Supportive Periodontal Therapy Research Articles

Changes in periodontal parameters of splinted versus non-splinted posterior teeth during ten years of supportive periodontal therapy – A retrospective evaluation

ObjectivesTo compare periodontal parameters of splinted posterior teeth versus control teeth over ten years of supportive periodontal therapy (SPT) and to assess the survival rate of splints.Material and methodsRetrospective data of 372 SPT-patients was screened for splints (composite/fiberglass-reinforced composite) in the posterior (molars/premolars) which were inserted at least ten years before due to increased tooth mobility. For each splinted tooth (test), a corresponding control tooth had to be present at the first SPT-session after splint insertion (T1). Data was assessed at T1 and ten years later (T2). Possible influencing covariates for splint survival (mobility degree/Eichner class) were tested by Cox regression. The change in clinical attachment level (ΔCAL), probing pocket depth (ΔPPD) and the testing of possible influencing covariates was analyzed by using mixed linear regression.ResultsTwenty-four patients (32 splints, 58 splinted teeth) were included. Ten test and two control teeth were lost. No differences were observed between ΔCAL and ΔPPD of test teeth compared to control teeth (ΔCAL -0.38 ± 1.90 vs. 0.20 ± 1.27 mm; ΔPPD -0.17 ± 1.18 vs. 0.10 ± 1.05 mm). Twenty-two splints fractured during the observation period (survival-rate: 31%). Mobility degree and Eichner class did not influence time until fracture.ConclusionsSplinting of periodontally compromised and mobile posterior teeth does not have any disadvantage regarding the clinical periodontal situation when regular SPT is applied. However, splint fractures occur very often.Clinical relevanceSplinting of posterior teeth is a treatment option in addition to active periodontal therapy when patients are disturbed by tooth mobility but splints have a high susceptibility to fracture.

Implant Survival in Renal-Transplanted Patients: A Prospective Long-Term Study.

The present study aims to assess the feasibility of implant rehabilitation in kidney-transplanted patients. Patients with kidney transplantation included in periodontal supportive care and at least one year of dialysis with mono- or partial edentulism were eligible for this study. Histomorphometric evaluation of the harvested bone was matched with radiological bone assessment. Implant stability was also monitored with resonance frequency analysis and insertion torque value. Fixed cemented prostheses have been delivered after conventional loading protocol. Supportive periodontal therapy has been administered. Eleven patients (9 males and 2 females) were included. The mean age was 58.1 ± 9.9 years. A total of 17 implants were inserted and analyzed. Mean ITV was 39.3 ± 23.8 Ncm. The mean primary stability (implant stability quotient) at T0 was 71.7 ± 10.5, whereas the mean secondary stability at T1 was 73.0 ± 7.3. The minimum follow-up was 62 months, with a maximum of 84 months (7 years) reached by 4 patients. Fourteen out of 15 implants were in function at a 5-year follow-up (survival rate: 93.3%). Two implants showed peri-implantitis. Seventeen bone samples were collected (13 in the mandible and 4 in the maxilla). The mean percentage of marrow spaces and lamellar bone was 41.6% and 58.4%, respectively. Class 3, according to Misch classification, was found as the mean value of radiological bone density. It can be concluded that implant-supported rehabilitation in kidney-transplanted patients is possible. Adequate periodontal maintenance allows implant rehabilitation in kidney-transplanted patients with long-term sufficient survival rates.

L. reuteri in Supportive Periodontal Therapy-Are There Already Clinical Effects after 3 Months with One Lozenge a Day? A Double-Blind Randomized Placebo-Controlled Study.

The purpose of this study was to investigate whether a clinical effect of Lactobacillus reuteri in supportive periodontal therapy can already be detected with a minimum dose of one tablet a day and a minimum observation and intake period of 3 months. 28 patients with stage III and IV periodontitis undergoing periodontal follow-up were randomly divided into two groups receiving a lozenge containing L. reuteri or a placebo preparation daily for 90 days. After 0, 4, 8, and 12 weeks, the parameters bleeding on probing (BoP), plaque control record (PCR), periodontal probing depth (PPD), and clinical attachment level (CAL) were recorded in the test and control groups. The results sed a different effect of L. reuteri on the respective patients. In certain patients, clinical parameters worsened or remained largely unchanged. However, in other patients, there were positive effects on the clinical parameters. In the overall analysis, BoP was the only clinical parameter that was statistically significantly reduced. The oral administration of one lozenge per day for 3 months with L. reuteri in supportive periodontal therapy might have a positive influence on clinical parameters in supportive periodontal therapy, depending on the individual.

