Periodontal Treatment Need Research Articles

HASTALARIN PERİODONTAL KEMİK KAYBI VE TEDAVİ İHTİYACININ COVID-19'A GÖRE DEĞERLENDİRİLMESİ

Objective: This study aimed to evaluate patients' periodontal bone loss and treatment needs according to the COVID-19 and determine whether there is a relationship between COVID-19 and periodontal disease.
 Method: This cross-sectional study included patients admitted to the periodontology department for treatment between April 2021 and July 2021. According to the personal health system records of the patients, a positive real-time polymerase chain reaction (PCR) test indicated a positive COVID-19 history [COVID(+)], whereas no positive PCR in the records was defined as a negative history [COVID(-)]. Periodontal treatment need was assessed by the Community Periodontal Index of Treatment Needs (CPITN). In addition, periodontal bone loss (PBL) was measured from the digital panoramic radiographs according to the Progressive Rate Index (PRI). 
 Results: The study was conducted with 138 patients [COVID(+) 73, COVID(-) 65]. There was no statistically significant difference between COVID(+) and COVID(-) in terms of age and sex. The number of smokers in COVID(-) was significantly higher than COVID(+) (p: 0.045). No significant difference was found between the groups regarding the PRI and the presence of PBL. While COVID(+) had a greater percentage of score 0, 1, 3, and 4 than COVID(-); COVID(-) had a higher percentage of score 2 (p

One Third of Patients before Endoprosthesis Implantation Show an Oral Focus as Potential Source of Infectious Complication-The Value of Pre-Operative Dental Risk Stratification in a German Cohort.

Objective: The aim of this cross-sectional cohort study was to evaluate a comprehensive dental examination and referral concept for patients prior to endoprosthesis (EP) implantation in an interdisciplinary setting. Methods: Patients, who were prepared for EP surgery in the clinic for orthopaedics, were referred to the dental clinic for a dental examination. Thereby, dental and periodontal treatment need, radiographic and temporomandibular joint findings were assessed. Based on oral and radiographic investigation, a risk classification for potential source of prosthetic infection was performed. If potential oral foci of EP infection were present (e.g., apically radiolucent teeth, severe periodontitis or additional inflammatory findings), patients were classified as at high risk for EP infection with oral origin. Those individuals were allocated to their family dentist or special clinic for dental treatment prior to EP surgery. Results: A total of 311 patients were included (mean age: 67.84 ± 10.96 years, 51% male). A dental treatment need of 33% was found, while the periodontal treatment need was 83%. Thirty-one percent of patients showed at least one apical radiolucency (a sign of chronic infection/inflammation). Furthermore, additional findings such as radiographic signs of sinusitis maxillaris were found in 24% of patients. Temporomandibular disease was probable in 17% of individuals. One-third (34%) were assigned to the high risk group for an EP infection with oral origin. Conclusion: German patients before EP have a high periodontal treatment need and show frequently (34%) a potential oral focus of infection, underlining the necessity of including dental examination and risk stratification as part of the pre-operative assessment prior to EP implantation. Therefore, an approach as applied in this study appears reasonable for those individuals.

Periodontal health status in patients with periodontal disease: A descriptive study among Emirati population

Globally, around 10-15% of adults aged 21 to 50 years and around 30% of the elderly are diagnosed with severe periodontitis. About 20-50% of the population is affected with periodontal disease. However, there is a lack of actual national data in the UAE on oral health and periodontal health status. To determine the periodontal health status among the Emirati population aged 18 to 65 years. Periodontal health status of the patients with periodontitis was assessed by measuring plaque index; gingival index, clinical attachment loss (CAL) and community periodontal index treatment need (CPITN). All collected data were processed descriptively by presenting in numbers and percentages and analytically by cross-tabulation between variables. The majority of the patients (84%) had a mild level of clinical attachment loss and 54% had probing pocket depth of 3.5-5.5 mm. Moderate loss of clinical attachment was observed in 30.8% of patients with a medical history of diabetes mellitus and hypertension and 10.8% with no medical history. Most of the patients need non-surgical periodontal treatment that is scaling and root planning along with oral hygiene instructions and maintenance to reduce the progression of periodontal diseases.

Comparative assessment of periodontal treatment needs among the electronic cigarette users and traditional smokers.

