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Figuero E, Gürsoy M, Monnet-Corti V, Iniesta M, Antezack A, Kapferer-Seebacher I, Graetz C, Vered Y, Stavropoulos A, Wilensky A, Eickholz P, Sanz M. Domains, competences and learning outcomes for undergraduate education in periodontology. J Clin Periodontol 2024. [PMID: 38655768 DOI: 10.1111/jcpe.13991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/07/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
AIM This review is intended to adapt the current conceptual framework in dental education based on four domains to propose a set of competences, learning outcomes and methods of teaching, learning and assessment for undergraduate education in periodontology. REVIEW Based on the current framework of competences and learning outcomes recommended by the Association for Dental Education in Europe (ADEE), undergraduate education in periodontology has been updated using the classification and clinical practice guidelines for the diagnosis and treatment of periodontal and peri-implant diseases. CONCLUSIONS Specific learning outcomes have been proposed within each competence area, that is in Domain I (n = 10), Domain II (n = 13), Domain III (n = 33) and Domain IV (n = 12). Teaching methods and learning activities based on the different dimensions of the cognitive process have been proposed. Additionally, 10 key learning outcomes have been proposed as exit outcomes, which implies their accomplishment within the final assessment of any graduating student.
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Affiliation(s)
- Elena Figuero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
- The Wellbeing Services County of Southwest Finland, Oral Health Care, Turku, Finland
| | | | - Margarita Iniesta
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Angeline Antezack
- Department of Periodontology, Aix-Marseille Université, Marseille, France
| | - Ines Kapferer-Seebacher
- Medical University of Innsbruck, University Hospital of Conservative Dentistry and Periodontology, Innsbruck, Austria
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Yuval Vered
- Faculty of Dental Medicine, Department of Community Dentistry, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Asaf Wilensky
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt, Germany
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
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Härdter AK, Nordloh A, Cyris M, Straßburger M, Rinder T, Dörfer CE, Sälzer S, Graetz C. New design of interdental rubber picks - does the archimedean screw design bring an improvement for experimental cleaning efficacy and force? BMC Oral Health 2024; 24:404. [PMID: 38553668 PMCID: PMC10981285 DOI: 10.1186/s12903-024-04162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Up to date, interdental brushes (IDB) are the first choice for interdental cleaning because of their cleaning efficacy. Cylindrical ones must be selected individually according to the size/morphology of the interdental area (IDR), whereas conical ones cover a larger variability of IDR. However, there is a trend on the part of patients towards interdental rubber picks (IRP) which are in general conically shaped, and which seem to be linked with lower cleaning efficacy. A new IRP with an Archimedes´ screw design was developed to overcome this limitation. Therefore, the in vitro study aimed to measure the experimental cleaning efficacy (ECE) and force (ECF) during interdental use of IDBs versus the new IRP type. METHODS Three IRPs with different tapers (PHB angled: 0.039, PHB straight S: 0.027, Vitis straight M: 0.045; all Flexipicks, Dentaid, Cerdanyola del Vallès, Spain) were compared to one IDB (Interprox micro PHD 0.9, Dentaid, Cerdanyola del Vallès, Spain). IDR were reproduced by a 3D-printer (Form2, Formlabs Sommerville, MA, USA) according to human teeth and matched to equivalent pairs (isosceles triangle, concave, convex) in three different diameters (1.0 mm,1.1 mm,1.3 mm). Covered with simulated biofilm, pre-/ post-brushing situations of IDR (standardized, computer-aided ten cycles) were photographed and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. Statistically significant differences were detected using the Mann-Whitney-U-test and the Kruskal-Wallis-test with Bonferroni correction for multiple testing. RESULTS Overall, the ECE (mean ± SD) was higher for IDB micro 0.9 (45.95 ± 11.34%, p < 0.001) compared to all IRPs (PHB angled: 25.37 ± 15.29%; PHB straight: 22.28 ± 16.75%; Vitis straight: 25.24 ± 12.21%; p ≤ 0.001), whereat best ECE was achieved in isosceles triangle IDR of 1.0-1.1 mm (IDB micro 0.9: 70.7 ± 7.7%; PHB angled S: 57.30 ± 4.43%; p < 0.001). The highest ECF occurred for Vitis straight M with 2.11 ± 0.46 N, while IDB micro 0.9 showed lowest ECF values (0.64 ± 0.14 N; p < 0.001). CONCLUSIONS IRP with an Archimedes´ screw design and a higher taper were associated with advanced ECE but also higher ECF, nevertheless, ECE didn't reach the cleaning efficacy of conventional IDBs.
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Affiliation(s)
- Ann-Kristin Härdter
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Anna Nordloh
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Miriam Cyris
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Martin Straßburger
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
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Geiken A, Kock M, Banz L, Schwendicke F, Graetz C. Dental Practice Websites in Germany-How Do They Inform about Fluoridation? Dent J (Basel) 2024; 12:65. [PMID: 38534289 DOI: 10.3390/dj12030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 03/28/2024] Open
Abstract
Fluoridation (Fl) is effective in preventing caries; however, it is unclear to what extent its use is counteracted by misinformation on the internet. This study aimed to evaluate the information provided on professional websites of German dental practices regarding fluoridation. A systematic search was performed by two independent examiners, utilizing three search engines, from 10 September 2021 to 11 December 2021. Modified, validated questionnaires (LIDA, DISCERN) were used to evaluate technical and functional aspects, generic quality, and risk of bias. Demographic information and statements about Fl were also collected. The intra- and inter-rater reliability assessments were excellent. Of the 81 websites analyzed, 64 (79%) mentioned Fl, and 31 (38%) indicated it as a primary focus. Most websites met at least 50% of the LIDA (90%) and DISCERN criteria (99%), indicating that the general quality was good. Thirty (37%) of the websites explained the impact of Fl, and forty-five (56%) indicated an opinion (for/against) on Fl. The practice location and the clinical focus were not associated with the overall quality of websites. Only a minority of websites explained the effects of Fl. Taken together, this study highlights that there is a distinct lack of good-quality information on FL.
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Affiliation(s)
- Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, 24105 Kiel, Germany
| | - Mirja Kock
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, 24105 Kiel, Germany
| | - Lisa Banz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, 24105 Kiel, Germany
| | - Falk Schwendicke
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Ludwig-Maximilians-University Munich, 80336 Munich, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, 24105 Kiel, Germany
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Cyris M, Holtmann P, Dörfer CE, Holtmann L, Kern M, Graetz C. Long-term effect of simulated five years professional mechanical biofilm removal on the luting gap of ceramic restorations. BMC Oral Health 2024; 24:291. [PMID: 38429695 PMCID: PMC10908180 DOI: 10.1186/s12903-024-04066-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Achieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = Vbaseline-V1-5; in µm3). METHODS Two operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests. RESULTS Ninety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 106(4.8 × 106)µm3 versus 8.79 × 104(1.05 × 106)µm3 for control at V5 (p ≤ 0.001). No significant differences of ∆V1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 107 (7,2 × 106) µm3), followed by LAPA-2 on CAB (∆V: -6.29 × 106 (4,24 × 106) µm3), LAPA-1 on CGIZ (∆V: -4.15 × 106 (3,25 × 106) µm3), LAPA-2 on CGIZ (∆V: -3.0 × 106 (2,23 × 106) µm3), RCP on CAB (∆V: -1.86 × 106 (2,23 × 106) µm3) and CGIZ (∆V: -1.2 × 106 (1,31 × 106) µm3; p ≤ 0.001)). CONCLUSIONS Within study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower.
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Affiliation(s)
- Miriam Cyris
- Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Philipp Holtmann
- Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Louise Holtmann
- Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts University at Kiel, Kiel, Germany.
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Geiken A, Banz L, Kock M, Schwendicke F, Graetz C. Does information about MIH on dental homepages in Germany offer high quality? A systematic search and analysis. Eur Arch Paediatr Dent 2024; 25:127-135. [PMID: 38300412 PMCID: PMC10942881 DOI: 10.1007/s40368-023-00857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The internet is increasingly used to seek health information. A dental condition of increasing concern and public interest is molar incisor hypomineralisation (MIH), why we evaluated the information quality of German dentists 'websites on the topic of MIH. METHODS A systematic search was performed by two independent investigators using three search engines. The information content of websites on MIH and technical, functional aspects, overall quality, and risk of bias were assessed using validated instruments (LIDA, DISCERN). Practice-related characteristics (practice type, specialization, setting, number and mean age of dentists) were recorded, and associations of these characteristics with websites' overall quality were explored using multivariable linear regression modelling. RESULTS 70 sites were included. 52% were multipractices in urban areas (49%). The most common age group was middle-aged individuals (41-50 years). The average number of dentists/practice was 2.5. The majority met more than 50% of the DISCERN and LIDA criteria (90%, 91%). The MIH definition was frequently used (67%), MIH symptoms were described (64%), and 58% mentioned therapies. The prevalence of MIH was mentioned less frequently (48%). MIH example photographs were rarely shown (14%). In multivariable analysis, most practice-related factors were not significant for overall site quality. Only chain practices had slightly higher quality in this regard (2.2; 95% CI of 0.3-4.1). CONCLUSIONS MIH is mentioned on a large proportion of dentists' websites. Overall technical, functional, and generic quality was high. Risk of bias is limited. While most websites provided a basic definition of MIH and its symptoms, important information for patients was missing.
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Affiliation(s)
- A Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - L Banz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - M Kock
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - F Schwendicke
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Tölle J, Koch A, Schlicht K, Finger D, Kaehler W, Höppner M, Graetz C, Dörfer C, Schulte DM, Fawzy El-Sayed K. Effect of Hyperbaric Oxygen and Inflammation on Human Gingival Mesenchymal Stem/Progenitor Cells. Cells 2023; 12:2479. [PMID: 37887323 PMCID: PMC10605813 DOI: 10.3390/cells12202479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
The present study explores for the first time the effect of hyperbaric oxygen (HBO) on gingival mesenchymal stem cells' (G-MSCs) gene expression profile, intracellular pathway activation, pluripotency, and differentiation potential under an experimental inflammatory setup. G-MSCs were isolated from five healthy individuals (n = 5) and characterized. Single (24 h) or double (72 h) HBO stimulation (100% O2, 3 bar, 90 min) was performed under experimental inflammatory [IL-1β (1 ng/mL)/TNF-α (10 ng/mL)/IFN-γ (100 ng/mL)] and non-inflammatory micro-environment. Next Generation Sequencing and KEGG pathway enrichment analysis, G-MSCs' pluripotency gene expression, Wnt-/β-catenin pathway activation, proliferation, colony formation, and differentiation were investigated. G-MSCs demonstrated all mesenchymal stem/progenitor cells' characteristics. The beneficial effect of a single HBO stimulation was evident, with anti-inflammatory effects and induction of differentiation (TLL1, ID3, BHLHE40), proliferation/cell survival (BMF, ID3, TXNIP, PDK4, ABL2), migration (ABL2) and osteogenic differentiation (p < 0.05). A second HBO stimulation at 72 h had a detrimental effect, significantly increasing the inflammation-induced cellular stress and ROS accumulation through HMOX1, BHLHE40, and ARL4C amplification and pathway enrichment (p < 0.05). Results outline a positive short-term single HBO anti-inflammatory, regenerative, and differentiation stimulatory effect on G-MSCs. A second (72 h) stimulation is detrimental to the same properties. The current results could open new perspectives in the clinical application of short-termed HBO induction in G-MSCs-mediated periodontal reparative/regenerative mechanisms.
