Periodontal Pocket Probing Research Articles

Application of periodontal tissue regeneration combined with orthodontics in oral prosthodontics and its influence and significance on the expressions of IL-1β, TNF-α and IL-5 in periodontal tissue

ABSTRACT The aim is to investigate the application of periodontal tissue regeneration combined with orthodontics in oral restoration, and explore its effect and significance on the expressions of Interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-5 (IL-5) in periodontal tissue. The patients in observation group were treated with orthodontics combined with periodontal tissue regeneration, and the control group was treated with periodontal tissue regeneration. The total effective rate, adverse reactions, recurrence rate and treatment satisfaction were compared. The masticatory function, language function, aesthetic level, VAS score, quality of life, gingival index (GI), plaque index (PLI), periodontal pocket probing depth (PD), sulcus bleeding index (SBI), IL-1β, TNF-α and IL-5 levels were compared. The recurrence rate of observation group was lower than control group, while the treatment satisfaction was higher after treatment. After treatment, the scores of masticatory, language, aesthetics, physiological, social, emotional, cognitive, and emotional functions and overall health score were higher than before treatment. After treatment, the scores of masticatory and language functions, aesthetics and quality of life of observation group were significantly higher than control group. After treatment, the VAS score, GI, PLI, SBI, PD, IL-1β, TNF-α and IL-5 levels were lower than before. The VAS score, GI, PLI, SBI, PD levels, IL-1β, TNF-α and IL-5 levels of observation group were lower after treatment. Orthodontics combined with periodontal tissue regeneration can help improve the periodontal condition of patients with periodontitis, reduce inflammatory response, improve the level of efficacy and overall safety, and further improve patients’ quality of life and treatment satisfaction.

Adjunctive use of a nanocolloidal silver-based local antiseptic solution in the nonsurgical treatment of periodontitis: A split-mouth clinical study

Objectives. The aim of the present study was to evaluate the potential additional clinical benefit of a commercial nano colloidal silver-based local antiseptic used as irrigation solution after subgingival mechanical instrumentation. Material and methods. Periodontitis patients were treated following the current guidelines. Two randomly assigned hemiarches of each patient received subgingival mechanical instrumentation plus irrigations with the commercial product (experimental group); the other two hemiarches received mechanical instrumentation plus saline irrigations (control group). A clinical periodontal examination at baseline moment and after 3 months was performed. The parameters considered for analysis were oral hygiene index (IHI), bleeding on probing score (BoP), periodontal pocket probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). 72 sites were included in the analysis, the site with the highest PD/quadrant for each patient. Data were analyzed using GraphPad Prism version 8.0.1 (GraphPad Software Inc., La Jolla, CA, USA). p<0.05 was set as statistical significance level. Outcomes. Eighteen periodontitis patients were treated. All clinical parameters improved at re-evaluation, compared to baseline, both in experimental and control group. The differences were statistically significant in terms of IHI, BoP and PD reduction. At re-evaluation, there were no statistically significant differences between periodontal parameters registered in the experimental and control sites. Conclusions. The present study failed to prove an adjunctive clinical benefit of the antiseptic product in the nonsurgical treatment of periodontitis. These results support the gold standard role of subgingival mechanical instrumentation in the periodontitis’ therapeutic protocol.

Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis.

