Tooth Mobility Research Articles

Periodontal Abscess Occurrence Post Wire Splint Therapy on Mobile Teeth

Tooth mobility is one of the cases of periodontal disease caused by the destruction of the bone that supports the teeth. Stabilization of loose teeth using splinting wire can be one of the treatment options. The use of splinting wire may increase plaque accumulation and is sometimes difficult to clean. Plaque accumulation will cause bacterial invasion into the surrounding tissues of the periodontal pockets which will eventually develop into an inflammatory process. As time goes by, connective tissue destruction and pus formation will occur which eventually leads to a periodontal abscess. Periodontal abscess is a localized accumulation of pus in the gingival wall of a periodontal socket with periodontal tissue destruction. The purpose of this case report is to report the incidence of periodontal abscess after wire splinting application in a case of tooth unsteadiness. A 76-year-old female patient came to RSGM with complaints of feeling uncomfortable because some of her teeth were loose. The complaint has been felt approximately 1 year ago. The complaint was accompanied by pain when used to eat and toothbrushing. Objective examination showed reddish gingiva, rounded interdentals, soft consistency, and unstippling texture on the labial and lingual side of teeth 33, 32, 31, 41, 42 and 43 with BOP (+) at all points. The patient's Oral Hygiene Index (OHI) was 2.16 and PI was 18.67%. Probing depth average was 3 mm, recession was 3 mm, and tooth decay was grade 2. Supportive examination showed horizontal bone destruction in the anterior region of the mandible. The first visit was carried out wire splinting on the lingual part of the loose tooth, at the time of control there was a periodontal abscess on the labial side so the splinting was moved to the labial side. The increase in socket depth and the appearance of periodontal abscesses are caused by plaque accumulation which eventually makes bacteria invade the periodontal tissue. Periodontal therapy really needs to pay attention to the patient's OHI, therefore plaque control and removal of bacterial deposits must be carried out by scaling and root planning regularly and carrying out other periodontal therapies such as curettage if tissue destruction is severe enough

Stage III Grade A Mandibular Anterior Tooth Periodontitis Treatment

Chronic periodontitis is inflammation caused by periodontopathogenic microorganisms characterized by alveolar bone resorption, loss of attachment and apical migration of junctional epithelium. Non-surgical and surgical periodontitis treatments including curettage are performed to reduce inflammation and form new attachments before flap surgery. The purpose of this writing is to treat periodontitis before flap surgical treatment is carried out. Case report: Female, 39 years old, came to RSGM UMY with complaints of loose lower front teeth and gums that bleed easily when brushing her teeth. The patient had no history of systemic disease. Intra-oral examination at the first visit revealed that the gingiva of the mandibular anterior teeth was reddish, unstippling and loose texture grade 2, OHI 7.3 (poor), PD 8 mm, PI score 30%, CAL 8 mm, and 3 tooth loss due to periodontitis. X-ray results showed resorption of the alveolar bone horizontally in the apical 1/3. DHE treatment plan, scaling and root planning, occlusal adjustment, splinting, curettage, flap surgery. Results: Control 2 weeks after curettage, gingiva was coral pink and PD was reduced. Conclusion: Curettage treatment in periodontitis cases reduces the depth of periodontal pockets and there are changes in clinical attachment levels (CAL) in mandibular anterior teeth. Surgical flap treatment is required in this case after curettage

