Blended intensive programme's implementation in dental education: post-pandemic evolution of learning.

Blended Intensive Programmes (BIP's) represent a valuable tool for gathering knowledge and summarising the latest trends in medicine and dentistry. Blended education has been found, even before the COVID-19 pandemic, to increase the level of education and stimulate effective learning for postgraduate healthcare professionals. Interprofessional education is critical for preparing students to enter the health workforce, where teamwork and collaboration are important competencies. This article outlines the key points of the Blended Intensive Programme's implementation in dental education organised by Wroclaw Medical University in Poland. BIP involved professors from 12 universities or research institutions from Europe and South America and 28 participants from 8 countries. The course was taught remotely and in person. In addition, it included a visit to the university and practical classes with artificial simulation and practice in dentistry. A structured questionnaire enabled measuring the evaluation of students' perception of the COVID-19 education before and after the pandemic. The European Region Action Scheme for the Mobility of University Students (ERASMUS) was fundamental to carrying out the BIP with the participation of several countries, allowing the exchange of knowledge, assessing the impact of the pandemic on dental universities, and strengthening international collaborations and the future project of research, education and clinical assistance. We conclude that hybrid teaching programmes broaden the learning spectrum in dental studies by allowing transnational and interdisciplinary approaches that make students aware of the importance of their work within the framework of the general health approach, as this differs from country to country.

A Case Control Study Evaluating the Relationship between Vitamin K2 Serum Level and Periodontitis.

BACKGROUND AND AIM: Vitamin K2 (VK2) is an essential co-factor for bone metabolism. There is still very little data regarding possible VK2 relation to periodontitis. This study aimed to investigate any potential link between VK2 serum level and the severity of periodontitis in comparison to a control group of healthy individuals. The trial was performed on 100 patients among whom 50 were diagnosed with periodontitis. The patients underwent full clinical periodontal and radiological examination. The VK2 serum level was assessed using the ELISA kit (Gla-type osteocalcin EIA Kit, Takara, Kusatsu). Patients with periodontitis had mean serum levels of VK2 significantly lower (0.27 ± 0.06 nmol/L; p < 0.001) than the control group (0.43 ± 0.09 nmol/L; p < 0.001) regardless of the patient's age or sex. The VK2 serum level decreased with the severity of periodontitis with the lowest level in stage IV of the disease (0.19 ± 0.01 nmol/L; p < 0.001). Also, a significant drop was noticed between the grades of periodontitis. Individuals with localized forms of the disease had significantly lower VK2 levels (0.26 ± 0.006 nmol/L; p < 0.001) in comparison to subjects with generalized periodontitis (0.30 ± 0.01 nmol/L; p < 0.001). The VK2 serum levels were also associated with most of the clinical parameters such as bleeding on probing (-0.805, 95% CI: -0.894 to -0.654, p < 0.001), attachment loss (-0.752, 95% CI: -0.862 to -0.574, p < 0.001), and bone loss (-0.656, 95% CI: -0.801 to -0.439, p < 0.001). In the present study, the VK2 serum level was correlated to periodontitis, and its severity, complexity, extension, and grade. The range of VK2 was decreasing together with the worsening of all clinical parameters of periodontitis.

Diagnostic Imaging Studies on Local and Systemic Erythropoietin Application for Promoting Bone Regeneration in Rat Calvarial Defects.

The purpose of this study was to compare the effects of local and systemic application of recombinant human erythropoietin (rhEPO) on the healing of rat calvarial defects. Twenty-four male skeletally-mature Wistar rats were used. Two bone 5 mm critical size defects were created in calvarial bones of each rat. In rats from experimental group I (n = 12), EPO was applied locally on a collagen cone in left defects, whereas a collagen cone soaked with physiological saline was placed in right defects. The rats from experimental group II were injected once intraperitoneally with 4900 IU/kg EPO; a collagen cone was only placed in left defects, whereas the right defects were left empty. The systemic effect of EPO treatment was monitored by haematological analyses on days 0, 30 and 90. Bone healing was monitored via radiography and computed tomography on the same time intervals. The results demonstrated that local EPO application had no significant effect on haemopoiesis, unlike the systemic application. At the same time, it resulted in new bone formation and therefore, could be successfully used as a means of promoting bone regeneration.

