Știri

Pacienții cu poliartrită reumatoidă prezintă un risc semnificativ mai mare de parodontoză, iar acest risc crește și mai mult în cazul pacienților cu poliartrită reumatoidă deosebit de activă.

Lupta pentru recuperarea și păstrarea dinților parodontotici este, de cele mai multe ori, opțiunea cea mai avantajoasă pentru pacienți, din punct de vedere financiar, fiind de regulă mai ieftină decât manoperele de extracție și implantare ulterioară.

Un tratament parodontal nechirurgical poate reduce nivelul glicemiei pe termen lung (HbA1c) la diabeticii de tip 2, cu 0,3%, iar acest efect a persistat chiar și după șase luni de la tratament.

Explore the complexities of dental implant care: This scientifically backed article summarises the critical aspects of diagnosis, oral hygiene, and expert strategies for the effective management of both, mucositis and peri-implantitis.

Forma coroanei implantului are o influență semnificativă asupra modului în care aceasta poate fi întreținută în condițiile obiceiurilor de igienă orală la domiciliu. Se observă, de asemenea, că formele concave ale coroanei par să fie mai ușor de curățat; iar partea inferioară a coroanei implantului, din zona posterioară, este mai ușor de accesat cu ața dentară.

Factorii care pot fi atribuiți unui stil de viață nesănătos și, în mai ales, o combinație a acestora, au dus la constatări îngrijorătoare privind creșterea semnificativă a profunzimii pungilor parodontale. La sondări reziduale, creșterile au fost în medie de 6 mm. Astfel, se observă diminuarea substanțială a probabilității atingerii rezultatelor de tratament dorite, la pacienții cu parodontoză, în urma tratamentului parodontal nechirurgical (etapele de tratament 1 și 2).

Acumularea de biofilm este principalul factor etiologic în dezvoltarea bolilor periimplantare; controlul plăcii și terapia de întreținere a implantului sunt, prin urmare, esențiale în prevenirea bolilor periimplantare.

O definiție a tratamentului parodontal de succes este dificil de realizat, însă acesta poate fi asociat cu o rată mai mică de pierdere a dinților; totuși, rata de pierdere a dinților la pacienții care participă cu regularitate la ședințele de tratament parodontal de susținere este, în general, foarte scăzută.

La o vârstă mai înaintată, pierderea dinților determină o reducere semnificativă a participării sociale în viața societății, în timp ce menținerea unui număr de minim 20 de dinți produce efectul opus, ducând la o îmbunătățire semnificativă și, prin urmare, la o prezență socială mai frecventă.

În acest studiu, tratamentul nechirurgical al periimplantitei a avut succes doar în 25% din cazuri și a fost influențat negativ de un istoric medical cu parodontoză și fumat, de o igienă orală inadecvată și de un diametru mare al implantului.

Prevenirea bolilor periimplantare este cel mai bun tratament, iar țesutul moale periimplantar poate juca un rol decisiv în acest caz; din acest motiv, echipa trebuie să determine dacă este nevoie de tratament la pacienții cu lipsă de mucoasă cheratinizată (adică o profunzime a mucoasei cheratinizate de < 2 mm).

Un procent foarte mare de pacienți au avut experiențe pozitive, în urma implantării, iar majoritatea pacienților au fost foarte mulțumiți de rezultat; cu toate acestea, criticile frecvente au fost legate de costurile tratamentului și dificultatea procesului de igienizare.

Femeile care fac exerciții fizice în mod regulat au prezentat un risc semnificativ mai scăzut de parodontopatie și o severitate mult diminuată a parodontozei.

Reabilitarea și înlocuirea dentiției lipsă duc la o îmbunătățire semnificativă a calității vieții, în raport cu sănătatea orală și, de asemenea, tind să îmbunătățească și starea generală de sănătate

Un studiu bazat pe chestionare a arătat că parodontoza crește semnificativ riscul de alterare a simțului gustativ și olfactiv.

Fumatul și adâncimea de sondare crescută, la vârste tinere (adică < 20 de ani), reprezintă factori de risc semnificativi pentru debutul timpuriu al parodontozei (de exemplu, sub 30 de ani).

