JCP 1 - Galli

Question 1

Rotundo

Answer 1

• Factors influencing the aesthetics of smile: An observational study on clinical assessment and patient’s perception*
• Used the Smile Esthetic Index (SEI) (Rotundo 2015) to assess smile aesthetics (10 variables)

Aim: to assess smile aesthetics and influencing factors

Cross sectional n=100 (80 had high school of college)
Questionaire: Do you perceive that you have 1 or more of these issues? Grade from 0-10 how much discomfort from this.
Rotundo exams

Results:
NO CORRELATION btw clinical assessment (SEI) and patient’s perceived esthetics (VAS)
~40% notice tooth alignment
~33% notice discoloration
~25% notice papilla loss/diastema
Only ~20% of recession recognized by patient (deep/maxilla/front)

Patient may not preceive abnormal factors as negative

Question 2

Muñoz

Answer 2

Bone-level changes around implants with 1- or 3-mm-high abutments and their relation to crestal mucosal thickness: a 1yr RCT

Aim: to evaluate 1-yr bone level changes at implants w/ 1 or 3mm abutments (subcrestal + PS). Does mucosal thickness influence?

RCT - n=69p 112i - Implants placed 1.5mm subcrestal - receive 1 or 3mm abutments - followed for 1yr and radiographed

MT ranged from 1-5mm (3mm most common - 1 in 3)

Results:
NSD Crestal bone level changes
SSD interproximal MBL favoring 3mm group
No correlation with initial MT

(what about different connections? ex hex, int hex, morse…)

Question 3

Deng (Tonetti)

Answer 3

• DANG - your gums are bleeing*
• Gingival bleeding on brushing as a sentinel sign of gingival inflammation: A diagnostic accuracy trial for the discrimination of periodontal health and disease*

Aim: 1: assess diagnostic accuracy of GBoB for health vs disease - 2: define optimal Hb concentration for self-detection of GBoB

M&M: Brush - Saliva/Toothpaste slurry collection - self assess blood

Sensitivity:
Health: 60% - Disease: 40%
Specificity:
Health: 84% - Disease: 84%

Results: Self reported GBoB had SSD higher Hb concentration
%Hb positive correlation w/: number of bleeding sites | number pockets _>_4mm | number pockets _>_6mm (highest corr.) | number bleeding pockets

Conclusion: Low sensitivity for detecting disease - promising sentinel marker for health/disease - may improve self awareness - visible even after minor blood loss

Question 4

Huang

Answer 4

Clinical evaluation of XCM vs FGG for KT augmentation around implants: an RCclinicalT

Aim: to eval outcomes of ArPF w/ XCM vs FGG in KTW autmentation around implants

n=26 (13 vs 13)

3 and 6mo follow ups

Results:
FGG resulted in ~2mm more KTW vs XCM
FGG resulted in ~9x more MT
XCM better color/worse texture - NSSD in aesthetic
NSSD in pain/satisfaction

Conclusion:
FGG greater but XCM better chair time - valid alternative

no subanalysis - small sample - supported by Geistlich - No photos

Question 5

Cosyn

Answer 5

A multi-centre RCT comparing CTG vs collagen matrix to increase soft tissue thickness at the buccal aspect of single implants: 3mo results

Aim: longitudinally compare Buccal Soft Tissue Profile (BSP) in CTG vs CMX at implants (IMMEDIATE IMPLANT w/ CTG vs XCM)

M&M: Single anterior immediate implant w/ CTG or XCM - 3mo - assess BSP w/ iOS - clinical and pt-reported outcomes

Results:
SSD more shrinkage in CMX vs CTG (0.8mm difference)
NSSD in outcome but trend favoring CTG (BSP increase 1.5mm vs 0.85mm) (p=0.054)
CMX: lower VAS/chair time - higher MBL (+0.38mm) - deeper pockets (+0.3mm) - midfacial recession (+0.75mm)

Question 6

Thoma (Hämmerle)

Answer 6

Two short implants vs one short w/ cantilever: 5-yr results of RCT

n=36

M&M: ONE-C vs TWO - 1yr FU - 3yr FU - 5yr FU - PD/BOP/PCR/Technical complications….

Results:
NSSD in technical complications (screw loosening/chipping - both 44%) - trend toward ONE-C higher
NSSD mucositis or Pi
ONE-C: more early failure (within 1yr)
NSSD Survival
NSSD clinical parameters/MBL

Conclusion
similar survival/MBL/biologic/technical complications - Cantilever may increase early failure suggesting overload

(no data on maxilla vs mandible or cantilever side mesial vs distal)

Question 7

Saleh (Dukka, Troiano, Ravida, Galli, Qazi, Greenwell, Wang)

Answer 7

External validation and comparison of the predictive performance of `10 different tooth-level prognostic systems

Retrospective - n=148p 3787teeth

Med hx/smoking status/maintenance/10yr minimum/perio chart

Average follow up 26.5yrs

All systems had Harrell’s C-index ranging from 0.925 to 0.949
(all had good predictive capacity for TLP)
Best - Miller 2014
2nd - Nunn 2012
Worst - Fardal 2004

Question 8

Stein

Answer 8

Comparison of three full-mouth concepts for non-surgical treatment of stage III and IV perio - an RCT

• *QSRP -** Quandrant-wise SRP 1wk apart
• *FMS** - Full-mouth SRP in 24hrs
• *FMD** - Full-mouth disinfection - SRP in 24hrs w/ CHX brush of tongue, rinse, spray tonsils, rinse 2x/day, spray 2x/day for 2mo
• *FMDAP** - FMD w/ Air-Polishing

Results
Most patients lost to follow up in QSRP group

PI/GI - NSSD btw groups at 6mo
CAL gain - NSSD btw groups at 6mo
BOP - NSSD btw groups at 6mo
PPD reduction - FMDAP better than QSRP in mod (4-6) and deep (7+) pockets - FMD better than QSRP in deep
Pocket closure (pockets 4 or less) - FMDAP & FMD had more for all groups of single rooted - only in mod pockets for multi rooted
Time - significantly more for QSRP and treatment efficacy lower than any other group

• *Conclusion**
• *Full mouth protocols were more time efficient - FMDAP improved clinical outcomes vs QSRP for mod-deep pockets**
• *In comparison to QSRP, FMD and FMDAP may have more benefit for PPD reduction**