Dynamics of Gingival Indices and Microbiological Findings During Treatment of Plaque-Induced Gingivitis in Children Aged 10-14 Years.

BACKGROUND: The study analyzed the dynamics of the clinical periodontal status during the treatment of adolescents with generalized plaque-induced gingivitis. AIM: Assessment of the predominant subgingival microflora in the case of a diagnosed inflammatory process in the gingiva in childhood. METHODS: Full-mouth periodontal assessment of plaque accumulation and bleeding on probing with an electronic periodontal probe was performed during the treatment of 34 adolescents with generalized plaque-induced gingivitis. The treatment protocol includes five visits (1, 3, 7, 14, and 30 days). Subgingival biofilm sampling was performed by real-time PCR testing to identify, follow-up in dynamics, and determine the quantities of main subgingival periodontopathogens during treatment. Three samples per child were taken from five teeth with the most severe inflammation. RESULTS: For children aged 10-14 years with generalized plaque-induced gingivitis, two weeks after the start of treatment, the index values for bleeding on probing decreased twice from 53 to 27%. C. gingivalis was isolated before the start of treatment in all children, followed by P. intermedia, P. micros (70,4%) and T. denticola, T. forsythia (52,9%). Representatives of the red complex according to Socransky showing greater resistance to the therapy performed in terms of frequency and amount. CONCLUSION: The predominant subgingival microflora in adolescents with generalized plaque-induced gingivitis is representative of the orange and red Socransky complex, with index values decreasing smoothly at each subsequent visit during treatment.

Periodontal health status in systemic sclerosis patients: Systematic review and meta-analysis.

OBJECTIVE: The present systematic review and meta-analysis aimed to evaluate the periodontal health of systemic sclerosis patients compared with non-systemic sclerosis controls. MATERIALS AND METHODS: Online databases were searched for eligible studies on February 24, 2023. The primary outcomes of interest in systemic sclerosis patients and controls included the clinical attachment level, periodontal probing depth, recession depth, plaque index, bleeding on probing score, gingival index, number of teeth with periodontitis, prevalence of periodontitis and gingivitis, and extent and severity of periodontitis. RESULTS: Fourteen studies met inclusion criteria and were incorporated in the qualitative and quantitative analysis. In comparison with the controls, systemic sclerosis patients had a higher prevalence of periodontitis (OR = 7.63 (1.74-33.50), p = 0.04, I2 = 69%), including more severe forms of periodontitis (OR = 6.68 (3.39-13.15), p = 0.85, I2 = 0%), as well as higher periodontal probing depth ((0.88 (0.45-1.31), p = 0.02, I2 = 99%)), clinical attachment level (1.22 (0.8-1.64), p = 0.003, I2 = 98%), and plaque presence (0.83 (0.13-1.53), p = 0.03, I2 = 96%). There was no statistically significant difference in gingival inflammation (1.14 (0.07-2.21), p = 0.04, I2 = 98%). CONCLUSIONS: The systematic review and the meta-analysis showed that systemic sclerosis patients suffer from worse periodontal health than non-systemic sclerosis individuals.

Evaluation of two different remineralising toothpastes in children with drug-controlled asthma and allergic rhinitis: a randomised clinical trial.

AIM: To compare the efficacy of two remineralising toothpastes in children suffering from asthma and allergic rhinitis after a 6-month study. METHODS: 40 patients aged between 6-14 years with enamel demineralisations were enrolled for the study at the Unit of Dental Hygiene of the University of Pavia (Italy). The following indices were collected: Schiff air index (SAI), plaque index (PI), bleeding on probing (BoP), salivary pH, Basic Erosive Wear Examination (BEWE), susceptibility index (SI) for hard and soft tissues' pathologies, and decayed missing filled teeth (DMFT). After mechanical debridement with piezoelectric instrumentation and glycine powder, patients were equally divided into two groups: Group 1 using a toothpaste with zinc hydroxyapatite, and Group 2 using a toothpaste containing calcium sodium phosphosilicate. The toothpaste had to be used twice a day. The time frames of the study were: baseline (T0), after 1 month (T1), after 3 months (T2), after 6 months (T3). CONCLUSION: The tested toothpastes can be proposed for home use in children with asthma and allergic rhinitis as they significantly reduced dental sensitivity and periodontal indices.

