Clinical application of the new classification of periodontal diseases: Ground rules, clarifications and “gray zones”

BackgroundSuccessful dissemination of the new classification of periodontitis is facilitated by emphasis on the basic ground rules, clarification of ambiguities, and identification of “gray zones” where thoughtful application of the guidelines by an informed, experienced clinician is paramount to arrive at a correct Stage and Grade.MethodsHighlighted ground rules are (1) Stage is a patient‐based, not a tooth‐based concept, therefore, a single Stage is assigned per patient; (2) Stage can shift upward over time, if the periodontal status deteriorates, but the initially assigned Stage is retained even after improvement post‐therapy; (3) the complexity factors that determine Stage must be evaluated collectively, not in isolation, to arrive at a clinically meaningful assessment; (4) a single Grade is assigned to a patient based on a deliberate evaluation of the “biological fabric” of the case, in terms of history of/risk for further progression, interplay of risk factors, and the two‐way effects of periodontitis or its treatment on general health; (v) shift of Grade over time is possible towards either direction, after thorough, collective, evaluation of changes in the above parameters. Exemplified gray zones include a radiographically intact patient with minimal attachment loss in older age; presence of “frank” periodontitis affecting a single tooth; and assessment of factors that do/do not lead to increased complexity of therapy.ConclusionDifferentiating between Stage I/II versus Stage III/IV periodontitis is relatively uncomplicated; further distinction between Stages and correct assignment of Grade requires nuanced, thorough interpretation of a broad array of findings by a knowledgeable clinician.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154677/1/jper10481.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154677/2/jper10481_am.pd

Η αναγκαιότητα της Απενημέρωσης «Debriefing» μετά από τη διαχείριση κρίσιμων συμβάντων καταστροφής

Σκοπός της παρούσας βιβλιογραφικής ανασκόπησης ήταν να εμβαθύνει αλλά και να αναλύσει τη διαδικασία της τεχνικής της απενημέρωσης - «Debriefing». Εξετάστηκε επίσης κατά πόσο αναγκαία είναι, καθώς και αν τελικά θα πρέπει να αποτελεί αναπόσπαστο κομμάτι στην ολοκληρωμένη διαχείριση μιας καταστροφής. Αρχικά παρατέθηκαν ιστορικά στοιχεία χρήσιμα τόσο για την κατανόηση της διαδικασίας του «Debriefing» όσο και για την εξέλιξη της τεχνικής κατά το πέρας των ετών. Ακολούθως αναλύθηκε εις βάθος η καθ` αυτού μέθοδος αναφέροντας τα στάδια της και εξετάστηκε κατά πόσο επηρεάζεται από την διαπολιτισμική κουλτούρα. Στη συνέχεια παρατέθηκαν στατιστικά στοιχεία για τη διαδικασία του «Debriefing» που προέκυψαν μετά από έρευνα μέσω δομημένου ερωτηματολογίου δίνοντας μια εικόνα όσον αφορά την Ελληνική προσέγγιση και νοοτροπία ως προς τη μέθοδο του «Debriefing». Η επεξεργασία της συλλογής όλων των δεδομένων οδήγησε στο συμπέρασμα ότι αν και η απενημέρωση θεωρείται παγκοσμίως αναγκαία ως προς την ολοκληρωμένη διαχείριση ενός κρίσιμου συμβάντος παρόλα αυτά στην Ελλάδα αν και συντελείται στα σώματα ασφαλείας και όχι απαραίτητα σε τακτική βάση, δεν έχει το απαραίτητο υπόβαθρο ως προς τον ψυχολογικό τομέα καθώς συνήθως δεν συντελείται με την συνδρομή επαγγελματία ψυχικής υγείας.The purpose of this literature review was to deepen and analyze the process of the technique of "Debriefing". It was also considered whether it is necessary, and whether it should be an integral part of the disaster management. Initially, historical data were presented that are useful both for understanding the "Debriefing" process as also presenting the evolution of the technique over the years. The method itself was then analyzed in depth presenting the necessary teaching stages. It was also examined in which level the “debriefing” process is depending from the cultural influence. Then statistics were provided for the "Debriefing" process that emerged after a survey through a structured questionnaire giving an overview of the Greek approach to the "Debriefing" method. The processing of all data collected led to the conclusion that although the «Debriefing» is globally considered as a necessary process for the integrated management of a critical event, in Greece it is usually been conducted not at a regular base and usually at the security forces but without the presence of a mental health professional

