Platelet indices (mean platelet volume and platelet distribution width) have correlations with periodontal inflamed surface area in coronary artery disease patients: A pilot study

1 Background

The plausible mechanisms regarding the relationship between periodontitis and coronary artery disease (CAD) has long been the focus of studies. This study aimed to test the hypothesis that higher periodontal inflamed surface area (PISA) values have positive correlations with increased complete blood parameters in patients with CAD.

2 Methods

Patients who underwent coronary angiography with a suspicion of CAD between the ages 30 to 75 years were included. Clinical periodontal parameters (probing depth [PD], clinical attachment loss, bleeding on probing) were recorded, and the participants were divided into four groups after the coronary angiography: group 1: CAD (+) with periodontitis (n = 20), group 2: CAD (+) without periodontitis (n = 20), group 3: CAD (‐) with periodontitis (n = 21), group 4: CAD (‐) without periodontitis (n = 16). Complete blood counts were analyzed regarding the differences and correlations between the investigated parameters.

3 Results

CAD (+) P (+) individuals had significantly higher platelet distribution width (PDW) values than the other groups (P < 0.0125). Positive lower correlations were found between PISA scores and mean platelet volume (MPV, P = 0.021, rho = 0.264), PISA and PDW (P = 0.240, rho = 0.036) in the whole study group; and moderate correlation between PD and red blood cell distribution width (RDW, P = 0.049, rho = 0.445) in CAD (‐) groups with/without periodontitis were found. Age was found to predict CAD with o lower OR (1.17, P < 0.01).

4 Conclusion

The results of the present study highlight some blood parameters (PDW, RDW, and MPV) in CAD patients with/without periodontitis in terms of the relationship between inflammatory diseases and their significant low and moderate correlations with PISA values.     

Combination of ultrasonic decontamination,soft tissue curettage,and submucosal air polishing with povidone‐iodine application for non‐surgical therapy of peri‐implantitis: 12‐month clinical outcomes

1 Background

The aim of this study is to evaluate clinical outcomes of a concept for non‐surgical peri‐implantitis combining stepwise mechanical debridement measures with adjuvant povidone‐iodine application with and without systemic antibiotics.

2 Methods

Forty‐five patients with chronic periodontitis and a total of 164 screw‐typed implants with peri‐implantitis were included. Peri‐implantitis was defined as radiographic bone loss of > 2 mm, probing depth (PD) ≥5 mm with bleeding on probing (BOP). Stepwise treatment of implants was performed with ultrasonic debridement, soft tissue curettage (STC), glycine powder air polishing (GPAP), and a repeated submucosal application of povidone‐iodine. Teeth with PD > 4 mm were treated simultaneously according to the same concept except STC. In cases with severe periodontitis (n = 24), amoxicillin and metronidazole (AM) were prescribed for 7 days.

3 Results

After 12 months, implants treated without AM showed significant reductions (P < 0.05) of mean PD (1.4 ± 0.7 mm), clinical attachment level (CAL) (1.3 ± 0.8 mm), and BOP (33.4% ± 17.2%). In deep pockets (PD > 6 mm) changes of mean PD (2.3 ± 1.3 mm), CAL (2.0 ± 1.6 mm), and BOP (44.0% ± 41.7%) were more pronounced. Intake of AM did not significantly influence the changes in these parameters. However, the reduction of implant sites with PD > 4 mm and BOP was significantly higher in patients with AM than in those without AM (31.8% ± 12.6% versus 20.8% ± 14.7%; P < 0.05).

4 Conclusions

The combination of ultrasonic debridement, STC, and GPAP with adjuvant povidone‐iodine led to significant clinical improvements at implants. Systemic antibiotics had limited effects on the reduction of persisting implant sites with treatment need.     

Spinal disorders and mastication: The potential relationship between adolescent idiopathic scoliosis and alterations of the chewing patterns

Objective

To evaluate mastication in a group of patients with adolescent idiopathic scoliosis (AIS) with a control group, by means of the prevalence of reverse chewing cycles (RCCs).

