scholarly journals Fine-Tuning Multilevel Modeling of Risk Factors Associated with Nonsurgical Periodontal Treatment Outcome

2019 ◽  
Author(s):  
João Botelho ◽  
Vanessa Machado ◽  
Paulo Mascarenhas ◽  
Ricardo Alves ◽  
Maria Alzira Cavacas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fine Tuning ◽  
Periodontal Treatment ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Hierarchical Levels ◽  
Variance Component Models

This retrospective study aimed to investigate the effect of known risk factors on nonsurgical periodontal treatment (NSPT) response using a pocket depth fine-tuning multilevel linear model (MLM). Thirty-seven patients (24 males and 13 females) with moderate to severe chronic periodontitis were treated with nonsurgical periodontal therapy. Follow-up visits at 3, 6, and 12 months included measurement of several clinical periodontal parameters. Data were extracted from a database system. Probing depth (PD) and Clinical Attachment Loss (CAL) reductions after NSPT in an overall of 1416 initially affected sites (baseline PD ≥ 4 mm), distributed on 536 teeth, were analyzed against known risk factors at three hierarchical levels (patient, tooth and site). The variance component models fitted to assess the three-level variance of PD and CAL decrease for each post-treatment follow-up showed that all levels contributed significantly to the overall variance (P < 0.001). Patients that underwent NSPT and were continually monitored had very curative results. All three hierarchical levels included risk factors who had impact on the to influence the magnitude of PD and CAL reduction. Specifically, the tooth’s type, surfaces involved and teeth mobility site-level risk factors showed the highest influence on these reductions, being highly relevant factors for the NSPT success.

scholarly journals Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and manual subgingival scaling at different probing pocket depths.

2020 ◽  
Author(s):  
Xin Zhang ◽  
Zixuan Hu ◽  
Xuesong Zhu ◽  
Wenjie Li ◽  
Jun Chen
Keyword(s):  
English Language ◽  
Periodontal Treatment ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Dental Calculus ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Subgingival Scaling

Abstract Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: English-language databases (PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Medline, and ClinicalTrials.gov, by January, 2019) were searched. Weighted mean differences in primary outcomes, PPD and clinical attachment loss (CAL) reduction, were estimated by random effects model. Secondary outcomes, bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus, were analyzed by comparing the results of each study. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The GRADE approach was used to assess quality of evidence. Results: Ten randomized controlled trials were included out of 1,434 identified. Initial PPD and follow-up periods formed subgroups. For 3-months follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-months follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial PPD was 4-6mm, PPD reduction proved manual subgingival scaling was superior, but CAL results showed no statistical differences between the two means. When initial PPD was ≥6mm, PPD and CAL reductions suggested that manual subgingival scaling was superior.

scholarly journals Influence of Depression and Anxiety on Non-Surgical Periodontal Treatment Outcomes: A 6-Month Prospective Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9394
Author(s):  
Catherine Petit ◽  
Victor Anadon-Rosinach ◽  
Nicolas Tuzin ◽  
Jean-Luc Davideau ◽  
Olivier Huck
Keyword(s):  
Risk Factors ◽  
Treatment Outcomes ◽  
Periodontal Treatment ◽  
Scaling And Root Planing ◽  
Depression And Anxiety ◽  
Clinical Attachment Loss ◽  
Probing Depth ◽  
Severe Periodontitis ◽  
Risk Patients ◽  
Periodontal Probing

Periodontal treatment could be worsened by risk factors. Depression and anxiety have been suggested as potentially influencing periodontal treatment outcomes. The aim of this study was to determine their association with non-surgical periodontal treatment outcomes in patients with generalized severe periodontitis (stage III/IV generalized periodontitis) at 6 months. A total of 68 patients diagnosed with generalized severe periodontitis were treated with scaling and root planing (SRP) and were followed at 3 and 6 months. The data of the 54 patients that followed the entire protocol were considered for analysis. Depression and anxiety levels were determined at baseline by the Beck Depression Inventory (BDI) and State-Trait Inventory (STAI) questionnaires. The association between psychological scores and periodontal parameters was evaluated by multivariate analysis. At 3 and 6 months, SRP induced an improvement for all periodontal parameters (plaque index (PI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment loss (CAL)). BDI and STAI scores were associated with the evolution of PI, BOP, mean PPD and number of sites with PPD > 3 mm and with CAL > 3 mm. Depression and anxiety should be considered as risk factors for SRP and the identification of at-risk patients should be performed using well-established tools.

scholarly journals Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and manual subgingival scaling at different probing pocket depths.

