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Objectives: To examine the influence of the decision-making algorithms published by Tonetti and Sanz in 2019 on the diagnostic accuracy in two differently experienced groups of dental students using the current classification of periodontal diseases. Materials and methods: Eighty-three students of two different clinical experience levels were randomly allocated to control and study group, receiving the staging and grading matrix, resulting in four subgroups. All diagnosed two patient cases with corresponding periodontal charts, panoramic radiographs, and intraoral photographs. Both presented severe periodontal disease (stage III, grade C) but considerably differed in complexity and phenotype according to the current classification of periodontal diseases. Controls received the staging and grading matrix published within the classification, while study groups were additionally provided with decision-trees published by Tonetti and Sanz. Obtained data was analyzed using chi-square test, Spearman's rank correlation, and logistic regression. Results: Using the algorithms significantly enhanced the diagnostic accuracy in staging (p = 0.001*, OR = 4.425) and grading (p < 0.001**, OR = 30.303) regardless of the clinical experience. In addition, even compared to the more experienced control, less experienced students using algorithms showed significantly higher accuracy in grading (p = 0.020*). No influence on the criteria extent could be observed comparing study groups to controls. Conclusion: The decision-making algorithms may enhance diagnostic accuracy in dental students using the current classification of periodontal diseases. Clinical relevance: The investigated decision-making algorithms significantly increased the diagnostic accuracy of differently experienced under graduated dental students and might be beneficial in periodontal education. [ABSTRACT FROM AUTHOR]

Objectives: To detect and evaluate early signs of apical periodontitis using MRI based on a 3D short-tau-inversion-recovery (STIR) sequence compared to conventional panoramic radiography (OPT) and periapical radiographs in patients with apical periodontitis. Materials and methods: Patients with clinical evidence of periodontal disease were enrolled prospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR sequence. The MRI sequences were assessed for the occurrence and extent of bone changes associated with apical periodontitis including bone edema, periradicular cysts, and dental granulomas. OPTs and intraoral periapical radiographs, if available, were assessed for corresponding periapical radiolucencies using the periapical index (PAI). Results: In total, 232 teeth of 37 patients (mean age 62±13.9 years, 18 women) were assessed. In 69 cases reactive bone edema was detected on MRI with corresponding radiolucency according to OPT. In 105 cases edema was detected without corresponding radiolucency on OPT. The overall extent of edema measured on MRI was significantly larger compared to the radiolucency on OPT (mean: STIR 2.4±1.4 mm, dental radiograph 1.3±1.2 mm, OPT 0.8±1.1 mm, P=0.01). The overall PAI score was significantly higher on MRI compared to OPT (mean PAI: STIR 1.9±0.7, dental radiograph 1.3±0.5, OPT 1.2±0.7, P=0.02). Conclusion: Early detection and assessment of bone changes of apical periodontitis using MRI was feasible while the extent of bone edema measured on MRI exceeded the radiolucencies measured on OPT. Clinical relevance: In clinical routine, dental MRI might be useful for early detection and assessment of apical periodontitis before irreversible bone loss is detected on conventional panoramic and intraoral periapical radiographs. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the correlation between standard clinical findings, radiographic (OPT) and magnetic resonance imaging (MRI) as well as to assess whether MRI is capable of providing additional information related to the severity and extent of periodontal disease. Methods: 42 patients with generalized periodontitis received pre‐interventional MRI scans. These were compared to MR images of a periodontal healthy control group (n = 34). The extent of the osseous oedema, detected by MRI, was set in correlation with clinical periodontitis‐associated findings. Results: A highly significant correlation between bone oedema and clinical testings such as probing depth (p < 0.0001) and bleeding on probing (p < 0.0001) was revealed. The oedema exceeded the extent of demineralized bone. Patients with a positive BOP test showed a 2.51‐fold increase in risk of already having a bone oedema around the respective tooth even if probing depth was ≤3 mm (logistic binary regression analysis, OR 2.51; 95% CI: 1.54–4.11; p < 0.0001). Conclusion: MRI findings correlated with standard clinical findings, and MRI was able to depict intraosseous changes before any osseous defect had occurred. [ABSTRACT FROM AUTHOR]