Material and Methods

This study included a group of patients (N = 32; F = 24; M = 8; mean age ± SD = 14 ± 3 years) with a confirmed diagnosis of AIS and a group of control subjects (N = 32; F = 24; M = 8; mean age ± SD = 13 ± 6 years) without spinal disorders. Mastication was recorded with both a hard and a soft bolus, following a standardized protocol, and the prevalence of RCCs was compared between the groups.

Results

The prevalence of RCCs was significantly higher in the AIS group, with both a soft and a hard bolus, compared to the control group (P < .001).

Conclusion

The results of this study indicate that the presence of AIS influences mastication, one of the main functions of the stomatognathic system. A multidisciplinary approach to these patients may be relevant in providing the best possible treatment outcomes.     

Autoimmune disorders in oral lichen planus: A systematic review and meta-analysis

Objectives

The association of OLP with other autoimmune processes points to the possibility that OLP-affected patients are actually developing an autoimmune status that predisposes them to autoaggression against different targets. This systematic review and meta-analysis aim to evaluate the current evidence on the prevalence of autoimmune disorders in patients with OLP and their magnitude of association.

Methods

We searched PubMed, Embase, Web of Science, Scopus databases for the studies published before May 2021, with no limitation in regards to their publication date or language. We evaluated the quality of studies, carried out meta-analyses and performed heterogeneity, subgroups, meta-regression, and small-study effects analyses.

Results

Inclusion criteria were met by 153 studies (23,327 patients). Our results indicate the existence of high prevalence and a frequent association between OLP and some autoimmune disorders, especially in regards to thyroid disease (PP = 7.96%, 95% CI = 6.32–9.75; OR = 1.99, 95% CI = 1.60–2.49, p < 0.001) and diabetes mellitus (PP = 9.41%,95% CI = 8.16–10.74; OR = 1.64, 95% CI = 1.34–2.00, p < 0.001).

Conclusions

Our study demonstrates the existence of a comorbidity between autoimmune thyroid diseases as well as between diabetes mellitus and OLP respectively. Quality of evidence should be upgraded on other autoimmune diseases (fibromyalgia, gastrointestinal disorders, rheumatic diseases, Sjogren's syndrome, lupus erythematosus, and dermatological diseases) for which the current data do not allow us to know whether they are really associated with OLP.     

Epidemiological aspects of dental trauma associated with maxillofacial injures: Ten years of clinical experience in Trieste,Italy

Background/Aims

The prevalence of dental injuries in patients with facial fractures is relevant. Epidemiologically, dental trauma in association with facial fractures generally affects the age group between 20 and 40 years old, with a higher prevalence in males. The aim of this retrospective study was to identify the incidence and etiology of dental trauma associated with facial fractures over a 10-year period.

Methods

From January 2009 to April 2019, among 381 patients with facial fractures, 353 were included in this study. Age, gender, trauma etiology, injured teeth and dental treatment were investigated.

Results

From 353 patients, with a mean age of 49.7 ± 19.9 years, 247 (70%) were males and 106 (30%) were females. Accidental falls were the most common type of injury (n = 118, 33.4%), followed by road accidents (n = 90, 25.5%), assaults (n = 60, 17%) and sports trauma (n = 37, 10.5%). Fifty-five subjects (15.60%) had dental injuries associated with facial fractures. Of the 145 teeth involved, 48 (33.1%) were diagnosed with luxation, 22 teeth (15.2%) were avulsed, 11 teeth (7.5%) suffered a concussion and there were 10 (6.8%) alveolar wall fractures.Uncomplicated enamel-dentin fracture was the more frequent hard tissue injury (n = 21, 14.5%), followed by complicated crown-root fracture (n = 10, 6.9%), infraction (n = 8, 5.5%), enamel fracture (n = 3, 2%) and complicated enamel-dentin fracture (n = 3, 2%). There was a peak in incidence between 21 and 40 years (42%). Males had a significantly higher risk of facial fractures with dental injury (75%). Maxillary incisors and canines (62.8%) were the most affected teeth.

Conclusions

There was a high prevalence of dental injuries associated with facial fractures. Maxillary incisors were the most injured teeth, with a higher prevalence in males.     

