Update on the Bidirectional Link Between Diabetes and Periodontitis.

AIM: To provide an update on the evidence on the bidirectional relationship between periodontitis and diabetes. METHODS: This narrative review was focused on recent studies between 2015 and 2020. The literature search was performed on PubMed. The inclusion criteria were systematic reviews, consensus reports and controlled trials assessing the effect of diabetes on periodontitis, the effect of periodontitis on diabetes, and the influence of periodontitis non-surgical treatment on diabetes. RESULTS: Data concerning the influence of periodontitis on diabetes, and the influence of diabetes on periodontitis were summarized in descriptive tables. CONCLUSION: The control of hyperglycemia in the prevention of periodontitis and the control of periodontitis systemic inflammation in the prevention of diabetes, should be take into account in the treatment planning of both diseases.

Update on the Roles of Oral Hygiene and Plaque Control on Periodontal Disease.

AIM: to provide an update of the evidence on the effect of oral hygiene instructions (OHI), dental plaque control and in the prevention and treatment of periodontitis. METHODS: Literature searches were performed using MeSH terms, keywords and free words and were published between 2015 and November 2020. The data from the articles were summarized in a narrative review. RESULTS: Data concerning the influence of OHI on periodontal features, the impact of OHI before periodontitis non-surgical treatment, its efficacity on periodontitis prevention and maintenance of healthy periodontium were summarized in the tables of the present narrative review. CONCLUSION: as prevention is better than a cure, it is relevant to bring in light the role of oral hygiene instructions, the patient self-control of dental plaque as well as the professional mechanical plaque removal in the prevention of periodontitis.

Instrumentation during the second stage of periodontal therapy: a European survey.

OBJECTIVES: To gather practice-based information about instrumentation during the second stage of periodontal therapy among the members of the European Federation of Periodontology. METHODS: This survey was conducted to investigate periodontal instrumentation (e.g., frequency, instruments, their maintenance) during the second stage of periodontal therapy. RESULTS: Questionnaires from 2008 responders actively involved in periodontal therapy (general dental practitioners, periodontists, and dental hygienists) were analyzed. The frequency of use of hand and mechanical instruments was similar during the second stage of periodontal therapy and 94.4% of the participants combined both. The most popular hand instruments were Gracey curettes, and the preferred mechanical devices were ultrasonic scalers. For the latter, mostly the combination of standard and micro/slim inserts was preferred (42.4%) over solely standard inserts (32.1%) or micro/slim inserts (25.5%). The wear of hand instruments was sytematically checked by 46.1% of the respondents and the wear of the inserts by 41.3%. The more experienced the dental professional, the more frequent the wear of the instruments and inserts was checked. CONCLUSION: The most popular periodontal instrumentation technique in clinical practice during the second stage of periodontal therapy is a combination of hand and mechanical instruments. CLINICAL RELEVANCE: Clinicians should check the wear of their instruments systematically to have the most performant instruments possible for periodontal instrumentation. Scientists should see the results of this questionnaire as an incentive to set up studies investigating whether the combination of hand and mechanical instruments, the preferred treatment method of clinicians, is better than either of these instruments alone.

Oral Hygiene Instructions and Methods: A Comparative Survey of European General Dentists, Periodontists and Dental Hygienists.

PURPOSE: To study the practices of general dentists, periodontists and dental hygienists who are members of the European Federation of Periodontology, regarding oral hygiene education, plaque control assessment, recommended dental and interdental hygiene tools, and antimicrobial agents. MATERIALS AND METHODS: A web-based survey was sent to 13,622 members of the European Federation of Periodontology (EFP) through its 29 national member societies. It targeted general dentists (GD), specialists in periodontology (DSP) and dental hygienists (DH). Data were collected between 24 April and 17 May 2015. A data-driven statistical analysis was conducted and differences between professions were explored. RESULTS: A total of 2076 answers were collected. Only the 2009 answers originating from GD, DSP and DH were analysed (67 answers originated from other professions and were excluded). Among those 2009 respondents, 43.2% were DSP and 37.2% were GD. Overall, DH, DSP and GD reported spending 17.1 minutes for the initial teaching of OH, with differences between professions (p < 0.0001). DH, GD and DSP exhibited differences in the type of toothbrushes they recommend (p < 0.0001). DSP recommended electric and manual toothbrushes (TB) equally. DH predominantly recommended electric TB (56.8%). Overall, 95% of DH, DSP and GD recommended interdental brushes, with no statistically significant differences between professions. Low concentration chlorhexidine was considered the most relevant antimicrobial agent for daily oral care of periodontitis patients. Half of GD prescribed antimicrobial mouthrinses for long-term use in 70%-100% of their patients with periodontitis. CONCLUSION: EFP-affiliated practitioners allocate a significant amount of time to educating patients on oral health. Their practices are mostly in line with the current scientific evidence. Some discrepancies were found between the different professions. Similar surveys could be conducted over time to monitor the evolution of practices.

EFP Delphi study on the trends in Periodontology and Periodontics in Europe for the year 2025.

AIM: The aim was to assess the potential trends in Periodontology and Periodontics in Europe that might be anticipated by the year 2025, using the Delphi method. MATERIAL AND METHODS: The expert opinion of 120 experts was sought through the use of an open-ended questionnaire, developed by an advisory group, containing 40 questions concerning the various trends in periodontology. RESULTS: The experts (113 responders) expect a stabilization of the prevalence of periodontitis, both for the chronic as well as the aggressive cases, but an increase in implant-related diseases up to the year 2025. Concurrently, the importance of implants is seen to be increasing. They foresee an increased demand for postgraduate periodontology and implantology training. This is mirrored in an increase in publications for implant dentistry and increase in demand and need for training. Concerning the patients, better-informed individuals seeking more routine check-ups are expected. CONCLUSION: A continued need for specialized periodontists, but also well trained dental practitioners is foreseen for next decade in Europe. Apart from periodontology they will be increasingly exposed to and trained in implant dentistry.

[Need for clinical guidelines for chronic periodontitis in general and specialized Belgian practice]. / Parodontite chronique: pourquoi des recommandations cliniques en pratique générale et spécialisée sont-elles nécessaires en Belgique?

As the prevalence of periodontitis is more than 40 % in the adult Belgian population, periodontists are clearly understaffed to treat this disease in all patients. Therefore, it seems logic that mild forms of chronic periodontitis are treated by the general practitioner especially because Belgium lacks dental hygienists. Important prerequisites for organizing periodontal care as such relate to the general practitioner who should use the same techniques, have comparable communicative skills to motivate patients and create a similar amount of time for periodontal treatment as the specialist. After all, the patient has the right to qualitative treatment regardless of the level of education of the care provider. In order to guarantee this in general practice as much as possible, there is a need for clinical guidelines developed by specialists. These guidelines should not only support the general practitioner in treating disease; above all, they should assist the dentist in periodontal diagnosis. Hitherto, periodontal screening by general dentists seems to be infrequently performed even though reimbursement of the Dutch Periodontal Screening Index is implemented in the Belgian healthcare security system. In this manuscript possible explanations for this phenomenon are discussed. Apart from the need for guidelines in general practice, guidelines for surgical treatment seem compulsory to uniform treatment protocols in specialized practice. Extreme variation in the recommendation of surgery among Belgian specialists calls for consensus statements.