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Jepsen K, Tietmann C, Martin C, Kutschera E, Jäger A, Wüllenweber P, Gaveglio L, Cardaropoli D, Sanz-Sánchez I, Fimmers R, Jepsen S. Synergy of Regenerative Periodontal Surgery and Orthodontics Improves Quality of Life of Patients with Stage IV Periodontitis: 24-Month Outcomes of a Multicenter RCT. Bioengineering (Basel) 2023; 10:695. [PMID: 37370626 PMCID: PMC10295428 DOI: 10.3390/bioengineering10060695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/15/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
In stage IV periodontitis patients with pathologic tooth migration (PTM), interdisciplinary treatment includes regenerative periodontal surgery (RPS) with an application of biomaterials and orthodontic therapy (OT) to restore function, esthetics and thereby quality of life (QoL). In a 24-month randomized trial we explored the synergy between regenerative medicine and biomechanical force application. The following methods were used: Forty-three patients had been randomized to a combined treatment comprising RPS and subsequent OT starting either 4 weeks (early OT) or 6 months (late OT) post-operatively. Clinical periodontal parameters and oral health-related QoL (GOHAI) were recorded up to 24 months. We obtained the following results: Mean clinical attachment gain (∆CAL ± SD) was significantly higher with early OT (5.96 ± 2.1 mm) versus late OT (4.65 ± 1.76 mm) (p = 0.034). Pocket closure (PPD ≤ 4 mm) was obtained in 91% of defects with early OT compared to 90% with late OT. GOHAI-scores decreased significantly from 26.1 ± 7.5 to 9.6 ± 4.7 (early OT) and 25.1 ± 7.1 to 12.7 ± 5.6 (late OT). Inconclusion, teeth severely compromised by intrabony defects and PTM can be treated successfully by RPS followed by early OT with the advantage of an overall reduced treatment time. As a result of the combined periodontal-orthodontic therapy, the oral health-related QoL of patients was significantly improved. Early stimulation of wound healing with orthodontic forces had a favorable impact on the outcomes of regenerative periodontal surgery.
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Affiliation(s)
- Karin Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany; (C.T.)
| | - Christina Tietmann
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany; (C.T.)
- Private Practice for Periodontology, Krefelder Strasse 73, 52070 Aachen, Germany
| | - Conchita Martin
- BIOCRAN Research Group, University Complutense of Madrid, 28040 Madrid, Spain
| | - Eric Kutschera
- Department of Orthodontics, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany
| | - Andreas Jäger
- Department of Orthodontics, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany
| | - Peter Wüllenweber
- Private Practice for Orthodontics, Theaterstraße 98-102, 52062 Aachen, Germany
| | - Lorena Gaveglio
- Private Practice, Corso Galileo Ferraris 148, 10129 Turino, Italy
| | | | | | - Rolf Fimmers
- Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, 53127 Bonn, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany; (C.T.)
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Butrungrod W, Chaiyasut C, Makhamrueang N, Peerajan S, Chaiyana W, Sirilun S. Postbiotic Metabolite of Lactiplantibacillus plantarum PD18 against Periodontal Pathogens and Their Virulence Markers in Biofilm Formation. Pharmaceutics 2023; 15:pharmaceutics15051419. [PMID: 37242661 DOI: 10.3390/pharmaceutics15051419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/27/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
Alternative methods to reduce infectious diseases caused by bacterial pathogens and their virulence factors, biofilm formations, have arisen to reduce the pressure on existing or currently developed disinfectants and antimicrobial agents. The current strategies for reducing the severity of periodontal pathogen-caused disease by using beneficial bacteria and their metabolites are highly desirable. Probiotic strains of lactobacilli related to foods from Thai-fermented foods were selected and their postbiotic metabolites (PM) were isolated with inhibitory activity on periodontal pathogens and their biofilm formation. The PM from Lactiplantibacillus plantarum PD18 (PD18 PM) with the highest antagonistic effect against Streptococcus mutans, Porphyromonas gingivalis, Tannerella forsythia and Prevotella loescheii was selected from 139 Lactobacillus isolates. The minimal inhibitory concentration (MIC) and minimum biofilm inhibitory concentration (MBIC) values of PD18 PM against the pathogens ranged from 1:2 to 1:4. The PD18 PM demonstrated the ability to prevent the biofilm formation of S. mutans and P. gingivalis by showing a significant reduction in viable cells, high percentages of biofilm inhibition at 92.95 and 89.68%, and the highest effective contact times at 5 and 0.5 min, respectively. L. plantarum PD18 PM showed potential as a promising natural adjunctive agent to inhibit periodontal pathogens and their biofilms.
