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Pocket Probing Depth (pocket + probing_depth)

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Medical Sciences	100%

Selected Abstracts

Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2007
M. A. Huwiler
Objectives: To monitor resonance frequency analysis (RFA) in relation to the jawbone characteristics and during the early phases of healing and incorporation of Straumann® dental implants with an SLA surface. Material and methods: 17 Straumann 4.1 mm implants (10 mm) and 7 Straumann 4.8 mm implants (10 mm) were installed and ISQ determined at baseline and after 1, 2, 3, 4, 5, 6, 8 and 12 weeks. Central bone cores were analyzed from the 4.1 mm implants using micro CT for bone volume density (BVD) and bone trabecular connectivity (BTC). Results: Pocket probing depths ranged from 2,4 mm and bleeding on probing from 5,20%. At baseline, BVD varied between 24% and 65% and BTC between 4.9 and 25.4 for the 4.1 mm implants. Baseline ISQ varied between 55 and 74 with a mean of 61.4. No significant correlations were found between BVD or BTC and ISQ Values. For the 4.8 mm diameter implants baseline ISQ values ranged from 57,70 with a mean of 63.3. Over the healing period ISQ values increased at 1 week and decreased after 2,3 weeks. After 4 weeks ISQ values, again increased slightly, no significant differences were noted over time. One implant (4.1 mm) lost stability at 3 weeks. Its ISQ value had dropped from 68 to 45. However the latter value was determined after the clinical diagnosis of instability. Conclusion: ISQ values of 57,70 represented homeostasis and implant stability. However no predictive value for loosing implant stability can be attributed to RFA since the decrease occurred after the fact. [source]

A systematic review of definitions of periodontitis and methods that have been used to identify this disease

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2009
Amir Savage
Abstract Objective: To perform a systematic review and critical analysis of the definitions of periodontitis and the methods which have been used to identify and measure this disease. Material and Methods: Relevant publications were identified after searching MEDLINE, EMBASE, SCISEARCH and LILACS electronic databases. Screening of titles and abstracts and data extraction was conducted independently by two reviewers. To be included in the review, studies were required to define periodontitis and to indicate how it was measured. Studies that related purely to gingivitis, and/or intervention studies, and/or studies where prevalence or severity of periodontitis was not a principal outcome were excluded. Results: From a total of 3472 titles and abstracts, 104 potentially relevant full text papers were identified. Of these, 15 met the criteria for inclusion in the final stage of the review. The survey revealed heterogeneity between the studies in the measurement tools used, particularly the types of probes and the sites and areas of the mouth that were assessed. There was also heterogeneity in the use of clinical attachment loss (CAL) and pocket probing depth (PPD) as criteria for periodontitis. In the 15 studies, the threshold for a diagnosis of periodontitis when CAL was the criterion ranged from 2 to 6 mm and when PPD was used, from 3 to 6 mm. Conclusions: This review has confirmed previous work which has suggested that epidemiological studies of periodontal diseases are complicated by the diversity of methodologies and definitions used. The studies that were reviewed utilized a minimum diagnostic threshold defining periodontitis, at a given site in terms of CAL of 2 mm and PPD of 3 mm. [source]

Periodontal attachment loss over 14 years in cleft lip, alveolus and palate (CLAP, CL, CP) subjects not enrolled in a supportive periodontal therapy program

