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Objective@#To compare the efficacies of two training protocols, i.e. the multimedia instruction and the conventional method, in periodontal surgery teaching for undergraduate students.@*Methods@#One hundred and twenty-three dental undergraduates in their pre-clinical training course were recruited and divided into two groups according to the learning grade matching principle: the experimental group (multimedia instruction, 60 students) and the control group (conventional method, 63 students). The teaching aim was to train the students gingivectomy and periodontal flap surgery by using the pig jaws. The conventional teaching method of teacher-demonstrating and student-practicing was used in the control group, and the practice time of the students′ for each surgery was 45 minutes. A standardized teaching video combined with the teachers′ explanations of the key steps was used in the experimental group. The students′ practice time for each surgery was 60 minutes. The efficacy of teaching protocol was evaluated by the teachers according to the scoring criteria set by the teaching group.@*Results@#In gingivectomy training, accuracy of fixed points, angle of postoperative gingival margin and morphology of gingiva of the experimental group were better than those of the control group. The experimental group also had more complete and continuous excised gingivae and more thorough adjacent gingival removal. The total scores of the experimental group were significantly higher than those of the control group (92.8±2.6 vs. 89.9±3.7, P<0.05). In periodontal flap surgery training, the experimental group operated the blade around the shape of the tooth better in internal bevel incision than the control group. Additionally, the incision position of internal bevel incision, periosteal integrity after flapping and flap depth of the experimental group were better than those of the control group. Besides, the experimental group had smoother flap edge and more thorough debridement. The total scores of the experimental group were significantly higher than those of the control group (92.2±4.1 vs. 89.2±4.4, P<0.05).@*Conclusions@#The teaching efficacy of multimedia instruction was better than that of the conventional method. Its value needs to be further tested in future teaching practice.
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Periodontitis could be categorized as mild, moderate, and severe according to the severity of the disease. This categorizing system could also be used together with other classification systems. The present article introduced the status about the case definition of severe periodontitis, including the standard of case definitions for surveillance of periodontitis reported by the Centers for Disease Control and Prevention (CDC) in partnership with the American Academy of Periodontology (AAP) and the consensus report on the definition of periodontitis case for use in risk factor research by Europe workshop. A consensus on the state of the art definition of severe periodontitis for use in clinical work was gained base on the expertise of Chinese Society of Periodontology, Chinese Association of Stomatology. The background of this consensus and the significance of the criteria for the case definition were discussed.
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It is complicated to decide the treatment plan of hopeless anterior teeth in esthetic zone due to severe periodontitis, periodontal-endodontic combined lesion or teeth trauma.The optional treatment plan for this kind of teeth includes retention after periodontal treatment, extraction and implant treatment, extraction and prosthodontic treatment and so on.To make an appropriate treatment plan, patients'' periodontal conditions, periodontal biotype, local anatomy, esthetic demand, economic condition and social psychological status should be comprehensively considered.A combine of periodontal, endodontic and orthodontic therapy may achieve a good treatment effect in hopeless anterior teeth with severe periodontal destruction, tooth extrusion and occlusal trauma.In this case, a 20-year-old female who presented with symptoms of bleeding on brushing and upper incisors loosening for 1 month came to the Department of Periodontology, Peking University School and Hospital of Stomatology.The clinical examinations revealed that the patient''s right upper incisor had signs of mobility (Ⅲ°), intrusion of 1-2 mm, and probing depth (PD) of 9-10 mm.The periapical radiograph showed that the alveolar bone of right upper incisor absorbed horizontally to the apex.And the patients showed Angle Ⅱ° malocclusion with Ⅱ° overbite in anterior teeth and maxillary protrusion.A diagnosis of aggressive periodontitis and Angle Ⅱ° malocclusion was made.The treatment of this patient lasts for 5 years which include periodontal initial therapy, orthodontic therapy, guided tissue regeneration (GTR) of right upper incisor and supportive periodontal therapy and the clinical result is fine.A hopeless upper incisor was successfully retained and the longtime clinical condition was stable.The strategy of retention of hopeless upper anterior teeth, the relationship of periodontal treatment and orthodontic treatment, and the indications of periodontal and orthodontic combined therapy were also discussed on the basis of this case.Generally, the positive factors in retention of hopeless teeth includes young age, absence of systemic conditions, strong motivation for maintaining the tooth, single root anatomy, integrated dentition, good response to cause-related therapy, intrabony alveolar bone defect, thick periodontal biotype, and regular supportive periodontal therapy.And in the progress of orthodontic therapy, regular supportive periodontal therapy and good plaque control is extremely important.
