| 1. |
- Hussain, Badra, et al.
(författare)
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Peri-Implant Health and the Knowing-Doing Gap-A Digital Survey on Procedures and Therapies
- 2021
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Ingår i: FRONTIERS IN DENTAL MEDICINE. - : Frontiers Media S.A.. - 2673-4915. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Peri-implant tissue maintenance and treatment is becoming a serious challenge in implantology. With increasing numbers of implants being placed, more cases of peri-implant mucositis and peri-implantitis is seen. A digital survey on peri-implant disease management was issued to experts in periodontology and implantology to identify the tools and procedures most commonly used today to treat peri-implant diseases and successfully manage peri-implant health. The primary aim was to assess whether there is consensus in the choice of treatment to manage peri-implant diseases and to prevent their recurrence once treated. The secondary aim was to obtain insight into future protocols and /or devices, and the research and development needed.Materials and Methods: Participants in this digital survey were professionals specialising in periodontology, oral surgery, and implant dentistry. The questionnaire included both a series of closed- and open-ended questions. A total of 16 countries participated. The survey was sent by e-mail to 70 individuals, 66 received the survey and 37 of receivers responded, two of the participants were excluded due to insufficient filling of the survey. In the end 35 respondents completed the survey.Results: Respondents agree that the efficacy of mechanical and chemical decontamination of implant surfaces needs to be improved and better documented. It is a common opinion that the current remedies, mostly adapted from periodontal practises, do not provide effective and reliable clinical outcomes when treating peri-implant ailments. There is a general agreement amongst experts that regularly scheduled (3-6-month intervals) maintenance treatments are essential for maintaining peri-implant health in patients experiencing implant complications. Respondents are also concerned about unnecessary use of systemic antibiotics for managing peri-implant health.Conclusion: Regardless of agreements in parts, there was no observed consensus on the most effective treatment options for treating peri-implantitis. The experts all agree it is an urgent need for well-designed, long-term follow-up randomised and controlled clinical trials comparing interventions to provide an evidence-based strategy for peri-implant health management.
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| 2. |
- Berglundh, Jessica, 1989, et al.
(författare)
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Clinical findings and history of bone loss at implant sites.
- 2021
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 32:3, s. 314-323
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate whether clinical findings at implant sites are relevant as screening tests for a history of marginal bone loss.427 patients provided with implant-supported reconstructions 9 years earlier were evaluated clinically (probing pocket depth (PPD), bleeding on probing (BoP)) and radiographically. A history of bone loss was confirmed through baseline documentation. Diagnostic accuracy was evaluated through Receiver Operating Characteristic curves and multi-level regression analyses. Results were expressed as sensitivity/specificity, area under the curve and odds ratios.While the sensitivity of PPD in regard to bone loss was low, specificity was generally high. Multi-level modelling revealed that each additional millimeter of PPD corresponded to an additional bone loss of 0.30 mm (95%CI 0.27; 0.33). The sensitivity of BOP in regard to bone loss >2 mm was 80.9% (95%CI 73.9; 86.7), while the specificity was 42.2% (95%CI 39.6; 44.8).Clinical parameters at implant sites obtained at a single time point were associated with a history of marginal bone loss. While BoP demonstrated a high level of sensitivity, the sensitivity of PPD was generally low. The present data suggest that BoP is a relevant screening test for history of bone loss.
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| 3. |
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| 4. |
- Figuero, Elena, et al.
(författare)
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Domains, competences and learning outcomes for undergraduate education in periodontology
- 2024
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Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This review is intended to adapt the current conceptual framework in dental education based on four domains to propose a set of competences, learning outcomes and methods of teaching, learning and assessment for undergraduate education in periodontology.Review: Based on the current framework of competences and learning outcomes recommended by the Association for Dental Education in Europe (ADEE), undergraduate education in periodontology has been updated using the classification and clinical practice guidelines for the diagnosis and treatment of periodontal and peri-implant diseases.Conclusions: Specific learning outcomes have been proposed within each competence area, that is in Domain I (n = 10), Domain II (n = 13), Domain III (n = 33) and Domain IV (n = 12). Teaching methods and learning activities based on the different dimensions of the cognitive process have been proposed. Additionally, 10 key learning outcomes have been proposed as exit outcomes, which implies their accomplishment within the final assessment of any graduating student.
