Comparison of two different probing systems for evaluation of bleeding on probing (BOP)

: Bleeding on probing (BOP) is the best documented parameter in the monitoring of periodontal health and inflammation of the gingival tissues. It is measured as bleeding provoked by applying a probe to the bottom of a sulcus/pocket. Since BoP may be provoked by trauma to the tissues using a periodontal probe hence, probing pressure can be considered as an important factor in the assessment of bleeding on probing. The purpose of the study was to evaluate bleeding on probing by conventional probe and pressure sensitive probe. : 50 subjects (1400 sites) in this split mouth study were evaluated for bleeding on probing by using a conventional periodontal probe and a manual pressure sensitive probe. Gingival Bleeding Index (Ainamo and Bay 1975) was used in the study for assessment of BOP. : More bleeding sites were found in the quadrant associated with the conventional probe as compared to the sites associated with pressure sensitive probe. : Amount of pressure applied during probing can be a significant factor in assessment the periodontal disease activity.

Comparative Effects of E-Cigarette Aerosol on Periodontium of Periodontitis Patients

Introduction: Tobacco use is one of the main causes of periodontitis. E-cigarette are gaining in popularity, and studies are needed to better understand the impact of e-cigarettes on oral health.Objective: To perform a longitudinal study to evaluate the adverse effects of e-cigarettes on periodontal health.Methods: Naïve E-cigarette users, cigarette smokers, and non-smokers were recruited using newspaper and social media. Age, gender, and ethnicity, were recorded. Participants were scheduled for two visits 6 months apart. At each visit, we collected data on the frequency and magnitude of e-cigarette and cigarette use, and alcohol consumption. Carbon monoxide (CO) levels, cotinine levels, salivary flow rate, periodontal probing depth (PD), bleeding on probing (BoP), and clinical attachment loss (CAL) were also determined at both baseline and follow-up visits and compared between groups with two-way repeated measures ANOVA. Periodontal diagnosis and other categorical variables were compared between groups with the chi-square statistic and logistic regression.Results: We screened 159 subjects and recruited 119 subjects. One-hundred-one subjects (31 cigarette smokers, 32 e-cigarette smokers, and 38 non-smokers) completed every assessment in both visits. The retention and compliance rate of subjects was 84.9%. The use of social media and craigslist was significant in recruiting e-cigarette subjects. Ethnicity and race differed between groups, as did average age in the male subjects. Carbon monoxide and salivary cotinine levels were highest among cigarette smokers. Bleeding on probing and average PDs similarly increased over time in all three groups, but CAL uniquely increased in e-cigarette smokers. Rates of severe periodontal disease were higher in cigarette smokers and e-cigarette users than non-smokers, but interpretation is confounded by the older age of the cigarette smokers.Conclusion: Among the recruited participants, CAL after 6 months was significantly worse only in the e-cigarette smokers. This study design and protocol will assist in future larger studies on e-cigarette and oral health.

Can Fixed Space Maintainers Have Adverse Effect on the Teeth and Periodontium?

BACKGROUND Space maintenance after premature loss of primary teeth is of importance in preventing space loss and potential crowding in future. Fixed space maintainers are used to prevent space loss but the presence of such fixed appliances near the tooth and its supporting structures may have some adverse effects. The purpose of this study was to evaluate the potential adverse effects of fixed space maintainers on the teeth and periodontium. METHODS Twenty young children in mixed dentition period (between 8 – 11y 7m years old) who were considered for space maintainer treatment were selected. Each patient had bilateral first molars that went under the band for fixed space maintainer. The patients were examined for decayed, missed and filled teeth (DMFT), bleeding on probing, clinical attachment level, gingival index and periodontal pocket depth at the beginning (T0), one month (T1), three months (T2) and six months (T3) later. Repeated measures ANOVA then Post - hoc LSD (Friedman test for gingival index) tests were used to interpret the data. RESULTS As compared to the beginning of the study, at the end of the 6 months follow-up period DMFT of the involved first molars did not change significantly (P = 0.163). But bleeding on probing, clinical attachment level, gingival index and periodontal pocket depths changed significantly at the same time frame (P < 0.001). CONCLUSIONS The fixed space maintainers might have some adverse effects on the periodontal structures of the banded teeth, so the clinicians should insist more on oral hygiene instructions and the patients must be under intense oral hygiene control. KEY WORDS Space Maintainers, DMFT, Bleeding on Probing, Clinical Attachment Level, Periodontal Pocket Depth