BACKGROUNDSevere periodontitis is a major oral health concern today as it can lead to loss of teeth. Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIMTo investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β (IL-1β) and IL-10 in gingival crevicular fluid (GCF) in patients with severe periodontitis.METHODSEighty-six patients with severe periodontitis were randomly divided into a research group (n = 43) and a control group (n = 43). The control group was treated with simple periodontal therapy, and the research group was treated with dental pulp periodontal therapy. The total effective rates of the treatments; periodontal status before and after treatment through the measurement of the periodontal pocket probing depth (PPD), gingival sulcus bleeding index (SBI), mobility (MD), and plaque index (PLI); the levels of inflammatory factors IL-1β and IL-10 in the GCF; and the incidence of complications were calculated for both groups and compared using the Student’s t test and the χ2 test.RESULTSThe total effective rate of treatment in the study group (93.02%) was higher than that in the control group (76.74%; P < 0.05). While before treatment, there was no significant difference in the PLI, MD, SBI, or PPD between the two groups, the post-treatment values of PLI, MD, SBI, and PPD (4.71 ± 0.16 mm, 0.61 ± 0.09 mm, 0.96 ± 0.17 mm, and 0.76 ± 0.26 mm, respectively) were significantly lower (P < 0.05) in the research group than in the control group (5.35 ± 0.24 mm, 0.93 ± 0.15 mm, 1.35 ± 0.30 mm, and 1.04 ± 0.41 mm, respectively). There was no significant difference in the level of IL-1β or IL-10 in the GCF before treatment between the two groups; after treatment, the IL-1β level in the research group (139.04 ± 15.54 pg/mL) was significantly lower than that in the control group (156.35 ± 18.10 pg/mL), and the level of IL-10 in the research group (7.98 ± 1.01 ug/L) was higher than that in the control group (5.56 ± 0.96 ug/L) (P < 0.05). The incidence of complications in the study group (4.65%) was significantly lower than that of the control group (18.60%; P < 0.05). CONCLUSIONEndodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction. In addition, it can improve the periodontal condition and the overall treatment effect, reduce the risk of complications, and ensure the safety of treatment.

Selective Influence of Smoking on Periodontal Treatment Outcomes after 3 Years of Follow-up.

The impact of smoking habits on periodontal treatment has not been clearly elucidated. This study aimed to specify the effects of cigarette consumption and nicotine addiction on periodontal therapy. In this retrospective case-control study, 20 moderate smokers and 20 non-smokers with severe periodontitis were examined after initial diagnosis, and non-surgical active and supportive therapies for 1-6 years (mean follow-up = 3.37 years). Fagerström's test of nicotine dependence (FTND) was evaluated at re-examination. Treatment efficacy was assessed by periodontal pocket probing depth (PPD) changes and number of teeth lost per year (TL). Bayesian multilevel and regression analyses were performed at site, tooth, and patient levels. During the mean follow-up period of > 3 years including active and supportive periodontal therapies, mean PPD, PPD > 3 mm and PPD > 7 mm percentage reductions were 1.03, 1.48 and 2.57 times statistically significantly less pronounced, respectively, in smokers than in non-smokers. Multilevel analysis showed that the variability of PPD > 7 mm reduction was mainly associated with patient-level factors. Smokers presented a higher risk for periodontitis progression. In smokers, periodontal parameter improvement was less pronounced in the maxilla and molars. The mean TL was related to the FTND score, not to cigarette consumption. Regression analysis did not demonstrate other influences of demographic and periodontal treatment characteristics on treatment outcomes, except patient age. Smoking negatively impacted periodontal treatment outcomes at specific tooth sites (deep pockets, maxillary molars) and periodontitis progression, independent of other risk factors.

Does the third molar position influence periodontal status and overall condition of patients with acute pericoronitis? A cross-sectional study.

The teeth positioning may be an important associated factor for the pericoronitis' clinical signs. Our objective was to verify the association between lower third molar position according to the Pell and Gregory classification and clinical variables in patients with pericoronitis. Cross-sectional analysis of panoramic radiographs and medical records of patients with pericoronitis. Primary outcomes: pain and oral health-related quality of life (OHRQoL); secondary outcomes: mouth opening, edema/erythema extension, visible plaque index, bleeding on probing index, periodontal pocket probing depth, and distal alveolar bone crest height of the adjacent second molar. The edema/erythema extension was higher in the IIA position compared with the IA position (p = 0.03). Regarding the OHRQoL, the OHIP-14 score was 21.0 (± 9.26, range from 4 to 44). The most scored domain was physical pain (5.24), followed by psychological discomfort (4.43). Third molars in IIA position are associated with worse OHRQoL than IB and IIB positions (p = 0.03). There was a higher extension of edema/erythema and worse OHRQoL when the third molar was in IIA position. Prophylactic removal of mandibular third molar in position IIA may avoid the onset of mucosal edema/erythema and prevent pericoronitis from promoting impairment of individuals' quality of life.

Comparative evaluation of the effect of Ozone therapy and Photodynamic therapy in non-surgical management of Chronic periodontitis: A split mouth longitudinal study.