Guest Editorial: Clarifications on the use of the new classification of periodontitis

This editorial provides clarifications on the application of the Stage and Grade classification of periodontitis. In particular it describes: (1) how to apply the extent criterion to the defined Stage of the disease; and (2) how to calculate tooth loss because of periodontitis in Stage III and IV cases presenting with evidently hopeless (irrational to treat) teeth with a clinical definition of such teeth.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155462/1/jcpe13286_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155462/2/jcpe13286.pd

Periodontal lesions in slaughtered cattle in the west of Scotland

No abstract available

Clinical and Serologic Markers of Periodontal Infection and Chronic Kidney Disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141492/1/jper1670.pd

Στάθμιση της κλίμακας άγχους κοινωνικής εμφάνισης (social appearance anxiety scale) στην ελληνική γλώσσα και διερεύνηση της σχέσης άγχους κοινωνικής εμφάνισης- χρήσης των μέσων κοινωνικής δικτύωσης- μοναξιάς σε εφήβους και νέους ενήλικες.

Πολλοί άνθρωποι ανησυχούν για την κοινωνική τους εμφάνιση. Ο φόβος αρνητικής αξιολόγησης και κριτικής σχετικά με την εμφάνιση κάποιου σε κοινωνικές καταστάσεις αναφέρεται ως άγχος κοινωνικής εμφάνισης. Το άγχος κοινωνικής εμφάνισης αποτελεί μορφή κοινωνικού άγχους, που συνδέεται με την αντίληψη της εικόνας του σώματος και εντείνεται στις μέρες μας λόγω της χρήσης των μέσων κοινωνικής δικτύωσης και οδηγεί στη μοναξιά. Σκοπός της παρούσας μελέτης είναι αρχικά η μετάφραση του εργαλείου Social Appearance Anxiety Scale (SAAS) στην Ελληνική γλώσσα, η στάθμισή του σε δείγμα του Ελληνικού πληθυσμού, σε εφήβους και νέους ενήλικες 18-35 ετών και η αξιολόγηση των ψυχομετρικών ιδιοτήτων του. Επιπλέον, θα διερευνηθεί η σχέση του άγχους κοινωνικής εμφάνισης με μεταβλητές ψυχικής υγείας (στρες, κατάθλιψη, άγχος), μεταβλητές για την εικόνα σώματος (αποδοχή, εκτίμηση, δυσαρέσκεια σώματος), κοινωνικές (φύλο), και συμπεριφορικές μεταβλητές (χρήση των μέσων κοινωνικής δικτύωσης και εξάρτηση από αυτά, μοναξιά, κοινωνική απομόνωση). Τέλος, θα εξεταστεί το τρίπτυχο άγχος κοινωνικής εμφάνισης -χρήση των μέσων κοινωνικής δικτύωσης- μοναξιά. Στην έρευνα συμπεριλήφθηκαν τα εξής εργαλεία για τη στάθμιση: 1) Social Appearance Anxiety Scale (SAAS), 2) Social Physique Anxiety Scale (SPAS), 3) 2 υποκλίμακες του Multidimensional Body-Self Relations Questionnaire Appearance Scale (MBSRQ), 4) Appearance Schemas Inventory-Revised Scale (ASI-R), 5) Depression Anxiety Stress Scale (DASS) και για τη συγχρονική: 1) Social Media Disorder Scale και 2) UCLA Loneliness Scale. Η στατιστική ανάλυση έδειξε ότι η ελληνική έκδοση του SAAS έχει καλές ψυχομετρικές ιδιότητες. Η εσωτερική συνέπεια των ερωτήσεων του SAAS ήταν 0,942. Βρέθηκαν θετικές συσχετίσεις μεταξύ SAAS και SPAS, της υποκλίμακας υπέρβαρης ενασχόλησης του MBSRQ, του ASI-R και του DASS, ενώ αρνητικές συσχετίσεις παρατηρήθηκαν μεταξύ του SAAS και της υποκλίμακας αξιολόγησης εμφάνισης του MBSRQ και της ηλικίας. Τα αποτελέσματα αυτής της μελέτης υποδηλώνουν ότι η ελληνική έκδοση του SAAS μπορεί να χρησιμοποιηθεί ως αξιόπιστο και έγκυρο εργαλείο στον ελληνικό πληθυσμό. Σύμφωνα με τα αποτελέσματα της συγχρονικής, η ανάλυση παλινδρόμησης έδειξε ότι υπήρχε σημαντική θετική σχέση μεταξύ της κλίμακας SAAS και UCLA. Η μοναξιά προβλέφθηκε σημαντικά από το κοινωνικό άγχος εμφάνισης (p<0,0001). Από την άλλη, υπήρξε σημαντική αρνητική συσχέτιση μεταξύ SAAS και της SMDS (p=0,002). Τα ευρήματα εξετάστηκαν υπό το φως της διαθέσιμης βιβλιογραφίας και έγιναν προτάσεις για το μέλλον.Many people are worried about their social appearance. The fear of negative evaluation and judgment regarding one’s look in social circumstances is referred to as social appearance anxiety. Social appearance anxiety belongs to social anxiety, which is related to body image perception and is intensified nowadays due to the use of social media and leads to loneliness. The aim of the present study was to validate the Social Appearance Anxiety Scale (SAAS) in the Greek language, in a Greek population sample of adolescents and young adults aged 18-35 years though an online survey and to examine its psychometric properties. Additionally, the relationship of social appearance anxiety with mental health variables (stress, depression, anxiety), body image variables (acceptance, esteem, body dissatisfaction), social (gender), and behavioral variables (social media use, loneliness) will be explored. Finally, the triple: stress of social appearance - use of social media - loneliness will be examined. The survey instruments included the Social Appearance Anxiety Scale, the Social Physique Anxiety Scale (SPAS), 2 subscales of Multidimensional Body-Self Relations Questionnaire Appearance Scale (MBSRQ), the Appearance Schemas InventoryRevised Scale (ASI-R) and the Depression Anxiety Stress Scale (DASS). A total of 429 respondents participated in this research. The statistical analysis showed that the Greek version of the SAAS has good psychometric properties. The internal consistency of questions within the SAAS was 0.942. Positive correlations were found between SAAS and SPAS, the overweight preoccupation subscale of MBSRQ, the ASI-R and the DASS, while negative correlations observed between SAAS and appearance evaluation subscale of MBSRQ and age. The results of this study suggest that the Greek version of SAAS can be used as a reliable and valid instrument in the Greek population. According to the cross-sectional results, the regression analysis showed that there was a significant positive relationship between the SAAS and UCLA. Loneliness was significantly predicted by social appearance anxiety (p<0.0001). On the other hand, there was a significant negative correlation between SAAS and SMDS (p=0.002). The findings were reviewed in light of the available literature and suggestions for the future were made

