2023; 51:1169-1179. [PMID: 36951361 DOI: 10.1111/cdoe.12856] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/03/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
Once a while, disease classifications have needed revision because new knowledge has accumulated, and new technologies and better treatments have emerged. Changes made to disease classifications should be trustworthy and openly justified. The periodontitis definition and classification system was changed in 2017 by the 'World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions'. The workshop, comprising clinicians and researchers, resulted in the production of a 23-article special issue that introduced the new definitions and classifications of periodontitis. In this narrative review, we critically review how the changes made to the periodontitis definition and classification were justified in the light of the Checklist for Modifying Disease Definitions. Under each of the eight items of the checklist, we have discussed how the item was or could have been considered in the light of the checklist and its guidance. In our view, the new definition and classification of periodontitis was presented in an understandable way, even though the changes from the previous definition were not made visible. However, the issues of (1) estimated changes in prevalence or incidence, (2) triggers for the change, (3) prognostic ability, (4) repeatability or reproducibility, (5) incremental benefits, (6) incremental harms or (7) net benefits and harms related to the introduction of new classification were not considered in the way suggested in the checklist. Thereby, a balanced assessment of potential benefits and harms associated with the new periodontitis classification system was not presented, and to a large extent it remains unknown if the use of the new classification system will provide more net benefits to patients and to the community than previous systems. It is our view that patients and societies deserve transparent and balanced assessments of the potential benefits and harms associated with the periodontitis classification. Importantly, these should reflect the values and preferences also of the patients and the wider community and consider the impact on resource usage.
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Affiliation(s)
- Eero Raittio
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Vibeke Baelum
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Du Y, Qi YS, Chen H, Shen G. The expression and clinical significance of miR-1226 in patients with periodontitis. BMC Oral Health 2021; 21:487. [PMID: 34592963 PMCID: PMC8485457 DOI: 10.1186/s12903-021-01855-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/13/2021] [Indexed: 02/07/2023] Open
Abstract
Background miR-1226 has been reported to be dysregulated in periodontitis, implying its potential functional role, which needs to be validated. The purpose of this study was to assess the clinical significance of miR-1226 in periodontitis. Methods Gingival crevicular fluid samples were collected from 50 healthy volunteers and 72 periodontitis patients. The expression of miR-1226 in collected samples was detected by RT-qPCR. The concentrations of pro-inflammatory cytokines were analyzed by ELISA. The relationship of miR-1226 expression level with patients’ characteristics was evaluated by the χ2 test and the Pearson correlation test. Results It was found that miR-1226 was downregulated in the gingival crevicular fluid of periodontitis patients compared with healthy volunteers. The downregulation of miR-1226 was negatively correlated with the pocket depth, attachment loss, plaque index, bleeding index, and MMP-8 concentration of patients. miR-1226 showed high sensitivity and specificity to discriminate periodontitis patients from healthy volunteers. Additionally, periodontitis patients had a relatively high concentration of pro-inflammatory cytokines, which is correlated with miR-1226 expression negatively. Conclusions miR-1226 could be an indicator for the diagnosis of periodontitis and has the potential to predict the development and severity of periodontitis.
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Affiliation(s)
- Yimin Du
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China
| | - Yue-Sun Qi
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China
| | - Hui Chen
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China
| | - Guorong Shen
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China.
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Heo JS, Ahn KH, Park JS. Radiological screening of maternal periodontitis for predicting adverse pregnancy and neonatal outcomes. Sci Rep 2020; 10:21266. [PMID: 33277556 PMCID: PMC7718227 DOI: 10.1038/s41598-020-78385-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/24/2020] [Indexed: 12/04/2022] Open
Abstract
It is well known that periodontitis, diagnosed mainly by periodontal probing, is associated with adverse pregnancy outcomes. However, periodontal probing is time-consuming, highly discomforting, inaccurate, and invasive. We aimed to assess whether periodontitis severity based on radiological staging in accordance with the 2017 new consensus classification was related to adverse pregnancy and neonatal outcomes. The medical records of 165 mothers who underwent panoramic radiography within 5 years before and after the time of delivery and of their singleton neonates were retrospectively reviewed. Twenty-two mothers (13.3%) had severe periodontitis (SP), and 143 (86.7%) had mild or moderate periodontitis (MP). In relation to adverse pregnancy outcomes, uterine leiomyoma (18.2% vs. 4.2%, P = 0.029), chronic hypertension (9.1% vs. 0.7%, P = 0.047), and preeclampsia (13.6% vs. 2.1%, P = 0.032) occurred significantly more frequently in the SP group than in the MP group. The incidences of very preterm birth (13.6% vs. 1.4%, P = 0.017), extremely preterm birth (9.1% vs. 0.7%, P = 0.047), and small for gestational age (22.7% vs. 5.6%, P = 0.017) were also significantly higher in the SP group than in the MP group. Radiological screening of maternal periodontitis could be useful for predicting adverse pregnancy and neonatal outcomes as well as diagnosing SP in pregnant women.
