Nd:YAG (1064 nm) laser for the treatment of chronic periodontitis: a pilot study.

AIM: To evaluate the clinical and microbiological effects of neodymium: yttrium-aluminum-garnet laser therapy as an adjunct to scaling and root planing during the hygienic phase. METHODS: In eight patients, sites with a mean probing pocket depth (PPD) of ≥5 mm were treated by either scaling and root planing (n=28) (control) or by scaling and root planing and adjunctive laser therapy (n=28) (power: 5W). Re-evaluation was at 4-6 weeks. Thereafter, remaining pockets (mean PPD ≥5 mm) were eliminated by either laser surgery (power: 7 W) or gingivectomy (control). RESULTS: At baseline, the mean PPD of sites originally presenting with a mean PPD ≥4 mm were 4.69 and 4.73 mm in the test and control sites, respectively. Six months following surgery, there was a similar average mean PPD reduction in the test (1.18 mm, P<0.01) and control sites (1.35 mm, P<0.01). Also, the reduction in bleeding on probing in both groups was statistically significant (P<0.01, paired t-tests). No statistically-significant differences between the test and control sites were found for any clinical or microbiological parameters at baseline, after initial, and 3 or 6 months' post-surgical therapy. CONCLUSION: During the hygienic phase, neodymium: yttrium-aluminum-garnet (1064 nm) laser treatment yielded no superiority in clinical efficacy compared to conventional debridement. Laser gingivectomy resulted in similar treatment outcomes (mean PPD and bleeding on probing reduction), as did conventional gingivectomy.

Restoration margins in young adolescents: a clinical and radiographic study of Swiss Army recruits.

PURPOSE: The aim of the present study was to report the radiographical prevalence of overhanging fillings in a group of Swiss Army recruits in 2006 and to relate the dimensions of the overhangs to clinical parameters. MATERIALS AND METHODS: A total of 626 Swiss Army recruits were examined for their periodontal conditions, prevalence of caries, and stomatological and functional aspects of the masticatory system and halitosis. In particular, the present report deals with the presence or the absence of fillings, the presence or the absence of overhangs and their relation to clinical and radiographic parameters. RESULTS: A total of 16,198 interdental sites were evaluated on bitewing radiographs. Of these sites, 15,516 (95.8%) were sound and 682 (4.2%) were filled. Amalgam restorations were found in 94.1% and resin composite fillings in 5.9% of the sites. Of these 682 sites, 96 (14.1%) yielded overhanging margins of various sizes. This low prevalence of fillings represents not only a substantial reduction when compared with a similar Swiss Army study (Lang et al, 1988), but also an improvement in the quality of dental care delivery to young Swiss males. Plaque Index and Gingival Index increased statistically significantly with the presence of fillings, when compared with healthy non-filled sites. Clinical parameters that were significantly associated with the presence of overhangs included clinical attachment loss. Moreover, between 1985 and 2006 the prevalence of fillings was significantly reduced from 20.0% to 4.2% of all surfaces. Furthermore, the marginal fit of the fillings improved from 33.0% with overhangs to 14.1%. CONCLUSIONS: A significant improvement was observed in the periodontal and dental conditions of young Swiss males that was shown to have taken place within the previous two decades. From 1985 to 2006, the prevalence of fillings was reduced fourfold and that of overhanging margins twofold, documenting an improvement in the quality of restorative dentistry.

Influence of suture tension to the tearing characteristics of the soft tissues: an in vitro experiment.

OBJECTIVES: To evaluate the influence of flap tension on the tearing characteristics of mucosal tissue samples in relation to various suture and needle characteristics. MATERIAL AND METHODS: Lining and masticatory mucosal tissue samples obtained from pig jaws were prepared for in vitro testing. Tension tearing diagrams of 60 experiments were traced for 3-0, 5-0 and 7-0 sutures with applied forces up to 20 N. In the second part, the same experiments were repeated with 100 diagrams to test the influence of needle characteristics with 5-0 and 6-0 sutures using only gingival tissue samples. RESULTS: 3-0 sutures mainly lead to tissue breakage at an average of 13.4 N. In contrast, 7-0 sutures only resulted in breakage of the thread at a mean applied force of 3.7 N. With 5-0 sutures, both events occurred at random at a mean force of 14.6 N. Irrespective of the needle characteristics, the mean breaking force for gingival samples with 5-0 and 6-0 sutures was approximately 10 N. CONCLUSIONS: Tissue trauma may be reduced by choosing finer suture diameters, because thinner (6-0, 7-0) sutures lead to thread breakage rather than tissue breakage.