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Affiliation(s)
- Widawal Butrungrod
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chaiyavat Chaiyasut
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Netnapa Makhamrueang
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | | | - Wantida Chaiyana
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sasithorn Sirilun
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
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Needleman I, Almond N, Leow N, Phillips J. Outcomes of periodontal therapy: Strengthening the relevance of research to patients. A co-created review. Periodontol 2000 2023. [PMID: 36786482 DOI: 10.1111/prd.12483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/09/2022] [Accepted: 01/03/2023] [Indexed: 02/15/2023]
Abstract
Periodontitis is a long-term condition affecting up to half of the population globally and causing significant impacts on life quality. Successful management depends on taking life-long ownership of the condition by those affected. There is a wealth of research to inform on management options. However, most of the research has been designed by professional experts with outcomes to gauge benefits and harms based on parameters that inform on the disease process but which might not be informative to support decision-making in people with lived experience (PWLE) of periodontal ill-health (including both patients and carers). The importance of relevant outcomes is highlighted in the concept of the "expert patient" which aims to strengthen the capacity of PWLE to make health-care choices that are important for them, elements of which are likely to be already familiar to many clinicians delivering periodontal health care. Therefore, the voice and collaboration of PWLE in research are recognised as crucial to developing high quality, relevant evidence especially for long-term conditions. In this paper, we review what is known about the relevance of treatment outcomes to PWLE. We also examine the degree to which PWLE have been involved in identifying outcomes that are important to them as well as the diversity and therefore representativeness of PWLE recruited for studies. We consider why having more relevant outcomes could enhance the expertise of PWLE in managing their periodontitis. We then conclude with key learnings from our review which we hope will encourage more rapid development of these initiatives in periodontology for the benefit of global health and wellbeing.
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Affiliation(s)
- Ian Needleman
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | | | - Natalie Leow
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Jim Phillips
- Centre for Empowering Patients and Communities (CEMPAC), Cirencester, UK
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4
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Yuan H, Liu Q, Tang T, Qin H, Zhao L, Chen W, Guo S. Assessment of early wound healing, pain intensity, quality of life and related influencing factors during periodontal surgery: a cross-sectional study. BMC Oral Health 2022; 22:596. [PMID: 36496401 PMCID: PMC9741525 DOI: 10.1186/s12903-022-02630-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This cross-sectional study assessed early wound healing, pain intensity, quality of life, surgical satisfaction, and related factors during periodontal surgery. METHODS A total of 369 patients completed the questionnaire before undergoing periodontal surgery (baseline), immediately after the operation (phase I), on the day of suture removal (phase II), and one month later (phase III). The Early Wound Healing Score (EHS) was assessed, and the short-form McGill Pain Questionnaire (SF-MPQ), tooth hypersensitivity visual analog scale (VAS), oral health-related quality of life measure (OHQoL-UK), and surgical satisfaction VAS were administered and analysed. RESULTS The EHS was 8.41 ± 2.74 and was influenced by disease severity and surgical factors. Scores on the SF-MPQ, pain intensity scores, and OHQoL-UK scores were significantly increased in phase I and decreased later. Tooth sensitivity decreased significantly one month after periodontal surgery. Psychological factors were positively related to SF-MPQ, pain intensity, OHQoL-UK and tooth sensitivity VAS scores in all phases, while disease severity and surgical factors were only related to these scores at baseline or in phases I/II/III. Surgical acceptance and reoperation willingness continuously decreased after surgery, and all these scores were related to surgical satisfaction. CONCLUSIONS EHS, pain intensity and quality of life were closely related to disease severity, psychological factors and surgical factors in phase I (i.e., immediately after surgery). The findings suggest that surgical details should be enhanced and that behavioural and psychological interventions measures should be implemented to improve outcomes during periodontal operation and during the early postoperative period as well as to improve patient-oriented periodontal surgery experiences. Trial registration This cross-sectional study did not include interventions with human participants, and all the experimental procedures involving humans in this study were approved by the Ethics Committee of West China College of Stomatology, Sichuan University (WCHSIRB-D-2020-284).
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Affiliation(s)
- Hongmei Yuan
- grid.13291.380000 0001 0807 1581Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Qian Liu
- grid.13291.380000 0001 0807 1581Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China ,grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Tian Tang
- grid.13291.380000 0001 0807 1581Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Huan Qin
- grid.13291.380000 0001 0807 1581Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Lei Zhao
- grid.13291.380000 0001 0807 1581Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China ,grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Wen Chen
- grid.13291.380000 0001 0807 1581Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
| | - Shujuan Guo
- grid.13291.380000 0001 0807 1581Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China ,grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
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Ng E, Tay JRH, Ong MMA. Minimally Invasive Periodontology: A Treatment Philosophy and Suggested Approach. Int J Dent 2021; 2021:2810264. [PMID: 34257659 PMCID: PMC8245214 DOI: 10.1155/2021/2810264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 01/20/2023] Open
Abstract
Severe periodontitis is a highly prevalent dental disease. With the advent of implant dentistry, teeth are often extracted and replaced. Periodontal surgery, where indicated, could also result in increased trauma to the patient. This literature review discusses different treatment modalities for periodontitis and proposes a treatment approach emphasizing maximum preservation of teeth while minimizing morbidity to the patient. Scientific articles were retrieved from the MEDLINE/PubMed database up to January 2021 to identify appropriate articles that addressed the objectives of this review. This was supplemented with hand searching using reference lists from relevant articles. As tooth prognostication does not have a high predictive value, a more conservative approach in extracting teeth should be abided by. This may involve repeated rounds of nonsurgical periodontal therapy, and adjuncts such as locally delivered statin gels and subantimicrobial-dose doxycycline appear to be effective. Periodontal surgery should not be carried out at an early phase in therapy as improvements in nonsurgical therapy may be observed up to 12 months from initial treatment. Periodontal surgery, where indicated, should also be minimally invasive, with periodontal regeneration being shown to be effective over 20 years of follow-up. Biomarkers provide an opportunity for early detection of disease activity and personalised treatment. Quality of life is proposed as an alternative end point to the traditional biomedical paradigm focused on the disease state and clinical outcomes. In summary, minimally invasive therapy aims to preserve health and function of the natural dentition, thus improving the quality of life for patients with periodontitis.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - Marianne Meng Ann Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
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Bizenjima T, Irokawa D, Tanaka K, Saito A, Tomita S. Periodontal Regenerative Therapy with Recombinant Human Fibroblast Growth Factor-2 and Deproteinized Bovine Bone Mineral in Patient with Chronic Periodontitis: An 18-month Follow-up Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2021; 62:107-117. [PMID: 33994421 DOI: 10.2209/tdcpublication.2020-0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This report describes a case of generalized chronic periodontitis requiring periodontal regenerative therapy. The patient was a 62-year-old man who presented with the chief complaint of gingival swelling in the molar region. An initial examination revealed that 31.6% of sites had a probing depth of ≥4 mm and 18.5% bleeding on probing. Radiographic examination revealed vertical bone resorption in #14, 25, 26, 27, 32, 37, 45, and 47, and horizontal resorption in other regions. Based on a clinical diagnosis of moderate chronic periodontitis, initial periodontal therapy consisting of plaque control and scaling and root planing was performed. Occlusal adjustment of premature contact sites was performed after inflammation was suppressed. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 was performed on #14, 25, 26, 32, and 37. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #45 and 47. Other sites with residual periodontal pockets were treated by open flap debridement, and #27 was extracted due to a bone defect exceeding the root apex. Progress was then reevaluated and the patient placed on supportive periodontal therapy. Periodontal regenerative therapy using rhFGF-2 in combination with DBBM resulted in an improvement in clinical parameters and vertical bone resorption. This improvement has been adequately maintained over an 18-month period. The periodontal treatment provided resulted in a marked improvement in the patient's oral health-related quality of life.