It is currently presumptuous that electric cigarettes are less harmful than the conventional ones; this is increasing the consumption of electric cigarettes. Therefore, this study intended to evaluate the periodontal treatment needs among conventional smokers, electronic cigarette smokers and non-smokers. This cross-sectional designed study involved 150 patients with a mean age of 29.88±7.81 years. Among all patients, 50 patients were recruited in each group. The periodontal condition and the treatment need for the patients were assessed using the community periodontal index treatment need (CPITN). Fisher exact test was used to find the significant association of all three groups with the periodontal status and the treatment need. Female patients (12.5%) showed better periodontal status than the male patients (87.5%) and required less complicated periodontal treatment independently from smoking type. Furthermore, deeper pocket depth ≥6 mm (75%) has been found among the conventional cigarette smokers whereas the majority of the electric cigarette smokers (50%) have calculus deposition. Thus, 50% of the electric smokers require professional scaling whereas 57.1% of conventional smokers prerequisite complex periodontal treatment. Besides, there was a significant difference (p≤0.05) observed among all groups in periodontal health index and treatment need. Conventional cigarette consumers need more complicated periodontal treatment compared to the patients who consume electric cigarettes.

PERIODONTAL STATUS IN PATIENTS WITH MANDIBULAR FRACTURES

Purpose: The aim of the present study was to assess the gingival and periodontal status of patients with maxillofacial trauma and to determine the need for periodontal treatment after removal of the intramaxillary fixation. Material and methods: The study included 36 patients with a fracture of the lower jaw. After the clinical and radiological examination of the patients, treatment was performed on a case-by-case basis. 30 days after fixation and removal of the wire ligatures of the patients, the oral-hygienic and periodontal status was assessed using the following indices: simplified oral hygiene index, gingival bleeding index, community periodontal index of treatment needs and evaluation of oral malodour. Results: The most common cause of fractures is a traffic accident, followed by domestic injuries. The level of oral hygiene immediately after removal of the wire ligatures and intermaxillary fixation varied between relatively good and poor, with a greater number of patients having poor hygiene (OHI-S ≥5). The periodontal status of the patients, measured by CPITN, also showed a statistically significant level of clinically established periodontal destruction. Halitosis was detected in all patients. Conclusions: The course of the healing process in the alveolar bone and the functional rehabilitation of patients with mandibular fractures depends not only on the type of surgical treatment for immobilization of the fragments but also on the maintenance of optimal oral hygiene.

Oral Alterations in Individuals in Pre and Post Heart Transplantation

Abstract: Heart failure in advanced stages and unsuccessful alternative treatments can lead the patient to heart transplantation. Patients in pre-heart transplantation who present periodontal alterations can progress to an infectious condition and compromise the success of the transplant. Transplanted patients have intraoral changes associated with immunosuppressive therapy, such as gingival hyperplasia and opportunistic infections that deserve attention, as they result in poor quality of life and worse prognosis. This study searched the literature for oral alterations frequently found in patients with heart failure in a transplant program and heart transplant recipients, highlighting the importance of the dentist in the multidisciplinary team and the long-term follow-up of the transplanted patient. In this review, cohort studies, cross-sectional studies, case-control studies and clinical cases included in the PubMed, Biblioteca Eletrônica Científica Online (SciELO) and Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) databases of the last 11 years (from 2009 to 2020) and in English, Portuguese and Spanish. The search result made available 577 articles, which were screened and selected, so that they included all the information necessary for the statistical analysis. Among the most relevant data regarding the oral condition of pre-heart transplant patients, it was observed that 74.21% of individuals have systemic arterial hypertension as the main comorbidity and 42.69% use immunosuppressants. As for the oral diagnosis, there is a high need for periodontal treatment in 75.57% of the patients. In the profile of transplanted patients, there is a higher prevalence of diabetes mellitus (48.26%), and all patients follow drug therapy, with an association of more than one drug. Of these individuals, 90% need periodontal treatment and 17.34% had gingival hyperplasia. The data obtained allowed us to conclude that both heart transplant and transplant patients need special attention with regard to oral care, as they are susceptible to opportunistic infections and have periodontal care needs, which suggests that oral adequacy prior to transplantation is relevant, as is the control of the secondary effects of immunosuppressive therapy

Flapless application of enamel matrix derivative in non-surgical periodontal treatment: A systematic review.