Prevention and treatment of peri-implant diseases-The EFP S3 level clinical practice guideline.

BACKGROUND The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I-IV periodontitis provided evidence-based recommendations for treating periodontitis patients, defined according to the 2018 classification. Peri-implant diseases were also re-defined in the 2018 classification. It is well established that both peri-implant mucositis and peri-implantitis are highly prevalent. In addition, peri-implantitis is particularly challenging to manage and is accompanied by significant morbidity. AIM To develop an S3 level CPG for the prevention and treatment of peri-implant diseases, focusing on the implementation of interdisciplinary approaches required to prevent the development of peri-implant diseases or their recurrence, and to treat/rehabilitate patients with dental implants following the development of peri-implant diseases. MATERIALS AND METHODS This S3 level CPG was developed by the European Federation of Periodontology, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations, and a structured consensus process involving leading experts and a broad base of stakeholders. RESULTS The S3 level CPG for the prevention and treatment of peri-implant diseases culminated in the recommendation for implementation of various different interventions before, during and after implant placement/loading. Prevention of peri-implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded. Once the implants are loaded and in function, a supportive peri-implant care programme should be structured, including periodical assessment of peri-implant tissue health. If peri-implant mucositis or peri-implantitis are detected, appropriate treatments for their management must be rendered. CONCLUSION The present S3 level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to maintain healthy peri-implant tissues, and to manage peri-implant diseases, according to the available evidence at the time of publication