Automatic toothbrushing could have future potential, but still requires further technical developments to improve existing shortcomings with regard to customizsation for different jaw sizes and tooth positions, interdental spaces and choice of optimal brushing time.

Even when told to brush their teeth as well as possible, the quality of tooth brushing among young adults is poor; the main weaknesses are cleaning palatal/lingual surfaces and overall brushing technique.

Controlul optim al diabetului zaharat, terapia de susținere periodică a implantului și ameliorarea deficitului de țesuturi moi periimplantare s-au dovedit a fi caracteristici esențiale în prevenirea primară a bolilor periimplantare.

Optimal diabetes control, regular supportive implant therapy and augmentation of peri-implant soft tissue deficits have proven to be crucial features in primary prevention of peri-implant diseases.

Măsuri suplimentare aplicate local, sau luate sistematic de pacient (de exemplu, antiseptice sub formă de soluții de clătire a gurii sau probiotice), ar putea avea un efect pozitiv suplimentar în tratamentul mucozitei periimplantare.

Aditivii chimici utilizați pentru curățarea suprafeței implantului, ca parte a terapiei non-chirurgicale a peri-implantitei, ar putea da rezultate, însă pentru că există destul de puține studiile bine realizate, cu un număr suficient de pacienți și o perioadă de urmărire suficient de lungă, astfel că nu putem recomanda cu adevărat o metodă specifică și/sau un produs specific.

Din cauza lipsei continue de studii clinice bine realizate, nu este încă posibil, pe baza dovezilor, să se ofere recomandări de tratament clare, pentru o curățare mecanică în cadrul unui tratament nechirurgical al peri-implantitei.

Având în vedere dovezile existente, nu se pot recomanda terapii chimice adjuvante, administrate profesional, pentru tratamentul mucozitei periimplantare; produsele testate până în prezent nu au demonstrat niciun beneficiu semnificativ, comparativ cu debridarea exclusivă.

Dispozitivele de curățare interdentară acționate electric par să aibă o eficacitate comparabilă cu cea a aței dentare, pentru pacienții cu gingivită, dar în același timp au avantajul că pacienții le preferă.

Oral health (gingivitis, periodontitis) influences the occurrence and the healing process of oral mucositis in patients with haematological disorders who are given high-dose chemotherapy.

As part of non-surgical periodontal treatment, the additional use of air-polishing treatment could be beneficial for deep baseline probing pocket depths (≥ 5.5 mm) in particular.

Pacienții cu afecțiuni intestinale inflamatorii prezintă un risc mai mare de boli ale cavității bucale (parodontoză și pierderea dinților), iar aceste boli par, la rândul lor, să crească gradul de activitate al bolii inflamatorii intestinale.

Treating gingivitis is not only the most effective option for preventing the occurrence of periodontitis, but also leads to a reduction in systemic inflammatory markers, whilst also improving the patient’s quality of life in terms of oral health.

Pe baza literaturii disponibile, fumatul țigărilor electronice pare să aibă un efect negativ întrucâtva mai redus, asupra sănătății parodontale, în comparație cu țigările tradiționale.

Pacienții cu parodontoză ar trebui să fie întotdeauna integrați într-un program de tratament de suport, întrucât rata de recurență și, prin urmare, un nou episod inflamator, este foarte probabil.

Am încercat mereu să îmbunătățim sănătatea dinților pacienților noștri, dar reușim noi cu adevărat să facem acest lucru? S-a îmbunătățit oare sănătatea orală în Europa în ultimii ani/decenii? Oare pacienții noștri pierd mai puțini dinți?

Emdogain este un produs care are în componență derivați din matricea proteică a smalțului, sintetizați din țesuturi embrionare porcine. Este utilizat cu succes în chirurgia parodontală de peste 20 de ani și, cu indicații și aplicații corecte, poate fi folosit pentru obținerea unor rezultate remarcabile, inclusiv regenerarea cel puțin parțială a defectelor parodontale.

