Comparative Analysis of Periodontal Parameters and Patient Satisfaction Utilising Different Temporary Crown Fabrication Techniques: A Parallel-Group Randomised Controlled Trial.

Aim The study aims to evaluate the efficacy of different techniques for temporary crown fabrication in maintaining periodontal health and patient satisfaction, addressing a critical gap in the existing literature and informing evidence-based clinical practices. Materials and methods This study, conducted in accordance with CONSORT guidelines, was a parallel-group randomised trial conducted at a dental institute in India. In total, 36 participants aged 18-65 requiring anterior tooth region crowns were randomly assigned to three groups: direct (control), indirect (Test Group 1) and direct-indirect (Test Group 2) fabrication techniques. Participants were selected from outpatient departments based on eligibility criteria, and interventions were allocated using randomization tables. Outcome assessments included gingival health metrics and patient satisfaction levels, with statistical analyses performed using the Kruskal-Wallis test. Results Significant differences were observed in the pink esthetic score (PES) and patient satisfaction (P=0.029) among the three groups, with the direct-indirect technique group demonstrating the highest median PES (9 out of 10). However, no significant disparities were noted in the plaque index (PI) or probing depth (PD) among the groups. Conclusion The direct-indirect technique demonstrated superior PES and patient satisfaction, indicating potential benefits for periodontal health and patient experiences. Integration of virtual preparation workflows may optimise outcomes, but further research is needed for validation and guideline development.

A Bibliometric Analysis of Literature on the Impact of Rheumatoid Arthritis on Oral Health (1987-2024).

This bibliometric analysis investigates the research landscape concerning the impact of rheumatoid arthritis (RA) on oral health through a comprehensive literature review. The study includes all English-language articles retrieved from the PubMed database, focusing on the relationship between RA and various aspects of oral health without any filter. The analysis of 261 publications revealed fluctuations in publication patterns from 1987 to 2024, with notable surges and declines in research activity. Collaborative networks among authors and institutions were identified, highlighting key contributors and prolific institutions such as Karolinska Institutet. The themes prevalent in the research included demographics, oral microbiota, biomarkers, treatment outcomes, and molecular mechanisms. Trend topic and thematic evolution analyses elucidated shifts in research focus from traditional concerns to emerging areas such as oral microbiology and immunological mechanisms. Key findings underscored the need for more clinical trials to comprehend the impact of RA on oral health, enhanced interdisciplinary collaboration, exploration of emerging areas, and longitudinal studies. This analysis provides valuable insights into the evolving research landscape, informing future investigations and interventions to improve oral health outcomes in individuals with RA.

The Influence of Orthodontic Treatment on Periodontal Health between Challenge and Synergy: A Narrative Review.

By correctly repositioning teeth, orthodontic therapy improves both the function and appearance of an occlusion. The relationship between teeth and the tissues that surround and support them significantly influences these alterations. With ever more adults seeking orthodontic care, orthodontists are increasingly seeing patients with periodontal issues. Concerns about the patient's appearance, such as uneven gingival margins or functional issues caused by inflammatory periodontal diseases, should be accounted for when designing orthodontic treatment plans. Furthermore, orthodontics may increase the chances of saving and recovering a degraded dentition in cases of severe periodontitis. Today, general dentists, dontists, and orthodontists play integrative roles that enable them to achieve the best possible results for their patients. This review will improve the results of interdisciplinary treatments and increase cooperation between dental specialists by drawing attention to the essential connection between orthodontics and periodontics in regular clinical practice.

Periodontal outcomes of surgically exposed and orthodontically aligned buccally impacted maxillary canines: A systematic review and meta-analysis.