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Rawlinson A, Vettore MV, Baker SR, Robinson PG. Do psychological factors predict changes in oral health-related quality of life and clinical status after periodontal treatment? J Clin Periodontol 2021; 48:795-804. [PMID: 33476416 DOI: 10.1111/jcpe.13429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/08/2020] [Accepted: 01/15/2021] [Indexed: 12/26/2022]
Abstract
AIMS To determine psychological factors predicting changes in OHRQoL and clinical status after periodontal treatment. METHODS Cohort of 140 patients with chronic periodontitis receiving non-surgical treatment consisting of scaling, root surface debridement and instruction in plaque control. Participants self-completed questionnaires enquiring about sense of coherence, locus of control, self-esteem and task-specific self-efficacy before treatment, and the Oral Health Impact Profile-14 before treatment, at oral hygiene review and end of study. Relationships among OHRQoL, clinical changes, individual factors (demographic and psychological) and environmental characteristics were analysed using latent growth curve modelling guided by the Wilson and Cleary model. RESULTS OHRQoL and periodontal status improved after treatment. Being male and having a greater sense of coherence predicted better OHRQoL before treatment. Stronger internal dimension of locus of control predicted a greater rate of improvement in OHRQoL, whereas greater external dimensions predicted a slower rate of improvement. Greater task-specific self-efficacy predicted less gains in probing attachment and reductions in probing depth. CONCLUSIONS Knowledge of psychological factors may be helpful in explaining individual differences in OHRQoL and clinical responses to periodontal treatment, and in identifying where health-promoting interventions may strengthen relevant factors to improve these outcomes.
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Affiliation(s)
- Andrew Rawlinson
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Mario V Vettore
- Universidade Federal de Minas Gerais, Rio de Janeiro, Brazil
| | - Sarah R Baker
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
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Rawlinson A, Vettore MV, Baker SR, Robinson PG. Periodontal treatment, psychological factors and oral health-related quality of life. J Clin Periodontol 2020; 48:226-236. [PMID: 33263182 DOI: 10.1111/jcpe.13405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/19/2020] [Accepted: 11/22/2020] [Indexed: 12/26/2022]
Abstract
AIMS To determine changes in OHRQoL and clinical status after periodontal treatment and the factors predicting these changes. METHODS Cohort of 140 patients with chronic periodontitis receiving non-surgical treatment. Participant self-completed questionnaires: Sense of Coherence, Locus of Control, Self-esteem and Task-specific Self-efficacy before treatment, and Oral Health Impact Profile at treatment, oral hygiene review and end of study. Relationships between OHRQoL, clinical data, individual and environmental characteristics were analysed with structural equation modelling guided by the Wilson and Cleary model. RESULTS OHRQoL and the periodontal status improved after treatment. Greater sense of coherence and age, better periodontal status, lower DMFT and being male predicted better OHRQoL after treatment. Better task-specific self-efficacy and self-esteem, but worse plaque score predicted better end periodontal status. CONCLUSIONS OHRQoL and periodontal status improved after periodontal treatment, and this was predicted by individual demographic and psychological factors. These factors may assist with case selection and as possible points for intervention to improve clinical and subjective outcomes of periodontal treatment.
