Residual periodontal ligament in extracted teeth - is it associated with indication for extraction?

BACKGROUND: Periodontal disease is a major cause of tooth loss. Few studies have evaluated the residual area of the periodontal ligament in extracted teeth and, to the best of our knowledge, none from Latin America have done so regarding indications for extraction. The aim of this study was to evaluate the residual periodontal ligament (RPL) with respect to indication for extraction in a sample of teeth from a Brazilian Public Health Service district. MATERIALS AND METHODS: All teeth extracted within the Public Health Service district of Santa Maria, Brazil, over a 5-month period were requested for analysis. A total of 414 teeth eligible for measurement were stained and evaluated for RPL using a stereo microscope. Participating Public Health Service dentists completed a questionnaire detailing demographic variables and indication for each extracted tooth. The percentage of RPL was determined for each tooth. Comparisons of RPL between teeth extracted on periodontal versus other indications were made using the Mann-Whitney test. RESULTS: RPL averaged 34.8% for teeth extracted on periodontal indications versus 79.5% for other teeth (P ≤ 0.001). When considering teeth with an RPL ≥ 30% as possible to maintain, 189 (76%) of the teeth extracted on periodontal indications could have been maintained. When RPL cut-off limits of ≥ 40% or ≥ 50% are applied, 93 (37%) and 43 (17%) teeth, respectively, could have been maintained. CONCLUSION: This study suggests that strictly based on RPL, a large number of teeth extracted on periodontal indications conceivably could be maintained.

Effect of self-performed mechanical plaque control frequency on gingival health in subjects with a history of periodontitis: A Randomized Clinical Trial.

AIM: This randomized clinical trial evaluated the effect of the frequency of self-performed mechanical plaque control (SPC) on gingival health in subjects with a history of periodontitis. MATERIALS AND METHODS: Forty-two subjects participating in a routine periodontal maintenance program were randomized to perform SPC at 12-, 24- or 48-hr intervals. Plaque index (PlI) and gingival index (GI) were evaluated at baseline, and days 15, 30 and 90 of study. Probing depths, clinical attachment levels and bleeding on probing were assessed at baseline, days 30 and 90. Mixed linear models were used for the analysis and comparison of experimental groups. RESULTS: Mean GI at baseline remained unchanged throughout study (90 days) only in the 12-hr group (0.7 ± 0.1 versus 0.8 ± 0.1; p < .05). At the end of study, mean GI was significantly increased in the 48-hr group over that in the 12- and 24-hr groups. When GI = 2 scores were considered, only the 48-hr group failed to maintain gingival health throughout the study (18.8%). CONCLUSION: SPC performed at a 12- or 24-hr frequency appears sufficient to controlling gingival inflammation whereas this clinical status was not maintained using a 48-hr frequency in subjects with a history of periodontitis subject to a routine periodontal maintenance program (ClinicalTrials.gov: 50208115.9.0000.5346).

Validity of self-reported measures for periodontitis surveillance in a rural sample.

BACKGROUND: To evaluate the predictive performance of self-reported questions for periodontitis screening in a representative sample of a rural population. METHODS: Nine questions were compared with gold standard clinical examinations (probing six sites/tooth, full-mouth). Case definition for severe periodontitis was defined according to World Workshop (2017-WW) and Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). Diagnostic tests such as sensitivity (SN), specificity (SP), positive and negative predictive values were performed for all questions alone and grouped into models. Binary logistic regression modeling was used to derive parameter estimates for all variables in a given model and the area under ROC curve was calculated. RESULTS: Clinical examinations showed a prevalence of periodontitis in the sample (n = 585) of 99.4% and 86.3%, being 40.3% and 33.8% of severe disease according to 2017-WW and CDC/AAP case definitions, respectively. Individually, only the questions regarding the self-perception of teeth/gum health and loose and lost teeth were valid to predict severe periodontitis. The best logistic regression models combined sociodemographic variables and risk-factors with the self-reported measures of self-perception of gum disease, teeth/gum health, loose teeth and history of tooth loss. CONCLUSION: Predictive performance of these self-reported questions presented herein support its potential use for surveillance of severe periodontitis in rural populations with high periodontitis prevalence.