Tooth preservation vs. extraction and implant placement in periodontally compromised patients: A systematic review and analysis of studies.

PURPOSE: The aim of this systematic review was to identify studies with a minimum of 5-years follow-up, reporting on the management of periodontally compromised teeth with either extraction and subsequent implant placement or teeth preservation with conventional periodontal treatment and application of regenerative procedures. The outcomes of these two approaches, based on clinical and radiographic data and the incidence of tooth- and implant-loss, were also investigated. MATERIAL AND METHODS: A systematic search for studies reporting on clinical and radiographic outcomes of periodontal treatment or replacement of periodontally compromised teeth with implants was conducted in 3 electronic databases, followed by a hand-search in 8 journals. Only randomized controlled trials (RCTs), cohort studies, and case series with prospective design were included. RESULTS: The initial search resulted in 1080 papers. After the first two screenings, 24 publications were selected for inclusion in this systematic review. The treatment protocols for the teeth preservation group contained nonsurgical and/or surgical periodontal treatment with or without regeneration procedures. The implant studies included extraction of periodontally involved teeth and implant placement with or without bone and soft tissue augmentation, followed by restoration with fixed dental prostheses (FDPs). Survival rates ranged between 81.8% and 100% in the tooth retention group, and between 94.8% and 100% in the implant group. In the extraction group, no complications were reported for 76.09% of the implants. Similarly, no complications were reported for 86.83% of the tooth retention group. The lack of standardized comparable studies prohibited conduction of a metaanalysis. CONCLUSION: Both treatment approaches, treatment of periodontally compromised teeth, or tooth extraction followed by implant placement, present high survival rates. The application of bone regeneration techniques improves the long-term prognosis of periodontally involved teeth. Hence, treatment of periodontally involved teeth with subsequent application of a rigorous maintenance protocol can be a viable alternative for a number of years, before proceeding to extraction and replacement with dental implants. More well-designed randomized controlled trials are needed in order to draw definite conclusions on the subject.

A Survey on Oral Health Knowledge, Attitudes and Practices of Pregnant Women Attending Four General Health Hospitals in Switzerland.

PURPOSE: To evaluate the knowledge and practices of Swiss women regarding oral health during pregnancy. MATERIALS AND METHODS: Self-reported questionnaires were attributed to 385 women from 4 public hospitals in the French speaking part of Switzerland from February 2015 to June 2016.The questionnaire consisted of 32 questions including demographic characteristics, oral health habits and awareness of oral changes during pregnancy. RESULTS: The majority of women (64%) were in the 3rd trimester of pregnancy and had a university education (41%). Oral health was considered very important for half of the women (52%) and moderately important for 38% of them. 71% of the women did not notice any change concerning their oral health conditions. Of the remaining 29%, gingival bleeding was the main symptom reported, followed by gingival redness and oedema. Pain and sensitivity were also reported by a few participants. Most of the pregnant women attended dental appointments during their pregnancy, but not on a regular basis, mainly because of lack of time. Almost half of the population had an adequate oral hygiene routine and adapted their eating habits to a much healthier pattern during pregnancy. A large proportion of the participants (71%) was aware that pregnancy renders teeth and gums more vulnerable and that oral health is related to adverse pregnancy outcomes. However, this information was rarely imparted to them by health professionals. CONCLUSION: Although pregnant women in the French speaking part of Switzerland seem to be moderately informed about the importance of oral health during pregnancy, health-care professionals do not seem to participate actively. Health professionals need to more actively inform pregnant patients about the importance of preventive oral health measures and oral health care during pregnancy.

Diode laser assisted excision of a gingival pyogenic granuloma: A case report.

Pyogenic granuloma is a non-neoplastic, exuberant, reactive lesion seen in response to local irritation or trauma caused by dental calculus, bacterial plaque, caries and restorations, with a strong predilection for the gingiva. It is among the frequently encountered oral lesions, occurring at a challenging oral site, the gingiva. Herein, we report a 71-year-old medically compromised Caucasian female who presented with a relatively large lobulated pyogenic granuloma on the buccal gingiva of the maxillary molar-premolar region. Total surgical excision was performed with an 840nm diode laser followed by the placement of hyaluronate gel and relevant periodontal dressing. Two weeks after surgical excision, complete healing was observed, but patient denied replacement of dental restoration. After 4 months of follow-up, an overall reduction of associated teeth mobility was also observed, with a minor recurrence in gingival inflammation. The objective of this report is to briefly review clinical, radiographic and histological findings of pyogenic granuloma along with a detailed discussion on its management through a diode laser.