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Affiliation(s)
- Johannes Tölle
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University, 24105 Kiel, Germany; (J.T.); (D.F.); (C.G.); (C.D.)
| | - Andreas Koch
- German Naval Medical Institute, 24119 Kiel, Germany; (A.K.); (W.K.)
| | - Kristina Schlicht
- Institute of Diabetes and Clinical Metabolic Research, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (K.S.); (D.M.S.)
| | - Dirk Finger
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University, 24105 Kiel, Germany; (J.T.); (D.F.); (C.G.); (C.D.)
| | - Wataru Kaehler
- German Naval Medical Institute, 24119 Kiel, Germany; (A.K.); (W.K.)
| | - Marc Höppner
- Institute of Clinical Molecular Biology, School of Medicine, Christian-Albrechts-University, 24105 Kiel, Germany;
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University, 24105 Kiel, Germany; (J.T.); (D.F.); (C.G.); (C.D.)
| | - Christof Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University, 24105 Kiel, Germany; (J.T.); (D.F.); (C.G.); (C.D.)
| | - Dominik M. Schulte
- Institute of Diabetes and Clinical Metabolic Research, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (K.S.); (D.M.S.)
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine I, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
| | - Karim Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University, 24105 Kiel, Germany; (J.T.); (D.F.); (C.G.); (C.D.)
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo 12613, Egypt
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Hahn T, Christofzik DW, Fawzy El-Sayed K, Freitag-Wolf S, Conrad J, Graetz C, Größner-Schreiber B, Dörfer C. Effect of operators' proficiency level and patients' related factors on possible complications, using a high frequency polyamide sonic intracanal irrigation device: A prospective clinical cohort study. PLoS One 2023; 18:e0285492. [PMID: 37141251 PMCID: PMC10159143 DOI: 10.1371/journal.pone.0285492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
OBJECTIVES Sonic/ultrasonic devices are essential tools in today's endodontics. This prospective trial evaluated for the first time the impact of practitioners' proficiency levels and patient-related factors on complications associated with a high frequency polyamide sonic irrigant activation device. METHODS In total 334 patients (females:158, males:176; age:18-95 years) received in the course of their endodontic therapy an intracanal irrigation, using a high frequency polyamide sonic irrigant activation device, by practitioners of different proficiency levels (undergraduate students, general practitioners or endodontists). Intracanal bleeding (yes/no), postoperative pain (0-10 scale), emphysema (yes/no) and polyamide tip fractures (yes/no) were recorded and related to proficiency levels, age, gender, tooth type, smoking-status, systemic conditions affecting healing ability, baseline pain, swelling, fistula, sensitivity to percussion and diagnosis. RESULTS Intracanal bleeding was associated with patients' age (p<0.05), baseline pain level (OR = 1.14, 95%CI = 0.91-1.22) and baseline swelling (OR = 2.73, 95%CI = 0.14-0.99; p<0.05) but not proficiency level, gender, tooth type, smoking, systemic conditions, baseline fistula or sensitivity to percussion (p>0.05). Postoperative pain development was related to proficiency level (p<0.05) and baseline pain level (p<0.001), with no influence of age, gender, tooth type, smoking, systemic conditions, baseline fistula, swelling or sensitivity to percussion (p>0.05). Emphysema and polyamide tip fractures were not reported. CONCLUSIONS Within the current study's limitations, younger patients with higher baseline pain and swelling, were associated with higher intracanal bleeding. Apart from higher postoperative pain observed with less experienced practitioners, proficiency level had no influence on bleeding, polyamide tip fracture or emphysema, endorsing the high frequency polyamide sonic irrigation device as a safe therapeutic device.
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Affiliation(s)
- Tobias Hahn
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - David W Christofzik
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Karim Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
- Faculty of Oral and Dental Medicine, Oral Medicine and Periodontology Department, Cairo University, Cairo, Egypt
| | - Sandra Freitag-Wolf
- Institute of Medical Informatics and Statistics, Christian-Albrechts-University of Kiel, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Jonas Conrad
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Birte Größner-Schreiber
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christof Dörfer
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
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Graetz C, Ehrenthal JC, Kowalski R, Cyris M, Geiken A, Dörfer CE. Periodontal maintenance: individual patient responses and discontinuations. BMC Oral Health 2022; 22:610. [DOI: 10.1186/s12903-022-02655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/08/2022] [Indexed: 12/16/2022] Open
Abstract
Abstract
Aim
There is a lack of data on long-term impact of different psychological variables on periodontitis. Aim of the current study was to investigate the impact of psychological factors in patients with chronic periodontitis (CP; according to the 1999 Classification of Periodontal Diseases) to explain adherence to or discontinuation of supportive periodontal therapy (SPT) in a university setting.
Methods
A sample of n = 119 patients were examined in a questionnaire-based, cross-sectional survey. All patients had received active periodontal treatment (APT) and were reevaluated in a university setting (Kiel) before 2016 [T1: start SPT]. Patients who showed sufficient adherence to SPT of ≥ 2 years (maximum ± 6 months of deviation between SPT intervals, last visit and questionnaire at T2) were assigned to the adherence group (AG: n = 58), or, if they interrupted SPT or stopped treatment altogether, to the non-adherence group (NAG: n = 61). In addition to dental parameters, we assessed socio-demographic, treatment-related (critical attitudes/complaints), dental as well as psychological variables (especially psychological attachment, but also dental fear, patient participation style, personality functioning) and examined between-group differences as well as possible mediating factors of non-adherence to treatment continuation.
Results
For both groups we found similar average observation time (NAG/AG: 15.9(8.9)/14.9(10.6)years). There were significant differences in age, critical attitudes, dental fear, and patient participation style between the groups. With the help of exploratory sequential mediation models, we found a significant indirect pathway of the impact of attachment anxiety on discontinuation of treatment mediated through dental fear and number of critical attitudes/complaints.
Conclusion
Considering the limitations, dentists should be aware of personality-related risk-factors such as attachment anxiety as well as their interplay with levels of dental fear and critical attitudes which may influence adherence to SPT.
Trial registration: The clinical trial was retrospectively registered in the DRKS—German Clinical Trials Register (https://www.drks.de) with registration DRKS00030092 (26/08/2022).
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Graetz C, Härdter AK, Schorr S, Cyris M, Geiken A, Rinder T, Dörfer CE, Sälzer S. The influence of artificial saliva on the cleaning force of interdental rubber picks: an in-vitro comparison. BMC Oral Health 2022; 22:459. [PMID: 36320016 PMCID: PMC9624009 DOI: 10.1186/s12903-022-02479-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The familiar aids for interdental cleaning such as dental floss or interdental brushes (IDB) are often associated with difficult handling or an increased potential for trauma. Interdental picks (IRP), which have no metal core and silicone flaps instead of nylon brushes, offer the alternative. However, in-vitro studies found a lower cleaning effectiveness combined with higher forces for cleaning compared with conventional IDBs. The aim of this in-vitro study was to measure the experimental cleaning forces (ECF) using IRP with versus without an artificial saliva (AS; GUM Hydral, Sunstar Suisse SA, Etoy, Switzerland). METHODS The test set-up was developed to investigate the cleaning of 3D-printed interdental area (IDR) mimicking human teeth (Form 2, Formlabs Sommerville, MA, USA) under standardized conditions. Three different morphologies (isosceles triangle, convex, concave) and three different sizes (1.0 mm,1.1 mm,1.3 mm) were used. Two different IRPs (GUM Soft-picks Advanced: SPA versus GUM Soft-picks Advanced Plus: SPA+, Sunstar Suisse SA, Etoy, Switzerland) in three sizes (small, regular, large), were used with versus without AS. ECF during ten cleaning cycles were recorded by a load cell [N]. RESULTS Using AS leaded to significant lower values for ECF than without (1.04 ± 0.66 N versus 1.97 ± 1.01 N, p < 0.001). In general, a lower ECF was recorded for convex IDR compared to isosceles triangle and concave morphologies (p < 0.001) as well as for gap sizes of 1.3 mm compared to the smaller sizes (p < 0.001). For SPA+ we found significantly higher force values than for SPA (1.67 ± 0.93 N versus 1.31 ± 0.97 N, p < 0.001) independent of the use of AS. CONCLUSION Within the study´s in-vitro limitations, we found AS reduced ECF of IRPs by half and allowed using larger diameters interdentally, which could be associated with (1) a higher cleaning effectiveness and (2) a higher acceptance e.g. of patients with dry mouth. This has to be confirmed by further clinical investigations.
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Affiliation(s)
- Christian Graetz
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Ann-Kristin Härdter
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Susanne Schorr
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Miriam Cyris
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Antje Geiken
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Thomas Rinder
- grid.440947.a0000 0001 0671 1995Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E. Dörfer
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Sonja Sälzer
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
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10
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Kocher T, Holtfreter B, Priess HW, Graetz C, Jablonowski L, Grabe HJ, Völzke H, Raedel M, Walter MH. Tooth loss in periodontally treated patients: A registry- and observation-based analysis. J Clin Periodontol 2022; 49:749-757. [PMID: 35634709 DOI: 10.1111/jcpe.13668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/03/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Abstract
AIM According to retrospective clinical studies, periodontal treatment retains teeth. However, evidence on the effectivity of periodontal treatment stemming from the general population is lacking. MATERIALS AND METHODS We analysed data of periodontally treated patients from routine data of a major German national health insurance (BARMER-MV; sub-sample of the Federal State of Mecklenburg-Vorpommern) and from a clinical cohort (Greifswald Approach to Individualized Medicine, GANI_MED), as well as periodontally untreated and treated participants of the Study of Health in Pomerania (SHIP-TREND) with either ≥2 or ≥4 teeth with pocket depths ≥4 mm. Yearly tooth loss (YTL) estimates and incidence rates were evaluated. RESULTS For moderately to severely affected groups, YTL and incidence rates were higher in BARMER-MV patients (0.35 and 0.18, respectively) than in untreated SHIP-TREND controls (0.19 and 0.08, respectively). In line, treated SHIP-TREND participants exhibited higher YTL rates than untreated SHIP-TREND controls (0.26 vs. 0.19). For severely affected groups, results with respect to tooth loss were inconclusive regarding the beneficial effects of periodontal treatment conducted either in the university (GANI_MED data) or in the general practice. CONCLUSION Until 2021, periodontal treatment performed in German general dental practices within the national health insurance system was probably not efficient in retaining more teeth in the short- to mid-term. Since reimbursement schemes were changed in 2021 and now cover periodontal treatment to a much larger extent, the future will show whether these new reimbursement codes will improve the quality of periodontal treatment and whether they will lead to more long-term tooth retainment.
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Affiliation(s)
- Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Heinz-Werner Priess
- AGENON, Gesellschaft für Forschung und Entwicklung im Gesundheitswesen, Berlin, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Lukasz Jablonowski
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Michael Raedel
- Prosthodontics, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Michael H Walter
- Prosthodontics, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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11
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Mewes L, Knappe C, Graetz C, Wagner J, Demetrowitsch TJ, Jensen-Kroll J, Mohamed Fawzy El-Sayed K, Schwarz K, Dörfer CE, Schreiber S, Laudes M, Schulte DM. Vitamin C and Omega-3 Fatty Acid Intake Is Associated with Human Periodontitis-A Nested Case-Control Study. Nutrients 2022; 14:1939. [PMID: 35565905 PMCID: PMC9101799 DOI: 10.3390/nu14091939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/22/2022] Open
Abstract
Vitamins and omega-3 fatty acids (Ω3FA) modulate periodontitis-associated inflammatory processes. The aim of the current investigation was to evaluate associations of oral nutrient intake and corresponding serum metabolites with clinical severity of human periodontitis. Within the Food Chain Plus cohort, 373 periodontitis patients—245 without (POL) and 128 with tooth loss (PWL)—were matched to 373 controls based on sex, smoking habit, age and body mass index in a nested case-control design. The amount of oral intake of vitamins and Ω3FAs was assessed from nutritional data using a Food Frequency Questionnaire. Oral intake and circulatory bioavailability of vitamins and Ω3FA serum metabolomics were compared, using ultra-high-resolution mass spectrometry. Periodontitis patients exhibited a significantly higher oral intake of vitamin C and Ω3FA Docosapentaenoic acid (p < 0.05) compared to controls. Nutritional intake of vitamin C was higher in PWL, while the intake of Docosapentaenoic acid was increased in POL (p < 0.05) compared to controls. In accordance, serum levels of Docosapentaenoic acid were also increased in POL (p < 0.01) compared to controls. Vitamin C and the Ω3FA Docosapentaenoic acid might play a role in the pathophysiology of human periodontitis. Further studies on individualized nutritional intake and periodontitis progression and therapy are necessary.