Follicular Ameloblastoma of Maxillary: A Case Report

Introduction: Ameloblastoma is a benign odontogenic tumor that appears in the mandible and maxilla. Ameloblastoma has slow growth that takes several years for symptoms to appear, but ameloblastoma in the maxilla has a more aggressive clinical course compared to the mandible. The lack of initial symptoms leading to diagnosis at an advanced disease when the tumour has already extended beyond maxilla. The cancellous structure of the maxillary bone makes it easier for tumors to spread to the nasal cavity, paranasal sinuses, orbitals, parapharyngeal tissue and skull base. This article reports a case of resection of maxillary ameloblastoma. Case Report: A 63 year old female patient came with complaints of a lump on her right cheek since 2 years back that gradually increased in size. Since 2 months ago, pus and blood have been coming out of the lump. Extra oral examination revealed a well-defined mass with a solid and hard consistency, there were no ulcers or fistulas. Intraorally, a mass measuring 5x5x3cm was found in the region of teeth 12 to 15 which extended to the buccal-palatal area. History of allergies and weight loss was denied. Supporting examinations including panoramic radiography, PA chest radiography, CT-Scan, FNAB, and biopsy resulted in a diagnosis of ameloblastoma. Treatment was carried out by resection of the right maxillary tumor mass under general anesthesia. Discussion: In this case, the patient's clinical examination showed a hard and large palpable swelling in the right maxilla area which extended from the region of tooth 12 to tooth 15 which caused facial asymmetry and no tooth mobility was found. This hard and painless swelling takes about 2 years before the patient experiences symptoms of pus and blood discharge. The post-maxillectomy defect in this case was covered with an intraoral prosthesis in the form of a post-surgical obturator made of acrylic resin. The obturator functions to hold the surgical packing, and prevent food or dirt contamination in the defect area which can cause infection and slow healing. The use of a prosthesis also helps restore swallowing and speech function to the patient. Conlussion: In principle, the treatment for ameloblastoma is resection of the involved bone, as in this case the action taken is a maxillectomy. Maxillectomy can result in facial and oral cavity deformities characterised by facial disfigurement and alterations in oral functionality.Therefore, maxillary reconstruction is needed to treat maxillary defects after surgical procedures involving the loss of part or all of the maxilla.

CLINICAL AND RADIOGRAPHIC FEATURES OF ODONTOGENIC CYSTS OF JAW PRESENTED TO THE DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY, KHYBER COLLEGE OF DENTISTRY PESHAWAR

Objectives: To determine frequency, clinical and radiographic features of diff erent types of odontogenic cysts in patients reported to the department of Oral and Maxillofacial surgery, Khyber College of Dentistry Peshawar.Materials and Methods: This descriptive, cross sectional study was conducted at department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar from November 2019 to October 2021.This study was conducted on 89 patients with histopathologically confi rmed reports of odontogenic cysts. Data with respect to age, gender, type of odontogenic cyst, clinical and radiographic features of these cysts were analyzed from the data obtained through a customized structured proforma.Results: Out of the total 89 patient, there was male predilection (2.17:1). The most frequent age group was 2nd and 3rd decades. Among diff erent types of odontogenic cysts, radicular cyst (37.1%) was the most common cyst followed by dentigerous cyst (33.7%) and odontogenic keratocyst (27%). The most common aff ected site was posterior mandible (46.1%). Paresthesia was present in 22.5% cases. Unicortical expansion was present in 59.6 % and bicortical expansion in 38.2% cases. Tenderness was present in 50.6% cases and teeth mobility in 28.1% cases. Needle aspiration test was positive in 78.7% cases. Mean size was 32.23mm + 14.53 standard deviation. Unilocular radiolucency was present in 74.2% and multilocular radiolucency in 25.8%. Root resorption was present in 64% cases and impacted tooth was associated with 52.2% odontogenic cysts.Conclusion: It is concluded from this study that odontogenic cysts frequently encountered during 2nd and 3rd decades of life and more common in males with a predilection for the posterior mandible. Radicular cysts are most frequent among the other types of odontogenic cysts. Majority of patients has cortical expansion and positive needle aspiration test. Impacted tooth is associated with all the dentigerous cysts and most of OKC‘s and none of radicular cyst. Odontogenic cysts can reach to a considerable size to involve even half of the mandible.

Analysis of subgingival microbiota and IL-1β, TNF-α and CX3CL1 levels in gingival crevicular fluid of fixed dental prostheses.

Prosthetic biomaterials can affect the composition of the subgingival microbiota and consequently the production of proinflammatory cytokines, causing damage to the periodontium. A total of 40 patients were divided into two groups: 20 with monolithic zirconia (MZ) prostheses and 20 with porcelain fused to metal (PFM) with nickel-chromium (Ni-Cr) alloy prostheses. Subgingival plaque and gingival crevicular fluid samples were taken. The Checkerboard technique for DNA-DNA hybridization and the enzyme-linked immunosorbent assay technique were performed. Teeth with MZ presented a lower percentage of bleeding on probing and tooth mobility compared to teeth with PFM with Ni-Cr alloy. Prosthodontic teeth harbored higher total levels of the 18 bacterial species than non-prosthodontic teeth. There was a higher prevalence of S. gordonii and V. parvula species in PFM with Ni-Cr alloy compared to MZ. There was an increase in IL-1β, TNF-α and CX3CL1 levels in PFM with Ni-Cr alloy compared to MZ. MZ is a candidate biomaterial with fewer negative effects on the periodontium, allowing for longer prostheses longevity in the mouth.

