Dentists' knowledge about domestic violence against women: A questionnaire-based study.

BACKGROUND: Dentists are the first healthcare professionals to identify cases of domestic violence and abuse (DVA) with head and neck injuries. OBJECTIVES: The aim of this study was to assess dentists' knowledge regarding behavioral and physical findings in female victims of DVA. MATERIAL AND METHODS: The study included 558 volunteer dentists who completed a two-part questionnaire designed to assess their knowledge and awareness of DVA against women. The first part of the questionnaire inquired about the participants' demographic data, including age, sex, specialty, and the duration of professional practice. The second part assessed 15 statements on a 5-point Likert scale, concerning both behavioral (5/15) and clinical aspects (10/15) of DVA. For each statement, if a minimum of 70% of respondents selected the same option, it was interpreted as being agreed upon by the participants. The level of statistical significance was set at p < 0.05. RESULTS: Most of the participants were between the ages of 31 and 40 (29.1%). The study sample was predominantly female (70.4%), with 57.2% of the participants being married. The statement "Abused women tend to avoid eye contact" had the highest agreement rate (70.6%) for the behavioral assessments. However, the participants were mostly "undecided" on the remaining 4 statements in this section. In contrast, the agreement rate for 5 statements related to the clinical assessment of head, neck and intraoral injuries exceeded 70%. One-fifth of the behavioral assessment statements and half of the clinical assessment statements were negatively correlated with the age of the participants (p < 0.05). CONCLUSIONS: The findings of this study indicate that dentists can recognize and diagnose DVA symptoms to a certain extent. However, they may encounter difficulties in identifying the suspicious behavior that is indicative of DVA.

Clinical Efficacy of Conventional and Diode Laser-Assisted Frenectomy in Patients with Different Abnormal Frenulum Insertions: A Retrospective Study.

Objective: This retrospective study aimed to assess the recurrence of frenulum attachment and clinical parameters following conventional and diode laser-assisted frenectomy in patients with abnormal frenulum insertions. Material and methods: The records of 429 patients who underwent maxillary labial frenectomy between 2016 and 2018 were screened. A total of 70 records were included and evaluated based on gender, age, frenulum type, presence of diastema, periodontal disease, and surgical technique. Plaque index (PI), gingival index (GI), and probing depth (PD) were evaluated at baseline and 6 weeks postoperatively. Recurrence was determined by assessing the alteration in the distance from the frenulum attachment to the mucogingival junction (FMGJ) at baseline, 6 weeks, and 12 months. Results: Out of 70 patients (female/male 47/23; age 35.24 ± 11.69 years), 32.9% presented gingival, 38.6% papillary, and 28.6% papilla-penetrating frenulum attachments. Clinical parameters and mean FMGJ values between the conventional (n = 36) and diode laser (n = 34) groups demonstrated no differences at baseline (p > 0.05). PI and GI were significantly higher in the conventional group (p < 0.001), whereas PD was similar (p > 0.05) at 6 weeks. No recurrence was observed in any of the patients at the sixth week. Moreover, 31 participants in the conventional group and 33 participants in the diode-laser group, a total of 64 patients (91.43%), did not present recurrence after 12 months. Conclusions: Within the limits of the study, considering the absence of recurrence in all types of abnormal frenulum insertions in both treatment groups, it was concluded that the diode laser could be used effectively as an alternative to the conventional frenectomy technique.

Evaluation of Patient's Perceptions, Healing, and Reattachment After Conventional and Diode Laser Frenectomy: A Three-Arm Randomized Clinical Trial.

Objective: The aim of this study is to compare the conventional and diode laser techniques in terms of patient's perceptions, epithelization, reattachment, and periodontal clinical parameters in the treatment of abnormal papillary frenum. Materials and methods: Forty-eight patients with abnormal papillary frenum were enrolled in the study. Patients were randomly assigned into three groups; conventional frenectomy operation (C group), diode laser-assisted frenectomy (L group), and diode laser-assisted frenectomy with conventional horizontal incision on the periosteum (L + P group). Postoperative pain, discomfort in speaking, and chewing scores were assessed with visual analogue scale (VAS) at postoperative 3rd hour and on days 1, 7, 14, 21, and 45. Epithelialization process of the wound surface was evaluated by hydrogen peroxide solution applied to the wound on days 7, 14, 21, and 45 following operations. The distance between the frenum attachment point and mucogingival junction (FMGJ) was recorded at baseline, postoperative 45th day, and 6th month to assess the reattachment of the frenum. Plaque index, gingival index, bleeding on probing, and probing depth were recorded at baseline and postoperative 7th, 14th, 21st, and 45th days. Results: On the 1st and 7th day after operation, VAS pain score in the C group was significantly higher than in the L and L + P groups (p < 0.017). Difficulty in speaking and chewing scores were significantly lower in the L and L + P groups compared to the C group at postoperative 3rd hour and 7th day (p < 0.017). The FMGJ and epithelization period demonstrated no difference among the groups at any time point (p > 0.05). Conclusions: Our results suggest that diode laser provides better postoperative patient's perceptions than the conventional technique in frenectomy operation. In addition, both conventional and laser-assisted frenectomy surgeries prevent the frenum reattachment regardless of periosteal horizontal incision.

