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Introduction: Diseases of the periodontal tissues including gingivitis and periodontitis can affect up to 90% and 50% of the population respectively. These conditions are multifactorial inflammatory conditions involving a dysbiotic biofilm that, if left untreated, can lead to the destruction of the supporting structures of the teeth and have significant systemic implications, specifically on cardiovascular health. The elevation of inflammatory markers, particularly high-sensitive C-reactive protein (hsCRP), are strongly associated with an increased risk of atherosclerosis, a key risk factor for cardiovascular disease (CVD). HsCRP as well as other inflammatory markers can be detected in blood samples as early as 21 days after ceasing toothbrushing, due to the immune response to stagnant oral biofilm. The most effective way to ensure oral biofilm cannot remain on oral tissues, thus preventing periodontitis and reducing inflammatory CVD risk, is with good oral hygiene. The primary aim of this study is to assess whether individualised oral hygiene instruction (OHI) partnered with a digital oral health education (DOHE) package can improve the oral health of patients living with CVD. Methods and analysis: A total of 165 participants will be recruited from the Westmead and Blacktown Mt Druitt cardiac rehabilitation out-patient clinics into this dual centre, single blind, parallel design, randomised controlled trial. A baseline oral health clinical examination will be completed, followed by a self-report questionnaire before they are randomised in a 1:1:1 ratio into one of 3 arms as follows: individualised OHI partnered with DOHE (Group A), (Group B) DOHE only (Group B), and control/usual care (no oral health education) (Group C). Groups will have their intervention repeated at the 6-week follow-up. After completing the 12-week follow-up, Group B and Group C will receive tailored OHI. Group C will also receive the DOHE package. The primary outcome is the change in approximal plaque index score between baseline and 6-week follow up. Ethics and dissemination: The study has been approved by the Western Sydney Local Health District Human Ethics Committee 2023/ETH00516. Results will be published in peer-reviewed journals and presented at conferences. Trial registration number: ACTRN12623000449639p ANZCTR: https://www.anzctr.org.au/. [ABSTRACT FROM AUTHOR]

Objectives: To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri‐implant diseases. Material and Methods: In the first step, a modified one‐round online Delphi survey including 44 five‐point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively. Results: An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long‐term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept. Conclusions: In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri‐implant therapy and prophylaxis is patient compliant and efficient. [ABSTRACT FROM AUTHOR]

Objective: This systematic review analyzes existing literature on the clinical efficacy of air polishing devices (APDs), discussing the evidence-based data available for justifying their use as an alternative to conventional periodontal debridement in supportive periodontal therapy. The main objective of the review was to assess whether APD was as equally efficient or superior in obtaining successful treatment outcomes when compared with conventional methods. Data Sources: Following PRISMA guidelines, a systematic literature search of articles in English, up to December 2016, was conducted using PubMed, Cochrane, and Medline. Relevant articles were selected based on specific criteria. Seven studies were selected for the final assessment. One more study was added after a manual search of the literature. Due to considerable heterogeneity in study designs and outcome variables measured, only clinical parameters (probing depth, bleeding on probing, and clinical attachment level) were selected for meta-analysis. Conclusion: The studies selected for this systematic review provide some evidence that APDs as monotherapy could be an alternative to conventional debridement of single- and multi-rooted teeth with no furcation involvement, during supportive periodontal therapy. Comparing clinical and microbiologic outcomes, APDs seem to be as effective as conventional treatments. The primary advantage for the use of APDs in supportive periodontal therapy seems to be their ability to efficiently remove biofilm, without causing damage to the periodontal soft tissues or tooth and root structure. There may also be an advantage regarding patient comfort and time consumed. [ABSTRACT FROM AUTHOR]

Abstract Objectives: Various surgical techniques have been proposed for coverage of denuded root surfaces. The aim of this study was to evaluate a comparison of coronally repositioned flap procedure with or without the use of enamel matrix proteins in the treatment of recession defects. Material and methods: This study was an intra-individual longitudinal test of 12 months duration conducted as a blinded, split-mouth, placebo-controlled and randomised design. It was performed in 2 dental schools. 36 patients, aged 22–62 years, with 2 paired buccal recession defects of at least 3 mm participated. Surgical recession coverage was performed as coronally-advanced flap technique at both sites in the same session. One site was additionally treated with commercially-available enamel matrix proteins (Emdogain®) and the other site with placebo (propylene glycol alginate) in accordance with the randomisation list. A blinded examiner assessed pre- and post-surgical measurements. Clinical measurements and photographs were taken pre-surgically and after 1 week, 3 weeks, 3 months, 6 months and 12 months, postoperatively. Measurements comprised height and width of the gingival recession, height of keratinized tissue, probing attachment level, probing pocket depth and alveolar bone level by periodontal probe, Florida Probe® or caliper to the nearest 0.5 mm. Results: 12 months after therapy, both treatment modalities showed significant root coverage and probing attachment gain. Gingival recession decreased from 3.7 mm to 0.8 mm for the Emdogain® treated sites and from 3.9 mm to 1.0 mm for the control sites, corresponding to mean root coverages of 80% and 79%, respectively. This difference was not significant. With the exception of keratinized tissue gain, which was significantly higher (p=0.003) in the Emdogain® group, all other clinical variables were not different in the between-group comparison.... [ABSTRACT FROM AUTHOR]