Effect of NSAIDs in the Tooth Movement in Orthodontic Treatment

Background: Patients undergoing tooth movement in orthodontics often utilize non-steroidal anti-inflammatory medications (NSAIDs) to alleviate inflammation and discomfort. On the other hand, the orthodontic profession is still debating whether or not NSAIDs slow down or hinder tooth mobility. Materials and Methods: About 60 mouths that needed their teeth moved participated in a randomized controlled experiment. There were two groups of patients: Group A received NSAIDs (ibuprofen, 400 mg), while group B received a placebo. Tooth movement was measured using digital calipers at baseline and then at intervals of 4 weeks over a period of 12 weeks. Results: The mean rate of tooth movement in group A was 1.5 ± 0.3 mm per month, whereas in group B it was 1.8 ± 0.4 mm per month. Analysis of variance (ANOVA) showed a statistically significant difference (p < 0.05) in the rate of tooth movement between the two groups, with group B demonstrating faster tooth movement compared to group A. Conclusion: The administration of NSAIDs during orthodontic treatment appears to have a modest but statistically significant inhibitory effect on the rate of tooth movement. Clinicians should consider the potential impact of NSAIDs on treatment outcomes when managing pain and inflammation in orthodontic patients.

ORTHODONTIC EXTRUSION TECHNIQUE AS A METHOD FOR ALVEOLAR BONE VOLUME INCREASE BEFORE DENTAL IMPLANTATION. CLINICAL CASE

Objectives: Tooth extraction and replacement with dental implant represents a common treatment choice, when teeth are hopeless. We presented a clinical case, the treatment of which was carried out by the method of orthodontic extrusion technique. This technique can increase alveolar bone level and also soft tissue level. The increased amount of alveolar bone can improve primary implant stability and be compared with bone regeneration techniques. The purpose of presenting this clinical case is to emphasize the efficiency of orthodontic extrusion. Methods and materials: A 45-year-old female patient referred by the general dentist regarding cosmetic defect and tooth mobility in the area of the anterior upper teeth. During the examination, her upper right central incisor was found to be mobile, with diastema and slight congestion in the anterior teeth Photographs, CT and X-ray studies of the patient were used. The patient was bonded with .018 slot Roth prescription ceramic brackets (Dentaurum, Germany). After achieving the optimal results of orthodontic treatment and the necessary extrusion of the upper right central incisor, the tooth was removed and replaced with a dental implant. After six months, the patient had a crown with a screw fixation of zirconium dioxide with ceramic application Results: As a result of orthodontic extrusion, clinically significant increase in alveolar bone and gingival tissue was reported. This resulted significant qualitative and quantitative improvements in the implant site. As the clinical case was in aesthetic zone, we could also rehabilitate beautiful smile of patient and increase her self-esteem. Conclusions: Summing up the above and the results of the treatment of this patient, we can definitely say that orthodontic extrusion technique is effective for implant site development. As we have described, this can effectively move the facial gingival margin and allow for esthetic restoration of implant placed in the extruded tooth position without any bone graft.

INDEX ASSESSMENT OF PERIODONTAL TISSUE AND ORAL HYGIENE OF PATIENTS AT THE PREOPERATIVE STAGE OF TREATMENT OF GENERALIZED PERIODONTITIS II-III DEGREE