Background:A split-mouth longitudinal study was conducted to compare and evaluate the effect of ozonated water and photodynamic therapy (PDT) in nonsurgical management of chronic periodontitis, along with mechanical debridement procedure.Materials and Methods:Twenty-two patients diagnosed with chronic generalized periodontitis were subjected to the study. Following the assessment of gingival index, periodontal pocket depth, and clinical attachment loss, all patients underwent full-mouth scaling and root planing. Upper right and left quadrants of each patient were considered as sample sites in the study. Among these split-mouth sites, upper right quadrant of each patient was subjected to ozonated water irrigation with a 22-gauge needle and left upper quadrant was treated with PDT, which involved sulcus irrigation with indocyanine green dye (0.05 mg/ml) followed by low-level diode laser light application at 0.5 W and 810 nm (AMD Picasso) through a fiber-optic tip of 10 mm length, default angle of 60°, and fiber core diameter of 400 μm in noncontact continuous wave mode. Patients were recalled at the 2nd and 4th months regularly, and the therapy was repeated at the same sites in the same manner. Clinical parameters recorded before the study were assessed again at the end of the 2nd- and 6th-month period.Results:A statistically significant reduction (P < 0.05) was observed in gingival index scores within both the study groups at all intervals of the study. In Ozone therapy (OT) group, a statistically significant difference was noted for total periodontal pocket depth values between baseline and 2nd month (P = 0.000), baseline and 6th month (P = 0.000), and between 2nd month and 6th month (P = 0.029). In the PDT group, on contrary, a statistically significant difference was noticed in total periodontal pocket probing depth values between baseline and 2nd month (P = 0.000) and baseline to 6th month (P = 0.000), but a similar significant difference was not noticed between 2nd-month and 6th-month periods (P = 0.269). In group OT, a statistically significant difference was noted for total clinical attachment loss between baseline and 2nd month (P = 0.000), baseline and 6 months (P = 0.000), and 2nd month and 6th month (P = 0.019). In group PDT, a statistically significant difference in terms of its improvement was noted at intervals between baseline and 2 months (P = 0.000) and from baseline to 6 months (P = 0.000) but not between 2nd month and 6th month (P = 0.129).Conclusion:Results of the study showed that sub-gingival OT and PDT equally improved the clinical outcomes of treatment drastically following mechanical debridement at the end of first 2 months. Thereafter, it was shown to improve steadily throughout the study period, with slightly better results with OT compared with PDT.

Effects of a Dental Gel Over 6 Months on Periodontal Health in Subjects with Stage II and III (Mild and Moderate) Periodontitis

Objective:Overall aim of this prospective, randomized, positive controlled, double-blind in vivo study was to identify the effects of a test dental gel containing 2.6% edathamil with an added carrier and permeability enhancer vs. a positive control dentifrice on periodontal health measures in patients with Stage II and III periodontitis.Methods:In this prospective double-blinded, randomized study, 33 subjects were randomly assigned in a 1:1 ratio to brushing their teeth with either the test gel (LivFresh®, Livionex Dental Gel, Los Gatos, CA 95030) or the positive control toothpaste (Crest ProHealth®, P&G, Cincinnati, OH 45202).Full-mouth gingival index, modified sulcus bleeding index, and periodontal pocket probing depths were recorded for all teeth at baseline, and on days 90 and 180.Subjects brushed with the study material twice a day.Results:The test dental gel reduced gingival inflammation and bleeding, as well as periodontal pocket probing depths significantly more than a control dentifrice.Conclusions:In this pilot study in subjects with Stage II and III periodontitis, a test dental gel was found to improve gingival inflammation and bleeding, as well as periodontal pocket depths significantly better than a control dentifrice.