As early as 2016 (Monsarrat et al. 2016), a study outlined a link between periodontitis and 57(!) systemic diseases, the most well-known of these being diabetes mellitus and cardiovascular diseases. Time and again, these links prompt a discussion about the need for positive cooperation between dentists and doctors in order to improve early diagnosis of specific systemic diseases.

Încă din 2016 (Monsarrat et al. 2016), un studiu a evidențiat o legătură între parodontoză și 57(!) de boli sistemice, cele mai cunoscute dintre acestea fiind diabetul zaharat și bolile cardiovasculare. De fiecare dată, aceste legături provoacă o discuție despre necesitatea unei colaborări pozitive între stomatologi și medici pentru a îmbunătăți diagnosticarea timpurie a bolilor sistemice specifice.

Aveți sensibilitate la nivelul coletului dentar după tratamentul parodontal? Iată ce puteți face în acest sens! Aveți sensibilitate la nivelul coletului dentar după tratamentul periodontal nechirurgical, care, din nefericire, poate implica o serie de dezavantaje, care sunt sursele apariției unor nemulțumiri din partea pacienților noștri în repetate rânduri. De exemplu, aceștia se plâng de aspectul mai lung al dinților lor și/sau de sensibilitatea crescută a coletului dentar expus. Studiile au arătat că aproximativ 60 până la 90% dintre pacienții noștri suferă de sensibilitate dentară la nivelul coletului în perioada imediat următoare terapiei parodontale nechirurgicale și că între o treime și un sfert dintre pacienți suferă încă de sensibilitate dentară la nivelul coletului după 4 până la 8 săptămâni (Lin et al. 2012).

Discuția despre periuțele de dinți cu peri moi, medii sau tari nu este una nouă și, cu toate acestea, nu încetează să apară literatură nouă pe această temă, așa că este un subiect pe care ținem să-l abordăm.

"Noua" clasificare a afecțiunilor parodontale și peri-implantare, deși apărută acum aproape cinci ani, a inclus pentru prima dată o definiție pentru un pacient cu parodontoză tratată cu succes.

The optimal treatment result for periodontitis patients is for them to keep their own teeth in good condition for as long as possible. However, there are both patients and teeth with certain characteristics that make it significantly harder to actually achieve this objective!

Pandemia Covid-19 a reprezentat și continuă să reprezinte o provocare majoră pentru noi toți - inclusiv pentru pacienții noștri și pentru respectarea de către aceștia a obligației de a se prezenta la controale stomatologice regulate. De exemplu, încă din primele luni ale pandemiei, pacienții s-au dovedit a fi mult mai reticenți în ceea ce privește participarea la controalele și programările medicale (Makiyama 2020). Cu toate acestea, acum că pandemia a continuat mult mai mult timp decât s-a anticipat inițial, este important să ne încurajăm pacienții să înceapă să se prezinte din nou la programările regulate pentru controale și tratamente.

Rezultatul optim al tratamentului pentru pacienții cu parodontoză este ca aceștia să-și păstreze dinții proprii în stare bună cât mai mult timp posibil. Cu toate acestea, există atât pacienți, cât și dinți cu anumite caracteristici care îngreunează semnificativ atingerea efectivă a acestui obiectiv!

Curățarea interdentară nu este o activitate preferată de majoritatea pacienților. Mai mult, pe baza unui sondaj efectuat pe un eșantion reprezentativ de 2000 de americani, s-a constatat că aproape o treime dintre pacienți își mint medicul dentist atunci când sunt întrebați despre obiceiurile lor de curățare a dinților și, în special, despre utilizarea aței dentare. Acestea fiind spuse, este responsabilitatea noastră să recomandăm cel mai bun instrument de curățare interdentară eficientă pentru fiecare dintre pacienții noștri - în ceea ce privește îndepărtarea eficientă a plăcii dentare, dar și în ceea ce privește respectarea cerințelor pe termen lun.

According to the recently published S3 guidelines about treating patients with stage I–III periodontitis (Sanz 2020), the current evidence-based recommendation is to perform subgingival debridement as part of non-surgical periodontal treatment with hand instruments and/or (ultra)sound devices. But of course, the search continues to find options that will further improve the outcome of non-surgical periodontal treatment.

