The number of diabetic patients visiting stomatology for periodontal disease is increasing, and the symptoms are relatively severe, and often complications increase the complexity of periodontal treatment. This article briefly describes the research progress and clinical manifestations of the epidemiology and related pathological mechanisms of periodontitis with diabetes, focusing on the treatment and providing reference for stomatologists in the clinical diagnosis and treatment of patients with diabetic periodontitis.
Humans ; Periodontitis/therapy* ; Diabetes Mellitus/therapy* ; Periodontal Diseases ; Dental Care ; Diabetes Mellitus, Type 2 ; Diabetes Complications/complications*

2018 international classification of periodontal and implant diseases relates the classifications with the approaches of prevention and treatment based on the stages and grades of disease. European Federation of Periodontology (EFP) evaluated the available evidences following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), and published the EFP S3 level clinical practice guideline for the treatment of stage Ⅰ-Ⅲ and Ⅳ periodontitis in 2020 and 2022, respectively. The present manuscript gives introduction and interpretation based on the EFP S3 level clinical practice guideline and Chinese national conditions. On the base of the diagnostic key points of staging and grading, it introduces in detail the step treatment procedures of stageⅠ-Ⅲ periodontitis as well as the multi-disciplinary treatment procedures of stage Ⅳ periodontitis, compares the similarities and differences between the step and phase procedures, and then proposes a strategy for determining the recall interval more suitable for Chinese clinicians. The present manuscript aims to help dentists to learn and grasp the key points more quickly and accurately on the clinical application of the guideline and to assist them in making the optimal treatment plans after judging and evaluating the specific clinical circumstances, so as to maximize the chances of favorable outcome.
Humans ; Periodontal Diseases/therapy* ; Periodontics ; Periodontitis/therapy* ; Tooth

Report of the fourth national oral health survey showed that the prevalence of gingivitis and periodontitis stayed at a high level in Chinese population and the periodontitis was the most common cause of tooth loss in Chinese adults. Therefore, the examination of periodontal health status, disease condition and risk assessment are particularly important. The Society of Periodontology of the Chinese Stomatological Association organized experts of related disciplines to formulate the standard of basic periodontal examination and evaluation during oral diagnosis and treatment, aiming to emphasize the necessity and importance of periodontal health and to improve dental clinicians' abilities in understanding, diagnosis and treatment planning of periodontal disease. As a national and professional standard, it will play an important and practically significant role in conservation of natural teeth and improvement of people's oral health in China.
Adult ; China ; Diagnosis, Oral ; Gingivitis ; Humans ; Periodontal Diseases/therapy* ; Reference Standards

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

The purpose of this study was to investigate the relationship between hormone replacement therapy (HRT) and periodontal disease in postmenopausal women using data from the 4th and 5th Korea National Health and Nutrition Examination Survey. A total of 5,482 postmenopausal women aged 45~75 years were included as study subjects in the final analysis. The HRT group comprised 1,035 postmenopausal women who had received HRT for at least one month, and the non-HRT group comprised 4,447 postmenopausal women who did not receive HRT. The chi-square test was used to confirm the bivariate relationship between the variables. Multinomial logistic regression analysis was used to adjust for covariance (age, education, family income, body mass index, age of menopause, alcohol, smoking, dental visit < 1 per year, use of oral care products, and frequency of tooth brushing per day). After adjusting for all covariates, HRT was found to be associated with periodontal disease. In particular, the relationship between HRT and periodontal disease was more evident in older women and women younger than 45 years of menopausal age. The relationship between HRT and periodontal disease was stronger in women who brushed their teeth less than 3 times per day, women without regular oral examination, and women who did not use oral hygiene products. The results of this study confirmed the importance of actively considering hormone therapy when determining policy recommendations for postmenopausal women. Especially, health programs such as HRT, regular dental examination, and oral care are needed for older women who have undergone premature menopause.
Body Mass Index ; Diagnosis, Oral ; Education ; Female ; Hormone Replacement Therapy ; Humans ; Korea ; Logistic Models ; Menopause ; Menopause, Premature ; Nutrition Surveys ; Oral Hygiene ; Periodontal Diseases ; Smoke ; Smoking ; Tooth