Serum,salivary, and tissue levels of plasminogen in familial Mediterranean fever,amyloidosis, and chronic periodontitis

1 Background

There are no published studies regarding the role of the plasminogen (PLG) system in familial Mediterranean fever (FMF), FMF‐associated secondary amyloidosis, or chronic periodontitis (CP), although recent limited data have focused on the association between FMF and chronic periodontitis. Therefore, the aim of this study was to evaluate the serum, salivary, and gingival tissue levels of PLG in patients with CP, FMF, and amyloidosis.

2 Methods

The study population included 122 patients with FMF (only FMF, and FMF and amyloidosis and 128 individuals who were systemically healthy controls. Blood and salivary samples were obtained from the cases and controls, and clinical periodontal parameters were recorded. Serum and salivary PLG levels were assessed. The gingival tissue samples of the case and control groups were analyzed histopathologically and immunohistochemically for amyloid deposition and PLG.

3 Results

The amyloidosis group had significantly more severe clinical periodontal parameters than those of the FMF and systemically healthy groups (P < 0.05). Salivary levels of PLG were significantly higher in the FMF and amyloidosis groups compared with those in the control group (P < 0.001). The FMF with periodontitis and amyloidosis with periodontitis groups had higher salivary PLG levels compared with those in the CP group. Serum and salivary PLG levels were significantly associated with the clinical periodontal parameters in the FMF group. The amyloidosis cases had hyperplasia, severe inflammation, and activation of the gingiva.

4 Conclusion

The PLG system could play an important role in inflammatory diseases, such as chronic periodontitis, FMF, and FMF‐associated secondary amyloidosis.     

The KCNQ1 gene polymorphism as a shared genetic risk for rheumatoid arthritis and chronic periodontitis in Japanese adults: A pilot case‐control study

1 Background

A number of studies have suggested a bidirectional relationship of periodontitis with rheumatoid arthritis (RA) and type 2 diabetes mellitus (T2DM). However, the genetic factors that underlie these relationships have not been elucidated.

2 Methods

We conducted a multicenter case‐control study that included 185 patients with RA and chronic periodontitis (CP), 149 patients with T2DM and CP, 251 patients with CP, and 130 systemically and periodontally healthy controls from a cohort of Japanese adults to assess the shared genetic risk factors for RA and CP as well as for T2DM and CP. A total of 17 candidate single nucleotide polymorphisms (SNPs) associated with RA, T2DM, and CP were genotyped.

3 Results

Multiple logistic regression analyses revealed that the KCNQ1 rs2237892 was significantly associated with comorbidity of RA and CP (P = 0.005) after adjustment for age, sex, and smoking status. The carriers of the T allele among patients with RA and CP showed significantly higher disease activity scores including 28 joints using C‐reactive protein values than the non‐carriers (P = 0.02), although the age, female percentage, and smoking status were comparable. Other SNPs were not associated with comorbidity of RA and CP, T2DM and CP, or susceptibility to CP.

4 Conclusion

The results of the present pilot study suggest for the first time that the KCNQ1 rs2237892 may constitute a shared genetic risk factor for RA and CP, but not for T2DM and CP in Japanese adults.     

Prevalence of periodontitis based on retrospective radiographic evaluation at dental hospital in Eastern Province of Saudi Arabia: A retrospective study