Influence of cognitive impairment and dementia on oral health and the utilization of dental services

Background The aim of this study was to show the influence of cognitive impairment and dementia on oral health and on the utilization of dental services. Methods A cross-sectional analyzation of data of the OrBiD (Oral Health, Bite Force and Dementia) pilot study was conducted. 137 subjects were stratified into five dementia groups on the basis of the Mini Mental State Examination (MMSE) (1—no dementia (MMSE 28–30), 2—mild cognitive impairment (MMSE 25–27), 3—mild dementia (MMSE 18–24), 4—moderate dementia (MMSE 10–17), and 5—severe dementia (MMSE < 10)). Information on the utilization of dental services and oral health parameters (DMFT index, degree of restoration, Periodontal Screening Index, Bleeding on Probing, Oral Hygiene Index, Denture Hygiene Index) were collected. Results An increase in dementia resulted in significant reduction in utilization. Moreover, with increasing cognitive impairment/dementia there was a significant difference in the number of teeth that were decayed, but not in the number of filled or missing teeth or the DMF/T index itself. With increasing dementia, the degree of restoration decreased and oral/denture hygiene deteriorated significantly. Nevertheless, periodontal therapy was required for all subjects independent of their degree of dementia while bleeding on probing was increasing with increasing dementia. Conclusions An influence of cognitive impairment and dementia on oral health and on the utilization of dental services was shown. However, no conclusions about the influence of the utilization behavior of people with dementia on oral health parameters can be drawn. Further longitudinal studies are needed. Trial registration ClinicalTrials.gov NCT03775772. Registered 14th December 2018, https://clinicaltrials.gov/ct2/show/NCT03775772.

The Presence of Periodontitis in Patients with Von Willebrand Disease: A Systematic Review

The aim of this systematic review and meta-analysis was to analyze the available evidence on the assessment of periodontal disease in patients with von Willebrand disease (VWD). An electronic search in three databases (PubMed, Web of Science, and Scopus) was conducted by three independent reviewers to identify cross-sectional, cohort, and clinical trial studies. Studies considered eligible for this review were evaluated according to the quality and risk assessment tool proposed by the CLARITY Group at McMaster University. In order to analyze the possible correlation of VWD patients and periodontitis and their susceptibility to bleeding during the periodontal screening phase, periodontal parameters evaluated were probing pocket depth (PPD), bleeding on probing (BOP), gingival bleeding index (GBI), and periodontal inflamed surface area (PISA). After a screening of 562 articles, three articles were selected for the qualitative analysis. Within the limitation of our review, VWD patients are not more susceptible to periodontitis as compared with non-VWD patients. Nevertheless, bleeding on probing and gingival index needs to be carefully taken into consideration during periodontal screening of VWD due to the possible presence of false positives.

The Detrimental Impact of Smoking on Periodontal Health: A Comparative Study

Objectives: To evaluate the detrimental impact of smoking on oral health.Methodology: A Cross sectional comparative study was carried out on 100 patients, 50 smokers and 50 non-smokers, visitingSharif Medical and Dental College, Lahore from June 2019 to July 2020. Intra-oral examination was done using the CommunityPeriodontal Index of Treatment Needs (CPITN). Recorded data was coded, entered and analyzed using SPSS statistical Packageversion 23.ResultsThe periodontal health was significantly associated with status of smoking (p=0.001). The most prevalent periodontal problemsof smokers were periodontal pockets of 4 to 5 mm (19%) while the least (4%) had bleeding on probing. Majority of the nonsmokers(32%) had bleeding on probing. The number of cigarettes smoked in a day and periodontal health status weresignificantly associated (p=0.004). Light smokers (1 to 10 cigarettes/day) had periodontal pockets of 4 to 5mm as their biggestperiodontal problems (38%) while the least (8%) had bleeding on probing. The periodontal problem that intermittent smokers(11 to 15 cigarettes/day) predominantly had was periodontal pockets of 6 mm or more (8%) and same was the case with heavysmokers (2%).Conclusion: The main periodontal problem of smokers was periodontal pockets of 4 to 5 mm while the least was bleeding onprobing. Most of the non-smokers had bleeding on probing while none of the non-smokers had periodontal pockets. Lightsmokers (1 to 10 cigarettes/day) mainly had periodontal pockets of 4 to 5mm as their main concern. The periodontal problemthat intermittent and heavy smokers mainly had were periodontal pockets of 6 mm or more.

