BOOK
Unanswered Questions in Periodontology, An Issue of Dental Clinics of North America, E-Book
(2016)
Additional Information
Book Details
Abstract
This issue, edited by Dr. Frank Scannapieco, is devoted to "Unanswered Questions in Periodontology." Review articles will help answer clinical questions such as: Can lost bone in furcations be regenerated?; What biomarkers exist to detect active periodontal disease?; Which mouthrinse products are beneficial for plaque control and gingival health?; Do mobility and occlusal trauma impact periodontal longevity?; Can peri-implantitis be treated?; Is there a genetic basis for periodontitis?; What is the minimal sample size for studies of periodontal treatment?; Does treatment of periodontal disease influence systemic disease?; Does periodontal disease cause cancer?; Is the use of photodynamic therapy beneficial to conventional mechanical therapy in the treatment of periodontitis and peri-implantitis?; Are radiographs the best modality to diagnose and monitor periodontitis?; Does gingival recession require surgical treatment?; and Should antibiotics be prescribed to treat chronic periodontitis?
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Unanswered Questions\rin Periodontology | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Unanswered Questions in Periodontology | vii | ||
| What is the Contribution of Genetics to Periodontal Risk? | vii | ||
| What is the Proper Sample Size for Studies of Periodontal Treatment? | vii | ||
| Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis Control? | vii | ||
| Is Photodynamic Therapy an Effective Treatment for Periodontal and Peri-Implant Infections? | viii | ||
| Is Radiologic Assessment of Alveolar Crest Height Useful to Monitor Periodontal Disease Activity? | viii | ||
| Do Mobility and Occlusal Trauma Impact Periodontal Longevity? | viii | ||
| Does Treatment of Periodontal Disease Influence Systemic Disease? | viii | ||
| Should Antibiotics Be Prescribed to Treat Chronic Periodontitis? | ix | ||
| Unanswered Questions: Can Bone Lost from Furcations Be Regenerated? | ix | ||
| Can Periimplantitis Be Treated? | ix | ||
| Does Gingival Recession Require Surgical Treatment? | ix | ||
| DENTAL CLINICS OF NORTH AMERICA | xi | ||
| FORTHCOMING ISSUES | xi | ||
| January 2016 | xi | ||
| April 2016 | xi | ||
| July 2016 | xi | ||
| RECENT ISSUES | xi | ||
| July 2015 | xi | ||
| April 2015 | xi | ||
| January 2015 | xi | ||
| Preface: Unanswered Questions in Periodontology | xiii | ||
| What is the Contribution of Genetics to Periodontal Risk? | 761 | ||
| Key points | 761 | ||
| INTRODUCTION | 761 | ||
| PERIODONTITIS IS A COMPLEX DISEASE | 762 | ||
| PERIODONTITIS DEVELOPMENT AND PROGRESSION | 764 | ||
| SOME THEORETIC BACKGROUND ON GENETICS | 766 | ||
| HOW TO IDENTIFY PERIODONTITIS-ASSOCIATED GENETIC MARKERS | 768 | ||
| Candidate Gene Approach | 768 | ||
| The Genomewide Association Study Approach | 770 | ||
| THE BEST REPLICATED AND VALIDATED GENETIC FACTORS FOR PERIODONTITIS | 771 | ||
| COX2 on Chromosome 1 | 771 | ||
| IL10 on Chromosome 1 | 771 | ||
| IL1 Genes on Chromosome 2 | 772 | ||
| DEFB1 on Chromosome 8 | 772 | ||
| ANRIL on Chromosome 9 | 772 | ||
| GLT6D1 on Chromosome 9 | 773 | ||
| Other Suggested Periodontitis Genes Based on Genomewide Association Study | 773 | ||
| Other Suggested Periodontitis Genes Based on the Candidate Gene Approach | 775 | ||