2019 ◽  
Author(s):  
Xin Zhang ◽  
Zixuan Hu ◽  
Xuesong Zhu ◽  
Wenjie Li ◽  
Jun Chen
Keyword(s):  
Meta Analysis ◽  
Gingival Recession ◽  
Periodontal Treatment ◽  
Dental Calculus ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Probing Pocket Depth ◽  
Study Results ◽  
Subgingival Scaling

Abstract Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: Public databases were searched. Weighted mean differences in PPD and clinical attachment loss (CAL) reduction were estimated by random effects model. Bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus were analyzed by comparing the results of each study. Results: Ten randomized controlled trials were included out of 1,434 identified. Selected outcomes were PPD and CAL. Initial PPD and follow-up periods formed subgroups. For 3-month follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-month follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial probing pocket depth was 4-6mm, PPD reduction proved manual scaling superior to ultrasonic subgingival scaling, but CAL and GR results showed no statistical differences between the two means. When initial probing pocket depth was ≥6mm, PPD, CAL and BOP reductions suggested that manual subgingival scaling was superior to ultrasonic subgingival scaling, but GR results showed no statistical differences. No conclusion could be drawn about residual dental calculus.

scholarly journals Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and manual subgingival scaling at different probing pocket depths.

2020 ◽  
Author(s):  
Xin Zhang ◽  
Zixuan Hu ◽  
Xuesong Zhu ◽  
Wenjie Li ◽  
Jun Chen
Keyword(s):  
English Language ◽  
Periodontal Treatment ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Dental Calculus ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Subgingival Scaling

Abstract Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: English-language databases (PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Medline, and ClinicalTrials.gov, by January, 2019) were searched. Weighted mean differences in primary outcomes, PPD and clinical attachment loss (CAL) reduction, were estimated by random effects model. Secondary outcomes, bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus, were analyzed by comparing the results of each study. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The GRADE approach was used to assess quality of evidence. Results: Ten randomized controlled trials were included out of 1,434 identified. Initial PPD and follow-up periods formed subgroups. For 3-months follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-months follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial PPD was 4-6mm, PPD reduction proved manual subgingival scaling was superior, but CAL results showed no statistical differences between the two means. When initial PPD was ≥6mm, PPD and CAL reductions suggested that manual subgingival scaling was superior.

scholarly journals Efficacy of melatonin supplementation in the treatment of periodontitis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Yuexiang Zhen ◽  
Hui Yue ◽  
Yiting Xiao ◽  
Qin Liu ◽  
Meilin Zhao
Keyword(s):  
Systematic Review ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Clinical Attachment Loss ◽  
Beneficial Effects ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Subgroup Analyses

Abstract Background: The aim of this systematic review and meta-analysis was to analyze the additive effects of the melatonin supplementation with nonsurgical periodontal therapy (NSPT) on periodontal status in patients affected by chronic periodontitis. Methods: In December 2020, We searched PubMed, EMBASE, Web of Science, CENTRAL databases and Google Scholar databases. Four RCTs were recruited with the same inclusion criteria. PD and CAL were the primary outcome measures. Subgroup analyses were performed according to health statuses and follow-up times, and Cochran’s Q and I-square ( I2 ) tests were used to assess heterogeneity.Results: This review included four RCTs. Four studies reported probing depth (PD) and 3 studies reported clinical attachment loss (CAL). Compared with the placebo groups, the melatonin groups showed a significant reduction in PD (weighted mean difference [WMD], -1.01; 95% confidence intervals [CI], -1.67 to -0.35; I2 = 76%) and CAL (WMD, -1.08; 95% CI: -1.36 to -0.79, I2 = 0%). Subgroup analyses revealed that the use of systemic melatonin + NSPT significantly reduced PD and CAL at the 2-, 3-, and 6-month follow-ups compared to NSPT alone, and stronger treatment effects of reducing PD were observed at shorter follow-ups than at longer follow-ups when adjunctive systemic melatonin was used.Conclusions: Melatonin supplementation in adjunct with nonsurgical periodontal therapy can moderately improve the efficacy of NSPT in reducing PD and greater CAL gain in patients with periodontitis. With the limited evidence available, it is evident that additional good quality RCTs are required to demonstrate additional beneficial effects of oral melatonin supplementation on periodontal clinical parameters after NSPT.