ObjectivesThe contemporary information on the prevalence of periodontitis and associated risk factors is deficient in the Kingdom of Saudi Arabia. Our aim was to measure the prevalence of periodontitis and associated risk factors among the Saudi population in the Eastern Province of Saudi Arabia who visited the University Dental Hospital.MethodsIn this retrospective study, the demographic data and medical and dental records of 700 subjects were examined. Bitewing radiographs were analyzed to measure the alveolar bone loss in posterior teeth by measuring the distance between the cementoenamel junction and the crest of the alveolar bone. A chi-square test was performed to compare the severity of periodontitis. A comparison of multivariate mean bone loss was performed using a t-test. Logistic regression analysis was used to evaluate the predictors of periodontitis. A P-value equal to or under 0.05 reflected statistical significance.ResultsAmong 700 cases, the patients’ mean age was 35.6 ± 12.1; 52.6 % were male and 47.4 % were female. Overall periodontitis prevalence was 52.1 %. The distribution of mild, moderate, and severe periodontitis prevalence was 36.1 %, 14.1 %, and 1.8 %, respectively. The severity of periodontitis was statistically similar between males and females (p = 0.148); however, significantly more Saudi than non-Saudi patients had moderate periodontitis. Higher proportions of severe periodontitis were seen in the age group of over 50-years-old (p < 0.001) and in patients with poor oral hygiene (p < 0.001), diabetes mellitus (p < 0.005), and hypertension (p < 0.002). Six total predictors of periodontitis were depicted, i.e., age > 50 years (OR = 3.73), poor OH status (OR = 2.24), BOP (OR = 3.35), presence of plaque (OR = 2.61), diabetes mellitus (OR = 3.19), and hypertension (OR = 3.62).ConclusionThe primary factors associated with the prevalence of periodontitis were age, nationality, diabetes, hypertension, BOP, plaque, and OH status. However, no association was observed between gender or cardiovascular disease and the prevalence of periodontitis in the studied population.     

High serum procalcitonin levels in patients with periodontitis and chronic migraine

1 Background

To evaluate the contribution of chronic periodontitis (CP) to serum procalcitonin (proCT) levels in chronic migraine (CM) patients in a cross‐sectional study.

2 Methods

We included 138 subjects divided into 4 groups based on clinical features of CM and periodontal parameters: systemically and periodontally healthy individuals (n = 37), systemically healthy and CP patients (n = 19), CM and periodontally healthy patients (n = 34), and CM+CP patients (n = 48). Demographic, neurological, clinical data as well as full‐mouth periodontal records were obtained. ProCT and high sensitive C‐reactive protein (hs‐CRP) serum levels were determined from blood samples taken during migraine interictal period.

3 Results

Patients from the CP+CM group (0.056±0.006 ng/mL) had significantly higher serum proCT levels in comparison with the systemically and periodontally healthy group (0.029±0.019 ng/mL), CM group (0.041±0.002 ng/mL), or CP group (0.034±0.014 ng/mL) (p < 0.001). There were no significant differences in hs‐CRP between groups (p = 0.081). Multiple linear regression analysis showed that CP was associated with increased proCT levels in CM patients (R² = 0.293, p < 0.001).

4 Conclusions

CP independently contributes to elevated serum proCT levels in CM patients. These findings suggest that CP could play a role in migraine chronification.     

Periodontal disease and its connection to systemic biomarkers of cardiovascular disease in young American Indian/Alaskan natives

1 Background

Periodontal disease has been shown to be associated with cardiovascular disease (CVD). No known studies evaluate the relationship between periodontal disease status and biomarkers of CVD risk in the American Indian/Alaskan Native (AI/AN) population despite their disproportionately high rates of poor oral health and cardiovascular disease–related outcomes. This study compared levels of interleukin (IL)‐6 and C‐reactive protein (CRP) across increasing severity of periodontal disease status among younger adults between the ages of 21 and 43 years.

2 Methods

Plasma levels of IL‐6 and CRP were measured in adult participants (ages 21 to 43 years) as part of a study of periodontal disease and CVD risk among an AI/AN population in southern California (n = 59). Periodontal evaluations were performed and disease status was classified into three categories based on highest probing depth (none/mild: < 3 mm; moderate: 4 to 5 mm; severe: ≥6 mm). Participants with known systemic disease or active infection were excluded.

3 Results

Severe periodontitis was significantly associated with increased levels of IL‐6 compared with those with none or mild periodontitis before controlling for other variables (P = 0.02), but lacked significance after controlling for sex, BMI, smoking status, and high‐density lipoprotein (P = 0.09). Moderate periodontal disease was positively associated with IL‐6 levels after controlling for potential confounders (P = 0.01). Periodontal status was not associated with CRP, before or after adjusting for covariates.

4 Conclusions

In this otherwise healthy AI/AN adult sample, moderate periodontal disease compared with none or mild periodontal disease was associated with increased levels of IL‐6. High levels of CRP found in this population warrant further research.     

