Non-surgical and surgical therapy: decision-making and clinical approaches

Periodontal therapy consists of a set of surgical and non-surgical treatments in case of periodontitis. With the technology advances and the introduction of new methods for non-surgical periodontal therapy, several procedures such as the removal of contaminated root cement have been ignored. As well, the use of antibiotic therapy as an adjunct to root scaling is a topic to be discussed. Surgery has long been compared to non-surgical methods as both treatments aim to control infection and to preserve the periodontium and teeth. Mechanical debridement and optimal plaque control remain essential for successful nonsurgical and surgical periodontal therapy

Current knowledge and future perspectives of barrier membranes: A biomaterials perspective

Periodontal regenerations and bone augmentations are common procedures practiced on a daily basis worldwide. This had led to the introduction of a wide number of barrier membranes, all aiming at regenerating a sufficient amount of bone while being safe, cost effective and easy to handle. Membranes have different characteristics that may influence their clinical properties and the result obtained. The article aims at presenting an overview of the different barrier membranes commonly used in the oral surgery field, while shedding light on the new advances in the third generation membranes

Effect of Supportive Periodontal Therapy on Tooth Loss in Regular and Irregular Compliant Smokers and Non-smokers: A Systematic Review

Aim: The aim of this systematic review is to analyze and compare tooth loss (TL) rates between regular and irregular compliant patients having different smoking habits. Materials and Methods: Electronic and manual literature searches were conducted by one author in several databases, including Medline (PubMed), Embase, Google Scholar. A total of 156 publications were screened. Three reviewers analyzed the articles and extracted the data. A total of 33 studies met the inclusion criteria. Results: A total of 30 articles were eligible for qualitative analysis, and only 3 for quantitative analysis. Compliance and smoking case definition as well as recall intervals during supportive periodontal therapy (SPT) differed widely between studies. A total of 10 publications reported significant differences in TL rates between regular (RC) and irregular compliant (IC) patients, while 25 publications reported significant differences in TL rates between smokers and non-smokers. Conclusion: Regular attendance to SPT visits and non-smoking patients are associated with fewer TL rates. Smoking is considered a major modifiable risk factor for TL

Follicular cyst associated with a de novo EDA mutation: A case report.

A dentigerous /follicular cyst is an odontogenic cyst associated with the crown of a non-erupted or partially erupted tooth. The exact histogenesis of this cyst remains unknown. Multiple signaling pathways and cellular modification are involved in its formation.The aim of this article is to report a case of a 9-year-old boy with a de novo EDA mutation, having an extreme oligodontia accompanied by the formation of a follicular cyst. This study hypothesizes the existence of causative relation between the EDA mutation and the cyst development around the impacted tooth

Comparing clinical and radiographic periodontal parameters to software generated CBCT measurements

The aim of this study was to compare direct surgical measurements to data extracted from periapical radiographs and CBCT by means of software (coPeriodontix™ and Blue Sky Plan®) in order to assess the accuracy delivered by these 2 software. Ten patients were included in the study, and the number of teeth selected for measurements ranged from one to 10 per patient. All CBCT scans and X-rays were acquired within a maximum period of 1 month prior to surgery. Clinical linear measurements were performed at 6 sites for each tooth. Furcation defects were recorded according to the Hamp classification.Differences between data acquired from these 3 modalities were analyzed. Linear measurements showed statistically significant difference, where CBCT showed the least bone loss, periapical radiographs showed more bone loss, while direct surgical measurements showed the most bone loss. The Blue Sky Plan® that measured the furcation involvement accurately depicted the true furcation defect