OBJECTIVE: This systematic review aimed to compare periodontal outcomes of surgically exposed and orthodontically aligned buccally impacted maxillary canines to spontaneously erupted maxillary canines. DATA SOURCES: An unrestricted search was carried out of indexed databases (Medline, EMBASE, Web of Science and Scopus), reference lists of included studies, and grey literature published until December 2023. DATA SELECTION: Observational and experimental studies that addressed the focused question 'Do periodontal outcomes of buccally impacted maxillary canines that were surgically exposed and subsequently extruded and aligned using orthodontic alignment differ from those of spontaneously erupted maxillary canines?' were included. DATA EXTRACTION: Study screening, selection and data extraction were performed independently by two authors, with disagreement resolved by a third reviewer. The risk of bias was assessed using the JBI Critical Appraisal Checklist and GRADE approach. RESULTS: A total of 857 citations were found and five studies were eligible for inclusion. Supragingival plaque accumulation and gingival inflammation were similar between impacted canines and their contralaterals in most studies. Meta-analyses revealed no significant differences in keratinised tissue width (prospective studies: MD = -0.28, 95% confidence interval [CI] = -1.13-0.56, I² = 78%; retrospective studies: MD = 0.61, 95% CI = -1.51-2.72, I² = 94%). However, a meta-analysis of prospective studies showed slightly greater mean probing depth for impacted canines compared to their contralateral canines (prospective studies: MD = 0.16, 95% CI = 0.04-0.28, I² = 0%). The evidence certainty for keratinised tissue width and probing depth outcomes was low. CONCLUSION: Surgically exposed and orthodontically aligned buccally impacted canines have slightly greater probing depths, potential bone loss and increased clinical crown length, compared to their counterparts. However, these small differences (<1 mm) are unlikely to be clinically significant.

Mean platelet volume is associated with periodontitis: a cross-sectional study.

BACKGROUND: It is uncertain if mean platelet volume and periodontitis are related. The objective of this study was to examine the association between levels of mean platelet volume and moderate/severe periodontitis in adult persons who inhabit the U.S. METHODS: We screened 6,809 people from the National Health and Nutrition Examination Survey (NHANES 2009-2012). Mean platelet volume was measured in the Mobile Examination Centers (MECs) using the Beckman Coulter analyzer. The category of periodontitis was defined by the CDC/AAP using clinical periodontal parameters. Multiple logistic regression models were employed to examine the distribution for covariate differences across the various independent groups. Four models were employed to examine the relationship between mean platelet volume level and periodontitis. Smoothed curve fitting was utilized to confirm the linearity of the relationships. To determine the impact of factors on the connection between MPV and periodontitis, subgroup analysis and interaction testing were utilized. RESULTS: Results from the multiple logistic regression analysis indicate a significant association between moderate/severe periodontitis and the mean platelet level, even after considering any potential confounding variables (OR = 1.090, 95% CI: 1.019-1.166, P-value = 0.01211). Additionally, those in the upper tertile of mean platelet volume levels had a 21.6% higher probability of developing periodontitis when compared with those in the least tertile of mean platelet levels (OR = 1.216, 95% CI:1.052-1.406, P-value = 0.00816). Moreover, it showed a positive correlation between mean platelet volume (MPV) and moderate/severe periodontitis. Subgroup analyses indicated a positive association between the level of mean platelet volume and moderate/severe periodontitis among individuals who were under 60 years of age, had low income, were obese, never smoked, were heavy drinkers, had hypertension, and had no cardiovascular disease (p < 0.05). However, none of the subgroups exhibited significant interactions (p for interaction > 0.05). CONCLUSION: A correlation has been found between mean platelet volume levels and periodontal disease in individuals residing in the United States.

Comparative Evaluation of CBCT and MRI in Temporomandibular Joint (TMJ) Disorders and their Relationship to Periodontal Health.

Cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) are diagnostic tools frequently employed to evaluate temporomandibular joint (TMJ) disorders, yet their comparative efficacy remains a subject of interest. In this study, we conducted a comparative evaluation of CBCT and MRI in diagnosing TMJ disorders and assessing their association with periodontal health. We recruited a sample of 100 patients presenting with TMJ symptoms and divided them into two groups. Group A underwent CBCT imaging, while Group B received MRI scans. Clinical assessments of periodontal health were performed using established periodontal indices. Diagnostic accuracy, sensitivity, specificity, and interobserver agreement were calculated for each imaging modality. In the current study, CBCT demonstrated superior diagnostic accuracy (85%) compared to MRI (72%) in identifying TMJ disorders. Sensitivity and specificity for CBCT were 87% and 83%, respectively, while for MRI, sensitivity was 68%, and specificity was 76%. Interobserver agreement was substantial for CBCT (κ = 0.75) and moderate for MRI (κ = 0.56). In addition, CBCT revealed a significant correlation between TMJ disorders and periodontal health (P < 0.05), while MRI showed a weaker association (P < 0.1). We concluded from this study and suggest that CBCT is a more accurate imaging modality for diagnosing TMJ disorders compared to MRI. Moreover, CBCT provides valuable insights into the relationship between TMJ disorders and periodontal health, highlighting the importance of comprehensive dental assessments.

