Radiographic evaluation of alveolar bone height in HIV-positive patients.

BACKGROUND: This prospective case-control study was performed to assess alveolar bone height in HIV-positive and HIV-negative patients. METHODS: Twenty-three HIV-positive patients, 16 men and 7 women, aged 24 to 40 years (mean age: 33 years), consecutively referred to the Dental Clinic, University of Ferrara, for clinical and radiographic assessment of oral conditions, were included in the study (test group). All patients had undergone laboratory evaluation to assess HIV-infection status and were classified according to CDC diagnostic criteria. Nineteen patients were intravenous drug abusers. Thirty-four HIV-negative subjects were matched for demographic characteristics and smoking status as a control group. Radiographic evaluation was based on panoramic radiography and bone measurements were limited to premolars and molars. Alveolar bone height was measured mesially and distally to each tooth and determined as the distance from the apex of the root to a point where the lamina dura became continuous with the compact bone of the interdental septum. Alveolar bone height was recorded as well as the ratio between alveolar bone height and tooth length. RESULTS: The results indicated a tendency for a difference in alveolar bone height between groups, lower in the test group compared to controls. However, this difference only reached statistical significance on a tooth-specific basis. CONCLUSIONS: In conclusion, the results show a greater trend for alveolar bone loss of posterior teeth in HIV-positive patients compared to HIV-negative patients

Clinical and microbiological effects of mechanical instrumentation and local antimicrobials during periodontal supportive therapy in aggressive periodontitis patients. Smoker vs non-smoker patients.

AIM: To compare the clinical and microbiological effects of ultrasonic mechanical instrumentation (UMI) associated to home-care use of amine fluoride/stannous fluoride (AmF/SnF(2) )-containing mouthrinse and toothpaste in smoker and non-smoker patients affected by generalized aggressive periodontitis (G-AgP) during a recall session of supportive periodontal therapy (SPT). MATERIAL AND METHODS: Thirteen smokers and 25 non-smokers G-AgP patients enrolled in an SPT programme received a single session of UMI associated with home-care use of AmF/SnF(2) -containing mouthrinse and toothpaste. Clinical and microbiological parameters were assessed pre-treatment, at 6 and 12 weeks post-treatment. RESULTS: In both groups, UMI plus AmF/SnF(2) -implemented oral hygiene use determined a significant decrease of total bacterial counts, with non-smokers exhibiting a lower count compared with smokers at 12 weeks. No significant differences were observed between smokers and non-smokers in the counts of total pathogens and red complex species at each observation interval. Clinically, a significant reduction of supragingival plaque, gingival inflammation and probing pocket depth was similarly observed in both groups. CONCLUSIONS: A combined mechanical/chemical plaque control approach based on UMI and the use of AmF/SnF(2) agents resulted in the reduction of supragingival plaque deposits, gingival inflammation and subgingival periodontal pathogens in G-AgP patients during SPT, with no substantial difference between smokers and non-smokers

Prevalence of bleeding on probing: a cohort study in a specialist periodontal clinic.

OBJECTIVES: to assess the prevalence and distribution of bleeding on probing (BoP) in a cohort of periodontally diseased patients, evaluate the influence of patient-related predictors on BoP variability, and characterize two subgroups of patients with a significantly different BoP score. METHOD AND MATERIALS: six hundred and one patients were retrospectively included. The percentage of BoP-positive sites was calculated for the entire dentition (%BoPtotal) and within different areas of the dentition. The influence of patient-related predictors on intersubject variability in %BoPtotal was evaluated. Two subgroups of patients, belonging to the lowest (LB, low bleeding) and highest (high bleeding, HB) quartile of patient distribution according to %BoPtotal, were identified. RESULTS: median %BoPtotal was 26.4%, with 99% of the population showing at least one BoP-positive site. %BoPtotal was positively correlated with patient age and number of sites with pocket probing depth (PPD) ⋝ 5 mm, and significantly more prevalent in mandibular vs maxillary sites, posterior vs anterior sites, interproximal vs oral/buccal sites, and sites with PPD ⋝ 5 mm vs PPD ⋜ 4 mm. LB and HB patients were significantly different for %BoPtotal, as well as in sites with PPD ⋜ 4 mm and PPD ⋝ 5 mm, but not for sex, age, smoking status, daily cigarette consumption, diabetic status, and number of sites with PPD ⋝ 5 mm. CONCLUSIONS: BoP was highly prevalent and variable in both patients and different areas of the dentition; patient-related factors and site-specific characteristics (such as age, number of periodontal pockets, probing depth, tooth type, and aspects) seem to be partly responsible for the individual variation in BoP; and HB and LB were not significantly different with respect to the investigated predictors

Effetti microbiologici della strumentazione meccanica ultrasonica.