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Affiliation(s)
- Andrew Rawlinson
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Mario V Vettore
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sarah R Baker
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
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Yoshida W, Takeuchi T, Imamura K, Seshima F, Saito A, Tomita S. Treatment of Chronic Periodontitis with Recombinant Human Fibroblast Growth Factor-2 and Deproteinized Bovine Bone Mineral in Wide Intrabony Defects:12-month Follow-up Case Series. THE BULLETIN OF TOKYO DENTAL COLLEGE 2020; 61:231-241. [PMID: 33177268 DOI: 10.2209/tdcpublication.2019-0050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Clinical use of 0.3% recombinant human fibroblast growth factor (rhFGF)-2 for periodontal regeneration received formal approval in Japan in 2016. The combination of growth factor and bone graft material is used to enhance periodontal healing in regenerative therapy. The exact effects of combination therapy on periodontal healing remain unknown, however. Here, we report three cases of chronic periodontitis treated with the combination of rhFGF-2 and deproteinized bovine bone mineral (DBBM). Following initial periodontal therapy, periodontal regenerative therapy using rhFGF-2 in combination with DBBM was performed to treat wide intrabony defects. Periodontal parameters and radiographic bone fill were reevaluated at 3 months, 6 months, and 1 year postoperatively. Oral health-related quality of life (OHRQL) was assessed as a patient-reported measure of outcome. At 1 year postoperatively, probing pocket depth and clinical attachment level showed a significant improvement in comparison with at baseline. An improvement was also noted in radiographic evidence of bone fill and total OHRQL scores. Combination therapy yielded clinically favorable results in the present cases.
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Affiliation(s)
| | | | | | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College
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10
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Wong LB, Yap AU, Allen PF. Periodontal disease and quality of life: Umbrella review of systematic reviews. J Periodontal Res 2020; 56:1-17. [PMID: 32965050 DOI: 10.1111/jre.12805] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/29/2020] [Accepted: 09/02/2020] [Indexed: 12/12/2022]
Abstract
This umbrella review appraised existing systematic reviews and meta-analysis to establish the impact of periodontal disease and therapy on general and oral health-related quality of life. A systematic electronic literature search was carried out in accordance with the PRISMA guideline up to January 2020 using PubMed, LIVIVO, EMBASE and OpenGrey (PROSPERO CRD 42020163831). Hand searching was performed through the reference lists of periodontal textbooks and related journals. All English language-based systematic reviews and meta-analysis that assessed the impact of periodontal disease and treatment interventions on general and oral health-related quality of life were included. Overall, eight articles met the inclusion criteria and their methodological quality was assessed using the AMSTAR2 criteria. Two systematic reviews showed a significant impact of oral conditions on general health-related quality of life, although the specific impact of periodontal disease remains inconclusive. Three systematic reviews established a negative impact of periodontal disease on oral health-related quality of life. Another three systematic reviews concluded that periodontal treatment can improve oral health-related quality of life. Oral conditions, like periodontal disease, can impact the general health-related quality of life. Periodontal disease is negatively correlated with oral health-related quality of life, although treatment interventions can improve self-reported quality of life. In view of the heterogeneity of generic instruments currently utilized to assess the self-reported quality of life of periodontal patients, the development of a general and oral health-related quality of life instrument specific for periodontal disease is strongly recommended.
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Affiliation(s)
- Li Beng Wong
- Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.,Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.,Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Abstract
Patient-based outcomes complement clinical data with patients' self-evaluation of their physical, psychological, and social well-being, and as such facilitate clinical decision-making, assessing the quality of care provided, and evaluating practices and policies. Some validated generic oral health-related quality of life measures used in recent research indicated a high performance. There is a proportional relationship between the quality of life and periodontitis, ie, the higher the level of periodontitis, the poorer the oral health-related quality of life. This relationship is heightened by the presence of symptoms such as bleeding, halitosis, and mobility. On the other hand, periodontal treatment has demonstrated the capability to improve quality of life substantially. Future research should focus on questionnaires that are able to explain the interlinked pathways between periodontal conditions, approaches to treatment approaches, and patients' well-being. The acquisition of new knowledge in the field is essential for the whole community, as we treat people not millimeters.
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Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, UCL, London, UK
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12
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Graetz C, Schwalbach M, Seidel M, Geiken A, Schwendicke F. Oral health‐related quality of life impacts are low 27 years after periodontal therapy. J Clin Periodontol 2020; 47:952-961. [DOI: 10.1111/jcpe.13324] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology University of Kiel Kiel Germany
| | - Maike Schwalbach
- Clinic of Conservative Dentistry and Periodontology University of Kiel Kiel Germany
| | - Miriam Seidel
- Clinic of Conservative Dentistry and Periodontology University of Kiel Kiel Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology University of Kiel Kiel Germany
| | - Falk Schwendicke
- Department of Oral Diagnostics Digital Health and Health Services Research Charité University of Berlin Berlin Germany
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13
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Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population-A Prospective Cohort Study. Dent J (Basel) 2020; 8:dj8020054. [PMID: 32466149 PMCID: PMC7344508 DOI: 10.3390/dj8020054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/01/2020] [Accepted: 05/20/2020] [Indexed: 11/17/2022] Open
Abstract
While periodontitis deteriorates patients’ quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients’ perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters.
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14
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Palaiologou A, Kotsakis GA. Dentist-Patient Communication of Treatment Outcomes in Periodontal Practice: A Need for Dental Patient-Reported Outcomes. J Evid Based Dent Pract 2020; 20:101443. [PMID: 32473794 DOI: 10.1016/j.jebdp.2020.101443] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 11/18/2022]
Abstract
Periodontal practice has made tremendous progress toward evidence-based treatment over the past decade. Importantly, a new classification scheme for periodontal and peri-implant treatments has recently been devised that is incorporating current evidence and enabling patient-specific periodontal care. However, this important progress can be further accelerated with the availability of patient-perceived outcomes of periodontal and implant interventions. The majority of existing clinical studies assess treatment effects based on clinician-measured surrogate outcomes, such as probing depth and attachment levels which are easily communicated to or perceived by dental patients. As dental patient-reported outcomes (dPROs) gain momentum in dental practice, our understanding of the true outcome of dental therapies is vastly increasing. In periodontal research in particular, the utilization of dPROs has clearly demonstrated that periodontal disease contributes to an individual's burden of disease in a substantial manner. Correspondingly, disease treatment interventions seem to lead to varying levels of patient-perceived improvements. The present editorial aims to highlight the importance of patient communication of treatment outcomes in periodontal and implant research and to review the information on available measures for capturing dPROs.
