Each individual is capable of maintaining low PI, even if using a toothbrush that shows evidence of wear.

AimThe objective of this study was to evaluate consistency and accuracy of the periodontitis staging and grading classification system.MethodsThirty participants (10 periodontal experts, 10 general dentists and 10 undergraduate students) and a gold‐standard examiner were asked to classify 25 fully documented periodontitis cases twice. Fleiss kappa was used to estimate consistency across examiners. Intraclass correlation coefficient (ICC) was used to calculate consistency across time. Quadratic weighted kappa and percentage of complete agreement versus gold standard were computed to assess accuracy.ResultsFleiss kappa for stage, extent and grade were 0.48, 0.37 and 0.45 respectively. The highest ICC was provided by students for stage (0.91), whereas the lowest ICC by general dentists for extent (0.79). Pairwise comparisons against gold standard showed mean value of kappa >0.81 for stage and >0.41 for grade and extent. Agreement with the gold standard for all three components of the case definition was achieved in 47.2% of cases. The study identified specific factors associated with lower consistency and accuracy.ConclusionsDiagnosis was highly consistent across time and moderately between examiners. Accuracy was almost perfect for stage and moderate for grade and extent. Additional efforts are required to improve training of general dentists.

Background/aim This study evaluated marginal soft tissue recession at implants with simultaneous lateral guided bone regeneration (GBR), at least five years after prosthetic loading. Material and methods Patients treated with GBR at the time of implant placement and adherent to supportive periodontal therapy (SPT) program with at least 5 years of follow‐up were re‐examined in 5 clinical centers. At the last follow‐up, clinical and radiographic data on peri‐implant hard and soft tissue were collected. Multilevel analysis considering center, patient, and implant (brand, length, diameter, position) was performed. Results A total of 96 patients and 195 augmented implants were included. The mean duration of SPT was 8.3 ± 3.1 years, while mean recall frequency was 4.5 ± 1.3 months. Sixty‐five (33%) implants received soft tissue graft before prosthetic delivery. Twenty‐one (11%) implants developed biological complications during the follow‐up. No implant failure was reported. Mean difference in bone levels (ΔBL) was −0.7 ± 0.9 mm, while mean difference in keratinized tissue (ΔKT) was −0.4 ± 0.9 mm. Eighty‐five (44%) implants showed recession (REC) of soft tissue margin (mean 0.6 ± 0.8 mm). The presence of REC was associated with use of non‐resorbable membrane (p < .0001) and wider implant diameter (p = .0305), while use of soft tissue graft significantly predicted higher stability of peri‐implant mucosal margin (p = .0003). Conclusion Peri‐implant mucosal recession is a common feature 5 years after lateral GBR. The risk of recession may be reduced using GBR with resorbable membranes, small diameter implants, and soft tissue grafting before prosthetic treatment.

IntroductionDuplications of the gastrointestinal tract are rare congenital anomalies that can occur anywhere throughout the gastrointestinal tract. The reported incidence is 1/4500, and more than 80% occurs before the age of two as an acute abdomen or bowel obstruction. The most common site is Ileum (60%), while the colonic localisation is reported between 4 and 18%.Presentation of the caseHerein we report the case of a 35-year-old man, presented at the Emergency Department with fever and localised abdominal pain in the right iliac fossa. Preoperative abdominal ultrasound and CT scan showed a cystic mass of 44 × 43 × 70 mm adjoining the posterior wall of the right colon. He underwent explorative laparoscopy, laparotomy conversion, right hemicolectomy with an intra-operative diagnosis of colonic duplication cyst, confirmed by histology.DiscussionThe review of the literature showed as the intestinal duplication cysts are rare congenital anomalies. The clinical presentation is variable and depends on the site and the related complications. A surgical approach based on the resection of the involved bowel tract is the treatment associated with the best long-term outcomes.ConclusionIt is important to include intestinal duplication in the differential diagnosis of acute abdomen, to ensure the best therapeutic strategy.