Periodontal indexes of two types of 3 x 3 retainers: 0.032-in SS V-loop versus 0.0215-in SS coaxial - a randomized crossover trial.

OBJECTIVE: This randomized crossover trial evaluated periodontal indexes of two types of 3 x 3 retainers (a modified 0.032-in SS V-loop retainer and a conventional 0.0215-in SS coaxial wire retainer) after bonded for six months. Also, bonded failure rate, and a questionnaire about comfort, ease of cleaning and overall preference were recorded. MATERIAL AND METHODS: 15 patients were enrolled in this study who used both retainers for six months each, having a 15-day wash-out interval between each bonded retainer usage. The following periodontal index were recorded: Plaque Index (PI), Calculus Index (CI) and Gingival Index (GI). Patients answered a questionnaire to assess comfort, ease of cleaning and overall retainer-type preference. Rate of bonding failure was also evaluated. RESULTS: V-Loop retainer showed higher PI (P<0.05) as compared to conventional 0.0215-in coaxial wire retainer. However, CI and GI presented no statistically significant differences between both types of retainers. The conventional 0.0215-in coaxial wire retainer was chosen as the most comfortable (p<0.05), although no statistically significant differences were found for all other questionnaire answers. Bonding failure events were more observed in the 3x3 V-Loop retainer (p<0.002), as compared to the conventional 0.0215-in coaxial retainer. CONCLUSION: V-Loop retainer showed higher PI (p<0.05), higher bonding failure rate and less comfortable, as compared to conventional 0.0215-in coaxial wire.

Multiple Imputation for Partial Recording Periodontal Examination Protocols.

AIM: Partial-mouth recording protocols often result in underestimation of population prevalence and extent of periodontitis. We posit that multiple imputation of measures such as clinical attachment loss for nonselected tooth sites in partial-mouth samples can reduce bias in periodontitis estimates. METHODS: Multiple imputation for correlated site-level dichotomous outcomes in a generalized estimating equations framework is used to impute site-level binary indicators for clinical attachment loss exceeding a fixed threshold in partial-mouth samples. Periodontitis case definitions are applied to the imputed "complete" dentitions, enabling estimation of prevalence and other summaries of periodontitis for partial-mouth samples as if for full-mouth examinations. A multiple imputation-bootstrap procedure is described and applied for point and variance estimation of these periodontitis measures. The procedure is evaluated with pseudo-partial-mouth samples based on random site selection protocols of 28 to 84 periodontal sites repeatedly generated from full-mouth periodontal examinations of 3,621 participants in the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) survey. RESULTS: Multiple imputation applied to partial-mouth samples overestimated periodontitis mean extent, defined as the number of sites with clinical attachment loss 3 mm or greater, by 9.5% in random site selection protocols with 84 sites and overestimated prevalence by 5% to 10% in all the evaluated protocols. CONCLUSIONS: In the 2013 to 2014 NHANES data, multiple imputation of site-level periodontal indicators provides less biased estimates of periodontitis prevalence and extent than has been reported from estimates based on the direct application of full-mouth case definitions to partial-mouth samples. Multiple imputation provides a promising solution to the longstanding, vexing problem of estimation bias in partial-mouth recording, with potential application to a wide array of case definitions, periodontitis measures, and partial recording protocols. KNOWLEDGE TRANSFER STATEMENT: Partial-mouth sampling, while a resource-efficient strategy for obtaining oral disease estimates, often results in underestimation of periodontitis metrics. Multiple imputation for nonselected periodontal sites produces pseudo-full-mouth data sets that may be analyzed and combined to produce estimates with small bias.

Assessment of periodontal status in patients with oral lichen planus.