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Affiliation(s)
- Ju Sun Heo
- Department of Pediatrics, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Jung Soo Park
- Department of Periodontology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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Müller Campanile V, Megally A, Campanile G, Gayet-Ageron A, Giannopoulou C, Mombelli A. Risk factors for recurrence of periodontal disease in patients in maintenance care in a private practice. J Clin Periodontol 2019; 46:918-926. [PMID: 31271667 DOI: 10.1111/jcpe.13165] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/03/2019] [Accepted: 06/30/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess periodontal and dental conditions in individuals in maintenance care after periodontal therapy in private practice, and to identify risk factors for recurrence of disease and tooth loss. MATERIALS AND METHODS One hundred patients attending a routine recall visit were included. All had been treated for periodontal disease and were in maintenance since ≥ 2 years. RESULTS Examinations took place 18.0 (±8.71) years after the start of periodontal therapy. A total of 40.1 ± 22.5 recall visits were registered during this time. 91% of the participants had an initial diagnosis of chronic, 9% of aggressive periodontitis. The average participant was 46 years old and had 26 teeth. 283 of 2,549 initially present teeth were lost, half of them being molars. Periodontal and endo-periodontal complications accounted for only 16 lost teeth. The prevalence of all probing depth (PD) categories decreased significantly. The longer the time, the more frequent the recall visits, and the more was spent during the maintenance phase, the greater was the reduction. Multivariate analysis rendered BMI and smoking as factors influencing number of sites with PD ≥ 4 mm and bleeding on probing. CONCLUSION Tooth loss and periodontal tissue damage can be contained over prolonged periods if periodontal disease is treated and patients attend regular maintenance care.
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Affiliation(s)
| | - Andrew Megally
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Angèle Gayet-Ageron
- CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University Hospitals Geneva, Geneva, Switzerland
| | - Catherine Giannopoulou
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrea Mombelli
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
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Theodoro L, Cláudio M, Nuernberg M, Miessi D, Batista J, Duque C, Garcia V. Effects of Lactobacillus reuteri as an adjunct to the treatment of periodontitis in smokers: randomised clinical trial. Benef Microbes 2019; 10:375-384. [DOI: 10.3920/bm2018.0150] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this randomised clinical trial was to evaluate the effect of Lactobacillus reuteri in chewable tablets as an adjunct to non-surgical periodontal treatment of chronic periodontitis in smoking patients. 34 patient smokers were selected and randomly divided into two groups. The SRP group (n=17) received scaling and root planing (SRP) in one session and a placebo; the PRO group (n=17) received SRP in one session and 2 probiotic tablets 2× per day, for 21 days. Bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and pockets with PD≥5 mm and bleeding were measured at baseline and 90 days. After 90 days of treatment, the PD and pockets with PD≥5 mm and bleeding were significantly lower in both groups compared to baseline (P<0.05). In the PRO group, the BOP had significantly reduced at 90 days when compared with the baseline (P<0.05). There was statistically significant reduction in PD between baseline and 90 days in the PRO group in deep pockets (P<0.05). There was no statistically significant difference between the groups in the reduction in PD (P=0.95) or gain in CAL (P=0.97) in moderate and deep pockets. The adjuvant use of L. reuteri in the treatment of chronic periodontitis was effective in controlling gingival inflammation because reduced bleeding on probing which means reduced gingival inflammation and was effective in reducing deep pocket in manner clinically relevant.