To assess the effects of the flapless application of enamel matrix derivative (EMD) in combination with non-surgical periodontal treatment (NSPT) when compared to non-surgical periodontal treatment alone in adult patients. An electronic literature search was conducted in MEDLINE, Scopus and Cochrane Library up to March 2021 complemented by a manual search. Human longitudinal studies of >5 participants and at least 3months follow-up were eligible for inclusion in the review. Clinical outcomes were extracted and pooled. Meta-analysis of the included studies was not possible due to methodological differences. A total of 1199 publications were identified and reviewed for eligibility. Nine of them fulfilled the inclusion criteria. Eight studies were randomized clinical trials. The clinical findings of the majority of the included studies demonstrated that the adjunctive use of EMD with NSPT could lead to significantly improved treatment outcomes including higher PPD reduction, more CAL gain, more robust BOP reduction, higher number of sites with PPD<5mm and more frequent pocket closure which reduces the need for further periodontal surgical treatment. Limited biological, microbiological and histological findings were reported. Minimal adverse events were observed. The flapless application of EMD during NSPT leads to an improved clinical outcome in regards to CAL gain and PPD reduction when compared to conventional treatment alone. The potential effect on the biological and microbiological outcome is unclear.

Unmet Dental Treatment Needs and Barriers to Dental Care of Patients with Special Needs Attending a Dental Teaching Hospital

Objectives: This work attempted to determine the unmet dental treatment needs and self-reported barriers to continued care, in patients with special needs, attending a dental teaching hospital in the English-speaking Caribbean. Methods: A chart audit of patients who were planned for comprehensive treatment for the period from August 1, 2015 to July 31, 2017 was used to determine the types of treatment required for the sample of patients. Treatment was classified as either urgent, preventive, or restorative. Restorative treatment was further divided into operative, endodontic, periodontic, and prosthodontic treatment. Reasons for not returning to the clinic to complete planned treatment care were ascertained via a telephone interview. A non-parametric McNemar change test for related samples at an alpha level of 0.05 was used to compare planned treatment with completed treatment. Results: 34% of patients with special needs had comprehensive treatment plans developed for the period under investigation. Preventive dental treatment was included in most comprehensive plans (96.1%). Large proportions of patients also required care for periodontal disease (65.7%) and operative management of caries (52.9%). While there was no significant difference between preventive treatment planned and received, there were significant differences in treatment planned and received for all types of restorative care. Major identified barriers included cost, accessibility, and psychosocial issues. Conclusions: There was an unmet need for restorative and periodontal treatment. Major self-reported barriers to dental care included cost, accessibility to care in terms of transportation issues, and psychosocial issues.

Relationship between dental anxiety with dental caries and periodontal disease among army recruits in Bangalore city - A cross sectional study.

Introduction:Dental anxiety can affect the dental health status of an individual leading to avoidance behavior, poor oral hygiene and periodontal health and delay in seeking necessary treatment.Objectives:This study aimed to assess the prevalence of dental anxiety in army recruits in Bangalore city and to explore the relationship of dental anxiety with dental caries and periodontal disease among army recruits in Bangalore city.Methodology:The total population of the army recruits in Army Service Corps Center and College was around 1000. General information included name, age, sex educational qualification, address, number of dental visits and age of first visit. The closed ended multiple-choice questionnaire consisting of 4 questions based on previous dental experience given by Corah was used to assess the anxiety level of the individual. Clinical examination of dental and periodontal health was noted using Decayed, Missing, Filled and Surface (DMFS) Index and Community Periodontal Index and Treatment Needs (CPITN) Index.Results:The mean Dental Anxiety Scale score was 9.64 with a standard deviation of 3.6. Of the 836 participants in the study, 444 (53.1%) reported no dental anxiety at all. Two hundred and sixty-three (31.5%) were moderately dental anxious (scoring 9–12), 10.4% were highly anxious (scoring 13–14) and 5% were severely anxious (scoring 15–20). Anxious individuals had poorer periodontal health necessitating treatment compared to nonanxious individuals. The mean DMFS of the study population was highest among those having high and severe dental anxiety (mean DMFS = 11.0 and 12.59, respectively) which was statistically significant (P < 0.001).Conclusion:The present study showed a prevalence of dental anxiety of 47%. Impact of dental anxiety on oral health was found to be obvious as higher DMFT/DMFS was evident among dentally anxious subjects; dental anxiety also showed a strong association with higher CPITN scores.

