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Brief Background Complex anatomy of bifurcations and trifurcations predisposes plaque accumulation in multirooted teeth leading to periodontal infection and difficulty in managing furcation defects. Assessing degree of furcation involvement depending on external tooth surface points may lead to underestimation of positive treatment outcomes. Aim To determine and compare the buccolingual width of furcation of mandibular molar with the mesial and distal roots at the level of root separation. Materials and Methods 40 mandibular molars (20 first and 20 second molars) were assessed for four horizontal buccolingual distances: CEJ, Furcation entrance (FE), Mesial root width (MRW), Distal root width (DRW). Discrepancies between FE and MRW, DRW, CEJ were determined by subtracting the FE respectively from MRW, DRW, and CEJ. Results The width of FE has a mean of 5.41 ± 0.67 mm varying from 4-7 mm in first molars and a mean of 5.18 ± 0.64 mm varying from 4-6 mm in second molars. The FE is measured more internally and shows that the actual FE is much less than the CEJ width, MRW and DRW measured buccolingually. Summary and Conclusions Clinical measurements of horizontal probing depth using external root surfaces as reference points overestimate the true anatomical component of furcation involvement in mandibular molars. Conversely, positive treatment outcomes may be underestimated. Thus, estimation of actual FE width before a surgical intervention is necessary that influences the prognosis of involved teeth after different regenerative-therapies for furcation defects. [ABSTRACT FROM AUTHOR]

Aim The gingival architecture is determined by the spatial orientation of the gingival zenith ( GZ) and the inter-dental papillae ( IP). Among the factors commonly associated with the presence and morphology of the IP, the contact point ( CP) and the inter-dental distance relationships have been considered the most important. The objective of the present controlled clinical trial was to evaluate the role of the CP in determining the clinical and morphometric parameters of the inter-dental papilla. Materials and methods The inter-dental papillae of sixty patients with unilateral diastemas were evaluated by means of periodontal probing, transgingival probing, the papilla presence index and morphometric measurement with a digital calliper and were analysed with a paired t-test, with significance set at alpha value of 0.05 or lower. Results All the papillae exhibited PPI score = 1. Papillary measurements were significantly increased in the experimental (diastema) group. Conclusions In patients with gingival health, the dimensions of the IP are significantly increased in teeth without a contact point in comparison with their contra-lateral controls with a contact point. The contact point does not determine the presence and size of the inter-dental papilla, in patients with a healthy gingiva and without periodontal attachment loss. [ABSTRACT FROM AUTHOR]

Background: Data on periodontal conditions in adolescents in the Dominican Republic are scarce. The aim of the present cross-sectional study was to estimate the prevalence of periodontal attachment loss among Dominican adolescents. This study did not attempt to classify the disease into aggressive and chronic periodontitis. Methods: A random sample of 2,007 Dominican adolescents was obtained. A probability, weighted sample was selected using a complex, multi-stage probability sampling design. The study was clustered in 26 schools and 106 classes. The study subjects were clinically examined under field conditions by a single calibrated examiner who measured gingival recession and probing depth at six sites per tooth, with subsequent calculation of clinical periodontal attachment level for each site. Results: The prevalence of clinical attachment loss ≥1 mm was 49.5%, with the prevalence ranging between 48.7% and 502%, depending on age and gender. Clinical attachment loss ≥2 mm was found in 15% of the students and attachment loss ≥3 mm in 4.0% of the students. Logistic regression model revealed that only age significantly increased the probability of having clinical attachment loss. Conclusion: We conclude that clinical attachment loss is common in adolescents in Santo Domingo, Dominican Republic, suggesting the necessity for improved standards of prevention, diagnosis, and treatment of these lesions. [ABSTRACT FROM AUTHOR]