Efficacy of adjunctive photodynamic therapy in the treatment of generalized aggressive periodontitis: A randomized controlled clinical trial.

OBJECTIVES: Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease characterized by rapid loss of attachment and alveolar bone occurring in young individuals. Photodynamic therapy (PDT) was introduced in periodontology as an adjunctive approach to non-surgical periodontal treatment (NPT) in periodontitis patients. In this trial, the aim was to evaluate the clinical and microbiological effects of adjunctive PDT to NPT in patients with GAgP. METHODS: In this prospective controlled clinical study, 24 systemically healthy, non-smoking subjects with GAgP were enrolled. Subjects were randomly assigned into a control group (n = 12) treated with NPT only or to a test group (n = 12) treated with NPT and PDT. Plaque index, sulcus bleeding index (SBI), probing depth (PD), relative attachment level, gingival recession, and tooth mobility were recorded at baseline and on day 63. Microbiological samples were obtained from the sites with PD ≥ 5 mm at both time periods and evaluated for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola via micro-IDent® test. RESULTS: Clinical and microbial parameters declined significantly in both groups after the treatments (P < 0.01). The comparisons between the groups showed that only the full mouth SBI score of the test group was significantly lower than the control group on day 63 (P < 0.05). Although the reduction in periodontopathogens of the test group was greater than the control group, there was no significant difference between the groups (P > 0.05). CONCLUSIONS: Within the limits of this study, it can be concluded that in the treatment of GAgP, usage of PDT as an adjunct to NPT does not lead to any beneficial effects on the investigated clinical and microbiological parameters except for SBI. Nevertheless, the statistically significant difference for the SBI score demonstrates that PDT may have additional effect on the reduction in gingival bleeding. Lasers Surg. Med. 51:167-175, 2019. © 2018 Wiley Periodicals, Inc.

Relationships between initial probing depth and changes in the clinical parameters following non-surgical periodontal treatment in chronic periodontitis.

PURPOSE: The aim of this study was to evaluate the relationship between initial probing depth (IPD) and changes in clinical parameters following non-surgical periodontal treatment (NPT) in chronic periodontitis patients. SUBJECTS AND METHODS: A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD), clinical attachment level, gingival recessions (GR) were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth. RESULTS: Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001). Attachment gains (AG) were significant in all single-rooted teeth (p<0.001) again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm≤IPD≤9mm (p<0.05). Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001). Furthermore, positive correlations were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001), but there was no correlation between IPD and AG. CONCLUSION: NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.

Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma.

Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone. Surgical site was reconstructed with free gingival graft obtained from hard palate. Hematoxylin-eosin stained sections revealed a nodular mass composed by dense collagen fibers in lamina propria covered by a stratified squamous epithelium, which were consistent with fibroma. Gingival healing was uneventful and without any recurrence during the 12-month follow-up. Conclusions. In order to achieve optimal functional and aesthetical outcomes, free gingival graft can be used for the reconstruction of the wound site after the excision of the fibroma.

Treatment of lateral periodontal cyst with guided tissue regeneration.

Lateral periodontal cyst (LPC), originated from epithelial rests in the periodontal ligament, is a noninflammatory cyst on the lateral surface of the root of a vital tooth. LPC is generally asymptomatic and presents a round or oval uniform lucency with well-defined borders radiographically. In this case report, clinical, histological and radiographical findings and periodontal treatment of 32-year-old female patient, who was referred to Department of Periodontology Clinic of Faculty of Dentistry, Marmara University with a painless hyperplastic lesion on the distobuccal site of the tooth number 12, were presented. The tooth number 12 was vital and a well-defined round radiolucent area with corticated borders was determined radiographically. Preliminary diagnosis was LPC based on clinical and radiographical findings. Mechanical periodontal treatment consisted of oral hygiene instructions, scaling and root planing was applied and flap operation was performed to gain access to the lesion. Following enucleation of the lesion, alveolar bone destruction shaped as a tunnel from labial to palatinal site was observed. The bone cavity was grafted with bovine-derived xenograft, followed by placement of a resorbable collagen membrane. Tissues removed from of the lesion were examined histologically. Hematoxylen-eosin stained sections showed vasculature granulomatous structure underlying squamous epithelium, and destructed bone spaces, all of which were consisted with LPC. Acceptable clinical healing was achieved at 6 months follow-up period. Satisfactory clinical and radiographical outcome can be achieved in the treatment of LPC using regenerative periodontal approach.