Periodontal Status Research Articles

Periodontal status and risk factors in patients with type 1 diabetes mellitus

ObjectiveConduct a cross-sectional study to investigate the periodontal conditions and oral health behaviours among adult subjects with type one diabetes mellitus and compare them with those of a group of age- and gender-matched without diabetes. Furthermore, we also intend to evaluate the potential indicators of the risk for the development of periodontal disease.MethodsThe evaluation was undertaken with patients with diabetes (n = 70) from a patients’ cohort of the the Hospitalar Center of Tâmega e Sousa and subjects without diabetes (n = 69).ResultsThe prevalence of periodontal disease showed significant differences between groups. Gingivitis reached a prevalence of 37.1% in patients with type one diabetes mellitus and periodontitis 55.7%. These systemically compromised patients exhibited a higher prevalence of Plaque Index, Bleeding on Probing and Periodontal Probing Depth and a reduced number of teeth when compared to the control group. The stage II was the most prevalent in the diabetes population, followed by the stage IV and most of diabetes subjects presented grade C progression.ConclusionsThere is a higher prevalence of periodontal disease in type one diabetes mellitus individuals when compared to the controls. Age, Bleeding on Probing and number of cigarettes per day are associated with higher risk of periodontal disease in type one diabetes mellitus patients.Clinical relevanceOur study provides evidence about the prevalence of periodontal disease among type 1 diabetes mellitus and creates awareness regarding the factors that potentially contribute to worsening periodontal tissues. Furthermore, informing diabetic patients about the importance of early diagnosis and prevention of periodontal disease and the importance of reducing/quitting smoking.

Changes in Serum Inflammatory Markers and in Clinical Periodontal Condition After Non-Surgical Periodontal Treatment in Hypertensive Patients

Background: Chronic inflammatory disorders, such as periodontitis, may contribute to pro-hypertensive inflammation. Objectives: This study aimed to analyze changes in parameters for periodontitis, such as periodontal inflamed surface area (PISA) and serum inflammatory markers, following non-surgical periodontal treatment in hypertensive patients. Methods: A quasi-experimental pre-and-post study was conducted, involving 42 controlled hypertensive patients with periodontitis. The patients underwent periodontal assessment and tests, including complete blood count, glucose, triglycerides, HDL-C, LDL-C, and serum levels of inflammatory biomarkers. All patients received scaling and root planning treatment in a single session and were reevaluated one month after the treatment. Results: Post-treatment evaluations showed significant improvements in periodontal inflammation parameters, such as pocket depth, attachment level, bleeding on probing, and biofilm percentage, with statistically significant differences (p < 0.001). There were decreases in serum VEGF levels (p < 0.001) and reductions in PISA associated with declines in cytokine levels such as IL-10, IL-6, IL-12p70, IL-17A, and VEGF. PISA for IL-6 and IL-10 had a positive correlation before periodontal treatment and with IL-1β and IL-10 after treatment. Conclusions: Hypertensive patients with periodontitis who underwent non-surgical periodontal treatment showed improvements in their periodontal condition, a decrease in cytokine levels such as VEGF, and reductions in PISA associated with declines in cytokines such as IL-10, IL-6, IL-12p70, IL-17A, and VEGF. These findings confirm the role of inflammation in hypertensive patients with periodontitis.

Sexual dimorphism in periodontal inflammation: A cross-sectional study.