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Affiliation(s)
- L.H. Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 16015-050, Brazil
| | - M.M. Cláudio
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 16015-050, Brazil
| | - M.A.A. Nuernberg
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 16015-050, Brazil
| | - D.M.J. Miessi
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 16015-050, Brazil
| | - J.A. Batista
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 16015-050, Brazil
| | - C. Duque
- Department of Pediatric and Social Dentistry, São Paulo State University (UNESP), Dentistry School of Araçatuba, São Paulo, 16015-050, Brazil
| | - V.G. Garcia
- Latin American Institute of Dental Research and Education (ILAPEO), Department of Periodontology, Curitiba, Paraná, Brazil
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Hashim D, Cionca N, Combescure C, Mombelli A. The diagnosis of peri‐implantitis: A systematic review on the predictive value of bleeding on probing. Clin Oral Implants Res 2018; 29 Suppl 16:276-293. [DOI: 10.1111/clr.13127] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Dena Hashim
- Division of PeriodontologyUniversity Clinics of Dental MedicineUniversity of Geneva Geneva 4 Switzerland
| | - Norbert Cionca
- Division of PeriodontologyUniversity Clinics of Dental MedicineUniversity of Geneva Geneva 4 Switzerland
| | - Christophe Combescure
- Division of Clinical EpidemiologyDepartment of Health and Community MedicineFaculty of MedicineCenter of Clinical ResearchGeneva University HospitalsUniversity of Geneva Geneva Switzerland
| | - Andrea Mombelli
- Division of PeriodontologyUniversity Clinics of Dental MedicineUniversity of Geneva Geneva 4 Switzerland
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Hulme C, Robinson P, Douglas G, Baxter P, Gibson B, Godson J, Vinall-Collier K, Saloniki E, Meads D, Brunton P, Pavitt S. The INCENTIVE study: a mixed-methods evaluation of an innovation in commissioning and delivery of primary dental care compared with traditional dental contracting. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BackgroundOver the past decade, commissioning of primary care dentistry has seen contract currency evolving from payment for units of dental activity (UDAs) towards blended contracts that include key performance indicators such as access, quality and improved health outcome.ObjectivesThe aim of this study was to evaluate a blended/incentive-driven model of dental service provision. To (1) explore stakeholder perspectives of the new service delivery model; (2) assess the effectiveness of the new service delivery model in reducing the risk of and amount of dental disease and enhancing oral health-related quality of life (OHQoL) in patients; and (3) assess cost-effectiveness of the new service delivery model.MethodsUsing a mixed-methods approach, the study included three dental practices working under the blended/incentive-driven (incentive) contract and three working under the UDAs (traditional) contract. All were based in West Yorkshire. The qualitative study reports on the meaning of key aspects of the model for three stakeholder groups [lay people (patients and individuals without a dentist), commissioners and the primary care dental teams], with framework analysis of focus group and semistructured interview data. A non-randomised study compared clinical effectiveness and cost-effectiveness of treatment under the two contracts. The primary outcome was gingivitis, measured using bleeding on probing. Secondary outcomes included OHQoL and cost-effectiveness.ResultsParticipants in the qualitative study associated the incentive contract with more access, greater use of skill mix and improved health outcomes. In the quantitative analyses, of 550 participants recruited, 291 attended baseline and follow-up. Given missing data and following quality assurance, 188 were included in the bleeding on probing analysis, 187 in the caries assessment and 210 in the economic analysis. The results were mixed. The primary outcome favoured the incentive practices, whereas the assessment of caries favoured the traditional practices. Incentive practices attracted a higher cost for the service commissioner, but were financially attractive for the dental provider at the practice level. Differences in generic health-related quality of life were negligible. Positive changes over time in OHQoL in both groups were statistically significant.LimitationsThe results of the quantitative analysis should be treated with caution given small sample numbers, reservations about the validity of pooling, differential dropout results and data quality issues.ConclusionsA large proportion of people in this study who had access to a dentist did not follow up on oral care. These individuals are more likely to be younger males and have poorer oral health. Although access to dental services was increased, this did not appear to facilitate continued use of services.Future workFurther research is required to understand how best to promote and encourage appropriate dental service attendance, especially among those with a high level of need, to avoid increasing health inequalities, and to assess the financial impact of the contract. For dental practitioners, there are challenges around perceptions about preventative dentistry and use of the risk assessments and care pathways. Changes in skill mix pose further challenges.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Claire Hulme
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Peter Robinson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Gail Douglas
- School of Dentistry, University of Leeds, Leeds, UK
| | - Paul Baxter
- Division of Biostatistics, University of Leeds, Leeds, UK
| | - Barry Gibson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Jenny Godson
- Division of Population Health and Care, Health and Wellbeing Directorate, Public Health England, London, UK
| | | | - Eirini Saloniki
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - David Meads
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Paul Brunton
- School of Dentistry, University of Leeds, Leeds, UK
| | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
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Dula LJ, Shala KS, Pustina–Krasniqi T, Bicaj T, Ahmedi EF. The influence of removable partial dentures on the periodontal health of abutment and non-abutment teeth. Eur J Dent 2015; 9:382-386. [PMID: 26430367 PMCID: PMC4569990 DOI: 10.4103/1305-7456.163234] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of removable partial dentures (RPD) on the periodontal health of abutment and non-abutment teeth. MATERIALS AND METHODS A total 107 patients with RPD participated in this study. It was examined 138 RPD, they were 87 with clasp-retained and 51 were RPD with attachments. The following periodontal parameters were evaluated for abutment and non-abutment teeth, plaque index (PLI), calculus index (CI), bleeding on probing (BOP), probing depth (PD) (mm) and tooth mobility (TM) index. These clinical measurements were taken immediately before insertion the RPD, then one and 3 months after insertion. The level of significance was set at (P < 0.05). RESULTS The mean scores for PLI, CI, BOP, PD, and TM index, of the abutment teeth and non-abutment teeth were no statistically significant at the time of insertion of RPD. After 1-month, PLI was statistically significant (0.57 ± 0.55 for abutment and 0.30 ± 0.46 for non-abutment teeth). After 3 months, there were significant differences between abutment and non-abutment teeth with regard to the BOP (1.53 ± 0.50 and 1.76 ± 0.43 respectively), PD (0.28 ± 0.45 and 0.12 ± 0.33 respectively) and PLI (1.20 ± 0.46 and 0.75 ± 0.64 respectively). No significant mean difference in TM and CI was found between the abutment and non-abutment teeth (P > 0.05). CONCLUSIONS With carefully planned prosthetic treatment and adequate maintenance of the oral and denture hygiene, we can prevent the periodontal diseases.
