Reliability assessment of the 2018 classification case definitions of peri-implant health, peri-implant mucositis, and peri-implantitis

Background: The purpose of this study was to evaluate the reliability and accuracy in the assignment of the case definitions of peri-implant health and diseases according to the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions. MethodsTen undergraduate students, 10 general dentists, and 10 experts in implant dentistry participated in this study. All examiners were provided with clinical and radiographic documentation of 25 dental implants. Eleven out the 25 cases were also accompanied by baseline readings. Examiners were asked to define all cases using the 2018 classification case definitions. Reliability among examiners was evaluated using the Fleiss kappa statistic. Accuracy was estimated using percentage of complete agreement and quadratic weighted kappa for pairwise comparisons between each rater and a gold standard diagnosis. ResultsThe Fleiss kappa was 0.50 (95% CI: 0.48 to 0.51) and the mean quadratic weighted kappa value was 0.544. Complete agreement with the gold standard diagnosis was achieved in 59.8% of the cases. Expertise in implantology affected accuracy positively (p < 0.001) while the absence of baseline readings affected it negatively (p < 0.001). ConclusionBoth reliability and accuracy in assigning case definitions to dental implants according to the 2018 classification were mostly moderate. Some difficulties arose in the presence of specific challenging scenarios

Primary prevention of peri-implantitis: Managing peri-implant mucositis

Abstract AIMS: Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis. METHODS: Discussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants. RESULTS: Key findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention comprising oral hygiene instructions and mechanical debridement revealed a reduction in clinical signs of inflammation; (vii) adjunctive measures (antiseptics, local and systemic antibiotics, air-abrasive devices) were not found to improve the efficacy of professionally administered plaque removal in reducing clinical signs of inflammation. CONCLUSIONS: Consensus was reached on recommendations for patients with dental implants and oral health care professionals with regard to the efficacy of measures to manage peri-implant mucositis. It was particularly emphasized that implant placement and prosthetic reconstructions need to allow proper personal cleaning, diagnosis by probing and professional plaque removal

GRUPO DE GESTANTES MAMÃE MODELO: RELATO DE EXPERIÊNCIA

Um dos períodos de maior transformação fisiológica que altera fisicamente e emocionalmente as mulheres é a gravidez, aonde há a necessidade de atenção integral a gestação o que contribui para minimizar a insegurança, as dúvidas e medos que surgem neste período. Com objetivo de abordar a experiência da condução de um grupo de gestantes sobre aspectos relacionados à saúde da mãe e do bebê, realizado em uma unidade de saúde de Criciúma/ SC, durante o ano de 2016

GRUPO DE GESTANTES MAMÃE MODELO: RELATO DE EXPERIÊNCIA

Um dos períodos de maior transformação fisiológica que altera fisicamente e emocionalmente as mulheres é a gravidez, aonde há a necessidade de atenção integral a gestação o que contribui para minimizar a insegurança, as dúvidas e medos que surgem neste período. Com objetivo de abordar a experiência da condução de um grupo de gestantes sobre aspectos relacionados à saúde da mãe e do bebê, realizado em uma unidade de saúde de Criciúma/ SC, durante o ano de 2016

On Approaches to Periodontal Infection Control

The purpose of the project was to gain understanding of clinical possibilities and applicability of non-surgical periodontal therapy. A clinical study was designed to compare a full-mouth ultrasonic debridement approach with the traditional approach of consecutive sessions of quadrant-wise scaling/root planing with respect to the clinical outcome and long term stability. A second study evaluated the outcome of locally delivered doxycycline as an adjunct to initial subgingival instrumentation in smokers and non-smokers. A third study was designed to evaluate the clinical outcome of mechanical re-treatment of non-responding pockets, with or without the use of adjunctive locally delivered doxycycline. Furthermore, a multilevel analysis was performed to investigate factors affecting the clinical outcome of pocket debridement at initial as well at re-treatment phase. In patients with moderate to advanced periodontitis an initial, 1-hour session of full-mouth ultrasonic debridement resulted in clinical improvements that were not significantly different from those following the traditional treatment approach. No significant difference with regard to the risk for recurrence of diseased periodontal pockets between the two treatment approaches was found, which lends support to the concept that the full-mouth ultrasonic approach to pocket/root debridement is as effective as quadrant-wise SRP in the initial treatment phase. Locally applied, controlled-release doxycycline gel partly counteracted the negative effect of smoking on periodontal healing following initial non-surgical therapy. However, when used as an adjunct to mechanical debridement in the re-treatment of periodontal pockets, locally delivered doxycycline did not significantly improve the treatment outcome compared to mechanical debridement alone. The multilevel analysis demonstrated that smoking habits, presence of supra-gingival plaque at the tooth site and location of the pocket at a molar were significant factors for an inferior outcome of initial non-surgical periodontal treatment. Molars, furcation sites, presence of plaque and presence of angular bony defects were associated with an inferior clinical result after re-treatment. The findings show that a full-mouth debridement approach is justified as an initial treatment modality. Furthermore, the results point to the importance of considering factors associated with the individual tooth site in the decision-making process regarding the selection of treatment procedures, particularly for sites showing poor healing response following initial pocket/root debridement. Locally applied controlled-release doxycycline gel may partly counteract the negative effect of smoking on periodontal healing following initial non-surgical therapy, but showed no significant benefit when applied in conjunction with re-treatment of remaining diseased sites

Chemical attributes and organic matter in highlands red oxisol under different uses and managements