The purpose of the present study was to evaluate the role of sexual dimorphism (SD) in the clinical manifestation of plaque-induced periodontal inflammation by analyzing the association between patient-related factors and the full-mouth prevalence of bleeding on probing (BOP%) within 2 cohorts of male and female individuals. Data on BOP (dichotomously recorded as present/absent after the assessment of probing depth [PD]) were retrospectively obtained from the files of adult patients undergoing a first periodontal visit at a University center. Two multiple regression models (1 for males, 1 for females) were built with BOP% as the dependent variable and patient-related factors (i.e., age; smoking status; daily cigarette consumption; history of diabetes diagnosis; number of teeth present; proportion of sites with PD ≥ 5mm around teeth) as independent variables. In males (n=212), BOP% was 5.9% lower in smokers compared to non-smokers (p=0.021). In females (n=389), BOP% increased by 1.6% for each 10-year increase in age (p=0.046). The proportion of sites with PD ≥ 5mm showed a strongly significant, positive association with BOP% irrespective of biological sex (p<0.001). SD manifested as a sex-dependent diversity in the association between patient-related factors and periodontal inflammation expressed as BOP%. While smoking determined a lower BOP% only in males, aging was associated with increased BOP% only in females. Gingival bleeding upon mechanical stimulation of the bottom of the gingival sulcus/pocket with a periodontal probe (bleeding on probing [BOP]) is suggestive of the presence of an inflammatory infiltrate induced by dental plaque within the gingival tissue. The prevalence of BOP within the dentition (BOP%) has a diagnostic relevance, being one of the main parameters to discriminate between periodontal health and disease. Also, BOP% informs the probability for a patient to either develop destructive form of periodontal disease (i.e., periodontitis) or manifest periodontitis progression. Based on the documented influence of biological sex on the incidence, traits, and/or progression rate of several diseases, which goes under the name of sexual dimorphism (SD), the effect of SD was investigated in relation to the factors that were previously associated with BOP% in a cohort of patients with heterogeneous periodontal conditions undergoing their first periodontal visit. Interestingly, SD manifested as a sex-dependent diversity in the association between patient-related factors and periodontal inflammation expressed by BOP%. While smoking determined a lower BOP% only in males, aging was associated with increased BOP% only in females. The present findings may find potential applications in personalized periodontal medicine and inspire future studies in this field.

Application of the 2018 Periodontal Status Classification to Epidemiological Survey Data (ACES) Framework to Estimate the Periodontitis Prevalence in the United States.

To compare periodontitis prevalence estimates based on the Application of the 2018 periodontal status Classification to Epidemiological Survey data (ACES) and the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) classification. National Health and Nutrition Examination Survey data for the years 2009/2010, 2011/2012 and 2013/2014 were survey-weighted and post-stratified to estimate the prevalence of periodontitis. Estimates based on ACES and CDC/AAP were cross-classified and stratified by age group. Prevalence estimates using different partial recording protocols were examined. Using the ACES framework, the prevalence of adults with periodontitis was 93.1% (95% CI: 91.9-94.2) (Stage I: 17.9%; Stage II: 46.2%; Stage III: 16.7%; Stage IV: 12.4%). Complexity factors did not alter Stage II prevalence. The CDC/AAP classification yielded a periodontitis prevalence of 38.9% (95% CI: 36.4-41.4) (Mild: 3.5%; Moderate: 28.1%; Severe: 7.3%). Partial recording protocols resulted in increased prevalence in the lower stages of periodontitis. The European Federation of Periodontology/American Academy of Periodontology Classification (using the ACES framework) overestimates periodontitis cases compared with the CDC/AAP classification. Including complexity factors in the ACES framework provides limited benefits in staging periodontitis. Partial-mouth recording protocols overestimate health and early disease stages while underestimating more severe disease.

The Association Between Periodontal Status, Oral Health-Related Quality of Life and Self-Rated Oral Health in Socially Underprivileged Adolescents.

To assess the associations between periodontal conditions, dental caries, sex, psychosocial factors, socioeconomic status, oral health-related quality of life (OHRQoL), and self-rated oral health among adolescents living in socially deprived neighbourhoods. A school-based survey was conducted in a random sample of 406 12-year-old adolescents in 11 neighbourhoods in the East region of Manaus, Brazil. Gingival status, dental calculus (Community Periodontal Index), and dental caries (DMFT index) were registered through clinical examinations. Adolescents self-completed questionnaires to assess psychosocial factors (self-esteem, sense of coherence, and oral health beliefs), socioeconomic status (family income, parent's schooling, number of goods, and house crowding), oral health-related quality of life (OHRQoL) (CPQ11-14), and self-rated oral health. Direct and indirect relationships between variables were tested using structural equation modelling guided by the Wilson and Cleary model. Greater gingival bleeding was directly associated with worse self-rated oral health. Poor OHRQoL was directly linked to the number of teeth with dental calculus, more teeth with dental caries experience, and worse psychosocial factors. Worse socioeconomic status and dental calculus were associated with gingival bleeding. Dental calculus and socioeconomic status were indirectly associated with self-rated oral health via gingival status. OHRQoL mediated the association of dental caries experience and psychosocial factors with self-rated oral health. Gingival bleeding and dental calculus may negatively affect self-reported oral health in adolescents. Socioeconomic status and psychosocial factors were also relevant determinants for oral health in this age group.