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Affiliation(s)
- Linda J. Dula
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
| | - Kujtim Sh. Shala
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
| | - Teuta Pustina–Krasniqi
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
| | - Teuta Bicaj
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
| | - Enis F. Ahmedi
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
- Department of Prosthetic and Parodontology, MedUni Graz, Dental School, Graz, Austria
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Dula LJ, Ahmedi EF, Lila-Krasniqi ZD, Shala KS. Clinical evaluation of removable partial dentures on the periodontal health of abutment teeth: a retrospective study. Open Dent J 2015; 9:132-9. [PMID: 25926896 PMCID: PMC4406999 DOI: 10.2174/1874210601509010132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 02/21/2015] [Accepted: 03/03/2015] [Indexed: 11/22/2022] Open
Abstract
The aim of this retrospective study was to evaluate the effect of removable partial dentures in periodontal abutment teeth in relation to the type of denture support and design of RPD in a five-year worn period. Methods : A total of 64 patients with removable partial dentures (RPDs), participated in this study. It were examined ninety-one RPDs. There were seventy-five RPDs with clasp-retained and sixteenth were RPDs with attachments. There were 28 females and 36 males, aged between 40-64 years, 41 maxillary and 50 mandible RPDs. For each subjects the following data were collected: denture design, denture support, and Kennedy classification. Abutment teeth were assessed for plaque index (PI), calculus index (CI), blending on probing (BOP), probing depth (PD), gingival recession (GR), tooth mobility (TM). Level of significance was set at p<0.05. Results : According to denture support of RPD, BOP, PD, PI, GR, CI and TM-index showed no statistically significant difference. Based on the denture design of RPD’s, BOP, PD, PI, CI, and TM-index proved no statistically significant difference. Except GR-index according to denture design confirmed statistically significant difference in RPD with clasp p<0.01. The higher values of all periodontal parameter as BOP, PD, PI, CI and TM were in patients with RPD’s with claps comparing with RPD’s with attachment. Conclusion : RPD’s with clasp increased level of gingival inflammation in regions covered by the dentures and below the clasp arms in abutment teeth.
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Affiliation(s)
- Linda J Dula
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
| | - Enis F Ahmedi
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo ; MedUni Graz, Dental School, Graz, Austria
| | - Zana D Lila-Krasniqi
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
| | - Kujtim Sh Shala
- Department of Prosthetic Dentistry, Faculty of Medicine, School of Dentistry, Prishtina, Kosovo
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Gomes SC, Romagna R, Rossi V, Corvello PC, Angst PDM. Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation. Braz Oral Res 2014; 28. [PMID: 25000595 DOI: 10.1590/s1806-83242014.50000004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study investigated the clinical effects of using a supragingival biofilm control regimen (SUPRA) as a step prior to scaling and root planing (SRP). A split-mouth clinical trial was performed in which 25 subjects with periodontitis (47.2 ± 6.5 years) underwent treatment (days 0–60) and monitoring (days 90–450) phases. At Day 0 (baseline) treatments were randomly assigned per quadrant: SUPRA, SRP and S30SRP (SUPRA 30 days before SRP). The full-mouth visible plaque index (VPI), gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were examined on days 0, 30, 60, 90, 120, 270, and 450. Baseline data were similar among all groups. From days 0 to 60, the groups showed similar significant decreases in VPI and GBI. Reductions in PPD for the SRP (3.39 ± 0.17 to2.42 ± 0.16 mm) and S30SRP (3.31 ± 0.11 to 2.40 ± 0.07 mm) groups were greater (p < 0.05) than those for the SUPRA group. This pattern was also observed for BOP. Attachment gain was similar and greater for the SRP (3.34 ± 0.28 to 2.58 ± 0.26 mm) and S30SRP (3.25 ± 0.21 to 2.54 ± 0.19 mm) groups compared to the SUPRA group. Results were maintained from day 90 forward. Overall, the S30SRP treatment reduced the subgingival treatment needs in 48.16%. Performance of a SUPRA step before SRP decreased subgingival treatment needs and maintained the periodontal stability over time.