Long-term Association of Periodontitis With Decreased Kidney Function

Previous studies have yielded inconclusive findings regarding the relationship between periodontitis and kidney function. We sought to investigate whether periodontitis is associated with subsequent decreases in kidney function (reductions in estimated glomerular filtration rate [eGFR] and increased urinary albumin-creatinine ratio [UACR]) in the general population. Population-based cohort study. We used baseline and 11-year follow-up data from 2,297 and 1,512 adult participants, respectively, in the Study of Health in Pomerania (SHIP). Age range was limited to 20 to 59 years to avoid the potential influence of tooth loss. Periodontal status defined by periodontal pocket probing depth (PPD) and clinical attachment level. Mean levels and the percentage of sites≥ 3mm was determined for either all sites (PPD) or interproximal sites (clinical attachment level). All PPDs≥4mm were summed to calculate the total PPD. GFR estimated from serum creatinine and serum cystatin C (eGFRcr-cys). Moderately increased albuminuria defined as UACR>30mg/g. Adjusted linear and logistic mixed regression models. At baseline and follow-up, average eGFRcr-cys was 118.3 and 105.0mL/min/1.73m2, respectively. Using mixed models, no consistently significant associations between periodontitis variables and eGFRcr-cys were detected. Long-term changes in UACR were inconsistently associated with periodontitis measures. After imputation of missing data, associations were either attenuated or no longer detectable. Because periodontal assessments were performed using a partial recording protocol, periodontal disease severity estimates might have been underestimated, resulting in attenuated effect estimates. We found no consistent evidence for an association between periodontitis and decreased kidney function. In contrast to previous studies, these results do not support the hypothesis that periodontitis is an important risk factor for chronic kidney disease.

Anaerobic Bacteria in Implants and Homologous Teeth 2-14 Years after Implantation.

ObjectiveThe objective of the study was to establish whether there is a difference in the presence of potentially pathogenic anaerobic microorganisms around the implant and the homologous tooth in implant-prosthetic patients who received individual information about maintaining their oral hygiene.Material and methodsThe study included 30 subjects with dental implants and metal-ceramic crowns. A periodontal probe was used to record the approximal plaque index (API), the papilla bleeding index (PBI), the periodontal pocket probing depth (PD) and the gingival recession. The fluid around the implant and the gingival sulcus fluid around the homologous tooth on the opposite lateral side were sampled.ResultsThe results have shown a positive API and PBI on 30% of the implants and a negative one on 70% of the implants. The average mucosal retraction measured around the implants was 0.15 mm, and the average probing depth was 2.25 mm. The API and PBI were positive on 78.3% of the homologous teeth. The average gingival retraction measured was 1.06 mm, and the average probing depth was 1.85 mm. Anaerobic bacteria were found in 12 out of 30 subjects (40%). Anaerobic bacteria were isolated only on the implant in 7 subjects, only on the homologous tooth in 3 subjects and both on the implant and the homologous tooth in 2 subjects.ConclusionsAnaerobic bacteria were more abundantly present on implants than on homologous teeth.

Assessment of C-reactive Proteins, Cytokines, and Plasma Protein Levels in Hypertensive Patients with Apical Periodontitis.

Chronic apical periodontitis (CAP) manifests mostly as periapical radiolucency. Various inflammatory mediators play a significant role in the pathogenesis of apical periodontitis. In acute inflammatory conditions, C-reactive proteins (CRP) and fibrinogen show a rise in their concentrations. In chronic diseases with high inflammatory components, an increased prevalence of hypertension has been observed. Hence, we assessed the association of CAP and plasma levels of various inflammatory markers (CRP, interleukin 6 [IL-6], and fibrinogen) in severely hypertensive patients. This study was conducted in the conservative wing of the institute and included assessment of 250 hypertensive patients with apical periodontitis. With the help of periapical radiographs and clinical examination, the assessment of following parameters was done: Amount of teeth present, visible plaque index, periodontal pocket probing depth, clinical attachment level, bleeding on probing, presence/absence of carious lesions, which included assessment of caries in crown portion, in the root portion, and residual tooth roots (RR), presence of CAP from each patient; 8 mm of venous blood was collected in the morning for the assessment of plasma levels of IL-6, CRP, and fibrinogen levels. Immediate collection and processing of the samples were done in the hospital laboratory. All the results were analyzed by Statistical Package for the Social Sciences software. Out of 250, 155 patients were females. Mean plasma levels of CRP observed in our study were 0.8 mg/dL. Mean plasma levels of IL-6 and fibrinogen were found to be 3.3 and 337.1 mg/dL respectively. A significant correlation was observed while comparing mean body mass index (BMI), RR, and CAP in hypertensive patients. While comparing the mean plasma IL-6 levels, mean BMI, and CAP in the patients, significant results were obtained. Significant correlation was observed while comparing the mean BMI and CAP in hypertensive patients. Systemic levels of CRP, IL-6, and fibrinogen levels are influenced by the presence of CAP in hypertensive patients. In hypertensive patients, CAP alters the systemic levels of various inflammatory markers.