Periodontal treatment need, interdental cleaning habit and dental services utilization of a Nigerian population

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Objective: Optimal home-use plaque-control measure maintains a functional dentition and reduces the risk of loss of periodontal attachment throughout life. The combination of toothbrushing and inter-proximal oral hygiene devices optimally prevents plaque accumulation. Individual’s attitude, lack of awareness and affordability are barriers for the utilization of dental services. This study evaluated the interdental cleaning habits; periodontal treatment needs and dental service utilization of a Nigerian population.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Methods: Self-administered questionnaires were used to obtain information on socio-demographics, use of interdental cleaning aid and health services utilization of participants. A full-mouth examination was done to assess the periodontal status and the treatment needs of the participants using the CPITN probe. Data was analyzed using Epi info 2008 version 3.5.1.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Result: Only 24.4% of the participants who claimed to clean interdentally actually used dental floss and interdental brushes) while majority of them ({160(71.2%)} used toothpicks. Three out of five participants {49(59%)} who do not clean interdentally, didn’t know that they had to do so. Though 284(92.2%) of the participants do not routinely access oral care, almost half (49.7%) had previous dental check-ups, scaling and polishing, tooth extractions and restorations. 44(14.3%) did not need periodontal treatment, 131(42.5%) needed Oral Hygiene Instruction (OHI) and Scaling and Polishing (S&amp;P) and 19(6.2%) needed OHI, S&amp;P and sub-gingival scaling.&#x0D; Conclusion: Dental services utilization was low until they perceived that they have a dental ailment, appropriate interdental aids were not used and knowledge on the need for interdental cleaning and advance periodontal treatment need of the participants were low.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Periodontal disease status and treatment need among a Kurdish population in Sulaimani - Iraq as assessed by CPITN index

Background and Objective: This study identifies the prevalence and severity of periodontal diseases in a given population of Sulaimani using the Community Periodontal Index of Treatment Needs (CPITN) and attempts to find the relation of CPITN with age, sex, location, visit to dentist, tooth brushing, use of mouth wash and interdental aids, systemic disease, smoking status and missing teeth. Methods: Periodontal examinations were performed using CPITN, plaque index (PI) and bleeding index (BI). Other data including location, visit to dentist, tooth brushing, use of mouth wash and interdental aids, presence of systemic diseases, smoking status and missing teeth were also collected. The data were subjected to logistic regression to find a relation between periodontal status and other variables. Results: Among the 1354 subjects examined, 43.6% were male and the majority of these (80.9%) were from urban areas. The mean PI and BI were 0.64±24 and 0.39±0.28, respectively. Calculus was the most prevalent highest score amongst examined subjects (62.2%), followed by shallow pocket (22.2%) and bleeding (9%). Among the sextants, lower central sextants were found to have the highest percentage of calculus. The highest percentages of shallow and deep pockets were found at upper left (14%, 2.5%, respectively) and upper right (11.4%, 3.2%, respectively) sextants. Logistic regression analysis showed that age, sex, frequency of brushing and smoking significantly correlated with CPITN scores. Conclusion: Prevalence and severity of periodontal diseases are high in the examined population and age, sex, brushing and smoking were shown to have an impact on periodontal condition.

Oral Health Status and its Impact on Daily Performance in Adult Population with Diabetes