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Malchiodi L, Ghensi P, Cucchi A, Pieroni S, Bertossi D. Peri-implant conditions around sintered porous-surfaced (SPS) implants. A 36-month prospective cohort study. Clin Oral Implants Res 2014; 26:212-9. [PMID: 24383851 DOI: 10.1111/clr.12311] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The specific aim of this study was to assess sintered porous-surfaced (SPS) implant system from a biological point of view, through a prospective study of the health status and the evolution of the peri-implant tissues over time and analysis of the changes observed in the various peri-implant parameters. MATERIAL AND METHODS Hundred and fifty-one patients were treated consecutively from 2005 to 2007 using 280 SPS implants, which were restored with a single crown or a partial fixed denture. To accurately monitor the health and biological evolution of peri-implant soft and hard tissues, a number of clinical parameters were adopted, such as the modified Plaque Index (mPI), the modified sulcus Bleeding Index (mBI), Peri-implant Probing Depth (PPD), and Crestal Bone Level (CBL). Clinical and radiographic examinations were scheduled over a 36-month follow-up of functional loading according to a well-established protocol generally applied to determine implant success rates and Peri-implant Bone Loss (PBL). Statistical analysis was used to determine any significant differences or correlations (P = 0.05). RESULTS A total of 259 SPS implants in 136 patients were followed up for 36 months. According to Buser's success criteria, the overall implant-based success rate was 98.1% and the mean PBL was 0.48 ± 0.29 mm. MBI and mPI mean values showed statistically significant differences between baseline and follow-up analyses (P < 0.001). No statistically significant differences in mean PPD values were found between baseline and control analyses (P = 0.060). CONCLUSION This prospective cohort study revealed that the biological behavior of SPS implant system was characterized by high tissue stability during the observation period, both as regards soft and hard tissues. In particular, the crestal bone remodeling pattern was very similar to that reported in other studies, confirming that the bone loss around SPS implants, at least at 36 months, seems to be predictable.
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Affiliation(s)
- Luciano Malchiodi
- Department of Morphological and Biomedical Sciences, Section of Dentistry and Maxillofacial Surgery, University of Verona, Verona, Italy; Private Dentist, Brescia, Italy
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Kumar A, Masamatti SS. A new classification system for gingival and palatal recession. J Indian Soc Periodontol 2013; 17:175-81. [PMID: 23869122 PMCID: PMC3713747 DOI: 10.4103/0972-124x.113065] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 03/14/2013] [Indexed: 11/29/2022] Open
Abstract
Various classifications have been proposed to classify gingival recession. Miller's classification of gingival recession is most widely followed. With a wide array of cases in daily clinical practice, it is often difficult to classify numerous gingival recession cases according to defined criteria of the present classification systems. To propose a new classification system that gives a comprehensive depiction of recession defect that can be used to include cases that cannot be classified according to present classifications. A separate classification system for palatal recessions (PR) is also proposed. This article outlines the limitations of present classification systems and also the inability to classify PR. A new comprehensive classification system is proposed to classify recession on the basis of the position of interdental papilla and buccal/lingual/palatal recessions.
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Affiliation(s)
- Ashish Kumar
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
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Peres MFS, Ribeiro ÉDP, Casarin RCV, Ruiz KGS, Junior FHN, Sallum EA, Casati MZ. Hydroxyapatite/β-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial. J Clin Periodontol 2013; 40:252-9. [DOI: 10.1111/jcpe.12054] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 10/20/2012] [Accepted: 11/30/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Maria F. S. Peres
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Érica D. P. Ribeiro
- Department of Periodontics; Bahian Foundation for Development of Science; Bahia Brazil
| | | | - Karina G. S. Ruiz
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Francisco H. N. Junior
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Enilson A. Sallum
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Márcio Z. Casati
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
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Liu H, Marcus M, Maida CA, Wang Y, Shen J, Spolsky VW. Predictive power of the severity measure of attachment loss for periodontal care need. J Periodontol 2012; 84:1409-15. [PMID: 23173829 DOI: 10.1902/jop.2012.120466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The prevalence of periodontal diseases is high, and >15% of adults have severe gum disease. Clinical attachment loss (AL) is one of the most important measures for periodontal disease severity. With AL, one could measure the worst scenario, the average, or the cumulative sum of AL among all teeth. The objective of this study is to evaluate which of the 15 measures of periodontal problems (e.g., maximum, mean, and cumulative AL) best predict the need for periodontal treatment. METHODS Using detailed periodontal data obtained through clinical examination from the National Health and Nutrition Examination Survey 1999 to 2002, weighted logistic regression was used to model the periodontal treatment need of 15 different periodontal disease measures. The outcome measure is the clinically determined periodontal need. RESULTS After adjustment for the covariates of age, sex, ethnicity, education, smoking status, and diabetes, the three most predictive measures were identified as: 1) the sum of the maximum mid-buccal (B) and mesio-buccal (MB) measures, which reflects the worst case of both B and MB measures; 2) the sum of the maximum MB measure or the worst case of the MB measure; and 3) the sum of all B and MB measures, or the cumulative AL measures. CONCLUSIONS Cumulative periodontal morbidity, particularly the worst case of B and MB measures, has the strongest impact on the need for periodontal care. All the demographic variables and covariates follow the classic pattern of association with periodontal disease.