Long-term effect of simulated five years professional mechanical biofilm removal on the luting gap of ceramic restorations

BackgroundAchieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = Vbaseline-V1-5; in µm3).MethodsTwo operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests.ResultsNinety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 106(4.8 × 106)µm3 versus 8.79 × 104(1.05 × 106)µm3 for control at V5 (p ≤ 0.001). No significant differences of ∆V1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 107 (7,2 × 106) µm3), followed by LAPA-2 on CAB (∆V: -6.29 × 106 (4,24 × 106) µm3), LAPA-1 on CGIZ (∆V: -4.15 × 106 (3,25 × 106) µm3), LAPA-2 on CGIZ (∆V: -3.0 × 106 (2,23 × 106) µm3), RCP on CAB (∆V: -1.86 × 106 (2,23 × 106) µm3) and CGIZ (∆V: -1.2 × 106 (1,31 × 106) µm3; p ≤ 0.001)).ConclusionsWithin study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower.

Comparative evaluation of Indocyanine Green and 810nm Diode Laser Assisted Antimicrobial Photodynamic Therapy with 810nm Diode Laser Assisted New Attachment Procedure as adjuncts to Scaling and Root Planning in Supportive Periodontal Therapy: A Randomized Controlled Split-Mouth Clinical Trial

BACKGROUND: Minimally invasive nonsurgical management of recurrent periodontal pockets remains the most viable option during supportive periodontal therapy (SPT), but with inconclusive results. The purpose of this study is to evaluate and compare the adjunctive use of Indocyanine green (ICG) and 810nm Diode laser assisted photodynamic therapy (IG-PDT) with 810nm Diode laser assisted new attachment procedure (LANAP) in the management of persistent pockets in SPT. MATERIALS AND METHODS: This single blinded randomized controlled split mouth clinical trial included 20 participants with at least two adjacent teeth with PPD ≥5mm and Clinical attachment level (CAL) ≥3mm in the contralateral quadrants. IG-PDT group received application of 5mg/ml solution of ICG for one minute followed by 810±10nm diode laser with 1W power density. LANAP group received 810±10nm diode laser application at 3W power density with 100ms and 650ms pulse duration at two consecutive passes. Clinical parameters i.e., Plaque index (PI), Gingival index (GI), PPD, CAL gain were recorded at baseline, 3 and 6 months. Landry’s Healing index was assessed on the 7th day and 1 month postoperatively. Patient comfort was assessed using Visual Analog Scale (VAS) immediate post-operatively. RESULTS: Student t test and repeated measures of ANOVA were used for statistical analysis. Both site level and patient level assessments of clinical parameters showed improvement in clinical parameters in both groups. However, IG-PDT group showed significantly greater improvements in PPD (<0.001) and CAL (<0.001) at 3 and 6 months evaluation. IG-PDT showed better healing (P-0.03) at 7th post-operative day. However, LANAP showed less discomfort (2.40±0.50) compared to IG-PDT group (3.20±0.61). CONCLUSION: IG-PDT is shown to provide better clinical outcomes compared to LANAP in management of patients under SPT.

IMPLANT SURVIVAL IN RENAL-TRANSPLANTED PATIENTS: A PROSPECTIVE LONG-TERM STUDY.

