| 1. |
- Cosgarea, Raluca, et al.
(author)
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Non-surgical periodontal treatment in conjunction with 3 or 7 days systemic administration of amoxicillin and metronidazole in severe chronic periodontitis patients : A placebo-controlled randomized clinical study
- 2016
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 43:9, s. 767-777
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Journal article (peer-reviewed)abstract
- AIM: To evaluate the effect of 3 or 7 days systemic administration of amoxicillin (AMX) and metronidazole (MET) or placebo as adjunct to non-surgical periodontal treatment in severe chronic periodontitis patients. METHODS: One hundred and two patients with severe chronic periodontitis [e.g. ≥1 site with probing pocket depth (PD) ≥ 6 mm per quadrant] were randomly divided into three equally sized groups and treated with either scaling and root planing within 24 h (SRP) + placebo (Group A) or SRP + AMX + MET (both 500 mg × 3 times daily) for 3 days (Group B) or SRP + AMX + MET (both 500 mg × 3 times daily) for 7 days (Group C). PD, clinical attachment level (CAL), bleeding on probing (BOP), full-mouth plaque scores (FMPS) and gingival bleeding index (GBI) were assessed prior to treatment (baseline), and at 3 and 6 months post-treatment. The primary outcome variable was the difference (Δ) in the number of sites with PD ≥ 6 mm. RESULTS: Ninety-one patients completed the study. At both 3 and 6 months, all three treatment protocols resulted in statistically significant improvements compared to baseline for all evaluated clinical parameters (p < 0.001). At 6 months, a statistically significantly greater reduction in the mean number of sites with PD ≥ 6 mm was observed in group B (28.62 ± 15.32 sites) and group C (30.45 ± 15.04 sites) compared to the placebo group (17.10 ± 14.68 sites). Furthermore, both the 3- and the 7-day antibiotic regimen resulted in statistically significantly higher clinical improvements compared to the placebo group (p < 0.05). CONCLUSION: The present findings indicate that in patients with severe chronic periodontitis, non-surgical periodontal therapy in conjunction with a 3 or 7 days systemic administration of AMX + MET may lead to significantly greater clinical improvements compared to non-surgical therapy alone.
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| 2. |
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| 3. |
- Eick, Sigrun, et al.
(author)
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Adhesion of Porphyromonas gingivalis and Tannerella forsythia to dentin and titanium with sandblasted and acid etched surface coated with serum and serum proteins - An in vitro study
- 2017
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In: Archives of Oral Biology. - : Elsevier. - 0003-9969 .- 1879-1506. ; 75, s. 81-88
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Journal article (peer-reviewed)abstract
- Objective: To evaluate the adhesion of selected bacterial strains incl. expression of important virulence factors at dentin and titanium SLA surfaces coated with layers of serum proteins. Methods: Dentin-and moderately rough SLA titanium-discs were coated overnight with human serum, or IgG, or human serum albumin (HSA). Thereafter, Porphyromonas gingivalis, Tannerella forsythia, or a six species mixture were added for 4 h and 24 h. The number of adhered bacteria (colony forming units; CFU) was determined. Arg-gingipain activity of P. gingivalis and mRNA expressions of P. gingivalis and T forsythia proteases and T. forsythia protease inhibitor were measured. Results: Coating specimens never resulted in differences exceeding 1.1 log10 CFU, comparing to controls, irrespective the substrate. Counts of T forsythia were statistically significantly higher at titanium than dentin, the difference was up to 3.7 log10 CFU after 24 h (p = 0.002). No statistically significant variation regarding adhesion of the mixed culture was detected between surfaces or among coatings. Arggingipain activity of P. gingivalis was associated with 1og10 CFU but not with the surface or the coating. Titanium negatively influenced mRNA expression of T. forsythia protease inhibitor at 24 h (p = 0.026 uncoated, p = 0.009 with serum). Conclusions: The present findings indicate that: a) single bacterial species (T forsythia) can adhere more readily to titanium SLA than to dentin, b) low expression of T. forsythia protease inhibitor may influence the virulence of the species on titanium SLA surfaces in comparison with teeth, and c) surface properties (e.g. material and/or protein layers) do not appear to significantly influence multi-species adhesion. (C) 2016 Elsevier Ltd. All rights reserved.