Background: According to World Health Organization (WHO), diabetes mellitus, is a silent epidemic which affects large number of people around the world and is directly related to the oral health status of the patients.&#x0D; Objectives: To know the level of oral health and its impact on daily performance in adult population with Diabetes.&#x0D; Methods: A cross sectional study was comprised of group of 100 diabetic patients (males=68, females=32) from the OPD of Dhaka Dental College and Shaheed Suhrawardy Medical college, Dental unit of Dhaka. Oral health status is assessed by WHO described DMFT caries index and CPITN (community periodontal index treatment need). And oral impact on daily performance is determined by a modified form of OIDP index. Clinical examinations were included for the assessment of Dental Status. Chi-square was used for statistical evaluation.&#x0D; Results: Mean DMFT of the study population of Decayed, Missing and filled tooth were 3.89±3.35, 3.04±2.66 and 3.87±2.66 However, in case of CPITN index of the study population, Supragingival or subgingival pocket more than 6mm was in 32% cases. Mean scores of overall impacts on daily performances (OIDP) was 2.18±1.85. Bivariate analysis revealed that the self-reported oral impacts from the participants were not significantly associated (p≥0.05) with those who were diagnosed with presence of periodontal pockets more than 6 mm (32%).&#x0D; Conclusions: Oral health is an essential part of general health. Despite dental caries was comparatively low in diabetics, periodontal status was compromised which affected the participant’s daily life chiefly through difficulty in eating. Routinely follow-up of dental problems of the diabetics and oral health education is much required.&#x0D; Update Dent. Coll. j: 2021; 11 (1): 7-10

Epidemiology of periodontal diseases among the adult population in the city of Ufa

The article presents the results of an epidemiological study of the prevalence and intensity of inflammatory periodontal diseases (IPD) in the northern and southern parts of Ufa, as well as the need for complex periodontal treatment. The number of visits by primary persons for periodontal care in the NW is 2.1 times less than in the SW. The rank values of common risk factors for the development of IPD have been identified. When assessing the KPI index, the risk to this pathology and its difference in different parts of Ufa, taking into account the nosological form and gender, were identified. With acute gingivitis, men living in NW and SW were statistically equally treated to a periodontist, while women living in NW were 1.8 times more. With acute periodontitis in the NW, men visit a periodontist 1.9 times more than in the SW, and women, on the contrary, in the SW are 1.2 times more likely to visit than in the NW. With chronic forms of IPD, the differences in treatment among men and women were not statistically significant and did not depend on the area of residence.

Periodontal Treatment Needs of Hemodialized Patients.

End-stage renal failure is the reason for complications in many systems and organs, and the applied pharmacotherapy often causes the deepening of already existing pathologies within the oral cavity, such as: caries, periodontal diseases, mucosal lesions or reduced saliva secretion. Reduced saliva secretion results in an increased accumulation of dental plaque, its mineralization and prolonged retention, which leads to the development of gingival and periodontal inflammation. There is some evidence that chronic kidney diseases are influenced by periodontal health. The aim of the work was to evaluate the dental needs by the usage of clinical assessment of periodontal tissues of patients suffering from end-stage chronic kidney disease, arterial hypertension or/and diabetes mellitus. Material and methods: 228 patients underwent the research. 180 patients were hemodialized in Diaverum dialysis stations (42 of them were diagnosed with end stage chronic disease, 79 with the end stage chronic disease and arterial hypertension, 16 with end stage chronic kidney disease and diabetes, 43 with end-stage chronic disease, arterial hypertension and diabetes) and 48 patients of the Conservative Dentistry with Endodontics Clinic of Academic Centre of Dentistry of Silesian Medical University in Bytom and patients of the dentistry division of Arnika Clinic in Zabrze not diagnosed with any of the aforementioned diseases. The scheme of the research comprised 2 parts: analysis of the general health and assessment of the periodontal status which contain the following indices: Periodontal Probing Depth (PPD), Clinical Attachment Lost (CAL), Bleeding Index or Bleeding on Probing Index (BI or BOP), Community Periodontal Index for Treatment Needs (CPITN). Results: Significantly lower percentage of patients with healthy periodontal tissues and higher percentage with periodontal pockets deeper than 3.5 mm and the loss of trainers connective of 5 mm or higher were in the examined group. The values of the bleeding index were significantly lower in control group. The analysis of the CPITN index indicates higher percentage of patients qualified as CPI 1 or 2 in the control group while in the examined one most of the patients turned out to require specialist periodontal treatment. Conclusions: there is a direct relationship between periodontal status and end-stage renal disease which typically includes other chronical civilization ailments. It is important to develop a scheme for the easy and rapid examination of periodontal status, to determine the treatment needs in this area, which will allow precise assignment of long-term dialyzed patients to the range of prophylactic and therapeutic procedures.