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Affiliation(s)
- Louisa Mewes
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, 24105 Kiel, Germany; (L.M.); (C.G.); (K.M.F.E.-S.); (C.E.D.)
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14197 Berlin, Germany
| | - Carina Knappe
- Institute of Diabetes and Clinical Metabolic Research, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (C.K.); (M.L.)
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, Kiel University, 24105 Kiel, Germany; (J.W.); (S.S.)
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, 24105 Kiel, Germany; (L.M.); (C.G.); (K.M.F.E.-S.); (C.E.D.)
| | - Juliane Wagner
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, Kiel University, 24105 Kiel, Germany; (J.W.); (S.S.)
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Tobias J. Demetrowitsch
- Department of Food Technology, Institute for Human Nutrition & Food Science, Kiel University, 24118 Kiel, Germany; (T.J.D.); (J.J.-K.); (K.S.)
| | - Julia Jensen-Kroll
- Department of Food Technology, Institute for Human Nutrition & Food Science, Kiel University, 24118 Kiel, Germany; (T.J.D.); (J.J.-K.); (K.S.)
| | - Karim Mohamed Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, 24105 Kiel, Germany; (L.M.); (C.G.); (K.M.F.E.-S.); (C.E.D.)
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Giza 12613, Egypt
| | - Karin Schwarz
- Department of Food Technology, Institute for Human Nutrition & Food Science, Kiel University, 24118 Kiel, Germany; (T.J.D.); (J.J.-K.); (K.S.)
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, 24105 Kiel, Germany; (L.M.); (C.G.); (K.M.F.E.-S.); (C.E.D.)
| | - Stefan Schreiber
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, Kiel University, 24105 Kiel, Germany; (J.W.); (S.S.)
- Department of Internal Medicine I, Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
| | - Matthias Laudes
- Institute of Diabetes and Clinical Metabolic Research, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (C.K.); (M.L.)
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, Kiel University, 24105 Kiel, Germany; (J.W.); (S.S.)
- Department of Internal Medicine I, Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
| | - Dominik M. Schulte
- Institute of Diabetes and Clinical Metabolic Research, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; (C.K.); (M.L.)
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, Kiel University, 24105 Kiel, Germany; (J.W.); (S.S.)
- Department of Internal Medicine I, Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
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12
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Geiken A, Holtmann L, Splieth CH, Conrad J, Doerfer CE, Graetz C. Are the Dental Guidelines for Early Dental Visits and Fluoridation Measures Supported by Pediatricians, and What Are Their Caries Prevention Efforts? J Clin Med 2022; 11:jcm11051159. [PMID: 35268250 PMCID: PMC8911210 DOI: 10.3390/jcm11051159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/11/2022] [Accepted: 02/19/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: In Germany, new recommendations for dental examinations of children and the use of fluorides have been introduced. The pediatrician (PA) should refer the patient to the dentist for dental examinations and check-ups (DEs) from the sixth month of age. Therefore, our aim was to determine with a questionnaire the extent to which PAs find DE useful, make referrals for DE and recommend fluoride. (2) Methods: The nationwide empirical survey was conducted with a self-developed and validated standardized online questionnaire. In addition to personal information, 16 items were collected. Agreement with the items was recorded using Likert scales. The data were primarily analysed descriptively. (3) Results: 696 PAs participated in the survey (age: 51.7 (8.4) years, women/men: 428/286 (61.5/38.5%). A total of 11% of PAs found referral by eruption of first tooth very important (important/neutral/unimportant: 13.8/32/43.2%), compared to 70% for complete deciduous teeth (21.3/7.3/1.4%). A total of 48.8% of PAs always recommended fluoridated toothpaste from the first tooth (often/occasionally/rarely/never: 18.3/7.8/8/17.1%) and 50.6% completely refused to recommend fluoride-free toothpaste (always/often/occasionally/rarely: 9.8/9/14.7/15.9%). A total of 44.8% never recommended the use of fluoridated toothpaste if the child cannot yet spit (always/often/occasionally/rarely: 19.2/13.9/7.8/14.3%). (4) Conclusions: Among PAs, referral to DEs was increasingly implemented as children grew older. Specific fluoride recommendations were accepted.
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Affiliation(s)
- Antje Geiken
- Clinic for Conservative Dentistry and Periodontology, University Schleswig-Holstein, 24105 Kiel, Germany; (L.H.); (J.C.); (C.E.D.); (C.G.)
- Correspondence: ; Tel.: +49-431-500-262-65
| | - Louise Holtmann
- Clinic for Conservative Dentistry and Periodontology, University Schleswig-Holstein, 24105 Kiel, Germany; (L.H.); (J.C.); (C.E.D.); (C.G.)
| | - Christian H. Splieth
- Department of Preventive and Pediatric Dentistry, University Greifswald, 17475 Greifswald, Germany;
| | - Jonas Conrad
- Clinic for Conservative Dentistry and Periodontology, University Schleswig-Holstein, 24105 Kiel, Germany; (L.H.); (J.C.); (C.E.D.); (C.G.)
| | - Christof E. Doerfer
- Clinic for Conservative Dentistry and Periodontology, University Schleswig-Holstein, 24105 Kiel, Germany; (L.H.); (J.C.); (C.E.D.); (C.G.)
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, University Schleswig-Holstein, 24105 Kiel, Germany; (L.H.); (J.C.); (C.E.D.); (C.G.)
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13
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Fawzy El-Sayed KM, Bittner A, Schlicht K, Mekhemar M, Enthammer K, Höppner M, Es-Souni M, Schulz J, Laudes M, Graetz C, Dörfer CE, Schulte DM. Ascorbic Acid/Retinol and/or Inflammatory Stimuli's Effect on Proliferation/Differentiation Properties and Transcriptomics of Gingival Stem/Progenitor Cells. Cells 2021; 10:cells10123310. [PMID: 34943818 PMCID: PMC8699152 DOI: 10.3390/cells10123310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
The present study explored the effects of ascorbic-acid (AA)/retinol and timed inflammation on the stemness, the regenerative potential, and the transcriptomics profile of gingival mesenchymal stem/progenitor cells' (G-MSCs). STRO-1 (mesenchymal stem cell marker) immuno-magnetically sorted G-MSCs were cultured in basic medium (control group), in basic medium with IL-1β (1 ng/mL), TNF-α (10 ng/mL) and IFN-γ (100 ng/mL, inflammatory-medium), in basic medium with AA (250 µmol/L) and retinol (20 µmol/L) (AA/retinol group) or in inflammatory medium with AA/retinol (inflammatory/AA/retinol group; n = 5/group). The intracellular levels of phosphorylated and total β-Catenin at 1 h, the expression of stemness genes over 7 days, the number of colony-forming units (CFUs) as well as the cellular proliferation aptitude over 14 days, and the G-MSCs' multilineage differentiation potential were assessed. Next-generation sequencing was undertaken to elaborate on up-/downregulated genes and altered intracellular pathways. G-MSCs demonstrated all mesenchymal stem/progenitor cells characteristics. Controlled inflammation with AA/retinol significantly elevated NANOG (p < 0.05). The AA/retinol-mediated reduction in intracellular phosphorylated β-Catenin was restored through the effect of controlled inflammation (p < 0.05). Cellular proliferation was highest in the AA/retinol group (p < 0.05). AA/retinol counteracted the inflammation-mediated reduction in G-MSCs' clonogenic ability and CFUs. Amplified chondrogenic differentiation was observed in the inflammatory/AA/retinol group. At 1 and 3 days, the differentially expressed genes were associated with development, proliferation, and migration (FOS, EGR1, SGK1, CXCL5, SIPA1L2, TFPI2, KRATP1-5), survival (EGR1, SGK1, TMEM132A), differentiation and mineral absorption (FOS, EGR1, MT1E, KRTAP1-5, ASNS, PSAT1), inflammation and MHC-II antigen processing (PER1, CTSS, CD74) and intracellular pathway activation (FKBP5, ZNF404). Less as well as more genes were activated the longer the G-MSCs remained in the inflammatory medium or AA/retinol, respectively. Combined, current results point at possibly interesting interactions between controlled inflammation or AA/retinol affecting stemness, proliferation, and differentiation attributes of G-MSCs.
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Affiliation(s)
- Karim M. Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany; (A.B.); (M.M.); (C.G.); (C.E.D.)
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo 11553, Egypt
- Stem cells and Tissue Engineering Unit, Faculty of Dentistry, Cairo University, Cairo 11553, Egypt
- Correspondence:
| | - Amira Bittner
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany; (A.B.); (M.M.); (C.G.); (C.E.D.)
| | - Kristina Schlicht
- Institute of Diabetes and Clinical Metabolic Research, School of Medicine, Christian-Albrechts-University of Kiel, 24104 Kiel, Germany; (K.S.); (K.E.); (J.S.); (M.L.); (D.M.S.)
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine I, School of Medicine, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany
| | - Mohamed Mekhemar
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany; (A.B.); (M.M.); (C.G.); (C.E.D.)
| | - Kim Enthammer
- Institute of Diabetes and Clinical Metabolic Research, School of Medicine, Christian-Albrechts-University of Kiel, 24104 Kiel, Germany; (K.S.); (K.E.); (J.S.); (M.L.); (D.M.S.)
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine I, School of Medicine, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany
| | - Marc Höppner
- Institute of Clinical Molecular Biology, School of Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany;
| | - Martha Es-Souni
- Department of Orthodontics, School of Dental Medicine, University Clinic Schleswig-Holstein (UKSH), Christian-Albrechts University of Kiel, 24105 Kiel, Germany;
| | - Juliane Schulz
- Institute of Diabetes and Clinical Metabolic Research, School of Medicine, Christian-Albrechts-University of Kiel, 24104 Kiel, Germany; (K.S.); (K.E.); (J.S.); (M.L.); (D.M.S.)
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine I, School of Medicine, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, School of Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany
| | - Matthias Laudes
- Institute of Diabetes and Clinical Metabolic Research, School of Medicine, Christian-Albrechts-University of Kiel, 24104 Kiel, Germany; (K.S.); (K.E.); (J.S.); (M.L.); (D.M.S.)
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine I, School of Medicine, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, School of Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany; (A.B.); (M.M.); (C.G.); (C.E.D.)
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany; (A.B.); (M.M.); (C.G.); (C.E.D.)
| | - Dominik M. Schulte
- Institute of Diabetes and Clinical Metabolic Research, School of Medicine, Christian-Albrechts-University of Kiel, 24104 Kiel, Germany; (K.S.); (K.E.); (J.S.); (M.L.); (D.M.S.)
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine I, School of Medicine, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany
- Cluster of Excellence, Precision Medicine in Chronic Inflammation, School of Medicine, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany
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14
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Richter GM, Kruppa J, Keceli HG, Ataman-Duruel ET, Graetz C, Pischon N, Wagner G, Rendenbach C, Jockel-Schneider Y, Martins O, Bruckmann C, Staufenbiel I, Franke A, Nohutcu RM, Jepsen S, Dommisch H, Schaefer AS. Epigenetic adaptations of the masticatory mucosa to periodontal inflammation. Clin Epigenetics 2021; 13:203. [PMID: 34732256 PMCID: PMC8567676 DOI: 10.1186/s13148-021-01190-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/25/2021] [Indexed: 12/13/2022] Open
Abstract
Background In mucosal barrier interfaces, flexible responses of gene expression to long-term environmental changes allow adaptation and fine-tuning for the balance of host defense and uncontrolled not-resolving inflammation. Epigenetic modifications of the chromatin confer plasticity to the genetic information and give insight into how tissues use the genetic information to adapt to environmental factors. The oral mucosa is particularly exposed to environmental stressors such as a variable microbiota. Likewise, persistent oral inflammation is the most important intrinsic risk factor for the oral inflammatory disease periodontitis and has strong potential to alter DNA-methylation patterns. The aim of the current study was to identify epigenetic changes of the oral masticatory mucosa in response to long-term inflammation that resulted in periodontitis. Methods and results Genome-wide CpG methylation of both inflamed and clinically uninflamed solid gingival tissue biopsies of 60 periodontitis cases was analyzed using the Infinium MethylationEPIC BeadChip. We validated and performed cell-type deconvolution for infiltrated immune cells using the EpiDish algorithm. Effect sizes of DMPs in gingival epithelial and fibroblast cells were estimated and adjusted for confounding factors using our recently developed “intercept-method”. In the current EWAS, we identified various genes that showed significantly different methylation between periodontitis-inflamed and uninflamed oral mucosa in periodontitis patients. The strongest differences were observed for genes with roles in wound healing (ROBO2, PTP4A3), cell adhesion (LPXN) and innate immune response (CCL26, DNAJC1, BPI). Enrichment analyses implied a role of epigenetic changes for vesicle trafficking gene sets. Conclusions Our results imply specific adaptations of the oral mucosa to a persistent inflammatory environment that involve wound repair, barrier integrity, and innate immune defense. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01190-7.