Vitamin D3 Serum Levels in Periodontitis Patients: A Case-Control Study.

Background: Periodontitis is a multifactorial disease characterized by bacterial-dysbiosis-associated, host-mediated inflammation, which results in the loss of the tooth-supporting tissues. Vitamin D3 plays an important role in the tissue homeostasis and its deficiency might have a negative effect on the periodontitis progression and treatment outcomes. Objectives: The aim of the study was to evaluate the vitamin D3 serum levels among patients with periodontitis and healthy subjects. Materials and Methods: A total of 100 generally healthy adult participants (50 diagnosed with periodontitis, 50 with healthy periodontium) were enrolled in the study. The periodontal clinical parameters were measured, radiographs were performed and the 25-hydroxy vitamin D (25(OH)D) test was used to assess vitamin D3 levels. Results: Vitamin D3 levels were found to be statistically significantly lower among periodontitis patients (31.34; SD = 5.62) compared with healthy controls (39.64; SD = 8.77). Vitamin D3 deficiency was corresponding to the stage and grade of the disease as well as the clinical attachment and bone loss. Conclusion: Adequate monitoring of the vitamin D3 serum levels and supplementation could be of benefit in periodontitis treatment.

Treatment of Residual Periodontal Pockets Using a Hyaluronic Acid-Based Gel: A 12 Month Multicenter Randomized Triple-Blinded Clinical Trial.

The aim of the present study was to evaluate the adjunctive effect of hyaluronic acid (HA) gel in the treatment of residual periodontal pockets over a 12-month period. Periodontal patients presenting at least one residual periodontal pocket 5-9 mm of depth in the anterior area were recruited from six university-based centers. Each patient was randomly assigned to subgingival instrumentation (SI) with the local adjunctive use of HA for test treatment or adjunctive use of local placebo for control treatment at baseline and after 3 months. Clinical parameters ( )probing depth (PD), bleeding on probing (BoP), plaque index (PI), recession (REC), clinical attachment level (CAL)) and microbiological samples for the investigation of the total bacterial count (TBC) and presence of specific bacterial species (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum) were taken at baseline and every 3 months, until study termination. PD was determined as the primary outcome variable. From a total of 144 enrolled, 126 participants (53 males, 73 females) completed the entire protocol. Both treatments resulted in statistically significant clinical and microbiological improvements compared to baseline. Although the local application of HA showed a tendency for better results, there was a lack of statistically significant differences between the groups.

A Comparative Clinical Study of Er:YAG Laser and Hand Instruments in the Treatment of Moderate Chronic Periodontitis.

INTRODUCTION: Moderate chronic periodontitis is the most common periodontal disease. The treatment of this condition should aim at achieving a biocompatible root surface and decontamination of the pocket, thereby restoring the health status. AIM: In the present study, the aim was to examine the clinical effectiveness of fibreless Er:YAG laser used for scaling and root planing and to compare it with a conventional treatment with Gracey curettes. MATERIALS AND METHODS: The study included 909 periodontal pockets which were treated in a split-mouth design with either Gracey curettes or with Er:YAG laser (1.5 W). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BoP), and plaque index were recorded. RESULTS: There was a considerable decrease of PPD, CAL, BoP, and plaque presence values at 1 and 3 months after therapy in both treatment groups. Sites treated with Er:YAG laser demonstrated mean CAL gain of about 1.00 mm and 0.44 mm at the first and third month, respectively. In the control group, there was also significant gain of CAL of about 1.33 mm at the first and 0.30 mm at the third month. Significant difference was observed in all parameters between both groups in favour of the laser treatment. CONCLUSIONS: The results of the present study suggest that the Er:YAG laser shows clinical effectiveness in the treatment of moderate chronic periodontitis. It can be used as a single treatment modality for subgingival scaling and root planing resulting in greater improvements in all recorded data in contrast to conventional treatment.

In Vitro Study of Temperature Changes in Pulp Chamber During Root Planing Procedure Using Er:YAG Laser.