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2003
Giovanni E. Salvi
Abstract Objectives: (i) To assess the overall and (ii) cleft-associated rate of periodontal disease (PD) progression in subjects with cleft lip, alveolus and palate (CLAP) and (iii) to compare these rates with those of subjects with cleft lip (CL) and cleft palate (CP). Material and methods: Twenty-six subjects not enrolled in a supportive periodontal therapy (SPT) program were examined in 1979, 1987 and 1993. PD progression was assessed as increase in pocket probing depth (PPD in mm) and probing attachment loss (PAL in mm). Results: Extensive plaque accumulation and high frequencies of gingival units bleeding on probing were observed at all three examinations. A statistically significant increase in mean PPD of 0.57±0.21 mm (SD) in both groups as well as a statistically significant loss of PAL of 1.85±0.23 mm (SD) in the CLAP group and of 1.72±0.21 mm (SD) in the CL/CP group occurred over the observation period (p<0.05). In subjects with CLAP, statistically significant increases in PPD and loss of PAL were recorded over time at sites adjacent to the cleft as well as at control sites (p<0.05). Over 14 years, however, PPD increased 1.72±1.08 mm (SD) at cleft sites versus 0.72±1.14 mm (SD) at control sites (p<0.05), and PAL amounted to 3.19±1.35 mm (SD) at cleft sites versus 2.41±1.52 mm (SD) at control sites (p<0.05). Conclusion: Both the CLAP and the CL/CP subjects are at high risk for PD progression if no SPT program is provided. This also suggests that alveolar cleft sites in subjects with high plaque and gingival inflammation scores underwent more periodontal tissue destruction than control sites over a 14-year period. Zusammenfassung Ziele: 1. Beurteilung der gesamten und 2. der mit der Spalte assoziierten Progressionsrate der Parodontalerkrankung (PD) bei Patienten mit Lippen-Kiefer-Gaumenspalten (CLAP) und 3. der Vergleich dieser Progressionsraten mit denen von Patienten mit Lippenspalten (CL) sowie Gaumenspalten (CP). Material und Methoden: 26 Patienten, die nicht an einem SPT-Programm teilnahmen wurden in 1979, 1987 und 1993 untersucht. Die PD-Progression wurde über die Zunahme der Sondierungstiefe (PPD in mm) und den klinischen Attachmentverlust (PAL in mm) beurteilt. Ergebnisse: Bei allen drei Untersuchungszeitpunkten wurde eine ausgedehnte Plaqueakkumulation und eine große Häufigkeit von Gingivabereichen, die bei Sondierung bluteten beobachtet. Während der Beobachtungsperiode fand in beiden Gruppen ein statistisch signifikanter Anstieg der mittleren PPD von 0.57±0.21 mm (SD) als auch ein statistisch signifikanter Attachmentverlust von 1.85±0.23 mm (SD) in der CLAP-Gruppe sowie von 1.72±0.21 mm (SD) in der CL/CP-Gruppe statt (p<0.05). Bei den Patienten mit CLAP wurde im Laufe der Zeit sowohl an den Parodontien neben der Spalte als auch an den Kontrollstellen (p<0.05) ein statistisch signifikanter Anstieg der PPD und Attachmentverlust registriert. Während der 14 Jahre jedoch nahm die PPD an Stellen mit Spalte um 1.72±1.08 mm (SD) zu im Gegensatz zu den Kontrollstellen (p<0.05) wo dieser Wert 0.72±1.14 mm (SD) betrug. Für den Attachmentverlust lag dieser Wert bei 3.19±1.35 mm (SD) an den Stellen mit Spalte im Gegensatz zu den Kontrollstellen (p<0.05) mit 2.41±1.52 mm (SD). Schlussfolgerung: Wenn keine parodontale Erhaltungstherapie zur Verfügung gestellt wird haben beide Personen, die mit CLAP und die mit CL/CP ein hohes Risiko hinsichtlich der Parodontitisprogression. Dies läßt annehmen, dass bei Personen mit viel Plaque und ausgeprägter Entzündung der Gingiva, die Stellen mit Kieferspalten während einer 14-jährigen Zeitperiode eine stärkere Zerstörung der parodontalen Gewebe erfahren als die Kontrollstellen. Résumé Les buts de cette étude ont été de suivre la progression du taux de la maladie parodontale associée au bec de lièvre (CLAP) et de comparer ces taux avec ceux de sujets ayant lèvre fendue (CL) et palais fendu (CP). Vingt-six sujets non-soumis à un programme parodontal de maintien (SPT) ont été examinés en 1979, 1987 et 1993. La progression PD a été enregistrée telle une augmentation de la profondeur au sondage (PPD en mm) et une perte d'attache au sondage (PAL en mm). Une énorme accumulation de plaque dentaire et de très hautes fréquences dans les nombres d'unités gingivales avec saignement au sondage ont été observées lors des trois examens. Une augmentation statistiquement significative dans la moyenne PPD de 0.57±0.21 mm (SD) dans les deux groupes ainsi qu'une perte significative de PAL de 1.85±0.23 mm (SD) dans le groupe CLAP et de 1.72±0.21 mm (SD) dans le groupe CL/CP apparaîssaient durant cette période d'observation (p<0.05). Chez les sujets avec CLAP, les augmentations statistiquement significatives de PPD et la perte de PAL ont été enregistrées avec le temps sur les sites adjacents au bec de lièvre ainsi qu'au niveau des sites contrôles (p<0.05). Sur les quatorze années, cependant, PPD augmentait de 1.72±1.08 mm (SD) au niveau des sites bec de lièvre vs 0.72±1.14 mm (SD) au niveau des contrôles (p<0.05), et PAL s'élevait à 3.19±1.35 mm (SD) au niveau des sites bec de lièvre vs 2.41±1.52 mm au niveau des contrôles (p<0.05). Tant les sujets CLAP que les CL/CP étaient à haut risque pour la progression PD si un programme SPT n'était pas suivi. Ceci suggère également que les sites alvéolaires associés au bec de lièvre avec des scores de plaque et de gingivite importants s'accompagnaient de plus de destruction que les sites contrôles sur une période de quatorze années. [source]

