Aim The current in vitro model aims to evaluate the adjunctive effect on artificial biofilm removal determined by the use of a glycine‐powder air‐polishing procedure (GPAP) over the ultrasonic debridement (USD) alone when the removal of artificial biofilm on abutment surface is performed. The procedures were carried out also evaluating the impact of the site (mesial, distal, vestibular, and oral) and three different mucosal tunnel depths (2 mm, 4 mm, and 6 mm). Materials and Methods Single tooth implant replacement was simulated. Three different abutment heights together with a prosthetic contour were investigated (2 mm, 4 mm, and 6 mm); custom‐made gingival masks were created to mimic peri‐implant soft tissue. Biofilm was simulated with an indelible ink. The protocol consisted in two intervention stages for each abutment: (a) USD with PEEK tip plus (b) GPAP. At the end of each intervention, abutments were unscrewed, and standardized photographs were taken. Statistical analysis was carried out to compare residual stain percentage between the two intervention stages and among different sites and mucosal tunnels. Results A total of 30 abutments were instrumented. A significant reduction of the percentage of residual staining (PRS) after the combination of GPAP + USD over USD alone was demonstrated (16% vs. 32%; p < 0.05). Moreover, the better performance of the GPAP + USD protocol was observed regardless of the different mucosal tunnel heights and the sites analyzed. Intragroup analysis unveils that the smaller PRS was observed for shallow mucosal tunnels (2 mm) and vestibular sites for both protocols. Conclusion GPAP + USD provided adjunctive effect on artificial biofilm removal in comparison to the USD alone. Furthermore, proximal surfaces and deeper mucosal tunnels (4 and 6 mm) showed a reduced instrumentation efficacy for both protocols.
Aim This study aims to review the available evidence on the efficacy of behaviour change techniques to improve compliance in young orthodontic patients and to compare these with conventional oral hygiene instructions. Methods The review was conducted according to the PRISMA statement. PICO method was used to define eligibility criteria. Two independent reviewers performed the research, examined electronic databases (MEDLINE, Scopus and CENTRAL) and manually checked relevant journals. Only RCTs with more than 10 participants and 3 months follow‐up were included. Data extraction and their qualitative analysis were performed for included studies. Results Search strategy identified 320 articles. After screening for titles, abstracts and full texts, 10 articles were then selected for qualitative analysis. High methodological heterogeneity was present among studies and therefore no meta‐analysis was performed. Low risk of bias was detected for one study only. The most common intervention was “mobile phone communication,” which was investigated in five studies. Motivational interviewing, repeated reinforcements and visual‐aided approach were also examined. Conclusion The interest in remote control of patients compliance appears to be fruitful, nonetheless there is no consensus as to a unique treatment protocol. Every other treatment looks beneficial but higher methodological homogeneity should be sought for in future investigations.
Background: The systematic review was designed to answer the following focused question: Are enamel matrix derivatives able to improve the quantity of keratinized tissue (KT) around natural dentition in patients with recessions defects after their treatment with periodontal plastic procedures? Methods: Only Randomized Clinical Trials (RCT) in English language evaluating root coverage procedures in combination with enamel matrix derivatives (commercially known as Emdogain®—EMD), with at least 10 subjects and a minimum duration of six months, were included. The search was applied to PUBMED and SCOPUS and it consists of a combination of MeSH terms and free text words (from January 2000 to June 2019). Risk of bias in individual studies and across studies was also evaluated. Results: After the full text analysis and the exclusion of further 18 articles, 12 articles were finally included. In total 639 recessions were treated (334 tests and 305 control). The recessions defects were classified according to the classification of Miller (Class I, II, III, IV). Only one trial included Miller Class III recessions (7 in total). Enamel matrix derivatives were applied in conjunction with Coronally Advanced Flap (CAF), Coronally Advanced Flap + Sub Epithelial Connective Tissue Graft (CAF + CTG), Semilunar Flap (SF). For the group CAF vs CAF + EMD the mean difference between the keratinized tissue gain in the two procedures was 0.40 mm (95% Confindence Interval Lower/Upper: 0.014–0.81) (p < 0.058); for the comparison CAF + CTG + EMD vs. CAF + CTG the mean difference between the two groups resulted in −0.06 mm (95% Confindence Interval Lower Upper −0.45 to 0.33) (p = 0.7603). Discussion: Randomized clinical trials included medium-low quality evidence. The application of Enamel Matrix Derivatives to surgical procedures aimed to cover gingival recessions does not add robust clinical benefit to conventional plastic procedure alone.
Background Patient's illness perception, assessed through the Brief‐Illness Perception Questionnaire (Brief‐IPQ), plays a decisive role in the treatment effectiveness of a wide range of chronic diseases; nonetheless, evidence is still lacking regarding periodontitis. The aim of the present pre‐post quasi‐experimental study was to evaluate the change in the Brief‐IPQ before and after non‐surgical periodontal treatment (NST) and to evaluate its ability to foresee the efficacy of NST. Methods A total of 126 periodontitis participants starting NST were asked to participate in the study. The nine‐item Brief‐IPQ together with a full periodontal chart were recorded at baseline and at the 3‐month follow up (reevaluation) after NST. Pre‐post comparisons of psychometric and periodontal variables were carried out through the Wilcoxon signed‐rank test (α = 0.05). A predictive model was built to test the ability of the Brief‐IPQ items to foresee the efficacy of NST. Results NST led to a significant reduction in all periodontal parameters (P < 0.001); the proportion of pockets closed was 64.18%. Although the overall sum score of the Brief‐IPQ remained fairly stable (P = 0.0673), significant changes occurred for items seven (“understanding”) (P < 0.001) and 8 (“emotional response”) (P < 0.05). The best model (R2 = 0.068, F = 2.15, P = 0.033) obtained from the multivariate linear regression analysis demonstrated that item five (“identity”) (β = 2.340, P = 0.017) and item eight (“emotional response”) (β = ‐2.569, P = 0.008) significantly predict the efficacy of NST (i.e., the proportion of pockets closed at reevaluation). Conclusions NST significantly ameliorates patient's understanding and emotional burden related to periodontitis. Baseline values of perceived symptoms and emotional response are predictive for the short‐term efficacy of NST.
Today, older adults are routinely classified into different categories based on their degrees of independence. However, due to the extreme heterogeneity of this group, and the fact that ageing is a progressive process, older adults may require customized prosthetic treatment. Older people, during ageing, may quickly pass into a frail condition, with loss of independence and of the manual skills necessary for proper hygiene maintenance. With this in mind, complete arch rehabilitations can make an important contribution to a patient’s quality of life. New treatment strategies are needed which take into account the priorities of ageing. The aim of this case report is to show an adaptable prosthetic treatment protocol that is useful for older adults. This protocol provides individual satisfaction and also aids forecasting of the patient’s future functional and maintenance needs.
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