Guided Tissue Regeneration, Periodontal ; Humans ; Periodontal Attachment Loss

OBJECTIVETo evaluate the accuracy of partial- mouth periodontal examination (PMPE) protocols frequently used in epidemiological periodontal surveys.

METHODSArticles in English or Chinese published before Jan 31st 2014 were searched, which compared the results of PMPE protocols with those of gold-standard protocol, i.e.full-mouthmesialbuccal-midbuccal-distobuccal-mesiolingual-midlingual-distolingual (MB-B-DB-ML-L-DL) protocol.

RESULTSTwelve articles were included and nine that frequently used PMPE protocols were evaluated. All these protocols underestimated the prevalence scores. For prevalence of probing depth (PD) ≥ 4 mm, 6 mm and attachment loss (AL) ≥ 4 mm, 6 mm, smaller amount of underestimation was observed in community periodontal index of treatment needs (CPITN) teeth (-12.6%--3.5%), full-mouth MB-B-DB (-16.1%--3.5%), full-mouth MB-B-DL (-10.8%--6.1%) and half-mouth MB-B-DB-ML-L-DL (-23.6%--2.0%) protocols. For severity and extent estimates, half-mouth MB-B-DB-ML- L-DL provided lowest biased results (relative bias: -1.0%- 1.1% for severity and -6.7%-0.1% for extent). Full-and half-mouth MB-B-DB also performed well, with relative bias within ± 5.0% in most cases. CPITN overestimated the severity and extent of periodontal disease, the relative bias of which amounted to 42.3% and 38.1%, respectively.

CONCLUSIONSHalf-mouth MB-B-DB-ML-L-DL and full-mouth MB-B-DB protocols caused lower biased results in prevalence, severity and extent estimates of PD and AL.

Bias ; Dental Care ; Health Surveys ; Humans ; Periodontal Attachment Loss ; Periodontal Diseases ; epidemiology ; Periodontal Index ; Prevalence

OBJECTIVETo evaluate the adjunctive effect of diode laser irradiation for the treatment of periodontal-endodontic combined lesions.

METHODS30 cases with periodontal-endodontic combined lesions were selected. All cases were randomly divided into experimental group and control group (n=15). In the control group, patients were treated with root canal therapy and conservative periodontal treatment (scaling and root planning), and patients in the experimental group were treated with root canal therapy and conservative periodontal treatment followed by diode laser irradiation. Clinical measurements including pocket probing depth (PPD), clinical attachment level (CAL), modified bleeding index (mBI), periapical index (PAI) were taken before treatment (baseline). Three and six months after the treatment, the adjunctive effects of diode laser in the treatment of periodontal-endodontic combined lesions were evaluated.

RESULTSThree months after the treatment, the average PPD, CAL and mBI levels were reduced significantly in both groups. But the average PPD reduction in the experimental group was significantly greater (P<0.05) than in control group. However the average CAL and mBI reduction were not significantly different between two groups. Six months after the treatment, the average PPD, CAL and mBI levels were further reduced in the experiment group, but not in the control group. The average PAI levels were reduced significantly in both groups, but the PAI reduction was not significantly different between two groups.

CONCLUSIONThe use of diode laser as an adjunct procedure in the treatment of periodontal-endodontic combined lesions can aid in achieving success.

Dental Scaling ; Humans ; Lasers, Semiconductor ; Periodontal Attachment Loss ; Periodontal Index ; Periodontal Pocket

OBJECTIVETo study the severity of periodontitis and risk factors in Chengdu.

METHODS202 periodontitis patients (65 male, 137 female), aged from 25 to 60, were requested to fill a questionnaire. Probing depth (PD), clinical attachment level (CAL), gingival recession and bleeding on probing (BOP) on 6 sites of each tooth were measured and recorded.

RESULTSThe mean PD, AL, gingival recession and BOP% of 202 subjects was (3.2 +/- 0.31) mm, (3.5 +/- 0.37) mm, (0.3 +/- 0.02) mm and 21.16%. 59% of subjects missed at least one tooth. 129 subjects suffered with initial to moderate periodontitis. 73 subject suffered with advanced periodontitis. 40, 86, 55 and 21 subjects had received college education, high school education, middle school education and primary school education. 18% of subjects had smoking history, 67% subjects had tea/coffee history, 66% of subjects had psychosocial problem, and only 8% of subjects had received regular periodontal treatment. There is no relationship between the severity of periodontitis and education.

CONCLUSIONIt is very important to develop an education program on oral healthy for people in Chengdu.

Adult ; Female ; Gingival Recession ; Humans ; Male ; Middle Aged ; Periodontal Attachment Loss ; Periodontal Index ; Periodontitis ; Risk Factors

The factors influencing long-term prognosis of teeth must be carefully considered. Among these, attachment level is strongly associated with tooth loss. The purpose of the present study was to estimate pattern of attachment loss based on attachment area in extracted teeth. 197 satisfied the criteria for assessment after staining. The protocol described by Waerhaug(1975) was performed. An indir ect method, based on digital image abstracted from digital camera and digital imaging software program, was used to calculate the root surface area and the attachment loss area. The data were analysed using SPSS. Except maxillary central incisior and mandibular canine, no statistical significant differences between each root surfaces were observed in anterior teeth. In posterior teeth, statistical significant differences in palatal surface of maxillary molar and mandibular molar compared with others were observed. Statistical significant difference in buccal surface compared with others was lowly observed in single and multi rooted. This study did not reveal progressive loss pattern of attachment area in each root surface but clarified root surface that has relative high loss rate of attachment area at extraction. Thus understanding this pattern of attachment loss is helpful for dentist to treat the periodontitis.
Dentists ; Humans ; Molar ; Periodontal Attachment Loss* ; Periodontitis ; Prognosis ; Tooth Loss ; Tooth*