Maxillary sinus floor elevation using the (transalveolar) osteotome technique with or without grafting material.

CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2009
Part I: implant survival, patients' perception
Abstract Objectives: To analyze the survival and success rates of implants installed utilizing the (transalveolar) osteotome technique, to compare peri-implant soft tissue parameters and marginal bone levels of osteotome-installed implants with implants placed using standard surgical procedures, and to evaluate patient-centered outcomes. Material and methods: During 2000 to 2005, 252 Straumann® dental implants were inserted in 181 patients. The surgical technique was a modification of the original osteotome technique presented by Summers. In addition to the clinical examination, the patients were asked to give their perception of the surgical procedure, utilizing a visual analogue scale. Results: The cumulative survival rate of the osteotome-installed implants after a mean follow-up time of 3.2 years, was 97.4% (95% confidence intervals: 94.4,98.8%). From the 252 implants inserted, three were lost before loading and another three were lost in the first and second year. According to residual bone height the survival was 91.3% for implant sites with ,4 mm residual bone height, and 90% for sites with 4 mm and 5 mm, when compared with that of 100% in sites with bone height of above 5 mm. According to implant length the survival rates were 100% for 12 mm, 98.7% for 10 mm, 98.7% for 8 mm and only 47.6% for 6 mm implants. Soft tissue parameters (pocket probing depth, probing attachment level, bleeding on probing and marginal bone levels) did not yield any differences between the osteotome-installed and the conventionally placed implants. More than 90% of the patients were satisfied with the implant therapy and would undergo similar therapy again if necessary. The cost associated with implant therapy was considered to be justified. Conclusion: In conclusion, the osteotome technique was a reliable method for implant insertion in the posterior maxilla, especially at sites with 5 mm or more of preoperative residual bone height and a relatively flat sinus floor. [source]