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| 4. |
- Eick, Sigrun, et al.
(author)
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Gingipains impair attachment of epithelial cell to dental titanium abutment surfaces
- 2019
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In: Journal of Biomedical Materials Research. Part B - Applied biomaterials. - : John Wiley & Sons. - 1552-4973 .- 1552-4981. ; 107:8, s. 2549-2556
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Journal article (peer-reviewed)abstract
- The study investigated in vitro the effect of Porphyromonas gingivalis and its cysteine proteases (gingipains) on epithelial cell adhesion to titanium-zirconium alloy surfaces. Titanium-zirconium discs with a standard machined (M) or chemically modified hydrophilic surface (modM) were coated with lamin-5 and incubated with telomerase-inactivated gingival keratinocytes (TIGK). Three P. gingivalis strains or gingipains were either added simultaneously with TIGK or after TIGK cells were already attached to the disks. Adhered TIGK cells were counted at 24 h. All P. gingivalis strains clearly inhibited adhesion of TIGK cells to M and modM surfaces. Compared with bacteria/gingipain-free TIGK cell cultures, the number of attached TIGK cells was reduced by about 80% and 60% when P. gingivalis was added simultaneously or after TIGK cells were already attached to the disks (each p < 0.01), respectively. Counts of attached cells were similarly reduced when only gingipains were used. Adhesion molecules of TIGK cells, in particular E-cadherin, were cleaved by P. gingivalis. In conclusion, P. gingivalis and gingipains interfere with the adhesion of epithelial cells to titanium-zirconium alloy surfaces by cleaving adhesion molecules, while a chemically modified hydrophilic titanium-zirconium alloy surface did not yield any protection. (c) 2019 Wiley Periodicals, Inc. J Biomed Mater Res B Part B, 2019.
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| 5. |
- Herrera, David, et al.
(author)
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Consensus report of the second European Consensus Workshop on Education in Periodontology
- 2024
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In: JOURNAL OF CLINICAL PERIODONTOLOGY. - 0303-6979 .- 1600-051X.
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Journal article (peer-reviewed)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. |
- Horváth, Attila, et al.
(author)
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Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste
- 2013
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In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 17:2, s. 423-430
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of the study was to clinically and histologically evaluate the healing of human intrabony defects treated with open flap surgery (OFD) and application of a new, resorbable, fully synthetic, unsintered, nanocrystalline, phase-pure hydroxyapatite (nano-HA). MATERIALS AND METHODS: Six patients, each of them displaying very advanced intrabony defects around teeth scheduled for extraction due to advanced chronic periodontitis and further prosthodontic considerations, were included in the study. Following local anaesthesia, mucoperiosteal flaps were reflected; the granulation tissue was removed, and the roots were meticulously debrided by hand and ultrasonic instruments. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) in order to serve as a reference for the histological evaluation. Following defect fill with nano-HA, the flaps were sutured by means of mattress sutures to allow primary intention healing. At 7 months after regenerative surgery, the teeth were extracted together with some of their surrounding soft and hard tissues and processed for histological analysis. RESULTS: The postoperative healing was uneventful in all cases. At 7 months following surgery, mean PPD reduction and mean CAL gain measured 4.0 ± 0.8 and 2.5 ± 0.8 mm, respectively. The histological analysis revealed a healing predominantly characterized by epithelial downgrowth. Limited formation of new cementum with inserting connective tissue fibers and bone regeneration occurred in three out of the six biopsies (i.e. 0-0.86 and 0-1.33 mm, respectively). Complete resorption of the nano-HA was found in four out of the six biopsies. A few remnants of the graft particles (either surrounded by newly formed mineralized tissue or encapsulated in connective tissue) were found in two out of the six biopsies. CONCLUSION: Within their limits, the present results indicate that nano-HA has limited potential to promote periodontal regeneration in human intrabony defects. CLINICAL RELEVANCE: The clinical outcomes obtained following surgery with OFD + nano-HA may not reflect true periodontal regeneration.
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| 7. |
- Horváth, Attila, et al.