The present study aims to assess the feasibility of implant rehabilitation in kidney-transplanted patients. Patients with kidney transplantation included in periodontal supportive care and at least one year of dialysis with mono- or partial edentulism were eligible for this study. Histomorphometric evaluation of the harvested bone was matched with radiological bone assessment. Implant stability was also monitored with RFA and ITV. Fixed cemented prostheses have been delivered after conventional loading protocol. Supportive periodontal therapy has been administered. Eleven patients (9 males and 2 females) were included. The mean age was 58.1 ± 9.9 years. A total of 17 implants were inserted and analyzed. Mean ITV was 39.3 ± 23.8 Ncm. The mean primary stability (ISQ) at T0 was 71.7 ± 10.5, whereas the mean secondary stability at T1 was 73.0 ± 7.3. The minimum follow-up was 62 months, with a maximum of 84 months (7 years) reached by four patients. Fourteen out of 15 implants were in function at a 5-year follow-up (survival rate 93.3%). Two implants showed peri-implantitis. Seventeen bone samples were collected (13 in the mandible and 4 in the maxilla). The mean percentage of marrow spaces and lamellar bone was 41.6% and 58.4%, respectively. Class 3, according to Misch classification, was found as the mean value of radiological bone density. It can be concluded that implant-supported rehabilitation in kidney-transplanted patients is possible. Adequate periodontal maintenance allows implant rehabilitation in kidney transplanted patients with long-term sufficient survival rates.

Supportive Periodontal Therapy: A Review

Supportive Periodontal Therapy: A Review

Impact of COVID-19 spread on visit intervals and clinical parameters for patients with periodontitis in supportive periodontal therapy: a retrospective study.

This study investigated the relationship between the number of days that hospital visits were postponed and changes in clinical parameters due to the spread of coronavirus disease 2019 (COVID-19), after the Japanese government declared a state of emergency in April 2020. Regarding the status of postponement of appointments, we analyzed the patients who had visited the Nihon University Hospital at Matsudo for more than 1 year for supportive periodontal therapy (SPT) and classified them into low-, moderate- and high-risk subgroups according to the periodontal risk assessment (PRA). Clinical parameters for periodontal disease such as probing depth (PD), full-mouth bleeding score (FMBS), full-mouth plaque score, periodontal inflamed surface area (PISA), and periodontal epithelial surface area (PESA) were analyzed in 2 periods, from October 2019 to March 2020 and after April 2020. Correlation coefficients between days of deferral and the degree of changes in clinical parameters were calculated. The mean age of the 749 patients was 67.56±10.85 years, and 63.82% were female. Out of 749 patients, 33.24% deferred their SPT appointments after April 2020. The average total of postponement days was 109.49±88.84. The number of postponement days was positively correlated with changes in average PD (rs=0.474) and PESA (rs=0.443) in the high-risk subgroup of FMBS, and average PD (rs=0.293) and PESA (rs=0.253) in the high-risk subgroup of tooth number (TN). Patients belonging to the high-risk subgroups for both FMBS and TN had a positive correlation between postponement days and PISA (rs=0.56). The findings, the spread of COVID-19 appears to have extended the visit interval for some SPT patients. Moreover, longer visit intervals were correlated with the worsening of some clinical parameters for SPT patients with high PRA.

Long Term Outcomes of Implant Treatment in Patients with a History of Moderate Periodontitis and With Type 2 Diabetes Mellitus

Purpose: The aim of this study was to evaluate the long-term outcome of implant treatment in patients with previous tooth loss due to a history of moderate periodontitis and with type 2 diabetes mellitus. Materials and methods: The study included 42 patients with partially edentulous, with a history of moderate periodontitis and with type 2 diabetes mellitus using 134 dental implants over the period from 2021 to 2023. It the baseline and at 3 month intervals bleeding on probing (BOP), probing depth (PD), marginal bone loss (MBL) were recorded. All patients prior implant surgery periodontal therapy were treated, which included the following: supragingival and subgingival scaling and root debridement were performed with an ultrasonic device, magnetic laser irradiation, local use of antibacterial agents. Results: Implant surgery was performed 3 months after periodontal therapy, when PPD <4 mm and BOP <10%, with stable clinical index. After 12-month in patients mean MBL 0.76±0.6 mm, after 5 years MBL was 1.34 ± 0.25 mm (P> 05), after 10 years MBL was 1.56 ± 0.28 mm (P> 05). Survival rate of implants 5 years after was 96.4% implants 10 years after was 93.6%. Conclusions: This study confirmed that implant therapy can be successfully used in patients diagnosed with moderate periodontitis and with type 2 diabetes mellitus who have received individualization supportive periodontal therapy, regular periodontal maintenance and if their HbA1c level was <7.2% or less than 154 mg/dL.