Assessing the Alkaline Phosphatase Levels as A Bone Biomarker in Gingival Crevicular Fluid during Semi-Rapid Expansion

In orthodontics, the expansion of the maxilla is done to treat transverse maxillary deficiency in childhood. The cause of maxillary constriction may be genetic or environmental leading to crowding of teeth, cross bite and development of malocclusions. This expansion leads to increased maxillary dimensions. Objectives: To detect changes in alkaline phosphatase level as a bone biomarker in crevicular fluid during the phases of semi-rapid palatal expansion. Methods: Fifteen growing patients with an age range from 8-13 years were selected who needed maxillary semi-rapid palatal expansion as a part of orthodontic treatment. This quasi-experimental study was based on a non-probability purposive sampling technique conducted from August 2023 to July 2024. The samples were collected by inserting paper points in the gingival sulcus. The Periodontal status was evaluated before starting the sampling. The probing depths were recorded at different levels throughout the study until the completion of the retention period. The alkaline phosphatase levels in the gingival crevicular fluid were measured at buccal and palatal sites before, during and in the retention period after treatment. The alkaline phosphatase values were compared using the ANOVA test at different points in time with p&lt;0.05 considered as statistically significant. Results: The ANOVA test showed a statistically significant increase in enzyme activity at different sites throughout maxillary semi-rapid palatal expansion treatment. Conclusions: It was concluded that the enzyme alkaline phosphatase as a biomarker is an indicator of active bone metabolism in growing children while going through the maxillary semi-rapid palatal expansion treatment.

Association between periodontitis and physical fitness in law enforcement workers.

Oral and periodontal health have been linked to systemic health, cardiovascular disease and inflammation markers. Physical fitness has been linked to increased inflammatory response, but only few studies have investigated the association between oral health with physical activity. The aim of this study was to evaluate the association between oral and periodontal health status and physical fitness in British law enforcement workers. 89 subjects were recruited between November and December 2019. Cardiopulmonary fitness was measured by Maximal Oxygen Uptake (VO2max) (ml/kg/min) and Maximum Load (Loadmax) (W) generated at the end of the Bruce incremental treadmill test; physical activity levels through accelerometers; functional strength tests by Countermovement Jump (CMJ) Power (W) and Height (cm) average. Oral variables included percentage of sites with PPD > 4mm (% PPD > 4), full-mouth bleeding score (FMBS) and Decayed, Missing, and Filled Teeth (DMFT) index. Linear regression models were adjusted for age, gender and fat %. Mean age was 41.5 years (range 23-61; 71.9% male). Higher % PPD > 4 was consistently correlated with lower Loadmax (-4.96; p = 0.092), CMJ Height average (-0.39; p = 0.064), and press-ups in 60s (-0.85; p = 0.052) though the associations were not statistically significant. FMBS was associated with the % of a day spent in sedentary (0.78; p = 0.030) and light activities (-0.75; p = 0.022). Periodontitis may be negatively associated with certain components of physical performance. Oral health status may be associated with physical fitness and functional strength.