Effectiveness of a Specially Designed Dental Model for Training, Evaluation, and Standardization of Pocket Probing

The aim of this study was to evaluate the effectiveness of a dental model in training, evaluation, and standardization of examiners in pocket probing and to determine the appropriate thresholds of accuracy and measuring time when using this model for evaluation of probing skills without measuring patients' pockets repeatedly. In 2011-12, a total of 66 dental professionals and 20 dental students in Japan measured the probing depths of 24 artificial teeth using the six-point method on a dental model. All examiners measured the probing depths of six tooth groups and then checked the correct depths in each group. Each examiner measured four groups in a group-by-group manner. For each group, the measuring time and examiner's accuracy were recorded. Receiver operating characteristic (ROC) curves for various thresholds of measuring time were drawn for thresholds of accuracies to determine the passing mark as a skilled examiner. The accuracy significantly increased from the first to the fourth measurements, and the measuring time was significantly reduced for both the professionals and students. The total measuring time was significantly longer for the students than the professionals. The students' accuracy was significantly lower than that of the professionals in the first measurement group. The increasing rate of accuracy was significantly higher for the students than the professionals. These results and ROC curves suggested that the dental model is effective for periodontal pocket probing training and for the evaluation and standardization of examiners' probing skill at a preclinical level. An examiner having accuracy ≥80% within four minutes for six tooth measurements in this model could be considered a skilled examiner.

Clinical and postextraction evaluation of periodontal disease indicators.

Background:Clinical attachment level is the most frequently used and acceptable parameter in monitoring periodontal status in diseased individual and denotes patterns of periodontal destruction. Awareness of root morphology and the condition of the periodontal tissues is essential for reliable periodontal pocket probing and for effective debridement of root surfaces. Clinically, it is challenging to observe exact nature of complex periodontal attachment loss. The aim of the present study was to evaluate patterns of periodontal destruction based on vertical and horizontal attachment loss.Materials and Methods:A total of 200 extracted teeth were obtained from chronic periodontitis patients. Prior to extraction, clinical measurements were recorded and after extraction, the teeth were stained with crystal violet. Root length, vertical and horizontal attachment loss were measured using digital caliper.Results:There was a significant difference between clinical attachment level and vertical attachment loss for both maxillary and mandibular teeth. Mean vertical attachment loss varied between 5.17 mm and 9.17 mm. Interproximal surfaces exhibited statistically significant vertical attachment loss in both maxillary and mandibular dentition. Results indicated that vertical attachment loss was more severe with teeth belonging to the anterior sextant whereas the horizontal attachment loss was more pronounced with posterior teeth.Conclusion:Both vertical and horizontal attachment loss were observed in all periodontally involved teeth. There was a difference in clinical measurements and actual periodontal status denoted by postextraction staining. These findings have an impact on determining the prognosis and appropriate treatment plan for patients.

Incidencia de bolsas periodontales en terceros molares erupcionados como determinante para la extracción profiláctica de los mismos.

El objetivo del presente estudio es determinar si es necesario la extracción profiláctica de terceros molares asintomáticos, por la presencia de bolsas periodontales mayores a 3mm en la zona de los terceros molares y en distal del segundo molar adyacente al mismo.Se analizaron 30 pacientes al azar, que tuvieran al menos un tercer molar en boca; el cual se encuentre asintomático y que no tenga enfermedades sistémicas que pueden afectar la salud del periodonto como es la diabetes, hipertensión, cáncer, inmunodeficiencias, epilepsia, entre otras; el método de análisis fue mediante un sondaje por vestibular y palatino/lingual, en mesial medio y distal con una sonda calibrada de 3 en 3mm.De los 30 pacientes; 60% fueron hombres mientras 40% fueron mujeres, la muestra posee una edad de 18 años en adelante.Del total de pacientes analizados el 71,08% de los mismos presentó al menos 1 bolsa periodontal con un sondaje mayor a 3mm en la región de los terceros molares, obteniendo una probabilidad de dicho suceso de 0,7; por otro lado únicamente el 20,48% de los mismos presentaron caries. En los 76 segundos molares analizados en la zona distal adyacente al tercer molar presente; 69,74% de los mismos presentó igualmente un sondaje mayor a 3mm; no obstante la dependencia de estas variables es negativa ya que el valor obtenido fue de: Sig. = 0.125 &gt; 0.05.Se llegó a la conclusión que es recomendable la extracción profiláctica de los terceros molares.