Background: Successful treatment of molar furcation defects remains a challenge in clinical practice. Knowledge of anatomic factors facilitates predictable management of furcation involvement lesions. The degree of success in managing furcation involvement is inversely related to the horizontal probing depth. The depth of the horizontal component of attachment loss can vary depending on the external tooth-surface reference points used. However, the anatomical factors affecting horizontal component of attachment loss have not been previously assessed. Therefore, this study determined the bucco-lingual measurements of the cemento-enamel junction and the mesial and distal roots and at the level of root separation. Methods: One hundred extracted permanent human mandibular first (N = 50) and second (N = 50) molars were studied. Four horizontal bucco-lingual widths were measured with calibrated calipers: 1) furcation entrance/roof (FE); 2) cemento-enamel junction level (CEJ); 3) mesial root width (MRW); and 4) distal root width (DRW). Results: The mean widths at FE, CEJ, MRW, and DRW were, respectively, 5.53 ± 0.45 mm, 8.71 ± 0.54 mm, 8.57 ± 0.54 mm, and 7.97 ± 0.65 mm in the first molars and 5.61 ± 0.65 mm, 8.40 ± 0.65 mm, 7.95 ± 0.88 mm, and 7.16 ± 0.84 mm in the second molars. Analysis of variance revealed significant differences between FE and the other variables tested. The results showed that the bucco-lingual width of the furcation roof is considerably shorter than the MRW and DRW. The difference in the mean bucco-lingual dimension between FE and the other measurements occurred in all teeth evaluated and varied between 0.7 and 4.30 mm. Conclusions: Our findings demonstrate that clinical measurements of horizontal probing depth that use the external surfaces of roots as reference points overestimate the true anatomical component of furcation involvement in mandibular molars. Conversely, positive treatment outcomes in these teeth may be underestimated. This has implications not only for clinical practice but also for clinical research studies evaluating treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: The objective of this investigation is to use noninvasive, state-of-the-art, diagnostic techniques to measure periodontal disease progression and model periodontal disease activity over time. In this investigation, digital subtraction radiography and on electronic controlled force periodontal probe capable of attachment level measurement were used to measure bone loss and attachment loss, respectively. The use of these nearly continuous measures of attachment and bone loss allowed detection of small amounts of disease activity and provided data to be used in modeling of the disease process over time Methods: Forty four patients were studied for 18 months. Examinations used clinical attachment level measures at 1-month intervals and quantitative radiology at 6-month intervals The sites were analyzed by regression for statistically significant changes. These data were used to determine sites of periodontal disease activity for testing various models of periodontal dial ease progression. Results: Overall 22.8% of sites lost attachment, 5.4% gained, and 71.7% demonstrated no statistically significant change. The mean time to lose 1 mm of attachment was 8.4 ± 0.6 months In the first model tested a step wise discriminant analysis was used to determine whether or not baseline measurements of plaque (PI), gingival inflammation (GI), attachment loss, and probing depth (PD) could be used to derive a satisfactory model for disease progression. Although the overall model was statistically significant with PI, PD, and GI contributing to the model (Wilks' lambda = 0.859, F = 5.71, P <0.0012), its predictive power was relatively weak. A considerably stronger significant model resulted when the rate of attachment loss over the first 6 months, baseline PI, and baseline GI were included Wilks' lambda = 0.712, F = 14.17, P <0.00001). A significant model also resulted when bone loss during the first 6 months and baseline probing depth were included (Wilks' lambda = 0.438, F = 61.48, P <0.00001). When the last model was applied to each site, the sensitivity in predicting disease progression was 80.0% and the specificity in ruling out progressive disease was 93.9%. Conclusions: This study indicates that clinically significant progression of attachment loss in posterior tooth sites occurs as a frequent event in adult periodontitis. The modeling data also suggest that short term (6 month) measures of periodontal disease progression greatly improve the ability to model attachment loss over a longer period in untreated periodontitis patients. [ABSTRACT FROM AUTHOR]

Background: Longitudinal site-specific attachment level change (SSAC), identified from serial relative attachment level measurements (RAL), is the principal indicator of progression/regression of periodontal diseases. Many variables confound RAL reproducibility and affect measurement error. The Option-4 algorithm was designed to reduce measurement error and improve accuracy and sensitivity of SSAC detection. The study aimed to evaluate the performance of the Option-4 algorithm. Methods: A precalibrated clinician recorded full mouth RAL with a third generation disc probe on 4 occasions over 6 months in 16 subjects (mean age 48.1 years) with moderately advanced chronic adult periodontitis (2,312 sites). Option-4 allowed up to 4 RAL recordings per site per visit until 2 values had differences ≤ 1.0 mm and their mean was ≤ 1.0 mm from the previous visit mean: the clinician made the selection if these criteria were unfulfilled. Results: Within-visit agreement ≤ 1.0 mm was ≥ 99.6%: all within-visit correlation coefficients = 0.98 (P < 0.001). At each visit, mean difference in Option-4 values was < 0.05 mm, mean absolute difference (ignoring direction) was ≤ 0.34 mm. Mean site-specific variances ranged from 0.092 mm² to 0.097 mm² across all visits. Subject thresholds for site-specific attachment level change (from estimated 95% confidence limits of visit 1 data) ranged from 0.52 mm to 0.67 mm. Linear SSAC (by linear regression) and between-visit patterns of SSAC were investigated. SSAC was detected in 100% subjects and at 51.0% measured sites. Linear SSAC (R² ≥ 0.90: P ≤ 0.05) occurred at 105 sites (4.5%): 32 sites (1.4%) deteriorated, 73 sites (3.1%) improved. Between-visit SSAC occurred at 1,074 sites (46.5%): 391 sites (16.9%) deteriorated, 295 sites (12.8%) improved, and 388 sites (16.8%) showed exacerbation/remission patterns. Conclusions: The Option-4 algorithm produced high RAL agreement. Site-specific attachment level change was detected in both directions in 100% subjects and at 51.0% measured sites. [ABSTRACT FROM AUTHOR]