4.12.23_Jon 6 Perio articles

Question 1

What is the impact of perio phenotype in premolars and molars after full-thickness flaps?

Answer 1

Saleh
Primary aim: Assess the impact of Full thickness flaps (FTF) during implant surgery on vertical and horizontal bone loss at adjacent teeth.
* Secondary aim: Evaluate the influence of a patient’s periodontal phenotype on alveolar bone loss.

• O’Leary - first one to mention optimal oral hygiene is < 10% overall plaque score
  Changes measured via CBCT for both the hard and soft tissue.
  Results:
  Facially, mesial site changes were significantly
  higher (−0.31± 0.30 mm) than in the mid (−0.20 ±
  0.22 mm) and distal (−0.24± 0.24 mm) area.
  Lingually: NSSD

Conclusion: Thicker bone (> 2mm) prevented bone loss

Question 2

What implant sizes does Dr. Wang recommend for different M-D posterior ridge widths?

Answer 2

M-D width between crowns:
7-13 mm: 4 or 5mm implant
14-15mm:
* 2 small implants (3.0 or 3.3 or 3.5)
* 1 implant and prosthetically, create a “two heart” shaped crown
* 4.8 x 6.5 Straumann (wide neck)
* 4.1 x 4.8 Straumann is also good.
* 4.8 x 4.8 can be used if not able to gain primary stability with 4.1 x 4.8
* 1 implant, leave a distal space. This means placing the implant more mesially

Question 3

What is the effect of periodontal treatment on HbA1c and metabolic syndrome parameters?

Answer 3

Milanesi
n=79 in 2 groups (perio treated vs. not treated)
All patients had periodontal disease and metabolic syndrome.
Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that
include elevated blood pressure, dysglycemia, atherogenic dyslipidemia &
abdominal obesity.
NSSD between groups with regards to HbA1c, MetS parameters, CRP HOMA indexes. The periodontally treated group did have improvements in periodontal measures.

Question 4

What study did a 10 year followup on M-MIST regeneration for infrabony defects?

Answer 4

Cortellini
Study Aims:
A) To evaluate and compare the clinical stability of:
(1) M-MIST alone
(2) M-MIST + EMD
(3) M-MIST + EMD + bone-mineral-derived xenograph (BMDX) in
intrabony defects
B) To evaluate the costs of re-interventions required over a follow-up period of 10 years
with regular SPC.

n=45 patients
NSSD in outcomes for the 3 groups
The estimated complication-free survival
was 7.46 years (95% CI: 7.05–7.87, N =
45) for the whole population.

In cost comparisons: M-MIST is the cheapest

Question 4

What study did a 10 year followup on M-MIST regeneration for infrabony defects?

Answer 4

Cortellini
Study Aims:
A) To evaluate and compare the clinical stability of:
(1) M-MIST alone
(2) M-MIST + EMD
(3) M-MIST + EMD + bone-mineral-derived xenograph (BMDX) in
intrabony defects
B) To evaluate the costs of re-interventions required over a follow-up period of 10 years
with regular SPC.

n=45 patients
NSSD in outcomes for the 3 groups
The estimated complication-free survival
was 7.46 years (95% CI: 7.05–7.87, N =
45) for the whole population.

In cost comparisons: M-MIST is the cheapest

Question 5

Which study looked at the longevity of teeth in patients susceptible to periodontitis over 30 years

Answer 5

Agudio
n= 642 patients
30-year followup of tooth loss after active periodontal therapy

154 patients were compliant over 25 years
Tooth loss rate: 3.6%
In comparison:
* Eickholz ‘08: 6.7%
* Matuliene ‘10: 7.2%

Risk factors for tooth loss per the 2017 WW:
Stage III or IV vs. I or II: OR = 2.10
Generalized vs. Localized: OR = 3.24

Question 6

What study looked at the periodontal risk score: Initiation and model validation for 6,762 teeth?

Answer 6

Saleh
Created the Periodontal Risk Score (PRS) based on strengthening the weak points of the Miller-McEntire Periodontal Prognostic Index (MMPPI)
** * Score 1: Excellent prognosis
* Score 2: Good prognosis
* Score 3: Guarded prognosis**

Compared the performances between the MMPPI vs. PRS = PRS displayed excellent predictive capability for anterior as well as posterior tooth loss due to periodontitis.

Question 7

What systematic review examined treatment of periodontitis and systemic inflammation (via CRP)?

Answer 7

Luthra
Systematic review: 26 RCT’s
Compared the effect on CRP of two groups:
* NSPT
* “no treatment” (only OHI with prophies)
Treatment of periodontitis reduced CRP by 0.69 mg/L over 6 months - however, results were heterogeneous