A significant concern in modern dentistry is the increasing prevalence of periodontitis among the Ukrainian population. At present, there is a high frequency of diagnosis for initial-І degree and II-degree periodontitis in our country. However, a comprehensive comparative chronological analysis of index evaluation of periodontal tissues before the beginning of surgical treatment of generalized periodontitis of II and III degree of severity and after its completion has not yet been carried out, which determined the relevance of this study. Therefore, this study aims to address this gap in the literature.
 The aim of the study was to evaluate the state of periodontal tissues of patients at the preoperative stage of generalized periodontitis ІІ-ІІІІ degree treatment using periodontal and hygienic indices.
 Materials and Methods. Analysis of periodontal indices (PMA, PBI, Rtg-index, HEC, and tooth mobility
 score) was performed in 39 patients with GP II degree and 21 patients with GP III degree. Assessment of oral cavity hygiene by the OHI-S index was performed in patients with GP II-III degree and compared with data from 30 practically healthy people without dental diseases. The classification of M.F. Danilevsky (1994) with the additions of I.S. Mashchenko (2002) was used to evaluate the condition of periodontal tissues. Statistical processing of the research results was carried out using the software packages for statistical analysis of data from biomedical research “Microsoft Excel” and “Statistica”.
 Results and Discussion. As a result of the study, it was found that the values of periodontal indices: PMA ranged from 49.90±2.28% in patients with GP II degree to 64.25±3.22% in patients with GP III degree, p<0.01; PBI in patients with GP III degree was 1.2 times lower than in patients with GP II degree (2.39±0.05 points vs. 2.86±0.07 points, p<0.01; tooth mobility in patients with GP II degree was 2.00±0.10 points and was 1.5 times lower than in patients with GP III degree (2. 98±0.13 points), p<0.01; the value of HEC in patients with GP III degree was 1.5 times higher than in patients with GP II degree (3.57±0.10 mm vs. 2.45±0.08 mm, p<0.01); the values of Rtg-index in patients with GP ranged from 2.45±0.08 points in patients with GP II degree to 1.49±0.06 points in patients with GP III degree. According to the OHI-S index, in the control group and in patients with GP II degree, the values of the analyzed parameter were 1.82±0.13 points and 2.26±0.14 points, p<0. 05, while in patients with GP III degree the value of OHI-S index (2.92±0.16 points) corresponded to poor hygiene of oral cavity and exceeded the value in the control group by 1.6 times, p<0.01, and in patients with GP II degree by 1.3 times, p1<0.01.
 Conclusions. Thus, the need for comprehensive treatment of GP II-III degree was emphasized by high index scores of periodontal indices, which in patients with GP III degree were significantly higher compared with similar data in patients with GP II degree, p<0.01. The assessment of the hygienic state of the oral cavity in patients of both the comparison group and patients with advanced forms of GP degree the need to strengthen and improve individual, professional and motivational measures in this cohort of subjects.

FEATURES OF THE USE OF DENTAL SPLINTS FOR COMPLETE DISLOCATION OF TEETH

Among dental injuries, complete dislocation of a tooth has a prevalence of 1.2 to 14.8% in the permanent dentition, and is defined as a complete displacement of the tooth from the socket with rupture of the fibers of the periodontal ligament. Among the teeth, the upper central incisors are most often affected. Among children aged seven to eleven, boys are more susceptible to this type of injury than girls. This is mostly associated with industrial and auto traumatism and sports activities, protrusion of front teeth, open bite, etc. In such cases, the severity of the damage is higher, the more pronounced the tooth protrusion.
 The purpose of the study: comparison and analysis of clinical data on the use of rigid and semi-rigid dental splints after tooth replantation under the conditions of its complete dislocation and immobilization time.
 We conducted a retrospective study of the medical records of 65 outpatient dental patients with complete dislocation of a tooth on the basis of the Poltava Regional Center of Stomatology Dental Clinical Polyclinic.
 In 26% of cases, a semi-rigid splint was used for 7-10 days, which was fixed with composite resin and a steel wire with a diameter of 0.02 cm. With rigid fixation, a higher degree of bone tissue regeneration in the periodontal space was observed in 57.5% of cases. According to our data, it was established that in relation to dental splints, semi-rigid nylon splints were used in 62% of cases, steel wire in 9%, and restorative material in 18%. According to the received data on the processing and preparation of the tooth for replantation and immobilization, physiological solution is the most suitable medium for storage (62.4%), the ideal extraalveolar time period was 25-27 minutes (58.5%), while the teeth were in a dry place within 10 minutes after storage in physiological solution. Due to the presence of serious inflammatory root resorption, which demonstrates a connection with the periodontal tissue associated with increased tooth mobility, in 27.6% of cases an intervention regarding extraction, use of a temporary prosthesis, followed by prosthetics with adhesive materials is chosen. Autotransplantation is used in 12.9% of cases and is positioned as an alternative for replacing missing incisors. However, this method has limitations, as the root of the donor tooth must be 2/3 formed, in addition to anatomical problems, where approximately 60% of autografted teeth are dissimilar in appearance in terms of asymmetric gingival width or color mismatch.
 When evaluating pulp and periodontal tissue regeneration for permanent teeth, the best results were observed with the use of platelet-rich plasma, especially for incisors, with separation after more than 8 hours of extraoral storage of the tooth and delayed replantation. The obtained data allow us to state that several factors can influence the success of replantation: the duration of the injury, the extra-alveolar period of permanence, means of preservation, contamination, manipulation and condition of the extracted tooth, the type of splint used and the time of application.
 Conclusion. Based on a retrospective analysis of medical records and literature data, it can be stated that after replantation, the use of a splint is mandatory to ensure immobilization of the teeth in the initial period, which is necessary for the restoration of the periodontal ligament.

