Plaque score changes based primarily on patient performance at specific time intervals.

Patient plaque removal is a major component of periodontal therapy and should be continuously monitored during and following treatment. There do not appear to be studies which address plaque score changes achieved primarily by patient performance from the time of initial presentation to, during, and following active therapy. We assessed individual tooth surfaces and segment plaque scores for 24 adult subjects presenting with periodontitis, the majority of which was ADA case types III and IV, at 3 time points (initial presentation, post-initial preparation, and at 3 months following active therapy), using the O'Leary Plaque Index. The assessments describing surfaces and segments were made prior to any professional intervention. Analysis of buccal (B), interproximal (I), and lingual (L) plaque retentive surfaces at t-0 indicated the mean plaque index on B and L surfaces (30.7% and 41.9% respectively) was less than that on I surfaces (79.6%). At t-1 and t-2, the mean plaque index on all three surfaces was significantly (P less than 0.05) less than at t-0. Analysis of plaque indices in each of 6 segments at each time point revealed that plaque scores in all segments, except the mandibular right segment, were analogously reduced from t-0 to t-1 and to t-2. Our results indicate that plaque reduction for all subjects based primarily on patient performance consistently approaches or exceeds 50% on all surfaces and that interproximal surfaces present with and retain more plaque than buccal and lingual surfaces. Furthermore, patient plaque performance achieved at the time of post-initial preparation may be a predictor of the plaque control achievable during therapy based on patient performance.

Retained "hopeless" teeth. Effects on the proximal periodontium of adjacent teeth.

The retention of teeth diagnosed as periodontally "hopeless" may accelerate the destruction of the adjacent proximal periodontium. Studies determining the influence these teeth have on the health status of adjacent teeth appear nonexistent. It was the intent of this retrospective study to assess the status of the periodontium in adjacent teeth proximal to the periodontium of "hopeless" teeth. We evaluated 17 teeth, each being mesially adjacent to one "hopeless" tooth, in 17 subjects treated for periodontal disease. In each case, the "hopeless" and the adjacent teeth received the same treatment. Probing depths (P-D), radiographic alveolar bone level (R-BL) and the width of the periodontal ligament space (W-PL) were measured for both the adjacent interproximal and the nonadjacent interproximal surface for each hopeless tooth. At both pretherapy and posttherapy, there were no significant differences for any of the variables (P-D, R-BL and W-PL) for the adjacent interproximal surfaces with the nonadjacent interproximal surfaces. However, there was a significant reduction in the mean probing depth for the adjacent interproximal surfaces, pretherapy to posttherapy. No other significant changes were found in any of the other variables for either the adjacent or nonadjacent interproximal surfaces. These data suggest that teeth considered periodontally "hopeless" and retained have no effect on the proximal periodontium of adjacent teeth prior to and following therapy.

Retained "hopeless" teeth: lack of effect periodontally-treated teeth have on the proximal periodontium of adjacent teeth 8-years later.

We previously reported the lack of effect periodontally-treated teeth prognosed "hopeless" and retained for 3.4 +/- 1.5 years have on the proximal periodontium of adjacent teeth. We now report our findings for the same group of subjects following 8.4 +/- 0.7 years of "hopeless" tooth retention. Of the 17 "hopeless" and adjacent teeth originally measured in 17 subjects, 14 of the subjects were still available for re-evaluation. Measures used to assess the periodontium of proximal surfaces of adjacent teeth included pocket depths (PD), radiographic alveolar bone level (R-BL), and periodontal ligament space width (W-PL). Treatment for the subjects consisted of surgical therapy (N = 15) and scaling and root planing (N = 2). Of the 14 subjects re-examined, 2 were eliminated due to loss of adjacent tooth reference points and 2 due to extraction of the "hopeless" tooth (N = 10). Differences in measurements (i.e., nonadjacent to "hopeless" tooth value minus adjacent to "hopeless" tooth value) were analyzed using a repeated measures ANOVA. There were no significant differences for PD (P = 0.20), R-BL (P = 0.29), or W-PL (P = 0.16). These data confirm our original findings that retained periodontally "hopeless" teeth do not significantly affect the proximal periodontium of adjacent teeth following therapy.

Bone loss following periodontal therapy in subjects without frequent periodontal maintenance.

The longitudinal effects of periodontal therapy in patients without a frequent periodontal maintenance program have been minimally documented. In this study we used Duckworth's modification of the Schei Ruler Technique to assess the difference in bone level around individual teeth treated for periodontal disease in subjects receiving infrequent posttherapy maintenance (less than or equal to 1 time/year). Crestal bone height differences were evaluated using the initial presenting series of long cone parallel radiographs of 23 subjects with their subsequent posttherapy analogous radiographic series taken 5.4 +/- 2.9 years later. Bone loss was defined as a reduction in the alveolar crest of greater than 50% of the radiographic crown height which corresponds to approximately 4 mm in posterior and 5 mm in anterior teeth. The loss for each tooth was expressed as a per cent of the measured height of the crown after conversion from millimeters using the mean crown-root ratio for each tooth. We found increased alveolar bone loss and tooth loss in subjects examined posttherapy when compared with conditions present when each subject initially presented for periodontal treatment. Our data suggest that molar teeth are more at risk than incisors and cuspids and that a lack of periodontal maintenance care and inadequate plaque control contribute to progressive bone loss following treatment.

Cognitive style as related to emotional empathy.

This study examined relationships among two measures of FDI (the hidden figure test (HFT) and the portable rod and frame test (PRFT) and a measure of interpersonal sensitivity (the questionnaire measure of emotional empathy (QMEE] in a group of dental hygiene students. All measures were administered to 44 dental hygiene students and 42 students enrolled in an introductory psychology course. While the dental hygiene students were more field independent than a previously reported normative sample (t = 24.6 p less than 0.002), they were not characteristically different than a representative group of college students on any of the measures. For students enrolled in the psychology course, but not the dental hygiene students, the more field independent students were, the less empathic they appeared to be. These results do not entirely support previous research indicating that dental hygiene students typically are more field independent.

A system for insuring success of long-term supportive periodontal therapy.

The article describes a program of supportive periodontal therapy (SPT) for patients who have been treated for periodontal disease. Emphasis is placed on identifying the specific supportive therapy needs of periodontally treated patients as distinct from the needs of patients who are not at risk for periodontal disease. The critical components of SPT for clinical practice are defined and discussed. The parameters necessary for a through clinical and radiographic assessment are outlined. The use of assessment data to direct therapy is explained. Implementation of site-specific therapeutic measures as well as the use of evaluative procedures to assure appropriate long-term care are defined.

Legal issues involved in academic sterilization monitoring services.

With the advent of regulatory requirements regarding infection-control procedures, the business of sterilization monitoring is becoming ever more popular across the country. Therefore, monitoring services, many of which are associated with an academic institution, are providing such services for dental practitioners. The relationship between the service and its clients, as well as the types of service the sterilization monitoring service provides, presents some interesting legal issues. The documentation of services provided, including record keeping, requires compliance with various state confidentiality and privacy laws. The service must also be concerned about potentially misrepresenting itself to its clients about the services it offers. Additionally, the service must avoid making warranties that its clients may detrimentally rely on to escape sanctions by applicable regulatory agencies. Finally, the service must concern itself with general business regulations, including those specific policies and rules that apply to the academic institution with which it is associated.