Periodontal conditions in Swiss army recruits: a comparative study between the years 1985, 1996 and 2006.

AIM: To compare the periodontal conditions of Swiss Army recruits in 2006 with those of previous surveys in 1996 and 1985. MATERIAL AND METHODS: A total of six hundred and twenty-six Swiss Army recruits were examined for their periodontal conditions, caries prevalence, stomatological and functional aspects of the masticatory system and halitosis. In particular, this report deals with demographic data, the assessment of plaque index (PlI), gingival index (GI) and pocket probing depth (PPD). RESULTS: Two per cent of all teeth were missing, resulting in a mean of 27.44 teeth per subject, and 77% of the missing teeth were the result of pre-molar extractions due to orthodontic indications. The mean PlI and GI were 1.33 and 1.23, respectively. On average, 27% of the gingival units bled on probing. The mean PPD was 2.16 mm (SD 0.64). Only 3.8% of the recruits showed at least one site of PPD > or = 5 mm, and 1.4% yielded more than one site with PPD > or = 5 mm. In comparison with previous, this survey yielded lower bleeding on probing (BOP) percentages than in 1985, but slightly higher scores than in 1996. This may be attributed to increased PlI scores in 2006. However, PPD remained essentially unaltered from 1996 to 2006 after having improved significantly from 1985. CONCLUSION: A significant improvement of the periodontal conditions of young Swiss males was demonstrated to have taken place between 1985 and 1996, but no further changes during the last decade were noticed.

Patterns of tissue remodeling after placement of ITI dental implants using an osteotome technique: a longitudinal radiographic case cohort study.

The aim of this prospective study was to document radiographically tissue remodeling patterns around ITI implants placed according to an osteotome technique. In 19 consecutive patients from a private practice, 25 implants of the ITI Dental Implant System were placed subjacent to the sinus floor. Implant beds were pre-prepared with pilot drills and/or using the Summers Osteotome Kit. Bio Oss particles were mixed with autologous bone and inserted into the apex area. Implants were placed self-tapping. The sinus floors were thereby pushed up with attempts not to sever the Schneiderian membrane. Healing occurred submerged or semi-submerged and was uneventful in 24/25 implants. At 1 year, all implants had been restored with crowns or short fixed partial dentures. One implant was lost in the first 3 weeks, but was replaced 6 months later in a second attempt. Intraoral radiographs were obtained presurgically and postsurgically at 3 and 12 months. The mean preoperative distance between the sinus floor and the crest was 7.0 mm (range 2.3-10.3 mm). The mean distances between the implant apex and the initial sinus floor were: 3.66 +/- 1.74 mm mesially and 4.44 +/- 1.62 mm distally. The mean height of the new bone reaching apically and mesially to the implants was 1.52 +/- 2.48 mm at surgery, but was reduced significantly to 1.24 +/- 1.30 mm at 3 months and 0.29 +/- 1.91 mm after 12 months (Hotelling's test P< or =0.01). Similar values were obtained at the disto-apical aspects. In an attempt to assess periapical bone/graft remodeling, a novel index was applied: 0=no bone/graft visible, 1=cloudy appearance of new bone/graft, 2=clearly visible new bone/graft disappearing structures of original sinus floor, 3=new bone/graft with new cortical plate and the former boundary of the sinus floor disappearing. This index increased statistically significantly from baseline to 12 months (Hotelling's test P< or =0.02). In conclusion, this study shows that in areas with reduced bone height subjacent to the sinus, an osteotome technique may provide a minimally invasive way to obtain implant abutments predictably. The grafted area apical to the implants undergoes shrinkage and remodeling. The original boundary of the sinus is eventually consolidated and replaced by a new cortical plate. In addition to the linear measurements, the novel index may assist in assessing periapical remodeling at implants placed with an osteotome technique.

Influence of compliance and smoking habits on the outcomes of supportive periodontal therapy (SPT) in a private practice.