Folwaczny M, Glas J, Török H-P, Tonenchi L, Paschos E, Bauer B, Limbersky O, Folwaczny C. Polymorphisms of the interleukin-18 gene in periodontitis patients.J Clin Periodontol 2005; 32: 530–534. doi: 10.1111/j.1600-051X.2005.00711.x.© Blackwell Munksgaard, 2005.Interleukin (IL)-18 regulates the expression of the proinflammatory cytokine interferon (IFN)-γ. The present study sought to test the putative involvement of six different IL-18 gene polymorphisms in pre-disposition to destructive periodontal disease.A total of 123 patients with periodontitis and 121 healthy controls were genotyped for six IL-18 polymorphisms at position−656,−607,−137,+113,+127 and codon 35/3. Genotyping has been performed by PCR and restriction fragment length polymorphism analysis. The frequencies of alleles and genotypes as well of haplotypes within both study groups were compared using the Pearson Chi-square test at a level of significance of 5% (p<0.05).Coseggregation was found to be 100% for the two polymorphisms at position−656 and−607 as well as for the polymorphisms at position−137,+113, and+127. The distribution of genotypes for the IL-18 gene polymorphism at position−656/−607 (p=0.854), at position−137/+113/+127 (p=0.320), and at codon 35/3 (p=0.481) was not significantly different among periodontitis patients if compared with healthy control subjects. The distribution of haplotype combinations for the−607 and−137 polymorphism also showed not significant difference between the both study groups (p=0.545).Herein the six different IL-18 gene polymorphisms were not associated with destructive periodontal disease. [ABSTRACT FROM AUTHOR]

Folwaczny M, Glas J, Török H-P, Fricke K, Folwaczny C: The CD14−159C-to-T promoter polymorphism in periodontal disease. J Clin Periodontol 2004; 31: 991–995. doi: 10.1111/j.1600-051X.2004.00600.x.© Blackwell Munksgaard, 2004.A single-nucleotide promoter polymorphism in the CD14 gene was associated with various inflammatory conditions. The present study sought to determine the frequency of the CD14−159C-to-T polymorphism among subjects with periodontitis and healthy control individuals.A total of 70 patients with periodontal disease and 75 healthy controls were genotyped for the CD14−159C-to-T polymorphism. Genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism analysis. The allele frequencies and distribution of genotypes within both study groups were compared using Fisher's exact test at a level of significance of 5% (p<0.05).Overall, the frequency for the CD14−159T allele in patients with periodontitis was 39.3% (55/140) and 48.0% (72/150) for the controls (p=0.135). The CD14−159C allele was significantly more prevalent (p=0.013) among females with periodontitis (33.3%; 24/72) as compared with healthy control subjects (55.6%; 30/54). In contrast, the distribution of the CD14−159C-to-T polymorphism showed no significant difference among males with and without periodontitis (p=0.816).Herein, the C−159T promoter polymorphism of the CD14 gene was associated in female but not in male patients with periodontal disease. [ABSTRACT FROM AUTHOR]

Folwaczny M, Glas J, Török H-P, Mauermann D, Folwaczny C. The 3020insC mutation of the NOD2/CARD15 gene in patients with periodontal disease. Eur J Oral Sci 2004; 112: 316–319.© Eur J Oral Sci, 2004 The 3020insC mutation of the NOD2/CARD15 gene leads to impaired activation of nuclear factor-kappa B (NF- κB) in vitro. As the destruction of periodontal tissue is mediated via activation of NF- κB, with subsequent transcription of proinflammatory cytokines, the c-insertion mutation of the NOD2/CARD15 gene might contribute to the proposed genetic background of periodontitis. The present study analysed the frequency of this mutation in 80 patients with chronic periodontal disease and 122 healthy controls. The 3020insC mutation was identified by employing the polymerase chain reaction followed by restriction fragment length polymorphism analysis. The prevalence of the 3020insC mutation of the NOD2/CARD15 protein in patients with periodontitis was 1.9% (three of 160) and that for the control group was 2.0% (five of 244) ( P = 0.942). Hence, unlike in Crohn's disease, the 3020insC mutation of the NOD2/CARD15 gene does not seem to influence the pathophysiology of periodontitis. [ABSTRACT FROM AUTHOR]

Immunorelevant gene polymorphisms might influence the susceptibility for periodontal disease. The present study assessed the frequency of a promoter polymorphism (−308G-to-A) of the tumour necrosis factor (TNF) α gene in patients with periodontitis and controls. Eighty-one patients with generalized chronic periodontitis and 80 healthy controls were genotyped for the −308 polymorphism of the TNF α gene by PCR amplification and subsequent restriction fragment length polymorphism analysis. The diagnosis of chronic periodontitis was made for each subject on basis of standardized clinical and radiographic criteria. In patients with peridontitis and controls, the frequency of the TNF α−308 A allele was comparable (19.1% [31/162] versus 13.8% [22/160]; p=0.193). The present study revealed no association between the −308 TNF α gene polymorphism and periodontal disease. [ABSTRACT FROM AUTHOR]

The article presents a case study of a young patient with a rapidly progressive caries, severe periodontitis and gingivitis who was sent to the dentistry. It states that he had undergone a radiotherapy in his young age. He was provided with an effective treatment plan where his two molars were removed and periodontal with endodontic treatment was also performed. The article discusses the relationship of dental and skeletal developmental disturbances resulting from radiotherapy.