Abstract Objectives: The aim of this study was to evaluate the effect of Emdogain® (EMD), used for periodontal regeneration, on the growth of periodontal pathogens like Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia. For comparison, we studied the effect of EMD on several microbes associated with other oral diseases as well as its effect on non-pathogenic oral inhabitants. Methods: Freshly prepared EMD or its vehicle propylene glycol alginate (PGA) alone were added to calibrated suspensions of microbes. As a control, imitating the post-surgical subgingival situation after flap closure, a serum/NaCl-solution mixture was used. Aliquots for growth assays were taken at scheduled times for calculation of colony-forming units and cell densities over an observation period of 24 h. Additionally, EMD was spotted onto selected, newly seeded microbes growing on agar plates to see if growth inhibition zones could be produced. Results: The study revealed a marked inhibitory effect of EMD on the growth of the gram-negative periodontal pathogens. A. actinomycetemcomitans showed a significant decrease (p=0.012) in viable counts after 24 h when EMD was added at baseline. P. gingivalis and P. intermedia also showed a marked growth reduction in the presence of EMD and in these cultures no viable microbes could be detected anymore after 24 h. In contrast, no significant growth inhibition was observed in gram-positive bacteria. Conclusions: The results suggest that EMD has a positive effect on the composition of bacterial species in the post-surgical periodontal wound, by selectively restricting growth of periopathogens that could hamper the wound healing and reduce the outcome of regenerative procedures. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate in vitro the marginal quality of Class II composite restorations at the gingival enamel margins as affected by contamination of the cavities with gingival fluid (GF) during different steps of resin bonding procedures. MATERIALS AND METHODS: 70 Class II cavities were prepared in extracted human molars and restored with composite using a multi-component bonding system (OptiBond FL/Herculite XRV; OPTI) or a single-bottle adhesive (Syntac Sprint/Tetric Ceram; SYN). The cavities were contaminated with human GF: C1 after acid etching, C2 after application of the primer (OPTI) or light-curing of the primer-adhesive (SYN), and C3 after light-curing of the resin adhesive (OPTI). Uncontaminated cavities were used as the control (C0). The restored teeth were subjected to thermocycling (TC) and replicated for SEM analysis of marginal gap formation. Microleakage at the gingival margins was determined by dye penetration with basic fuchsin. Statistics: non-parametric tests (Kruskal-Wallis test, Mann-Whitney test with Bonferroni correction). RESULTS: In both bonding systems, contamination with GF after acid etching (C1) did not impair the marginal quality; the mean percentages of continuous margin/mean depths of dye penetration were: OPTI: C0: 88.5%/0.10 mm, C1: 95.6%/0.04 mm; SYN: C0: 90.9%/0.08 mm, C1: 97.0%/0.05 mm. Marginal adaptation was adversely affected when GF contamination was performed after [ABSTRACT FROM AUTHOR]

Periodontitis is a chronic inflammatory disease of the supportive tissues and bone surrounding the teeth. In severe cases, it can consequently lead to tooth loss. This disease is most prevalent in rural and remote communities where regular dental visits are limited. Hence, there's a need for a periodontal screening tool for use by allied health professionals outside of dental clinics to detect periodontitis for early referral and intervention. In this paper two algorithms have been proposed and applied on two independently collected datasets in Germany and Australia with 20 and 24 participating subjects respectively; in the first algorithm, intra-oral images of before periodontitis treatment have been considered as diseased subjects and the images of after treatment have been considered as healthy subjects. Using the histogram of pixel intensity as our classification feature, the healthy and diseased subjects have been classified with an accuracy of 66.7%. In the second algorithm, using the difference between the histograms as our classification features, images of "before" and "after" treatment have been classified with an accuracy of 91.6%. If used in a smart phone application, the first algorithm can help people with limited access to dental clinics to be screened for periodontitis by allied health professionals in any healthcare setting. The second algorithm may be useful in helping non-dental personnel to monitor the progress of periodontal treatment.