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BMC Oral Health ; 20(1): 346, 2020 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-33256683


BACKGROUND: The current study evaluated whether a new digitized scaling training program (DTP: n = 30; supervisor-student-ratio 1:10) improves the performance of undergraduate dental student during a preclinical course in regard to two different instruments [sonic scalers (AIR) and Gracey curettes (GRA)] compared to a conventional training program (CTP: n = 19; supervisor-student-ratio 1:4). METHODS: All the participants received a two-hour lecture on both instruments, followed by a 12-week period with a weekly training program lasting 45 min (10 sessions); one group was supported by DTP. At the end of the training phase, all the participants performed the subgingival scaling of six equivalent test teeth using GRA and AIR. Treatment time, proportion of removed simulated biofilm (relative cleaning efficacy, RCE-b) and hard deposits (RCE-d) were recorded. By using a pseudonymized questionnaire with a 5-point Likert scale, self-assessment of scaling effort, handling, root surface roughness/destruction and effectiveness were evaluated. In addition, personal data such as age, gender, handedness, regularity of playing computer games/consoles and previous dental/technical or medical education were elevated and correlated with cleaning efficacy. RESULTS: The DTP participants showed higher effectiveness in RCE-b compared to those who used the CTP with GRA (71.54% vs. 67.23%, p = 0.004) and AIR (71.75% vs. 62.63%, p ≤ 0.001), and the DTP students were faster with both instruments (p ≤ 0.001). For RCE-d, there was no significant difference between the DTP and CTP groups (GRA p = 0.471; AIR p = 0.158), whereas DTP showed better RCE-d results with GRA versus AIR (84.68% vs. 77.85%, p < 0.001). According to the questionnaire, no significant differences were detected between the training groups in terms of self-assessment, handling, treatment time, root surface roughness/destruction or effectiveness of the instruments. The CTP group favored AIR compared to GRA regarding the fatigue effect. The CTP and playing computer games/consoles regularly was correlated with lower RCE-b, whereas previous education in medicine/dentistry was correlated with higher RCE-b values. CONCLUSIONS: Within the limitations of the study, the DTP with a reduced supervision effort compared to the CTP resulted in higher effectiveness and lower instrumentation time for removing simulated biofilms.

BMC Oral Health ; 20(1): 136, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32384897


BACKGROUND: Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility. METHODS: Five different sizes of commercially marketed IRP with elastomeric fingers (IRP-F) (GUM SOFT-PICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) or slats (IRP-S) (TePe EasyPick™, TePe D-A-CH GmbH, Hamburg, Germany) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N]. RESULTS: IRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area. CONCLUSIONS: New interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S.

Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Escovação Dentária/instrumentação , Alemanha , Humanos , Fotografia Dentária , Pressão , Reprodutibilidade dos Testes , Escovação Dentária/métodos
J Clin Periodontol ; 47(8): 952-961, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32473059


AIM: This pilot study assessed the oral-health-related quality of life (OHRQoL) after long-term periodontal therapy and explored OHRQoL differences along the 2018 Classification of Periodontal Diseases. METHODS: Sixty patients were examined before (T0) and after active periodontal therapy (APT/T1) and 32.0 ± 2.9 [range: 27-38] years of supportive periodontal therapy (SPT/T2). Periodontal diagnosis at T0 was assessed according to the 2018 Classification of Periodontal Diseases (stage 1/2/3/4: n = 1/3/44/13; grade n = A/B/C: 0/8/53). OHRQoL at T2 was measured using the Oral Health Impact Profile-G14 (OHIP-G14). Patients' Eichner's classification, accumulated tooth loss and treatment outcomes (SSO criteria) were assessed at T2. Generalized linear modelling (GLM) assessed associations between different factors and OHrQoL. RESULTS: Mean OHIP-G14 sum score was 3.7 (SD 5.6). There was no statistically significant association between OHIP-G14 and gender, stage, SSO criteria and tooth loss. OHIP-G14 was significantly lower in older patients (-0.2[-0.3;0] per year, p = .008), non-smokers (-5.9[-9.9;-1.9] p = .003) and former smokers (-7.4[-11.6;-3.2]; p < .001) versus current smokers, patients with Eichner class A1-B2 versus C2 (p < .05), sufficient adherence during SPT (-2.3[-4.6;-0.1], p = .044) versus insufficient ones. Patients with grade B (4.4[1.3;7.4]; p < .005) showed higher OHIP-G14 than those with grade C. CONCLUSION: A number of aspects, grounded in the initial diagnosis, the adherence to SPT, the resulting dentition, socio-demographic and behavioural covariates, were associated with good OHrQoL.

Clin Oral Investig ; 22(1): 235-244, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28353021


OBJECTIVES: The aim of this retrospective study was to evaluate the long-term implant survival in patients with a history of chronic periodontitis, during supportive periodontal therapy (SPT), compared to periodontally healthy patients. MATERIALS AND METHODS: Twenty-nine periodontitis patients (test) with SPT for ≥9 years and implant-supported restorations (≥5 years follow-up) were recruited and pair-matched with 29 periodontally healthy patients (control). Subjects in both groups were examined following active periodontal therapy and/or implantation (T1) (test 69 implants, control 76 implants) and at end of SPT or supportive postimplant therapy (T2). Differences between the groups in implant survival (primary outcome), mean marginal bone loss (MBL) and pocket probing depths (PPDs) (secondary outcomes) were evaluated. RESULTS: Implant survival over 5 years was 97.1% in test compared to 97.4% in control group (p = 0.562). MBL was significantly different (test 18.7 ± 18.2%; control 12.5 ± 21.3%) (p < 0.05). PPDs increased at T2 in both groups (test: T1 3.4 ± 1.0 mm; T2 4.2 ± 1.6 mm; control: T1 1.0 ± 1.2 mm; T2 2.9 ± 0.8 mm; p < 0.05 between groups). Prognostic factors for implant loss appeared to be the presence of residual periodontal pockets of ≥4 mm (OR 1.90), bone height (OR 1.81) and age (OR 1.16) at T1. CONCLUSION: In terms of implant survival, no differences were observed between periodontitis and periodontally healthy patients. However, patients with history of periodontitis showed higher MBL and PPDs compared to periodontally healthy patients. CLINICAL RELEVANCE: The presence of a good periodontal maintenance program with preceding successful active periodontal treatment seems to be indispensable components of successful implant treatment in patients with history of chronic periodontitis.

Periodontite Crônica/complicações , Periodontite Crônica/terapia , Implantes Dentários , Falha de Restauração Dentária , Adulto , Idoso , Estudos de Casos e Controles , Prótese Dentária Fixada por Implante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos