Prevalence of Periodontitis and Associated Factors among Pregnant Women: A cross sectional survey in Southern Province, Rwanda

Background The literature has shown the relationship between maternal periodontitis and complications associated with pregnancy. Thus, prevalence estimates and risk factor identification for periodontitis during pregnancy in Rwanda are paramount. Aim The aim of the current study was to determine the prevalence of periodontitis and identify related risk factors among pregnant women in Rwanda. Methods A cross sectional study was conducted to determine the prevalence of periodontal diseases in a convenience sample of 400 pregnant women in the Southern Province of Rwanda. A logistic regression analysis using a hierarchical approach was performed to assess the risk factors for periodontal disease. Socio demographic factors were put in the regression model first followed by a second step for other potential factors. Results The overall prevalence of periodontitis was 60.5%. Multivariable logistic regression showed that age OR=2.48 (95% CI. 1.18-5.22), education level OR=82.15 (95% CI. 8.21-822.11), socio economic status OR=2.28 (95% CI. 1.49-6.62), employment status OR=7.3 (95% CI. 1.38-38.74, and tobacco use OR=6.89 (95% CI. 1.78-60.65) were significantly associated with periodontitis. Conclusion Periodontitis appears to be a common problem among pregnant women in Rwanda. Risk factor screening could help identify pregnant women at higher risk of periodontal disease. Rwanda J Med Health Sci 2021;4(1):131-15

Impact of Maternal Periodontitis on Preterm Birth and Low Birth Weight in Babies: Results of a Scoping Review

Background Periodontitis has been documented as public health concern but its association with preterm and low birth weight remains uncertain, thus the objective of this scoping review is to summarize the most recent published evidence related to the impact of periodontitis on preterm birth and low birth weight in order to improve public awareness and to inform policies for oral health during pregnancy. Methods Hinari, PubMed, and Google Scholar were searched to acquire the published literature. The retrieved studies included cross-sectional, case control studies and randomized controlled trials with available full text published in English from 2008 to 2019. Results After combining the key words, 333 articles were identified with only 133 eligible articles published from 2008 to 2019. After reviewing the available 50 full text articles, duplicates were removed and 15 studies fully met the inclusion criteria. There were 13 articles that supported the association between maternal periodontitis and preterm low birth weight while 2 found no evidence to support the association. Conclusion The results of this scoping review contribute to an increasing body of evidence to support the hypothesis that maternal periodontal disease may be a risk factor for preterm delivery and low birth weight. Rwanda J Med Health Sci 2020;3(3):372-38

Evaluation of poly lactic-co-glycolic acid-coated β-tricalcium phosphate for alveolar ridge preservation: A multicenter randomized controlled trial.

BACKGROUND Alveolar ridge preservation via socket grafting (ARP-SG) is indicated to attenuate physiologic alveolar bone resorption as a consequence of tooth extraction. However, a specific bone grafting material that is patently superior has not been identified yet. The aim of this randomized controlled trial was to evaluate the efficacy of a moldable alloplastic graft, Poly Lactic-Co-Glycolic Acid-Coated β-Tricalcium Phosphate (PLGA-β-TCP), for ARP purposes [Group A] compared to freeze-dried bone allograft (FDBA) particles covered with a rapidly absorbable collagen dressing (RACD) (Group B) in function of a panel of radiographic, histomorphometric, and implant-related outcomes. METHODS Patients in need of extraction of a single posterior tooth (premolar or molar) and subsequent replacement with a dental implant were recruited and randomly allocated into one of the two treatment groups. Follow-up visits took place at 1, 2, 4, 8, and 16 weeks. Cone-beam Computed Tomography (CBCT) scans were obtained at baseline and at 16 weeks. Sites were re-entered at 20 weeks for bone core biopsy harvesting and subsequent implant placement. After delivery of the final implant-supported restoration, follow-up visits were scheduled at 6 and 12 months to monitor peri-implant tissue health and marginal bone levels using standardized intraoral periapical radiographs. RESULTS A total of 45 patients were initially enrolled in the study, of whom 43 received an implant and 32 completed the study. Healing was uneventful in all sites after ARP-SG and implant placement. No site required bone augmentation to allow for implant placement. CBCT scan analyses showed no statistically significant differences between groups in terms of reduction of horizontal width, midbuccal / midlingual height and ridge volume. Histomorphometric assessments revealed a statistically significant difference between both groups in terms of mineralized tissue formation (Group A = 27.0% ± 22.1% versus Group B = 38.2% ± 12.5%; P < 0.05). On the contrary, no significant differences were observed regarding percent of remaining bone grafting material and non-mineralized tissue. No implant failed throughout the study period and marginal bone level change was negligible in both groups. CONCLUSIONS Although a higher proportion of mineralized tissue was associated with the use of FDBA+RACD compared to PLGA-β-TCP alone, both ARP-SG approaches rendered comparable outcomes in terms of maintenance of alveolar bone dimensions, feasibility of implant placement, implant survival, and peri-implant bone level stability up to 12 months post-loading

Repeated delivery of chlorhexidine chips for the treatment of peri‐implantitis: A multicenter, randomized, comparative clinical trial

BackgroundPeri‐implantitis is a challenging condition to manage and is frequently treated using non‐surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri‐implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5 mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri‐implantitis.MethodsA multicenter, randomized, single‐blind, two‐arm, parallel Phase‐3 study was conducted. Peri‐implantitis patients with implant pocket depths (IPD) of 5‐8 mm underwent subgingival implant surface debridement followed by repeated bi‐weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12 weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24 weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24 week.ResultsA total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24 weeks, a significant reduction in IPD (P = 0.01) was measured in the ChxC group (1.76 ± 1.13 mm) compared with the control group (1.54 ± 1.13 mm). IPD reduction of ≥2 mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (P = 0.03). Changes in gingival recession (0.29 ± 0.68 mm versus 0.15 ± 0.55 mm, P = 0.015) and relative attachment gain (1.47 ± 1.32 mm and 1.39 ± 1.27 mm, P = 0.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were < 65 years exhibited significantly better responses (P < 0.02); likewise, non‐smokers had similarly better response (P < 0.02). Both protocols were well tolerated, and no severe treatment‐related adverse events were recorded throughout the study.ConclusionsPatients with peri‐implantitis that were treated with an intensive treatment protocol of bi‐weekly supragingival plaque removal and local application of chlorhexidine chips had greater mean IPD reduction and greater percentile of sites with IPD reduction of ≥2 mm as compared with bi‐weekly supra‐gingival plaque removal.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/166183/1/jper10672.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166183/2/jper10672_am.pd