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| 5. |
- Herrera, David, et al.
(författare)
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Consensus report of the second European Consensus Workshop on Education in Periodontology
- 2024
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Ingår i: JOURNAL OF CLINICAL PERIODONTOLOGY. - 0303-6979 .- 1600-051X.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe second European Consensus Workshop on Education in Periodontology was commissioned, as a result of the changes in the discipline and the advances in educational methods/technology, to update the 2009 Consensus report of the first European Federation of Periodontology (EFP) Workshop on the same topic that was jointly authored by the Association for Dental Education in Europe.AimTo identify and propose changes necessary in periodontal education at three levels, namely undergraduate, specialist and continuing professional development (CPD), with respect to learning outcomes, competencies and methods of learning/training and evaluation.MethodsFour working groups (WGs) considered education in periodontology at the undergraduate, specialist and CPD levels, and education methods. Four commissioned position papers, one per WG, summarized the relevant information. Workshop participants gathered at an in-person consensus meeting to discuss the individual reviews, and this consensus report summarizes the conclusions.ResultsThe learning outcomes for undergraduate and specialist education in periodontology have been updated, and a proposal for learning outcomes for CPD programmes was made. Learning/teaching/training and evaluation methods were proposed for each level of education, which included face-to-face, virtual and blended learning methods.ConclusionDevelopments in oral/dental medicine and in contemporary educational technologies have been translated into updated learning outcomes and learning/teaching/ training/evaluation methods relevant to education in periodontology.
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| 6. |
- Romandini, Mario, et al.
(författare)
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Diagnosis of peri-implantitis in the absence of baseline data: a diagnostic accuracy study.
- 2021
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 32:3, s. 297-313
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate the diagnostic accuracy of clinical and radiographic evaluations made at a single time point during follow-up in identifying (i) a history of peri-implant bone loss and (ii) the presence of peri-implantitis.427 patients provided with implant-supported reconstructions 9 years earlier were evaluated clinically by Probing Pocket Depth, Bleeding or Suppuration on Probing (PPD, BoP & SoP) and radiographically. Bone levels were assessed relative to the most coronal point of the intra-osseous part of the implant. A history of bone loss and diagnosis of peri-implantitis was confirmed through baseline documentation (direct evidence). Diagnostic accuracy of radiographic bone levels at 9 years and clinical findings (indirect evidence/secondary case definition) in identifying a history of bone loss and peri-implantitis were evaluated through correlation and multi-level regression analyses as well as Receiver Operating Characteristic curves. Results were expressed as sensitivity/specificity and area under the curve (AUC).Bone levels observed at 9 years were highly accurate in identifying pronounced bone loss (>2 mm; AUC=0.96; 95%CI 0.95-0.98). In the absence of baseline documentation, a secondary case definition based on the presence of BoP/SoP & bone level ≥1 mm (indirect evidence) provided the overall best diagnostic accuracy (AUC=0.80; 95%CI 0.77-0.82) in identifying peri-implantitis cases (direct evidence: BoP/SoP & bone loss >0.5 mm). Moderate/severe peri-implantitis (BoP/SoP & bone loss >2 mm) was most accurately identified by the combination of BoP/SoP & bone level ≥2 mm (AUC=0.93; 95%CI 0.91-0.96). Sensitivity of the secondary case definition suggested by the 2017 World Workshop of Periodontology (WWP) (BoP/SoP ≥1 site & bone level ≥3 mm & PPD ≥6 mm) was low.The present results underline the importance of baseline documentation for the correct diagnosis of peri-implantitis, especially in its early/incipient forms. The secondary case definition of peri-implantitis suggested at the 2017 WWP demonstrated a high level of specificity but low sensitivity. Moderate/severe peri-implantitis was most accurately identified by the combination of BoP/SoP & bone level ≥2 mm.
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| 7. |
- Thoma, Daniel S., et al.
(författare)
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Soft tissue management at implants: : Summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021
- 2021
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 32:S21, s. 174-180
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient-reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment.Materials and methods: Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions.Results: The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority. Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased. A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes. PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs.Conclusions: Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited.
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