OBJECTIVE: Inflammatory pathogenesis is common to periodontitis and oral lichen planus. This study was conducted to assess and compare the periodontal status of patients with and without oral lichen planus. METHOD AND MATERIALS: 108 patients comprising 54 with oral lichen planus and 54 age-matched systemically healthy participants without oral lichen planus were selected. Periodontal parameters, ie Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, clinical attachment level, and periodontal phenotype were measured. RESULTS: On comparing the test and control groups, statistically significant differences were observed in respect to Plaque Index (P = .00), Gingival Index (P = .00), and bleeding on probing (P = .00). A higher proportion of sites with deeper pockets was observed in the test group (P = .00). On comparison of various oral lichen planus subtypes, significant difference was observed in respect to Gingival Index (P = .00) and bleeding on probing (P = .00). A higher proportion of sites with deeper pockets (P = .01) and greater CAL (P = .00) was observed in the erosive/atrophic subgroup compared to the reticular group. However, the differences between the reticular (a less severe form of oral lichen planus) and control group in terms of Gingival Index (P = .94), Plaque Index (P = .05), bleeding on probing (P = .17), probing pocket depth (P = .56), and clinical attachment level (P = .23) were not statistically significant. Statistically significant differences were observed in terms of Gingival Index (P = .01) and bleeding on probing (P = .00) between thin and thick periodontal phenotypes in the oral lichen planus group. Statistically significant positive correlations in periodontal parameters with increased gingival involvement and severity were observed using Spearman rank correlation coefficient. CONCLUSION: Significantly greater periodontal inflammation in the test group means there is a risk of greater attachment loss in future. Thus, increased attention towards periodontal health in these patients might reduce the rate of disease progression.

A Meta-analysis Comparing Toothbrush Technologies on Gingivitis and Plaque.

BACKGROUND: Research continues to show an association between oral health and systemic health, further stressing the importance of effective daily plaque removal via toothbrushing to maintain periodontal health and overall well-being. This investigation was undertaken to compare the efficacy of oscillating-rotating, sonic, and manual toothbrushes in reducing gingivitis and plaque in randomised controlled trials (RCTs) with up to 6 months' follow-up. METHODS: This meta-analysis was conducted from a single database (Procter & Gamble Oral Care Clinical Archive) including RCTs from 2007 to 2022. Three authors independently assessed study eligibility. Disagreements concerning selected studies were resolved by discussion with an expert colleague. Direct and indirect treatment comparisons along with transition rates to gingival health were calculated using participant-level data. Transition-to-health time was calculated using data from all time points. Subregion analyses evaluated number of bleeding sites and plaque reduction. RESULTS: This meta-analysis included 21 gingivitis RCTs and 25 plaque RCTs. Relative to manual and sonic brushes, oscillating-rotating brushes had a higher percentage of participants who transitioned to gingival health (72% vs 21% and 54%; P < .001). Compared with manual and sonic brushes, respectively, oscillating-rotating brushes demonstrated greater bleeding site reductions (by 52% and 29%; P < .001) and superior plaque reductions (by 19% and 5%; P < .001). Oscillating-rotating brushes provided faster transitions to health than sonic brushes and showed greater efficacy across subregions. The most advanced oscillating-rotating brush demonstrated statistically significantly greater efficacy compared with traditional oscillating-rotating, manual, and sonic brushes when analysed separately. Risk of bias was deemed low for all studies. CONCLUSIONS: Oscillating-rotating toothbrushes offer superior results for transition to health, gingivitis, and plaque reduction compared with manual and sonic brushes. The most advanced oscillating-rotating model offers enhanced efficacy vs traditional models.

Evaluation of characteristics of periodontal probes

Aim: This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods: Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey's post-hoc test. Statistical significance was set at p<0.05. Results: A comparison of measurements between the 15UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion: There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability

Periodontitis of maxillary teeth screened by community periodontal index is associated with chronic rhinosinusitis defined by EPOS 2020 guideline.

We aimed to evaluate the association between periodontitis in the upper jaw and chronic rhinosinusitis (CRS) using the nationwide Korean National Health and Nutrition Examination Survey (KNHANES) data. In this cross-sectional study, data of KNHANES participants enrolled between 2008 and 2012 were reviewed. Periodontitis of the upper teeth was diagnosed by dentists according to the community periodontal index with standardized methods. CRS was diagnosed by otorhinolaryngologists according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 with nasal endoscopy findings. We also evaluated the association between periodontitis and CRS according to smoking and drinking status. Univariate and multivariate logistic regression analyses were performed. Overall, 28,761 participants were eligible for analysis, and 210 were diagnosed with CRS. Periodontitis was associated with CRS diagnosis (odds ratio [OR] = 1.391, 95% confidence interval [CI] = 1.013-1.912). Non-drinkers showed no significant association between periodontitis and CRS (OR = 1.142, 95% CI 0.746-1.749). However, among drinkers, periodontitis was significantly associated with CRS (OR = 1.733, 95% CI 1.091-2.753). The number of smokers with CRS was not statistically sufficient and a logistic regression model based on smoking status could not be generated. Individuals with periodontitis in the upper jaw may need to consult an otorhinolaryngologist for comorbid CRS especially according to drinking status.

