Background We previously reported in a cross-sectional study that patients who were in periodontal maintenance programs and were taking vitamin D and calcium supplementation had a trend for better periodontal health compared with patients not taking supplementation. The objective of the present study was to determine, for the same group of subjects, whether there was a difference in periodontal health over a one–year period. Methods Fifty-one patients enrolled in maintenance programs from two dental clinics were recruited. Twenty-three were taking vitamin D (≥400 international units/day) and calcium (≥1000mg/day) supplementation, and twenty-eight were not taking supplementation. All subjects had ≥2 interproximal sites with ≥3 mm clinical attachment loss. For mandibular-posterior teeth, these clinical parameters were recorded: gingival index, plaque index, probing depth, attachment loss, bleeding upon probing, calculus index and furcation involvement. Photostimulable-phosphor, posterior bitewing radiographs were taken to assess alveolar bone. Daily vitamin D and calcium intakes were estimated by nutritional analysis. Data were collected at baseline, 6 months, and 12 months. Results Clinical parameters improved with time in both groups (p<0.01). When clinical measures were considered collectively, the results were borderline significant at baseline (p=0.061), significant at 6 months (p=0.049) but not significant at 12 months (p=0.114). After adjusting for covariates, the effect of supplements was significant at baseline (p=0.037), borderline at 6 months (p=0.058) and not significant at 12 months (p=0.142) Conclusion Calcium and vitamin D supplementation has a modest positive effect on periodontal health, and consistent dental care improves clinical parameters of periodontal disease regardless of such supplements. Calcium and vitamin D supplementation has a modest positive effect on periodontal health, and consistent dental care improves clinical parameters of periodontal disease regardless of such supplements. Our findings raise the possibility that vitamin D, perhaps at higher doses, may positively impact on periodontal disease severity.

Background Low dietary intakes of vitamin D and calcium hasten bone loss and osteoporosis. Because vitamin D metabolites may also alter the inflammatory response and have anti-microbial effects, we studied whether use of vitamin D and calcium supplements affects periodontal disease status. Methods A cohort of 51 subjects receiving periodontal maintenance therapy was recruited from 2 dental clinics. Of these, 23 were taking vitamin D (≥400 international units/day) and calcium (≥1000mg/day) supplementation, and 28 were not taking such supplementation. All subjects had ≥2 interproximal sites with ≥3 mm clinical attachment loss. Daily calcium and vitamin D intakes (from food and supplements) were estimated by nutritional analysis. The following clinical parameters of periodontal disease were recorded for the mandibular posterior teeth: gingival index, probing depth, cementoenamel junction-gingival margin distance (attachment loss), bleeding upon probing, and furcation involvement. Posterior photostimulable-phosphor bitewing radiographs were taken to determine cementoenamel-junction-alveolar-crest distances (alveolar crest height loss). Data were analyzed with a repeated-measures, multivariate analysis of variance. Results Relative to subjects who did not take vitamin D and calcium supplementation, supplement takers had shallower probing depths, fewer bleeding sites, lower gingival index values, fewer furcation involvements, less attachment loss and less alveolar crest height loss. The repeated-measures analysis indicated that collectively these differences for clinical parameters were borderline significant (P=0.08). Conclusion In these subjects receiving periodontal maintenance therapy, there was a trend for better periodontal health with intake of vitamin D and calcium supplementation. More expanded longitudinal studies are required to determine the potential of this relationship.

Within the same patient, teeth with abfractions presented more attachment loss than those without abfractions. However, associations were not demonstrated between PCCR and the presence of abfractions or increased attachment loss. Future studies are needed to improve the knowledge regarding interactions among occlusal factors, attachment loss, and abfractions.

Introduction Due to COVID‐19, innovative, virtual educational methods are being developed to provide students with learning experiences comparable to established clinical practices. Our objective was to produce the Periodontal Senior Case Clinical Challenge (PSCCC) that would provide fourth‐year students an alternative for senior case presentations and would be a formative assessment for which student opinions would be provided and analysed. The PSCCC would utilise an online, case‐based, written, clinical assessment and follow‐up, structured discussion to challenge students to demonstrate ability to apply didactic periodontal knowledge to patient‐based experiences. We hypothesised the PSCCC would provide effective learning and a formative assessment. Material and Methods Relevant didactic resources were distributed to 48 students for independent review. The PSCCC was delivered in two sections, (1) a case‐based assessment via a virtual classroom with written student responses, and (2) oral discussions conducted via virtual meetings that were moderated and assessed by ten periodontists, with the collaboration of nine residents. A voluntary six‐statement survey was used to evaluate the students’ opinions of the PSCCC. The scores for 75% (36/48) of students who participated were evaluated for statistical and clinical importance. Results The value of our PSCCC was supported by 91.7% (33/36) of the analyses (p < .0008). Discussion The PSCCC was a successful alternative pathway to assess students’ clinical and didactic integrated knowledge in periodontics. It provided a unified vision of treatment of the selected case, building on all aspects of the students’ periodontal education whilst allowing interaction in a simultaneous, three‐tiered educational approach, involving dental students, periodontal residents and faculty. Conclusion In support of our hypothesis, for each of the 6 statements, ≥94.44% (34/36) of the scores given by the students were considered exceptionally strong clinical support for our pedagogical strategy that combines educational resources and can be successfully implemented in other programmes.