(author)
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Histologisk evaluering af humane intraossøse parodontale defekter behandlet med en usintret nanokrystallinsk hydroxyapatit pasta
- 2013
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In: Tandlægebladet. - : Dansk Tandlægeforening. - 0039-9353. ; 117:1, s. 12-13
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Journal article (other academic/artistic)abstract
- Formål Formålet med undersøgelsen var at evaluere den kliniske og histologiske heling af humane intraossøse defekter behandlet med konventionel flapkirurgi (OFD) og anvendelse af en ny, resorberbar, fuldsyntetisk, usintret, nanokrystallinsk, hydroxyapatit (nano-HA ). Materialer og metoder Seks patienter, som hver viste en meget avanceret intraossøs defekt omkring en tand planlagt til ekstraktion på grund af svær kronisk marginal parodontitis og yderligere restaurerende overvejelser, blev inkluderet i undersøgelsen. Efter lokalbedøvelse, mucoperiosteal lapløft, granulationsvævs fjernelse og omhyggelig roddepuration og afglatning med hånd- og ultralydsinstrumenter blev der på roden placeret et mindre boremærke ved den mest apikale tilstedeværelse af tandsten eller ved bunden af defekten (hvis ikke tandsten var til stede); boremærket tjente som reference ved den histologiske evaluering. Efter defektudfyldelse med nano-HA blev lapperne syet ved hjælp af madras-suturer mhp. primær heling. Syv måneder efter regenerativ kirurgi blev tænderne ekstraheret sammen med en mindre del af de omgivende bløde og hårde væv og præpareret til histologisk undersøgelse. Resultater Postoperativ heling var komplikationsfri i alle tilfælde. Syv måneder efter operationen sås der betydelig pochedybdereduktion og klinisk fæstegevinst på 4,0 mm ± 0,8 mm og 2,5 mm ± 0,8 mm, henholdsvis. Den histologiske analyse viste, at helingen hovedsageligt kendetegnede sig ved et lang epitelialt fæste. Begrænset dannelse af ny cement med indlejrede kollagenfibre og knogleregeneration sås hos tre ud af de seks biopsier på op til henholdsvis 0,86 mm og 1,33 mm. Komplet resorption af nano-HA-partikler blev fundet i fire ud af de seks biopsier. Nogle få rester af de implanterede partikler (enten omgivet af nydannet mineraliseret væv eller indkapslet i bindevæv) blev fundet i to ud af de seks biopsier. Konklusion De foreliggende resultater viser, at nano-HA har begrænset mulighed for at fremme parodontal regeneration i humane intraossøse defekter. Klinisk relevans: De kliniske resultater opnået efter kirurgi med OFD + nano-HA afspejler måske ikke ægte parodontal regeneration. Horváth A, Stavropoulos A, Windisch P et al. Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste. Clin Oral Investig 2012.
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| 8. |
- Hämmerle, Christoph H F, et al.
(author)
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Biology of soft tissue wound healing and regeneration : consensus report of group 1 of the 10th European workshop on periodontology
- 2014
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 41:s15, s. S1-S5
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Journal article (other academic/artistic)abstract
- BACKGROUND:The scope of this consensus was to review the biological processes of soft tissue wound healing in the oral cavity and to histologically evaluate soft tissue healing in clinical and pre-clinical models. AIMS:To review the current knowledge regarding the biological processes of soft tissue wound healing at teeth, implants and on the edentulous ridge. Furthermore, to review soft tissue wound healing at these sites, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. COLLECTION OF DATA:Searches of the literature with respect to recessions at teeth and soft tissue deficiencies at implants, augmentation of the area of keratinized tissue and soft tissue volume were conducted. The available evidence was collected, categorized and summarized. FUNDAMENTAL PRINCIPLES OF ORAL SOFT TISSUE WOUND HEALING:Oral mucosal and skin wound healing follow a similar pattern of the four phases of haemostasis, inflammation, proliferation and maturation/matrix remodelling. The soft connective tissue determines the characteristics of the overlaying oral epithelium. Within 7-14 days, epithelial healing of surgical wounds at teeth is completed. Soft tissue healing following surgery at implants requires 6-8 weeks for maturation. The resulting tissue resembles scar tissue. Well-designed pre-clinical studies providing histological data have been reported describing soft tissue wound healing, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. Few controlled clinical studies with low numbers of patients are available for some of the treatments reviewed at teeth. Whereas, histological new attachment has been demonstrated in pre-clinical studies resulting from some of the treatments reviewed, human histological data commonly report a lack of new attachment but rather long junctional epithelial attachment and connective tissue adhesion. Regarding soft tissue healing at implants human data are very scarce. CONCLUSIONS:Oral soft tissue healing at teeth, implants and the edentulous ridge follows the same phases as skin wound healing. Histological studies in humans have not reported new attachment formation at teeth for the indications studied. Human histological data of soft tissue wound healing at implants are limited. CLINICAL RECOMMENDATIONS:The use of barriers membranes, growth and differentiation factors and soft tissue substitutes for the treatment of localized gingival/mucosal recessions, insufficient amount of keratinized tissue and insufficient soft tissue volume is at a developing stage.