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Objective: To investigate molecular mechanism involved in nicotine in combination with Porphyromonas gingivalis ( P.g ) caused monocyte-endothelial cell adhesion .Methods: The effect of nicotine, P.g-lipopolysaccharide (P.g-LPS) and their combination on the proliferation of U 937 cells was determined by CCK-8 method .Interleukin-6 ( IL-6 ) expression was investigated by Real-time PCR after U937 cells were treated with nicotine , P.g-LPS and their combination .In human umbilical vein endothe-lial cells ( HUVECs ) , the expressions of monocyte chemoattractant protein CCL-8 and adhesion mole-cules including vascular cell adhesion molecule 1 ( Vcam-1 ) , very late antigen 4 alpha ( VLA4α) , tumor necrosis factor receptor superfamily member 4 ( OX40) and OX40 ligand ( OX40L) were detected by Real-time PCR or Western blotting assays after HUVEC cells were treated with nicotine , P.g-LPS and their combination .Adhesion of monocytes to endothelial cells was detected after the HUVECs and U 937 cells were stimulated with nicotine , P.g-LPS and their combination, respectively.Results:P.g-LPS did not affect the proliferative ability of nicotine in U 937 cells.However, the ability of P.g-LPS induced IL-6 expression was inhibited by 100 μmol/L nicotine in U937 cells.In HUVECs, the expressions of CCL-8, Vcam-1, VLA4α, OX40 and OX40L were significantly up-regulated by nicotine and P.g-LPS combi-nation compared with nicotine alone , P.g-LPS alone and the untreated control .Adhesion of monocytes to HUVECs results showed that the two types of cells treated with nicotine in combination with P.g-LPS could markedly increase the adhesion ability of monocytes to HUVECs .Conclusion:P.g-LPS in combi-nation with nicotine could recruit monocytes to endothelial lesion through up-regulation of CCL-8, and promote adhesion of monocytes to endothelial cells through enhancement of Vcam -1/VLA4αand OX40/OX40L interactions, which could be involved in the initiation and development of atherosclerosis .
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<p><b>OBJECTIVE</b>To evaluate the accuracy of partial- mouth periodontal examination (PMPE) protocols frequently used in epidemiological periodontal surveys.</p><p><b>METHODS</b>Articles in English or Chinese published before Jan 31st 2014 were searched, which compared the results of PMPE protocols with those of gold-standard protocol, i.e.full-mouthmesialbuccal-midbuccal-distobuccal-mesiolingual-midlingual-distolingual (MB-B-DB-ML-L-DL) protocol.</p><p><b>RESULTS</b>Twelve articles were included and nine that frequently used PMPE protocols were evaluated. All these protocols underestimated the prevalence scores. For prevalence of probing depth (PD) ≥ 4 mm, 6 mm and attachment loss (AL) ≥ 4 mm, 6 mm, smaller amount of underestimation was observed in community periodontal index of treatment needs (CPITN) teeth (-12.6%--3.5%), full-mouth MB-B-DB (-16.1%--3.5%), full-mouth MB-B-DL (-10.8%--6.1%) and half-mouth MB-B-DB-ML-L-DL (-23.6%--2.0%) protocols. For severity and extent estimates, half-mouth MB-B-DB-ML- L-DL provided lowest biased results (relative bias: -1.0%- 1.1% for severity and -6.7%-0.1% for extent). Full-and half-mouth MB-B-DB also performed well, with relative bias within ± 5.0% in most cases. CPITN overestimated the severity and extent of periodontal disease, the relative bias of which amounted to 42.3% and 38.1%, respectively.</p><p><b>CONCLUSIONS</b>Half-mouth MB-B-DB-ML-L-DL and full-mouth MB-B-DB protocols caused lower biased results in prevalence, severity and extent estimates of PD and AL.</p>
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Humans , Bias , Dental Care , Health Surveys , Periodontal Attachment Loss , Periodontal Diseases , Epidemiology , Periodontal Index , PrevalenceABSTRACT
Objective:To evaluate the effect of decalcified freeze-dried bone allograft(DFDBA) and DFDBA with platelet-rich plasma(PRP) in the treatment of periodontal infrabony defects.Methods: Fifteen periodontal infrabony defects(30 sites) in 12 patients with periodontitis(9 patients with chronic periodontitis and 3 patients with aggressive periodontitis) were selected.Three months after initial therapy,they were assigned to either the DFDBA group(10 defects with 20 sites) or the DFDBA with PRP group(5 defects with 10 sites).The patients were evaluated for plaque index(PI),bleeding index(BI),probing depths(PD) and clinical attachment loss(CAL) before the treatment and at 6 months after periodontal bone graft surgery.Results: The PI,BI,PD and CAL in the DFDBA group were 1.7,2.7,6.0 mm and 7.0 mm at baseline;1.5,1.8,3.9 mm and 4.4 mm at the 6 months after periodontal surgery.The PD,CAL and BI in DFDBA with PRP group at baseline were 6.2 mm,7.1 mm and 2.9;3.2 mm,3.6 mm and 1.7 at the 6 months after periodontal surgery.The PI did not change significantly after surgery in both groups.While both groups showed significant improvement(P