Reliability of gingival blood sample to screen diabetes in dental hospital

Background:Early detection and treatment of diabetes mellitus may reduce the burden of diabetes and its complications. Screening of undiagnosed diabetes with gingival blood sample in patients attending to the dental hospital and to check the reliability with standard method.Methods:Five hundred and fifty new patients age ranged from 30 to 50 years were randomly selected. Of 550 patients examined, gingival blood samples of 454 patients were collected from bleeding site and analyzed with self-monitoring device. Blood glucose values were recorded. In addition, all the patients were advised for the second visit with overnight fasting for fasting Blood glucose assessment. Among them, 442 patients returned for fasting blood glucose assessment in laboratory with blood glucose analyzer.Results:In the total of 454 patients gingival blood glucose assessment with self-monitoring device, 64 patients showed ≥200 mg/dL, which indicates diabetes, and the other 390 patients showed ≤200 mg/dL, which indicates patients are not diabetic. Whereas, the results of the laboratory blood glucose analysis, 24 (5.43%) patients showed ≥126 mg/dL, 36 (8.14%) patients showed 100–125 mg/dL and the other 382 patients are not diabetic. Comparison of blood glucose measurements by two methods showed sensitivity 96.66% and specificity 99.47%.Conclusions:The results of the present study showed blood obtained from periodontal pocket probing is a reliable sample to screen diabetes in periodontal disease population. Early diagnosis of diabetes in the dental hospitals can help improve the patient's oral health and overall health status by helping patients avoid or reduce complications from diabetes.

歯周ポケット測定訓練用顎模型の開発

歯周ポケット測定訓練用顎模型の開発

Glucometric assessment of gingival crevicular blood in diabetic and non-diabetic patients: A randomized clinical trial

BackgroundDiabetes mellitus is one of the most incessant metabolic afflictions with high prevalence rate in Indians. Diagnosis of diabetics in the initial stage helps to prevent its long term complications that are responsible for high morbidity and mortality. The aim of the present study was to assess whether glucometric analysis using Gingival Crevicular Blood (GCB) can be used for screening of diabetic patients in dental chair. Materials and methodsPresent study was a double blinded randomized controlled trial. A total of 50 patients, 25 diabetic and 25 non-diabetic with chronic periodontitis were enrolled in the study. Blood oozing from the gingival crevices after periodontal pocket probing of anterior teeth and Finger Prick Blood (FPB) was taken and analysed by glucometer. ResultMean ± S.D was 195.84 ± 27.19 and 138.78 ± 29.95 for GCB and FPB respectively in diabetic group. For non-diabetic group Mean ± S.D was 103.84 ± 12.56 and 84.36 ± 10.36 respectively for GCB and FPB. A Karl Pearson correlation coefficient value of r = +0.735 for diabetic and r = +0.802 for non-diabetic group comparing GCB and FPB. ConclusionGCB cannot be used for screening blood glucose during periodontal examination.

Developing a chair side, safe and non-invasive procedure for assessment of blood glucose level using gingival crevicular bleeding in dental clinics.

Aim:To study the accessibility of chair side blood glucose non-invasive screening method for diabetes mellitus during routine periodontal examination.Materials and Methods:Fifteen non-diabetics and 15 newly onset type 2 diabetics patients with moderate to severe periodontitis were selected after meeting inclusion and exclusion criteria. Periodontal pocket probing was performed using a Williams Graduated periodontal probe. Blood oozing from gingival sulcus of anterior teeth following periodontal pocket probing was collected with stick of a glucose self-monitoring device. As control, finger stick capillary blood was taken.Results:A statistically significant correlation was observed between the blood glucose level of gingival crevicular blood (GCB) and peripheral fasting blood (PFB) of diabetic subjects. The mean GCB glucose level of the subjects in diabetic group was 172.27 ± 5.02 mg/dl while mean PFB glucose was 167.80 ± 8.87 mg/dl. The correlation coefficient of diabetic and non-diabetic subjects were r = +0.715 and r = +0.619, respectively.Conclusion:The results suggested that blood oozing during routine periodontal examination may be used for diabetic mellitus screening in a dental office setting without the need for any extra procedure.