Influence of residual pockets on periodontal tooth loss: A retrospective analysis.

Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined "threshold" at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk. Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc≥5mm or ≥6mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model. Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5mm (90.8%) or ≥6mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4mm/grade A. Grading exhibited the best discrimination and model fit. Patients with RPc ≥5mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5mm displayed very good predictive capability of TLP.

Remote assessment of dental records by using intraoral scan-based digital three-dimensional models in an elderly patient population - an exploratory study.

To assess the agreement rates of dental records derived from intraoral scan-based digital three-dimensional models (3DM) and 3DM + panoramic radiographs (3DM+PAN-X) compared to clinical findings. Based on the 3DM/3DM+PAN-X of 50 patients undergoing supportive periodontal therapy (SPT), ten remote raters (inexperienced in using IOS or 3DM) assessed for each site of the dental scheme (32 sites) whether a tooth was missing (M), filled (F), restoration- and caries-free (H), replaced by an implant (I) or decayed (D). Remote records were compared to the clinical reference record of each patient at tooth-level. The clinical records were assessed by an experienced dentist who supplemented the clinical findings with information from available radiographs and the patient records to define the clinical reference record. The agreement-rates for 3DM/3DM+PAN-X at tooth-level are: M: 93%/94%, F: 84%/88%, H: 92%/92%, I: 65%/96%, D: 29%/29%. The overall agreement-rate is 88% for the 3DM-based dental records (14093 of 16000 entries true) and 91% for 3DM+PAN-X (14499 of 16000 entries true). Using 3DM for dental record assessment, posterior teeth had higher odds of correct findings compared to anterior teeth (upper jaw OR=2.34, lower jaw OR=1.27). The remote detection of healthy, missing and filled teeth and implants by raters inexperienced in using IOS or 3DM shows a high agreement-rate with the clinical findings. The additional evaluation of PAN-X increased the agreement-rate significantly for implants. Thus, the remote assessment of dental records using 3DM+PAN-X has a high accuracy when applied in SPT-patients with low caries activity.

ИНФЕКЦИОННЫЙ ЭНДОКАРДИТ В ПРАКТИКЕ ВРАЧА-СТОМАТОЛОГА: КЛИНИЧЕСКИЙ СЛУЧАЙ

Subject. The subject of this case report is infective endocarditis.
 Objective. The objective is to describe a clinical case under outpatient-polyclinic conditions at the dentist’s (periodontist’s) office.
 Methodology. Infective endocarditis is one of the most severe coronary vascular diseases associated with high mortality affected by the area and characteristics of infection, the phase of development, the type of a causative agent, the time to start antibacterial therapy, coexisting diseases, the extent of sequelae, surgical treatment and other circumstances. Following the appropriate treatment, more than 70% patients with infective endocarditis achieve recovery. 
 Conclusions. This case report presents clinical manifestations in the oral cavity of a patient with infective endocarditis. The patient did not exhibit specific symptoms of infective endocarditis serving as the basis for the preliminary dental diagnosis and sending the patient to a cardiologist, rheumatologist for examination and treatment. It should be noted that the patient needs the complex treatment of periodontitis, oral cavity sanation, the case follow-up, supportive periodontal therapy and professional oral hygiene on a quarterly basis. These all can significantly improve the patient’s quality of life and longevity.

Ligneous periodontitis exacerbated by Behçet’s disease in a patient with plasminogen deficiency and a stop-gained variant PLG c.1468C > T: a case report