O objetivo deste trabalho foi avaliar os impactos gerados por distintos usos e manejos em solos subtropicais sob seus atributos químicos, matéria orgânica, adsorção de fósforo (CMAP) e área superficial específica (ASE) em ambientes sob campo nativo (CN), campo nativo queimado (CNq), lavoura (LA), florestamento de pinus (FP) e mata nativa (MN), em diferentes profundidades, em Latossolo Vermelho distroférrico da região dos Campos de Cima da Serra, RS. O CN apresentou baixos teores de COT e de seus atributos químicos em relação aos demais ambientes, reflexo da sua constituição mineralógica e do clima local e altos teores de substâncias húmicas (SHs), conseqüência da ausência de interferência antrópica. Na MN, obteve-se altos teores da fração humina (HU) devido ao elevado aporte e ciclagem vegetal. A queima superficial do CN determinou diminuição dos teores de COT e aumento da CMAP, em superfície. A fertilização e correção do solo do ambiente LA determinaram altos valores dos atributos químicos. O FP apresentou os mais baixos teores químicos e de COT, que se correlacionou com a alta CMAP. O incremento de COT refletiu em diminuição da CMAP mesmo que os resultados apontam em aumento da ASE fazendo deste (COT), fator preferencial nas reações de adsorção de fósforo no solo. A forma de uso e seus distintos manejos geraram importantes modificações pedoambientais proporcionando informações auxiliares na determinação de parâmetros para sua utilização sustentável.The objective of this study was to evaluate the impacts generated by different uses and management in subtropical soils by its chemical attributes, organic matter, maximum phosphorus adsorption capacity (MPAC) and specific surface area (ESA) in environments under natural grassland (NG), natural grassland burned (NGb), farming (FA), pine forest (PF) and native forest (NF), at different depths in Oxisol of the region of Campos de Cima da Serra, RS. The NG had lower content of TOC and its chemical attributes in comparison with other environments, a reflection of its mineral composition and local climate, and high levels of humic substances (SHs), a consequence of the absence of human interference. In MN, we obtained high levels of the humin fraction (HU) due to high vegetal input and cycling. The burning surface of the NG determined a decrease of TOC concentration and increase of MPAC in the surface. Fertilization and soil remediation of the environment LA determined high values of chemical attributes. The PF had the lowest levels of chemicals and of TOC, which correlated with high CMAP. The increase in TOC a decrease in the MPAC even though the results point to increased ASE doing this, preferential factor (TOC) in the reactions of phosphorus adsorption in soil. The kind of use and their different managements have produced important changes pedoenvironment providing auxiliary information in the determination of parameters for its sustainable use

Chemical attributes and organic matter in highlands red oxisol under different uses and managements

O objetivo deste trabalho foi avaliar os impactos gerados por distintos usos e manejos em solos subtropicais sob seus atributos químicos, matéria orgânica, adsorção de fósforo (CMAP) e área superficial específica (ASE) em ambientes sob campo nativo (CN), campo nativo queimado (CNq), lavoura (LA), florestamento de pinus (FP) e mata nativa (MN), em diferentes profundidades, em Latossolo Vermelho distroférrico da região dos Campos de Cima da Serra, RS. O CN apresentou baixos teores de COT e de seus atributos químicos em relação aos demais ambientes, reflexo da sua constituição mineralógica e do clima local e altos teores de substâncias húmicas (SHs), conseqüência da ausência de interferência antrópica. Na MN, obteve-se altos teores da fração humina (HU) devido ao elevado aporte e ciclagem vegetal. A queima superficial do CN determinou diminuição dos teores de COT e aumento da CMAP, em superfície. A fertilização e correção do solo do ambiente LA determinaram altos valores dos atributos químicos. O FP apresentou os mais baixos teores químicos e de COT, que se correlacionou com a alta CMAP. O incremento de COT refletiu em diminuição da CMAP mesmo que os resultados apontam em aumento da ASE fazendo deste (COT), fator preferencial nas reações de adsorção de fósforo no solo. A forma de uso e seus distintos manejos geraram importantes modificações pedoambientais proporcionando informações auxiliares na determinação de parâmetros para sua utilização sustentável.The objective of this study was to evaluate the impacts generated by different uses and management in subtropical soils by its chemical attributes, organic matter, maximum phosphorus adsorption capacity (MPAC) and specific surface area (ESA) in environments under natural grassland (NG), natural grassland burned (NGb), farming (FA), pine forest (PF) and native forest (NF), at different depths in Oxisol of the region of Campos de Cima da Serra, RS. The NG had lower content of TOC and its chemical attributes in comparison with other environments, a reflection of its mineral composition and local climate, and high levels of humic substances (SHs), a consequence of the absence of human interference. In MN, we obtained high levels of the humin fraction (HU) due to high vegetal input and cycling. The burning surface of the NG determined a decrease of TOC concentration and increase of MPAC in the surface. Fertilization and soil remediation of the environment LA determined high values of chemical attributes. The PF had the lowest levels of chemicals and of TOC, which correlated with high CMAP. The increase in TOC a decrease in the MPAC even though the results point to increased ASE doing this, preferential factor (TOC) in the reactions of phosphorus adsorption in soil. The kind of use and their different managements have produced important changes pedoenvironment providing auxiliary information in the determination of parameters for its sustainable use

Movimentação vertical do calcário da superfície do solo no sistema plantio direto

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Movimentação vertical do calcário da superfície do solo no sistema plantio direto

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