| DISCUSSION AND CONCLUSIONS | 775 | ||
| REFERENCES | 776 | ||
| What is the Proper Sample Size for Studies of Periodontal Treatment? | 781 | ||
| Key points | 781 | ||
| INTRODUCTION | 781 | ||
| GENERAL REQUIREMENT OF SAMPLE SIZES FOR THE VALIDITY OF STATISTICAL TESTS | 783 | ||
| Tests for Categorical Data | 783 | ||
| Logistic Regression with Binary Outcomes | 783 | ||
| Tests for Numeric Data | 784 | ||
| Regression and Analysis of Variance with Numeric Outcomes | 785 | ||
| Goodness-of-Fit Testing | 786 | ||
| CHARACTERISTIC OF THE DATA IN PERIODONTAL RESEARCH AND THE CORRESPONDING SAMPLING DISTRIBUTIONS | 786 | ||
| CAUTION ON USING THE BOOTSTRAP METHOD FOR A SMALL SAMPLE SIZE | 789 | ||
| ALTERNATIVE METHODS FOR SMALL SAMPLE SIZES | 790 | ||
| Categorical Data Analysis | 790 | ||
| Exact Logistic Regression | 791 | ||
| Data Analysis with Numeric or Ordinal Data | 791 | ||
| Alternatives to Regression Given Small Sample Sizes | 792 | ||
| Confidence Intervals | 793 | ||
| DISCUSSION | 794 | ||
| REFERENCES | 795 | ||
| Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis Control? | 799 | ||
| Key points | 799 | ||
| INTRODUCTION | 800 | ||
| MATERIALS AND METHODS | 801 | ||
| Focused Question | 801 | ||
| Search Strategy | 801 | ||
| Screening and Selection | 801 | ||
| Inclusion and Exclusion Criteria | 802 | ||
| Data Extraction and Assessment of Heterogeneity | 802 | ||
| Quality Assessment | 802 | ||
| Grading the ‘Body of Evidence’ | 803 | ||
| RESULTS | 803 | ||
| Search and Selection Results | 803 | ||
| Study Outcomes and Assessment of Heterogeneity | 803 | ||
| Quality Assessment | 803 | ||
| Active Ingredients | 803 | ||
| Single Active Ingredients | 804 | ||
| Alexidine | 804 | ||
| Cetylpyridinium chloride | 816 | ||
| Chlorhexidine | 816 | ||
| Delmopinol | 817 | ||
| Essential oils | 817 | ||
| Hexetidine | 818 | ||
| Oxygenating agents | 818 | ||
| Sanguinarine | 818 | ||
| Stannous fluoride | 818 | ||
| Triclosan | 819 | ||
| Comparisons of Active Ingredients | 819 | ||
| Chlorhexidine 0.12% versus chlorhexidine 0.2% | 819 | ||
| Essential oils versus chlorhexidine | 819 | ||
| Essential oil versus alcohol solution | 819 | ||
| Hexetidine versus chlorhexidine | 820 | ||
| Oxygenating agents versus chlorhexidine | 820 | ||
| Combination of Active Ingredients | 820 | ||
| Chlorhexidine and oxygenating agents | 820 | ||
| Evidence Profile | 820 | ||
| DISCUSSION | 820 | ||
| Grading | 822 | ||
| Side Effects | 822 | ||
| Chlorhexidine and sodium lauryl sulfate | 823 | ||
| Substantivity and bioavailability | 823 | ||
| Alcohol | 824 | ||
| Rinse Duration and Volume | 824 | ||
| Limitations of mouthwashes in the prevention of dental plaque formation | 825 | ||
| Cost-effectiveness | 826 | ||
| SUMMARY | 826 | ||
| ACKNOWLEDGMENTS | 826 | ||
| REFERENCES | 826 | ||
| Is Photodynamic Therapy an Effective Treatment for Periodontal and Peri-Implant Infections? | 831 | ||
| Key points | 832 | ||
| BIOLOGICAL RATIONALE | 832 | ||
| USE OF PHOTODYNAMIC THERAPY AS ADJUNCT TO NONSURGICAL PERIODONTAL THERAPY IN PATIENTS WITH UNTREATED CHRONIC PERIODONTITIS | 833 | ||
| USE OF PHOTODYNAMIC THERAPY AS ADJUNCT TO NONSURGICAL PERIODONTAL THERAPY IN PATIENTS WITH AGGRESSIVE PERIODONTITIS | 844 | ||
| USE OF PHOTODYNAMIC THERAPY AS AN ADJUNCT TO NONSURGICAL PERIODONTAL THERAPY IN MAINTENANCE PERIODONTITIS PATIENTS | 844 | ||
| USE OF PHOTODYNAMIC THERAPY AS AN ALTERNATIVE TO SYSTEMIC OR LOCAL ANTIBIOTICS | 844 | ||
