Aim: The aim of this systematic review was to identify the most recent widely accepted guidelines for risk factor control interventions and to assess their impact in patients with periodontitis. Materials and methods: The electronic search strategy included a first systematic search to identify guidelines for interventions for smoking cessation, diabetes control, physical exercise (activity), change of diet, carbohydrate (dietary sugar) reduction and weight loss in the general population and a second systematic search to identify the studies evaluating these interventions in periodontitis patients. Results: A total of 13 guidelines and 25 studies were selected. Most guidelines included recommendations for all healthcare providers to provide interventions and follow-up counselling with the risk factors considered in the present review. In patients with periodontitis, interventions for smoking cessation and diabetes control were shown to improve periodontal health while the impact of dietary interventions and the promotion of other healthy lifestyles were moderate or limited. Conclusions: While aiming to improve treatment outcomes and the maintenance of periodontal health, current evidence suggests that interventions for smoking cessation and diabetes control are effective, thus emphasizing the need of behavioural support in periodontal care.

Aim: This systematic review investigates the impact of specific interventions aiming at promoting behavioural changes to improve oral hygiene (OH) in patients with periodontal diseases. Methods: A literature search was performed on different databases up to March 2019. Randomized and non-randomized controlled trials evaluating the effects of behavioural interventions on plaque and bleeding scores in patients with gingivitis or periodontitis were considered. Pooled data analysis was conducted by estimating standardized mean difference between groups. Results: Of 288 articles screened, 14 were included as follows: 4 studies evaluated the effect of motivational interviewing (MI) associated with OH instructions, 7 the impact of oral health educational programmes based on cognitive behavioural therapies, and 3 the use of self-inspections/videotapes. Studies were heterogeneous and reported contrasting results. Meta-analyses for psychological interventions showed no significant group difference for both plaque and bleeding scores. No effect was observed in studies applying self-inspection/videotapes. Conclusions: Within the limitations of the current evidence, OH may be reinforced in patients with periodontal diseases by psychological interventions based on cognitive constructs and MI principles provided by oral health professionals. However, no conclusion can be drawn on their specific clinical efficacy as measured by reduction of plaque and bleeding scores over time. K E Y W O R D S behavioural changes, motivational interviewing, oral hygiene, periodontal diseases, psychological intervention | 73 CARRA et Al.

Objective The aim of the present study was (a) to evaluate the relationship between dental implant mucosa and dental implant papilla levels; and (b) to identify the clinical parameters associated with peri‐implant soft tissue stability over time. Materials and methods This is a retrospective study on a cohort of patients seeking a single‐tooth implant therapy in a private practice in the Paris area. Two independent examiners analyzed photographs and radiographs taken the day of definitive crown load (baseline) and the last follow‐up visit (at least 12 months later) in order to measure four peri‐implant soft and hard tissue parameters. Results Seventy‐four patients corresponding to 90 implants were analyzed. During a mean follow‐up of 53.88 months, five implants (5.6%) presented with an apical displacement of the mid‐facial marginal mucosal level of at least 1 mm. Changes in the mid‐facial mucosa level were explained by changes in (a) the keratinized tissue height over time (p < .0001); (b) changes in the papilla height (p < .0001); and (c) by the periodontal phenotype (p = .007). A significant difference between papillae that gain in height (n = 85) and papilla that lost height (n = 78) was observed concerning (a) the timing of the implant placement (p = .019); and (b) the presence of an incomplete papilla fill (distance from the top of the papilla to the contact point) at baseline (p = .004). Conclusions The present findings indicate a dependent association between dental implant mucosa and dental implant papilla levels. Stability of peri‐implant soft tissues depends on periodontal phenotype, keratinized tissue height and papilla height.