scholarly journals Lack in Periodontal Care of Patients Suffering from Severe Heart Diseases—Results after 12 Months Follow-Up

2020 ◽  
Vol 9 (2) ◽  
pp. 352 ◽  
Author(s):  
Dirk Ziebolz ◽  
Sylvia Friedrich ◽  
Christian Binner ◽  
Josephine Rast ◽  
Mirjam Eisner ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Periodontal Treatment ◽  
Clinical Attachment Loss ◽  
Ventricular Assist ◽  
Treatment Need ◽  
Total Cohort ◽  
Oral Conditions

Background: To assess whether the standardized recommendation of patients with heart failure (HF), left-ventricular assist device (LVAD) and heart transplantation (HTx) to visit their dentist leads to improved oral conditions after 12 months. Methods: Patients from the Department of Cardiothoracic Surgery, Leipzig Heart Centre, Germany were examined at baseline and after 12 months. A dental (decayed-, missing-, and filled-teeth index (DMF-T)) and periodontal examination (periodontal probing depth, clinical attachment loss) was performed. At baseline, patients received a standardized recommendation to visit their dentist. At follow-up, a standardized questionnaire regarding the dental consultation was applied. Results: Eighty-eight participants (HTx: 31, LVAD: 43, HF: 14) were included. The majority of patients (79.5%) followed the recommendation to visit their dentist. Within the total cohort, periodontal treatment need was significantly reduced from 91% (baseline) to 75% (follow-up; p < 0.01). Only 10% of total cohort stated that they received periodontal treatment. The outcome in periodontal and dental treatment need at follow-up appointment revealed no statistically significant associations to the questionnaire regarding dentist consultation (p > 0.05). Conclusions: The simple recommendation to visit the dentist appears not enough to obtain sufficient dental and periodontal conditions in patients with severe heart diseases. Thereby, a lack in periodontal treatment of patients with HF, HTx and LVAD was identified, making interdisciplinary dental special care programs recommendable.

scholarly journals Effect of hyperlipidemia on response to nonsurgical periodontal therapy: Statin users versus nonusers

2016 ◽  
Vol 10 (01) ◽  
pp. 069-076 ◽  
Author(s):  
Aditi Sangwan ◽  
Shikha Tewari ◽  
Harpreet Singh ◽  
Rajinder Kumar Sharma ◽  
Satish Chander Narula
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Clinical Attachment Level ◽  
Nonpharmacological Therapy ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Attachment Level

ABSTRACT Objective: To evaluate the response to nonsurgical periodontal therapy among hyperlipidemic subjects and whether statin use by hyperlipidemic subjects influences the response. Materials and Methods: This study was conducted on 107 chronic periodontitis subjects (35 normolipidemic [NL] controls, 36 hyperlipidemics on nonpharmacological therapy and 36 hyperlipidemics on statins). Periodontal (plaque index, gingival index [GI], probing depth [PD], and clinical attachment level [CAL]) and biochemical (plasma triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-DL-C [HDL-C] levels) examination was done at baseline and 3 months after nonsurgical periodontal treatment. Results: Both the NL and statin groups exhibited significantly greater improvement in GI as compared to the hyperlipidemic group on nonpharmacological therapy (P = 0.004 and 0.006, respectively). Mean change in PD correlated negatively with baseline TC (r = −0.306) and LDL-C (r = −0.360) while mean change in GI positively correlated with baseline HDL-C (r = 0.219). Regression analyses revealed that mean change in PD was negatively associated with LDL-C (β = −0.358, P < 0.001) while mean change in GI was positively associated with HDL-C (β = 0.219, P = 0.023). Conclusions: While higher baseline lipid levels were somewhat detrimental to the resolution of inflammation postperiodontal treatment, the inclusion of statin therapy among hyperlipidemic subjects seemed to improve clinical response as compared to those devoid of the drug. The findings of the study are suggestive of a possible adjunctive role of statins in periodontal treatment that warrants future studies.

scholarly journals Fine-tuning multilevel modeling of risk factors associated with nonsurgical periodontal treatment outcome

