Background Given the fact that most patients are not regular compliers in supportive peri‐implant maintenance programs, it is of interest to examine the significance of the peri‐implant soft tissue characteristics in relationship to the onset of peri‐implant diseases. Methods Based on an a priori statistical power calculation, a cross‐sectional study was conducted on erratic peri‐implant maintenance compliers (<2 times/year) to examine the significance of keratinized mucosa (KM) and gingival tissue (KT) on peri‐implant and adjacent periodontal conditions in implants restored ≥3 years. Seven clinical parameters were recorded around implants and the adjacent buccal sites. Radiographic assessment was performed using periapical X‐rays. In addition, a visual analog scale (VAS) was used to evaluate the impact of KM upon brushing comfort. The case definition used for peri‐implant diseases was in accordance with the 2017 World Workshop on the classification of periodontal and peri‐implant diseases and conditions. Results Overall, 37 patients with 45 edentulous gaps restored with 66 implants and 90 adjacent teeth were analyzed. On comparing a KM band of <2 mm versus ≥2 mm, with the exception of suppuration (P = 0.6), all the clinical and radiographic parameters were significantly increased when the KM band was <2 mm (P < 0.001). A significant correlation was observed between KM and KT (r = 0.55), though a lack of KM did not condition a lack of KT. In the presence of peri‐implantitis, only bleeding on probing at the adjacent dentate sites was identified to be increased. Conclusions The presence of <2 mm of KM around dental implants in erratic maintenance compliers seems to be associated with peri‐implant diseases. The lack of KM constitutes a site‐specific phenomenon independent of the keratinized tissue present in the adjacent dentition (NCT03501537).

Background/Aims: Traditionally, tobacco is considered as part of the military culture. A cross-sectional survey was designed to clarify if smoking habit increases the caries risk in a sample of Italian adults attending a Military Academy. Methods: Clinical examinations including dental caries and presence of bleeding at probing were carried out following WHO criteria. Related socio-behavioural factors were collected. Four calibrated examiners observed 763 subjects (men = 722; 94.6% and women = 41; 5.4%). Results: One of the 763 subjects did not declare the smoking status and was excluded from the analysis. Hundred twenty-six (16.5%) subjects claimed to have never smoked, 200 (26.3%) were coded as light smokers and 436 (57.2%) as heavy tobacco users. Statistically significant linear trend across the educational level (p = 0.03), self-satisfaction with the appearance of teeth and gums (p = 0.04) and dental check-up in the past 6 months (p = 0.02) was found among the 3 subgroups. Almost the entire sample showed caries experience (84.1%). Mean DS ranged from 0.6 in the nonsmokers subgroup to 1.1 in the heavy smokers. Differences among means were statistically significant for DS, DMFS and Significant Caries Index (p = 0.01, 0.04 and 0.03, respectively). The zero-inflated regression model showed that caries severity was significantly associated with smoking habit (p = 0.02), dental check-up in the past 6 months (p = 0.01), self-satisfaction with the appearance of teeth and gums (p < 0.01) and healthy gums (p = 0.04). Conclusion: Heavy smokers attending a Military Academy showed a higher prevalence of caries, confirming a correlation between the disease and tobacco use.

Competency-based education, introduced approximately 10 years ago, has become the preferred method and generally the accepted norm for delivering and assessing the outcomes of undergraduate (European) or predoctoral (North America) dental education in many parts of the world. As a philosophical approach, the competency statements drive national agencies in external programme review and at the institutional level in the definition of curriculum development, student assessment and programme evaluation. It would be presumptuous of this group to prescribe competences for various parts of the world; the application of this approach on a global basis may define what is the absolute minimum knowledge base and behavioural standard expected of a 'dentist' in the health care setting, while respecting local limitations and values. The review of documents and distillation of recommendations is presented as a reference and consideration for dental undergraduate programmes and their administration.

Twenty-nine previously untreated patients with squamous cell carcinoma of the oral cavity and pharynx underwent a treatment program with four courses of chemotherapy alternated with three courses of radiotherapy. Granulocyte-macrophage colony-stimulating factor (GM-CSF) was administered at a dose of 5 micrograms/mg subcutaneously on the same day as radiation treatment in order to prevent mucositis. No grade 4 mucositis was reported; only four episodes of grade 2 mucositis and thirteen grade 2. Comparing these results with historical patients treated with the same chemotherapy-radiation program but without GM-CSF, the authors concluded that GM-CSF is an effective treatment for preventing mucositis produced by chemotherapeutic and/or radiotherapeutic interventions in patients at high risk of oropharyngeal mucosal damage.