BackgroundPlasminogen serves as the precursor to plasmin, an essential element in the fibrinolytic process, and is synthesized primarily in the liver. Plasminogen activation occurs through the action of plasminogen activator, converting it into plasmin. This conversion greatly enhances the fibrinolytic system within tissues and blood vessels, facilitating the dissolution of fibrin clots. Consequently, congenital deficiency of plasminogen results in impaired fibrin degradation. Patients with plasminogen deficiency typically exhibit fibrin deposits in various mucosal sites throughout the body, including the oral cavity, eyes, vagina, and digestive organs. Behcet's disease is a chronic recurrent systemic inflammatory disease with four main symptoms: aphthous ulcers of the oral mucosa, vulvar ulcers, skin symptoms, and eye symptoms, and has been reported worldwide. This disease is highly prevalent around the Silk Road from the Mediterranean to East Asia.We report a case of periodontitis in a patient with these two rare diseases that worsened quickly, leading to alveolar bone destruction. Genetic testing revealed a novel variant characterized by a stop-gain mutation, which may be a previously unidentified etiologic gene associated with decreased plasminogen activity.Case presentationThis case report depicts a patient diagnosed with ligneous gingivitis during childhood, originating from plasminogen deficiency and progressing to periodontitis. Genetic testing revealed a suspected association with the PLG c.1468C > T (p.Arg490*) stop-gain mutation. The patient's periodontal condition remained stable with brief intervals of supportive periodontal therapy. However, the emergence of Behçet's disease induced acute systemic inflammation, necessitating hospitalization and treatment with steroids. During hospitalization, the dental approach focused on maintaining oral hygiene and alleviating contact-related pain. The patient's overall health improved with inpatient care and the periodontal tissues deteriorated.ConclusionsCollaborative efforts between medical and dental professionals are paramount in comprehensively evaluating and treating patients with intricate complications from rare diseases. Furthermore, the PLG c.1468C > T (p.Arg490*) stop-gain mutation could contribute to the association between plasminogen deficiency and related conditions.

Long-Term Effectiveness of Metal-Etched Splints and the Role of Patient Compliance During Supportive Periodontal Therapy

Long-Term Effectiveness of Metal-Etched Splints and the Role of Patient Compliance During Supportive Periodontal Therapy

Suppression of subgingival bacteria by antimicrobial photodynamic therapy using transgingival irradiation: A randomized clinical trial.

Antimicrobial photodynamic therapy (aPDT) is an effective method for eradicating bacteria in periodontal therapy. Standard aPDT requires the insertion of a laser tip into a periodontal pocket, in which the direction of irradiation is limited. Therefore, we devised an aPDT method that uses a transgingival near-infrared wavelength and indocyanine green-encapsulated and chitosan-coated nanoparticles as a photosensitizer. Forty patients undergoing supportive periodontal therapy, who had a single root tooth with a pocket of 5mm or deeper, were used as subjects. In the test group, aPDT was performed by laser irradiation from outside the gingiva using photosensitizer nanoparticles. In the control group, pseudo aPDT without photosensitizer was performed by transgingival irradiation. Subgingival plaque was sampled from inside the pocket before, immediately after, and 1 week after treatment, and evaluated by colony counting and real-time polymerase chain reaction. There were no significant differences in age, sex, periodontal pocket depth, and bleeding on probing between the test and control groups. Compared with the colony count before treatment, the count in the test group was significantly reduced immediately after treatment. The number of patients with colony reduction to ≤50% and ≤10% was significantly higher in the test group than in the control group. None of the participants reported pain, although one participant reported discomfort. As a bacterial control method for residual pockets in patients undergoing supportive periodontal therapy, transgingival aPDT is a promising treatment strategy that is not generally accompanied by pain or discomfort.

Impact of COVID-19 on patient follow-up during supportive periodontal therapy: a retrospective study based on phone call survey

BackgroundCOVID-19 and the subsequent intermittent lockdown measures from 2020 to 2022 in China critically disrupted regular medical activities, including dental care. This study aimed to investigate the impact of COVID-19 on long-term follow-up at the Stomatology Hospital, Zhejiang University School of Medicine and to evaluate potential causes of loss to follow-up.MethodsA total of 1062 patients with periodontitis who visited the hospital from January 2019 to June 2022 were included in this study, and patient information was collected retrospectively in the form of a telephone questionnaire. The questionnaire consisted of 19 questions in four areas: demographic characteristics, clinical periodontal parameters, oral hygiene habits, and follow-up-related open-ended questions (specific reasons for loss to follow-up, attitudes toward follow-up and suggestions for increasing participation in future follow-ups). Regression analysis of factors influencing the follow-up of patients with periodontitis were analyzed by regression analysis using R (v4.2.3) software.ResultsA total of 536 (50.47%) valid questionnaires were collected from 1062 patients. Personal factors (42.5%), instead of the COVID-19 epidemic (20.0%), were the main factors that impacted the loss to follow-up in long-term periodontal treatment, while work factors (19.8%), hospital factors (16.4%), and transportation or distance factors (14.7%) were all important factors. A family history of periodontitis [odds ratio (OR) = 0.567, 95% confidence interval (CI): 0.393, 0.817, p = 0.002], as well as frequent use of dental devices (OR = 0.540, 95% CI: 0.375, 0.777, p = 0.001), were significantly associated with a “negative” attitude toward follow-up visits.ConclusionThis survey suggests that the COVID-19 epidemic factor was an important cause contributed to the loss to follow-up during supportive periodontal therapy (SPT) among a variety of potential factors. Majority of patients had negative attitudes toward subsequent continued participation in supportive care.

