Objective: In patients with periodontitis, identification of protozoans and evaluation of some bacteria and clinical parameters associated and assessment of scaling and root planing (SRP) impact on their detection.Methods: Before and after SRP, subgingival microbiota was collected in two pathological and one healthy site from 30 periodontitis patients. One healthy site from 30 control patients was also sampled. The usual clinical periodontal parameters were recorded; microbial detection was determined by PCR hybridization system for bacteria and qPCR for protozoans.Results: In periodontitis group, Trichomonas tenax and two subtypes of Entamoeba gingivalis (ST1 and a variant ST2) were detected in respectively 33.3%, 70% and 18.3% of pathological samples, and in 6.7%, 10% and 3.3% healthy samples. In control group, ST1 alone was found in 3.3% of individuals. ST1 was associated with Gingival Index, Clinical Attachment Level (p ≤ 0.03) and with the total bacterial count (p = 0.02). T. tenax alone was associated with P. gingivalis, T. denticola and E. nodatum (p ≤ 0,02). After therapy, only T. tenax detection decreased significantly (p = 0.004) and no association between the protozoan elimination and improvement of pathological sites was found.Conclusions: Protozoans were associated with some clinical parameters and/or periodontopathogens in patients with periodontitis.

Objective The aim of this study was to provide a reliable instrument to assess evidence‐based practice (EBP) dimensions in French‐speaking dental students. To do so, a transcultural adaptation into French of the self‐administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated. Method Teachers and fourth‐year students completed once the translated KACE and fifth‐year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal‐Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively. Results 186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add‐on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score. Conclusion This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance.

(1) Background: The progression of periodontitis, induced by polymicrobial dysbiosis, can be modified by systemic or environmental factors such as stress or anxiety affecting host response. The purpose of this study is to evaluate the potential associations between psychosocial factors scores or salivary cortisol levels with clinical periodontal parameters and bacterial environment in patients with periodontitis; (2) Methods: Subgingival microbiota was collected in two pathological and one healthy sites from thirty diseased patients (before/after scaling and root planing (SRP)) and from one healthy site from thirty control patients. Usual clinical periodontal parameters were recorded, and a saliva sample was harvested. Patients completed stress and anxiety self-assessment questionnaires. Cortisol concentrations were determined by ELISA and bacteria were identified by PCR; (3) Results: No correlation between salivary cortisol and the stress-anxiety self-declared was found (p > 0.05), but high concentrations of this molecule were associated positively and linearly with periodontal pocket depth (p = 0.04). It appeared that certain psychosocial stressors are associated with a modulation of the bacterial colonization of pockets of diseased group (before/after SRP), notably concerning Tannerella forsythia (p = 0.02), Porphyromonas gingivalis (p = 0.03), Fusobacterium nucleatum (p = 0.049) and Campylobacter rectus (p = 0.01). (4) Conclusion: This study reveals associations between bacteria colonization and psychosocial parameters in periodontitis that needs to be further investigated.

Rationale, aim, and objective: "Periodontal medicine" is based on evidence of interactions between periodontal disease and overall health. The aim of the present study was to assess awareness of oral-systemic disease relationship among French general practitioners (GPs) and clarify how this influences their practices in a wider effort to better integrate oral health concerns into global health care delivery. Method: GPs registered in the north of France were invited to complete an online self-administered questionnaire through local divisions of the French Medical Board. The questionnaire was divided into four sections: socio-demographic aspects, knowledge, practices, and an overview. Results: The questionnaire was completed by 253 GPs. Among these, 75% were aware of the association between periodontitis (PD) and diabetes, and 53% to 59% were aware of the impact of PD on cardiovascular diseases, inflammatory bowel diseases, and respiratory infections. Few GPs identified PD as a possible risk factor of rheumatoid arthritis and Alzheimer disease (35.18% and <15%, respectively); 74.31% of GPs reported never asking their patients about their periodontal health. However, a personal history of PD and professional experiences seem to influence the medical practices of GPs to include oral examination. GPs largely self-rated their knowledge of the oral-systemic disease connection as being insufficient and were favourable to completing an up-to-date training course (86.56%). Conclusion: French GPs' knowledge about the association of PD with systemic diseases seems to be fair, but discrepancies in their daily clinical routine were found. Promisingly, a positive attitude was observed towards improving their knowledge of oral-systemic diseases link. These results indicate the importance to reinforce collaboration between medical doctors and oral health care specialists.

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The aim of the present survey is to investigate the use of antibiotics during periodontal therapy among French dentists with a focus on exploring potential differences between various groups of practitioners. A self-administered questionnaire was distributed to different groups of practitioners including members of (i) the French Society of Periodontology and Implantology; (ii) the College of University Teachers in Periodontology and, (iii) private practitioners participating in the French general dental practice-based research network. 272 questionnaires were included in the analysis. Prescription patterns were globally in line with the current recommendations. Systemic antibiotics are most frequently used as a first-line therapy in necrotizing periodontitis (92%) and aggressive periodontitis (53.3% to 66.1%). However, malpractice still exists, including in the management of periodontal abscesses. Antibiotics are prescribed (i) less frequently for periodontal abscesses and (ii) more frequently for generalized aggressive periodontitis by members of the periodontal society and University college (p < 0.05). Amoxicillin (59.9%) and the amoxicillin + metronidazole (59.6%) combination were the most frequently prescribed molecules. Providing a high number of periodontal treatments per week, being more recently graduated, having a post-graduate certificate in periodontology and holding or having held an academic position/hospital practice were all factors associated with a better knowledge of and/or more adequate antibiotic use.

Several chemical compounds are considered to be promising as adjuvants in the treatment of periodontitis. Antimicrobials, anti-inflammatory drugs or, more recently, pro-regenerative or antioxidant molecules have shown a very interesting potential to improve the outcomes of mechanical biofilm removal and promote the healing of the damaged tissues. However, their clinical effect is often limited by the challenge of achieving effective and prolonged drug delivery within the periodontal lesion, while limiting the risk of toxicity. In-situ forming implants (ISFI) are ‘implantable’ drug-delivery systems that have gained considerable attention over the last few decades due to their multiple biomedical applications. They are liquids that, when injected at the site to be treated, form a semi-solid or solid dosage form that provides safe and locally controlled drug release. This review discusses current data and future prospects for the use of ISFI in periodontal treatment.