| SUMMARY | 854 | ||
| CLINICAL RECOMMENDATIONS | 854 | ||
| REFERENCES | 855 | ||
| Is Radiologic Assessment of Alveolar Crest Height Useful to Monitor Periodontal Disease Activity? | 859 | ||
| Key points | 859 | ||
| INTRODUCTION | 859 | ||
| RADIOGRAPHIC ASSESSMENT OF ALVEOLAR CREST LEVEL | 860 | ||
| RADIOGRAPHIC MEASUREMENT OF ALVEOLAR CREST HEIGHT | 865 | ||
| LOOKING TOWARD THE FUTURE OF RADIOGRAPHIC ASSESSMENT OF PERIODONTAL DISEASE | 868 | ||
| SUMMARY | 870 | ||
| ACKNOWLEDGMENTS | 870 | ||
| REFERENCES | 870 | ||
| Do Mobility and Occlusal Trauma Impact Periodontal Longevity? | 873 | ||
| Key points | 873 | ||
| HISTORICAL EVIDENCE | 874 | ||
| RECENT EVIDENCE: OCCLUSAL TRAUMA AND MOBILITY IMPACT ON PERIODONTITIS PROGRESSION | 875 | ||
| POTENTIAL INDICATIONS AND SCIENTIFIC RATIONALE FOR REDUCING OCCLUSAL TRAUMA IN PERIODONTITIS | 876 | ||
| IMPACT OF OCCLUSAL TRAUMA ON PERI-IMPLANT BONE LOSS | 876 | ||
| CLINICAL CONSIDERATIONS | 877 | ||
| ACKNOWLEDGMENTS | 880 | ||
| REFERENCES | 880 | ||
| Does Treatment of Periodontal Disease Influence Systemic Disease? | 885 | ||
| Key points | 885 | ||
| INTRODUCTION | 885 | ||
| Periodontitis—What Is It? | 886 | ||
| SYSTEMIC EFFECTS OF PERIODONTAL INFECTION | 886 | ||
| How Does Periodontal Infection Affect Systemic Health? | 886 | ||
| Bacteremia | 887 | ||
| The oral bacterial burden | 888 | ||
| Inflammation | 888 | ||
| What is inflammation? | 888 | ||
| Inflammation originating in the periodontal microbiome | 889 | ||
| Immune response | 889 | ||
| SYSTEMIC EFFECTS OF PERIODONTAL TREATMENT | 889 | ||
| Effects on Bacterial Load, Inflammation, and Immune Response | 890 | ||
| Effects of Periodontal Treatment on Local and Systemic Inflammation | 890 | ||
| Bacteremia | 890 | ||
| Inflammatory response | 890 | ||
| Immune response | 891 | ||
| A Special Note on Antibodies (Immune Response) to Periodontal Bacteria | 891 | ||
| Gingivitis Treatment Alone Also Has a Positive Effect on Bacterial Load and Inflammation | 891 | ||
| Effects on Systemic Diseases | 892 | ||
| Diabetes | 892 | ||
| Periodontitis: associations with diabetes and prediabetes | 892 | ||
| Periodontal infection: effects on blood glucose levels | 892 | ||
| How Inflammation Leads to Hyperglycemia—What to Tell the Patient | 895 | ||
| Periodontal Treatment in Type 2 Diabetes: Effects on Glycemic Control | 895 | ||
| The diabetes and periodontal therapy trial | 896 | ||
| Is a reduction of 0.4 percentage points HbA1c clinically meaningful? | 898 | ||
| Periodontal Treatment in Prediabetes: Effects on Blood Glucose Levels | 898 | ||
| Gingivitis Treatment Only: Effect on Inflammation in Diabetes | 899 | ||
| In summary | 899 | ||
| Metabolic Syndrome | 899 | ||
| Nonalcoholic Fatty Liver Disease | 900 | ||
| In summary | 900 | ||
| Cerebrocardiovascular Disease | 900 | ||
| Bacteremia | 900 | ||
| Inflammation | 901 | ||
| Periodontal treatment: effect on cardiovascular diseases and events | 901 | ||
| Periodontal treatment: effects on risk factors for cardiovascular events | 901 | ||
| Periodontal treatment: effect on intima media thickness and endothelial dysfunction | 902 | ||
| Rheumatoid Arthritis | 902 | ||
| Gingivitis treatment alone: effect on rheumatoid arthritis manifestation | 903 | ||
| In summary | 903 | ||
| Respiratory Tract Diseases | 903 | ||
| Aspiration pneumonia | 903 | ||