We are used to telling our patients, ‘Clean your teeth twice daily!’. But where does this idea come from, and is it really necessary to brush twice daily? What would happen if we only brushed our teeth once every two days?

To achieve a high level of compliance among periodontitis patients in the maintenance phase of treatment, it is important to make this maintenance therapy, including professional mechanical plaque removal, as pleasant as possible. Unfortunately, however, patients often experience pain during cleaning with (ultra)sonic devices, which could reduce their compliance later on and, in particular, in the long term.

In the previous article we summarized the results of a systematic review about manifestations of oral symptoms in patients with a Covid-19 infection (see: Covid-19 & oral symptoms). Another fascinating study was recently published in the Journal of Clinical Periodontology. In this study, Marouf et al. (2021) investigated the possible influence of periodontitis on the progression of Covid-19 infections.

According to data from the World Health Organization (WHO), almost 110,000,000 people have tested positive for Covid-19 since the pandemic began in December 2019, and 2,435,000 of these cases have had a fatal outcome. On account of this huge outbreak, our professional and social lives have also changed over the past twelve months, in some cases massively.

Are anxiety and depression caused by periodontitis? Or is periodontitis caused by anxiety and depression? According to the literature, the connection between periodontal disease and mental illness or mood disorders is probably bi-directional; this means that each illness can influence the other.

‘Tooth brushing and risk of stroke’ – are the two really connected? This hypothesis is based on the following theory: Poor and insufficient oral hygiene can lead to gingivitis and, in turn, to periodontitis. In periodontitis, oral bacteria can enter the bloodstream, resulting in a local and systemic inflammatory reaction. This inflammatory reaction is accompanied by an increase in inflammatory markers, and it is this mechanism that could in turn increase the risk of having a stroke.

Mechanical biofilm management at home is indispensable for preventing gingivitis and subsequent periodontitis. The German Society for Periodontology (DG Paro) recently published new guidelines on this topic: ‘Mechanical biofilm management at home for the prevention and treatment of gingivitis’

Cum putem demonstra pacienților noștri cât de nociv este fumatul pentru dinți?? Am abordat deja acest subiect într-unul dintre primele noastre articole științifice și am reușit să oferim un exemplu puternic (Fumatul și parodontoza): 'Fumatul reduce substanțial capacitatea de vindecare a parodonțiului, în timpul tratamentului parodontal - se consideră că puterea de vindecare a parodonțiului unui fumător de 50 de ani corespunde, cu aproximație, cu cea a parodonțiului unui nefumător de 86 de ani - adică o diferență de 36 de ani!’

Periodontitis and pregnancy – it’s something we deal with regularly in our day-to-day work. But what can we do? And – most importantly – what are we allowed to do?

Diabetes mellitus and periodontitis are two of the most common chronic diseases. Diabetes mellitus affects approximately 415 million people worldwide, and periodontitis affects as many as 750 million. Furthermore, these two diseases mutually affect each other, and periodontitis constitutes one of the main complications of diabetes. But what exactly is the current situation among patients with periodontitis and/or type 2 diabetes mellitus?

We recently discussed the links between periodontitis and diabetes mellitus. But what do you need to watch out for when giving periodontal treatment to patients who also have diabetes?

The patient has received their new implant-supported prosthesis, but our work is not done yet. Now we have to help the patient enjoy their new implant and crowns for as long as possible, a task that includes keeping the implant and surrounding tissue healthy and free from inflammation. To enable prompt recognition of any peri-implant disease that may subsequently occur, it is important to perform a ‘baseline examination’ after the patient has received their implant-supported prosthesis.

Fumatul și parodontoza - cât de grav este cu adevărat?

To be able to diagnose peri-implant diseases correctly, it is helpful to have good-quality, informative X-rays. However, periapical bitewing X-rays of implants in particular can often turn out blurry. There is, however, one very simple rule you can follow to correct these images and to depict implant threads clearly and precisely, thus enabling exact determination of the patient’s bone level. Furthermore, this rule is easy to remember and, above all, can be implemented rapidly in daily clinical practice.

In June 2018, as part of the EuroPerio 9 conference in Amsterdam, the long-awaited new classification scheme for periodontal and peri-implant diseases was presented publicly to dentists.

