Comparison of gingival inflammatory parameters and pain perception on periodontal probing - a cross sectional study, part II / Comparación de parámetros inflamatorios gingivales y percepción del dolor en el sondaje periodontal - un estudio transversal, parte II

Background: Probing of the periodontal pocket is an essential part of the diagnosis of periodontal disease and 15-77% of untreated periodontal patients experience pain during probing. Therefore, the objective of this study is to evaluate the pain perceived by patients with dental plaque-induced gingivitis and chronic periodontitis during periodontal probing and the main objective includes the evaluation of the relationship between pain perceived during periodontal probing and gingival inflammatory parameters. Material and Methods: A total of 475 participants were recruited into the study. The patients were divided into two groups: Group-A (Gingivitis Group - 275 patients) and Group-B (Chronic Periodontitis Group - 200 patients). Clinical parameters included analysis of bleeding on probing, simplified gingival index, pocket depth on probing, and clinical attachment level. Pain score was recorded using the HP VAS scale and all patients participated in the study after a detailed explanation of the study protocol. Results: A significant difference in pain perception was noted between groups, highlighting the role of the degree of inflammation in the examination of periodontal parameters. Conclusion: Within the limitations of the present study, we can conclude that pain perception is directly correlated with the degree of inflammation in periodontitis rather than plaque-induced gingivitis during periodontal probing. Therefore, some form of adjuvant topical anesthesia may be considered in order to reduce pain levels in severely inflamed patients, to encourage continued acceptance of supportive periodontal therapy.

Antecedentes: El sondaje de la bolsa periodontal es una parte esencial en el diagnóstico de la enfermedad periodontal. 15-77% de los pacientes periodontales no tratados experimentan dolor durante el sondaje. Por lo tanto, el objetivo de este estudio es evaluar el dolor percibido por pacientes con gingivitis inducida por placa dental y periodontitis crónica durante el sondaje periodontal y el objetivo principal incluye la evaluación de la relación entre el dolor percibido durante el sondaje periodontal con parámetros inflamatorios gingivales. Material y Métodos: Un total de 475 sujetos fueron reclutados en el estudio. Los sujetos se dividieron en 2 grupos: Grupo - A (Grupo de gingivitis - 275 pacientes) y Grupo - B (Grupo de periodontitis crónica - 200 pacientes). Los parámetros clínicos incluyeron el análisis del sangrado al sondaje, el índice gingival simplificado, la profundidad de la bolsa al sondaje y el nivel de inserción clínica. La puntuación del dolor se registró utilizando la escala HP VAS y todos los pacientes participaron en el estudio después de una explicación detallada del protocolo del estudio. Resultados: Se notó una diferencia significativa en la percepción del dolor en el grupo B que en el grupo A, lo que significa el papel del grado de inflamación en el examen de los parámetros periodontales. Conclusión: Dentro de las limitaciones del presente estudio, podemos concluir que la percepción del dolor se correlaciona directamente con el grado de inflamación que se observa en la periodontitis más que con la gingivitis inducida por la placa dental durante el sondaje periodontal. Por lo tanto, se puede considerar alguna forma de anestesia tópica adyuvante para reducir los niveles de dolor en pacientes gravemente inflamados para fomentar la aceptación continua de la terapia periodontal de apoyo.

Evaluation of pain perception on periodontal probing in patients with dental plaque induced gingivitis and chronic periodontitis - a cross sectional study, part I / Evaluación de la percepción del dolor al sondaje periodontal en pacientes con gingivitis inducida por placa dental y periodontitis crónica: un estudio transversal, parte I

Background: Probing of periodontal pockets is an essential part in the diagnosis of periodontal disease. Fifteen to seventy seven percent of untreated periodontal patients experience pain during probing. Hence the aim of this study is to evaluate the pain perceived by patients with gingivitis and periodontitis during periodontal probing. The goals of this study were to compare the patients' pain perception when using a conventional UNC15 probe and a manual pressure sensitive periodontal probe, and to relate the clinical features of gingivitis and periodontitis to the discomfort associated with periodontal probing. Material and Methods: A total of 475 subjects were recruited into the study. The subjects were initially divided into two groups ­ Group ­ A (Gingivitis group - 275 patients) and Group ­ B (Chronic Periodontitis group -200 patients) according to the AAP 1999 Classification. These two groups were further subdivided into two groups each (Gingivitis ­ Conventional Probe ­ GCP, Gingivitis ­ Manual Pressure Sensitive Probe ­ GMPS, Periodontitis - Conventional Probe ­ PCP, Periodontitis ­ Manual Pressure Sensitive Probe ­ PMPS) using a computer generated program of random numbers. Results: A significant difference was noted in pain perception when pressure sensitive probe was used compared to conventional UNC-15 probe. Reduced Bleeding on Probing and Pain scores were noted in Chronic periodontitis subjects with use of pressure sensitive probe, which was statistically significant (p<0.001). Conclusion: Dentistry has changed its focus towards painless dentistry. In this context, the present study presents data towards use of manual pressure sensitive probes, which offers an advantage of low cost when compared to more advanced computerized systems with reduced pain during periodontal examination. It could result in a positive attitude of the patients towards continuous supportive periodontal therapy thereby monitoring periodontal health.