Development and Evaluation of a New Dental Model at Tokyo Medical and Dental University for the Practice of Periodontal Pocket Probing

Dental and dental hygiene students must acquire the skill of measuring periodontal pockets and learn to identify the bottom of a pocket, especially of deep periodontal pockets. A new dental model that would enable students to practice measuring deep periodontal pockets was developed at the Tokyo Medical and Dental University. The purpose of this study was to evaluate the feasibility and effectiveness of this model. Twenty dental hygiene students in their third year at the school and twenty-four instructors or dental hygienists of the University Hospital measured periodontal pockets on the newly designed dental model. Feasibility and effectiveness of the model were evaluated based on periodontal probing by the students and instructors, as well as results of a questionnaire. The results demonstrated an intraexaminer agreement (within ±1 mm) averaging 91 percent. The mean percentages of correct answers of the students and instructors were 82 percent and 80 percent, respectively. More than 90 percent of the instructors and students reported that the new model would be suitable for pocket probing training. In the questionnaire, they responded that this practice using the new model would contribute to students' future and that they wanted to try other dental models with various probing depths. The new dental model designed for periodontal pocket probing training was reported to be feasible and effective for student practice.

Periodontal, demographic and systemic condition characteristics of patients treated at a dental school

The aim of this study was to evaluatethe relations among: age, reasons for dental appointment, systemic conditions, use of medicines and periodontal disease, in patients assisted in the Periodontal Clinic at the Dental School of the Center of Higher Education of Campo Gerais (short Cescage – Ponta Grossa, Brazil), during 2007-2009. Material and methods: A total of 183 dental files were obtained and 100 were included in the study. Thefollowing tests were applied: student t, Mann-Whitney (quantitativevariables) and Qui-square (χ2) (qualitative variables). The level of significance adopted was of 5%. Results: The main reason for dentalappointment was not the need of periodontal treatment, but tooth pain and dental aesthetics. In relation to the systemic condition, women presented more systemic alterations in comparison with men, showing higher prevalence of diabetes and hypertension. In relationto the drugs, only 20% of men used systemic drugs, while 52% of women used them. Dental plaque showed similar percentage betweengenders, but bleeding on probing was lower in women. Concerning to periodontal disease the prevalence of pocket probing depth (until4 mm) was equivalent in both genders, and the buccal area of themouth showed a higher prevalence than the labial area. Considering periodontal pocket probing depth (7 mm or more), the result was similar in both genders and the buccal area of the mouth showedhigher prevalence that the labial area. Conclusion: Anamnesis andclinical examination accomplished in the periodontal clinic canestablish some demographic, clinical and systemic disease patterns related to the presence of the periodontal disease in patients seeking treatment at dental school clinics.

Development of noninvasive procedure for monitoring blood glucose level using gingival crevicular bleeding

Introduction. Diabetes mellitus (DM) and chronic periodontitis are common chronic diseases in adults. It is usually necessary to provide a sample of capillary blood to measure blood glucose level in diabetics. However, it is possible to obtain blood during periodontal probing without any discomfort. The aim of the study was to evaluate accessibility of chair side noninvasive screening method for blood glucose level in DM during routine periodontal examination. Material and Methods. 15 non diabetics and 15 newly onset type 2 diabetic patients with moderate to severe periodontitis were selected for the study after meeting inclusion and exclusion criteria. Periodontal pocket probing was performed using Williams Graduated periodontal probe. Blood oozing from gingival sulcus of anterior teeth following periodontal pocket probing was collected with a stick of glucose self monitoring device. As control, finger stick capillary blood was taken. Results. Statistically significant correlation was observed between the blood glucose level in gingival crevicular blood (GCB) and peripheral fasting blood (PFB) in diabetic subjects. The mean GCB glucose level in diabetic subjects was 172.27?5.02 mg/dL while mean PFB glucose level was 167.80?8.87 mg/dL. The correlation coefficients for diabetic and non diabetic subjects were r=0.715 and r=0.619, respectively. Conclusion The results suggested that blood oozing during routine periodontal examination may be used for DM screening in dental office without the need for any extra procedure.