For the first time, the new classification scheme for periodontal diseases, which was presented in June 2018, contains a definition of the concept of clinical periodontal health (Lang & Bartold, 2018).

The new classification continues to differentiate between plaque-induced gingivitis and non-plaque-induced gingival diseases (Chapple et al., 2018).

Up to what point can an implant and its surrounding tissue be described as healthy? And at what point are caution and appropriate treatment required because the diagnosis of peri-implant mucositis already applies?

The article ‘How to correctly diagnose peri-implant mucositis’ discussed the criteria for peri-implant health and peri-implant mucositis. But how can you tell that the patient’s condition has already reached an advanced stage – in other words, how can I correctly diagnose peri-implantitis?

Regardless of whether you are treating a new patient or seeing an existing patient for a check-up, there is no doubt that implants (see article ‘The patient has their new implant-supported prosthesis – what now?’) need to be monitored right from the start, just as natural dentition does – and that includes measurement of pocket probing depths!

In June 2018, as part of the EuroPerio 9 conference in Amsterdam, the long-awaited new classification scheme for periodontal and peri-implant diseases was presented publicly to dentists.

It is important to fully update our patients’ general medical history and medication at regular intervals (at least once per year) – even for patients we have known ‘for years’.

Mechanical biofilm management should always be regarded as the basis for preventing periodontal diseases. It combines tooth brushing and interdental cleaning.

Affecting approximately 750 million people, periodontitis is the sixth most common disease worldwide. Apart from caries, it is the most common cause of tooth loss. Consequently, periodontitis patients often ask their dentist about implant-supported dentures.

In light of the growing problem of antimicrobial resistance, any use of antibiotics in dentistry should be given careful consideration, and antibiotics should only be administered if they can genuinely lead to a clinically significant improvement in treatment outcome. It is therefore important to develop guidelines on this topic that are based on the available literature, and just such a guideline was recently drawn up by the German Society of Periodontology (DG Paro): ‘Use of systemic antibiotics as an adjuvant to subgingival instrumentation as part of systematic periodontal treatment’

It is a situation we are all too familiar with: following the active phase of treatment, nearly all the patient’s teeth are now unaffected by increased pocket probing depths. However, there are still 1 or 2 places where the treatment goal has unfortunately not been achieved.

A very common question after the active phase of periodontal therapy is how high the patient’s risk is of re-developing periodontal problems.

Whether manual, sonic or electric, a toothbrush on its own is unfortunately insufficient to achieve perfect oral hygiene, because it is simply unable to penetrate the interdental spaces deeply enough. But what advice should we give to our patients?

Bad breath (halitosis) can be extremely unpleasant for those affected, and it is estimated that approximately one person in four struggles with persistent bad breath. A Belgian study (Quirynen 2009) investigated 2000 patients whose main concern was unpleasant bad breath. The study showed that the oral cavity was the source of bad breath in 75% of patients and thus fell within the dentist’s remit. Only 10% of cases had an extraoral cause, and 15% of participants had what is known as pseudohalitosis, where a patient is convinced they have bad breath even though it can be neither detected nor perceived by other people.

Air polishing devices have become a firmly established part of periodontal treatment in recent years. But how efficient are they? What applications do they have? What should be considered when using them?

The previous article ‘Air-polishing devices in periodontal treatment’ has already discussed the effectiveness of air-polishing devices and the importance of using the right powder to avoid damaging the hard and soft tissues. But what else needs to be considered when using these devices?

Exposed dentine often leads to painful teeth and causes a short sharp pain. If this pain occurs regularly, it can substantially impair the patient’s quality of life. The prevalence of dentine hypersensitivity varies according to the population being investigated; as an example, however, one study found it affected 40% of individuals aged 18 to 35 (West et al. 2013). Any treatment should ideally be easy to use, effective, rapid and long-lasting.

The use of smart phones for ‘mHealth’ (mobile health) in prophylaxis is becoming more and more fashionable – but what does it involve exactly?