PHOTODYNAMIC THERAPY AS AN EFFICIENT ADJUNCT TO NON SURGICAL TREATMENT OF PERIODONTITIS: A CASE SERIES

The aim of this case series was to assess the efcacy of antimicrobial photodynamic therapy in the treatment of chronic periodontitis. This case series included two subjects with Presence of pocket depth 6 mm or more with clinical attachment loss(CAL) and bleeding on probing (BOP) in minimum of 1 tooth in atleast two quadrants. After full mouth mechanical debridement (SRP), rst site received no further treatment, whereas, second site was subjected to photodynamic therapy. SRP+PDT group showed signicant improvement in (CAL) and reduction in probing depth as compared to SRP group. Therefore, it can be concluded that Photodynamic therapy has its own advantage as an adjunct to SRP in the non surgical treatment of chronic periodontitis,further research for which may be advocated

Multilevel analysis of site, implant, and patient-level factors with peri-implant bleeding on probing: a cross sectional study

Aim This study was to evaluate the association between peri-implant bleeding on probing in peri-implant diseases and its association with multilevel factors (site specific factors, implant factors, and patient level factors). Methodology A cross-sectional study involved consented adult patients with ≥ 1 dental implant. Two calibrated operators examined the patients. BoP was outcome variable and peri-implant gingival biotype was principal predictor variable. The effects of site, implant, and patient level factors on BoP were assessed using a multilevel logistic regression model. Results Eighty patients for a total of 119 implants and 714 sites were included in the study. Bleeding on probing was observed in 42 implants (35.29%) with a significant higher risk observed in presence of gingival recession, thin peri-implant gingival biotype, duration of implant placement, smokers, and male patients. Conclusion Peri-implant bleeding on probing was associated with site specific, implant, and patient level factors.

Oral health status of patients with repaired cleft lip and palate: A prospective study

Purpose: To determine the oral hygiene habits, levels of dental caries, and periodontal condition of patients with repaired cleft lip and/or palate (CL/P) in Central Vietnam. Materials and Methods: A total of 78 patients (1–54 years old; median: 6 years) with CL/P were examined for dental caries, gingivitis and periodontitis using the decayed, missing, and filled teeth (dmft/DMFT) index, gingival bleeding on probing and periodontal pocket depth. Data about dental visits, brushing habits and socioeconomic status were collected. Results: A majority of patients brushed their teeth at least once a day with fluoride dentifrice but did not floss. The caries prevalence was 87.2%. The dmft of patients aged ≤ 5 years and 6–12 years were 7.4 and 9.0. The DMFT of patients aged 6–12 years, and ≥ 13 years were 1.6, and 6.7; the difference was statistically significant (p < 0.05). The percentages of patients who had bleeding on probing and had periodontal pocket depth 3.5–5.5 mm were 57.7% and 5.3%, respectively. Conclusions: Patients with repaired CL/P in Central Vietnam had a very high level of caries and had signs of gingivitis but not periodontitis. It is recommended to implement dental care in the treatment protocol for patients with CL/P.

The effect of bariatric surgery on periodontal health: systematic review and meta-analyses

IntroductionWe aimed to determine if periodontal health deteriorates after bariatric surgery (BS).Material and methodsA search was performed in Medline and Embase, for prospective cohort studies with data on change in periodontal parameters after BS. Me�ta-analysis was performed with available data.ResultsThe results of 4 included studies consistently show significant (p<0.05) worsening of bleeding on probing (4.21% (CI: 0.32, 8.11)), clinical attachment loss (0.16mm (CI: 0.05, 0.27)), periodontal pockets depth (PPD) (0.14mm(CI: 0.06, 0.23)) and percentage of PPD 4-5 mm: 1.72% (CI: 0.11, 3.34) 6-months after BS, but no change after 12-months.ConclusionsBS may have a transient negative consequence on periodontal health.