Community Water Fluoridation and its Influence on Periodontal Health in Different Age Groups.

Background: Community water fluoridation is a well-recognized public health initiative known for its efficacy in preventing dental cavities. The positive effects of fluoride on tooth enamel have led to widespread implementation of water fluoridation programs. Materials and Methods: This cross-sectional study involved 1,000 participants from diverse age groups, spanning children, adolescents, adults, and older adults, residing in both fluoridated and non-fluoridated communities. Comprehensive periodontal assessments included measurements of probing depth (PD), clinical attachment level (CAL), and the presence of gingival inflammation. Participants were categorized into "fluoridated" or "non-fluoridated" groups based on their residential history. Results: Fluoridated communities consistently displayed lower mean PDs, CALs, and rates of gingival inflammation across all age groups. Notably, the reduction in PD and CAL reached approximately 0.5 millimeters and 0.3 millimeters, respectively, while the decrease in gingival inflammation ranged from 3% to 5. Conclusion: This study suggests a potential link between community water fluoridation and enhanced periodontal health, as evidenced by improved PDs, CALs, and reduced gingival inflammation.

Effectiveness of Online vs. In-Person Periodontal Health Workshops for Public Awareness.

Background: Periodontal health is a critical aspect of overall oral health, yet public awareness and education on this topic remain limited. With the increasing prevalence of online health education platforms, it is essential to evaluate the effectiveness of online periodontal health workshops compared with traditional in-person workshops on improving public awareness. Materials and Methods: Study Design: This randomized controlled trial (RCT) aimed to assess the impact of online and in-person periodontal health workshops on public awareness. Participants (N = 500) were randomly assigned to one of two groups: the online workshop group or the in-person workshop group. Online Workshop: Participants in this group accessed an interactive online periodontal health workshop, consisting of video presentations, animations, and quizzes. The workshop covered topics, such as gum disease prevention, oral hygiene, and the importance of regular dental checkups. In-Person Workshop: Participants in this group attended a traditional in-person periodontal health workshop conducted by dental professionals. The content and duration of this workshop mirrored the online version. Pre- and Postworkshop Assessments: Both groups completed pre-workshop and postworkshop assessments, including a knowledge questionnaire and a self-assessment of oral health habits. Arbitrary scores were assigned to quantify knowledge gain (0-100%). Results: Participants in the online workshop group showed a mean knowledge gain of 30% (standard deviation (SD) = 5.2), while those in the in-person workshop group exhibited a mean knowledge gain of 35% (SD = 4.7). The self-assessment of oral health habits indicated an improvement in both groups, with 60% of participants reporting better oral hygiene practices. Conclusion: Both online and in-person periodontal health workshops demonstrated effectiveness in improving public awareness and promoting better oral health habits. Combining both modalities could be an effective strategy for comprehensive public education on periodontal health.

The Effect of a Low-Carbohydrate Diet on Periodontal Health and Inflammation in Patients with Type 2 Diabetes.

Background: The interaction between type 2 diabetes and periodontal disease underscores the importance of exploring dietary interventions that could mitigate inflammation and improve periodontal health in diabetic patients. Materials and Methods: This randomized controlled trial included 100 patients with type 2 diabetes who were equally divided into two groups: Group A (low-carbohydrate diet) and Group B (control group). Patients in Group A followed a low-carbohydrate diet for 12 weeks, while Group B maintained their regular dietary habits. Periodontal health was assessed using clinical parameters such as probing depth (PD) and clinical attachment level (CAL), and inflammation was measured by analyzing levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Statistical analyses were performed using appropriate tests. Results: After 12 weeks, Group A exhibited significant improvements in periodontal health compared to Group B. The mean PD reduction was 0.5 mm in Group A and 0.1 mm in Group B, with a corresponding mean CAL gain of 0.3 mm in Group A and no significant change in Group B. Inflammatory markers also showed favorable outcomes in Group A, with a decrease of 1.2 mg/L in CRP levels and 20% reduction in IL-6 levels. In contrast, Group B demonstrated minimal changes in inflammatory markers. The differences in PD, CAL, CRP, and IL-6 levels between the two groups were statistically significant (P < 0.05). Conclusion: The adoption of a low-carbohydrate diet for 12 weeks demonstrated significant improvements in periodontal health and reduction of inflammation in patients with type 2 diabetes.