Roduction of Polyvinyl Pyrrolidone (PVP) in the non surgical periotherapy of aggressive periodontitis

The non surgical periotherepy are based on the baeteriologic back ground ofperiodontal diseases. More than 46 different verulant species were composing thebacterial flora. Tetracyclin , Doxycyline , Minocyline were used systemically and / ortopicaly in association with conventional scaling and root planning , as wellchlorhixidine and wide variety of antiseptics were used . Generalized and localizedaggressive periodontitis being a complex disease showing a specific entity and acomplex bacterial flora, a curative non surgical remedy not yet well realized. The,polyvinyl pynolidone (PVP) a highly effective wide broad spectrum bactericidalfungycidal and virocidal antiseptic used in low concentration (3%) as an intrapocketirrigation solution accompanied with conventional ultrasound scaling and rootplanning . Eight patients having aggressive were involved in this study, 12 therapeuticsessions were performed during 6 months. Once a week , in the first month , twice amonth in the next 3 months , then once a month in the later 2 months . The resultshowed a significant improvement of the clinical parameters, gingival bleeding indexGBI), clinical pocket depth (CPD) , and clinical tooth mobility (CTM) , with(. radiologic evidences of bone formationThe result suggests that PVP could be the promising effective, save clinically. applicable , easy to use , and cheap remedy of complex periodontal diseases

Impact of Bisphosphonate Therapy on Oral Health in Patients with Breast and Prostate Cancer and Bone Metastases: A Comprehensive Study.

This study investigates the impact of bisphosphonate therapy on the stomatognathic system in 80 patients with cancer of the breast and prostate with bone metastases. Bisphosphonates are integral for managing skeletal complications in these malignancies but are associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), affecting 0.8-18.5% of patients. BRONJ manifests with pain, neuropathy, tissue swelling, mucosal ulceration, tooth mobility, and abscesses, yet its pathogenesis remains elusive, complicating risk prediction. The research employed comprehensive dental and radiological evaluations. Dental status was assessed using DMFT and OHI-S indices, Eichner's classification, and clinical periodontal measurements like the pocket depth (PD), clinical attachment loss (CAL), and modified Sulcus Bleeding Index (mSBI). A radiological analysis included panoramic X-rays for radiomorphometric measurements and TMJ lateral radiographs. Results indicated a significant decline in oral hygiene in patients with cancer after bisphosphonate therapy, marked by increased DMFT and OHI-S scores. Periodontal health also showed deterioration, with increased PD and CAL readings. The incidence of BRONJ symptoms was noted, although exact figures are not quantified in this abstract. The study also revealed changes in radiomorphometric parameters, suggesting bisphosphonates' impact on bone density and structure. No substantial alterations were observed in TMJ function, indicating a need for extended observation to understand bisphosphonates' long-term effects on the stomatognathic system. These findings highlight the importance of continuous dental monitoring and prophylaxis in patients undergoing bisphosphonate therapy. Implementing meticulous oral care protocols is essential for mitigating BRONJ risk and managing the complex oral health challenges in patients with cancer.

Patients’ perceptions of the importance of improvements and side effects from mandibular advancement device therapy for obstructive sleep apnea and snoring

ABSTRACT Objective To assess which improvements and side effects are considered most important by patients with OSA treated with a MAD. Methods A specific questionnaire consisting of 20 questions, including 10 questions on improvements and 10 on side effects, was developed and mailed to all subjects (54). Results 42 patients, participated in the survey by answering the questionnaire. The results showed that patients placed greater importance on the positive outcomes of treatment, with the most significant being the reduction in snoring and improvement in sleep quality. On the other hand, the side effects of difficulty speaking with the device, tooth mobility, and foreign body sensation were considered important. Conclusions The advantages perceived by the patients appear to outweigh the disadvantages, especially the reduction of snoring, increased productivity, and improved social and intellectual life. Most significant side effects are reversible and short-term, while occlusal changes, is not considered important by patients.