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Affiliation(s)
- Gesa M Richter
- Department of Periodontology and Synoptic Dentistry, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Jochen Kruppa
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - H Gencay Keceli
- Periodontology Department, Faculty of Dentistry, Hacettepe University, 06230, Sihhiye/Altindag/Ankara, Turkey
| | - Emel Tuğba Ataman-Duruel
- Periodontology Department, Faculty of Dentistry, Hacettepe University, 06230, Sihhiye/Altindag/Ankara, Turkey
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Nicole Pischon
- Private Practice, Karl-Marx-Straße 24, 12529, Schönefeld, Germany
| | - Gunar Wagner
- Department of Restorative Dentistry and Periodontology, University Medical Center Leipzig, 04103, Leipzig, Germany
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Yvonne Jockel-Schneider
- Department of Periodontology, Clinic of Preventive Dentistry and Periodontology, University Medical Center of the Julius-Maximilians-University, Pleicherwall, 97070, Würzburg, Germany
| | - Orlando Martins
- Institute of Periodontology, Institute of Medicine and Oral Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Corinna Bruckmann
- Department of Conservative Dentistry and Periodontology, Medical University Vienna, School of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | - Ingmar Staufenbiel
- Department of Conservative Dentistry, Periodontology & Preventive Dentistry, School of Dentistry, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Rosalind-Franklin-Straße 12, 24105, Kiel, Germany
| | - Rahime M Nohutcu
- Periodontology Department, Faculty of Dentistry, Hacettepe University, 06230, Sihhiye/Altindag/Ankara, Turkey
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstraße 17, 53111, Bonn, Germany
| | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Arne S Schaefer
- Department of Periodontology and Synoptic Dentistry, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
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Freitag-Wolf S, Munz M, Junge O, Graetz C, Jockel-Schneider Y, Staufenbiel I, Bruckmann C, Lieb W, Franke A, Loos BG, Jepsen S, Dommisch H, Schaefer AS. Sex-specific genetic factors affect the risk of early-onset periodontitis in Europeans. J Clin Periodontol 2021; 48:1404-1413. [PMID: 34409643 DOI: 10.1111/jcpe.13538] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/03/2021] [Indexed: 12/21/2022]
Abstract
AIMS Various studies have reported that young European women are more likely to develop early-onset periodontitis compared to men. A potential explanation for the observed variations in sex and age of disease onset is the natural genetic variation within the autosomal genomes. We hypothesized that genotype-by-sex (G × S) interactions contribute to the increased prevalence and severity. MATERIALS AND METHODS Using the case-only design, we tested for differences in genetic effects between men and women in 896 North-West European early-onset cases, using imputed genotypes from the OmniExpress genotyping array. Population-representative 6823 controls were used to verify that the interacting variables G and S were uncorrelated in the general population. RESULTS In total, 20 loci indicated G × S associations (P < 0.0005), 3 of which were previously suggested as risk genes for periodontitis (ABLIM2, CDH13, and NELL1). We also found independent G × S interactions of the related gene paralogs MACROD1/FLRT1 (chr11) and MACROD2/FLRT3 (chr20). G × S-associated SNPs at CPEB4, CDH13, MACROD1, and MECOM were genome-wide-associated with heel bone mineral density (CPEB4, MECOM), waist-to-hip ratio (CPEB4, MACROD1), and blood pressure (CPEB4, CDH13). CONCLUSIONS Our results indicate that natural genetic variation affects the different heritability of periodontitis among sexes and suggest genes that contribute to inter-sex phenotypic variation in early-onset periodontitis.
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Affiliation(s)
- Sandra Freitag-Wolf
- Institute of Medical Informatics and Statistics, Kiel University, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Matthias Munz
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Dental and Craniofacial Sciences, Berlin, Germany
| | - Olaf Junge
- Institute of Medical Informatics and Statistics, Kiel University, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Christian Graetz
- Department of Conservative Dentistry, Unit of Periodontology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Yvonne Jockel-Schneider
- Department of Periodontology, Clinic of Preventive Dentistry and Periodontology, University Medical Center of the Julius-Maximilians-University, Würzburg, Germany
| | - Ingmar Staufenbiel
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - Corinna Bruckmann
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Medical University Vienna, Vienna, Austria
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian-Albrechts University, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts University, Kiel, Germany
| | - Bruno G Loos
- Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Dental and Craniofacial Sciences, Berlin, Germany
| | - Arne S Schaefer
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Dental and Craniofacial Sciences, Berlin, Germany
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Seidel M, Borenius H, Schorr S, Christofzik D, Graetz C. Results of an experimental study of subgingival cleaning effectiveness in the furcation area. BMC Oral Health 2021; 21:381. [PMID: 34340674 PMCID: PMC8327450 DOI: 10.1186/s12903-021-01736-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sufficient biofilm removal in the furcation area (FA) is a major challenge in the clinical practice of supportive periodontal therapy. The aim of the present experimental study was to simulate subgingival cleaning of the FA using a powered scaler (sonic scaler (AIR), ultrasonic scaler (US)) for conventional mechanical debridement versus two air polishing with nonabrasive powder (LAPA-1: glycine powder, LAPA-2: erythritol powder) and different nozzles for supra-/subgingival cleaning for each device. METHODS Seven trained and calibrated operators with ≥ 2 years each of professional experience in treating periodontitis used the instruments to clean 3D-printed replicas of six molars with through-and-through FA (four 3-rooted and two 2-rooted teeth) in a manikin head. AIR and US were used in the control group; air polishing instruments were used in the test group. For reproducible evaluation, the test teeth were separated vertically into two or three parts, illuminated with ultraviolet light, photographed and evaluated planimetrically. Treatment time (TrT, in s) and relative cleaning efficacy (RCE, in %) were measured. RESULTS Overall, 3-rooted molars (RCE in the entire FA, 23.19 ± 20.98%) could be cleaned significantly less effectively than 2-rooted molars (53.04 ± 28.45%, p < 0.001), regardless of the instrument used. In the cleaning of the entire FA, significantly higher RCE values were achieved with conventional mechanical debridement (AIR/US: 46.04 ± 25.96%/39.63 ± 22.02%; AIR vs. US: p > 0.05) than with air polishing (LAPA-1/LAPA-2: 34.06 ± 29.48%/17.09 ± 18.85%; LAPA-1 vs. LAPA-2: p < 0.001) regardless of whether a supra- or subgingival cleaning nozzle used (p < 0.001). Only LAPA-1 with a subgingival nozzle showed RCE values comparable to those of US (41.07 ± 28.95% vs. 39.63 ± 22.02%, p > 0.05). TrT was longest for US (299.40 ± 120.69 s) and shortest for LAPA-1 with a supragingival nozzle (129.67 ± 60.92 s, p < 0.001). CONCLUSIONS All of the examined instruments were effective to some degree in removing the simulated biofilm from the FA, but they differed substantially in cleaning efficacy. Only one air polishing device (LAPA-1) with a rigid subgingival nozzle was able to achieve RCE values similar to those of US. The current investigation confirmed that conventional mechanical debridement with powered scalers were most effective, but treatment took longer with these devices than air polishing.
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Affiliation(s)
- Miriam Seidel
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
| | - Hannah Borenius
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
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Heimes D, Müller LK, Schellin A, Naujokat H, Graetz C, Schwendicke F, Goedecke M, Beck-Broichsitter B, Kämmerer PW. Consequences of the COVID-19 Pandemic and Governmental Containment Policies on the Detection and Therapy of Oral Malignant Lesions-A Retrospective, Multicenter Cohort Study from Germany. Cancers (Basel) 2021; 13:cancers13122892. [PMID: 34207863 PMCID: PMC8227890 DOI: 10.3390/cancers13122892] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Due to the COVID-19 pandemic, the oncology community was challenged with the need to protect a vulnerable population from a potentially fatal infection without jeopardizing cancer treatments. The impact of the crisis on the medical care of patients with oral cancer is largely unexplored. This multicenter cohort study from Germany aims to assess the consequences of the COVID-19 pandemic by comparing the healthcare of patients during the lockdown and post-lockdown periods in 2020 with the corresponding periods in 2018/19. We found the closure of dental practices during lockdown to possibly delay the diagnosis of oral cancer. Even if during this period no higher incidence of oral cancer was observed, data point to potentially fatal consequences for longer periods of treatment delay. Abstract (1) Background: In response to the global COVID-19 pandemic, governmental measures have been undertaken. The impact of the crisis on the healthcare of patients with cancer is largely unexplored. This multicenter cohort study aimed to investigate a potential screening delay and its consequences in patients with oral cancer (OC) during the pandemic. (2) Material and Methods: Data of patients who were first diagnosed with OC during different periods were collected, especially in terms of OC incidence, tumor stage/entity and time to intervention. The periods lockdown (LD) (13 March–16 June 2020), post-lockdown (PLD) (17 June–1 November 2020), and the corresponding equivalents in 2018/19 were differentiated and compared. (3) Results: There was no obvious trend towards a higher incidence of OC or higher tumor stages, whereas a trend towards a shorter time to intervention during the LD2020 could be observed. Subgroup analyses revealed an increased incidence in OC within the PLD2020 in Mainz, which might be explained by the partial closure of dental practices in this federal state during LD. (4) Conclusions: While there was no overall higher incidence of OC, we found closure of practices during LD to possibly delay cancer diagnosis. Therefore, measures must be taken to identify patients at risk and to ensure basic healthcare, especially in the context of dental screening measures.
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Affiliation(s)
- Diana Heimes
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (L.K.M.); (P.W.K.)
- Correspondence: ; Tel.: +49-6131-17-5086
| | - Lena Katharina Müller
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (L.K.M.); (P.W.K.)
| | - Alexandra Schellin
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany; (A.S.); (H.N.)
| | - Hendrik Naujokat
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany; (A.S.); (H.N.)
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany;
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité University of Berlin, 10117 Berlin, Germany;
| | - Maximilian Goedecke
- Department of Oral- and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (M.G.); (B.B.-B.)
| | - Benedicta Beck-Broichsitter
- Department of Oral- and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (M.G.); (B.B.-B.)
| | - Peer W. Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (L.K.M.); (P.W.K.)
