Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population-A Prospective Cohort Study.

While periodontitis deteriorates patients' quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients' perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters.

Systematic assessment of clinical outcomes in bone-level and tissue-level endosseous dental implants.

PURPOSE: The aim of the present systematic review was to address the following question: in patients treated with dental implants placed in pristine bone, what are the clinical and radiographic outcomes of bone-level (BL) implants in comparison to tissue-level (TL) implants after restoration with dental prostheses? MATERIALS AND METHODS: Scanning of online literature databases from 1966 to January 2012, supplemented by hand searching, was conducted to identify relevant prospective randomized controlled trials, controlled clinical trials, and cohort studies. Sequential screenings at the title, abstract, and full-text levels were performed independently and in duplicate. A meta-analysis was conducted to compile data from the primary studies included in this systematic review. RESULTS: The search strategy revealed a total of 5,998. Screening at the title level resulted in 752 papers, while screening at the abstract level yielded 92 publications. Full-text reading identified nine articles that fulfilled the inclusion criteria of this review. The pooled estimated difference between BL and TL implants in mean marginal bone loss was 0.05 mm (95% confidence interval [CI], -0.03 to 0.13 mm), with no statistically significant difference between the groups at 1 year after placement of the definitive prostheses. The relative risk of implant loss was estimated at 1.00 (95% CI, 0.99 to 1.02) at 1 year and at 1.01 (95% CI, 0.99 to 1.03) at 3 years after restoration, indicating no evidence of an increased risk of implant loss in BL compared to TL implants. CONCLUSIONS: No statistically significant differences in bone loss and survival rates were detected between BL and TL dental implants over a short-term observation period (1 to 3 years). Thus, both implant systems fulfill the requirements for the replacement of missing teeth in implant dentistry.

Cigarette smoking associated with advanced periodontal destruction in a Greek sample population of patients with periodontal disease.

OBJECTIVES: The objective of this study was to evaluate the possible risk factor related to the severity of periodontal destruction in an adult Greek population and to determine possible risk factors of chronic periodontal disease. METHODS: The 115 participants (mean age 47.5, range 28-74 years) were referred for periodontal treatment in two high-standard therapeutic centers. All individuals were clinically examined and answered a detailed questionnaire. The sociodemographic characteristics and periodontal findings were recorded and statistically analyzed. RESULTS: The prevalence of periodontal destruction was significantly high, as 91.3% of the participants had at least one tooth with attachment loss > or = 7 mm and 73% presented with mean loss of attachment > 4 mm. In this subject cohort, 31.3% had never smoked, 15.7% had quit smoking, and 53% were currently smokers (heavy, moderate, or occasional). Heavy smokers exhibited worse periodontal tissue breakdown and less bleeding tendency compared to moderate, infrequent, or never smokers. Among the other investigated parameters, age and customary oral hygiene practices were correlated with periodontal pocket formation and clinical attachment loss. CONCLUSIONS: The results of this study suggest that smoking appears to be a major environmental factor associated with accelerated periodontal destruction in an adult urban Greek population with regular oral hygiene habits.

Tetracycline fibers as an adjunct in the treatment of nifedipine-induced gingival enlargement.

BACKGROUND: The hypothesis that nifedipine-induced gingival enlargement in periodontitis patients can be treated with the adjunctive use of tetracycline (TCN) fibers was tested in this study. METHODS: Ten patients (mean age 66 +/- 4 years) with chronic periodontitis combined with nifedipine-induced gingival enlargement participated. Full mouth recordings of clinical parameters (probing depth, clinical attachment level, bleeding on probing, presence or absence of plaque) were assessed at baseline and gingival enlargement was estimated from casts. Participants were instructed in proper oral hygiene and received supragingival scaling before being reassessed 1 month later. They subsequently received full-mouth scaling and root planing followed by the immediate placement of TCN fibers in all pockets >5 mm. Clinical parameters were reassessed at 3, 6, and 12 months after completion of treatment. RESULTS: TCN fiber placement was well tolerated by patients. All clinical parameters recorded displayed significant improvements after treatment, and they were preserved for the 12-month experimental period. A significant reduction of the percentage of pockets >5 mm was noticed after treatment. The reduction of enlargement was still observed at 12 months despite patients not achieving optimal oral hygiene. CONCLUSION: Placement of tetracycline fibers as an adjunct to mechanical treatment is an option for the non-invasive therapy of nifedipine-induced gingival enlargement in periodontitis patients whose general medical condition and concomitant ailments do not favor a surgical approach.