Options for processing enamel before manufacturing an adhesive splinting structure

Relevance. The durability of a splint depends on a number of factors: the level of oral hygiene, the degree of tooth mobility, the presence of occlusal trauma, and the strength of adhesion of the splint-dental interface. In turn, the issues of adhesion are inextricably linked to the anatomical features of the structure of hard tissue, particularly enamel. The correct execution of the cleaning, removal of the aprismatic layer and acid etching steps in the fabrication of an extracoronal splint determines the quality of adhesion at the tire-tooth interface.The aim of the study is to study the enamel surface structure in preparation for extracoronal splinting of teeth.Material and research methods. The 40 teeth were divided into 4 groups depending on the chosen method of preparation for fixation of the reinforcement structure in the extracoronal splint: brushing with paste, treatment with air-abrasive and ultrasonic methods, preparation with a fine-dispersed diamond boron.Results of the study. The preparation of enamel surface with fine diamond boron with particle size of 20 µm and acid etching with 37 % orthophosphoric acid determined a uniform character of microstructure, in the full volume the etched areas of enamel prisms amounted to 98.55±0.51 % of the total surface area of the treated enamel.Conclusion. The preparation of the enamel surface with a fine diamond boron removes the aprismatic layer, ensuring the longevity of the fabricated splint by creating a high-quality "hybrid" layer at the splint-dental interface.

Oral health's role in diabetes risk: a cross-sectional study with sociodemographic and lifestyle insights.

Diabetes, a key chronic non-communicable disease, poses a substantial public health burden. The role of oral health as a determinant in the epidemiology of diabetes mellitus, particularly in the Central Eastern European region, remains underexplored. This research aims to examine the impact of specific oral health parameters, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on diabetes prevalence. Additionally, it seeks to clarify the moderating effects of socio-demographic and lifestyle variables on this relationship. Data were extracted from the 2014 and 2019 datasets of the Hungarian European Health Interview Survey, comprising a combined nationally representative sample of 11,429 participants. Descriptive statistics were presented as weighted proportions and unweighted counts, and weighted Pearson's chi-squared tests were employed for assessing associations and goodness-of-fit. Significant predictors were integrated into weighted multiple logistic regression models for analysis. Sensitivity analysis was then conducted to confirm the robustness of the findings. The study identified 'Bad' self-perceived oral health as a diabetes risk (OR=1.35; 95% CI: [1.04-1.75]), with filled teeth being protective (0.65 [0.51-0.84]). Subgroup analysis revealed higher diabetes odds among individuals with primary education (1.41 [1.02-1.96]) and rural residents with tooth loss from decay (3.54 [1.36-9.19]). The bootstrap analysis with 1,000 iterations reaffirmed the model's stability and predictive accuracy for diabetes. Enhanced oral health is associated with lower risk factors for diabetes. This research highlights the importance of including oral health measures in comprehensive diabetes management approaches.

Attitudes of Gynecologists on Oral Health Care During the Pregnancy in the Republic of North Macedonia

Objective: The aim of the study was to determine the attitudes and the knowledge of gynecologists in the Republic of North Macedonia on oral health care during the pregnancy.
 Materials and methods: The specialists and residents of obstetrics and gynecology in Republic of North Macedonia were involved in this cross-sectional study. The survey was conducted by a questionnaire which consisted the questions on general demographic data and issues related to the attitudes of gynecologists to oral health care of pregnant women. The data were collected from January to May 2022 using Google Form, a link to which questionnaire was send via available social media platforms.
 Results: Out of the total number of 120 respondents, 86 (71.64%) were specialists and 34(28.33%) residents of obstetrics and gynecology. As many as 116 (96.67%) gynecologists answered that they advise their patients to visit the dentist for an examination. However, of these 116 gynecologists, 16 (13.33%) responded by advising their patients to postpone a visit to the dentist until the end of the pregnancy. 79 (65.83%) gynecologists answered that their patients complained of gingival bleeding during pregnancy. 48 (40.33%) gynecologists answered that their patients complained about tooth mobility during pregnancy. When respondents were asked where they get information about the connection between oral health and pregnancy, only 27 respondents answered correctly that they receive information from all the above sources. Only 7 (5.83%) respondents, 5 specialists and 2 residents of obstetrics and gynecology know that breastfeeding a child can cause dental caries.
 Conclusion: Additional collaboration between gynecologists and doctors of dental medicine is essential in order for every pregnant woman to receive a satisfactory level of dental care and proper education on the preservation of oral health.