Maladies parodontales et diabète type 1 Enquête observationnelle

The aims of the present study were 1) to assess the prevalence of periodontal disease (PD) in a population of young people with type 1 diabetes in Lebanon; 2) to compare it to a nondiabetic control group; 3) to perform blood test of interleukin 6 (IL-6) for cases and controls and 4) to compare the results with theliterature and analyze the potential links between these two pathologies. A screening of the pocket depth (PD) by clinical examination of the entire mouth was performed in patients between 12 and 25 years, with a mean plaque index less than or equal to 1, with type 1 diabetes for more than 5 years, attending the ChronicCare Center (CCC). The control group comprised non-diabetics, meeting the same criteria of age and sex and attending the dental care center at the Faculty of Dental Medicine, SaintJoseph University of Beirut for non-periodontal treatments. The number of decayed, missing, filled teeth (DMF), periodontal pocket depth (PD), clinical attachment loss (CAL), gingival recession (RG), bleeding on probing (BOP) and the Community Periodontal Index of Treatment Needs (CPITN) were screened. The presence of moderate or severe periodontitis was defined by the criteria of Page & Eke [1]. Socio-demographic and personal data of the patients, as well as their oral hygiene habits, the history of diabetes, glycemic control, complications and treatment of diabetes, were collected from patient records;a standardized questionnaire was filled by the participants as well. A blood test was performed to evaluate the IL-6 among cases and controls. Eighty-three diabetic patients and 93 controls were included in our study. The prevalence of PD was 45.7% for moderate and 14.4% for severe forms in diabetic patients, and 0% incontrols. This study showed that the duration of diabetes, age, sex, socioeconomic level, and social status did not influence the periodontal status. However, in uncontrolled diabetes, deep pockets were significantly greater. There was no statistically significant difference between the CAO averages in the two groups. Finally, the rate of IL-6 was significantly higher in diabetics compared to healthy subjects and was greater in the presence of periodontal disease. The prevalence of PD in young type 1 diabetic patients treated at CCC is relatively high and comparable to the literature. A centralized multidisciplinary management and strict controlof the risk factors may contribute in controlling this disease. The inflammatory mediators such as IL-6 may constitute a potential link between these two diseases and remains to be assessed more accurately in prospective studies

Effect of Supportive Periodontal Therapy on Tooth Loss in Regular and Irregular Compliant Smokers and Non-Smokers: A Retrospective Cohort Study with a Follow-up Up to 50 Years

Aim: The aim of this study is to compare retrospectively tooth loss (TL) rates in two cohorts, regular vs irregular compliant individuals, and smokers vs non-smokers, with a follow-up up to 50 years. Materials and Methods: Chart data were collected from 192 patients undergoing supportive periodontal therapy (SPT) after non-surgical and/or surgical periodontal treatment for 10 - 50 (mean 24.89 ± 10.23) years. Patients were categorized as RC (attending regularly to their scheduled SPT with maximum delay of 6 months), and IC (patients missed at least one of the recall visits but continued to come on an irregular basis with a maximum delay of 18 months). Patients were then classified as smokers and non-smokers. Univariate comparisons between cohort groups were performed to assess significant differences at the level of baseline characteristics. Bivariate analyses were also performed between the main outcome variable (tooth loss) and baseline characteristics of the participants. Two negative binomial regression models were carried out in order to control confounding factors. Results: A total of 4870 (25.36 ± 4.08) teeth were present at baseline. 423 (2.2 ± 3.44) teeth were lost during follow-up (SPT), corresponding to 0.07, 0.11, 0.08, and 0.09 TL annually among RC, IC, smokers, and non-smokers, respectively, with significant difference present only between RC and IC. Age \u3e 40 years was found to increase TL rates. Conclusion: Compliance with SPT affects TL rates after a mean of 24.89 years of follow-up. RC showed less TL than IC patients. Smoking did not reach a statistical significance

Influence of the Maxillary Sinus on the Accuracy of the Root ZX Apex Locator: An Ex Vivo Study

This study evaluated the accuracy of the Root ZX (J. Morita, Tokyo, Japan) electronic apex locator in determining the working length when palatal maxillary molar roots are in a relationship with the sinus. Seventeen human maxillary molars with vital pulp were scheduled for an extraction and implant placement as part of a periodontal treatment plan. The access cavity was prepared, and a #10 K file (Dentsply Maillefer, Ballaigues, Switzerland) was inserted into the palatal root using the Root ZX apex locator in order to determine the electronic working length (EWL); then, the teeth were extracted. To determine the real working length (RWL), a #10 K file was introduced into the root canal until its tip touched a glass plate. EWL and RWL were compared. Images reconstructed with CBCT (cone beam computerized tomography) revealed that eight palatal roots were related to the maxillary sinus, whereas nine were not. The results showed a significant difference between the EWL and the RWL of the palatal roots related to the sinus (p < 0.001). No significant difference was observed in measurements of roots not in contact with the sinus (p > 0.05). Within the study limitations, the reliability of Root ZX was influenced by the relationship of the roots with the maxillary sinus