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Graetz C, Schoepke K, Rabe J, Schorr S, Geiken A, Christofzik D, Rinder T, Dörfer CE, Sälzer S. In vitro comparison of cleaning efficacy and force of cylindric interdental brush versus an interdental rubber pick. BMC Oral Health 2021; 21:194. [PMID: 33853594 PMCID: PMC8048228 DOI: 10.1186/s12903-021-01558-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Interdental brushes (IDB) are according to the actual evidence the first choice for cleaning interdental areas (IDR). Their size should be chosen individually according to the IDR morphology. However, interdental rubber picks (IRP) are appreciated better by the patients and are hence becoming more and more popular but the evidence regarding their efficacy is still limited. The aim of this in vitro study was to measure the experimental cleaning efficacy (ECE) and force (ECF) during the use of interdental brushes versus newer wireless types with rubber filaments (IRP), both fitted and non-fitted for different IDR. METHODS The medium size of a conical IRP (regular, ISO 2) with elastomeric fingers versus four sizes (ISO 1, 2, 3, 4) of cylindric IDB with nylon filaments (all Sunstar Suisse SA, Etoy, Switzerland) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to three different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at IDR (standardized, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. RESULTS Overall, a higher ECE was recorded for IDB compared to IRP (58.3 ± 14.9% versus 18.4 ± 10.1%; p < 0.001). ECE significantly depended on the fitting of the IDB. ECE was significant higher in isosceles triangle compared to concave and convex IDR for both IDB and IRP (p ≤ 0.001). ECF was lower for IDB (0.6 ± 0.4N) compared to IRP (0.8 ± 0.5N; p ≤ 0.001). ECE in relation to ECF increases with smaller IDB. For IRP highest values of ECF were found in the smallest IDR. CONCLUSIONS Within the limitations of an in vitro study, size fitted IDB cleaned more effectively at lower forces compared to conical IRP.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Kristina Schoepke
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Johanna Rabe
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Graetz C, Woeste S, Mrowietz U, Ehrenthal JC. The impact of psychological attachment on the relationship between periodontal health and dental fear in patients with versus without psoriasis: a questionnaire-based, cross-sectional study. BMC Oral Health 2021; 21:95. [PMID: 33663457 PMCID: PMC7934537 DOI: 10.1186/s12903-021-01457-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 02/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background While there is increasing evidence for the relevance of psychosocial variables such as dental fear or psychological attachment in dentistry, much less is known about the mechanisms that determine the strength of those associations. One potential moderator is the occurrence of a comorbid chronic disease such as psoriasis, which is linked to relevant disease parameters such as periodontal inflammation. The aim of the study was to test a moderation model of the relationship between dental fear, psychological attachment and psoriasis on periodontal health. Methods A total of 201 patients (100 with psoriasis, 101 without psoriasis) were included in a questionnaire-based, cross-sectional study. Dental status was measured with the Community Periodontal Index (CPI), dental fear was measured with the Hierarchical Anxiety Questionnaire (HAQ), and psychological attachment was measured with the Relationship Questionnaire (RQ). In addition to the examination of main effects, bootstrapping-based analyses were conducted to test the moderating influence of psychological attachment on the association between CPI and dental fear, gain moderated by group (with vs. without psoriasis). Results Controlling for several covariates, higher CPI scores were associated with higher levels of dental fear only in individuals without psoriasis under conditions of higher levels of psychological attachment anxiety and lower levels of attachment avoidance. Conclusion In individuals without psoriasis, psychological attachment can moderate the association between periodontal health and dental fear. This may provide a useful framework for reducing dental fear through interventions on the level of the dentist-patient relationship.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Sirka Woeste
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Ullrich Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus, Kiel, Germany
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Seidel M, Sutor S, Conrad J, Engel AS, Geiken A, Sälzer S, Graetz C. Influence of motivation and a new digitized training program on undergraduate dental students during preclinical scaling training. BMC Oral Health 2020; 20:346. [PMID: 33256683 PMCID: PMC7706025 DOI: 10.1186/s12903-020-01343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current study evaluated whether a new digitized scaling training program (DTP: n = 30; supervisor-student-ratio 1:10) improves the performance of undergraduate dental student during a preclinical course in regard to two different instruments [sonic scalers (AIR) and Gracey curettes (GRA)] compared to a conventional training program (CTP: n = 19; supervisor-student-ratio 1:4). METHODS All the participants received a two-hour lecture on both instruments, followed by a 12-week period with a weekly training program lasting 45 min (10 sessions); one group was supported by DTP. At the end of the training phase, all the participants performed the subgingival scaling of six equivalent test teeth using GRA and AIR. Treatment time, proportion of removed simulated biofilm (relative cleaning efficacy, RCE-b) and hard deposits (RCE-d) were recorded. By using a pseudonymized questionnaire with a 5-point Likert scale, self-assessment of scaling effort, handling, root surface roughness/destruction and effectiveness were evaluated. In addition, personal data such as age, gender, handedness, regularity of playing computer games/consoles and previous dental/technical or medical education were elevated and correlated with cleaning efficacy. RESULTS The DTP participants showed higher effectiveness in RCE-b compared to those who used the CTP with GRA (71.54% vs. 67.23%, p = 0.004) and AIR (71.75% vs. 62.63%, p ≤ 0.001), and the DTP students were faster with both instruments (p ≤ 0.001). For RCE-d, there was no significant difference between the DTP and CTP groups (GRA p = 0.471; AIR p = 0.158), whereas DTP showed better RCE-d results with GRA versus AIR (84.68% vs. 77.85%, p < 0.001). According to the questionnaire, no significant differences were detected between the training groups in terms of self-assessment, handling, treatment time, root surface roughness/destruction or effectiveness of the instruments. The CTP group favored AIR compared to GRA regarding the fatigue effect. The CTP and playing computer games/consoles regularly was correlated with lower RCE-b, whereas previous education in medicine/dentistry was correlated with higher RCE-b values. CONCLUSIONS Within the limitations of the study, the DTP with a reduced supervision effort compared to the CTP resulted in higher effectiveness and lower instrumentation time for removing simulated biofilms.
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Affiliation(s)
- Miriam Seidel
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Simone Sutor
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Jonas Conrad
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Anne Sophie Engel
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
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Sälzer S, Graetz C, Dörfer CE, Slot DE, Van der Weijden FA. Contemporary practices for mechanical oral hygiene to prevent periodontal disease. Periodontol 2000 2020; 84:35-44. [PMID: 32844413 DOI: 10.1111/prd.12332] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
It is well established that dental plaque on teeth leads to gingivitis and periodontitis, and that several mechanical and chemical methods of plaque control can prevent gingivitis. The aim of the current review is to summarize and synthesize the available scientific evidence supporting practices for mechanical oral hygiene to prevent periodontal diseases. Evidence for contemporary practices of mechanical oral hygiene to prevent periodontal disease relies on studies of gingivitis patients. General recommendations concerning the ideal oral hygiene devices and procedures are still inconclusive. However, toothbrushing and interdental cleaning remain the mainstays of prevention of periodontal diseases. The primary approach requires individually tailored instruction for implementation of a systematic oral hygiene regimen.
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Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fridus A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Schwendicke F, Krois J, Engel AS, Seidel M, Graetz C. Long-term periodontitis treatment costs according to the 2018 classification of periodontal diseases. J Dent 2020; 99:103417. [PMID: 32592828 DOI: 10.1016/j.jdent.2020.103417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To assess if long-term treatment costs in periodontitis patients differ between stage III vs. IV and grade B vs. C according to the 2018 classification of periodontal diseases. METHODS A cohort of 231 periodontitis patients (followed over a mean of 18.4 years) was evaluated. Costs for active periodontal therapy (APT, including scaling and root planning, open flap debridement, root resections) and supportive periodontal therapy (SPT, including also restorative, endodontic, prosthetic and surgical treatment) were estimated from a mixed payer-perspective in Germany (in Euro 2020). Multi-dimensional staging and grading was applied. The impact of stage, grade, sex and age on total and annual costs was assessed. RESULTS Mean (SD) total and annual treatment costs were 7154 (2554) Euro and 437 (222) Euro. Costs were generated during SPT (92 %) and by periodontal treatment (88 %) and decreased significantly with longer follow-up (p < 0.001). Total costs were 7120 (2692) Euro in stage III (n = 154) vs. 7221 (2271) Euro in stage IV (n = 77; p > 0.05), and 6256 (1605) Euro in grade B (n = 35) vs. 7314 (2660) Euro in grade C (n = 196; p < 0.001). Annual costs were 426 (219) Euro vs. 459 (228) Euro for stage III vs. stage IV (p > 0.05) and 308 (163) Euro vs. 460 (224) Euro for grade B vs. grade C (p < 0.001). Multivariable modelling found grade, but not stage, sex and age significantly associated with costs. CONCLUSIONS Within the limitations of this study, and in patients with severe periodontitis who were systematically treated long-term, grading, but not staging was associated with costs. CLINICAL SIGNIFICANCE Treatment costs were higher in patients with more progressive periodontitis and were found to decrease during follow-up. Dentists need to consider costs during treatment planning and communication with patients.
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Affiliation(s)
- Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Germany; Berlin Institute of AI and Health Policy (BAIP), Charité - Universitätsmedizin Berlin, Germany.
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Germany; Berlin Institute of AI and Health Policy (BAIP), Charité - Universitätsmedizin Berlin, Germany
| | - Anne Sophie Engel
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University, Kiel, Germany
| | - Miriam Seidel
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University, Kiel, Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University, Kiel, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Graetz C, Fecke P, Seidel M, Engel AS, Schorr S, Sentker J, Dörfer CE, Sälzer S. Evaluation of a systematic digitized training program on the effectivity of subgingival instrumentation with curettes and sonic scalers in vitro. Clin Oral Investig 2020; 25:219-230. [PMID: 32474807 PMCID: PMC7785550 DOI: 10.1007/s00784-020-03356-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
Objectives Whereas the key role of subgingival instrumentation in periodontal therapy is well known, the influence of operators’ experience/training with different devices on treatment results is yet uncertain. Therefore, we assessed untrained undergraduate students, working on manikins, as to how effectively they learn to use curettes (GRA) and sonic scalers (AIR); hypothesizing that AIR will result in higher relative cleaning efficacy (RCE) than GRA. Material and methods Before baseline evaluation (T0), 30 operators (9 males, 21 females) received a 2-h theoretical lesson for both instruments, followed by a 12-week period with a weekly digitized training program for 45 min. During three sessions (T1–T3), the operators had to instrument six equivalent test teeth with GRA and AIR. At T0–T3, treatment time, proportion of removed simulated biofilm (RCE-b), and hard deposits (RCE-d) were measured. Results At T0, RCE-b was in mean(SD) 64.18(25.74) % for GRA, 62.25(26.69) % for AIR; (p = 0.172) and RCE-d 85.48(12.32) %/ 65.71(15.27) % (p < 0.001). At T3, operators reached highest RCE-b in both groups (GRA/AIR 71.54(23.90) %/71.75(23.05)%; p = 0.864); RCE-d GRA/AIR: 84.68(16.84) %/77.85(13.98) %; p < 0.001). Both groups achieved shorter treatment times after training. At T3, using curettes was faster (GRA/AIR 16.67(3.31) min/19.80(4.52) min; p < 0.001). Conclusions After systematic digitized training, untrained operators were able to clean 70% of the root surfaces with curettes and sonic scalers. Clinical relevance It can be concluded that a systematic digitized and interactive training program in manikin heads is helpful in the training of root surface debridement.