Oral health treatment needs and dental service utilization among outpatients with mental disorders in Nigeria: A cross-sectional study

Aim: The aim of the study was to determine the dental treatment needs and the level of dental service utilization among patients with mental disorders (PWMD). Setting: This was a cross-sectional study at a tertiary hospital in Nigeria conducted between March and November 2018. Methodology: The community periodontal index of treatment of needs and the Decayed, Missing and Filled Teeth index were used to determine the dental and periodontal treatment needs. Dental service utilization was determined using a self-reporting assessment questionnaire. All data analyses were carried out using the IBM SPSS® Statistics version 20 and the statistical significance was set at P Results: A total of 116 PWMD participated in the study with 51.7% being females. The age range was between 19 and 57 years and the mean age was 37.16 (±10.52). Dental treatment need was 40.8%, while 66% needed a range of periodontal interventions and this showed no statistically significant differences in terms of gender (P = 0.67, P = 0.15, respectively). While 32.7% had made previous dental visits, past caries experience, and other factors such as gender were significant predictors for dental visits. Conclusion: There was a high dental and periodontal treatment need among PWMD, yet the dental service utilization was low. More collaborations between oral and mental health specialists are needed to improve dental service utilization and promote holistic health care for PWMD.

Low association between bleeding on probing propensity and the salivary aMMP-8 levels in adolescents with gingivitis and stage I periodontitis.

Bleeding on probing (BOP) is a widely accepted measure used in periodontal diagnostics. Previous studies suggest that several factors can affect BOP propensity. The aim of this study was to investigate the relative impact of different local and modifying factors on BOP levels. The oral health of five hundred and forty-four adolescents (two birth cohorts) aged 15-17years living in Kotka, Finland, was examined including periodontal probing depth, visible plaque index, root calculus, and BOP. Whole saliva samples were collected and measured for active matrix metalloproteinase-8 (aMMP-8) by time-resolved immunofluorometric assay (IFMA). Bacterial plaque/calculus accumulation (oral hygiene) had a major influence on BOP levels. The relative impact was several times greater compared with the extent of periodontal pocketing, aMMP-8 levels, smoking, toothbrushing, or gender. Furthermore, BOP levels were significantly elevated among adolescents with poor oral hygiene than good oral hygiene even if adjusted for the extent of periodontal pocketing (P<.001). BOP levels could be low even if several≥4mm deep periodontal pockets existed. The difference in the extent of periodontal pocketing was not significant between the two birth cohorts of adolescents (P=.731). BOP levels can be regarded as an important indicator of the extent of bacterial challenge and its adverse effects on the gingival inflammation. However, the level of oral hygiene may mask the association between the extent of gingival bleeding and the severity of the periodontal inflammatory condition. Thus, relying on BOP levels (below 10% or 20%) may provide insufficient information about the periodontal treatment need of an adolescent depending on his/her level of oral hygiene. Yet, more research is needed to confirm the results, also in adult populations.

Periodontal Health Status and Treatment Needs of Visually Impaired Student Attending “Extraordinary School in Jember Regency

Visually impaired people usually have limitation to do their activities in maintaining oral health including the periodontal tissue. This condition leads to inadequate efforts to maintain oral health that can cause various diseases, one of which is periodontal disease. Periodontal disease will gradually develop become severe, and therefore it is necessary to take proper care in handling it. The aim of this study was to determine the periodontal health status and the level of periodontal disease care needs of blind students in SLB Jember Regency. This research was a descriptive observational study with a cross sectional approach. The research sample of 20 people were obtained using the total sampling method. The health status of the periodontal tissue and the need for treatment are examined using CPITN. Subsequent research data are grouped and distributed based on gender and age. The result showed that the most common periodontal tissue health status was score two with clinical features of subgingival calculus or supragingival calculus with a total of 50%, while the most needed treatment needs were improvement in oral hygiene accompanied by 85% professional scaling.&#x0D; &#x0D; Keywords: periodontal health status; periodontal treatment needs; CPITN; visually impaired

"Comparative study of conventional anesthesia technique versus computerized system anesthesia: a randomized clinical trial".