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Botelho J, Machado V, Proença L, Bellini DH, Chambrone L, Alcoforado G, Mendes JJ. The impact of nonsurgical periodontal treatment on oral health-related quality of life: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:585-596. [PMID: 31901977 DOI: 10.1007/s00784-019-03188-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/23/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To estimate the impact of nonsurgical periodontal treatment (NSPT) on patients' oral health-related quality of life (OHRQoL). The focused question for this systematic review was: in adults patients with periodontitis, does NSPT improve oral health-related quality of life? MATERIAL AND METHODS Five databases (PubMed, CIHNL, EMBASE, LILACS and CENTRAL) were searched up to April 2019 (PROSPERO CRD42018103393). Intervention trials and cohort studies assessing the OHRQoL data of adults with periodontitis, enduring non-surgical periodontal treatment (NSPT) were eligible for inclusion. Subgroup random-effects meta-analysis was conducted methodically. RESULTS Overall, 491 studies were retrieved, out of which 19 met the inclusion criteria. Two randomized clinical trials (RCTs) and ten cohort studies were further analysed. Seven cohort studies were included in the statistical analysis. Subgroup meta-analyses of cohort studies revealed that NSPT improves in average 2.49 (95% CI 0.95-4.02), 8.94 (95% CI 6.89-10.99) and 6.49 (95% CI 5.11-7.88) OHRQoL levels at 1-2 weeks, 3-4 weeks and 6-12 weeks of post-treatment, respectively. CONCLUSIONS NSPT procedures greatly improve the oral health-related quality of life within a short time, remaining stable after 3 months of treatment. CLINICAL RELEVANCE This systematic review brings forward summary evidence that NSPT improves the OHRQoL in adults with periodontitis from a patient-centred perception and remain stable in the short term.
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Affiliation(s)
- João Botelho
- Periodontology Department, Egas Moniz Dental Clinic, Egas Moniz, CRL, Monte de Caparica, Portugal.,Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Vanessa Machado
- Periodontology Department, Egas Moniz Dental Clinic, Egas Moniz, CRL, Monte de Caparica, Portugal.,Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research Unit (MQIS), CiiEM, Egas Moniz, CRL, Monte de Caparica, Portugal
| | | | - Leandro Chambrone
- School of Dentistry, Ibirapuera University, São Paulo, SP, Brazil. .,Unit of Basic Oral Investigation (UIBO), El Bosque University, Bogota, Colombia.
| | - Gil Alcoforado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
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Radafshar G, Movahedi Amiri M. Impact of One-Stage Full Mouth Disinfection and Periodontal Surgery on Oral Health-Related Quality of Life. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2019. [PMID: 31875175 DOI: 10.30476/dentjods.2019.77748.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Statement of the Problem Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited. Purpose This study sought to compare patients' perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment. Materials and Method A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21. Results 38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p< 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p< 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. Conclusion Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.
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Affiliation(s)
- Golpar Radafshar
- Dental Sciences Research Center, Dept. of Periodontology, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Marziyeh Movahedi Amiri
- Dental Sciences Research Center, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Saito A, Bizenjima T, Takeuchi T, Suzuki E, Sato M, Yoshikawa K, Kitamura Y, Matsugami D, Aoki H, Kita D, Imamura K, Irokawa D, Seshima F, Tomita S. Treatment of intrabony periodontal defects using rhFGF-2 in combination with deproteinized bovine bone mineral or rhFGF-2 alone: A 6-month randomized controlled trial. J Clin Periodontol 2019; 46:332-341. [PMID: 30758076 PMCID: PMC6899590 DOI: 10.1111/jcpe.13086] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/14/2019] [Accepted: 02/10/2019] [Indexed: 01/07/2023]
Abstract
Aim To evaluate the use of recombinant human fibroblast growth factor (rhFGF)‐2 in combination with deproteinized bovine bone mineral (DBBM) compared with rhFGF‐2 alone, in the treatment of intrabony periodontal defects. Materials and Methods Patients with periodontitis who had received initial periodontal therapy and had intrabony defects of ≥ 3 mm in depth were enrolled. Sites were randomly assigned to receive a commercial formulation of 0.3% rhFGF‐2 + DBBM (test) or rhFGF‐2 alone (control). Clinical parameters and a patient‐reported outcome measure (PROM) were evaluated at baseline and at 3 and 6 months postoperatively. Results Twenty‐two sites in each group were evaluated. A significant improvement in clinical attachment level (CAL) from baseline was observed in both groups at 6 months postoperatively. CAL gain was 3.16 ± 1.45 mm in the test group and 2.77 ± 1.15 mm in the control group, showing no significant difference between groups. Radiographic bone fill was significantly greater in the test group (47.2%) than in the control group (29.3%). No significant difference in PROM between groups was observed. Conclusions At 6 months, no significant difference in CAL gain or PROM between the two treatments was observed, although combination therapy yielded an enhanced radiographic outcome.
