09142022_JCP_Jo Flashcards
(8 cards)
Demarco 2021
Dr. Wang –> the most area for NCCL is the maxillary premolar
Prevalence of NCCL is 26% at 31 YO
Most prevalent is mandib. 2nd PM (20%)
and Maxillary PMs (18%)
Higher prevalence in: males, frequent brushing, and prevalence of GR
Take home message
NCCL was less frequent seen in the presence of periodontal pockets, and gingival recession was a strong clinical indicator for the presence of NCCLs.
Bertl 2021
effect of stable Perio status on disease progression using tooth loss during long term SPT in compliant patients (adherence rate of at least 7.5 years)
Stage III & IV patients
Periodontal stability criteria:
- Stable: ≤4mm PD, if 4mm PD w/o BOP, BOP <10% (Chapelle 2018)
- Unstable: Not meeting previous criteria
- Non-Diseased teeth: All 6 sites of tooth ≤ 4mm PD, if 4mm PD w/o BOP
- Diseased teeth: not meeting above criteria
Outcomes assessed
- # of diseased/lost teeth (due to Perio) until last PMT
- # of lost teeth due to any reason until last PMT
Take home
+Only 20% of the patients were classified as stable after active periodontal treatment.
+After a mean follow-up of 10.77 years, 24 patients (25%) lost 38 teeth due to periodontitis.
+An unstable PPS and a higher Nº of diseased teeth per patient at first PMT, along with and poor oral hygiene levels over time, significantly increased the risk for a higher Nº of diseased teeth per patient at last PMT and for more lost teeth due to periodontitis.
+Tooth loss due to any reason was about 3 times higher than tooth loss due to periodontitis and was affected by a larger number of predictors.
However, high compliance to PMT appeared to mitigate the negative effect of an unstable PPS, especially regarding tooth loss due to periodontitis
Achieving a stable PPS is associated with a better prognosis after long-term PMT, while high patient compliance appears to balance a less than optimal result after active treatment.
RAVIDA 2021:
- The regularity of maintenance visits, but not the overall quantity, had a significant impact on risk of TLP and showed higher importance as staging and grading increased (larger impact for stages III/IV and grade C)
- Stage III and IV patients who skip more than 1 year of maintenance in a 5 year period have an increased risk of TLP (OR = 2.55) compared to those only miss 1 year. A similar trend was noted for grade C patients, but not for stages I/II or grades A/B.
Conclusions: Lack of SPT regularity and missing multiple years of maintenance had a larger influence on risk of TLP for higher-level staging and grading.
Anoixiodou
EMD as adjunct to
MINST (Minimally invasive non surgical technique) to tx intrabony defects (≤ 7mm, PD < 6mm, no PARL or mobility)
INCLUSION CRITERIA
(≤ 7mm, PD ≥ 6mm, no PARL or mobility)
Double blind?
Results (12months Minst vs Minst + EMD)
- PD reduction: 4 vs 4.2
- CAL GAIN: 3.5 vs 3.4
- Recession increase: 0.5 vs. 0.7
They didn’t have stent. Clinical photos shows that the CAL gain is most probably due to recession
You can gain 1 mm just from Non Sx - their baseline was before SRP (you can see calculus on X-ray)
BL PD –> 8 mm with Non Sx you should usually get 2 mm
in this case with emdogain
Minst vs Minst + EMD ==> 3.5 + 4.2 (SSD but not clinically Sig.)
Eeckhout
Hyaluronic acid in ARP
HA: Bacteriostatic, anti-inflamma & immunosuppressive
RESULTS
Width reduction → 1.92 control vs 3.5 test
TAKE HOME
Hyaluronic acid failed to promote wound resolution on a collagen matrix and resulted in more horizontal bone lo
HA on collagen membrane
EU ==> Buser allows soft tissue healing few weeks (?) immediate delayed implant placement
US ==> we use human Allograft cancellous or cortical (mineralized) they only diff is particle size
large particle ==> more soft tissue invagination
Cancellous ==> remodels faster than cancellous can do implant earlier (but usually 4-6 is the range)
If you use PTFE (do CHX? unless you use bioXclude) remove it in 4 weeks.
BG + collaPlug ==> Cyanoacrylate
Blanco
Adjunctive Metronidazole for non-Sx tx of Peri-implantitis
Metronidazole: bactericidal
METHODS
clinical, radiog and microbiol. at BL, 3, 6 & 12 months
1 implant diagnosed with peri-implantitis defined as presence of BOP and/or suppuration, probing depth ≥6 mm and ≥3 mm of detectable bone loss after initial re-modelling (Berglundh et al., 2018), and absence of implant mobility.
RESULTS (test vs. ctrl)
PD reduction → 2.5 vs 1 mm
CALgain → 2 vs. 0.5
Radiog bone gain → 2.3 vs. 1.3
Success criteria met: 56% vs. 25%
Micro: less Pg, TF and C. Rectus
Non Sx
Renvert and sculaster did a study showed that non Sx tx is non effective
Take home
The adjunctive use of systemic metronidazole as an adjunct to non-surgical treatment of peri-implantitis has resulted in significant additional improvements in clinical, radiographic, and microbiologic parameters after 12 months of follow-up
Iwasaki: Sleep duration and severe Perio?
Shorter sleep duration was associated with advanced age, current smoking status, and a later sleep onset
Sleep duration <5 hr was more likely to be associated with severe periodontitis than the reference duration of 7–7.9 hr [OR = 2.76]
Take Home
Japanese adults with short sleep duration may be at risk for periodontal destruction, and extra attention should be given to their periodontal
Philip
Effect Mechanical debridement with mouth rinse (CHX or Delmopinol) on micro of ginigvitis vs mucositis
+ Sites with peri-implant mucositis presented with a less diverse and less anaerobic microbiome
+ Exposure to delmopinol or CHX, but not placebo mouthrinses after 1 month resulted in sign. microbial changes
+ The healthy sites around the teeth showed a more diverse and more anaerobe -rich microbiome than the healthy sites around the implants
TAKE HOME
In cases of peri-implant mucositis the adjunctive use of antimicrobial mouth rinses, such as Delmopinol or CHX will affect the peri-implant biofilm composition but will have the same clinical effect as debridement alone
Silva
tissue changes at implants placed in sites with previous ARP in esthetic zone 1 year after final resto
22 months FU of an RCT
2 materials use for ARP (DBBM vs. DBBM-C)
T0: impression b4 EXT
T1: 2 weeks after crown
T2: 1 year after crown
Results (DBBM vs DBBM-C)
- Midfacial level change: NSSD
- Soft tissue thickness: T0-T1 → DBBM performed significantly better at 3 and 5 mm below the mucosal margin.
- , T1-T2 → NSSD for soft tissue thickness and MBL
TAKE HOME
- At the aesthetic zone, advanced recession from tooth extraction to crown placement can be expected at sites treated with ARP regardless of biomaterial used (DBBM or DBBM-C).*
- However, after crown insertion, tissue stability can be predicted*