2019 ◽  
Vol 33 ◽  
Author(s):  
João BOTELHO ◽  
Vanessa MACHADO ◽  
Paulo MASCARENHAS ◽  
Ricardo ALVES ◽  
Maria Alzira CAVACAS ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Multilevel Modeling ◽  
Fine Tuning ◽  
Periodontal Treatment ◽  
Factors Associated

scholarly journals Clinical and Microbiological Evaluation of Surgical and Nonsurgical Treatment of Aggressive Periodontitis

2019 ◽  
Vol 30 (6) ◽  
pp. 577-586 ◽  
Author(s):  
Camila Camarinha da Silva Cirino ◽  
Hugo Felipe do Vale ◽  
Márcio Zaffalon Casati ◽  
Enilson Antonio Sallum ◽  
Renato Corrêa Viana Casarin ◽  
...  
Keyword(s):  
Surgical Therapy ◽  
Gingival Recession ◽  
Aggressive Periodontitis ◽  
Posterior Teeth ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Microbiological Parameters ◽  
Clinical Benefits ◽  
Nonsurgical Therapy

Abstract The present study aimed to evaluate clinical and microbiological effects of surgical and nonsurgical periodontal therapy in generalized aggressive periodontitis (GAgP) treatment. Sixteen GAgP patients were included in this randomized split-mouth design clinical trial. Maxillary quadrants were allocated into two groups: Nonsurgical Therapy (NST) and Surgical Therapy (ST). The following clinical parameters were assessed: plaque index (PI), bleeding on probing index (BoP), probing depth (PD), clinical attachment level (CAL) and gingival margin position (GMP). Concentrations of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in the subgingival biofilm were also determined. Clinical and microbiological parameters were assessed at baseline (n=16), 3 (n=15), 6 (n=15) and 12 months (n=8) after treatment. ST was able to promote higher PD reduction compared to NST in deep pockets at 12 months (p<0.05) and in posterior teeth at 6 months (p<0.05). In addition, higher gingival recession was observed in posterior teeth of the ST group at the 6th month (p<0.05). However, ST failed to promoted additional CAL gain in any timepoint (p>0.05). Moreover, microbiological evaluation showed no statistical difference in levels of Aa and Pg for both groups at all follow-up periods. Surgical therapy promoted similar clinical benefits to GAgP therapy. Moreover, both therapies failed to reduce Aa and Pg levels at different follow-up times.

scholarly journals Digitalization in Dental problem diagnosis, Prediction and Analysis: A Machine Learning Perspective of Periodontitis

2020 ◽  
Vol 8 (5) ◽  
pp. 67-74
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Decision Making ◽  
Oral Health ◽  
Alveolar Bone ◽  
Vascular Diseases ◽  
Diagnostic Methods ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Gum Disease

Artificial Intelligence, Machine learning, deep learning and image processing is becoming popular in medical sciences. The present digitalized world is remodelling each facetadditionally impacting dentistry and medical field from patient record maintenance, data analysisto new diagnostic methods, novel interference waysand totally different treatment choices. Oral health contributes to various diseases and conditions like Endocarditis, Cardio vascular diseases, diabetes, osteoporosis, pregnancy and birth and many more. Bad breathe, tooth decay, periodontitis, oral abscess, tooth erosion, dentinal sensitivity and many more can be even trickier to detect in plain dental radiography. The most prevalent disease periodontitis is a gum disease when left untreated, leads to tooth loss and more hazardous complications. Early Prediction and Proper diagnosis in time will protect our health from the mentioned diseases which can be implemented by making use of emerging technologies to assist and support dentists in predictions and decision making. Hence focusing more on oral health, In the current paper, the most contributing risk factors and parameters like Pocket Depth, Black Triangles, Alveolar Bone Loss, Furcation, Periodontal Abscess, Smoking, Gingivitis, Clinical Attachment Loss, Mobility Etc. that progresses the disease were taken in to consideration and a Python code was implemented which can be used as a Decision making aid to check whether person suffers or likely to suffer in future or not suffering from the disease.In this paper, literature reviews on the various automated computerized methods used to detect and diagnose the disease were discussed and an attempt was made to clearly identify and describe both the clinical and radiological parameters that a dentist/Periodontist use as a metric to grade/assess the periodontitis. The present strategy can be enhanced as a tool and can be used as a decision making aid by dentists’ in the prediction of periodontitis and can also be used for demonstrating fresher’s or upcoming dentists the progress of gum disease, grading the severity of the disease and the associated risk factors considering clinical, radiological findings and adverse habits thereby improving overall time period taken for manual predictions.

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