PURPOSE: This article is to describe a modified device for intraoral radiography which was developed to obtain reproducible radiographic images for assessment of distal osseous defects of the mandibular second molar (2 Mm) after impacted third molar (3 Mm) surgery. MATERIALS AND METHODS: A commercial available alignment system for posterior region was modified by adding a reference gauge pin (millimetric) and threading a hollow acrylic cylinder at the ring of the radiographic positioner to attach the X-ray collimator. The design included customized resin acrylic stent for the occlusal surface of the 2Mm in maximum intercuspal position, individualizing the biteblock positioner. Periapical radiographs were taken before and after surgical extraction of 3 Mm, employing the radiographic technique of parallelism described by Kugelberg (1986) with this modified film holder and inserting the gauge pin on the deepest bone probing depth point. RESULTS: This technique permitted to obtain standardized periapical radiographs with a moderate to high resolution, repeatability, and accuracy. There was no difference between the measurements on the pre- and post-operative radiographs. This technique allowed better maintenance of the same geometric position compared with conventional one. The insertion of the gauge pin provided the same reference point and localized the deepest osseous defect on the two-dimensional radiographs. CONCLUSION: This technique allowed better reproducibility in posterior radiographic records (distal surface of 2 Mm) and more accurate measurements of radiographic bone level by the use of a millimetric pin.
Alveolar Bone Loss ; Molar ; Molar, Third ; Periodontal Attachment Loss ; Radiography, Dental ; Stents

PURPOSE: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. METHODS: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. RESULTS: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. CONCLUSIONS: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.
Dental Pulp Cavity ; Guided Tissue Regeneration ; Humans ; Periodontal Attachment Loss ; Periodontal Diseases ; Periodontal Ligament ; Root Canal Therapy ; Stress, Psychological ; Tooth

Although intentional replantation is frequently used as a treatment modality for endodontic problems, severe periodontal involvement has usually been regarded as a contraindication. However, there are some studies suggesting that intentional replantation could be a successful treatment alternative for periodontally involved teeth. This paper reports the treatment of a tooth with severe periodontal involvement using intentional replantation. The tooth, which had had root canal therapy due to endodontic-periodontal combined lesion but showed extensive bone loss, was gently extracted and replanted after thorough debridement of the root surface. By intentional replantation, a tooth with severe periodontal involvement in this case could be preserved, without extraction, over the course of a 3-year follow-up period.
Alveolar Bone Loss ; Debridement ; Follow-Up Studies ; Periodontal Attachment Loss ; Periodontal Diseases ; Replantation ; Root Canal Therapy ; Tooth Replantation ; Tooth

PURPOSE: Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. METHODS: The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. RESULTS: Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. CONCLUSIONS: Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.
Aggressive Periodontitis ; Epidemiologic Studies ; Female ; Gingival Recession ; Humans ; Male ; Molar ; Periodontal Attachment Loss ; Prevalence ; Tooth

OBJECTIVE: To survey the cigarette smoking status and periodontal status, and to study the correlation between cigarette smoking and periodontal status. METHODS: Questionnaires were distributed (including self-assessed periodontal status, such as bleeding while brushing teeth, oral odor, tooth loosening, gum swelling, etc.) and clinical periodontal examinations performed for parameters including probing depth (PD), bleeding index (BI), attachment loss (AL), plaque index (PLI) and amount of teeth loss, which was recorded in the population above 35 years of a community in Beijing. A total of 974 subjects were recruited in the study. The population was divided into current smokers and non-smokers, and the differences of self-assessed periodontal status and periodontal parameters between the groups analyzed. RESULTS: The smokers had significantly less bleeding during toothbrushing, and in the meantime, had significantly more self-reported tooth loosening compared with the non-smokers. The smokers brushed their teeth less than the non-smokers (P<0.05). The self-reported gum swelling and oral odor had no significant difference between the smokers and non-smokers. The smokers had 0.565 times and 1.572 times the risk of bleeding during toothbrushing, self-reported tooth loosening and from Logistic regression analyses, respectively (P<0.05). The mean PD, AL, PLI and the amount of tooth loss of the smokers were significant higher than the non-smokers (P<0.05). However, the mean BI of the smokers was slightly less than the non-smokers' (1.93±0.540 vs. 1.94±0.512, P=0.707). The smokers had 2.129 times, 1.698 times and 1.933 times the risk of the mean PD>3 mm, the mean AL>3 mm, and the amount of tooth loss above 8, respectively compared with the non-smokers (P<0.05) from Logistic regression analyses. CONCLUSION The self-assessed periodontal status is different between smokers and non-smokers in the population of a community in Beijing. Smokers have less bleeding during toothbrushing but no significant difference with BI. Smokers also have more self-reported tooth loosening. Compared with non-smokers, smokers have more severe periodontal destruction.
Adult ; Beijing ; Cigarette Smoking ; Dental Plaque Index ; Humans ; Periodontal Attachment Loss ; Surveys and Questionnaires