AIM: To assess temperature changes at specified time intervals during Er:YAG laser scaling and root planing of surfaces with dental calculus. MATERIALS AND METHODS: Fifteen single-rooted teeth with advanced periodontal disease were extracted and fixed in a cylinder thermostat filled with distilled water at constant temperature (35.5°C). A specially designed thermal probe (type K thermocouple) accurate to ±0.1°C over the range from 20°C to 80°C was fitted into the pulp chamber of tooth sample. Scaling and root planing of the mesial and distal root surfaces was performed using an Er:YAG laser (Lite Touch, Syneron Dental, Israel) with a wavelength of 2940 nm, provided with a chisel tip, and at the following settings: output energy 100 mJ and 50 Hz, duration of irradiation - 40 sec, the tip in contact mode oblique to the root surface at an angle of approximately 10-15 degrees and water spray level 5-6. The temperature inside the pulp chamber was measured every 10 sec. RESULTS: The temperature in the pulp chamber taken every 10 seconds and compared with the temperature of 35.5°C at baseline decreased by 1.6°C, 2.4°C, 2.5°C, and 2.5°C for the first, second, third and fourth measurement, respectively. These changes did not reach statistical significance. CONCLUSION: The Er:YAG laser does not increase the temperature inside the pulp chamber. The assessed changes do not depend on the duration of irradiation which was kept within 40 seconds. Therefore, this treatment modality causes no thermal damage to the pulp under the above defined conditions and can be considered safe.

Bactericidal effects of using a fiber-less Er:YAG laser system for treatment of moderate chronic periodontitis: preliminary results.

OBJECTIVE: The purpose of this study was to evaluate the bactericidal effectiveness of using a fiber-less Er:YAG laser in the first stage of therapy for moderate chronic periodontitis and to compare it with conventional treatment. METHOD AND MATERIALS: Two quadrants from 20 patients with moderate chronic periodontitis were treated with Gracey curettes (control), and the contralateral two quadrants in each patient were treated using an Er:YAG laser with total power of 1.5W (test). Subgingival plaque samples from the four deepest pockets in each quadrant were taken immediately before and 1 month after treatment, and the presence of nine marker bacteria was studied using real-time polymerase chain reaction technology. RESULTS: A significant reduction of total pathogens and bacteria from the red complex was observed 1 month after treatment with both procedures. The results were more significant for the test group (P = .003) than for the control group (P = .005). Qualitative analysis of sites that had a therapeutically significant number and proportion of marker bacteria also showed significant reduction after treatment. CONCLUSION: The results of the present study suggest that the Er:YAG laser possesses comparable with conventional treatment bactericidal effectiveness against periodontal pathogens in vivo in the initial treatment of moderate chronic periodontitis. More evaluations should be performed to prove these results for a longterm successful clinical outcome.

Effect of non-surgical periodontal therapy on patients with type 2 diabetes mellitus.

UNLABELLED: The AIM of this study was to evaluate the effect of non-surgical therapy on clinical variables and glycemic control on type 2 diabetics with chronic periodontitis. PATIENTS AND METHODS: Forty six type 2 diabetics with chronic periodontitis were randomized into two groups (group A and group B). Treatment included scaling and root planning for group A plus systematic use of doxycycline in both groups. Assessment was made prior to and 16 weeks following the therapy. RESULTS: Analysis of data showed that both groups had clinical and glycated hemoglobin (HbAlc) improvement after the treatment. Group A had a statistically significant reduction of plaque index and bleeding on probing scores compared with controls (P < 0.05) at 16 weeks. CONCLUSION: These results suggest that non-surgical therapy is of value in maintaining periodontal health and may be beneficial in reducing blood glucose level in type 2 diabetics with chronic periodontitis.

Effects of surgical periodontal therapy on serum levels of TNF-alpha in patients with chronic periodontitis.

AIM: To find if serum levels of tumor necrosis factor-alpha (TNF-alpha) can change after a surgical periodontal treatment. PATIENTS AND METHODS: Moderate to severe periodontitis subjects who received basic periodontal treatment were included in the study and randomly divided into two groups. In group A, periodontal surgery was performed. In group B, supportive periodontal therapy was administered. Clinical parameters including probing pocket depth, plaque index and circulating serum TNF-alpha levels were assessed at baseline and 16 weeks following treatment. RESULTS: There was a significant improvement in periodontal health of the surgery group compared with the control subjects, with reduction in plaque index and pocket probing depths. The circulating levels of TNF-alpha decreased statistically significantly in the group A (P < 0.05). CONCLUSION: Surgical periodontal therapy can reduce the circulating serum levels of TNF-t.