Comparative Evaluation and Correlation of Periodontal Status With Inflammatory Markers in Pregnant Women With or Without Chronic Periodontitis: A Clinico-Hematological Study.

Background The research delves into the intricate relationship between periodontal health and specific blood biomarkers in pregnant women during their second trimester. It specifically focuses on the levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), and C-reactive protein (CRP) in those suffering from chronic periodontitis compared to healthy controls. Methodology A detailed approach was taken involving 60 pregnant women categorized into two groups based on the presence or absence of chronic periodontitis. Out of 60 pregnant women, 30 had chronic periodontitis, while the other 30 served as controls selected from the regular patient population of the college. The study utilized blood sample analysis and advanced statistical tools for data analysis, ensuring precise and reliable results. Levels of IL-6, LDH, and CRP in those suffering from chronic periodontitis compared to healthy controls were checked. Results The findings revealed a notable variance in IL-6, LDH, and CRP levels between the two groups. Women with chronic periodontitis exhibited significantly higher levels of these biomarkers. The statistical analysis reinforced the validity of these differences, highlighting their significance. Conclusions The study underscored a clear link between higher levels of IL-6, LDH, and CRP and the presence of chronic periodontitis in pregnant women. These biomarkers emerge as potential indicators for early detection and monitoring of periodontal health in this demographic.

Prevalence and Severity of Periodontal Disease and its Association with Type-II Diabetes Mellitus and Smoking by Using Periodontal Screening and Recording: A Retrospective Study.

Background: Periodontal screening recording (PSR) is considered a quick, reliable, reproducible valuable screening tool for periodontal disease. This study aims to find the prevalence and severity of periodontal disease and its association with self-reported diabetic status and smoking history of the patients by using PSR codes over a period of 2 years. Material and Methods: This was a cross-sectional retrospective study in a dental hospital in Chandigarh. Data of 10,882 patients comprising self-reported history of smoking (893) and diabetes (725) patients were assessed for the prevalence of periodontal disease by using PSR codes. Pearson Chi-Square test was used for statistical evaluation of PSR codes data. Results: Out of a total of 65,292 sextants assessed, the maximum and minimum reported PSR codes were 2 and 4, respectively. Gingivitis was found to be the most prevalent, followed by periodontitis and periodontal health in the total assessed population (P < 0.001). Mucogingival problems and complete edentulism were found to be more prevalent in posterior sextants in comparison to anterior sextants. Both self-reported smokers and type-II diabetes mellitus patients presented gingivitis as the most common clinical presentation, with the highest prevalence seen in the 55-74-year age group, which also comprised the group with maximum mucogingival problems and edentulism. Conclusion: This study gives an overview of patients' general oral health status and reflects the burden of periodontal disease in the Chandigarh region, thus contributing to the national oral health data.

Association between Gingival Phenotype and Periodontal Disease Severity-A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment.

This longitudinal study aimed to compare the association between gingival phenotype (thin vs. thick) and periodontal disease severity in patients undergoing fixed orthodontic therapy (FOT) and Invisalign treatment over a six-month follow-up period. Clinical periodontal parameters, including full mouth plaque score (FMPS), full mouth bleeding score (FMBS), gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), keratinized tissue width (KTW), transgingival probing, and gingival biotype assessment, were recorded at baseline and 6 months into treatment for both orthodontic groups and a control group. Statistical analysis evaluated differences in parameters between groups and across time points. In the thick phenotype, both Invisalign and FOT groups showed a significant mean reduction in FMPS (baseline to 6 months) by -24.8707 and -12.3489, respectively (p < 0.05). The gingival index decreased significantly for both groups, with Invisalign and FOT showing reductions of -0.83355 and -1.10409, respectively (p < 0.05). FMBS (baseline to 6 months) decreased significantly for Invisalign and FOT, with mean differences of -9.10298 and -12.6579 (p < 0.05). Probing pocket depth (baseline to 6 months) was also significantly reduced for both Invisalign and FOT groups while CAL showed non-significant differences in both groups (p > 0.05). Similar changes were seen in the thin phenotype too. This study highlights the positive influence of both Invisalign and fixed orthodontic therapy on periodontal health, particularly in patients with thin and thick gingival biotypes. These findings, with significant reductions in key periodontal parameters, offer valuable insights to guide orthodontic treatment decisions and enhance patient outcomes.