The aim of the present study was to compare in terms of pain perception the use of conventional anesthesia and a computerized system. Forty patients in need for extractions, dental restorative, or periodontal treatment bilaterally, were selected. Each patient served as his/her own control being subjected to two anesthesia techniques: conventional and electronically controlled anesthesia with Calaject® (Rønvig Dental MFG, Daugaard, Denmark). Each patient received both treatments in a blind way 1week apart. The order was previously randomized. After performing the anesthesia (upper dental nerve, palatal posterior nerve, or inferior alveolar nerve), the patients evaluated their pain sensation with a visual analogue scale (VAS) (0-10). After treatment, the patients were asked about the presence of pain during the procedure. Finally, the patients selected their preference between the conventional and electronic anesthesia technique. Differences in assessment of pain's injection were analyzed using the Wilcoxon test and the Kruskal-Wallis test (α = 0.05). The mean general pain experienced was 3.73 (1.55 SD) for the conventional anesthesia, and 1.95 (0.53 SD) for computerized anesthesia. Statistical differences (p < 0.05) were found. There was no difference between the treatments (p value = 0.061). Most patients did not feel any pain during the treatment. Finally, 92.5% of the patients preferred the electronic system. Computerized anesthesia system produces significantly less pain compared with a conventional anesthesia syringe. Although both obtained sufficient anesthetic depth to perform treatments, the majority of patients chose electronic anesthesia as the most satisfactory. Computerized anesthesia devices are valid and more comfortable alternative to conventional anesthesia.

Dental and Periodontal Treatment Need after Dental Clearance Is Not Associated with the Outcome of Induction Therapy in Patients with Acute Leukemia: Results of a Retrospective Pilot Study.

This retrospective pilot study aimed to detect whether remaining dental/periodontal treatment need and periodontal inflammation after dental clearance would be associated with the initial therapy outcome of adult patients with acute leukemia undergoing induction chemotherapy. Different parameters were assessed from the patients' records: initial blood parameters, blood parameters during initial chemotherapy, leukemia/therapy related complaints, duration of fever, microbiological findings (blood and urine), as well as patients' survival. Dental treatment need was defined as the presence of at least one carious tooth; periodontal treatment need was determined by the presence of probing depth ≥3.5 mm in at least two sextants. To reflect periodontal inflammation, the periodontal inflamed surface area (PISA) was applied. Thirty-nine patients were included. A dental treatment need of 75% and periodontal treatment need of 76% as well as an average PISA of 153.18 ± 158.09 were found. Only two associations were detected: periodontal treatment need was associated with thrombocyte count after 7 days (p=0.03), and PISA was associated with erythrocyte count three days after induction of therapy (p=0.01). It can be concluded that remaining dental and periodontal treatment need as well as periodontal inflammation after dental clearance is not associated with the outcome of induction therapy in adult patients with acute leukemia.

Periodontal inflamed surface area in patients on haemodialysis and peritoneal dialysis: a Croatian cross-sectional study

BackgroundThe decision to initiate dialysis treatment via haemodialysis (HD) or peritoneal dialysis (PD) often involves the consideration of complex factors and remains a matter of debate. The purpose of this study was to quantify the inflammatory burden that periodontitis causes in dialysis patients and to examine whether patients on PD and HD differ in terms of the periodontal inflamed surface area (PISA), which can be helpful for selecting the most appropriate dialysis modality.MethodsA cross-sectional study was performed on 58 consecutive patients on HD and 31 consecutive patients on PD. PISA was calculated using measurements of the clinical attachment level, recession and bleeding on probing. We performed the primary analysis using multivariable robust regression.ResultsPatients on PD had a 746 mm2 (93%) lower mean PISA than patients on HD after adjustment for 20 possible confounders, including the duration of dialysis. The type of dialysis was independently correlated with the PISA (semipartial correlation: − 0.50; p = 0.017; false discovery rate < 5%). After adjusting for confounding factors, the correlation between the duration and type of dialysis was not significant (F (2,44) = 0.01; p = 0.994; η2 = 0.00). Differences in the PISA between patients who had undergone dialysis for less than a year, 2–3 years or ≥ 3 years were not significantly different in either of the two dialysis groups.ConclusionsPISA levels in Croatian patients on dialysis indicate a high need for periodontal treatment. PD is associated with a smaller PISA independent of many sociodemographic, lifestyle, laboratory and clinical factors. The duration of dialysis does not influence PISA levels.Trial registrationISRCTN17887630.A clinical study to investigate gum infection in patients undergoing kidney dialysis.