Microbial biomarkers as a predictor of periodontal treatment response: A systematic review.

To evaluate the prognostic accuracy of microbial biomarkers and their associations with the response to active periodontal treatment (APT) and supportive periodontal therapy (SPT). Microbial dysbiosis plays a crucial role in the disease processes of periodontitis. Biomarkers based on microbial composition may offer additional prognostic value, supplementing the limitations of current clinical parameters. While these microbial biomarkers have been clinically evaluated, there is a lack of consensus regarding their prognostic accuracy. A structured search strategy was applied to MEDLINE (PubMed), Cochrane Library, and Embase on 1/11/2022 to identify relevant publications. Prospective clinical studies involving either APT or SPT, with at least 3-month follow-up were included. There were no restrictions on the type of microbial compositional analysis. 1918 unique records were retrieved, and 13 studies (comprising 943 adult patients) were included. Heterogeneity of the studies precluded a meta-analysis, and none of the included studies had performed the sequence analysis of the periodontal microbiome. Seven and six studies reported on response to APT and SPT, respectively. The prognostic accuracy of the microbial biomarkers for APT and SPT was examined in only two and four studies, respectively. Microbial biomarkers had limited predictive accuracy for APT and inconsistent associations for different species across studies. For SPT, elevated abundance of periodontal pathogens at the start of SPT was predictive of subsequent periodontal progression. Similarly, persistent high pathogen loads were consistently associated with progressive periodontitis, defined as an increased pocket probing depth or clinical attachment loss. While there was insufficient evidence to support the clinical use of microbial biomarkers as prognostic tools for active periodontal treatment outcomes, biomarkers that quantify periodontal pathogen loads may offer prognostic value for predicting progressive periodontitis in the subsequent supportive periodontal therapy phase. Additional research will be required to translate information regarding subgingival biofilm composition and phenotype into clinically relevant prognostic tools.

Oral Manifestation of Papillon-Lefevre in Two Siblings

Background: Papillon-Lefèvre Syndrome (PLS) is a very rare genetic disorder (autosomal recessive) that usually affects infants between the ages of one and five years. PLS is characterized by palmar-plantar hyperkeratosis and premature loss of primary and permanent teeth with extensive, severe, and rapid destruction of the alveolar bone, leading to the premature loss of both teeth. Objective: To report on the management of PLS patients. Case: A 9-year-old girl and a 2.5-year-old boy from Nganjukto General Hospital, Pediatric Dentistry Division, RSGM Airlangga University with the main complaints of upper left tooth pain, rocking, difficulty eating, erythematous hyperkeratosis hands and feet, periodontal inflammation, mobility. bad teeth. Case Management: Nine-year-old girl: Teeth #26 and #46 could not be retained and extracted due to buccoversion and severe mobility. Periodontal supportive therapy was periodontal debridement, scaling and root planing and oral hygiene counseling with 0.20% chlorhexidine gluconate. Two-and-a-half-year-old boy: Too young, he is observed every 3 months. It is recommended to take vitamin B complex in appropriate doses and fruit juice as an additional supplement. Conclusion: Intensive periodontal treatment and administration of antibiotics only delays the progression of periodontal disease and cannot be used to prevent primary and permanent teeth. Extensive and repeated prosthodontic treatment is required to provide functional teeth to children during their period of jaw growth.