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| 9. |
- Kloukos, Dimitrios, et al.
(author)
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Gingival Thickness Assessment at Mandibular Incisors of Orthodontic Patients with Ultrasound and Cone-beam CT : A Cross-sectional Study
- 2021
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In: Oral Health & Preventive Dentistry. - : Quintessence. - 1602-1622 .- 1757-9996. ; 19:1, s. 263-270
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Journal article (peer-reviewed)abstract
- Purpose: To use and evaluate two methods for measuring gingival thickness (GT) at mandibular incisors of orthodontic patients and compare their performance in assessing periodontal anatomy through soft tissue thickness. Materials and Methods: The sample consisted of 40 consecutive adult orthodontic patients. GT was measured just before bracket placement at both central mandibular incisors, mid-facially on the buccal aspect, 2 mm apically to the free gingival margin with two methods: clinically with an ultrasound device (USD) and radiographically with cone beam computed tomography (CBCT). Results: CBCT measurements were consistently higher than USD measurements, with the difference ranging from 0.13 mm to 0.21 mm. No statistically significant difference was noted between the repeated CBCT measurements at the right central incisor (bias = 0.05 mm; 95% CI =-0.01, 0.11; p = 0.104). Although the respective results for the left incisor statistically indicated that the measurements were not exactly replicated, the magnitude of the point estimate was small and not clinically significant (bias = 0.06 mm; 95% CI = 0.01, 0.11; p = 0.014). Small differences between CBCT measurements made by the 2 examiners at the left central incisor (bias = 0.06 mm; 95% CI = 0.01, 0.11; p = 0.014) were detected. However, this difference was minor and also not clinically significant. The respective analysis on the right incisor showed no statistically significant difference (bias = 0.05 mm; 95% CI =-0.01, 0.11; p = 0.246). Conclusions: Based on reproducibility, CBCT imaging for gingival thickness assessment proved to be as reliable as ultrasound determination. However, CBCT consistently yielded higher values, albeit at a marginal level, than did the ultrasound device.
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| 10. |
- Kloukos, Dimitrios, et al.
(author)
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Transgingival probing : a clinical gold standard for assessing gingival thickness
- 2021
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In: Quintessence International. - : Quintessence. - 0033-6572. ; 52:5, s. 394-401
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Journal article (peer-reviewed)abstract
- Objective: Transgingival probing is often used in the clinic to assess gingival thickness. However, what is not completely known is how well this method represents the true value of soft tissue thickness. The aim of this study was to assess differences and variation in gingival thickness when measured with trans-gingival probing or scanned with an intraoral device. Method and materials: This ex vivo study evaluated gingival thickness on 20 porcine cadavers. Gingival thickness was assessed at both central and lateral mandibular incisors through transgingival probing with a standard metal periodontal probe and also using intraoral scanning, which was considered as the method providing the 'true value' of soft tissue thickness. Intra-examiner repeatability and method error were evaluated. Results: No evidence of systematic difference for any of the mandibular central or lateral incisors (mandibular right incisors: mean difference -0.17 to -0.01 mm, and mandibular left incisors: mean difference -0.11 to 0.04 mm) was observed between the periodontal probe and intraoral scanning methods. The absolute differences between the repeated measurements with intraoral scanning for each tooth type (n = 30) were calculated: the overall median was 0.089 mm and the interquartile range was 0.080 mm. Conclusions: Transgingival probing with a standard metal periodontal probe for assessing gingival thickness is a reliable method, with values very close to the true gingival thickness, and it can thus be considered as the clinical gold standard.
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