Adjunctive use of omega-3 fatty acids in combination with low-dose aspirin in periodontitis: Systematic review and meta-analysis.

Periodontitis is one of the most common dental diseases with a range of treatment approaches, including pathogenetically reasonable use of various host immune modulators. One such approach is the use of omega-3 polyunsaturated fatty acids (PUFAs) in combination with low-dose aspirin. This systematic review and meta-analysis were performed to compare the standard treatment alone and adjunctive use of omega-3 PUFAs in combination with low-dose aspirin with or without standard treatment in patients with periodontitis. A systematic review of the literature was performed using MEDLINE/PubMed, Cochrane Central and Google Scholar databases. Selection criteria included the following: randomized controlled trials in subjects with periodontitis in the age group above 18 years old, with follow-up periods ranging from 6 weeks to 6 months. The meta-analysis was performed using standard methodological procedures according to Cochrane recommendations, including assessment of risk-of-bias and level of evidence (GRADE). Meta-analysis was performed for such clinical outcomes as plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP) and bleeding index (BI) based on data from seven randomized clinical trials conducted between 2010 and 2020. It was shown that adjunctive use of omega-3 PUFAs in combination with low-dose aspirin results in significant clinical improvement in PD, CAL and GI during both short and prolonged follow-up periods. The use of omega-3 PUFAs and low-dose aspirin in periodontitis patients may be promising as an adjunct therapy, however, due to a limited number of patients and significant heterogeneity, further studies need to be conducted.

Discriminant validity of the current gingivitis classification in adolescents: a cohort study.

OBJECTIVES: To compare the prevalence of gingivitis estimated by the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classification with the other case definitions and assess the ability of this classification system in discriminating sociodemographic and clinical factors associated with the presence of gingivitis in a cohort study. MATERIALS AND METHODS: A multistage random sample of 1134 12-year-old adolescents was submitted to a full-mouth examination according to the Community Periodontal Index. Socioeconomic and clinical variables were collected at baseline. Gingivitis was considered according to the following criteria: (a) ≥ 10% of bleeding sites (the 2018 EFP/AAP criteria); (b) ≥ 15% of bleeding sites; and (c) the mean full-mouth bleeding sites. Adjusted multilevel Poisson regression assessed the association between independent variables at baseline and each definition of gingivitis at 2-year follow-up. RESULTS: Seven hundred forty-two 14-year-old adolescents were re-revaluated at follow-up. The prevalence of gingivitis was 28.7% according to 10% of bleeding threshold. The 2018 EFP/AAP criteria and other definitions showed higher prevalence and mean of gingivitis for low-household income adolescents and for those with higher levels of dental plaque and untreated dental caries. Nonetheless, the highest strengths of association were observed for the threshold of ≥ 15% of bleeding sites. CONCLUSION: The 2018 EFP/AAP case definition of gingivitis showed a similar discriminant validity compared to the 15% threshold and the mean full-mouth bleeding sites. CLINICAL RELEVANCE: The 2018 EFP/AAP classification allows the discrimination of important risk factors and should be used for the establishment of priorities for large-scale therapeutic programs.

A Randomized Clinical Trial of Monolithic Single-Tooth Crowns: 1-Year Preliminary Results.

PURPOSE: To investigate the clinical results of single-tooth ceramic crowns in the posterior region produced from three different monolithic materials. MATERIALS AND METHODS: A total of 36 posterior single-tooth crowns were fabricated from lithium silicate glass-ceramic (LSGC; n = 12), lithium disilicate glass-ceramic (LDGC; n = 12), and polymer-infiltrated ceramic network (PICN; n = 12) in 27 patients. Restorations were evaluated for prosthetic and periodontal criteria at baseline (0) and after 6 and 12 months. Prosthetic evaluation was performed according to the modified United States Public Health Service (USPHS) criteria, and probing depth (PD), clinical attachment level (CAL), gingival bleeding time index (GBTI), and gingival (GI) and periodontal indices (PI) were evaluated in the periodontal assessment. Friedman and Kruskal-Wallis tests were used for statistical analyses (P = .05). RESULTS: All restorations were evaluated according to survival and success rates. No dropouts occurred. The survival rate of all three materials was 100% after 1 year. However, in the PICN group, a statistically significant difference was found between baseline and 12 months for color match (from A to B) and surface texture (from A to C; P < .001). CONCLUSIONS: Although long-term clinical follow-up periods are needed, all three ceramics showed clinically acceptable survival and success rates over 1 year. The ceramics evaluated in the present study could be preferred for single-tooth full-crown restorations in the posterior region.

