4 modalities of periodontal treatment compared over 5 years *

The purpose of the present study was to assess in a clinical trial over 5 years the results following 4 different modalities of periodontal therapy (pocket elimination or reduction surgery, modified Widman flap surgery, subgingival curettage, and scaling and root planing). 90 patients were treated. The treatment methods were applied on a random basis to each of the 4 quadrants of the dentition. The patients were given professional tooth cleaning and oral hygiene instructions every 3 months. Pocket depth and attachment levels were scored once a year. 72 patients completed the 5 years of observation. Both patient means for pocket depth and attachment level as well as % distribution of sites with loss of attachment ≥2 mm and ≥3 mm were compared. For 1-3 mm probing depth, scaling and root planing, as well as subgingival curettage led to significantly less attachment loss than pocket elimination and modified Widman flap surgery. For 4 6 mm pockets, scaling and root planing and curettage had better attachment results than pocket elimination surgery. For the 7-12 mm pockets, there was no statistically significant difference among the results following the various procedures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72788/1/j.1600-051X.1987.tb02249.x.pd

Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology

Issues related to peri-implant disease were discussed. It was observed that the most common lesions that occur, i.e. peri-implant mucositis and peri-implantitis are caused by bacteria. While the lesion of peri-implant mucositis resides in the soft tissues, peri-implantitis also affects the supporting bone. Peri-implant mucositis occurs in about 80% of subjects (50% of sites) restored with implants, and peri-implantitis in between 28% and 56% of subjects (12-40% of sites). A number of risk indicators were identified including (i) poor oral hygiene, (ii) a history of periodontitis, (iii) diabetes and (iv) smoking. It was concluded that the treatment of peri-implant disease must include anti-infective measures. With respect to peri-implant mucositis, it appeared that non-surgical mechanical therapy caused the reduction in inflammation (bleeding on probing) but also that the adjunctive use of antimicrobial mouthrinses had a positive effect. It was agreed that the outcome of non-surgical treatment of peri-implantitis was unpredictable. The primary objective of surgical treatment in peri-implantitis is to get access to the implant surface for debridement and decontamination in order to achieve resolution of the inflammatory lesion. There was limited evidence that such treatment with the adjunctive use of systemic antibiotics could resolve a number of peri-implantitis lesions. There was no evidence that so-called regenerative procedures had additional beneficial effects on treatment outcome

Scaling and root planing with and without periodontal flap surgery

. Complete removal of calculus is a primary part of achieving a “biologically acceptable” tooth surface in the treatment of periodontitis. Rabbani et al. reported that a single episode of scaling did not completely remove subgingival calculus and that the deeper the periodontal pocket, the less complete the calculus removal. The purpose of the present study was to evaluate the effectiveness of scaling relative to calculus removal following reflection of a periodontal flap. Each of 21 patients who required multiple extractions had 2 teeth scaled, 2 teeth scaled following the reflection of a periodontal flap, and 2 teeth serve as controls. Local anesthesia was used. Following extraction, the % of subgingival tooth surfaces free of calculus was determined using the method described by Rabbani with a stereomicroscope. Results showed that while scaling only (SO) and scaling with a flap (SF) increased the % of root surface without calculus, scaling following the reflection of a flap aided calculus removal in pockets 4 mm and deeper. Comparison of SO versus SF at various pocket depths for % of tooth surfaces completely free of calculus showed 1 to 3 mm pockets to be 86% versus 86%, 4 to 6 mm pockets to be 43% versus 76% and >6 mm pockets to be 32% versus 50%. The extent of residual calculus was directly related to pocket depth, was greater following scaling only, and was greatest at the CEJ or in association with grooves, fossae or furcations. No differences were noted between anterior and posterior teeth or between different tooth surfaces.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73823/1/j.1600-051X.1986.tb01461.x.pd

The geosystem services concept – What is it and can it support subsurface planning?

The subsurface is a multifunctional natural resource. However, a mindset of “out of sight, out of mind” and a first-come-first-served principle are prevalent when accessing these resources, compromising fair intergenerational and intragenerational distribution and sustainable development. As with the ecosystem services (ES) concept, which acknowledges the contribution of the living part of nature to human well-being, the concept of geosystem services (GS) has been suggested as a way to highlight abiotic services and services provided by the subsurface. The overall aim of this study was to review current definitions of GS and their categorisation, and to suggest how the concept of GS can support subsurface planning. A systematic literature review on GS was carried out following the PRISMA protocol drawing from the Scopus database. The emerging picture from the reviewed articles is that the GS concept is both one of novelty and one currently showing inconsistency, with two prominent definitions: A) GS are abiotic services that are the direct result of the planet\u27s geodiversity, independent of the interactions with biotic nature – there is no differentiation between suprasurface and subsurface features, and B) GS provide benefits specifically resulting from the subsurface. Thirty-one out of thirty-nine GS listed in the reviewed literature are included in the abiotic extension of the common ES framework CICES v5.1, but some essential services are omitted. A unified definition of GS is desirable to build a common framework for classifying and describing GS, potentially following the CICES structure for ES. Such a framework can support systematic inclusion of GS in planning processes and contribute to improved subsurface planning. In planning practice, there are examples of important GS that are already included under the ES umbrella because planners are aware of their importance but a comprehensive framework to handle these services is lacking