Antecedentes: El sondaje de los sacos periodontales es una parte esencial en el diagnóstico de la enfermedad periodontal. Del quince al setenta y siete por ciento de los pacientes periodontales no tratados experimentan dolor durante el sondaje. De ahí que el objetivo de este estudio fué evaluar el dolor percibido por pacientes con gingivitis y periodontitis durante el sondaje periodontal. Los objetivos de este estudio fueron comparar la percepción del dolor de los pacientes al usar una sonda UNC15 convencional y una sonda periodontal sensible a la presión manual, y relacionar las características clínicas de la gingivitis y la periodontitis con la incomodidad asociada con el sondaje periodontal. Material y Métodos: Un total de 475 sujetos fueron reclutados en el estudio. Los sujetos se dividieron inicialmente en dos grupos - Grupo - A (grupo de Gingivitis - 275 pacientes) y Grupo - B (grupo de Periodontitis Crónica - 200 pacientes) de acuerdo con la Clasificación AAP 1999. Estos dos grupos se subdividieron en dos grupos cada uno (Gingivitis - Sonda convencional - GCP, Gingivitis - Sonda manual sensible a la presión - GMPS, Periodontitis - Sonda convencional - PCP, Periodontitis - Sonda manual sensible a la presión - PMPS) usando un programa generado por computadora de datos aleatorios. números. Resultados: Se notó una diferencia significativa en la percepción del dolor cuando se usó una sonda sensible a la presión en comparación con la sonda UNC-15 convencional (p<0,001). Conclusion: La odontología ha cambiado su enfoque hacia una odontología sin dolor. En este contexto, el presente estudio presenta datos hacia el uso de sondas manuales sensibles a la presión, que ofrece una ventaja de bajo costo en comparación con sistemas computarizados más avanzados con reducción del dolor durante el examen periodontal. Podría resultar en una actitud positiva de los pacientes hacia la terapia periodontal de apoyo continuo, monitoreando así la salud periodontal.

Anesthetic efficacy of 4% articaine and 2% lignocaine in achieving palatal anesthesia following a single buccal infiltration during periodontal therapy: A randomized double-blind split-mouth study.

BACKGROUND: The aim of this randomized split-mouth double-blind study was to evaluate whether 4% articaine hydrochloride with 1:100,000 epinephrine administered as a single buccal infiltration in the maxillary posterior sextant can provide palatal anesthesia when compared with 2% lignocaine with 1:100,000 epinephrine during scaling and root planing and access flap surgery (AFS). MATERIAL AND METHODS: A total of 40 patients with chronic generalized periodontitis requiring periodontal therapy in the maxillary posterior sextants were recruited in this study. About 4% articaine and 2% lignocaine were administered as buccal infiltration in a split-mouth design randomly. The pain scores in the palatal aspect were recorded during scaling and root planing and open flap debridement using Heft-Parker visual analog scale. The onset of anesthesia was also recorded and compared. RESULTS: The success rate for maxillary buccal infiltration to induce palatal anesthesia using articaine was 90% during scaling and root planing and 82.5% during AFS and for lignocaine solution was 20% and 15%, respectively. The difference between the two agents was statistically significant (P < 0.05). The onset of anesthesia between articaine and lignocaine was also found to be statistically significant (P < 0.05). CONCLUSION: In this study, we observed that the efficacy of 4% articaine was superior to 2% lignocaine to induce palatal anesthesia following maxillary buccal infiltration in maxillary posterior sextants.

Behavioral Pattern during Dental Pain in Intellectually Disabled Children: A Comparative Study.

Aim. Children with developmental disabilities generally experience more pain than the normal children. Description of pain is generally difficult in children and more so in children with intellectual disabilities. The study aimed at evaluating dental pain in children with intellectual disabilities. Methods. The survey was carried out in an institution caring for intellectually disabled children to determine the oral health status and the treatment needs of the special kids. 236 children were surveyed out of which the test group is comprised of 111 intellectually disabled children and the control group had 125 normal children with age ranging between five to eighteen years. A questionnaire was presented to the caregivers to elaborate about dental pain in their wards using the dental discomfort questionnaire (DDQ+). The children were examined for dental caries and periodontal status based on the WHO indices for oral hygiene status. Result. Results revealed a statistically significant difference between intellectual disability and brushing, chewing, and earache. The frequency of reporting dental pain was lesser in the intellectually disabled group. Conclusion. Children with intellectual disability tended to report dental pain of any nature with lesser frequency than typically developing peers. They also faced greater difficulty in brushing and chewing.