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Affiliation(s)
- Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Paula Fecke
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Miriam Seidel
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Anne Sophie Engel
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Johanna Sentker
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Ehrenthal JC, Woeste S, Mrowietz U, Gerdes S, Graetz C. Profiles of psychosocial variables and dental status in patients with psoriasis. J Eur Acad Dermatol Venereol 2020; 34:e586-e587. [PMID: 32277503 DOI: 10.1111/jdv.16452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J C Ehrenthal
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - S Woeste
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - U Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
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Graetz C, Rabe J, Schoepke K, Schorr S, Geiken A, Christofzik D, Rinder T, Dörfer CE, Sälzer S. New experimental setup for the measurement of cleaning efficacy and force of interdental aids in 3D-reproduced interdental areas. BMC Oral Health 2020; 20:136. [PMID: 32384897 PMCID: PMC7206737 DOI: 10.1186/s12903-020-01129-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/29/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility. METHODS Five different sizes of commercially marketed IRP with elastomeric fingers (IRP-F) (GUM SOFT-PICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) or slats (IRP-S) (TePe EasyPick™, TePe D-A-CH GmbH, Hamburg, Germany) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N]. RESULTS IRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area. CONCLUSIONS New interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Johanna Rabe
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Kristina Schoepke
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Graetz C, Bäumer A, Eickholz P, Kocher T, Petsos H, Pretzl B, Schwendicke F, Holtfreter B. Long-term tooth retention in periodontitis patients in four German university centres. J Dent 2020; 94:103307. [DOI: 10.1016/j.jdent.2020.103307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/31/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
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Freitag-Wolf S, Munz M, Wiehe R, Junge O, Graetz C, Jockel-Schneider Y, Staufenbiel I, Bruckmann C, Lieb W, Franke A, Loos B, Jepsen S, Dommisch H, Schaefer A. Smoking Modifies the Genetic Risk for Early-Onset Periodontitis. J Dent Res 2019; 98:1332-1339. [DOI: 10.1177/0022034519875443] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Periodontitis has low-prevalence, highly severe disease manifestations with an early onset and rapid progression. The diagnosis is based on severe destruction of the alveolar bone in adolescents and young adults. Genetic susceptibility variants and smoking are well-established risk factors, but their interactions in modifying disease susceptibility have not been studied. We aimed to identify genetic risk variants of early-onset periodontitis that unmask their effects on tobacco smoke exposure. To this end, we analyzed 79,780,573 common variants in 741 northwest Europeans diagnosed to have >30% bone loss at >2 teeth before 35 y of age, using imputed genotypes of the OmniExpress BeadChip. Never versus ever smokers were compared in a logistic regression analysis via a case-only approach. To explore the effect of tobacco smoke on the expression of the G×S-associated genes, cultures of primary gingival fibroblasts ( n = 9) were exposed to cigarette smoke extract, and transcripts were quantified by reverse transcription polymerase chain reaction. We identified 16 loci for which our analysis suggested an association with G×S increased disease risk ( P < 5 × 10−5). Nine loci had previously been reported to be associated with spirometric measures of pulmonary function by an earlier G×S genome-wide association study. Genome-wide significant cis expression quantitative trait loci were reported for G×S-associated single-nucleotide polymorphisms at ST8SIA1 and SOST, indicating a causal role of these genes in tobacco-related etiopathology. Notably, SOST is a negative regulator of bone growth, and ST8SIA1 has a role in tissue remodeling. Cigarette smoke extract significantly altered the expression of 2 associated genes: SSH1 ( P = 5 × 10−07), which is required for NF-κB activation and innate immune responses to bacterial invasion, and ST8SIA1 ( P = 0.0048). We conclude that the genetic predisposition to early-onset periodontitis is in part triggered by smoking and that tobacco smoke directly affects the expression of genes involved in bone homeostasis, tissue repair, and immune response.
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Affiliation(s)
- S. Freitag-Wolf
- Institute of Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Kiel University, Germany
| | - M. Munz
- Department of Periodontology and Synoptic Dentistry, Institute for Dental and Craniofacial Sciences, Berlin Institute of Health, Charité–University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - R. Wiehe
- Department of Periodontology and Synoptic Dentistry, Institute for Dental and Craniofacial Sciences, Berlin Institute of Health, Charité–University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - O. Junge
- Institute of Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Kiel University, Germany
| | - C. Graetz
- Unit of Periodontology, Department of Conservative Dentistry, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Y. Jockel-Schneider
- Clinic of Preventive Dentistry and Periodontology, Department of Periodontology, University Medical Center of the Julius-Maximilians-University, Würzburg, Germany
| | - I. Staufenbiel
- Periodontology and Preventive Dentistry, Department of Conservative Dentistry, Hannover Medical School, Hannover, Germany
| | - C. Bruckmann
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Medical University Vienna, Vienna, Austria
| | - W. Lieb
- Institute of Epidemiology, Christian-Albrechts-University, Kiel, Germany
| | - A. Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - B.G. Loos
- Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - S. Jepsen
- Operative and Preventive Dentistry, Department of Periodontology, University of Bonn, Bonn, Germany
| | - H. Dommisch
- Department of Periodontology and Synoptic Dentistry, Institute for Dental and Craniofacial Sciences, Berlin Institute of Health, Charité–University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - A.S. Schaefer
- Department of Periodontology and Synoptic Dentistry, Institute for Dental and Craniofacial Sciences, Berlin Institute of Health, Charité–University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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Abstract
Prediction models learn patterns from available data (training) and are then validated on new data (testing). Prediction modeling is increasingly common in dental research. We aimed to evaluate how different model development and validation steps affect the predictive performance of tooth loss prediction models of patients with periodontitis. Two independent cohorts (627 patients, 11,651 teeth) were followed over a mean ± SD 18.2 ± 5.6 y (Kiel cohort) and 6.6 ± 2.9 y (Greifswald cohort). Tooth loss and 10 patient- and tooth-level predictors were recorded. The impact of different model development and validation steps was evaluated: 1) model complexity (logistic regression, recursive partitioning, random forest, extreme gradient boosting), 2) sample size (full data set or 10%, 25%, or 75% of cases dropped at random), 3) prediction periods (maximum 10, 15, or 20 y or uncensored), and 4) validation schemes (internal or external by centers/time). Tooth loss was generally a rare event (880 teeth were lost). All models showed limited sensitivity but high specificity. Patients' age and tooth loss at baseline as well as probing pocket depths showed high variable importance. More complex models (random forest, extreme gradient boosting) had no consistent advantages over simpler ones (logistic regression, recursive partitioning). Internal validation (in sample) overestimated the predictive power (area under the curve up to 0.90), while external validation (out of sample) found lower areas under the curve (range 0.62 to 0.82). Reducing the sample size decreased the predictive power, particularly for more complex models. Censoring the prediction period had only limited impact. When the model was trained in one period and tested in another, model outcomes were similar to the base case, indicating temporal validation as a valid option. No model showed higher accuracy than the no-information rate. In conclusion, none of the developed models would be useful in a clinical setting, despite high accuracy. During modeling, rigorous development and external validation should be applied and reported accordingly.
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Affiliation(s)
- J Krois
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Graetz
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - B Holtfreter
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - P Brinkmann
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - T Kocher
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - F Schwendicke
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Graetz C, Mann L, Krois J, Sälzer S, Kahl M, Springer C, Schwendicke F. Comparison of periodontitis patients' classification in the 2018 versus 1999 classification. J Clin Periodontol 2019; 46:908-917. [PMID: 31152600 DOI: 10.1111/jcpe.13157] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/17/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We aimed to assess how the 2018 and 1999 classifications of periodontal diseases reflect (a) patients' characteristics, (b) disease severity/extent/progression and (c) tooth loss (TL) during observation period. METHODS A total of 251 patients were followed over 21.8 ± 6.2 years. For the 1999 classification, using clinical attachment level (CAL), patients were classified as localized/generalized, mild/moderate/severe and aggressive/chronic periodontitis. For the 2018 classification, patients were staged according to their CAL or bone loss (BL) and the number of lost teeth (stages I-IV). Further factors like probing pocket depths (PPD) or furcation involvement modified the stage. The extent was sub-classified as generalized/localized. Patients were graded according to the BL/age index, smoking and/or diabetes. RESULTS According to the 1999 classification, most patients suffered from generalized severe chronic periodontitis (203/251) or generalized aggressive periodontitis (45/251). Patients with aggressive periodontitis were younger and less often female or smokers. They showed similar TL (0.25 ± 0.22 teeth/patient*year) as generalized severe chronic periodontitis patients (0.23 ± 0.25 teeth/patient*year). According to the 2018 classification, most patients were classified as generalized III-C (140/251), III-B (31/251) or IV-C (64/251). Patients' age, smoking status, CAL, PPD and BL were well reflected. TL differed between IV-C (0.36 ± 0.47), generalized III-C (0.21 ± 0.24) and localized forms (0.10-0.15). CONCLUSIONS Patients' characteristics, disease severity/extent/progression and TL were well reflected by the 2018 classification.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Lucas Mann
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
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Woeste S, Graetz C, Gerdes S, Mrowietz U. Oral Health in Patients with Psoriasis—A Prospective Study. J Invest Dermatol 2019; 139:1237-1244. [DOI: 10.1016/j.jid.2018.12.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 11/07/2018] [Accepted: 12/10/2018] [Indexed: 10/27/2022]
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Helal O, Göstemeyer G, Krois J, Fawzy El Sayed K, Graetz C, Schwendicke F. Predictors for tooth loss in periodontitis patients: Systematic review and meta-analysis. J Clin Periodontol 2019; 46:699-712. [PMID: 31025366 DOI: 10.1111/jcpe.13118] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/19/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023]
Abstract
AIM A range of predictors for tooth loss in periodontitis patients have been reported. We performed a systematic review and meta-analysis to assess the consistency and magnitude of any association between a total of 12 predictors and tooth loss. MATERIALS AND METHODS Medline/Embase/Central were searched for longitudinal studies investigating the association between predictors and tooth loss in periodontitis patients. Random-effects meta-analysis was performed, and study quality assessed. RESULTS Twenty studies (15,422 patients, mean follow-up: 12 years) were included. The mean annual tooth loss/patient was 0.12 (min./max: 0.01/0.36). Older patients (n = 8 studies; OR: 1.05, 95% CI: 1.03-1.08/year), non-compliant ones (n = 11; 1.51, 1.06-2.16), diabetics (n = 7; 1.80, 1.26-2.57), those with IL-1-polymorphism (n = 3; 1.80; 1.29-2.52) and smokers (n = 15; 1.98, 1.58-2.48) had a significantly higher risk of tooth loss. Teeth with bone loss (n = 3; 1.04, 1.03-1.05/%), high probing pocket depth (n = 6; 3.19, 1.70-5.98), mobility (n = 4; 3.71, 1.65-8.38) and molars (n = 4; 4.22, 2.12-8.39), especially with furcation involvement (n = 5; 2.68, 1.75-4.08) also showed higher risks. Gender (n = 16; 0.95, 0.86-1.05) and endodontic affection (n = 3; 3.62, 0.99-13.2) were not significantly associated with tooth loss. CONCLUSIONS Older, non-compliant, smoking or diabetic patients, and teeth with bone loss, high probing pocket depth, mobility, or molars, especially with furcation involvement showed higher risks of tooth loss.
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Affiliation(s)
- Omar Helal
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Karim Fawzy El Sayed
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.,Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo, Egypt
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
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Graetz C, Schorr S, Christofzik D, Dörfer CE, Sälzer S. How to train periodontal endoscopy? Results of a pilot study removing simulated hard deposits in vitro. Clin Oral Investig 2019; 24:607-617. [PMID: 31111282 DOI: 10.1007/s00784-019-02913-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is uncertainty regarding the benefits of periodontal endoscopy (PE) for subgingival instrumentation. Moreover, the influence of operators' experience and training with such a device on treatment results is unclear. Therefore, we compared in an in vitro study the use of PE for scaling and root planing (SRP) with the conventional non-surgical therapy, hypothesizing that using a PE allows to remove more simulated hard deposits than without (nPE), influenced by the operators' experience and training. MATERIAL AND METHODS A sonic device and Gracey curettes were utilized by 11 operators (six dentists, five dental hygienists) in periodontitis manikins heads. The time required for treatment and the proportion of removed simulated hard deposits by SRP were measured. RESULTS Using the PE led to a significant difference in removal of simulated hard deposits (%) (mean ± SD) irrespective of operators' experience (PE 90.78 ± 12.10% (range 58.80-100%); nPE 79.98 ± 22.15% (range 38.10-100%, p < 0.001)), sub-analyses for different tooth types demonstrated a significant difference in favor of PE for front teeth (p < 0.001) and in the upper jaw independent of the tooth type (p < 0.001). Comparison of treatment times for two quadrants with and without PE showed a significantly longer treatment time with PE (∆22.27 ± 17.98 mins, p <0.001). CONCLUSIONS Within the present pilot study, the use of PE led to more removal of simulated hard deposits but was concomitantly related to more time and financial effort. Using PE was most beneficial in the front area. CLINICAL RELEVANCE PE may provide additional benefits for the removal of hard deposits compared to traditional SRP. The beneficial effect of PE seems not to be influenced by operators experience nor by pocket probing depth.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany.