Impact of sense of coherence on oral hygiene, dental caries and periodontal status of young adults in Chennai, Tamil Nadu

Background: Sense of Coherence (SOC) is a logical factor that enables people to cope with stressors and successfully improve health. Oral health has an impact on general health and Quality of Life. This study was undertaken with the aim to assess the impact of SOC with Oral Hygiene, dental caries and periodontal status among young adults in Chennai, Tamil Nadu. Materials and methods: The study was conducted among 500 young adults of age group 19 to 23 years selected using cluster random sampling. SOC data were collected using 13 item standardized versions of SOC scale proposed by Antonovsky. Oral hygiene status was assessed using Oral Hygiene Index- Simplified (OHI-S) by John C Greene and Jack R Vermillion, Dental caries was assessed using WHO criteria Decayed Missing Filled Treatment (DMFT) index and Periodontal status was estimated using the Community Periodontal Index (CPI). Analysis was done using Median test and Pearson correlation to compare SOC scores with dental parameters. Level of significance was set at 0.05. Results: SOC scores ranged from a minimum of 22 to a maximum of 81. The mean SOC score is 52.8 ± 7.6. There was no significant association between SOC and OHI(S), and mean DMFT. CPI and LOA were found to be significantly associated with SOC. The correlation test confirms that there is a significant weak correlation (R= -0.094; p&lt;0.05) between CPI and SOC, i.e., as SOC score increases, CPI score decreases. However, Correlation value is not significant in LOA vs SOC. Conclusion: Although there was a significant relation only between SOC and CPI, the concept can be used to modify the oral health care behaviours to improve their quality of life.

Association Between Periodontal Health Status and Pregnancy and Delivery Complications in Type 1 Diabetes Mellitus Pregnant Women: A Case-Control Study.

To assess the association between periodontal health and pregnancy or delivery complications in type 1 diabetic (TIDM) and non-diabetic pregnant women. 15 TIDM and 15 non-diabetic primiparous women were enrolled in the prospective case-control study. We compared periodontal status, levels of glycosylated hemoglobin (HbA1c), gestational week of birth, birth weight of a newborn and pregnancy or delivery complications between the groups. TIDM pregnant women gave birth statistically significantly earlier (2 weeks) (p = 0.034), but not before the 37th week of gestation. The odds ratio (OR) for pregnancy or delivery complications was ~ 5 times greater (95% CI: 1.1-26.4; p = 0.033) and for Caesarean section (C-section) ~ 6 times greater (95%CI: 1.2-30.7; p = 0.032) in TIDM group. The association between periodontal disease (PD) and pregnancy or delivery complications was not statistically significant in either group. The presence of TIDM (p = 0.002; R2 = 0.28), a higher bleeding-on-probing/full-mouth bleeding score (FMBS) (p = 0.043; R2 = 0.14), and a higher level of HbA1c (p = 0.026; R2 = 0.16) were statistically significantly more often associated with an earlier gestational week of birth. Higher levels of HbA1c were statistically significantly positively associated with a higher frequency of pregnancy or delivery complications (p = 0.024) and a higher frequency of C-section (p = 0.051). There are strong indications that both endocrinological and periodontal therapy should form a part of preventive prenatal care.

Evaluating the effects of chlorhexidine and vitamin c mouthwash on oral health in non-surgical periodontal therapy: a randomized controlled clinical trial

Chlorhexidine (CHX) is the most commonly used mouthwash with proven antiplaque and antibacterial activity. The aim is to evaluate the effect of vitamin C (VitC) in CHX mouthwash on plaque accumulation and gingivitis, and to compare it with CHX alone mouthwash and antiseptic phenol-containing mouthwashes. This study conducted as a multicenter, randomized, controlled, double-blind, parallel design clinical study. Sixty patients were included, randomly divided into three groups. 1. Antiseptic phenol agent (P, Phenol), 2. Antiseptic bisbiguanide agent CHX-only (CHX) and 3. Antiseptic bisbiguanide agent CHX + VitC mouthwash (CHX + VitC). The study assessed oral hygiene and periodontal health status, followed by scaling and root planning (SRP) and subsequent polishing. After using the mouthwash for 60 s twice daily along 14 days, patients recalled for evaluation of plaque index (PI), gingival index (GI), bleeding on probing (BOP) and staining. One-way analysis of variance (ANOVA) was used to compare the differences formed between groups and Tukey multiple comparison analysis was used to determine groups that showed the differences. Statistical significance was determined using a p-value threshold of 0.05. There were no significant differences between the groups regarding baseline PI, GI and BOP (p > 0.05). Changes at 14th day in PI, GI and BOP in all groups were similar and no significant differences were observed (p > 0.05). Regarding ‘all surfaces’, staining density of two mouthwashes containing CHX was significantly higher than that of P mouthwash. CHX, CHX + VitC, and P mouthwashes appeared to exhibit comparable effects as oral hygiene adjuncts to periodontal mechanical treatment, with the exception of staining, which was more noticeable in the CHX groups compared to the P group. Adding vitamin C did not enhance the effects of CHx alone.

