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Background: Treatment of head and neck cancers may cause sequelae affecting patients’ quality of life during and after treatment. As a result, periodontal management of a patient with parotid gland adenoid cystic carcinoma, particularly in advanced stage 4, can be challenging for dental practitioners, especially if the patient is on active oral molecular therapy and undergoing long-term radiotherapy and chemotherapy. Purpose: This report was intended to describe the conservative non-surgical management of tooth 27 with poor prognosis owing to grade II mobility in a patient on active Lenvatinib therapy – where the extraction was not advisable to lessen the risk of osteonecrosis. Case: A 52-year-old female patient was referred by an oncologist to our dental clinic for noncarious toothache. Five years ago, the patient was diagnosed with adenoid cystic carcinoma (ACC) and had a treatment history of radiotherapy, chemotherapy and surgical removal of the left parotid gland to manage the malignancy. Oral examination revealed characteristic findings of periodontitis. Case Management: Ultrasonic scaling, antimicrobial mouth rinses and reinforcement in oral hygiene instructions manage the tooth 27 conservatively. Conclusion: A cautious approach by the dental surgeon, together with the multidisciplinary team caring for cancer patients, is fundamental and helps with the palliative periodontal management of this patient to enhance oral health-related quality of life. With a lack of reports on conservative periodontal therapy in ACC patients, this report highlights the combination of smoking cessation, reinforcement of oral hygiene instructions and conservative periodontal treatment.

Periodontal disease affects 42% of adults in the United States. Both the periodontal microbiome and the host immune inflammatory response may be influenced by overweight/obesity status. This retrospective analysis sought to determine the associations of periodontal disease parameters with body mass index (BMI) and obesity status in patients undergoing periodontal maintenance therapy. The records of 418 patients who were undergoing periodontal maintenance after periodontitis treatment were examined, and the patients' demographic characteristics (sex, age, and race/ethnicity), self-reported Bill, periodontal disease condition, number of sites with probing depth 2 4 mm, missing teeth, and sites with bleeding on probing (BOP) were recorded. Patients were determined to have active moderate to severe periodontitis if they presented with 2 or more sites in 2 different quadrants with clinical attachment loss 2 5 mm and probing depth 2 5 mm. Individuals were also categorized into 3 groups: underweight/normoweight, BMI < 25; overweight, BMI 25 6 30; or obese, BMI ~ 30. In the study population, BMI ranged from 16.827 to 51.389. The periodontitis status was not significantly associated with a BMI status of overweight (odds ratio [OR] = 1.388 [95% Cl, 0.961- 2.006]) or obese (OR = 1.168 [95% Cl, 0.77-1.757]). Female sex (OR = 0.561 [95% Cl, 0.343-0.918]) and age (OR = 0.983 [95% Cl, 0.967-0.999]) were negatively associated with active periodontitis status. Obese patients demonstrated significantly more sites with BOP than either underweight/normoweight or overweight patients, and a BMI indicating obesity was associated with increasing age (P < 0.001) and higher number of missing teeth (P = 0.0064). In a population of patients undergoing periodontal maintenance therapy, BMI was associated with age and missing teeth, and obese status was associated with a significantly higher number of sites with BOR [ABSTRACT FROM AUTHOR]

The study aims were (1) to explore whether "periodontal treatment" consisting of surgical therapy (flap, resective, or regenerative) or scaling and root planing treatment with long-term periodontal maintenance treatment, is cost-effective in terms of preventing periodontitis-attributable tooth extraction and replacement by implant-supported crowns ("extraction/replacement"); (2) to assess the effect of cigarette smoking on this cost-effectiveness. Data for this observational retrospective study were collected from dental charts of patients who had received periodontal therapy and at least annual follow-up visits for >10 years were analyzed by linear regression generalized estimating equations and generalized linear models. Among 399 adults (199 males, 200 females), those with the least mean annual treatment cost experienced the greatest mean annual costs for extraction/replacement, indicating general cost-effectiveness. Cigarette smoking adversely impacted this cost-effectiveness, with current heavy smokers experiencing no cost-effectiveness. Former smokers with Grade C periodontitis benefitted most, whereas smoking did not influence cost-effectiveness for Grade B periodontitis. Assessed by mean annual costs of "extraction/replacement," periodontal treatment was cost-effective, which decreased in a dose-response manner by former and current smoking intensity. Cigarette smoking should be factored into treatment planning and cost-effective analyses of periodontal treatment. Smoking cessation should be encouraged., (© 2024 The Author(s). Periodontology 2000 published by John Wiley & Sons Ltd. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Oral health is an integral part of an individual’s general health, interfering with all dimensions of life: functional, aesthetic, psychological, social, physical, nutritional, and even psychosocial. Hence oral health is directly related to quality of life. Periodontitis is one of the most prevalent oral diseases and one of the major causes of tooth loss, impacting negatively on self-reported individuals’ quality of life. Periodontal maintenance therapy aims to effectively minimize the recurrence of periodontal disease, as well as the incidence of tooth loss. In periodontal literature, studies associated with quality of life indicators, presented in the form of questionnaires aimed at measuring the impact of periodontitis and tooth loss on self-reported individual’s quality of life, highlight the "Oral Impacts on Daily Performance" (OIDP) and "Oral Health Impact Profile" (OHIP). As such, this study presents a critical review of the literature and describes the impact of periodontal disease and tooth loss on the quality of life of patients undergoing periodontal maintenance therapy.

Aim: Removable partial dentures (RPDs) can influence the oral health and have the potential to cause further tooth loss, especially of abutment teeth. However, no evidence indicates the effective interval of regular periodontal maintenance after RPD provision. This study aimed to examine the impact of regular periodontal maintenance visits on survival of RPD abutment teeth. Materials and Methods: Patients were included if they had been provided with a clasp-retained RPD and had used it for 2 years or more. According to the frequency of periodontal maintenance, study samples were divided into three groups; every 3–6 months (3–6M) group, 1-year (1Y) group and no-maintenance (NM) group. Results: Five-year cumulative survival rates were 82.6% (3–6M), 74.4% (1Y) and 70.8% (NM) respectively. Survival of abutment teeth in the 3–6M group was significantly better than both 1Y and NM groups. Conclusion: The periodontal maintenance at least once in 6 months had the most favorable outcome. Frequent periodontal maintenance after RPD provision could be effective in preventing further tooth loss.

Multidisciplinary therapy is essential in dental practice to achieve optimized outcomes. The present case report describes the application of periodontal surgery with a five-year follow-up in a patient with malocclusion and chronic periodontitis. In the presence of periodontal inflammation, orthodontic therapy may result in further periodontal breakdown due to plaque accumulation. In order to prevent this progression, scaling and root planning with a periodontal endoscope was applied, and continuous clinical monitoring and risk assessment was performed every 3 months using a Florida Probe. This combined treatment supports the long-term maintenance of periodontal conditions, functional occlusion and harmony of the facial profile. [ABSTRACT FROM AUTHOR]

The main goal of periodontal therapy is to establish an oral environment compatible with periodontal health by the physical disruption of the plaque biofilm and adjunctive chemical means if required. Implicit in this objective is the ongoing requirement of detection and interception of new and recurrent disease, which continues at selected intervals for the life of the dentition after the initial (“active”) phase of periodontal treatment. This concept of ongoing periodontal maintenance therapy has been embraced as the mandatory requirement for favourable periodontal outcomes based on institutional clinical trials and in practice-based studies in various parts of the world. This review examines the ramifications of periodontal maintenance therapy based upon a multi-level assessment of logistic issues and risk factors at three levels: (1) The patient level – treatment time; patient attendance compliance; and homecare measures, antiseptics/antibiotics and smoking. (2) The level of the individual tooth – tooth loss; and evaluation of success versus survival. (3) The level of each tooth surface (“site”) – probing depth, loss of attachment and bleeding on probing; and changes in clinical attachment levels. In spite of the diversity of studies conducted, there is agreement on the efficacy of periodontal maintenance therapy when compared with studies on untreated populations and in treated cases that were not maintained. [ABSTRACT FROM AUTHOR]

Multidisciplinary therapy is essential in dental practice to achieve optimized outcomes. The present case report describes the application of periodontal surgery with a five-year follow-up in a patient with malocclusion and chronic periodontitis. In the presence of periodontal inflammation, orthodontic therapy may result in further periodontal breakdown due to plaque accumulation. In order to prevent this progression, scaling and root planning with a periodontal endoscope was applied, and continuous clinical monitoring and risk assessment was performed every 3 months using a Florida Probe. This combined treatment supports the long-term maintenance of periodontal conditions, functional occlusion and harmony of the facial profile.

The impact of tooth mobility and occlusal trauma (OT) on periodontal bone loss and need for therapy has been debated for many years. This paper summarizes the relevant literature reported in three Dental Clinics of North America articles in the late 1990s, and adds newer information from the 2000s. Principle findings indicate that strong evidence of mobility and OT impacting tooth longevity is lacking, but reducing inflammation in the surrounding periodontium remains a critical treatment. Occlusal therapy when mobility is increasing, comfort or function are compromised, or periodontal regeneration procedures are planned should be considered., (Copyright © 2015 Elsevier Inc. All rights reserved.)