Investigation of the Clinical Effects of Peri-Implant Gingival Morphology on Tissue Health.

This study aims to determine the gingival phenotype around dental implants and the clinical evaluation of the existing phenotype in relation to the tissue health around the implant. Included were 202 dental implants applied to 60 individuals who applied to our service and had at least 1 implant in the mouth, whose prosthetic restoration was completed at least 1 year ago. The effects of keratinized mucosa width (KMW) and gingival thickness (GT), which form the gingival phenotype, on clinical periodontal parameters were evaluated with the obtained data. Of the implants included in the study, 115 were found to have adequate KMW and 87 had insufficient KMW. At the same time, the GT around 74 implants was found to be thick, and the GT around 128 implants was found to be thin. The KMW of those with thin GT was lower than those with thick GT. Plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing depth (PD), gingival recession (GR), and suppuration (SuP) were found to be low in those with adequate KMW. GI, BoP, PD, GR, and SuP were low in patients with thick GT, but there was no significant difference between GT and PI. KMW and GT were associated with peri-implant tissue inflammation and GR. To maintain the health of the peri-implant tissues, it is recommended to have a KMW of at least 2 mm and a thick gingiva.

Evaluation of platelet-rich fibrin in the treatment of decorticated intrabony defects: a randomized clinical trial.

OBJECTIVE: The objective of the present study was to evaluate the clinical and radiographic outcomes of intrabony defects treated with decortication (intramarrow penetration) alone versus decortication combined with platelet-rich fibrin in periodontitis patients followed up for 6 months postsurgery. METHOD AND MATERIALS: A total of 46 intrabony defects from periodontitis patients with a mean age of 36.30 ± 6.10 years were randomly assigned into two treatment groups. The control group (n = 23) intrabony sites were accessed with simplified papilla preservation flap (SPPF) followed with debridement, decortication, and closure. The test group (n = 23) sites were accessed with SPPF, followed with debridement, decortication, platelet-rich fibrin placement, and closure. The clinical parameters Plaque Index, Gingival Index, probing pocket depth, relative attachment level, gingival marginal level, along with radiographic defect depth and defect width were recorded at baseline, 3 months, and 6 months postsurgery. Gain in clinical attachment level was the primary outcome, and probing pocket depth reduction and radiographic bone fill were secondary outcomes of the study. RESULTS: The Plaque Index and Gingival Index scores showed nonsignificant difference on intra- and intergroup comparison at baseline, 3 months, and 6 months. The probing pocket depth was 8.17 ± 1.56 mm, 6.65 ± 1.30 mm, and 5.26 ± 1.18 mm for the control group, and 8.17 ± 2.01 mm, 6.26 ± 1.42 mm, and 4.78 ± 1.28 mm for the test group, at baseline, 3 months, and 6 months, respectively. The relative attachment level was 8.83 ± 1.40 mm, 6.78 ± 1.31 mm, and 5.39 ± 1.16 mm for the control group, and 8.39 ± 1.62 mm, 6.96 ± 1.36 mm, and 5.48 ± 1.20 mm for the test group at baseline, 3 months, and 6 months, respectively. Statistically significant reductions were observed for probing pocket depth for the control (2.91 mm, P < .001) and test groups (3.39 mm, P < .001), as well as for relative attachment level for the control (3.44 mm, P < .001) and test groups (2.91 mm, P < .001). However, intergroup differences were nonsignificant for probing pocket depth and relative attachment level. The radiographic defect depth was reduced by 0.31 mm for the control and 1.57 mm for the test group. The radiographic defect width was reduced by 0.18 mm for the control and 0.83 mm for the test group. Intergroup statistically significant differences were observed at the 6-month follow-up (P < .001) for radiographic defect depth and width. CONCLUSION: Within the limitations of the present study, the results demonstrate statistically significant intragroup improvements in clinical outcomes with decortication alone and decortication combined with platelet-rich fibrin in the treatment of intrabony defects in periodontitis patients. The addition of platelet-rich fibrin did not improve the clinical results beyond decortication alone, and unacceptable postsurgery residual pockets were observed in both the protocols. Considering the small sample size, the addition of platelet-rich fibrin resulted in significant bone fill over and above that of decortication alone.