| Ventilator-assisted pneumonia | 904 | ||
| Chronic obstructive pulmonary disease | 904 | ||
| Chronic Kidney Disease | 904 | ||
| Periodontal treatment: effect on chronic kidney disease | 904 | ||
| In summary | 904 | ||
| Cancer | 905 | ||
| In summary | 905 | ||
| Other Diseases | 905 | ||
| Obesity | 906 | ||
| Pregnancy | 906 | ||
| Why It Is so Difficult to Determine Whether Periodontal Treatment Has Systemic Effects | 906 | ||
| SUMMARY | 907 | ||
| REFERENCES | 908 | ||
| Should Antibiotics Be Prescribed to Treat Chronic Periodontitis? | 919 | ||
| Key points | 919 | ||
| INTRODUCTION | 919 | ||
| PATIENT EVALUATION FOR POTENTIAL USE OF AN ANTIBIOTIC: OVERVIEW | 922 | ||
| EFFICACY OF SCALING AND ROOT PLANING AS THE SOLE TREATMENT OF PERIODONTITIS | 923 | ||
| EFFICACY OF SYSTEMIC ANTIBIOTICS AS THE SOLE TREATMENT OF PERIODONTITIS | 923 | ||
| EFFICACY OF SCALING AND ROOT PLANING COMBINED WITH SYSTEMIC ANTIBIOTICS | 924 | ||
| TREATMENT COMPLICATIONS AND RESISTANCE | 925 | ||
| EVALUATION OF OUTCOME AND LONG-TERM RECOMMENDATIONS | 929 | ||
| SUMMARY | 929 | ||
| REFERENCES | 930 | ||
| Unanswered Questions | 935 | ||
| Key points | 935 | ||
| INTRODUCTION | 935 | ||
| DIAGNOSIS AND CLASSIFICATION OF FURCATION DEFECTS | 936 | ||
| TREATMENT OF FURCATION DEFECTS | 937 | ||
| THE PROBLEM WITH PROBING | 937 | ||
| POUCHES WITHIN FURCATIONS | 938 | ||
| TYPES OF EVIDENCE FOR NEW BONE GROWTH IN FURCATION DEFECTS | 938 | ||
| HISTOLOGIC EVIDENCE FOR NEW BONE GROWTH IN FURCATION DEFECTS IN ANIMAL MODELS | 940 | ||
| HISTOLOGIC EVIDENCE FOR NEW BONE GROWTH IN HUMAN FURCATION DEFECTS | 942 | ||
| EVIDENCE FOR NEW BONE GROWTH IN HUMAN FURCATION DEFECTS OBTAINED BY SURGICAL REENTRY | 944 | ||
| PERIODONTAL REGENERATION | 946 | ||
| SUMMARY | 947 | ||
| REFERENCES | 947 | ||
| Can Periimplantitis Be Treated? | 951 | ||
| Key points | 951 | ||
| INTRODUCTION | 951 | ||
| Definition | 952 | ||
| Diagnosis | 952 | ||
| Classification | 953 | ||
| Epidemiology | 954 | ||
| Goals of Treatment | 954 | ||
| CONTROL OF CONTRIBUTING FACTORS | 954 | ||
| Patient-Related Factors | 954 | ||
| Smoking | 954 | ||
| Periodontal status | 955 | ||
| Implant-Related Factors | 955 | ||
| Implant position | 955 | ||
| Prosthetic considerations | 958 | ||
| THERAPEUTIC OPTIONS AND THEIR CLINICAL OUTCOMES | 959 | ||
| Nonsurgical Interventions | 959 | ||
| Antiinfective measures | 959 | ||
| Mechanical debridement | 959 | ||
| Chemotherapeutics | 959 | ||
| Lasers | 961 | ||
| Summary | 961 | ||
| Surgical Interventions | 961 | ||
| Access flap | 967 | ||
| Resective and regenerative | 967 | ||
| Summary | 969 | ||
| PROPOSED WORKFLOW | 969 | ||
| SUMMARY | 971 | ||
| REFERENCES | 972 | ||
| Does Gingival Recession Require Surgical Treatment? | 981 | ||
| Key points | 982 | ||
| INTRODUCTION | 982 | ||
| ETIOLOGY | 983 | ||
| Predisposing Factors | 983 | ||
| Precipitating Factors | 984 | ||
| PATHOGENESIS OF GINGIVAL RECESSION | 986 | ||
| FACTORS TO BE CONSIDERED FOR TREATING GINGIVAL RECESSION | 987 | ||
| Classification of Recession Defects | 987 | ||
| Patient’s Concerns | 987 | ||
| Unsatisfactory esthetics | 989 | ||
| Root hypersensitivity | 989 | ||
| Active Recession (Progression) | 990 | ||
| Restorative or Orthodontic Needs | 990 | ||
| TREATMENT GOALS | 990 | ||
| TREATMENT OUTCOMES OF VARIOUS SURGICAL PROCEDURES | 991 | ||
| SUMMARY AND FINAL REMARKS | 992 | ||
| REFERENCES | 993 | ||
| Index | 997 |