Laser therapy for treatment of peri‐implant mucositis and peri‐implantitis: An American Academy of Periodontology best evidence review

1 Background

Peri‐implant diseases are prevalent, with numerous therapies studied in an attempt to combat this condition. The present review aims to systematically evaluate the effectiveness of laser therapy with non‐surgical or surgical therapy in managing peri‐implant mucositis and peri‐implantitis.

2 Methods

An electronic search of three databases and a hand search of peer‐reviewed journals for relevant articles published (in English) from January 1980 to June 2016 were performed. Human clinical trials of ≥ 10 patients with peri‐implant diseases, treated with surgical or non‐surgical approaches and laser therapy, and a follow‐up period of ≥ 6 months, were included. Random‐effects meta‐analyses were performed to analyze weighted mean difference (WMD) and confidence interval for the recorded variables according to PRISMA guidelines. Risk of bias assessment was also performed for randomized controlled trials included.

3 Results

From 22 articles selected, 11 were included in the meta‐analyses. The outcomes of using lasers as a monotherapy could not be evaluated since no controlled studies were identified. Therefore, all reported results were the outcomes of applying lasers as an adjunct to surgical/non‐surgical treatment. For the non‐surgical approach, WMD of probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), marginal bone level (MBL) and recession (REC) was 0.15 mm (P = 0.50), ?0.10 mm (P = 0.32), 21.08% (P = 0.02), ?0.07 (P = 0.002), ?0.22 mm (P = 0.04) and ?0.11 mm (P = 0.34), respectively. For the surgical approach with a long‐term follow up, WMD of PD, CAL, BOP, and PI was 0.45 mm (P = 0.11), 0.22 mm (P = 0.56), 7.26% (P = 0.76) and ?0.09 (P = 0.84), respectively.

4 Conclusions

Current evidence shows laser therapy in combination with surgical/non‐surgical therapy provided minimal benefit in PD reduction, CAL gain, amount of REC improvement, and PI reduction in the treatment of peri‐implant diseases. Lasers when used as an adjunct to non‐surgical therapy might result in more BOP reduction in the short term. However, current evidence allowed for analysis of only Er:YAG, CO₂, and diode lasers. Studies on others failed to have controlled evidence supporting their evaluation.     

‘Study of the maxillary yaw on cone beam computed tomography: A preliminary report and comparison between two different dento-skeletal malocclusions’

Objectives

To assess the skeletal and dental maxillary transverse compensation (yaw) on the cone beam computed tomography (CBCT) three-dimensional reconstructed image of the skull in two groups of patients, both clinically affected by a class III malocclusion with deviation of the lower midline.

Materials and Methods

An observational retrospective study was designed to analyse differences in two groups of patients, the first one was composed by patients affected by horizontal condylar hyperplasia, the second one by patients affected by dento-skeletal asymmetric class III malocclusion. Each group was composed by 15 patients. Transverse analysis was performed by measuring five landmarks (three bilateral and two uneven) with respect to a mid-sagittal plane; sagittal analysis was performed by measuring the sagittal distance on the mid-sagittal plane between bilateral points. Means were compared through inferential analysis.

Results

In the condylar hyperplasia group, all differences between the two sides were not statistically significant, nor for canines' difference (P = .0817), for molars (P = .1105) or for jugular points (.05871). In the class III group, the differences between the two sides were statistically significant for molars (P = .0019) and jugular points (P = .0031) but not for canines (P = .1158). Comparing the two groups, significant differences were found only for incisors' midline deviation (P = .0343) and canine (P = .0177).

Conclusion

The study of the yaw on CBCT should be integrated into three-dimensional cephalometry and could help in differentiating the various malocclusion patterns.     

Radiographic alveolar bone morphology and progressive periodontitis

1 Background

This study evaluated the relationship between radiographic crestal alveolar bone morphology and progressive periodontitis.