The influence of radio frequency-based toothbrush on the accumulation of calculus and periodontal health: A randomized double-blind controlled prospective study.

OBJECTIVES: The use of a toothbrush with radio frequency (RF) has shown to be of benefit regarding the reduction of plaque, calculus, and dental staining and improving teeth shade compared to conventional powered and manual toothbrushes. AIM: To evaluate the efficacy of the RF toothbrush in the reduction of calculus accumulation and its effect on periodontal parameters as well as subject satisfaction as compared to an identical sham-tooth brush. MATERIALS AND METHODS: Patients who are under a strict maintenance program were included. Patients were allocated to test (RF toothbrush) or control (sham) randomly and were examined at baseline, one and three months. Clinical photos were taken and a consequential calculus assessment via ImageJ software. Clinical assessment included the following: plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and recession (REC). Patient satisfaction was assessed via a questionnaire. RESULTS: Fifty-eight patients (29 control, 29 test) were included. At baseline mean PPD, BOP, PI, REC, and calculus accumulation were similar between the groups. Mean buccal calculus was lower in the test group at one month 4.0% versus 6.7%, p < .05. Calculus accumulation within the groups was lower in the test group at 1 and 3 months when compared to baseline at the buccal aspect (2.8% vs. 8.9%, p < .05% and 3.8% vs. 8.9%, p < .05) and lingual aspect (6.7% vs. 16.5%, p < .05% and 8.9% vs. 16.5%, p < .05). No statistically significant results were found regarding periodontal parameters PPD, BOP, PI, and REC. No difference was found between groups regarding patient satisfaction. CONCLUSION: RF seems to have an additive effect on preventing calculus accumulation on the buccal aspect of anterior mandibular teeth at 1 month. Nevertheless, at 3 months, no difference between the toothbrushes is seen regarding calculus formation and maintaining periodontal health (ClinicalTrials.gov, Identifier NCT04640857).

Reliability assessment of the 2018 classification case definitions of peri-implant health, peri-implant mucositis, and peri-implantitis.

BACKGROUND: The purpose of this study was to evaluate the reliability and accuracy in the assignment of the case definitions of peri-implant health and diseases according to the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions. METHODS: Ten undergraduate students, 10 general dentists, and 10 experts in implant dentistry participated in this study. All examiners were provided with clinical and radiographic documentation of 25 dental implants. Eleven out the 25 cases were also accompanied by baseline readings. Examiners were asked to define all cases using the 2018 classification case definitions. Reliability among examiners was evaluated using the Fleiss kappa statistic. Accuracy was estimated using percentage of complete agreement and quadratic weighted kappa for pairwise comparisons between each rater and a gold standard diagnosis. RESULTS: The Fleiss kappa was 0.50 (95% CI: 0.48 to 0.51) and the mean quadratic weighted kappa value was 0.544. Complete agreement with the gold standard diagnosis was achieved in 59.8% of the cases. Expertise in implantology affected accuracy positively (p < 0.001) while the absence of baseline readings affected it negatively (p < 0.001). CONCLUSION: Both reliability and accuracy in assigning case definitions to dental implants according to the 2018 classification were mostly moderate. Some difficulties arose in the presence of specific challenging scenarios.

Comparison of periodontal indices, DMFT, xerostomia, hyposalivation and oral health-related quality of life in Sjögren's syndrome patients versus healthy individuals: A case-control study.

BACKGROUND: Sjögren's syndrome (SS) is a common systemic autoimmune disease that affects oral health, and consequently oral health-related quality of life (OHRQoL) due to the involvement of exocrine glands. OBJECTIVES: The present study aimed to evaluate the oral health-related quality of life and oral health indicators in patients with SS in comparison with healthy individuals. MATERIAL AND METHODS: In the case and control groups (45 patients and 45 healthy individuals), questions about demographic data, other systemic disorders, medications, the years of infection, xerostomia, as well as inquiries about the quality of life (Oral Health Impact Profile-14 - OHIP-14) were asked. The patients were evaluated clinically, and oral health indicators, including the plaque index (PI), the gingival index (GI), the sulcus bleeding index (SBI), and the number of decayed, missing and filled teeth (DMFT) were assessed on the Ramfjord teeth. Unstimulated saliva samples from both groups were obtained and weighed. The data was analyzed using IBM SPSS Statistics for Windows, v. 24.0. Quantitative variables were compared between the case and control groups with the use of the independent t test or their nonparametric equivalent (the Mann-Whitney test). RESULTS: The comparison of the quantitative variables between the study groups showed a statistically significant difference in the OHRQoL scores (p = 0.037) and the unstimulated saliva flow rate (p = 0.002) between the case and control groups. Also, there was a statistically significant difference in the DMFT index between patients with primary and secondary SS in the case group (p = 0.048). CONCLUSIONS: The lower OHRQoL of patients with SS requires more attention and follow-up to solve periodontal and dental problems in this group of patients.