Objectives Determine the level of calcium and vitamin D oral supplementation in patients in periodontal disease maintenance programs. Design Convenience survey. Setting St. Louis Metropolitan region. Subjects and Methods Patients (n=228) in two university-based, periodontal-disease maintenance programs. Main Outcome Measures Reported amounts of oral calcium and vitamin D supplementation were tested for differences based on gender and race. Results The last published recommended daily intakes from the United States (U.S.) Food and Nutrition Board (FNB) for adults >50 years of age are 1200 mg calcium and 400 IU vitamin D (or 600 IU if over 70). The mean age of the 228 patients (125 females and 103 males) was 63.6±11.0 years (standard deviation). Of the 228 patients surveyed: (1) 204(89%) were >50 years of age, and of these, only 15(7%) met the U.S. FNB’s recommended intakes of calcium and vitamin D from supplementation, (2) 138(66%) reported that they took no oral supplementation, with significantly more males (n=82) than females (n=56) not taking supplementation (p=0.03), (3) 88(39%) took calcium supplementation, with females (947±511mg/day) taking significantly (p<0.001) more than males (632±907mg/day), and (4) 66(29%) took vitamin D supplementation, with females(420±227 IU/day) taking approximately the same amount as males (443±317 IU/day, p>0.05). The amounts of oral supplementation did not vary with race (p>0.05). Conclusion The use of calcium and vitamin D supplementation has been promoted for years; yet the numbers of adults taking supplements remains low and the level of supplementation varies greatly. Knowledge of the benefits of supplementation needs to be better disseminated and research needs to be conducted to determine optimal levels of calcium and vitamin D supplementation.

Because of its excellent osteogenic potential, autogenous bone is the preferred grafting material for dental procedures; however, bone collected in osseous coagulum traps is subject to contamination by oral bacteria. This study assessed bacterial contamination of osseous coagulum and tested treatments for reducing contamination. Fifty bone samples from patients undergoing implant osteotomy procedures were collected in osseous coagulum traps, divided into groups of 10, and rinsed with normal saline, 0.12% chlorhexidine, or 50 mg/mL tetracycline. Twenty control samples received no treatment. The bone samples were plated in triplicate on selective and differential media to assay aerobic and anaerobic bacteria and potential bacterial pathogens, including staphylococci, streptococci, enterics, and black-pigmented bacteria (BPB). Inoculations were performed with an Autoplate 4000, and plates were incubated at 37 degrees C either aerobically or in a Coy anaerobic chamber. Bacteria were isolated from all samples. In control samples, the mean colony-forming units (cfu) per milliliter of suspended osseous coagulum was 6.5 x 10(4) +/- 9.6 x 10(4) in aerobic cultures and 4.8 x 10(4) +/- 6.9 x 10(4) in anaerobic cultures. Viridans streptococci were isolated from 46 samples, with a mean of 2.9 x 10(4) +/- 4.1 x 10(4) cfu/mL. Enterics were in 16 samples with cfu ranging from 200 cfu/mL to 3.4 x 10(4) cfu/mL. Mannitol nonfermenting staphylococci were found in one sample at 106 cfu/mL. BPB were not isolated. A Mann-Whitney U test with significance set at P = .05 determined that the only statistically significant reductions in bacterial numbers occurred in tetracycline-treated samples of anaerobic bacteria (5-fold decrease, P = .02) and aerobic bacteria (6-fold decrease, P = .01). Tetracycline treatments effected a 7-fold decrease in streptococci, but the difference was not significant (P = .07). These data indicate significant bacterial contamination of bone collected in osseous coagulum traps and justify further research into methods for eliminating that contamination.

Despite similar hydrophilicity, saline-stored and UV light-treated surfaces showed substantially different biological effects on osseointegration, associated with different surface chemistry and morphology.

Background Reports from studies of twins, disease aggregation in families, animal models for periodontal disease, and various genetic-analysis studies have determined that genetics plays a role in the susceptibility to periodontal disease. The purpose of this pilot study was to evaluate the effect of genetics on periodontal disease by evaluating the heritability of alveolar bone loss in a captive baboon population. Methods A collection of baboon skulls from a pedigreed colony (for which scientists and veterinarians maintain complete genealogical and veterinary records) were obtained from the Southwest National Primate Research Center and used in this pilot study. Measurements of alveolar bone loss were performed on 390 dry baboon skulls. A periodontal probe was used to measure alveolar bone loss. Maximum likelihood methods (designed to handle complex genealogies) were used to determine the heritability of alveolar bone loss. This software utilized known pedigrees in the captive baboon sample and tested the relationship between pairwise kinship and alveolar bone loss data to determine the heritability of alveolar bone loss from periodontal disease. Results Genetic data were available for 347 of the 390 specimens. Using age and sex as covariates, genetic analysis indicated a heritability of 35% (standard error=20%, p=0.01). While sex was not a significant factor in periodontal disease (p=0.96), age was highly significantly associated with periodontal disease (p<0.0001). Conclusion In this pilot study, analysis of alveolar bone loss measurements from captive baboons indicates that bone loss increases with age and that a portion of periodontal disease risk may be due to genetic variance. These findings provide evidence that periodontal disease is heritable in captive baboons and indicate that a larger, more-detailed study is warranted.