Clinical and radiographic periodontal status in hypertensive patients with or without obstructive sleep apnea 10 years after diagnosis and CPAP initiation.

OBJECTIVES: Through inflammation and hyposalivation, obstructive sleep apnea (OSA) is suggested to affect periodontal status over time. Our aim was to compare the clinical and radiographic periodontal status of hypertensive patients with or without long-term presence of OSA, treated or untreated with continuous positive airway pressure treatment (CPAP). MATERIALS AND METHODS: In 2007-2009, a screening for OSA was conducted among 394 hypertensive primary care patients. Polygraphy was used to create three groups: no OSA, non-CPAP, or adherent CPAP based on the apnea hypopnea index (AHI). After 10 years, a cross-sectional sleep and periodontal examination including a clinical and radiographic examination, a questionnaire, and a matrix metalloproteinase-8 (MMP-8) chair-side test was conducted. Based on levels of alveolar bone, bleeding on probing (BoP), and probing pocket depth (PPD), patients were categorized into four periodontal stages: periodontal health/gingivitis and three periodontal disease stages. Periodontal status and periodontal stages were compared between the OSA (n = 49), non-CPAP (n = 38), or adherent CPAP (n = 34) groups. RESULTS: The 121 patients (53% women) had a median age of 71 years. No differences were seen between the OSA groups regarding median number of teeth (p = .061), teeth/implants, (p = .107), plaque index (p = .245), BoP (p = .848), PPD ≥ 4 mm (p = .561), PPD ≥ 6 mm (p = .630), presence of MMP-8 (p = .693) except for bone loss (p = .011). Among patients with stage periodontal health/gingivitis a significant difference was seen, as 70% of those were categorized as no OSA, 20% as non-CPAP, and 10% as adherent CPAP (p = .029). Differences were not seen in periodontal disease stages. CONCLUSIONS: Hypertensive patients with obstructive sleep apnea (OSA) did not have an adverse clinical periodontal status compared to patients without OSA. However, when combining radiographic and clinical status into periodontal stages, patients without OSA more frequently exhibited periodontal health or gingivitis compared to patients without OSA, regardless of CPAP treatment.

Motivational Interviewing on Periodontal Treatment Outcomes: A Meta-Analysis.

OBJECTIVES: This systematic review investigated the clinical efficacy of motivational interviewing (MI) in improving oral hygiene and periodontal health in patients with periodontal diseases. METHODS: A comprehensive literature search was conducted across various databases up to May 2023. Randomised controlled trials (RCTs) evaluating the effects of MI on periodontal conditions in patients with gingivitis, periodontitis, and peri­implantitis were included. After data screening, a risk-of-bias assessment was performed using the Cochrane risk of bias (RoB) tool. The meta-analysis was performed using random-effects models. RESULTS: Out of 2108 records screened, 7 RCTs involving 474 patients were included in the qualitative synthesis, with 6 of these studies included in the meta-analysis. Amongst these, 5 studies had a high RoB and 2 had some concerns about bias. Although individual studies reported varied results regarding the effects of MI on different periodontal indices and parameters at different time points, the pooled results revealed no significant difference in the overall effect on plaque level, bleeding on probing, and gingival inflammation between the MI and control groups. In addition, there is insufficient evidence to suggest any significant effect on attachment loss or probing depth. CONCLUSIONS: The current evidence is insufficient to support the effectiveness of MI as an adjunctive intervention for improving oral hygiene and periodontal outcomes. However, these results should be interpreted with caution. Additional high-quality studies with standardised MI interventions are required to derive definite conclusions.