Clinical analysis of the soft tissue integration of non-submerged (ITI) and submerged (3i) implants: a prospective-controlled cohort study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 10 2008
Ricardo Vieira Garcia
Abstract Aim: The aim of this study was to compare the soft tissue integration of submerged and non-submerged implants by means of periodontal parameter assessments and analysis. Material and methods: Thirty-one patients, who received 42 non-submerged implants (ITI) and 48 submerged implants (3i), participated in the study. There was no significant difference (P>0.05) between both groups considering gender; educational level; handedness; toothbrushing frequency; the number of auxiliary devices used; and smoking habits. The parameters assessed were gingival index (GI), plaque index (PII), retention index (RI), pocket probing depth (PPD) and keratinized mucosa index. Results: At evaluation, 66.67% of all sites showed a GI of 0; 72.22% a PI of 0, and 93.33% the absence of calculus. The average PPD was 2.56 mm in the non-submerged and 2.70 mm in the submerged group. With regard to the width of keratinized mucosa, 100% of the ITI implants showed a band of keratinized gingiva around the implant, whereas 14.58% in the 3i group showed a complete absence of keratinized mucosa. The intra-examiner reproducibility was 90.96% for all parameters and the Kendall tau-b analysis showed a powerless correlation between the chosen parameters for both studied groups. Conclusions: The study material showed no major differences between submerged and non-submerged dental implants regarding GI, PII, RI and PPD, except the width of keratinized mucosa. Regarding the presence of keratinized mucosa, there is a need for further longitudinal studies to elucidate a possible benefit of one implant system over the other. [source]

Microbial colonization patterns predict the outcomes of surgical treatment of intrabony defects

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2006
Lisa Heitz-Mayfield
Abstract Aim: To explore the impact of bacterial load and microbial colonization patterns on the clinical outcomes of periodontal surgery at deep intrabony defects. Materials and Methods: One hundred and twenty-two patients with advanced chronic periodontitis and at least one intrabony defect of >3 mm were recruited in 10 centres. Before recruitment, the infection control phase of periodontal therapy was completed. After surgical access and debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CAL), pocket probing depths (PPD), recession (REC), full-mouth plaque scores and full-mouth bleeding scores were assessed. Microbial colonization of the defect-associated pocket was assessed using a DNA,DNA checkerboard analysis. Results: Total bacterial load and counts of red complex bacteria were negatively associated with CAL gains 1 year following treatment. The probability of achieving above median CAL gains (>3 mm) was significantly decreased by higher total bacterial counts, higher red complex and T. forsythensis counts immediately before surgery. Conclusions: Presence of high bacterial load and specific periodontal pathogen complexes in deep periodontal pockets associated with intrabony defects had a significant negative impact on the 1 year outcome of surgical/regenerative treatment. [source]

Early loading (2 or 6 weeks) of sandblasted and acid-etched (SLA) ITI® implants in the posterior mandible

CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2004
A 1-year randomized controlled clinical trial
Abstract: The aim of this 1-year prospective controlled clinical trial was to evaluate the effect of early loading of ITI® solid screw titanium implants with a sandblasted and acid-etched (SLA) surface on clinical and radiographic parameters. Material and methods: Twenty-seven consecutively admitted patients presenting bilateral edentulous posterior mandibular areas and in need of prosthetic reconstruction were recruited. Sixty-seven ITI® standard solid screw implants with an SLA surface, a diameter of 4.1 mm and a length of 8, 10 or 12 mm were installed bilaterally in molar and premolar areas according to a one-stage surgical protocol. One week (test) and 5 weeks (control) after implant placement, solid ITI® prosthetic abutments were connected using a torque of 35 N cm. No provisional restoration was fabricated. Two weeks (test) and 6 weeks (control) after implant placement, porcelain-fused-to-metal single-tooth crowns were cemented. Clinical measurements were obtained at day 0 and 2, 6, 12, 24 and 52 weeks thereafter. Periapical radiographs were taken immediately after implant placement, after 6 weeks and at the 1-year examination. Results: After 1 year, implant survival was 100%. Two test and one control implants rotated at the time of abutment connection and were left unloaded for 12 additional weeks. At the 1-year examination, no statistically significant differences were found between the test and control sites with respect to pocket probing depths (2.6 mm±0.5 vs. 2.7 mm±0.5), mean clinical attachment levels (3.1 mm±0.4 vs. 3.2 mm±0.5), mean percentages of sites bleeding on probing (9.7% vs. 8.3%), mean widths of keratinized mucosa (1.8 mm±0.4 vs. 1.9 mm±0.5), mean PerioTest® values (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) or mean crestal bone loss measurements (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusion: Based on these results, loading of titanium implants with an SLA surface as early as 2 weeks did not appear to jeopardize the osseointegration healing process in the posterior mandible. Furthermore, implants rotating at 35 N cm, if left unloaded for additional 12 weeks, did not negatively affect clinical and radiographic outcomes. Résumé Le but de cet essai clinique contrôlé prospectif d'une année a été d'évaluer l'effet de la mise en charge précoce d'implants en titane vis solide ITI® avec une surface sablée et mordancée (SLA) sur des paramètres cliniques et radiographiques. Vingt-sept patients présentant des aires bilatérales mandibulaires postérieures édentées et nécessitant donc une reconstruction prothétique ont été recrutés. Soixante-sept implants ITI® d'un diamètre de 4,1 mm et d'une longueur de 8, 10 ou 12 mm ont été placés bilatéralement dans les zones molaires et prémolaires suivant le processus chirurgical en une étape. Une semaine (test) et cinq semaines (contrôle) après leur placement des piliers prothétiques ITI® ont été serrés avec une force de 35 Ncm. Aucune restauration provisoire n'a été fabriquée. Deux semaines (test) et six semaines (contrôle) après le placement des implants des couronnes céramo-métalliques indépendantes ont été cimentées. Des mesures cliniques ont été obtenues aux jours 0 et deux, et aux semaines 6, 12, 24 et 52. Des radiographies périapicales ont été prises immédiatement après le placement des implants, après six semaines et une année. Après une année, le taux de survie implantaire était de 100%. Deux implants tests et un contrôle pivotaient au moment de la connexion du pilier et ont été laissés non-chargés pour 12 semaines supplémentaires. Après une année, aucune différence statistique n'a été trouvée entre les sites tests et contrôles en ce qui concerne les profondeurs de poches au sondage (2,6 ±0,5 mm vs 2,7± 0,5 mm), les niveaux d'attache clinique moyens (3,1±0,4 vs 3,2±0,5 mm,) les pourcentages moyens de sites saignant au sondage (9,7% vs 8,3%), les largeurs moyennes de muqueuse attachée (1,8±0,4 mm vs 1,9±0,5 mm), les valeurs Periotest moyennes (,1,4±0,9 PTV vs ,1,6 ±0,8 PTV) ou les mesures de perte osseuse crestale moyennes (0,57 ± 0,49 mm vs 0,72±0,52 mm). La charge d'implants en titane avec surface SLA aussitôt que deux semaines après leur placement ne semblait pas mettre en danger le processus d'ostéoïntégration dans la partie postérieure de la mandibule. De plus, les implants pivotant à 35 Ncm, si laissés non-chargés pour douze semaines supplémentaires, n'affectaient pas de manière négative les