OBJECTIVES. To evaluate the microbiological effects of mechanical instrumentation (SM) associated to self-administrated use of local antimicrobials (AmF/SnF 2) in periodontal patients. MATERIALS AND METHODS. Patients underwent single or multiple sessions of SM and were prescribed with AmF/SnF 2-containing toothpaste and mouthrinse for 12 weeks. Subgingival microflora was sampled before SM and 12 weeks after SM. RESULTS. 12-week after SM bacterial counts still exhibited a substantial reduction with respect to those before SM (Total Bacterial Count: - 70%; Total Pathogens: - 69%; Red Complex: - 75%; Aggregatibacter (Actinobacillus) actynomicetemcomitans: - 94%). CONCLUSIONS. SM plus antimicrobial regimen induce a non-selective reduction of subgingival microbial flora, including periodontal pathogens bacteria, which persists after 3 months following treatment

Il metodo UniFe per la valutazione del rischio parodontale.

Objectives: Periodontitis progression varies widely among individuals, with or without treatment. Not all risk determinants for periodontitis are relevant for diagnosing the disease. The purpose of the present report is to present two cases, which show how a simplified method for periodontal risk assessment (UniFe), devised by the University of Ferrara’s Research Center for the Study of Periodontal and Peri-Implant Diseases, can identify differences in periodontal risk among individuals with similarly severe periodontitis. Materials and methods: The UniFe method is described in detail, and its use is illustrated for calculating periodontal risk in two patients with similarly severe periodontitis. Results: Periodontal risk assessment with the UniFe method revealed different risk levels in the two patients although both had similarly severe disease. The UniFe method revealed that the poorer prognosis in one of the patients was due to exposure to environmental risk factors (i.e., smoking) and a higher prevalence of gingival bleeding. Conclusions: Preliminary data suggest that the UniFe method is a simple and reliable tool for periodontal risk assessment and that it can identify differences in periodontal risk among individuals with periodontitis of similar severity

Evaluation of additional amine fluoride/stannous fluoride-containing mouthrinse during supportive therapy in patients with generalized aggressive periodontitis. A randomized, crossover, double-blind, controlled trial.

OBJECTIVES: The objective of the present randomized controlled trial was to evaluate the efficacy of a mouthrinse containing a combination of AmF/SnF2 in controlling supragingival plaque accumulation and gingival inflammation during a 12-week period in patients affected by generalized aggressive periodontitis (GAP). METHODS: Eighteen subjects, six males and 12 females, mean age: 32.2 years, were evaluated. One-half of the patients was either prescribed an AmF/SnF2-containing mouthrinse (test mouthrinse) or a control mouthrinse in addition to mechanical plaque control for 12 weeks. After a 2-week wash-out period, the patients received the alternative mouthrinse. Before and after treatment plaque index (PlI), gingival index (GI), angulated bleeding index (AngBI), tooth stain (GMSI), and tongue stain were recorded. RESULTS: Test mouthrinse resulted in a statistically significant decrease in PlI (p = 0.029) and GI (p = 0.017). After treatment, PlI was significantly lower in test compared to control mouthrinse (p = 0.027). GMSI significantly increased post-treatment for both mouthrinse regimens (p < 0.001), a significantly higher score being observed for the test compared to control mouthrinse (p = 0.002). CONCLUSIONS: The 12-week use of a AmF/SnF2-containing mouthrinse as an adjunct to conventional mechanical oral hygiene procedures in GAP patients was effective in controlling the amount of supragingival plaque deposits

Microbiological profile and calprotectin expression in naturally occurring and experimentally induced gingivitis.

OBJECTIVES: This study was performed to evaluate the microbiological profile and the calprotectin expression in gingival crevicular fluid (GCF) in spontaneous and experimentally induced gingival inflammation. MATERIALS AND METHODS: Thirty-seven periodontally healthy subjects were evaluated in real life conditions (N-O gingivitis) as well as after 21 days of experimental gingivitis trial (E-I gingivitis). During the experimental gingivitis trial, in one maxillary quadrant (test quadrant), gingival inflammation was induced by oral hygiene abstention, while in the contralateral (control) quadrant, oral hygiene was routinely continued. RESULTS: The results of the study showed that (1) the microbiological profile of quadrants where gingival inflammation was experimentally induced (i.e., E-I test quadrants) differed significantly from that of either quadrants where gingival inflammation was controlled by proper plaque control (i.e., E-I control quadrants) or quadrants with N-O gingivitis, and (2) GCF calprotectin was significantly higher at E-I test quadrants compared to either E-I control quadrants or quadrants with N-O gingivitis. A positive intrasubject correlation was found between GCF concentration of calprotectin at sites presenting N-O and E-I gingivitis. CONCLUSIONS: N-O and E-I gingivitis showed a different microbiological profile of the subgingival environment. GCF calprotectin is a reliable marker of gingival inflammation, and its concentration in N-O gingivitis is correlated with its expression in E-I gingivitis. CLINICAL RELEVANCE: The modality of plaque accumulation seems to affect the subgingival microbiological profile associated with a gingivitis condition. Calprotectin levels in GCF may be regarded as a promising marker of the individual susceptibility to develop gingival inflammation in response to experimentally induced plaque accumulation