Humans ; Periodontal Diseases ; classification ; diagnosis

ABSTRACT Periodontal disease, generally known as a silent disease, is one of the major global oral health burdens that contributes to tooth loss in adults. This study was to compare findings and agreement between periodontal self-examination (SE) and self-reported (SR) assessments in detection of periodontal disease among selected adult patients in Kuala Lumpur. The subjects were patients who attended the periodontic clinics in Faculty of Dentistry, UKM. Periodontal patients who met the inclusion criteria were randomly assigned into two groups, SE and SR groups. Patients in the SE group performed a periodontal SE using illustrated written manual with questionnaire, while those in the SR group answered questionnaire. Both groups were given similar content of questionnaire. Clinical oral examinations were carried out on all patients by a single trained calibrated examiner. A total of 172 patients (86 in each group) participated in the study with the mean age of 48 years (SD 12.6). Majority of them had severe periodontal disease. Only item “total number of teeth” had showed good agreement (p < 0.01) between groups. SR group showed higher sensitivity for all items (mobility, colour, recession and bleeding). Meanwhile, the SE group demonstrated higher specificity for items on mobility, recession and bleeding. Both SR and SE assessment areas were reliable in measuring total number of teeth in periodontal patients. SR assessment is more sensitive in detecting periodontal disease in terms of items for mobility, colour, recession and bleeding.
Periodontal Diseases--diagnosis ; Adult ; Malaysia (Kuala Lumpur)

ABSTRACT In the management of periodontitis patients, periodontal risk assessment (PRA) tool is currently being applied during periodontal review (PR). However, an assessment of risk profiles during examination and diagnosis (E&D) may and would effectively assess and diagnose patients’ periodontal conditions, provide personalised treatment planning, and render an enhanced patient care through periodontal management by risk assessment (PEMBRA). From a retrospective study on selected records of 81 patients treated for chronic periodontitis, the PRA profiles of the patients were evaluated during E&D and two to three months after completion of nonsurgical periodontal therapy (NSPT) during PR. The results were analysed using SPSS version 24 for descriptive statistics. On E&D, the patients presented with 25.9% localised and 74.1% generalised chronic periodontitis. Of these, 2.5% of low-risk patients on E&D increased to 21% during PR signifying an improvement after the treatment. However, the medium-risk patients have a slight increase from 32% to 35%, and patients with a high risk of 62% were reduced to 43%. The improvement of the risk profiles for both low and high-risk groups was mostly contributed by the reduction in the plaque score, percentages of bleeding on probing (BOP), and probing pocket depth (PPD) ≥ 5 mm. This evidence-based evaluation of PRA tool during E&D and PR is important for PEMBRA as it encouraged the clinicians to adopt periodontal management through basic periodontal examination, detailed periodontal charting, radiographic interpretation, tooth per tooth prognosis, diagnosis, and targeted NSPT.
Risk Assessment ; Periodontal Diseases -- diagnosis ; Dental Instruments

The purpose of this study was to evaluate the alveolar bone surface following root separation angle in the mandibular second molars. The fifty mandibular second molars(which were extracted) were selected, and the alveolar bone surface following root separation angle of the selected teeth were evaluated. The results were obtained as follows; 1. The root separation angle of fifty mandibular second molars were divided into three groups. The first group(10-20degrees) was made up of ten teeth, the second group(20-30degrees) was made up of fifteen teeth, and the third group(30-40degrees) was made up of twenty-five teeth. 2. The mean root separation angle was 28.1degrees. The mean alveolar bone rate on the mesial surface of the mesial root was 44.27%, on the distal surface of the mesial root was 36.52%, on the mesial surface of the distal root was 33.45%, and on the distal surface of the distal root was 25.28%. 3. The mean alveolar bone rate on the distal surface of the mesial root, which composed the root separation area, was 32.95% in the first group, 36.06% in the second group, and 38.22% in the third group. The mean alveolar bone rate in the mesial surface of the distal root was 31.40% in the first group, 31.93% in the second group, and 35.18% in the third group. 4. The positive correlation was found between the root separation angle and the alveolar bone rate in the root separation area.(P<0.05) Although the mandibular second molar is a very important tooth in the oral cavity, its treatment and diagnosis is very difficult due to the variation of its root form. When periodontal disease involves the mandibular second molar, the result of this study assists in its treatment and diagnosis.
Diagnosis ; Molar* ; Mouth ; Periodontal Diseases ; Tooth

PURPOSE: The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. METHODS: Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. RESULTS: The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. CONCLUSIONS: The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic long-term periodontitis without treatment should be urged to undergo a TMJ examination.
Chronic Periodontitis* ; Diagnosis ; Humans ; Mastication* ; Osteoarthritis ; Periodontal Diseases ; Periodontal Index ; Periodontitis ; Temporomandibular Joint ; Temporomandibular Joint Disorders*