Association between periodontal health status and quality of life: a cross-sectional study.

Introduction: Attachment loss due to periodontal diseases is associated with functional limitations as well as physical pain and psychological discomfort, which may lead to a reduced quality of life. The purpose of this study is to determine if the oral health status, specifically the periodontal status, influences oral health-related quality of life. Materials and methods: Survey data were collected in a US dental school clinical setting in a cross-sectional study. Quality of life related to oral health was assessed with the Oral Health Impact Profile-49 (OHIP-49). In addition, DMFT index, periodontal status, and health literacy scores (dental and medical health literacy) were recorded, and the data of n = 97 subjects were statistically analyzed. Results: The DMFT index of the study population was 14.98 ± 6.21 (D: 4.72 ± 4.77; M: 3.19 ± 3.46; F: 7.12 ± 4.62). Of the subjects, 44% were identified as periodontitis cases. These periodontitis cases demonstrated significantly higher OHIP-49 scores (66.93 ± 30.72) than subjects without signs of periodontal diseases (NP) (32.40 ± 19.27, p < 0.05). There was also a significant difference between NP patients and patients with gingivitis (66.24 ± 46.12, p < 0.05). It was found that there was a statistically significant difference between Stage 3 (severe) periodontitis and periodontal health (p = 0.003). Pearson correlations were completed, and positive relationships were found with OHIP-49 and DMFT (0.206, p < 0.05), and periodontal risk self-assessment (0.237, p < 0.05). Age [odds ratio (OR) 4.46], smoking (OR 2.67), and the presence of mobile teeth (OR 2.96) are associated with periodontitis. Conclusions: Periodontal diseases may negatively impact the oral health-related quality of life. Patients suffering from periodontitis also showed more missing teeth, which might influence function. Age and smoking are associated with a higher prevalence of periodontitis. A good general health literacy was no guarantee for having an adequate oral literacy.

Role of ketogenic diet and its effect on the periodontium. A scoping review.

The purpose of this study is to investigate the relationship between the ketogenic diet and periodontitis, as well as the nature of such relationship. Furthermore, emphasis was given to know whether ketogenic diet causes changes in oral health parameters and more specifically on periodontal health. Studies from 2010 to 2023 were reviewed and analyzed. Databases used to search included PubMed, Mednet, Scopus, Cochrane, and Embase. The literature reviewed was limited to randomized clinical trials, observational studies, and case-control studies. Of the eight studies included, three studies found that diets with similarities to the ketone-based diet could have a significant positive impact on periodontal health. One study pointed to the potential positive effect of a diet such as keto, but no definitive conclusion could be made. The current body of evidence concluded that there may be a relationship between keto and periodontitis, although the evidence is not consistent. It can be implied, however, that it is a positive relationship as ketogenic diet has been shown to have an anti-inflammatory effect, reducing inflammatory markers found in many diseases, including periodontitis.

Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study.

Background: Periodontitis is a chronic infectious disease affecting periodontium having multifactorial etiology, can cause significant systemic challengein addition to localized inflammation, tissue damage, and bone resorption. A serological marker of systemic inflammation known as C-reactive protein has been linked to an increased risk for a number of pathological conditions, including cardiovascular diseases. Aim: To estimate levels of serum C-reactive protein in healthy individuals and subjects with periodontal diseases and to compare serum C-reactive protein levels in subjects having periodontal disease pre-operatively & post-operatively. Materials and methods: The study was conducted on 60 subjects age ranging from 35 to 60 years. 30 individuals with healthy periodontium were in group 1 (control group) and the remaining 30 were diagnosed as adult periodontitis were in group 2 (experimental group). Periodontal examination done using gingival index, plaque index, periodontal pocket depth, and Russel's index. CRP levels were examined between group 1 and group 2 and in group 2 between baseline visit before treatment and 2 months after treatment. Results: The findings of this study show a significant connection between periodontal disease and the inflammatory marker CRP in the body, as well as a tendency for a significant decrease in serumCRP levels following periodontitis therapy. At baseline, there was a positive correlation among C-reactive protein, probing pocket depth, and Russell's index. Conclusion: As CRP is a key mediator for cardiovascular disease, an increase in C- reactive protein levels in periodontal diseases suggests a significant connection between periodontitis and cardiovascular diseases. Early periodontal treatment might decrease the severity of cardiovascular disease that already exists. This suggests that periodontal examination should be part of routine practicealong with cardiovascular examination.