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Affiliation(s)
- Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | | | | | - Eiichi Suzuki
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Masahiro Sato
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Kouki Yoshikawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Yurie Kitamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Hideto Aoki
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daichi Kita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daisuke Irokawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Sachiyo Tomita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
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Abstract
While clinical indicators, or so-called surrogate outcomes in periodontology, allow us to assess periodontal health and evaluate outcomes of periodontal therapy from a clinician's perspective, they cannot be used to evaluate patients' subjective perceptions of their health status or satisfaction with the received treatment. These can be assessed through patient-based outcomes, such as quality of life. The aim of this paper is to give an overview of the multidimensional concept of oral health-related quality of life (OHRQoL), its measures and association with plaque-induced, inflammatory periodontal diseases. Periodontitis and its clinical consequences, such as tooth loss, have a considerable negative effect on OHRQoL, while periodontal treatment and alleviation of the symptoms can lead to improvement in OHRQoL. Implant rehabilitation of missing teeth also seems to positively influence OHRQoL.
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Aoki H, Seshima F, Saito A. Periodontal Regenerative Therapy Using Enamel Matrix Derivative in Patient with Chronic Periodontitis: a 3-year 6-month Follow-up Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2019; 60:201-209. [PMID: 31308309 DOI: 10.2209/tdcpublication.2018-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Here, we report a case of chronic periodontitis requiring periodontal regenerative therapy. The patient was a 73-year-old man who visited Tokyo Dental College Suidobashi Hospital with the chief complaint of gingival swelling and mobile tooth in the mandibular incisor region. An initial examination revealed that 33% of sites had a probing depth (PD) of≥4 mm and 27% bleeding on probing. Radiographic examination revealed bone resorption extending as far as the root apex in #32 and 47, vertical bone resorption in #37, and horizontal resorption in other regions. Based on a clinical diagnosis of moderate chronic periodontitis, initial periodontal therapy was carried out followed by periodontal surgery. The patient's oral health-related quality of life was also assessed at the time of each periodontal assessment. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using enamel matrix derivative was performed on #37. Other sites with a PD of ≥4 mm were treated with open flap debridement, and scaling and root planing. Following reevaluation, the patient was placed on supportive periodontal therapy. The patient's periodontal condition has remained stable over a 3-year 6-month period. The patient's oral health-related quality of life showed a marked improvement after periodontal therapy.
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Affiliation(s)
- Hideto Aoki
- Department of Periodontology, Tokyo Dental College
| | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College
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20
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Seshima F, Kigure T, Saito A. Periodontal Regenerative Therapy Using Enamel Matrix Derivative for Treatment of Generalized Severe Chronic Periodontitis: A 2-year Case Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2019; 60:97-104. [PMID: 30880297 DOI: 10.2209/tdcpublication.2018-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Here, we describe the treatment course and 2-year follow-up in a case of multiple deep intrabony defects treated with periodontal regenerative therapy. The patient was a 50-year-old woman presenting with the chief complaint of mobile teeth in the maxillary molar region. Examination at her initial visit revealed sites with a probing depth of ≥7 mm in the molar region. Radiographic examination revealed generalized bone resorption. Angular bony defects were evident in the molar region. Initial periodontal therapy was commenced based on a clinical diagnosis of generalized chronic periodontitis. At re-evaluation, an improvement was observed in periodontal conditions. Periodontal regenerative therapy with enamel matrix derivative was performed on teeth #13, 15, 24, 27, 33, 35, 37, 46, and 47. Following re-evaluation, a removable partial denture was used to replace teeth #26 and 45, and the patient placed under supportive periodontal therapy. Periodontal conditions have remained stable. Careful supportive periodontal therapy needs to be continued, however, to monitor and treat sites requiring further attention, including those with furcation involvement.
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Affiliation(s)
- Fumi Seshima
- Department of Periodontology, Tokyo Dental College
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21
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Effects of dropping out of dental treatment on the oral health-related quality of life among middle-aged subjects using web research. PLoS One 2018; 13:e0205462. [PMID: 30379933 PMCID: PMC6209193 DOI: 10.1371/journal.pone.0205462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/25/2018] [Indexed: 11/28/2022] Open
Abstract
Objective The oral health-related quality of life has recently been reported to be a rather important aspect of general health. Dropping out of dental treatment has long been a problem plaguing oral health. However, the relationship between dropout for dental treatment and the oral health-related quality of life is unclear. The purpose of this study was to investigate the oral health-related quality of life in patients who dropped out of dental treatment. Materials and methods We conducted a questionnaire-based investigation using web research. The participants were allocated to two groups (dropout group and maintenance group). The dropout group included participants who had stopped visiting their dental office in the past and had not revisited in the last decade. The maintenance group included patients who visited their dental office continually for a regular checkup. We analyzed the General Oral Health Assessment Index (GOHAI) as an indicator of the oral health-related quality of life and assessed the background characteristics of the subjects. Results We analyzed 225 people in the dropout group and 236 people in the maintenance group. The score of GOHAI was significantly different between the 2 groups (dropout group:47.07, maintenance:48.97, p = 0.035), and the more frequent dropouts brought the less GOHAI score (p = 0.012). Furthermore, the results of a logistic regression analysis showed that dropping out of dental treatment was significantly associated with the GOHAI score (p = 0.002). Conclusion A relationship was demonstrated between the oral health-related quality of life and dental treatment dropout. Furthermore, dental treatment dropout seemed to have negative effects on the oral health-related quality of life.