Particle release from implantoplasty of dental implants and impact on cells

Abstract: Background: With increasing numbers of dental implants placed annually, complications such as peri-implantitis and the subsequent periprosthetic osteolysis are becoming a major concern. Implantoplasty, a commonly used treatment of peri-implantitis, aims to remove plaque from exposed implants and reduce future microbial adhesion and colonisation by mechanically modifying the implant surface topography, delaying re-infection/colonisation of the site. This in vitro study aims to investigate the release of particles from dental implants and their effects on human gingival fibroblasts (HGFs), following an in vitro mock implantoplasty procedure with a diamond burr. Materials and methods: Commercially available implants made from grade 4 (commercially pure, CP) titanium (G4) and grade 5 Ti-6Al-4 V titanium (G5) alloy implants were investigated. Implant particle compositions were quantified by inductively coupled plasma optical emission spectrometer (ICP-OES) following acid digestion. HGFs were cultured in presence of implant particles, and viability was determined using a metabolic activity assay. Results: Microparticles and nanoparticles were released from both G4 and G5 implants following the mock implantoplasty procedure. A small amount of vanadium ions were released from G5 particles following immersion in both simulated body fluid and cell culture medium, resulting in significantly reduced viability of HGFs after 10 days of culture. Conclusion: There is a need for careful evaluation of the materials used in dental implants and the potential risks of the individual constituents of any alloy. The potential cytotoxicity of G5 titanium alloy particles should be considered when choosing a device for dental implants. Additionally, regardless of implant material, the implantoplasty procedure can release nanometre-sized particles, the full systemic effect of which is not fully understood. As such, authors do not recommend implantoplasty for the treatment of peri-implantitis

Methodology for integrated socio-economic assessment of offshore platforms : towards facilitation of the implementation of the marine strategy framework directive

In this paper a Methodology for Integrated Socio-Economic Assessment (MISEA) of the viability and sustainability of different designs of Multi-Use Offshore Platforms (MUOPs) is presented. MUOPs are designed for multi-use of ocean space for energy extraction (wind power production and wave energy), aquaculture and transport maritime services. The developed methodology allows identification, valuation and assessment of: the potential range of impacts of a number of feasible designs of MUOP investments, and the likely responses of those impacted by the investment project. This methodology provides decision-makers with a valuable decision tool to assess whether a MUOP project increases the overall social welfare and hence should be undertaken, under alternative specifications regarding its design, the discount rate and the stream of net benefits, if a Cost-Benefit Analysis (CBA) is to be followed or sensitivity analysis of selected criteria in a Multi-Criteria Decision Analysis (MCDA) framework. Such a methodology is also crucial for facilitating of the implementation of the Marine Strategy Framework Directive (MSFD adopted in June 2008) that aims to achieve good environmental status of the EU's marine waters by 2020 and to protect the resource base upon which marine-related economic and social activities depend. According to the MSFD each member state must draw up a program of cost-effective measures, while prior to any new measure an impact assessment which contains a detailed cost-benefit analysis of the proposed measures is required

Nonsurgical and surgical periodontal therapy in single-rooted teeth

The purpose of this study was to compare the effect of tooth related and patient related factors on the success of non-surgical and surgical periodontal therapy. In 41 patients (22 female) with untreated and/or recurrent periodontitis, no therapy, scaling and root planing (SRP), or access flap (AF) were assigned according to probing pocket depth (PPD). PPD and vertical relative attachment level (RAL-V) were obtained initially, 3 and 6 months after therapy. Baseline data were compared according to therapy, jaw, tooth type, and site. Factors influencing clinical parameters were identified using multilevel analyses. Baseline PPDs were deeper interproximally, in the maxilla and at premolars compared to buccal/oral sites, mandibular, and anterior teeth. At 6 months, PPD reduction and RAL-V gain were significantly greater at sites receiving SRP and AF as compared to untreated sites (p < 0.001). PPD reduction and RAL-V gain were significantly less (p < 0.005) in smokers as compared to nosmokers and at interproximal sites (p < 0.0001) as compared to buccal/oral sites. RAL-V gain was less in aggressive periodontitis, and PPD reduction was less in the maxilla (p < 0.001). In sites with greater bone loss and infrabony defects, a poorer response was observed regarding RAL-V gain or PPD reduction, respectively. The conclusions of the study are the following: (1) Nonsurgical and surgical periodontal therapies are effective in single-rooted teeth; (2) severe interproximal bone loss and infrabony defects deteriorate clinical results; and (3) there seem to be more defect-associated (tooth, site) factors influencing treatment outcome than patient-associated factors

Effects of Hypericum Perforatum, in a rodent model of periodontitis

<p>Abstract</p> <p>Background</p> <p><it>Hypericum perforatum </it>is a medicinal plant species containing many polyphenolic compounds, namely flavonoids and phenolic acids. In this study we evaluate the effect of <it>Hypericum perforatum </it>in animal model of periodontitis.</p> <p>Methods</p> <p>Periodontitis was induced in adult male Sprague-Dawley rats by placing a nylon thread ligature around the lower 1st molars. Hypericum perforatum was administered at the dose of 2 mg/kg os, daily for eight days. At day 8, the gingivomucosal tissue encircling the mandibular first molar was removed.</p> <p>Results</p> <p>Periodontitis in rats resulted in an inflammatory process characterized by edema, neutrophil infiltration and cytokine production that was followed by the recruitment of other inflammatory cells, production of a range of inflammatory mediators such as NF-κB and iNOS expression, the nitration of tyrosine residues and activation of the nuclear enzyme poly (ADP-ribose) polymerase; apoptosis and the degree of gingivomucosal tissues injury. We report here that Hypericum perforatum exerts potent anti-inflammatory effects significantly reducing all of the parameters of inflammation as described above.</p> <p>Conclusions</p> <p>Taken together, our results clearly demonstrate that treatment with Hypericum reduces the development of inflammation and tissue injury, events associated with periodontitis.</p