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Affiliation(s)
- Honghu Liu
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA
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Andrade R, Espinoza M, Gómez EM, Espinoza JR, Cruz E. Intra- and inter-examiner reproducibility of manual probing depth. Braz Oral Res 2012; 26:57-63. [PMID: 22344339 DOI: 10.1590/s1806-83242012000100010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 11/16/2011] [Indexed: 11/21/2022] Open
Abstract
The periodontal probe remains the best clinical diagnostic tool for the collection of information regarding the health status and the attachment level of periodontal tissues. The aim of this study was to evaluate intra- and inter-examiner reproducibility of probing depth (PD) measurements made with a manual probe. With the approval of an Ethics Committee, 20 individuals without periodontal disease were selected if they presented at least 6 teeth per quadrant. Using a Williams periodontal probe, three calibrated thesis-level students (k > 0.6) assessed PD at 6 sites per tooth, from the gingival margin to the bottom of the periodontal sulcus (rounded to the next 0.5 mm). Initial and repeated measurements were performed by the same three examiners. The intra-examiner agreement (± 1 mm > 90%) was 99.85%, 100%, and 100% for the three examiners, respectively. When the variables vestibular/lingual surfaces, mesial/distal surfaces, or superior/inferior jaws were evaluated, no significant differences in reproducibility were detected at the inter-examiner level (p < 0.05). At this level, the only significant differences observed were in the three examiners' measurements of the anterior and posterior sites. While high intra-examiner reproducibility was detected, inter-examiner level proved to be low. We can conclude that measurement of PD with a manual periodontal probe produced high reproducibility in healthy individuals. The operators position can affect the reproducibility of repeated measures of PD. Calibration and operator training, rather than operator experience, were fundamental for reproducibility. Other factors, such as individual technique and probing depth force, can affect inter-examiner reproducibility.
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Konopka L, Pietrzak A, Brzezińska-Błaszczyk E. Effect of scaling and root planing on interleukin-1β, interleukin-8 and MMP-8 levels in gingival crevicular fluid from chronic periodontitis patients. J Periodontal Res 2012; 47:681-8. [PMID: 22510045 DOI: 10.1111/j.1600-0765.2012.01480.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVE There are few data concerning the effect of scaling and root planing on the levels of immune and inflammatory mediators in gingival crevicular fluid from patients with chronic periodontitis. Therefore, in this study the influence of scaling and root planing was determined on amounts of interleukin (IL)-1β, IL-8 and MMP-8 in gingival crevicular fluid from patients with chronic periodontitis, in relation to clinical parameters. MATERIAL AND METHODS A total of 51 patients were enrolled in this study. The study population consisted of 30 patients with generalized advanced chronic periodontitis, while 21 periodontally healthy subjects were recruited for the control group. The clinical parameters included approximal plaque index, gingival index, pocket depth and clinical attachment loss. The amounts of IL-1β, IL-8 and MMP-8 in gingival crevicular fluid were measured by ELISA. Periodontal parameters as well as gingival crevicular fluid humoral factor amounts were evaluated in the control group and in chronic periodontitis patients at baseline and at 1 and 4 wk after scaling and root planing treatment. RESULTS At baseline, there were significant differences between control subjects and chronic periodontitis patients in terms of clinical attachment loss, pocket depth, gingival index (p < 0.001) and approximal plaque index (p < 0.01). The amounts of IL-1β, MMP-8 (p < 0.001) and IL-8 (p < 0.01) in gingival crevicular fluid were significantly lower in healthy subjects than in chronic periodontitis patients. Scaling and root planing led to improvement in all examined clinical parameters, apart from clinical attachment loss. Periodontal treatment also resulted in a significant decrease in the amounts of IL-1β, IL-8 and MMP-8 in comparison to baseline, especially 4 wk after scaling and root planing (p < 0.001); however, the amounts of these humoral factors were still higher than those in control group. CONCLUSION Our observations indicated that short-term nonsurgical therapy resulted in a significant improvement in periodontal indices and in a marked decrease of IL-1β, IL-8 and MMP-8 gingival crevicular fluid levels. Nevertheless, no significant correlations were found between clinical parameters and amounts of humoral factors after therapy.