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Kita D, Kinumatsu T, Ishii Y, Yamanouchi K, Saito A. Treatment of Gingival Fenestration with Connective Tissue Graft: A Case Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 59:111-119. [PMID: 29962418 DOI: 10.2209/tdcpublication.2017-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Here, we report a case of gingival fenestration requiring periodontal plastic surgery. The patient was a 32-year-old man presenting with the chief complaint of esthetic impairment and gingival twitching due to gingival fenestration. Baseline examination revealed localized periodontal breakdown, including gingival fenestration in the lower right central incisor (#41). Periodontal examination revealed 3% of sites with a probing depth of ≥4 mm and 8.9% with bleeding on probing. Radiographic examination revealed vertical bone loss in #15 and 36, together with buccal fenestration in #41. Based on a clinical diagnosis of chronic periodontitis with gingival fenestration, initial periodontal therapy comprised plaque control and scaling and root planing. Following suppression of inflammation, occlusal adjustment was performed in the anterior teeth. As plastic surgery, combined use of an elevated flap and a connective tissue graft was applied at #41. Following reevaluation, the patient was placed on maintenance care. The patient's periodontal condition has remained stable over a 6-month period.
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Affiliation(s)
- Daichi Kita
- Department of Periodontology, Tokyo Dental College
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23
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He S, Wei S, Wang J, Ji P. Chronic periodontitis and oral health-related quality of life in Chinese adults: A population-based, cross-sectional study. J Periodontol 2018; 89:275-284. [DOI: 10.1002/jper.16-0752] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 09/03/2017] [Accepted: 09/09/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Songlin He
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; Chongqing China
| | - Shicheng Wei
- College of Stomatology; Chongqing Medical University; Chongqing China
- Center for Biomedical Materials and Tissue Engineering; Academy for Advanced Interdisciplinary Studies; Peking University; Beijing China
- Department of Oral and Maxillofacial Surgery; Laboratory of Interdisciplinary Studies; Peking University School and Hospital of Stomatology; Beijing China
| | - Jinhua Wang
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; Chongqing China
| | - Ping Ji
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; Chongqing China
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He S, Wei S, Wang J, Ji P. Chronic periodontitis and oral health-related quality of life in Chinese adults: A population-based, cross-sectional study. J Periodontol 2018. [PMID: 29520778 DOI: 10.1002/jper.17-0752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND This population-based, cross-sectional study explored the association between chronic periodontitis and oral health-related quality of life (OHRQoL) in Chinese adults, independently of sociodemographic factors and other common oral conditions. METHODS The present study was carried out in a sample population of 480 adults aged 35 to 74 years from Chongqing municipality. A multi-stage stratified random sampling approach was adopted to select participants. The Chinese version of the short-form oral health impact profile (OHIP-14) was used to assess OHRQoL. Chronic periodontitis was trichotomized into mild, moderate, and severe periodontitis. Logistic regression models were adopted to explore the association between the severity of chronic periodontitis and OHIP-14 scores. RESULTS After adjustment for sociodemographic factors and other common clinical conditions, participants with severe and moderate chronic periodontitis, respectively, had 1.63- (95% CI: 1.41 to 1.98) and 1.42-fold (95% CI: 1.29 to 1.63) higher odds for the OHIP-14 scores being above the median compared with participants without chronic periodontitis. However, participants with mild periodontitis did not have significantly higher odds for the OHIP-14 scores being above the median than participants without chronic periodontitis. Certain sociodemographic variables, including higher age, lower education level, number of missing teeth, and current smoker, had negative associations with OHRQoL. CONCLUSIONS Chronic periodontitis was associated with poorer OHRQoL in Chinese adults. In addition, the impairment in OHRQoL showed a significant correlation with the severity of chronic periodontitis.
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Affiliation(s)
- Songlin He
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Shicheng Wei
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Center for Biomedical Materials and Tissue Engineering, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.,Department of Oral and Maxillofacial Surgery, Laboratory of Interdisciplinary Studies, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jinhua Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ping Ji
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Baiju RM, Peter E, Varghese NO, Anju P. Patient Reported Outcome Assessment of Periodontal Therapy: A Systematic Review. J Clin Diagn Res 2017; 11:ZC14-ZC19. [PMID: 28969266 DOI: 10.7860/jcdr/2017/28505.10343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 07/15/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patient Reported Outcomes (PROs) are now regarded as a fundamental measure of therapeutic success. Patient's opinion regarding the impact of disease and its treatment is assessed using scales such as Oral Health Related Quality Of Life (OHRQoL) tools. Patient centred outcome assessment is now being considered as a primary outcome measure in clinical trials. AIM To evaluate whether treatment of periodontal disease could influence OHRQoL based on available literature. MATERIALS AND METHODS An electronic search was done in Google, Google Scholar and Pubmed for articles in English language using the terms Quality of Life or ORHQoL or PROs or patient centered outcome and periodontal therapy. The search commenced on 1st September 2016 and ended on 15th December 2016. Studies that employed one or more than one multi-item OHRQoL instrument to assess PROs related to either non-surgical or surgical periodontal therapy were reviewed. RESULTS Initially 423 relevant articles were obtained, from which based on screening titles and abstracts 396 were excluded. Full text of remaining 27 articles were retrieved. Nineteen clinical studies with 1345 participants and 2 systematic reviews were included after the full text review. CONCLUSION Both surgical and Non-surgical Periodontal Therapy (NSPT) significantly influenced the OHRQoL scores. However the change in scores after surgical therapy when compared to nonsurgical therapy was not statistically significant. There is a need for a specific PROs scale that could potentially tap the entire dimension of the change in patients' perception brought about by periodontal therapy.