Assessment of the association between coronary artery blockage and periodontal health status in patients undergoing coronary angiography: a cross-sectional study.

Growing evidence suggests a potential link between periodontal disease and the development of atherosclerosis, positioning periodontal disease as a possible risk factor for cardiovascular diseases (CVD). This study aimed to evaluate periodontal status in patients with coronary artery disease (CAD) by measuring the Periodontal Inflamed Surface Area (PISA) score in individuals undergoing coronary angiography. In this cross-sectional study, 300 patients scheduled for coronary angiography at K.S. Hegde Medical Hospital, Mangalore, India, were recruited. Comprehensive medical and dental histories were obtained prior to the procedure. The PISA score was calculated using standardized periodontal measurements. Patients were categorized into three groups based on angiographic findings: no coronary artery blockage, blockage in one or more vessels with <50% stenosis, and blockage in one or more vessels with ≥50% stenosis. Additional subgroup analyses were conducted for single-, double-, and triple-vessel disease. A p-value of <0.05 was considered statistically significant. A significant increase in PISA scores was observed in patients with ≥50% coronary artery stenosis compared to those with <50% stenosis and no stenosis. However, the extent of vessel obstruction appeared independent of the degree of periodontal destruction. This study suggests that periodontal disease may act as a pro-atherogenic factor in the context of CAD, potentially contributing to the progression of atherosclerosis rather than being a direct causative agent. These findings underscore the importance of considering oral health in cardiovascular risk assessment and management for patients with coronary artery disease.

Dental Caries, Erosive Tooth Wear, and Periodontal Status of Military Student Pilots in Finland: A Comparative Cross-Sectional Study.

Oral health is a crucial factor for service safety among military pilots, but studies specifically on pilots are still very few in Finland. The aim of this study was to assess the oral health status of military student pilots compared to other conscripts of the same age group. The data were collected during the oral health examinations of the annual class of the Pilot Reserve Officer Course students at the beginning of their duty at the Air Force Academy (N = 38). A voluntary random sample of conscripts' oral health data (N = 574) collected from the 8 largest garrisons was used as a peer group. The study included males born between 2000 and 2002. The examinations were conducted in accordance with the WHO guidelines. Values of decayed (DT), missing, and filled teeth as well as the combined decayed, missing, and filled teeth value were recorded along with Basic Erosive Wear Examination scoring and Community Periodontal Index. The study was designed in accordance with the STROBE guidelines. The proportion of student pilots without any decayed teeth (DT = 0) was 42.1% with third molars and 44.7% without third molars. Among other conscripts, the proportions were 29.1% and 30.8%, respectively. Mean DT values among student pilots were 1.16 (third molars included) and 1.11 (third molars not included) (P = .543), and among other conscripts 1.10 and 1.00 (P = .429), respectively.The mean decayed, missing, and filled teeth values were 2.50 among student pilots and 3.34 among others (third molars included), and 2.18 and 3.10 (without third molars), respectively (P = .289 and .211).The proportion of student pilots with at least moderate erosive tooth wear (Basic Erosive Wear Examination sum > 2) was 68.4%, while for other conscripts it was 22.1% (P = .000). None of the student pilots fell into Community Periodontal Index class 3 or 4, whereas 9.9% of other conscripts did (P = .006). The student pilots exhibited good overall oral health, which differed from that of other conscripts, mainly in terms of erosive changes. Continuous monitoring is crucial, as maintaining optimal oral health is vital for reducing the risk of barodontalgia and thus improving flight safety. Therefore, it is important to be aware that those who aspire to be military pilots are at an increased risk of erosive changes to their teeth.