From the patient’s point of view in particular, having treatment for periodontal disease can seem tedious and stressful. Patients find one fact hard to deal with in particular: periodontal disease is a chronic condition that requires a life-time follow-up (every 3 months in severe cases) to ensure the patient’s periodontal status remains stable after the active phase of treatment and during maintenance therapy. Inevitably we are asked the following question again and again: ‘will periodontal treatment really make me feel better?’

The previous report discussed a question that patients frequently ask: ‘will periodontal treatment really make me feel better?’ And, based on the literature, this question should be answered with a resounding ‘yes!’ However, personal well-being and oral-health-related quality of life are not the only issues – for many patients, financial considerations are also of primary concern, prompting the question: ‘does periodontal treatment really pay off?’

The bidirectional links between periodontitis and diabetes are undisputed, and a big problem associated with diabetes is the relatively high number of unreported cases. To improve this number and to identify patients with pre-diabetes and diabetes sooner, the potential role of the dental surgery has been discussed more and more in recent years.

It is often very hard to persuade our patients to clean between their teeth. Patients are often still advised to use dental floss, despite the fact we know that in many cases floss is not their method of choice and, above all, is often rather unpopular.

Sowohl periimplantäre Mukositis als auch Periimplantitis sind leider häufig auftretende biologische Komplikationen rund um dentale Implantate. Bei fast jedem 2. beziehungsweise 4.Patienten/Patientin wird eine periimplantäre Mukositis beziehungsweise Periimplantitis diagnostiziert (Derks & Tomasi 2015)!

Both when treating peri-implant diseases and after fitting a new implant-supported restoration, our top priority should always be to provide patients with instructions regarding home oral hygiene. However, there is one thing we must not forget: It must be possible for the patient to actually clean their implant-supported restoration!

Whether preventative or curative, dental measures need to be individually tailored according to the risk factors identified for each patient. In this context, general health is significantly influenced by three risk factors.

The ‘Perio–Cardio Workshop 2019’ took place in February 2019. This workshop was organized by the World Heart Federation in collaboration with the European Federation of Periodontology

Patients with periodontitis often suffer from the problem that loss of attachment has caused the position of their teeth to change – i.e. they have drifted, rotated and/or elongated. Flared anterior teeth with a gap between the central incisors is a very common finding among periodontitis patients. As a result, these patients very often ask about the possibility of getting the (usually unaesthetic) position of their teeth straightened – either before they undergo periodontal treatment, or at the latest after.

The article ‘Probiotics in periodontal treatment – an overview’ took a first look at the potential role of probiotics in periodontal therapy. The review presented in that article was from 2016. Since then, however, several new studies on this topic have been published, one of which had an interesting approach: Can probiotics be used in maintenance therapy?

Unfortunately, peri-implant diseases are an all too common part of our day-to-day work nowadays. Similar to gingivitis and periodontitis, the primary aetiological factor for developing peri-implant mucositis and peri-implantitis is the accumulation of oral biofilm. But how do the tissues respond to this bacterial load? Does the immune system also respond in a similar way?

The term ‘probiotics’ refers to a preparation that contains viable micro-organisms, such as species of lactobacilli and bifidobacteria, and is intended to have a positive effect on health.

The use of air-polishing devices for the treatment of periodontal and peri-implant diseases is now part of daily routine at the dental surgery. When used for the right indications, they are regarded as safe and effective. In addition, patients often find them more pleasant than traditional methods.

Air-polishing has long been an integral component of prophylaxis and expands the treatment spectrum of a comprehensive preventative–curative workflow. By achieving the perfect balance of powder, handpiece and spray head, the supra- and subgingival area can be cleaned both thoroughly and gently. To help achieve an optimum patient outcome, it is therefore advisable to use systems that belong together.

In collaboration with the German Society for Periodontology (DGParo), in October 2019 the German Society for Dental, Oral and Maxillary Medicine (DGZMK) published a new S3 guideline on the topic of ‘Subgingival instrumentation’, which is now valid for five years. This new guideline primarily focuses on the following two main topics:

Dagmar Else Slot is probably one of the most published dental hygienists, and her systematic reviews always make for interesting reading. This time she has published a review on the topic of the efficacy of manual toothbrushes, and this study also helps us to answer the question: Does it really make a difference whether I quickly brush my teeth for only one minute, or if I brush them for two?