Effect of mandibular advancement appliance use on oral and periodontal health in patients with OSA: a systematic review.

STUDY OBJECTIVES: Use of a mandibular advancement appliance (MAA) is an effective treatment option for mild-to-moderate obstructive sleep apnea (OSA). MAA is well-tolerated but undesirable effects may be observed over time. The present systematic review aimed to assess the effect of MAA use on oral and periodontal health in patients with OSA. METHODS: MEDLINE (PubMed), Cochrane, and Scopus were searched for randomized and non-randomized controlled trials (RCTs, NRCTs), cohorts, and case-control studies reporting on side effects of MAA treatment in OSA patients during a follow-up of at least 6 months. RESULTS: From a total of 169 articles screened, 28 were selected. The most frequently reported MAA-related effects on oral health were: hypersalivation (weighted mean prevalence, 33.3%), occlusal changes (30.2%), muscle pain (22.9%), tooth discomfort or pain (20.2%), and xerostomia (18.3%). No MAA-related periodontal effect was reported. The periodontal status prior to MAA treatment was rarely assessed and described, but 5 studies (17.8%) stated that periodontitis was an exclusion criterion for MAA. Only one retrospective study specifically evaluated periodontal parameters and reported no significant changes in periodontally healthy patients with OSA using MAA for over 7 years. CONCLUSION: MAA use is associated with a number of clinical consequences on oral health, but there is no evidence to conclude whether or not MAA affects periodontal health in patients with OSA. This aspect appears to be under-evaluated and should be further investigated in relation to the type of MAA, the duration of treatment, and prior history of periodontitis.

Impact of nutrition on the condition of the oral mucosa and periodontium: A narrative review.

Diet and eating habits significantly affect health and quality of life. Various diets and food eliminations can lead to nutritional deficiencies and malnutrition. This article discusses the relationship between nutrition, nutritional deficiencies, and the condition of the periodontium and oral mucosa. An analysis of PubMed materials was conducted to assess the impact of nutrition on the condition of the oral mucosa and periodontium. We also considered dietary habits such as vegetarianism, the ketogenic diet, the Paleo diet, the Mediterranean diet, the Western diet, and intermittent fasting. Vitamin deficiencies, both watersoluble and fat-soluble, as well as macroand microelements, can manifest in the oral cavity, among others, as gingivitis and bleeding, recurrent aphthous stomatitis, enamel hypomineralization, cheilitis, angular cheilitis, halitosis, glossitis, lingual papillae atrophy, and stomatitis. Malnutrition does not cause periodontal disease, but it increases the risk of its occurrence and accelerates disease progression. Inadequate nutrition, combined with other predisposing factors, may contribute to an increased risk of oral cancer and the development of leukoplakia.

Is inflammatory potential of the diet related to oral and periodontal health?

Inflammation is among the risks of periodontal diseases. The relationship between the inflammatory load of the diet and inflammation has been shown in previous studies, but the relationship between periodontal diseases and the inflammatory load of the diet is not clear. In this study, it was aimed to examine the relationship between dietary inflammatory index (DII) and periodontal health. Board approved the protocol. Information about the study was given to the patients who met the criteria of the study and agreed to participate in the study. Oral health status was evaluated by measuring the Decayed, Missing, and Filled Teeth (DMFT). Periodontal health status was determined using the plaque index (PI) and gingival index (GI). Twenty-four-hour dietary record was taken for 1 day to calculate the inflammatory load gained from daily diet, and the DII score was used. The study group consisted of 138 participants. DMFT scores were found with median 4.0, and no statistically significant difference was observed between DII quartiles. 65.8% of the participants had absence or small amount of plaque accumulation, while 39.2% had moderate or dense amount of plaque accumulation according to the PI classification. While DII did not differ by PI classification, DII quartile between second and third found a difference according to the GI classification. The new definition of periodontal health has been proposed as the absence of clinically detectable inflammation. It seems that pro-inflammatory properties of the diet and periodontal health are related. But future randomized controlled trials are needed.