D.S. Barendregt

Probing pressure, a highly undervalued unit of measure in periodontal probing: a systematic review on its effect on probing pocket depth.

AIM To investigate the influence of probing pressure on the probing pocket depth (PPD) in diseased and healthy periodontal tissue conditions through a systematic review. In addition, to facilitate comparison of the study outcomes, an attempt was made to provide a correction factor that compensates for the different probing pressures used. MATERIAL AND METHODS The MEDLINE-PubMed and Cochrane Central Register of controlled trails (Central) were searched up to June 2008 to indentify appropriate studies. RESULTS The search yielded 3032 titles and abstracts. In total, five papers fulfilled the eligibility criteria. These studies provided data with probing pressures ranging from 51 to 995 N/cm(2). For the evaluation of the results a distribution was made between diseased and healthy/treated sites. The incremental change in PPD in healthy/treated sites decreased as the pressure increased above 398 N/cm(2). In diseased sites, this phenomenon was already present at pressures above 100 N/cm(2). At healthy/treated sites, a mean increase of PPD of 0.002 mm per increase of 1 N/cm(2) in probing pressure could be calculated whereas at diseased sites this value amounted to 0.004 mm. CONCLUSION The results show that with increasing probing pressure, the PPD increases. The dimensions of the increase are dependent on the periodontal tissue conditions.

The effectiveness of conically shaped compared with cylindrically shaped interdental brushes – a randomized controlled clinical trial

AIM The purpose of this study was to compare the effectiveness of conically shaped versus cylindrically shaped interdental brushes (IDB) in patients receiving supportive periodontal therapy. MATERIALS AND METHODS Periodontal maintenance patients volunteered to be enrolled into this randomized controlled examiner-blind parallel study. At baseline and after 3 months, plaque scores, bleeding upon pocket probing scores and probing pocket depth (PPD) were assessed. The type of IDB (conical or cylindrical) was randomly assigned to each patient and individual instruction was provided regarding the method of use and the appropriate size. Only those approximal sites that had sufficient space for the IDB were eligible, and for those sites the data were analysed separately. Analyses were performed for all eligible approximal surfaces and a sub-analysis was performed for vestibular and lingual surfaces. RESULTS In total, 51 participants attended the baseline and the 3-month clinical appointments. Overall, there was no difference between conical and cylindrical IDBs. However, the conical IDB showed significantly higher plaque and bleeding scores at the lingual approximal sites. The cause of this difference was an increase in plaque and bleeding scores compared with baseline. With respect to the PPD, no difference between the IDBs was observed. CONCLUSION Within the limitations of this experiment, the conical IDBs are less effective than cylindrical IDBs with respect to lingual approximal plaque removal. Thus, in patients receiving supportive periodontal therapy, the cylindrical shape should be the first choice of IDB to obtain and maintain gingival health around natural teeth.

Prevention and Treatment of Peri-implant Diseases: Current Evidence on Cleaning of Titanium Dental Implant Surfaces

Decontamination of an implant surface is an important component of the prevention and treatment of peri-implant diseases. The most suitable instrument for surface cleaning should be chosen depending on surface characteristics, localization of the surface, and treatment goals. The best results in the available data have been reported for air-abrasive devices, and the selection of powders seems to be of importance. However, proper maintenance of peri-implant soft tissue health is largely in control of the patient and dependent on daily self-care. Subsequently, oral hygiene around dental implants should be a priority of the research agenda in dentistry. Prevention and early diagnosis are key for long-term success with dental implants.

37 Parodontale nazorg

De professionele nazorg speelt een essentiele rol in het behoud van het resultaat van parodontale behandeling op de lange termijn. Voor het behoud van gezonde parodontale weefsels rondom enossale implantaten is nazorg eveneens essentieel (Humphrey, 2006). Patienten in de nazorgfase vertegenwoordigen een populatie van mensen met een matig tot hoog risico op terugkerende parodontale infecties. Daarom is het belangrijk dat parodontitispatienten continu deelnemen aan een stringent nazorgprogramma (Axelsson & Lindhe, 1981).