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Affiliation(s)
- L Konopka
- Department of Experimental Immunology, Medical University of Łódź, Łódź, Poland
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Kaner D, Bernimoulin JP, Dietrich T, Kleber BM, Friedmann A. Calprotectin levels in gingival crevicular fluid predict disease activity in patients treated for generalized aggressive periodontitis. J Periodontal Res 2011; 46:417-26. [DOI: 10.1111/j.1600-0765.2011.01355.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lima PMA, Souza PEA, Costa JE, Gomez RS, Gollob KJ, Dutra WO. Aggressive and Chronic Periodontitis Correlate With Distinct Cellular Sources of Key Immunoregulatory Cytokines. J Periodontol 2011; 82:86-95. [DOI: 10.1902/jop.2010.100248] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Leininger M, Tenenbaum H, Davideau JL. Modified periodontal risk assessment score: long-term predictive value of treatment outcomes. A retrospective study. J Clin Periodontol 2010; 37:427-35. [PMID: 20507367 DOI: 10.1111/j.1600-051x.2010.01553.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the long-term clinical predictive value of the periodontal risk assessment diagram surface (PRAS) score and the influence of patient compliance on the treatment outcomes. MATERIALS AND METHODS Thirty subjects suffering from periodontitis were re-examined 6-12 years after the initial diagnosis and periodontal treatments. The baseline PRAS score was calculated from the initial clinical and radiograph records. Patients were then classified into a low-to-moderate (0-20) or a high-risk group (>20). Patients who did not attend any supportive periodontal therapy were classified into a non-compliant group. PRAS and compliance were correlated to the mean tooth loss (TL)/year and the mean variation in the number of periodontal pockets with a probing depth (PPD) >4 mm. RESULTS TL was 0.11 for the low-to-moderate-risk group and 0.26 for the high-risk group (p<0.05); PPD number reduction was 2.57 and 2.17, respectively, and bleeding on probing reduction was 6.7% and 23.3%, respectively. Comparing the compliance groups, the PPD number reduction was 3.39 in the compliant group and 1.40 in the non-compliant group (p<0.05). CONCLUSION This study showed the reliability of PRAS in evaluating long-term TL and patient susceptibility to periodontal disease. Our data confirmed the positive influence of patient compliance on periodontal treatment outcomes.
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Affiliation(s)
- Matthieu Leininger
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
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Schätzle M, Faddy MJ, Cullinan MP, Seymour GJ, Lang NP, Bürgin W, Ånerud Å, Boysen H, Löe H. The clinical course of chronic periodontitis: V. Predictive factors in periodontal disease. J Clin Periodontol 2009; 36:365-71. [DOI: 10.1111/j.1600-051x.2009.01391.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Giollo MD, Valle PM, Gomes SC, Rösing CK. A retrospective clinical, radiographic and microbiological study of periodontal conditions of teeth with and without crowns. Braz Oral Res 2007; 21:348-54. [DOI: 10.1590/s1806-83242007000400012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Accepted: 05/05/2007] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate retrospectively the periodontal conditions of teeth with fixed crowns that had been in place from 3 to 5 years before the study was conducted. Forty individuals were recalled for a follow-up visit. Full-mouth clinical examinations were carried out and Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD), and clinical attachment level (CAL) were assessed in 6 sites per tooth. Parallel radiographs were also taken and blindly analyzed by a digital caliper (distance between the apex and the bone crest). BANA tests were performed. A contra-lateral sound tooth was considered the control. Mean values were obtained and Wilcoxon and paired sample t tests were used to compare the test and control sites. Crowns had a mean VPI value of 30.42% as compared to 49.17% for sound teeth. The GBI was 33.33% and 26.25% for test and control teeth respectively. Assessment of PPD revealed values of 2.30 and 2.14 mm, and assessment of CAL revealed averages of 2.02 and 1.89 mm for test and control teeth respectively. The mean values for radiographic distances were 12.73 and 13.67 mm, and for the BANA test, 67.50 and 50.00 for sound and crowned teeth, respectively. Statistically significant differences were observed for all parameters except for CAL and for the BANA test. It may be concluded that, with the methods used in the present study, crowns may be associated with more signs of inflammation, however not with periodontal breakdown.
