Clinical and microbiological comparison of three non-surgical protocols for the initial treatment of chronic periodontitis.

OBJECTIVE: To compare the clinical and microbiological effects of three protocols for nonsurgical periodontal therapy, including full-mouth scaling and root planing plus systemic antibiotics, on the treatment of chronic periodontitis patients. METHODS: Twenty-nine patients diagnosed with moderate to severe chronic periodontitis, selected according to specific criteria, were randomly assigned to one of three treatment groups: quadrant scaling, full-mouth scaling, and full-mouth scaling supplemented by systemic antibiotics. Antibiotic selection was based on the results of individual susceptibility testing. Oral hygiene instructions and reinforcement were given during the study. All patients received a clinical periodontal and microbiological examination at baseline and at reexamination, 4-6 weeks after therapy. Means and standard deviations were calculated and differences between groups were analyzed via the Kruskal-Wallis test, p < 0.05. RESULTS: The mean age of the study sample was 49.1 + 11.6 years old, and there were 17 men and 12 women. Patients treated with antibiotics showed antimicrobial susceptibility for amoxicillin and doxycycline. All study groups showed a similar significant improvement in periodontal parameters. Plaque scores were reduced in a range of 29.0% to 42.6%. Bleeding on probing was reduced by 34.8% to 55.0%; the reduction for the full-mouth scaling group was larger. Mean reduction in pocket depth was 1.2 to 1.3 mm in all groups. Mean bacterial counts were reduced in the groups receiving full-mouth treatment, but not in the quadrant treatment group. CONCLUSION: The three protocols for non-surgical periodontal treatment demonstrated a similar positive effect on clinical parameters; however, only full-mouth treatment groups showed a reduction in anaerobic microbial counts at re-examination.

Adaptation and Psychometric Properties of the Spanish Version of Child and Youth Resilience Measure (CYRM-32).

Resilience is defined as a dynamic process that entails a positive adaptation to contexts of adversity. According to the ecological model, resilient behavior emerges as a result of the interaction between individual, relational, community and cultural variables. The Child and Youth Resilience Measure (CYRM-28), developed in Canada and based on the ecological model, has been validated in several countries. The objective of this article is to present the cultural adaptation (studies I and II) and validation (study III) in Spanish at risk youth. A three-study mixed-method design was selected. Study I includes translations and a confirmatory and exploratory factor analysis of a sample of 270 Spanish young persons (56.9% boys) aged between 12 and 18 years (M = 14.65; SD = 1.27) from an urban public elementary school. Study II uses semi-structured interviews with adolescents identified as resilient and presents a content analysis and a reformulation of items with experts. Study III includes the confirmatory factor analysis, internal consistency, test-retest, convergent and discriminant validity, and multivariate analysis of variance to explore group differences of the resulting scale CYRM-32. The sample consisted of 432 at-risk young persons (54.9% boys) aged between 12 and 19 years old (M = 14.99; SD = 2.23). The results confirm the adequate psychometric properties of the CYRM-32 scale. From the original scale, 4 items were eliminated, 5 were reformulated presenting very low saturations. Meanwhile, 6 items were added to the cultural adaptation phase, resulting in a 32-item scale. The confirmatory analysis confirms the 3 factors expected in the CYRM-32 scale with good reliability indexes (Cronbach's α total scale 0.88, family interaction 0.79, interaction with others 0.72 and individual skills 0.78). The scale has convergent and discriminant validity in relation to the Brief Resilient Coping Scale, Coping Scale for Adolescents and Self-Concept. Significant differences were found in the scores of the CYRM-32 scale for the ethnic variable [F(71. 358) = 1.714, p < 0.001], while no differences appear according to age and gender. This finding confirms the importance of culture in the resiliency processes. The CYRM-32 scale has good psychometric properties and is a new alternative for measuring resilience in Spanish at-risk youth.