CLINICAL APPLICATIONS OF INJECTABLE PLATELET RICH FIBRIN (IPRF) IN ADJUVANT THERAPY FOR PERIODONTITIS: A CASE SERIES

The purpose of this study is to evaluate the clinical outcomes of non-surgical periodontal therapy using injectable Platelet Rich Fibrin (iPRF). Materials and Methods: In the present study, analyzed the results of treatment in 82(43 men and 39 women, aged 36 to 63 years) patients in the period from 2018 to 2023 years with periodontitis stages I–II were included. The following clinical parameters were recorded at the beginning of the study (before and treatment), after 1 month (after iPRF therapy), at the end of the 3-month (after iPRF therapy). The diagnosis of periodontitis was established taking radiological signs of bone loss and indicators of bleeding on probing (BOP), probing depth (PD), Clinical attachment level (CAL). All patients subjected to the complex periodontal treatment included supragingival and subgingival scaling and root debridement with an ultrasonic device, antibacterial therapy. After 4 weeks, only those patients underwent I-PRF therapy who maintained optimal oral hygiene. I PRF was injected into the gum area. The number of plasma-based sessions is strictly individual and depends on the severity of the inflammatory process (4-6 sessions break between sessions 1 week). Results: The postoperative periods in all patients passed without complications, there were no serious intraoperative or immediate postoperative complications. After a course of I-PRF therapy, patients noted elimination of pain, bleeding and swelling of the gums, tooth mobility became less bad breath disappeared, loss of bone tissue stopped. The first changes in the gums are noticeable on the 7th-10th day. The clinical picture and diagnostic parameters were comparable at baseline and after treatment. The clinical periodontal parameters (BOP, PPD, CAL) were shown a reduction in their mean values after 3 months from the treatment with the PRP, with a highly significant difference no complications had been observed. The mean value BOP before treatment was 2.6 ± 0.32, after 1month treatment the mean BOP 1.8 ± 0.2, after 3 months treatment the mean BOP 1.4 ± 0.15. The mean value PPD before treatment was 5.41 ± 0.77 mm, 1 month after therapy it was 4,27 ±0.38 mm and 3 month after therapy it was 2.46 ± 0.42 mm. The mean value CAL before treatment was 5.84 ± 0.79 mm, 1 month after therapy it was was 4.92 ± 0.71 mm. and 3 months after therapy it was 3,4 ± 0,7 mm. Conclusion: This study confirmed that iPRF periodontal therapy can be successfully used in patients diagnosed with I-II periodontitis who have received individualization supportive periodontal therapy and regular periodontal maintenance. The use of iPRF in periodontal therapy represents a valuable minimally invasive adjunct to complex conservative therapy.

The Influence of the Clinicians' Experience on the Outcome of Dental Implants: A Clinical Audit.

The records of patients treated with SLA/SLActive Straumann implants were screened. This enabled us to have a minimum of 12 months of follow-up. Eligible patients, according to the inclusion criteria, were contacted and invited to undergo a follow-up assessment. Success was accounted for and defined in a comprehensive manner by considering four different categories: implant perspective, peri-implant soft tissue perspective, prosthetic perspective, and patient satisfaction. The patient investigations included a clinical examination of the implant mobility, suppuration, width of keratinized mucosa, probing depth, plaque accumulation, prosthetic complications, and patient satisfaction. In addition, a periapical radiograph was taken to evaluate bone loss and peri-implant radiolucency. The data were analysed using SPSS version 26. Thirty-eight patients with 84 SLA/SLActive Straumann implants were available for the assessment. The mean age of the patients at implant surgery was 49.05 ± 13.19 years. Over the mean follow-up period of 26 months, no implant fractures were noted. Overall, eight implants were considered failures (9.5%). Two out of six patients with a history of periodontitis (HoP) and two out of five smokers exhibited failed implants. The patients' satisfaction responses showed that all the responses were statistically higher than the test median value of three. The median value of general satisfaction using a visual analogue scale was 9 out of 10. The implants placed on partially and fully edentulous patients revealed high survival and success rates (100% and 90.5%, respectively) at a mean follow-up time of 26 months. It can be concluded that the implant practise among trainees in the programme is satisfactory. A history of periodontitis and a lack of patient compliance with supportive periodontal therapy in some cases have been shown to be risk factors associated with increased implant failure, mainly peri-implantitis.