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
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Schulz J, Knappe C, Graetz C, Mewes L, Türk K, Black AK, Lieb W, Schäfer AS, Fawzy El-Sayed KM, Dörfer CE, Schreiber S, Laudes M, Schulte DM. Secreted frizzled-related protein 5 serum levels in human periodontitis-A nested case-control study. J Clin Periodontol 2019; 46:522-528. [PMID: 30762911 DOI: 10.1111/jcpe.13087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 12/04/2018] [Accepted: 02/09/2019] [Indexed: 01/13/2023]
Abstract
AIM Recombinant secreted frizzled-related protein 5 (sFRP5) improved periodontal status in mice. Thus, this study aimed to investigate this finding in human periodontitis using an epidemiological approach. MATERIALS AND METHODS sFRP5 and wnt5a concentrations were determined in human serum from the Food Chain Plus cohort using ELISAs. A total of 128 patients with periodontitis and tooth loss and 245 patients with periodontitis without tooth loss were compared to 373 sex-, smoker-, age- and BMI-matched individuals in a nested case-control design. RESULTS Systemic sFRP5 serum levels were significantly lower in patients with periodontitis and tooth loss (2.5 [0.0-10.4] ng/ml, median [IQR]) compared to patients with periodontitis without tooth loss (6.0 [2.5-15.8] ng/ml, median [IQR], p = 0.04] and matched controls (7.0 [2.5-18.3] ng/ml, median [IQR], p = 0.02). No significant differences in sFRP5 serum levels were found among patients with periodontitis without tooth loss (6.0 [2.5-15.8] ng/ml, median [IQR]) and controls (3.1 [0.0-10.6] ng/ml, median [IQR], p = 0.06). CONCLUSIONS sFRP5 might serve as a novel biomarker for periodontitis severity. Modulating the inflammatory background of severe forms of periodontitis, in the time of precision medicine, needs to be revealed in further studies.
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Affiliation(s)
- Juliane Schulz
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany.,Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Carina Knappe
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Louisa Mewes
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Kathrin Türk
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Anna K Black
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Arne S Schäfer
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Berlin, Germany
| | - Karim M Fawzy El-Sayed
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.,Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Stefan Schreiber
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany.,Cluster of Excellence, Inflammation at Interfaces, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Matthias Laudes
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany.,Cluster of Excellence, Inflammation at Interfaces, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dominik M Schulte
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany.,Cluster of Excellence, Inflammation at Interfaces, Christian-Albrechts-University Kiel, Kiel, Germany
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Graetz C, Ostermann F, Springer C, Schwendicke F. Survival and maintenance efforts of adhesively attached extracted teeth in periodontitis patients. J Dent 2019; 83:56-60. [PMID: 30862558 DOI: 10.1016/j.jdent.2019.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES For extracted teeth in periodontitis patients, adhesively attaching their crown to the adjacent teeth temporarily closes the otherwise resulting gap, allowing to postpone more comprehensive prosthetic treatment to a more appropriate time if required. This study assessed the survival and maintenance efforts of adhesively attached extracted tooth crowns ('immediate pontics'; IPs). METHODS Patients receiving active and supportive periodontal treatment involving IPs in a university setting were retrospectively assessed. Survival and repairs of IPs were recorded. Multilevel Cox and linear regression analyses were performed to assess factors associated with survival and maintenance efforts. RESULTS Twenty-seven patients (male/female: 12/15) with 34 IPs (maxilla/mandible: 13/21) were followed over mean ± SD 8.0 ± 5.0 [range: 2.0-19.3] years. At baseline 85.2% suffered from periodontitis stage II or III and 59.3% showed rapid progression (grade C). The mean (95% CI) survival time of splinting was 5.3 ± 3.8 [range: 0.1-18.0] years. Three IPs had been removed without any significant association with patient- or tooth-level factors. 35.3% of the IPs (n = 12) required a repair, with a mean of 0.5 ± 0.9 [0-3] repairs per IP (annual: 0.1 ± 0.2 [0-0.5]). The risk of repairs significantly increased with patients' age (p = 0.018). CONCLUSION IPs showed moderate survival. However, to maintain IPs, frequent repairs were needed. CLINICAL SIGNIFICANCE Immediately and adhesively attached crowns of extracted teeth in periodontitis patients seems like a valid, albeit temporary strategy which may allow to postpone more comprehensive prosthetic treatment if required, for example during active periodontal therapy. However, to maintain immediate pontics, frequent repairs were needed.
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Affiliation(s)
- Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel Kiel, Arnold-Heller-Straße 3, Haus 26, 24105 Kiel, Germany.
| | - Freda Ostermann
- Department of Prosthodontics, Propaedeutics and Dental Material, Christian-Albrechts-University of Kiel, Arnold-Heller-Straße 3, Haus 26, 24105 Kiel, Germany
| | - Claudia Springer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel Kiel, Arnold-Heller-Straße 3, Haus 26, 24105 Kiel, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Aßmannshauser Straße 6, 14197 Berlin, Germany
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Graetz C. Periodontitis and compliance: how much can the patient contribute to long-term success? Clin Oral Implants Res 2018. [DOI: 10.1111/clr.27_13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fawzy El-Sayed K, Graetz C, Köhnlein T, Mekhemar M, Dörfer C. Effect of total sonicated Aggregatibacter actinomycetemcomitans fragments on gingival stem/progenitor cells. Med Oral Patol Oral Cir Bucal 2018; 23:e569-e578. [PMID: 30148477 PMCID: PMC6167108 DOI: 10.4317/medoral.22661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/16/2018] [Indexed: 01/24/2023] Open
Abstract
Background Aggregatibacter-actinomycetemcomitans (A.actinomycetemcomitans) are strongly associated with localized-aggressive-periodontitis (LAgP). The study’s aim was to test for the first time the effect of total sonicated A.actinomycetemcomitans-bacterial-fragments on gingival mesenchymal stem/progenitor cells’ (G-MSCs) proliferation and regenerative gene expression in-vitro. Material and Methods G-MSCs were isolated, characterized, expanded and stimulated by total sonicated A.actinomycetemcomitans-bacterial-fragments (0 (negative-control), 15, 60, 120 and 240µg/ml; serovar-b; n=6/group). Cellular proliferation and NF-κβ (NFKB1), Alkaline Phosphatase (ALPL), Collagen-I (COL1A1), Collagen-III (COL3A1), Osteonectin (SPARC) and Osteopontin (SPP1) m-RNA expression were assessed via reverse-transcription-polymerase-chain-reaction (RT-PCR) at 24, 48 and 72 hours and CFUs-ability evaluated at twelve days. Results G-MSCs demonstrated stem/progenitor cells’ characteristics. A.actinomycetemcomitans-bacterial-fragments (up to 72 hours) resulted in marked G-MSCs’ proliferation over-time (p<0.001) and elevated NFKB1 (p=0.017), COL1A1 (p=0.025), SPARC (p=0.025), decreased ALPL (p=0.017), with no significant differences for COL3A1 and SPP1 expression or stimulation times (p>0.05; Friedman-test). Longer-term stimulation for twelve days reduced G-MSCs’ CFUs. Conclusions Sonicated A.actinomycetemcomitans-bacterial-fragments’ exert beneficial short-term effects on G-MSCs’ proliferative and non-mineralized tissue forming aptitude. Results shed new light on the importance of periodontal treatment for LAgP patients, using power driven sonic/ultrasonic devices, which, in addition to reducing the subgingival microbial load, produces cell-stimulatory A.actinomycetemcomitans-bacterial-fragments, with positive attributes on tissue reparative/regenerative responses of tissue resident stem/progenitor cells in their niche. Key words:Ultrasonic, Aggregatibacter actinomycetemcomitans, stem cells, gingiva, Aggressive periodontitis.
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Affiliation(s)
- K Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, Haus 26, 24105 Kiel, Germany,
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Schwendicke F, Engel AS, Graetz C. Long-term treatment costs of chronic periodontitis patients in Germany. J Clin Periodontol 2018; 45:1069-1077. [PMID: 29981185 DOI: 10.1111/jcpe.12984] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/31/2018] [Accepted: 07/02/2018] [Indexed: 12/20/2022]
Abstract
AIM We assessed the long-term costs for treating chronic periodontitis (CP) patients. METHODS A cohort of compliant CP patients was retrospectively evaluated. Costs for active periodontal therapy (APT, including scaling and root planning, open flap debridement, root resections) and supportive periodontal therapy (SPT including periodontal, restorative, endodontic, prosthetic and surgical treatments) were estimated from a mixed payer perspective in Germany. The impact of tooth- and patient-level factors on annual costs was assessed using mixed-modelling. RESULTS Two hundred and seventy-three patients (mean ± SD age: 49.6 ± 8.8 years), with 24.3 ± 4.5 teeth, were included. Mean follow-up was 18.7 ± 5.7 years. Total treatment costs per patient and per tooth were 6,146 ± 2,236 and 222 ± 98 Euro, respectively. Costs were generated mainly by periodontal therapy and during SPT. Annualized patient- and tooth-level costs were 348 ± 159 and 12.4 ± 5.7 Euro, respectively. Annual costs increased significantly in older patients, regular attenders, those with fewer teeth (<24) at baseline and teeth with higher probing pocket depths or mobility 3 at baseline. CONCLUSIONS Annual costs for treating CP patients were lower than those found for aggressive periodontitis patients. Regular attendance and having more severe periodontitis came with higher costs per year.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin, Berlin, Germany
| | - Anne Sophie Engel
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University, Kiel, Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University, Kiel, Germany
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Schwendicke F, Schmietendorf E, Plaumann A, Sälzer S, Dörfer CE, Graetz C. Validation of multivariable models for predicting tooth loss in periodontitis patients. J Clin Periodontol 2018; 45:701-710. [DOI: 10.1111/jcpe.12900] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
| | - Elisa Schmietendorf
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof E. Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
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Munz M, Willenborg C, Richter GM, Jockel-Schneider Y, Graetz C, Staufenbiel I, Wellmann J, Berger K, Krone B, Hoffmann P, van der Velde N, Uitterlinden AG, de Groot LCPGM, Sawalha AH, Direskeneli H, Saruhan-Direskeneli G, Guzeldemir-Akcakanat E, Keceli HG, Laudes M, Noack B, Teumer A, Holtfreter B, Kocher T, Eickholz P, Meyle J, Doerfer C, Bruckmann C, Lieb W, Franke A, Schreiber S, Nohutcu RM, Erdmann J, Loos BG, Jepsen S, Dommisch H, Schaefer AS. A genome-wide association study identifies nucleotide variants at SIGLEC5 and DEFA1A3 as risk loci for periodontitis. Hum Mol Genet 2018; 27:941-942. [PMID: 29346566 DOI: 10.1093/hmg/ddy015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Matthias Munz
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany
- Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein - Campus Lübeck, Germany
| | - Christina Willenborg
- Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein - Campus Lübeck, Germany
| | - Gesa M Richter
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany
| | - Yvonne Jockel-Schneider
- Department of Periodontology, Clinic of Preventive Dentistry and Periodontology, University Medical Center of the Julius-Maximilians-University, Würzburg, Germany
| | - Christian Graetz
- Department of Operative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Ingmar Staufenbiel
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University Münster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University Münster, Germany
| | - Bastian Krone
- Institute of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital of Basel, Switzerland
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine Section of Geriatrics, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lisette C P G M de Groot
- Department of Epidemiology and the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Amr H Sawalha
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Center for Computational Medicine and Bioinformatics, University of Michigan Medical School, USA
| | - Haner Direskeneli
- Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | | | | | - Huseyin Gencay Keceli
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, Turkey
| | - Matthias Laudes
- Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Barbara Noack
- Clinic of Conservational Dentistry, Center of Dental, Oral and Maxillary Medicine, University Medical Center Carl-Gustav-Carus, Technical University Dresden, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Birte Holtfreter
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Germany
| | - Thomas Kocher
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Germany
| | - Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Jörg Meyle
- Department of Periodontology, University Medical Center Giessen and Marburg, Germany
| | - Christof Doerfer
- Department of Operative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Corinna Bruckmann
- Department of Conservative Dentistry and Periodontology, Medical University Vienna, School of Dentistry, Vienna, Austria
| | - Wolfgang Lieb
- Institute of Epidemiology, Biobank PopGen, Christian-Albrechts-University, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Stefan Schreiber
- Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Rahime M Nohutcu
- Department of Periodontology, Faculty of Dentistry, Kocaeli University, Turkey
| | - Jeanette Erdmann
- Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein - Campus Lübeck, Germany
| | - Bruno G Loos
- Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - Soeren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany
| | - Arne S Schaefer
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany
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Schwendicke F, Biffar AS, Graetz C. Long-term treatment costs for aggressive periodontitis in a German population. J Clin Periodontol 2017; 44:1245-1252. [DOI: 10.1111/jcpe.12814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Anne Sophie Biffar
- Clinic for Conservative Dentistry and Periodontology; Christian-Albrechts-University; Kiel Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology; Christian-Albrechts-University; Kiel Germany
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Munz M, Willenborg C, Richter GM, Jockel-Schneider Y, Graetz C, Staufenbiel I, Wellmann J, Berger K, Krone B, Hoffmann P, van der Velde N, Uitterlinden AG, de Groot LCPGM, Sawalha AH, Direskeneli H, Saruhan-Direskeneli G, Guzeldemir-Akcakanat E, Keceli HG, Laudes M, Noack B, Teumer A, Holtfreter B, Kocher T, Eickholz P, Meyle J, Doerfer C, Bruckmann C, Lieb W, Franke A, Schreiber S, Nohutcu RM, Erdmann J, Loos BG, Jepsen S, Dommisch H, Schaefer AS. A genome-wide association study identifies nucleotide variants at SIGLEC5 and DEFA1A3 as risk loci for periodontitis. Hum Mol Genet 2017; 26:2577-2588. [PMID: 28449029 DOI: 10.1093/hmg/ddx151] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 04/12/2017] [Indexed: 01/26/2023] Open
Abstract
Periodontitis is one of the most common inflammatory diseases, with a prevalence of 11% worldwide for the severe forms and an estimated heritability of 50%. The disease is characterized by destruction of the alveolar bone due to an aberrant host inflammatory response to a dysbiotic oral microbiome. Previous genome-wide association studies (GWAS) have reported several suggestive susceptibility loci. Here, we conducted a GWAS using a German and Dutch case-control sample of aggressive periodontitis (AgP, 896 cases, 7,104 controls), a rare but highly severe and early-onset form of periodontitis, validated the associations in a German sample of severe forms of the more moderate phenotype chronic periodontitis (CP) (993 cases, 1,419 controls). Positive findings were replicated in a Turkish sample of AgP (223 cases, 564 controls). A locus at SIGLEC5 (sialic acid binding Ig-like lectin 5) and a chromosomal region downstream of the DEFA1A3 locus (defensin alpha 1-3) showed association with both disease phenotypes and were associated with periodontitis at a genome-wide significance level in the pooled samples, with P = 1.09E-08 (rs4284742,-G; OR = 1.34, 95% CI = 1.21-1.48) and P = 5.48E-10 (rs2738058,-T; OR = 1.28, 95% CI = 1.18-1.38), respectively. SIGLEC5 is expressed in various myeloid immune cells and classified as an inhibitory receptor with the potential to mediate tyrosine phosphatases SHP-1/-2 dependent signaling. Alpha defensins are antimicrobial peptides with expression in neutrophils and mucosal surfaces and a role in phagocyte-mediated host defense. This study identifies the first shared genetic risk loci of AgP and CP with genome-wide significance and highlights the role of innate and adaptive immunity in the etiology of periodontitis.
