JOP Larissa Flashcards
What is the Delphi system?
An anonymous survey of a diverse set of experts. It allows panelists to not worry about repercussions for their opinions to create an unbiased consensus over time as opinions are swayed.
Alarcon
Latin American Consensus Delphi survey for identifying trends in diagnosis and treatment of periimplant diseases
Aim: to generate by consensus the future trends in diagnosis and treatment of Pi in LA countries for 2030
Questions about 8 topics:
Risk factors/indicators
Surgical/Prosthetic considerations
Prevalence
Prevention/Maintenance
Diagnosis
Diagnosis and Treatment of Pi Conditions
Treatment of PiM
Treatment of Pi
High Consensus:
Radiograph after loading for baseline bone
Bleeding on gentle probing is the main parameter for early mucositis
Polished abutment with highest possible transmucosal component
Combo of approaches for mechanical debridement
Treatment of Pi will be mainly by specialists (98%)
Non-surgical is necessary first
Low Consensus:
Curette material
Lasers for mucositis
Growht factors
Will prevalence of PIM/Pi/Soft tissue def. increase?
Ideal radiographic analysis to identify boneloss
Role of probing and material of probe
Gharpure (Daubert)
Role of gingival phenotype and inadequate KTW as risk indicators for Pi and PiM
Cross sectional (63p 193i)
Clinical measurements and radiographs
Probe visibility for phenotype (is not right - thats only MT)
Questionaire about food impaction/homecare+Pain
TnP = higher prevalence of:
Pi (27% vs 11%)
PiM (43% vs 34%)
Pain during OH (25% vs 5%)
<2mm KTW higher prevalence of:
Pi (24% vs 17%)
PiM (47% vs 34%)
Pain during OH (28% vs 10%)
TnP strong association with <2mm KTW
First study to show increase risk of Pi and PiM at sites with TnP and <2mm KTW
CROSS SECTIONAL - CANT STUDY THIS IN CROSS SECTIONAL MANNER - WHICH CAME FIRST???
Dukka (Saleh, Ravida, Greenwell, Wang)
BOP reliable clinical indicator of PiDiseases?
Graded scale based on:
Mucosa (normal/slight PiM/Mod PiM/Sev PiM or Pi)
Plaque (None/minimal/visible/evident)
Erythema/Edema (none/minor/evident/severe)
BOP type (none/dot/line drip/ulcer profuse or SUP)
Ravida (Travan, Saleh, Papapanou, Sanz, Wang, Kornman, Tonetti)
Agreement among international perio experts using world workshop classification
Aim: Assess agreement for severe cases and identify grey zones
Intended to differentiate Stage II from III and III from IV
Agreement from 103 evaluators of 9 cases:
Extent (84.8%)
Grade (82%)
Stage (76.6%)
0.479 inter-reliability agreement
What came from the grey zones paper?
Main determinants used for staging is interdental CAL DUE TO PERIO not restorative reasons
What’s a hopeless tooth and is it included in missing teeth due to perio? - a tooth thats irrational to treat (loss to the apex cirumfrentially and hypermobility
How much can complexity factors shift a Stage? only 3 to 4. IV jeopardizes large segment of dentition/whole dentition - not just individual teeth.
How do you define extent? - % of teeth with the stage-defining severity level
Lucas-Taule
Mid-term outcomes and perio prognostic factors of autotransplanted third molars (retrospective cohort)
Endo therapy 1mo prior
1˚: tooth survival
2˚: PD, REC, CAL, pulpal/periapical healing, resorption, RBL
Success: Normal function/mobility - Stable perio (PD _<_4 CAL _<_5) - Normal PDL,
n=36
Mean Fu: 29mo
Survival: 97% - Success: 92%
PPD: 2.7mm
REC: +0.13
CAL: -0.17
No-pain - felt like normal tooth
Kinaia
Meta analysis of GBR on immediate implants -= 12mo FU minimum
3 Meta analyses conducted:
IIP w/ GBR vs IIP w/out GBR (high heterogeneity - NSSD)
IIP w/ BG vs IIP w/ BG + Mem (NSSD)
IIP w/ GBR vs conventional Implant (CI) (NSSD)
NSSD
High heterogenity in all - not on exam
Tai
Impacted third molars influence on selves and adjacent teeth perio/endo
PAN only - overlaping = no lesion?
n-2600 mandibular third molars (MTM)
7% dental lesions due to MTM
38% perio lesions due to MTM
Distoangular most responsible for DENTAL (13%)
Mesioangular most responsible for PERIO (48%)
MSM infections:
Dental: 32% Mesioangular
Perio: 45% Mesioangular
High correlation between increasing age and developing lesion
Rexhepi
Bovine bone + LPRF vs Bovine bone + Collagen Membrane - randomized non-inferiority trial
non-inferiority margin 1: 1mm inferior (GR)
non-inferiority margin 2: 0.5mm inferior (GR)
n=31 in each group
Wide range of defects (1 wall, ½ wall, 2 wall, circumfrential)
CAL gain: 0.8mm more
Bone gain: 0.6mm more
GR : 1.2mm less
PD Reduction: 0.499 less ( second inferiority margin inferior)
Not inferior
More bone gain, less GR, not inferior CAL, Less PD Reduction