Prevalence of maxillary gingival recession in patients with occlusal plane rotation

Relevance. Gingival recession is a periodontal condition characterized by the apical displacement of the gingival margin and subsequent root surface exposure, which may remain stable or progress over time. This study aimed to assess the prevalence of gingival recession in the maxilla of patients with occlusal plane rotation. The authors present findings on the gingival margin status of maxillary teeth in individuals with transverse occlusal plane rotation.Materials and methods. The gingival margin status of 106 patients with transverse occlusal plane rotation in the maxilla was evaluated. Facial photometry was performed, and the angle of occlusal plane rotation was identified using rapid diagnostic techniques. The Miller classification system was employed to assess the severity of gingival recession.Results. The analysis of gingival recession prevalence on the lateralized sides of the maxillary dental arch revealed a clear correlation between the gingival margin status and the occlusal plane tilt angle. At lower tilt angles, gingival recession corresponded to Miller Class I and was primarily observed on the high side (Supra Latus) of the tilt, particularly in the canine and premolar regions. As the tilt angle increased, Miller Classes II and III were more frequently noted, with recession predominantly occurring in the canine and premolar regions on the low side (Infra Latus). No cases of Miller Class IV gingival recession were observed among the participants.Conclusion. The severity of gingival recession was directly correlated with the occlusal plane tilt angle: a greater tilt angle was associated with more severe recession, as classified by the Miller system. The findings indicate that gingival recession is more prevalent in the canine and premolar regions on the Supra Latus side compared to the Infra Latus side and occurs more frequently in these regions than in other tooth groups.

Modified titanium post with polished sidewalls and prefabricated shoulders can effectively preserve the teeth with subgingival defects

Objective of this study was to examine the clinical efficacy and mechanical characteristics of the modified titanium post in the restoration of subgingival defect teeth. Teeth with subgingival defects depth ≥ 2 mm were randomly restored using a fiber post after crown lengthening and a modified titanium post, respectively. Gingival index, sulcus bleeding index, probing depth, tooth mobility, and gingival papilla height were recorded before and after restoration. Tooth models with a 4 mm subgingival defect, which then underwent fiber post restoration after crown lengthening and modified titanium post restoration respectively, was established. The stresses in the tooth and tooth-supporting structures were measured under vertical and horizontal loads. The gingival index, sulcus bleeding index, and probing depth in the titanium post groups did not show significant differences compared to those of the crown lengthening group. However, the tooth mobility, gingival papilla height, and stress distribution in the tooth and periodontal tissue were significantly better in the titanium post than those in crown lengthening group. Teeth restored with modified titanium post had a healthy periodontal status, clinical efficacy and stress distribution in dental and periodontal tissues were superior to the teeth restored with crown lengthening. However, longer term observation was still needed.

Conventional periodontal probing versus salivary biomarkers in diagnosis and evaluation of chronic periodontitis in type 2 diabetes mellitus.

Chronic periodontitis is a prevalent inflammatory condition that affects both the oral health and systemic well-being of individuals, particularly those with type 2 diabetes mellitus (T2DM). Accurate diagnosis and evaluation of periodontal status are crucial for effective management of the disease. This narrative review aimed to compare the diagnostic and evaluative capabilities of conventional periodontal probing and salivary biomarkers in chronic periodontitis among individuals with T2DM. The available literature highlights the clinical utility of conventional periodontal probing as the gold standard for periodontal diagnosis and evaluation. It enables the assessment of clinical parameters such as probing depth, clinical attachment level, and bleeding on probing, providing valuable information about the severity and extent of periodontal disease. However, this approach has limitations, including its invasive nature, potential for examiner bias, and limited ability to detect early stages of periodontitis. In recent years, salivary biomarkers have emerged as promising diagnostic tools for periodontal diseases. Various biomarkers, such as inflammatory cytokines, matrix metalloproteinases, and host-derived enzymes, have shown potential in differentiating periodontal health from disease and assessing disease activity. Salivary biomarker analysis offers advantages such as non-invasiveness, ease of collection, and the potential for chair-side testing. However, standardization of collection protocols, biomarker panels, and interpretation criteria remain a challenge. This narrative review provides an overview of the strengths and limitations of conventional periodontal probing and salivary biomarkers in the diagnosis and evaluation of chronic periodontitis in individuals with T2DM. Both approaches have their unique advantages and contribute valuable information in clinical practice. Combining conventional periodontal probing with salivary biomarker analysis holds promise for enhancing the accuracy and precision of periodontal disease diagnosis and monitoring in individuals with T2DM.