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Affiliation(s)
- Matthias Munz
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany.,Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein - Campus Lübeck, Germany
| | - Christina Willenborg
- Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein - Campus Lübeck, Germany
| | - Gesa M Richter
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany
| | - Yvonne Jockel-Schneider
- Department of Periodontology, Clinic of Preventive Dentistry and Periodontology, University Medical Center of the Julius-Maximilians-University, Würzburg, Germany
| | - Christian Graetz
- Department of Operative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Ingmar Staufenbiel
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University Münster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University Münster, Germany
| | - Bastian Krone
- Institute of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Germany.,Human Genomics Research Group, Department of Biomedicine, University Hospital of Basel, Switzerland
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine Section of Geriatrics, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lisette C P G M de Groot
- Department of Epidemiology and the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Amr H Sawalha
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.,Center for Computational Medicine and Bioinformatics, University of Michigan Medical School, USA
| | - Haner Direskeneli
- Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | | | | | - Huseyin Gencay Keceli
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, Turkey
| | - Matthias Laudes
- Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Barbara Noack
- Clinic of Conservational Dentistry, Center of Dental, Oral and Maxillary Medicine, University Medical Center Carl-Gustav-Carus, Technical University Dresden, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Birte Holtfreter
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Germany
| | - Thomas Kocher
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Germany
| | - Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Jörg Meyle
- Department of Periodontology, University Medical Center Giessen and Marburg, Germany
| | - Christof Doerfer
- Department of Operative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Corinna Bruckmann
- Department of Conservative Dentistry and Periodontology, Medical University Vienna, School of Dentistry, Vienna, Austria
| | - Wolfgang Lieb
- Institute of Epidemiology, Biobank PopGen, Christian-Albrechts-University, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Stefan Schreiber
- Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany.,Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Rahime M Nohutcu
- Department of Periodontology, Faculty of Dentistry, Kocaeli University, Turkey
| | - Jeanette Erdmann
- Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein - Campus Lübeck, Germany
| | - Bruno G Loos
- Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - Soeren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany
| | - Arne S Schaefer
- Department of Periodontology and Synoptic Dentistry, Institute of Dental, Oral and Maxillary Medicine, Charité - University Medicine Berlin, Germany
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Schwendicke F, Stolpe M, Graetz C. Cost comparison of prediction-based decision-making for periodontally affected molars. J Clin Periodontol 2017; 44:1145-1152. [DOI: 10.1111/jcpe.12796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | | | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology; Christian-Albrechts-University; Kiel Germany
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44
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Schwendicke F, Stange J, Stange C, Graetz C. German dentists' websites on periodontitis have low quality of information. BMC Med Inform Decis Mak 2017; 17:114. [PMID: 28768511 PMCID: PMC5541403 DOI: 10.1186/s12911-017-0511-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 07/24/2017] [Indexed: 11/29/2022] Open
Abstract
Background The internet is an increasingly relevant source of health information. We aimed to assess the quality of German dentists’ websites on periodontitis, hypothesizing that it was significantly associated with a number of practice-specific parameters. Methods We searched four electronic search engines and included pages which were freely accessible, posted by a dental practice in Germany, and mentioned periodontal disease/therapy. Websites were assessed for (1) technical and functional aspects, (2) generic quality and risk of bias, (3) disease-specific information. For 1 and 2, validated tools (LIDA/DISCERN) were used for assessment. For 3, we developed a criterion catalogue encompassing items on etiologic and prognostic factors for periodontitis, the diagnostic and treatment process, and the generic chance of tooth retention in periodontitis patients. Inter- and intra-rater reliabilities were largely moderate. Generalized linear modeling was used to assess the association between the information quality (measured as % of maximally available scores) and practice-specific characteristics. Results Seventy-one websites were included. Technical and functional aspects were reported in significantly higher quality (median: 71%, 25/75th percentiles: 67/79%) than all other aspects (p < 0.05). Generic risk of bias and most disease-specific aspects showed significantly lower reporting quality (median range was 0–40%), with poorest reporting for prognostic factors (9;0/27%), diagnostic process (0;0/33%) and chances of tooth retention (0;0/2%). We found none of the practice-specific parameters to have significant impact on the overall quality of the websites. Conclusions Most German dentists’ websites on periodontitis are not fully trustworthy and relevant information are not or insufficiently considered. There is great need to improve the information quality from such websites at least with regards to periodontitis.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14199, Berlin, Germany
| | - Jörg Stange
- Stange Dental, Wilhelmstraße 1, 25436, Tornesch, Germany
| | - Claudia Stange
- Stange Dental, Wilhelmstraße 1, 25436, Tornesch, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Arnold-Heller-Str. 3 (Haus 26), 24105, Kiel, Germany.
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Kreutzer C, Graetz C, Schulz J, Mewes L, Türk K, Dörfer C, Schreiber S, Schulte DM, Laudes M. Antidiabetic sFRP5 is downregulated in patients with chronic periodontitis. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Kreutzer
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Innere Medizin, Kiel, Germany
| | - C Graetz
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Zahnerhaltungskunde und Parodontologie, Kiel, Germany
| | - J Schulz
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Innere Medizin, Kiel, Germany
| | - L Mewes
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Zahnerhaltungskunde und Parodontologie, Kiel, Germany
| | - K Türk
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Innere Medizin, Kiel, Germany
| | - C Dörfer
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Zahnerhaltungskunde und Parodontologie, Kiel, Germany
| | - S Schreiber
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Innere Medizin, Kiel, Germany
| | - DM Schulte
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Innere Medizin, Kiel, Germany
| | - M Laudes
- Universitätsklinikum Schleswig Holstein Campus Kiel, Klinik für Innere Medizin, Kiel, Germany
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46
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Graetz C, Sälzer S, Plaumann A, Schlattmann P, Kahl M, Springer C, Dörfer C, Schwendicke F. Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment. J Clin Periodontol 2017; 44:612-619. [DOI: 10.1111/jcpe.12725] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics; Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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Graetz C, Plaumann A, Schlattmann P, Kahl M, Springer C, Sälzer S, Gomer K, Dörfer C, Schwendicke F. Long-term tooth retention in chronic periodontitis - results after 18 years of a conservative periodontal treatment regimen in a university setting. J Clin Periodontol 2017; 44:169-177. [DOI: 10.1111/jcpe.12680] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics, Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Konstantin Gomer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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Graetz C, Plaumann A, Heinevetter N, Sälzer S, Bielfeldt J, Dörfer CE. Bristle splaying and its effect on pre-existing gingival recession—a 12-month randomized controlled trial. Clin Oral Investig 2016; 21:1989-1995. [DOI: 10.1007/s00784-016-1987-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
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Ehrenthal JC, Graetz C, Plaumann A, Dörfer CE, Herzog W. Number of teeth predict depressive symptoms in a longitudinal study on patients with periodontal disease. J Psychosom Res 2016; 89:16-9. [PMID: 27663105 DOI: 10.1016/j.jpsychores.2016.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/19/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Periodontal disease is associated with a wide range of psychosocial risk-factors. Disease-related tooth-loss has been associated with an increase in depressive symptoms in cross-sectional studies. However, while depression is a known risk-factor for the outcome of chronic diseases, it remains unclear if tooth loss can also predict depressive symptoms over the course of treatment. Aim of the current pilot study was to test, to what extend the number of teeth predict depressive symptoms several years later. METHODS Tooth status of 310 patients with chronic and aggressive periodontitis was evaluated at the beginning of a specialized, university based outpatient treatment. We assessed depressive symptoms with the Patient Heath Questionnaire (PHQ) on average 13years later. Regression analyses were used to relate initial number of teeth to self-reported depression scores. RESULTS Fewer teeth at the beginning of the treatment were related to higher scores of depressive symptoms, even when controlling for several covariates. CONCLUSIONS Tooth loss is a potential risk-factor for the development of depression in periodontal disease. Further longitudinal studies that control for initial depressive symptoms are needed to identify disease mechanisms.
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Affiliation(s)
- Johannes C Ehrenthal
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Germany; Department of Psychology, University of Kassel, Germany.
| | - Christian Graetz
- Department of Conservative Dentistry and Periodontology, University of Kiel, Germany.
| | - Anna Plaumann
- Department of Conservative Dentistry and Periodontology, University of Kiel, Germany.
| | - Christof E Dörfer
- Department of Conservative Dentistry and Periodontology, University of Kiel, Germany.
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Germany.
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Schwendicke F, Stolpe M, Plaumann A, Graetz C. Cost-effectiveness of regular versus
irregular supportive periodontal therapy or tooth removal. J Clin Periodontol 2016; 43:940-947. [DOI: 10.1111/jcpe.12595] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | | | - Anna Plaumann
- Clinic for Conservative Dentistry and Periodontology; Christian-Albrechts-University; Kiel Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology; Christian-Albrechts-University; Kiel Germany
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