PURPOSE: The purpose of this retrospective cohort study was to evaluate the effect of smoking habits and patient compliance on the outcomes of supportive periodontal therapy (SPT) (tooth loss and residual pockets defined by probing depth of > or = 5 mm) in a private practice situation. MATERIALS AND METHODS: Eighty-seven patients, who completed active periodontal treatment and then followed an SPT program for at least 5 years, were recruited from the patient pool of a private dental practice. After active periodontal therapy and at the follow-up examination 5-11 years later, pocket probing depths (PPD) and tooth loss were assessed, and the patients were divided into 4 subgroups based on their smoking history: non-smokers (NS); occasional smokers (OS); moderate smokers (S); and heavy smokers (HS). The patient cohort was also divided into 4 subgroups based on patient compliance (mean delay from the scheduled recall sessions): fully compliant (< 1 week); compliant within 1-3 weeks; compliant within 3-6 weeks; and not compliant (> 6 weeks). RESULTS: The mean tooth loss per patient and year ranged from 0.11 - 0.18 in the various subgroups with no significant differences between them. After a mean observation period of 7.3+/-1.5 years, the incidence of new sites with residual probing depth of > or =5 mm varied between 1.2% for the NS and 13.8% for the HS (p < 0.05,), and between 3.2% for the compliant and 5.8% for the non-compliant patients. CONCLUSION: Smoking habits significantly influenced the treatment outcomes of SPT, while compliance was less influential regarding the incidence of new residual pockets during 7.3 years of SPT.

[Comparison of undergraduate and continuing education in periodontology at Swiss universities at the turn of the century]. / Schweizer interuniversitärer Vergleich der Aus- und Fortbildung im Fach Parodontologie um die Jahrhundertwende.

The purpose of the present study was to evaluate the professional knowledge in periodontology of the dentists, a subject which has been taught officially since 1972 as an independent area, to determine the self-assessed level of competence and to elaborate on the needs for continuing education in periodontology. The present evaluation used questionnaires sent to all members of the Swiss Society of Odontology SSO in the summer of 2000. One third of the questionnaires were returned. The questionnaires contained three parts: A) Demographic information assuring that the distribution of the answering colleagues corresponded to that of all dentists in Switzerland. B) Self-assessment of undergraduate and continuing education. Colleagues with professional experience of less than six years evaluated themselves as being most competent theoretically, while those with professional experience of 6-25 years felt most competent practically. C) Objective professional knowledge of the etiology and therapy of periodontal diseases. Such evidence-based statements had also been presented to the European Academy of Periodontology (EAP) in 1993 at the 1st European Workshop in Periodontology. In comparison to the students and faculty of the University of Washington and the EAP, it was possible to evaluate the level of knowledge in periodontology of Swiss dentists. It was evident that their professional knowledge was on a level which corresponded to the state of scientific evidence. However, there were differences between graduates from the different Swiss universities.

Simultaneous or staged installation with guided bone augmentation of transmucosal titanium implants. A 3-year prospective cohort study.

A prospective cohort study of 45 nonsmoking consecutively admitted patients was studied for the treatment outcomes following jaw bone augmentation in conjunction with installment of oral implants. Twenty-eight patients were treated for both bone augmentation and implant treatment simultaneously, while 17 patients were treated with a staged approach with the bone augmentation being performed 6-8 months prior to implant installation. Three months following this, prosthetic reconstructions were incorporated. One year thereafter, baseline data and 3 years after reconstruction, follow-up data were obtained. Moderately low mean scores for the bleeding on probing percentage were found at baseline (24%) and after 3 years of function (17%), while the corresponding values at the implant sites were 40.6% and 52.4%, respectively. However, the modified gingival index (mGI) = 2 was found in only 4.8%, and 6.9% at the baseline and 3-year examinations. Peri-implant Probing depth (PPD) and level of attachment mean values did not vary between baseline and follow-up examinations. Only a small proportion of 1.8% yielded PPD = 6.0 mm after 3 years of function. Radiographic bone level measurements showed that 18.2% of the implants lost 0.5 mm during the observation period. Seventy percent of the sites were considered completely stable. It was concluded that predictable treatment outcomes resulted for oral implant installation combined with or staged after jawbone augmentation. Only 6.5% of the sites had lost 1.5% crestal bone with the staged approach while 14% of the sites had lost 1.5 mm, when the implants were placed simultaneously. This suggests that the staged approach may have a lower risk for greater amounts of crestal bone loss as the simultaneous approach. In general, crestal bone loss encountered in the present study corresponded very well with that reported following placement of the same implant system into nonaugmented bone.