Healthy lifestyles are associated with a better response to periodontal therapy: A prospective cohort study.

AIM: To evaluate the association between lifestyle behaviours and clinical periodontal outcomes following Steps 1/2 of periodontal therapy. METHODS: A total of 120 subjects with untreated Stage II/III periodontitis participated in this study. At baseline, questionnaires were administered to assess the following lifestyle behaviours: adherence to Mediterranean diet (MD), physical activity (PA) and stress levels, sleep quality, smoking and alcohol use. Participants received Steps 1/2 of periodontal therapy and were re-evaluated after 3 months. A composite outcome of the endpoint of therapy (i.e., no sites with probing pocket depth [PPD] ≥4 mm with bleeding on probing, and no sites with PPD ≥ 6 mm) was regarded as the primary outcome. Simple and multiple regression analyses were used to evaluate the association between lifestyle behaviours and clinical periodontal outcomes. Disease severity at baseline, body mass index, diabetes, household disposable income and plaque control were considered as confounders. RESULTS: Multiple regression analyses showed significantly lower odds of achieving the endpoint of therapy in subjects with poor sleep quality (odds ratio [OR] = 0.13; 95% confidence interval [CI]: 0.03-0.47; p < .01), smoking (OR = 0.18; 95% CI: 0.06-0.52; p < .05) and alcohol use above the suggested intake (OR = 0.21; 95% CI: 0.07-0.63; p < .01). Subjects with a combination of 'unhealthy lifestyles' (low adherence to MD and low PA levels and high levels of stress and poor sleep quality) showed higher proportions of residual PPD≥6 mm (MD = 1.51; 95% CI: 0.23-2.80; p < .05) and lower odds of achieving the endpoint of therapy (OR = 0.85; 95% CI: 0.33-0.99; p < .05) at re-evaluation. CONCLUSIONS: Subjects with unhealthy lifestyle behaviours showed worse clinical outcomes 3 months after Steps 1/2 of periodontal therapy.

Comparison of the impact of two types of removable partial dentures on the periodontal health of the remaining teeth: A prospective clinical study.

OBJECTIVE: To evaluate and compare the impact of two removable partial dentures (acrylic removable partial denture [ARPD] and metallic removable partial denture [MRPD]) on periodontal tissues of the remaining teeth in the first 12 months of denture use. MATERIALS AND METHODS: This prospective clinical study included 40 patients, of which 20 received ARPDs, 20 received MRPDs, nine in the maxilla, and 11 in the mandible each. The patients were 45-65 years old; 24 were females, and 16 were males. Patients' demographic details, clinical indicators of periodontal complications, and biochemical measurement of Hs-C-reactive protein (CRP) and alkaline phosphatase (ALP) were considered. One-way analysis of covariance and Friedman were used to measure the differences in clinical periodontal parameters between the two types of dentures. RESULTS: The significant findings were: Plaque index (PLAQ) scores for abutment teeth were higher in MRPD wearers (mean = 12.15) than ARPD wearers (mean = 10.45), whereas ARPD users had significantly higher mean bleeding on probing (BOP) values (mean = 1.5) than MRPD users (mean = 0.00); mobility of abutment teeth showed no significant differences; timeline comparisons showed a significant increase in the percentage of nonabutment teeth mobility in ARPD users (p = .028) compared with MRPD users over the same follow-up period (p = .102). CONCLUSIONS: For a short-term period of 1 year, periodontal and mobility parameters have no significant impact on the abutment and nonabutment teeth of ARPD and MRPD users. Moreover, biochemical markers (CRP and ALP) for periodontal inflammation exhibited no significant difference in both types of dentures.