2 Methods

A total of 1,356 posterior interproximal sites in 56 adults treated for chronic periodontitis and receiving systematic 3‐month maintenance care were scored for angular or horizontal marginal bone morphology, as well as for alveolar crestal lamina dura, on radiographs obtained at baseline of a 30‐month post‐treatment period. Semi‐annually, the study patients were clinically evaluated for progressive periodontitis. Logistic regression analysis assessed baseline parameters to progressive periodontitis over the 30‐month post‐treatment period.

3 Results

Progressive periodontitis was detected at 33 (2.4%) posterior interproximal sites in 20 (35.7%) patients. Sites with post‐treatment angular bony defects developed progressive periodontitis more frequently (14.7%) than sites with a horizontal bone topography (1.8%). Angular bony defects (odds ratio = 10.6) and periodontal probing depths ≥5 mm (odds ratio = 4.2) were identified as statistically significant independent predictors of progressive periodontitis at posterior interproximal sites. Angular bony and horizontal lesions with intact radiographic lamina dura revealed an absence of progressive periodontitis through 24 months.

4 Conclusions

Post‐treatment presence of angular bone morphology and periodontal probing depths ≥5 mm significantly increased risk of progressive periodontitis at posterior interproximal sites. Sites of all morphology and probing depth that displayed radiographic crestal lamina dura at post‐treatment baseline exhibited clinical stability for ≥24 months.     

Prevalence of Candida spp., xerostomia,and hyposalivation in oral lichen planus – A controlled study

Objective

To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non‐OLP group), and subjects without oral mucosal lesions (control group).

Material and methods

Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non‐OLP lesions (28 patients), and healthy subjects (32 subjects).

Results

There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non‐OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp.

Conclusions

Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.     

Obesity and periodontitis: An experimental study to evaluate periodontal and systemic effects of comorbidity

1 Background

Obesity and overweight have been associated with periodontitis. This study aims to evaluate periodontal and systemic effects of this association in a validated experimental model.

2 Methods

Twenty‐eight male Wistar rats were randomly divided into four groups: 1) control group (Con) (fed with standard diet); 2) high‐fat diet group (HFD) (fed with a diet containing 35.2% fat); 3) control group with induced periodontitis (Con‐Perio); and 4) HFD group with induced periodontitis (HFD‐Perio). To induce periodontitis, oral gavages with Porphyromonas gingivalis ATCC W83K1 and Fusobacterium nucleatum DMSZ 20482 were used. Periodontal outcomes were evaluated by inflammatory parameters, periodontal probing depth (PD), and modified gingival index (MGI). Systemic effects were evaluated by measuring levels of inflammatory cytokines, insulin, adiponectin, and leptin using multiplex immunoassays and levels of visfatin, resistin, lipid profiles, transaminases, and plasma endotoxin using colorimetric tests and the glucose tolerance test.

3 Results

Clinical parameters (PD and MGI) were significantly increased (P < 0.05) in the induced periodontitis groups compared with controls. The HFD‐Perio group demonstrated significantly higher PD compared with Con‐Perio group. Lipid profiles, cytokines, and adipocytokines showed significantly elevated levels in the HFD‐Perio group compared with the other groups. Similarly, glucose levels in the HFD‐Perio group were significantly higher (P < 0.05) than in the HFD group, and hepatic damage parameters demonstrated a tendency toward higher levels in the HFD‐Perio group.

4 Conclusion

Obesity and periodontitis demonstrated a comorbidity effect on both systemic inflammatory and metabolic dysregulation biomarkers, with increased glucose, dyslipidemia and hepatic damage.     

Comparison between digital and conventional impression techniques in children on preference,time and comfort: A crossover randomized controlled trial

Objective

To compare the conventional alginate impression and the digital impression taken with an intraoral scanner of both dental arches in children, using a randomized crossover design.

Trial Design

This is a monocentric, controlled, superiority, randomized, crossover, open study.

Methods

Twenty-four orthodontic patients between 6 and 11 years of age underwent intraoral scanning (TRIOS 3; 3Shape) and alginate impression of both dental arches with an interval of 1 week between the two procedures. Participants were recruited from September 2021 to March 2022 and the study was completed in April 2022. Impression time for the two procedures was compared. Patients were asked which one of the two impression procedures they preferred. A questionnaire including Visual Analogue Scale (VAS) for comfort, pain, gag reflex and difficulty in breathing, was administered to the patients.