Impact of the Removable Partial Denture Components on the Prognosis of the Abutment Teeth: An Exploratory Clinical Study

Introduction Partial edentulism is considered one of the challenging topics in dentistry. The main objectives of the patient are to restore function and esthetics. However, the dentist’s main goals are preserving the remaining teeth supporting structures and restoring the patient’s quality of life. A Removable Partial Denture (RPD) design should be considered carefully for each case, as there are clinical and personal variables for each patient that will impact the prognosis of the denture. With the growing need for RPD, design principles require more research to improve the preservation of abutment teeth. This study aims to clinically evaluate the abutment teeth and supporting tissues before and after RPD placement and to correlate these clinical findings with the RPD components. Methods: Patients were recruited from the dental clinic at Schulich Dentistry, Western University in London, Ontario, Canada. Abutment teeth were evaluated for the following clinical parameters: Tooth Mobility (TM), caries, defective restorations, tooth fracture, Probing Depth (PD), Gingival Recession (GR), bleeding on probing (BOP) and Plaque Index (PI). These clinical measurements were collected at the time of RPD insertion and at least two years after. Clinical parameters were analyzed using Kruskal Wallis H, Mann-Whitney U and Chi-Squared tests. Results: 34 participants were recruited, and 40 cast metal RPDs were evaluated. The mean age of participants was 73.8 years, and the mean duration of denture use was 37.6 months. Most frameworks assessed were Kennedy Class III RPDs. Caries were significantly associated with rest type, wherein occlusal rests showed an increased incidence of caries compared to cingulum rests. The retentive clasp arm type was associated with a mean difference in PD, wherein cast circumferential and wrought wire clasp arms had deeper PD after RPD insertion than Infra gingival clasps (I-bars). Conclusion: The results of this study suggest clasp arms and occlusal rests influence dental disease. Larger samples and more clinical studies are needed to confirm the role of specific RPD components on the abutment teeth prognosis.

Relationship Between Oral Health and Glaucoma Traits in the United Kingdom.

In this cross-sectional analysis of UK Biobank participants, we find no adverse association between self-reported oral health conditions and either glaucoma or elevated intraocular pressures. Poor oral health may cause inflammation, which accelerates the progression of neurodegenerative diseases. We investigated the relationship between oral health and glaucoma. United Kingdom Biobank participants. This is a cross-sectional analysis of participants categorized by self-reported oral health status. Multivariable linear and logistic regression models were used. Primary analysis examined the association with glaucoma prevalence. Secondary analyses examined associations with IOP, macular retinal nerve fiber layer (mRNFL), and ganglion cell inner plexiform layer (mGCIPL) thicknesses, and interaction terms with multitrait glaucoma polygenic risk scores (MTAG PRS) or intraocular pressure (IOP) PRS. A total of 170,815 participants (34.3%) reported current oral health problems, including painful or bleeding gums, toothache, loose teeth, and/or denture wear. A In all, 33,059, 33,004, 14,652, and 14,613 participants were available for analysis of glaucoma, IOP, mRNFL, and mGCIPL, respectively. No association between oral health and glaucoma was identified [odds ratio (OR): 1.04, 95% CI: 0.95-1.14]. IOPs were slightly lower among those with oral disease (-0.08mm Hg, 95% CI: -0.15, -0.009); specifically, among those with loose teeth ( P =0.03) and denture-wearers ( P <0.0001). mRNFL measurements were lower among those with oral health conditions (-0.14 μm, 95% CI: -0.27, -0.0009), but mGCIPL measurements ( P =0.96) were not significantly different. A PRS for IOP or glaucoma did not modify relations between oral health and IOP or glaucoma ( P for interactions ≥​​​​0.17). Self-reported oral health was not associated with elevated IOP or an increased risk of glaucoma. Future studies should confirm the null association between clinically diagnosed oral health conditions and glaucoma.

Imbalanced EphB4/EphrinB2 Signaling Modulates Bone Resorption in Periodontitis Induced by Porphyromonas gingivalis.