Effectiveness of nonsurgical re-instrumentation of residual pockets as step 3 of periodontal therapy: A field study.

The study aims to analyze the effectiveness of nonsurgical re-instrumentation of residual pockets as step 3 of periodontal therapy and the stability of treatment outcomes at 18 months. The study sample consisted of 489 patients diagnosed and treated nonsurgically for periodontitis. After a 6-month evaluation, residual pockets (≥5mm) were re-instrumented. A final examination was performed at 18 months. Participants were categorized by treatment outcome at 6 months: (A) No residual pockets ≥5mm, (B) Residual pockets 5-6mm, or (C) Residual pockets ≥7mm. The primary outcome was pocket closure (≤4mm). Logistic regression models were built to evaluate the effectiveness of re-instrumentation and stability of initial outcomes at 18 months. Re-instrumentation of pockets 5 to 6mm resulted in pocket closure of around 39% in groups B and C. The corresponding result at sites with deeper residual pocketing (probing pocket depth [PPD] ≥7mm) was 28%. Combining hand and ultrasonic instrumentation was more effective than each alone. Healed sites (6 months) were more likely to remain closed in group A (80%) than in groups B (50%) and C (40%). The logistic regression revealed that the stability of outcomes of step 1 and step 2 therapy was influenced by PPD at baseline, tobacco smoking, age, and type of tooth. At step 3, nonsurgical re-instrumentation can effectively improve periodontal health conditions. Treatment decisions after nonsurgical therapy should be based on residual probing depth, overall healing response, and patient behavior. The stability of clinical results was influenced by disease severity and the effectiveness of step 2 therapy. This study examined the effectiveness of nonsurgical re-treatment of residual pockets (periodontal pockets not healed) after initial therapy and the stability of treatment outcomes to 18 months. The study involved 489 patients with periodontitis (loss of tooth-supporting structures) treated in general dental practice. Residual pockets were re-treated after examination at 6 months. A final examination was performed at 18 months. Treatment of residual gingival pockets was more successful in moderately diseased pockets compared with the most severely diseased pockets. Clinical results achieved in patients with a mild form of periodontitis were better in terms of stability compared with patients suffering from moderate and severe periodontitis. The success of nonsurgical periodontal treatment was influenced by the severity of periodontitis at the study start, the type of tooth affected, the age of the patient, and whether the patient was a smoker or not.

Long-term changes in gingival recessions and their impact on oral health-related quality of life in patients under supportive periodontal therapy: a bidirectional cohort study.

To evaluate changes in gingival recessions (GR) in periodontitis patients over ten years of supportive periodontal therapy (SPT) and to assess the impact of GR on oral health-related quality of life (OHRQoL). Fifty-one patients with over ten years of SPT were followed up (V1) with complete periodontal status including periodontal probing depth (PPD) and clinical attachment level (CAL) at 6 sites/tooth, oral hygiene indices, and recession status. Patient anamnesis, oral hygiene habits, and orthodontic history were assessed. Data were compared with records from 10-11.5 years prior (V0). GR changes were analyzed at patient level, and for all teeth with deep GR ≥3mm at tooth and site level (mid-buccal site). OHRQoL was assessed at V1 (OHIP-G14 questionnaire). Possible risk factors for GR progression and the associations between the number of deep GR and OHRQoL were tested (linear mixed-effects models, linear regression). The analysis included 45 patients (stage III/IV periodontitis). Patients retained most teeth (V0: 23.87±4.38; V1: 22.53±4.78), with stable mean overall PPD (V0: 2.34±0.35mm; V1: 2.39±0.26mm) and CAL (V0: 3.56±0.94mm; V1: 3.56±0.89mm). Teeth with deep GR showed overall only minimal mean GR progression (0.16±0.97 mm). The mean increase at the mid-buccal sites was 0.66±1.58mm. 10% of patients had >1mm GR progression at the mid-buccal site. Molars showed less GR progression than anterior teeth. The number of deep GR did not significantly impact OHRQoL. Periodontitis patients on regular SPT showed high periodontal stability with minimal GR progression. The number of deep GR was not associated with OHRQoL.