Results

Eighteen out of 24 patients preferred digital impression (75%, 95% confidence interval [CI]: 55% to 88%; P = .014). Scanning time was significantly shorter than alginate impression time (difference −118 seconds; 95% CI: −138 to −99; P < .001). Comfort was significantly higher for digital impression (difference 1.7; 95% CI: 0.5 to 2.8; P = .007). There was no difference in pain (difference −0.2; 95% CI: −1.5 to 1.0; P = .686) while gag reflex and breathing difficulties were smaller for digital impression (gag reflex difference −2.5; 95% CI: −4.0 to −0.9; P = .004 and breathing difficulties difference −1.5; 95% CI: −2.5 to −0.5; P = −.004).

Conclusions

Digital impression is preferred by children aged 6–11 years and it is significantly faster in acquisition time than conventional alginate impression.

Registration

The study was registered on ClinicalTrials.gov with registration number NCT04220957 on January 7th, 2020 ( https://clinicaltrials.gov/ct2/show/NCT04220957 ).     

Influence of periodontal treatment on subgingival and salivary microbiotas

1 Background

The purpose of this study was to characterize and compare subgingival and salivary microbiotas before and after periodontal treatment to learn if any changes of the subgingival microbiota were reflected in saliva. We tested the hypothesis that salivary levels of specific periopathogens correlate with corresponding subgingival levels before and after periodontal treatment.

2 Methods

Twenty‐five patients with generalized chronic periodontitis completed the study. Stimulated saliva samples and subgingival plaque samples were collected at baseline and 2, 6, and 12 weeks after nonsurgical periodontal therapy. Subgingival and salivary microbiotas were processed by means of the Human Oral Microbe Next Generation Sequencing (HOMINGS) technique and characterized based on relative abundance. Spearman signed rank test was used to test correlation of periopathogens in subgingival and saliva samples.

3 Results

Periodontal treatment resulted in significantly higher relative abundance of Streptococcus, Rothia and Actinomyces in combination with a significant decrease in Porphyromonas and Treponema in subgingival plaque samples. Relative abundance of the overall predominant genera in saliva was not influenced by periodontal treatment. However, there was a positive correlation between samples of subgingival plaque and saliva before and after periodontal treatment (p < 0.0001) with respect to relative abundance of specific periopathogens, such as Porphyromonas gingivalis (r = 0.68), Prevotella intermedia (r = 0.72), Filifactor alocis (r = 0.58), Treponema denticola (r = 0.51), Tannerella forsythia (r = 0.45) and Parvimonas micra (r = 0.45).

4 Conclusions

Subgingival and salivary abundance of periodontal pathogens correlated before and after treatment. Thus, data from this study suggest that periopathogens identified in saliva may be spill‐over from the subgingival microbiota.     

Work‐related traumatic dental injuries: Prevalence,characteristics and risk factors

Background/Aims

The prevalence of work‐related oral trauma is underestimated because minor dental injuries are often not reported in patients with several injuries in different parts of the body. In addition, little data are available regarding their characteristics. The aim of this epidemiological study was to determine the prevalence, types, and characteristics of occupational traumatic dental injuries (TDIs) in a large working community.

Materials and Methods

Work‐related TDIs that occurred during the period between 2011 and 2013 in the District of Genoa (Northwest of Italy, 0.86 million inhabitants) were analyzed. Patients’ data were obtained from the National Institute for Insurance against Accidents at Work database.

Results

During the 2 year period, 112 TDIs (345 traumatized teeth) were recorded. The prevalence was 5.6‰ of the total amount of occupational trauma. The highest prevalence was found in the fourth and fifth decades of life (OR=3.6, P < .001), and males were injured more often than females (70.5% vs 29.5%, OR=2.8, P < .001). Service and office workers represented 52% of the sample, and construction/farm/factory workers and craftsmen were 48%. TDIs involved only teeth and surrounding tissue in 66% of cases, or in combination with another maxillofacial injury in 34%. They were statistically associated with construction/farm/factory workers group (Chi squared P < .01). Crown fracture was recorded in 34.5% of cases, subluxation/luxation in 10.7%, avulsion in 9%, root fracture in 3.8%, and concussion in 3.5%. Thirty‐two subjects (28.6%, 133 teeth, OR=4.3, P < .001) presented at least 1 traumatized tooth with previous dental treatment. Among 212 (61.4%) traumatized teeth, 67.5% were upper incisors, 17.5% were lower incisors, 3.3% were upper canines, 1.9% were lower canines, and 9.9% were bicuspids and molars.