Periodontitis, a chronic infectious disease in periodontal tissues, is characterized by an imbalance of alveolar bone resorption and remodeling, which eventually results in tooth loosening and even tooth loss. The etiology of periodontitis is polymicrobial synergy and dysbiosis, in which Porphyromonas gingivalis (P. gingivalis) is one of the primary pathogens responsible for periodontitis progression. The interplay of EphrinB2/EphB4 is crucial for osteoblast-osteoclast communication during bone remodeling and healing. This study investigates the mechanism of EphB4/EphrinB2 transduction modulating osteogenesis inhibition and bone resorption in periodontitis induced by P. gingivalis. An in vivo model of chronic periodontitis provoked by P. gingivalis was constructed, the inflammation and bone resorption were evaluated. The expression of EphB4 and EphrinB2 proteins in periodontal tissues was detected, which was also evaluated, respectively, in osteoblasts and osteoclasts infected with P. gingivalis in vitro. Then, a simulated coculture model of osteoblasts and osteoclasts was established to activate the forward and reverse pathways of EphB4/EphrinB2 with P. gingivalis infection. This study showed that P. gingivalis infection promoted alveolar bone resorption in rats and enhanced EphB4 and EphrinB2 expression in periodontal tissues. EphB4 and molecules associated with osteogenesis in osteoblasts infected with P. gingivalis were inhibited, while EphrinB2 and osteoclast differentiation-related markers in osteoclasts were activated. In conclusion, this study suggested that EphB4/EphrinB2 proteins were involved in alveolar bone remodeling in the process of periodontitis induced by P. gingivalis infection. Moreover, attenuated EphB4/EphrinB2 with P. gingivalis infection weakened osteoblast activity and enhanced osteoclast activity.

Self-perceived oral health

Aim: This study aimed to investigate the relationship between self-perceived oral health and the prosthetic status of individuals who seek care in prosthodontics clinics. Methods: Self-perceived oral health was analyzed through the Geriatric Oral Health Assessment Index (GOHAI). Abutment tooth mobility was assessed, and denture status was determined by clinical assessment of stability, retention, occlusal balance, vertical dimension, and integrity of dentures. The frequency of individuals in each variable was determined for the low and very low GOHAI conditions. Chi-square, Pearson, and stepwise logistic regression tests were used for the statistical analyses (α = 0.05). Results: Ninety wearers of removable dentures with a mean age of 55.1±9.1 years were evaluated. None of the variables was related to GOHAI values (p &gt; 0.05). The regression analysis showed that age predicts (p = 0.006) the variation of GOHAI conditions (OR = 0.924, CI = 0.873- 0.978), showing only 7.6% protective effect against very low GOHAI. Unsatisfactory stability showed the opposite effect (p = 0.034) and the individuals with this characteristic are more likely (OR = 3.055) to have very low GOHAI scores (CI = 1.085- 8.602). Conclusions: The self-perceived oral health of wearers of removable dentures worsens with age and unsatisfactory stability of dentures.

Identifying predictors of the tooth loss phenotype in a large periodontitis patient cohort using a machine learning approach

ObjectivesThis study aimed to identify predictors associated with the tooth loss phenotype in a large periodontitis patient cohort in the university setting. MethodsInformation on periodontitis patients and nineteen factors identified at the initial visit was extracted from electronic health records. The primary outcome is tooth loss phenotype (presence or absence of tooth loss). Prediction models were built on significant factors (single or combinatory) selected by the RuleFit algorithm, and these factors were further adopted by regression models. Model performance was evaluated by Area Under the Receiver Operating Characteristic Curve (AUROC) and Area Under the Precision-Recall Curve (AUPRC). Associations between predictors and the tooth loss phenotype were also evaluated by classical statistical approaches to validate the performance of machine learning models. ResultsIn total, 7840 patients were included. The machine learning model predicting the tooth loss phenotype achieved AUROC of 0.71 and AUPRC of 0.66. Age, periodontal diagnosis, number of missing teeth at baseline, furcation involvement, and tooth mobility were associated with the tooth loss phenotype in both machine learning and classical statistical models. ConclusionsThe rule-based machine learning approach improves model explainability compared to classical statistical methods. However, the model's generalizability needs to be further validated by external datasets. Clinical SignificancePredictors identified by the current machine learning approach using the RuleFit algorithm had clinically relevant thresholds in predicting the tooth loss phenotype in a large and diverse periodontitis patient cohort. The results of this study will assist clinicians in performing risk assessment for periodontitis at the initial visit.