OBJECTIVE: To retrospectively evaluate clinical and radiographic records of chronic periodontitis patients who underwent extraction-orthodontic treatment, in order to determine the effect of the treatment on probing depth, alveolar bone height of teeth adjacent to the extraction sites. METHODS: In the study, 33 chronic periodontitis patients who had finished extraction-orthodontic treatment were selected, the periodontal examination system tables and panoramic tomography were recorded before treatment (T0) and after treatment (T1), and the periodontal probing depth (PD), residual alveolar bone height (RBH) of the teeth adjacent to extraction sites (TAES) and the non-teeth adjacent to extraction sites (NTAES) were measured at T0 and T1. RESULTS: There was insignificant difference in PD of TAES and NTAES at T0 [(2.40±0.51) mm vs. (2.42±0.55) mm,P>0.05], neither was that at T1 [(2.70±0.67) mm vs. (2.67±0.64) mm, P>0.05]; From T0 to T1, PD of TAES and NTAES had mean increases of 0.3 mm [(2.40±0.51) mm vs. (2.70±0.67) mm,P<0.01] and 0.25 mm [(2.42±0.55 mm vs. (2.67±0.64) mm, P<0.01], respectively. And PD of TAES and NTAES increased from T0 to T1 statistically in the same degree [(0.30±0.64) mm vs. (0.25±0.58) mm,P>0.05]; at T0, RBH of TAES was 0.024 smaller than that of NTAES (0.74±0.16 vs. 0.76±0.16,P<0.05), but there was no difference in RBH between the TAES and NTAES at T1 (0.78±0.14 vs. 0.79±0.12,P>0.05); From T0 to T1, RBH of TAES and NTAES had mean increases of 0.04 (0.74±0.16 vs.0.78±0.14,P<0.05) and 0.02 (0.76±0.16 vs. 0.79±0.12,P<0.05), respectively. And the change of RBH between TAES and NTAES from T0 to T1 had no statistical difference (0.04±0.11 vs. 0.02±0.08,P>0.05)RBH of TAES in the side close to extraction sites was as the same as that of TAES in the side away from the extraction sites at T0 (0.73±0.17 vs. 0.74±0.16,P>0.05). From T0 to T1, RBH of both sides of TAES had mean increases of 0.04 (0.73±0.11 vs. 0.77±0.11,P<0.05) and 0.04 (0.74±0.11 vs. 0.78±0.11,P<0.05), respectively. But for both sides of TAES, from T0 to T1, there was no significant difference in change of RBH (0.04±0.11 vs. 0.04±0.11,P>0.05). CONCLUSIONS With strict control of periodontal inflammation and maintenance of oral hygiene, orthodontic treatment preserves the periodontal conditions in patients with chronic periodontitis, and the extraction-orthodontic treatment can preserve the bone height of the teeth adjacent to extraction sites.
Humans ; Oral Hygiene ; Periodontal Diseases/therapy* ; Retrospective Studies ; Tooth ; Tooth Extraction ; Treatment Outcome

PURPOSE: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. MATERIALS AND METHODS: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. RESULTS: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. CONCLUSION: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.
Anti-Inflammatory Agents ; Arachidonic Acid ; Drug Therapy ; Humans ; Periodontal Diseases* ; Prostaglandins

OBJECTIVETo compare the incidence of technical complications of implant-supported fixed dental prostheses in Chinese patients with a history of moderate or severe periodontitis and periodontally healthy patients(PHP) and analyze the effects of interproximal papillae patterns on food impaction and efficacy of plaque control.

METHODSA total of 103 partially edentulous patients treated with implant-supported fixed dental prostheses between December 2009 and December 2012 for a minimum 1-year follow-up period were recruited from Department of Periodontology, Peking University, School and Hospital of Stomatology. Based on the initial periodontal examination, the participants were divided into three groups: 30 PHP, 36 moderate periodontally compromised patients(mPCP) and 37 severe periodontally compromised patients(sPCP). Implant survival/loss, technical complications, plaque index, papilla index, food impaction and degree of proximal contact tightness of each patient were assessed around the implants at follow-up. According to the implant papilla index, the implants were divided into two groups: the "filling" group with the mesial and distal aspects with papilla index=3 and the "no filling" group with at least one aspect with papilla index<3. Data on implant survival, technical complications were analyzed. Comparisons of the incidence of technical complications were performed between the patients with different periodontal conditions with chi-square or Fisher's exact test. The influences of the interproximal papillae loss on food impaction and efficacy of plaque control were estimated with chi-square and Mann-Whitney U tests.

RESULTSThe total implant survival rate was 100%(162/162) for all three groups. Technical complications were as following: veneer fractures(1.9%, 3/162), abutment screw loosening(1.9%, 3/162), prosthetic screw loosening(3.1%, 5/162) and decementation(3.1%, 5/162) in all subjects. No implant/screw fracture was noted. The incidence of technical complications in sPCP, mPCP and PHP did not yield statistically significant differences(P>0.05). The proportion of the implant with the mesial and distal papilla index=3 in the sPCP was less than that in the PHP and mPCP. The interproximal papillae loss did not appear to affect the food impaction and the plaque index in all three groups(P>0.05). However, for the PHP, the accumulation of plaque at buccal aspect was more in the "no filling" group compared with the "filling" group (implant plaque index[M(Q)]: 1[1] vs 0[0]), and for the sPCP, the accumulation of plaque at lingual aspect was more in the "filling" group compared with the "no filling" group(implant plaque index[M(Q)]: 1[1] vs 0[1], (P<0.05).

CONCLUSIONSThe patients with a history of severe periodontitis did not exhibit more technical problems compared with the periodontally healthy patients. The interproximal papillae loss did not show a negative impact on the plaque control and food impaction. However, for the sPCP, changing the morphology and the position of the interproximal contact point to reduce the interdental black triangle may lead to accumulation of plaque at lingual aspect. More attention should be placed on the morphology design of prosthesis, but not the papillae filling up the interproximal space.

Beijing ; Dental Abutments ; Dental Implants ; Dental Plaque ; diagnosis ; etiology ; prevention & control ; Dental Plaque Index ; Dental Prosthesis, Implant-Supported ; adverse effects ; classification ; statistics & numerical data ; Dental Restoration Failure ; statistics & numerical data ; Follow-Up Studies ; Food ; Gingiva ; Humans ; Jaw, Edentulous, Partially ; rehabilitation ; Periodontal Diseases ; classification ; therapy

Humans ; Periodontal Diseases ; therapy ; Periodontics ; methods ; Risk

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