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Wang QT, Wu ZF, Wu YF, Shu R, Pan YP, Xia JL. Epidemiology and preventive direction of periodontology in China. J Clin Periodontol 2007; 34:946-51. [PMID: 17877744 DOI: 10.1111/j.1600-051x.2007.01139.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of this work was to estimate the present periodontal problems of people in China, based on an epidemiological investigation of adults. MATERIAL AND METHODS The data were collected from the northwest, southwest, northeast and east regions (400 subjects from each region) of China. All subjects were over 25 years of age. About half of the subjects were farmers and about half were urban professionals. Everyone was asked to fill out a questionnaire and to undergo a professional oral examination. Periodontal health status was evaluated by a simplified oral hygiene index (OHI-S), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PD), clinical attachment loss (CAL), and tooth mobility. RESULTS Of the 1590 subjects enrolled in this investigation, 45.7% were male, 45.5% were farmers, and the remaining were urban professionals, and 27.7% of the subjects were smokers. There was a significant difference in the educational background but not smoking between the rural and urban groups. While 34.9% of the subjects in the urban group brushed only once per day, 56.1% of the subjects in the rural group did so. The prevalence of bleeding during brushing was 71.1%, while about 61.4% of the subjects know nothing about scaling. All periodontal indices were significantly higher in males than in females and higher in the rural group than in the urban group. PD, CAL and tooth mobility increased with age. The percentage of sites with CAL>3 mm in the rural group (49.5%) was significantly higher than that in the urban group (37.5%). Both current and former smokers showed increased CAL than non-smokers. CONCLUSION Gingivitis and periodontitis are common findings in China. Most Chinese have no knowledge of common periodontal prevention and treatment and very few have regular dental care. The data of this study suggest that age, smoking, and limited education are significantly associated with Chinese adult periodontal attachment loss. Preventive periodontal care and education should be reinforced in the future by establishing relevant oral health projects.
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Affiliation(s)
- Qin-Tao Wang
- Fourth Military Medical University, Xian, Shannxi, China.
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Hernandez M, Valenzuela MA, Lopez-Otin C, Alvarez J, Lopez JM, Vernal R, Gamonal J. Matrix metalloproteinase-13 is highly expressed in destructive periodontal disease activity. J Periodontol 2007; 77:1863-70. [PMID: 17076612 DOI: 10.1902/jop.2006.050461] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) participate in extracellular matrix degradation in physiological and pathological conditions. The available evidence suggests that MMP-13 plays a significant role in both the initiation and progress of bone resorption. The aim of our study was to identify the presence of MMP-13 in adult patients with untreated chronic periodontitis. We also determined the activity of MMP-13 present in lesions undergoing episodic attachment loss in gingival crevicular fluid (GCF) samples. METHODS After monitoring at 2 and 4 months, 21 patients showed destructive periodontitis (periodontally affected sites presenting at least two sites with > or =2 mm clinical attachment loss), and GCF samples were collected both from active and inactive sites (21 GCF samples, each). GCF was collected during a 30-second interval using a paper strip, and an immunofluorescence assay was performed to determine the basal activity of MMP-13 and the relationship between 4-aminophenylmercuric acetate (APMA)-activated total MMP-13 and basal MMP-13 activity. Gingival tissues from five patients were fixed in formalin and MMP-13 expression was demonstrated using immunohistochemistry and in situ hybridization. MMP-13 molecular forms were examined by Western immunoblotting with monoclonal antibodies. RESULTS MMP-13 was found in 100% of GCF samples from patients with chronic periodontitis. Active sites, associated with tissue destruction, had significantly higher proportions of active MMP-13 and MMP-13 activity levels than their inactive counterparts (1.49 versus 1.17 ng fluorescent product, respectively; P <0.05). Western blot, immunohistochemical staining, and in situ hybridization confirmed the presence of MMP-13 in periodontal disease, with observable differences between periodontitis and healthy subjects. MMP-13 immunoreactivities were seen mainly as 55 and 48 kDa, corresponding to partially and fully activated forms, respectively, and a smaller proportion of 60-kDa proenzyme form. CONCLUSION MMP-13 activity in GCF samples was significantly increased in active sites from progressive periodontal disease, supporting its role in the alveolar bone loss developed in this disease.
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Affiliation(s)
- Marcela Hernandez
- Periodontal Biology Laboratory, Dentistry School, University of Chile, Santiago, Chile
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Affiliation(s)
- G Rutger Persson
- Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, Univerisity of Bern, Bern ,Switzerland and Departments of Periodontology and Oral Medicine, University of Washington, Seattle, Washington, USA
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Affiliation(s)
- Andrea Mombelli
- Department of Periodontology and Oral Pathophysiology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
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