Minimal invasiveness in nonsurgical periodontal therapy.

Periodontal treatment is quickly moving towards a philosophy consisting of a less invasive approach. In this context, minimally invasive nonsurgical therapy (MINST) is a promising option. This paper reviews the concepts behind minimal invasiveness in nonsurgical periodontology and reports the state-of the art evidence for this topic. Instruments used and protocols suggested for these applications are introduced and discussed. The original papers reviewed show probing pocket depth (PPD) reductions and clinical attachment level (CAL) gains ranging from 2 to 4 mm between baseline and 6 months to 5 years posttreatment for intrabony defects and from 1.5 to 3 mm between baseline and 2-6 months of follow-up for full-mouth results. These clinical outcomes are accompanied by statistically significant reductions in radiographic bone defect depth and increases in intrabony defect angles posttreatment. Wound healing mechanisms following MINST are presented, and clinical applications and directions for future research are suggested.

Awareness, practices, training, and confidence of Paediatric Diabetes Care Teams in relation to periodontitis.

Diabetes and periodontal disease are non-communicable chronic diseases that have a bi-directional relationship. The European Federation of Periodontology and International Diabetes Federation recommend patients with diabetes should be screened for periodontal disease and referred to a dental professional where appropriate. This study investigated the awareness among Paediatric Diabetes Care Teams across England and Wales of diabetes as a risk factor for periodontal disease. The study enquired to the practices, training, and confidence of health care professionals in relation to periodontal disease. A semi-structured online questionnaire was sent to all health care professionals working within Paediatric Diabetes Care Teams across England and Wales. Findings showed that 76.2% of participants were aware that periodontitis is a possible complication of diabetes. Only 5.2% screened for periodontal issues, while 27% of respondents stated that oral advice is not typically given to patients at their clinics and 92.3% said that there is no access to a periodontal service within their clinics. There were 76.4% participants who stated that patients are rarely or never referred to an external dental service for their periodontal health. Only 4.8% of respondents said they have received training for recognizing patients who require dental care for their periodontal health, while 23.2% feel confident identifying children who require referral and 85.4% of participants feel they would benefit from further training in periodontal health. In conclusion, patients are not routinely being informed of the risk of periodontitis or being screened or referred for it. Further training would be perceived as beneficial.