PURPOSE: An unresolved inflammatory state contributes to the pathogenesis of periodontal disease and metabolic syndrome (MetS). Therefore, the purpose of this study was to evaluate the role of lipoxin A4 (LXA4), a proresolving lipid mediator, in the association between periodontal disease and MetS. METHODS: Sixty-seven patients with MetS and 65 patients without MetS were included in the study. Sociodemographic information was obtained via a questionnaire, and detailed medical diagnoses were made. Periodontal parameters (plaque index [PI], gingival index [GI], probing pocket depth [PD], and clinical attachment level [CAL]) and metabolic parameters were measured, and serum LXA4 levels were determined. The associations among MetS, periodontal parameters, and serum LX levels were evaluated by adjusted multivariate linear regression analyses. RESULTS: Patients with MetS were older and had a higher body mass index than patients without MetS. Periodontal parameters (PI, GI, PD, and CAL) were higher in patients with MetS than in those without MetS. Serum LXA4 levels were higher in patients without MetS. Multivariate linear regression analysis indicated a positive association between MetS and periodontal parameters (PD and CAL). Negative associations were established between MetS and LXA4 levels, and between LXA4 and periodontal parameters (PI, PD, and CAL). CONCLUSIONS: The presence of higher values of periodontal parameters in patients with MetS and the negative relationship of LXA4 with MetS and periodontal disease may support the protective role of proresolving lipid mediators in the association between periodontal disease and MetS.
Body Mass Index ; Diagnosis ; Humans ; Inflammation ; Linear Models ; Lipoxins ; Metabolic Syndrome X ; Periodontal Diseases ; Periodontal Index

Periodontal defects of the furcation are characterized by several inherent anatomic factors that can make successful periodontal therapy difficult and results unpredictable. The severity and rate of occurrence of periodontal disease are directly related to the location of the furcation relative to the cemento-enamel junction and anatomical form of the root by limiting the accessibility and effectiveness of the periodontal instrumentation. This study investigated the reliability and accuracy of panoramic radiograph diagnoses of the periodontal state of mandibular molars, particularly regarding the diagnosis of furcation area periodontal defects, treatment planning, and prognosis prediction. This study examined a total of 110 teeth belonging to 33 subjects (19 male, 14 female) presenting with incipient to moderate periodontitis 4-7mm pocket depth. The alveolar bone level, length and width of the root trunk, and root separation angle were measured using the panoramic radiograph and compared to the results taken directly by retracting a full-thickness flap. The results of the study are as follows: 1. Data regarding the alveolar bone level of the mandibular first molar showed that the directly taken surgical measurements resulted in 5.1+/-0.9mm that was slightly deeper than the corresponding panoramic measurement resulted in 4.8+/-0.8mm, but these differences were statistically insignificant (p>0.05). 2. The data of the directly taken surgical measurement of the mandibular second molar (5.1+/-1.1mm) was slightly deeper than the corresponding panoramic measurement (4.7+/-1.2mm), but these differences were statistically insignificant (p>0.05). 3. The measured values of the length and width of the mandibular first molar root trunks were determined to be 4.1+/-0.6mm and 7.3+/-0.9mm, respectively, while the values of the mandibular second molar root trunks were determined to be 4.6+/-1.3mm and 7.6+/-0.9mm respectively. The differences between these values were found to be statistically significant (p<0.01). 4. The measured values of the root separation angle showed that the mandibular first molars averaged 34.5+/-4.4degrees, while the mandibular second molars averaged 23.0+/-10.0degrees. The differences between these values were found to be statistically significant (p<0.01). The results of the study show that when directly taken surgical measurements of periodontal defect depth are compared to depths indirectly measured using standard panoramic radiograph, the values are slightly deeper, but that these values are statistically insignificant. These results imply that panoramic radiograph is a reliable and effective means of making clinical diagnosis of incipient to moderate periodontitis.
Diagnosis ; Humans ; Male ; Molar* ; Periodontal Diseases ; Periodontitis ; Prognosis ; Tooth

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.
Dental Pulp Necrosis ; Diagnosis ; Incisor* ; Membranes ; Periodontal Diseases ; Tooth ; Transplants

PURPOSE: Optical coherence tomography (OCT) is a noninvasive diagnostic technique that may be useful for both qualitative and quantitative analyses of the periodontium. Micro-computed tomography (micro-CT) is another noninvasive imaging technique capable of providing submicron spatial resolution. The purpose of this study was to present periodontal images obtained using ex vivo dental OCT and to compare OCT images with micro-CT images and histologic sections. METHODS: Images of ex vivo canine periodontal structures were obtained using OCT. Biologic depth measurements made using OCT were compared to measurements made on histologic sections prepared from the same sites. Visual comparisons were made among OCT, micro-CT, and histologic sections to evaluate whether anatomical details were accurately revealed by OCT. RESULTS: The periodontal tissue contour, gingival sulcus, and the presence of supragingival and subgingival calculus could be visualized using OCT. OCT was able to depict the surface topography of the dentogingival complex with higher resolution than micro-CT, but the imaging depth was typically limited to 1.2–1.5 mm. Biologic depth measurements made using OCT were a mean of 0.51 mm shallower than the histologic measurements. CONCLUSIONS: Dental OCT as used in this study was able to generate high-resolution, cross-sectional images of the superficial portions of periodontal structures. Improvements in imaging depth and the development of an intraoral sensor are likely to make OCT a useful technique for periodontal applications.
Calculi ; Diagnosis ; Periodontal Diseases* ; Periodontium ; Tomography, Optical Coherence*

A tooth with primary endodontic disease that demonstrates a periodontal defect might be extracted because of misdiagnosis as severe periodontal disease or a vertical root fracture. The aim of this case report was to demonstrate the long-term survival of endodontically treated teeth, which had been initially considered unsavable. With meticulous evaluation including the patient's dental history, clinical and radiographic examinations, teeth with primary endodontic lesions could be differentiated and saved after proper root canal treatment. Pain history, vitality test, and radiographic examinations, as well as a general periodontal condition check with periodontal probing on an affected tooth, might be the key methods to differentiate endodontic pathosis from that of periodontal disease.
Dental Pulp Cavity ; Diagnosis* ; Diagnostic Errors ; Follow-Up Studies* ; Methods ; Periodontal Diseases* ; Tooth*