Regular Smoking Accelerates the Decline in Masticatory Performance in Japanese Men: The Suita Study.

Smoking is presumed to cause a decline in masticatory performance by worsening the intraoral environment in various ways. However, no longitudinal study has examined the relationship between smoking and masticatory performance. To clarify how smoking affects future decline in masticatory performance through a 5-year follow-up study of a general urban population. The study participants were 494 men (mean age at baseline: 65.8 years) who participated in baseline and follow-up dental examinations in the Suita Study. The masticatory performance of the participants was evaluated using a test gummy jelly. The rate of change in masticatory performance during the follow-up period was calculated by subtracting the masticatory performance at baseline from the masticatory performance at follow-up and dividing this by the masticatory performance at baseline. Logistic regression analysis was performed, with the presence or absence of a decline in masticatory performance as the objective variable and age at baseline, number of functional teeth, periodontal status, salivary flow rate, maximum bite force, smoking status, utilisation of dental services, and follow-up years as the explanatory variables. The rate of change in masticatory performance during the follow-up period was significantly higher in smokers than in non-smokers. Logistic regression analysis showed that age, maximum bite force, and smoking were significant explanatory variables for a decline in masticatory performance. A 5-year follow-up study showed that smoking causes a decline in masticatory performance in men, even after adjusting for confounding factors.

Factors influencing salivary lactate dehydrogenase levels in oral squamous cell carcinoma and oral potentially malignant disorders.

Salivary Lactate Dehydrogenase (sLDH) levels seem to be higher in patients with Oral Squamous Cell Carcinoma (OSCC) and Oral Potentially Malignant Disorders (OPMD) than a control group (CG). Case-control study. Patients with OPMD [oral leukoplakia (OL) and oral lichen planus (OLP)] and OSCC who attended two services in Spain were selected. sLDH in saliva was measured. Epidemiological, periodontal and specific variables related to OPMD and OSCC were collected. A total of 92 patients were included: 12 with OSCC, 51 with OPMD (17 OL and 34 OLP), and 29 controls. sLDH values were higher in the OSCC, followed by the OPMD and CG groups, although no significant differences were observed. In the OSCC group, larger tumor size was associated with higher sLDH levels. In the OLP group, sLDH values were higher in patients with symptomatic lesions than in patients with only white lesions, but not significantly. No associations were observed between sLDH and the type of OL (homogeneous vs. non-homogeneous) and the degree of dysplasia. When analyzing periodontal variables among OSCC, OPMD and CG, periodontal probing depth (PPD) and bleeding on probing were significantly higher in the OSCC group, while the plaque index was higher in OPMD patients. The linear regression model for sLDH in the total group identified age and PPD as significant predictors of sLDH levels. Although sLDH values were higher in OSCC and OPMD patients than in a CG, the results do not support the use of sLDH as a reliable prognostic biomarker of malignancy. Future studies need to consider other factors that may influence sLDH levels, such as age and periodontal status.

AI-Enabled Dental Imaging for Oral Disease Detection

This study aims to enhance the accuracy and efficiency of dental diagnostics using deep learning models to automatically detect and classify oral disease and dental structures on panoramic radiographs. By employing a quantitative research methodology, the study evaluates key performance metrics. The model's ability to accurately detect dental anomalies, such as caries, periodontal conditions, restorations, and implants, shows significant promise for real-time clinical applications (Arsiwala-Scheppach et al., 2023). In parallel, the study explores the broader potential of AI in dental imaging, addressing current limitations such as the adaptability of models trained on narrow datasets. It emphasizes the importance of expanding datasets to capture a wider range of patient demographics and imaging modalities and highlights the need to validate AI models in real-world clinical settings (Putra et al., 2022). Together, this research underscores the transformative role of AI in modernizing dental diagnostics, moving from traditional methods to advanced AI-enhanced techniques (Patil et al., 2022).