Interdental brushes are viewed as the tool of choice for patients with periodontitis. This is because for interdental attachment loss in particular, they are regarded as more effective than dental floss, for example. Most interdental brushes on the market are cylindrical in shape. However, a research group from Austria (Innsbruck Medical University) asked the valid question of whether this cylindrical shape truly is the ‘best’ for optimum cleaning efficacy (Schnabl 2019).

In periodontal maintenance therapy, keeping our patients motivated is particularly important – in terms of both oral hygiene and attending appointments at the dental practice.

Anyone who works in prophylaxis is aware of the importance of oral hygiene home care, particularly if we want to treat our periodontitis patients successfully in the long term.

Another topic that was discussed as part of the Perio Workshop 2019 was the efficacy of chemical adjunctive therapies in the treatment of gingivitis. Of course, this is not a ‘new’ topic, and several reviews on this subject already exist; this time, however, two new issues were tackled:

In the recently presented systematic review by Donos et al. (‘Adjunctive therapies in non-surgical periodontal treatment I’), local and systemic adjunctive therapies were discussed in the context of non-surgical periodontal treatment. However, as part of the Perio Workshop 2019, the possibilities offered by local antibiotics were also assessed.

Another topic that was discussed as part of the Perio Workshops 2019 was the effectiveness of local and systemic adjunctive therapies or medications in non-surgical periodontal treatment.

In addition to evaluating treatment methods, the following topic was also discussed at the Perio Workshop 2019: ‘What are we actually trying to achieve with periodontal treatment – from a practitioner’s perspective, but above all from a patient’s perspective?’

The main diseases we are confronted with in dentistry are caries and periodontal conditions. Although the results of the fifth German Oral Health Study show a positive trend for the two diseases, effective prevention of both must nonetheless be our primary goal. We discussed the options for caries prophylaxis in a previous article (‘Update on caries prophylaxis’). The current article is intended to provide an overview of the tests for determining patients’ caries risk.

Following Part I (local and systemic non-antibiotic adjunctive therapies) and Part II (local antibiotics and antiseptics) about adjunctive therapies in non-surgical periodontal treatment, Part III now goes on to look at the results from the Perio Workshop 2019 regarding the effects of using systemic antibiotics as part of non-surgical periodontal treatment.

Effective instrumentation of the root surface is an indispensable part of treating patients with periodontitis. In Part I of the topic ‘subgingival instrumentation’ based on the results of the Perio Workshop 2019, the effectiveness of ‘standard techniques’ [(ultra)sonic instruments, hand instruments or a combination of the two] was described. Part II of this topic will now focus on newer approaches, such as laser Technology and photodynamic therapy, as supplements to mechanical cleaning.

Since the outbreak of the pandemic and the resulting global spread of SARS-CoV-2, aerosol-generating activities have been a hot topic of discussion in dentistry. How should we handle them? How can we best protect our patients and ourselves? What measures should we take in daily clinical practice?

In a previous article (Using smart phones in prophylaxis) we discussed the possible advantages of mHealth, the use of mobile electronic devices in healthcare, for dentistry. Tonetti et. al have just published a new study on this topic in the Journal of Clinical Periodontology, about the use of an intelligent electric toothbrush in combination with a mobile app.

A patient-oriented tailoring of preventative measures seems to be next logical step to counter the complexity of oral diseases for the future. Although existing strategies – for example, caring for periodontitis patients by means of supportive periodontitis treatment (SPT) – can stabilize the treatment outcome of an individual disease, their integration in a case-specific and needs-oriented preventative approach is lacking.

The ‘spider web diagram’ devised by Bern University is intended to help clinicians assess the individual risk profile of patients with periodontitis. You can find more information about this in a previous article (Periodontal maintenance therapy – how often do I need it?). But does such a thing also exist for implant patients? As of this year, the answer is: yes, it does – the Implant Disease Risk Assessment.

The principal symptom of dementia is a worsening of cognitive capabilities. This can impact short-term memory, ability to think and/or motor skills, for example, and those affected lose the skills they once had.