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Affiliation(s)
- R M Baiju
- Associate Professor, Department of Periodontics, Government Dental College Thrissur, Kerala University of Health Sciences, Kerala, India
| | - Elbe Peter
- Associate Professor, Department of Orthodontics, Government Dental College Alleppey, Kerala University of Health Sciences, Kerala, India
| | - N O Varghese
- Principal, Department of Conservative Dentistry and Endodontics, Pms College of Dental Sciences, Trivandrum, Kerala, India
| | - P Anju
- Senior Resident, Department of Periodontics, Government Dental College Kottayam, Kerala University of Health Sciences, Kerala, India
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A Comparison of Impact of Chronic Periodontal Diseases and Nonsurgical Periodontal Therapy on Oral Health-Related Quality of Life. Int J Dent 2017; 2017:9352562. [PMID: 28588616 PMCID: PMC5446884 DOI: 10.1155/2017/9352562] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 04/10/2017] [Accepted: 04/20/2017] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate the impact of chronic periodontal diseases (PDs) and compare phases of nonsurgical periodontal therapy (NSPT) on oral health-related quality of life (OHRQoL) in patients attending a tertiary care center of eastern Nepal. Materials and Methods Matched for socioeconomic status, participants were recruited in two groups: moderate-to-severe chronic periodontitis (n = 24, 43 ± 46 years) and chronic gingivitis (n = 25, 30 ± 96 years). The treatment modalities were scaling and root surface debridement (RSD) and supragingival scaling, respectively. The impact of periodontal disease treatment status was assessed by a self-reported questionnaire of Nepali Oral Health Impact Profile (OHIP-14) at baseline and 9–12 weeks after NSPT. Results The median (IQR) OHIP-14 total scores for PDs reduced from 7 (3–11) to 3 (1–7.5) after NSPT. Both groups showed a significant improvement on OHRQoL (p value < 0.001). The periodontitis group showed an increased median (IQR) reduction of 52% (35.22–86.15) compared with the gingivitis group with 27% (0.00–50.00). The impact on orofacial pain, orofacial appearance, and psychosocial dimensions was observed, which improved after NSPT in both groups. Conclusion PDs are directly associated with OHRQoL and treatment of the disease may enhance quality of life from a patient's perspective. Scaling and RSD provided better influence on OHRQoL than supragingival scaling.
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Gadbury-Amyot CC, Austin KS, Simmer-Beck M. A review of the oral health-related quality of life (OHRQL) model for dental hygiene: Eighteen years later. Int J Dent Hyg 2017; 16:267-278. [PMID: 28474435 DOI: 10.1111/idh.12277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this paper is to review available evidence to determine the impact of the oral health-related quality of life (OHRQL) Model for Dental Hygiene on education, research, and practice. METHODS A search was conducted in PubMed using the search terms oral health-related quality of life, OHRQL, and dental hygiene and limited to publications between 1998 and 2016. Google Scholar was also used to identify citations for the two original OHRQL model papers to capture the literature widely read by practicing dental hygienists but not indexed in PubMed. A total of 40 publications met the predetermined search strategy. Full publications were obtained and reviewed to determine how this research is being used in education, research, and practice. FINDINGS The OHRQL is being utilized to a very limited degree in education, research, and practice. The literature shows how the OHRQL is actively being used in the school where the model originated in addition to a dental hygiene programme in Japan. Studies have been conducted on a variety of research instruments, including the OHRQL, designed to capture OHRQL outcomes. Japanese researchers have used the OHRQL in studies designed to determine the impact of oral healthcare delivery on patients' oral health-related quality of life. CONCLUSION Eighteen years of the literature confirms that the OHRQL is being used minimally in education, research, and practice. Greater emphasis is needed around the collection and assessment of oral health-related quality of life measures for providing patient-centred care.
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Affiliation(s)
- C C Gadbury-Amyot
- University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA
| | - K S Austin
- University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA
| | - M Simmer-Beck
- University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA
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28
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Suzuki E, Aoki H, Tomita S, Saito A. Improvement in Oral Health-related Quality of Life by Periodontal Treatment: A Case Report on Elderly Patient with Chronic Periodontitis. THE BULLETIN OF TOKYO DENTAL COLLEGE 2016; 58:163-170. [PMID: 28954951 DOI: 10.2209/tdcpublication.2016-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report a case of an elderly patient with chronic periodontitis requiring periodontal surgery. An 86-year-old man presented to Tokyo Dental College Suidobashi Hospital with the chief complaint of tooth fracture in the anterior region and occlusal pain in the posterior region. Clinical examination revealed 47% of sites with a probing depth (PD) of ≥4 mm and 47% of sites with bleeding on probing. Radiographic examination revealed generalized moderate horizontal bone loss with localized vertical defects. A clinical diagnosis of moderate chronic periodontitis was made. The patient's oral health-related quality of life (QoL) was also assessed at the time of each periodontal assessment. Initial periodontal therapy was provided followed by periodontal surgery. Open flap debridement was performed at sites with a PD of ≥5 mm (teeth #15-17). Surgical crown lengthening with an apically positioned flap was performed on #11 and 13 to gain an adequate biological width for the subsequent crown restoration. After confirming the stability of the periodontal tissue, provisional restorations were replaced with final restorations. No further deterioration was observed in the periodontal condition during the subsequent 1-year period of supportive periodontal therapy. Oral health-related QoL was markedly improved by the periodontal therapy. This suggests that periodontal therapy plays an important role in improving and maintaining oral health-related QoL in elderly people.
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