Evaluating clinical periodontal measures as surrogates for bacterial exposure: The Oral Infections and Vascular Disease Epidemiology Study (INVEST)

Epidemiologic studies of periodontal infection as a risk factor for cardiovascular disease often use clinical periodontal measures as a surrogate for the underlying bacterial exposure of interest. There are currently no methodological studies evaluating which clinical periodontal measures best reflect the levels of subgingival bacterial colonization in population-based settings. We investigated the characteristics of clinical periodontal definitions that were most representative of exposure to bacterial species that are believed to be either markers, or themselves etiologic, of periodontal disease. 706 men and women aged ≥ 55 years, residing in northern Manhattan were enrolled. Using DNA-DNA checkerboard hybridization in subgingival biofilms, standardized values for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia were averaged within mouth and summed to define "bacterial burden". Correlations of bacterial burden with clinical periodontal constructs defined by the severity and extent of attachment loss (AL), pocket depth (PD) and bleeding on probing (BOP) were assessed. Clinical periodontal constructs demonstrating the highest correlations with bacterial burden were: i) percent of sites with BOP (r = 0.62); ii) percent of sites with PD ≥ 3 mm (r = 0.61); and iii) number of sites with BOP (r = 0.59). Increasing PD or AL severity thresholds consistently attenuated correlations, i.e., the correlation of bacterial burden with the percent of sites with PD ≥ 8 mm was only r = 0.16. Clinical exposure definitions of periodontal disease should incorporate relatively shallow pockets to best reflect whole mouth exposure to bacterial burden

The influence of diabetes mellitus on periodontal tissues: a pilot study

PURPOSE: The purpose of this study was to preliminarily evaluate the influence of diabetes mellitus (DM) on periodontal tissue without establishment of periodontitis. METHODS: Seven-week-old db/db mice were used for the diabetic experimental group and systematically healthy mice of the same age were used as controls. After 1 week of acclimatization, the animals were sacrificed for hard and soft tissue evaluation. The pattern of bone destruction was evaluated by stereomicroscope evaluation with alizarin red staining and radiographic evaluation by microscopic computerized tomography images. Histological evaluation was performed with hematoxylin and eosin stain for evaluation of soft tissue changes. RESULTS: In both stereomicroscope evaluation and radiograph image analysis, aggressive form of bone destruction was observed in diabetic animals when compared to the systematically healthy controls. In histological evaluation, apical migration of junctional epithelium with slight inflammatory cell infiltration was observed with disarrangement of connective tissue fibers. CONCLUSIONS: Within the limits of this study, diabetic animals presented distortion in periodontal attachment and an aggressive bone loss pattern when compared to the healthy controls, suggesting that DM has an independent effect on periodontal tissue destruction irrespective of the presence or absence of periodontal diseaseope

Prevention and treatment of peri-implant diseases-The EFP S3 level clinical practice guideline.

BACKGROUND: The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I-IV periodontitis provided evidence-based recommendations for treating periodontitis patients, defined according to the 2018 classification. Peri-implant diseases were also re-defined in the 2018 classification. It is well established that both peri-implant mucositis and peri-implantitis are highly prevalent. In addition, peri-implantitis is particularly challenging to manage and is accompanied by significant morbidity. AIM: To develop an S3 level CPG for the prevention and treatment of peri-implant diseases, focusing on the implementation of interdisciplinary approaches required to prevent the development of peri-implant diseases or their recurrence, and to treat/rehabilitate patients with dental implants following the development of peri-implant diseases. MATERIALS AND METHODS: This S3 level CPG was developed by the European Federation of Periodontology, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations, and a structured consensus process involving leading experts and a broad base of stakeholders. RESULTS: The S3 level CPG for the prevention and treatment of peri-implant diseases culminated in the recommendation for implementation of various different interventions before, during and after implant placement/loading. Prevention of peri-implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded. Once the implants are loaded and in function, a supportive peri-implant care programme should be structured, including periodical assessment of peri-implant tissue health. If peri-implant mucositis or peri-implantitis are detected, appropriate treatments for their management must be rendered. CONCLUSION: The present S3 level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to maintain healthy peri-implant tissues, and to manage peri-implant diseases, according to the available evidence at the time of publication