mesures cliniques et radiographiques. Zusammenfassung Material und Methoden: Es wurden siebenundzwanzig Patienten mit beidseits zahnlosem Seitenzahnbereich im Unterkiefer, welche eine prothetische Versorgung benötigten, in die Studie aufgenommen. Es wurden 67 ITI® Standard Vollschraubenimplantate mit einem Durchmesser von 4.1 mm und einer Länge von 8, 10 oder 12 mm beidseits in der Molaren- und Prämolarenregion transmukosal eingesetzt. Eine Woche (Test) und 5 Wochen (Kontrolle) nach Implantation wurden ITI® Massivsekundärteile mit einem Drehmoment von 35 Ncm eingesetzt. Es wurde keine provisorische Versorgung angefertigt. Zwei Wochen (Test) und 6 Wochen (Kontrolle) nach Implantation wurden Gold-Porzellan Einzelkronen einzementiert. Klinische Messungen wurden am Tag 0 und nach 2, 6, 12, 24, und 52 Wochen aufgenommen. Periapikale Röntgenaufnahmen wurden sofort nach der Implantation, nach 6 Wochen und anlässlich der 1 Jahreskontrolle angefertigt. Resultate: Nach einem Jahr betrug die Implanta-tüberlebensrate 100%. Zwei Test- und ein Kontrollimplantat drehten sich beim Einschrauben der Sekundärteile und wurden für zusätzliche 12 Wochen unbelastet belassen. Bei der 1 Jahresuntersuchung konnten zwischen Test- und Kontrolli-mplantaten keine statistisch signifikanten Unterschiede bezüglich Sondierungswerten (2.6mm+/,0.5 gegenüber 2.7mm +/,0.5), mittlerem klinischem Attachmentniveau (3.1mm +/,0.4 gegenüber 3.2mm +/,0.5), mittlerem Prozentanteil beim Bluten auf Sondieren (9.7% gegenüber 8.3%), mittlerer Breite der keratinisierten Mukosa (1.8mm +/,0.4 gegenüber 1.9mm +/,0.5), mittleren Periotest® Werten (,1.4 PTV +/,0.9 gegenüber ,1.6 PTV +/,0.8) oder mittlerem marginalem Knochenverlust (0.57mm +/,0.49 gegenüber 0.72mm +/,0.50) gefunden werden. Schlussfolgerung: Gemäss dieser Resultate schien die Belastung von Titanimplantaten mit SLA Oberfäche bereits nach 2 Wochen den Heilungsprozess der Osseointegration im posterioren Unterkiefer nicht zu beeinträchtigen. Implantate, die bei 35Ncm rotierten und daraufhin für weitere 12 Wochen unbelastet blieben, beeinflussten die klinischen und radiologischen Resultate nicht negativ. Resumen La intención de este ensayo clínico prospectivo controlado fue evaluar el efecto de una carga temprana sobre implantes macizos roscados de titanio con una superficie pulverizada con arena y gravada con ácido (SLA) sobre parámetros clínicos y radiográficos. Material y Métodos: Se reclutaron veintisiete pacientes consecutivamente admitidos que presentaron áreas edéntulas bilaterales en la mandíbula posterior y necesitando reconstrucción protésica. Se instalaron bilateralmente en las áreas molar y premolar sesenta y siete implantes ITI® estándar macizos roscados de titanio con una superficie SLA, un diámetro de 4.1 mm y una longitud de 8, 10 o 12 mm de acuerdo con un protocolo quirúrgico de una sola fase. Una semana (prueba) y 5 semanas (control) tras la colocación del implante, se conectaron pilares prostéticos macizos ITI usando un torque de 35 Ncm. No se fabricaron restauraciones provisionales. Dos semanas (prueba) y 6 semanas (control) tras la colocación de los implantes, se cementaron coronas unitarias metalocerámicas. Se obtuvieron medidas clínicas en el día 0 y tras 2, 6, 12, 24 y 52 semanas. Se tomaron radiografías periapicales inmediatamente tras la colocación del implante, a las 6 semanas y en el examen de 1 año. Resultados: Tras 1 año, la supervivencia de los implantes fue del 100%. Dos implantes de prueba y uno de control rotaron en el momento de la conexión del pilar y se dejaron sin carga durante 12 semanas más. En el examen de 1 año, no se encontraron diferencias significativas entre los lugares de prueba y los de control respecto a las profundidades de sondaje (2.6 mm±0.5 vs. 2.7 mm±0.5), niveles medios de inserción clínica (3.1±mm±0.4 vs. 3.2 mm±0.5), porcentaje medio de lugares con sangrado al sondaje (9.7% vs. 8.3%), anchura media de mucosa queratinizada (1.8 mm±0.4 vs. 1.9 mm±0.5), valores medios de Perio Test® (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) o a las medidas medias de perdida de hueso crestal (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusiones: Basándose en estos resultados, la carga de implantes de titanio con superficie SLA tan pronto como a las 2 semanas no pareció comprometer el proceso de cicatrización de la osteointegración en la mandíbula posterior. Mas aun, los implantes que rotaron a 35 Ncm, si se dejan sin carga durante 12 semanas más, no afectaron negativamente los resultados clínicos y radiográficos. [source]