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Objective:To detect periodontopathic bacterial DNA in atherosclerotic vascular lesions in a group of Chinese patients by using polymerase chain reaction(PCR) techniques.Methods: Ten human specimens of atherosclerotic plaque were obtained sterilely.The sclerotic lesions were blade into fine pieces and DNA was isolated from the samples.To detect Porphyromonas gingivalis(Pg),Tannerella forsythia(Tf),Aggregatibacter actinomycetemcomitans(Aa),Prevotella intermedia(Pi),Prevotella nigre-scens(Pn),Treponema denticola(Td),Campylobacter rectus(Cr),PCR amplification of bacterial 16S ribosomal DNA(rDNA) was carried out.Results: PCR assays for bacterial 16S rDNA indicated the presence of periodontal pathogens in 3 out of 10 surgical specimens.DNA of Pg were found in 3 samples,Tf was found only in one among the 3 samples and Pn was found in another sample among the 3 samples.Conclusion: The data confirm that DNA of periodontal pathogens present in atherosclerotic plaques.Pg,Tf,Pn may play a role in the development and progression of atherosclerosis in these Chinese patients.Further studies with large size samples are needed.
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There were increasing studies on the association of periodontal diseases with coronary heat disease (CHD) in the recent 20 years. This article reviewed the evidence supporting the association between periodontal disease and CHD, the possible mechanisms explaining the association, and the possible effect of periodontal treatment on the risk of CHD. In general, it is suggested that periodontal disease especially periodontitis is modestly associated with CHD. Besides there are some common risk factors, such as smoking, stress, elder age, male gender and low socioeconomic status, between these two diseases, long chronic periodontal infections by periodontal pathogens, the systemic acute-phase response and host immuno-inflammatory response to the exposures of periodontal infection appear to be the important mechanisms for connecting the periodontal disease and CHD. Periodontal treatment can decrease the infection of periodontal pathogens and therefore, reduce the systemic inflammatory burden. It was observed in some studies that periodontal treatment could reduce the serum inflammatory biomarkers such as C-reactive protein and improve endothelial function. Even though the studies on effect of periodontal interfere on CHD are still limited now, it appears hopeful that periodontal treatment could reduce the risk of CHD and therefore become one of the preventing strategies for CHD.
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<p><b>OBJECTIVE</b>To observe the clinical results and the changes of gingival crevicular fluid prostaglandins E(2) (GCF-PGE(2)) levels three months after indomethcin rinsing.</p><p><b>METHODS</b>Nineteen periodontal patients who had received periodontal treatment before were chosen and divided into two groups randomly: indomethcin test group and placebo control group. The clinical parameters and gingival crevicular fluid (GCF) samples were obtained respectively at 0, 1, 3 month. The levels of GCF-PGE(2) were measured by radioimmunoassay (RIA).</p><p><b>RESULTS</b>After 3 months' rinse treatment, the bleeding index and the amounts of GCF in test group decreased significantly than those of the control group. Attachment level improved in test group as well. The levels of GCF-PGE(2) significantly decreased in test group, which not changed in control group. The percentage value of plaque reduced considerably in both test group and control group after rinsing, but no significant difference was found between these two groups.</p><p><b>CONCLUSION</b>Gingival inflammation and the levels of GCF-PGE(2) are reduced after topical indomethcin administration. The effect is related to the decrease of local PGE(2) levels.</p>