Conclusions

Work‐related TDIs had a low overall prevalence, and fractures were the most frequent dental injury. Age, gender, and preexisting dental treatments represented risk factors for work‐related TDIs.     

Long‐term evaluation (20 years) of the outcomes of coronally advanced flap in the treatment of single recession‐type defects

1 Background

Coronally advanced flap (CAF) has been considered as one of the most predictable and versatile root coverage procedures. Thus, the aims of this study are two‐fold: 1) to evaluate the long‐term outcomes following CAF in the treatment of gingival recession (GR); and 2) to explore the influence of several tooth/patient‐related factors on the stability of gingival margin at 5, 10, and 20 years after surgery.

2 Methods

Ninety‐four patients with 97 GR (73 Miller`s Class I and 24 Miller's Class III) were treated with CAF in a private practice between 1984 and 1996. Recession depth (RD), probing depth (PD), keratinized tissue (KT) width and patient/tooth‐associated variables were recorded for each GR at baseline, 1 year, 5 years, 10 years, 15 years and 20 years after surgery. Parametric, non‐parametric, and logistic regression statistics were used throughout the study

3 Results

A total of 72 patients with 72 GR were available for analysis at the 20‐year follow‐up examination (final patients’ dropout rate = 23.4%). Statistically significant improvements were found for RD in all evaluations (P < 0.05). Little more than a half (56%) of the sites treated with CAF did not display RD changes between the short‐term (i.e., 1 year) and long‐term (i.e., 20 years) examinations. Overall, mean root coverage (MRC) decreased from 68.59% to 56.11%. The achievement of complete root coverage (CRC) 1 year after treatment was associated to GR not presenting interdental tissue loss (P = 0.001), the root condition (i.e., lack of non‐carious cervical lesion [step] – P < 0.001), an attached KT band ≥ 2 mm (P = 0.019), and baseline RD (P = 0.020). GR recurrence seemed to be influenced by age, RD at 1‐year follow‐up, sites displaying an attached KT < 2 mm and interdental tissue loss.

4 Conclusions

The aging process, the condition of the interdental periodontal tissue, and the presence of an attached KT band < 2 mm seem to be negative factors influencing the stability of the gingival margin during the 20‐year observation period.     

Back pain prevention program: An evaluation after a 10-year implementation amongst dental students

Background

Many studies show a higher prevalence of back pain for dentists and dental students than in the general population. This leads to a need to integrate an effective back pain prevention program (BPPP) into the student's curriculum. We have implemented such a program for 10 years, and the objective was to evaluate its effectiveness.

Material and Methods

Data from 102 dentists and students who benefited from the BPPP were collected. Back pain prevalence and its intensity (0–10 scale) regarding neck, upper back and lower back location were studied, as well as sex, age, implementation or not of elements of the BPPP into daily practice, and if so at what moment of the professional life. For identical items, answers were compared with those from a national survey conducted amongst French students and practitioners in 2018.

Results

Amongst the BPPP beneficiaries, 60% were suffering from chronic back pain versus 77% in the previous national survey (p < .001). Mean pain intensity was lower in each location for the BPPP beneficiaries on the 0–10 scale: neck 1.91 vs. 2.40 (p = .05); upper back 1.94 vs. 2.72 (p < .001); lower back 2.26 vs. 2.67 (p = .15). Respondents who implemented elements of the BPPP from the start of their clinical practice showed a prevalence of chronic back pain of 48.4%, against 77% for respondents who did so only from the first year or after (p < .05).

Conclusion

Our BPPP seems to show a positive preventive effect on dentists and students after a 10-year implementation. It is a solid basis that can however be further improved.