Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.

Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.

Effect of professional mechanical plaque removal performed on a long-term, routine basis in the secondary prevention of periodontitis: a systematic review AbstractAims: To systematically review the evidence evaluating the efficacy of long-term, routine, professional mechanical plaque removal (PMPR) in the prevention of periodontitis progression. Methods: A literature search was conducted to identify prospective studies evaluating the effect of PMPR in periodontitis patients undergoing active periodontal therapy and enrolled in a maintenance programme including PMPR for at least 3 years. Results: No RCTs evaluating the efficacy of the intervention when compared with no treatment during maintenance were found. Nineteen prospective studies assessing the effect of PMPR as part of the supportive therapy were included. In general, studies reported no to low incidence of tooth loss during follow-up. The weighted mean yearly rate of tooth loss was 0.15 AE 0.14 and 0.09 AE 0.08 for follow-up of 5 years or 12-14 years, respectively, with no significant differences between groups. Mean clinical attachment loss was <1 mm at follow-up ranging from 5 to 12 years. Conclusions: Supportive therapy, which encompasses PMPR, may limit the incidence and yearly rate of tooth loss as well as the loss in clinical attachment in patients treated for periodontitis. However, whether and to what extent the intervention may impact on long-term periodontal parameters still needs to be assessed. The removal of the dental biofilm and calcified deposits from the tooth surface (here identified under the term "plaque removal") contrasts the evolution of plaque-induced gingival inflammation from a sub- treatment of plaque-induced periodontal diseases (Lang 1983, Cobb 2002, van der Weijden & Slot 2011. When performed in patients undergoing active periodontal therapy (APT), professional mechanical plaque removal (PMPR) is programmed on a routine basis to control periodontal re-infection. In this respect, the term routine is used to indicate that professional PMPR is "a regular course or procedure" (Concise Oxford Dictionary 1995) that is intended to be provided at specific intervals to patients (without specifying any particular frequency at which patients may receive this intervention) (Worthington et al. 2013). PMPR is usually combined with an update of the patient medical and dental history, oral status, review of the patient's plaque control effectiveness, motivation to oral hygiene, reinforcement of oral hygiene instructions and, when appropriate, smoking cessation and promotion of healthy lifestyles. This group of procedures is identified under the term supportive periodontal therapy (SPT), supportive periodontal care or maintenance therapy/care (American Academy of Periodontology 1998, Sanz & Teughels 2008, and aims at preventing the recurrence of periodontal disease in terms of tooth loss and additional attachment loss (American Academy of Periodontology 1998Periodontology , 2000.Although PMPR, performed as part of a SPT programme, is a com...

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After buccal SFA, greater post-surgery increase in bREC must be expected for deep intraosseous defects associated with a buccal dehiscence. The combination of a graft material and a bioactive agent in adjunct to the SFA may limit the postoperative increase in iREC.

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The objective of this study was to evaluate the usefulness of a galactose-based ultrasonographic contrast agent, Levovist (Schering AG, Berlin, Germany), in differentiating benign from malignant thyroid nodules by analysis of the time-intensity curves correlating the variation of the intensity signal value during the contrast transit time. Fifty-four patients scheduled for surgical removal of a nodule or the thyroid gland or both after cytologic examination were enrolled in this study; all of the nodules underwent a baseline color and power Doppler evaluation and then to a color Doppler examination after an intravenous bolus injection of Levovist. The time-intensity curves were analyzed with respect to the histologic results. Carcinomas showed a significantly earlier arrival time of Levovist than nodular hyperplastic benign nodules and adenomas (8.1 +/- 1.41 versus 19.6 +/- 2.2 and 16.1 +/- 2.8 seconds; P < .0001), although no significant difference occurred between hyperplastic benign nodules and adenomas; carcinomas and adenomas showed an earlier time to peak than hyperplastic benign nodules (14.6 +/- 1.2 and 23.1 +/- 3.8 versus 33.0 +/- 3.0 seconds; P < .0001). No significant difference was found in baseline, peak, final intensity signal, and percent variation of intensity signal among hyperplastic benign nodules, adenomas, and carcinomas. Although cytologic examination still remains the standard of reference for the presurgical diagnosis of thyroid nodules, the preliminary data of this pilot study demonstrate that the analysis of time-intensity curves after Levovist injection might provide useful, complementary, and quantitative information to differentiate benign from malignant thyroid nodules.

BackgroundTo propose a novel composite outcome measure (COM) for periodontal regenerative treatment of intraosseous defects.MethodsCOM is based on the combination of clinically relevant clinical attachment level (CAL) gain (≥3 mm) and pocket closure (post‐surgery probing depth [PD] ≤ 4 mm). Treatment was regarded as successful when a clinically relevant CAL gain was associated with pocket closure, and failing when either clinically relevant CAL gain and pocket closure were not achieved. The effect of the different regenerative treatments was both collectively and separately evaluated according to COM in a defect cohort accessed by Single Flap Approach (SFA).ResultsIn the entire study cohort, the procedure resulted in a 6‐month CAL gain of 3.7 ± 1.9 mm, which was clinically relevant in 71.8% of patients. Six‐month residual PD was 3.7 ± 1.1 mm, with pocket closure recorded in 79.6% of patients. COM revealed a successful treatment in 60 patients (58%), and a treatment failure in 7 patients (7%). Mean CAL gain was clinically relevant for each treatment, whereas the residual PD values were consistent with pocket closure for the majority of treatment options. However, when COM was used to rate the treatment outcome of each procedure, it appeared that a successful treatment ranged from 41.5% to 77.5%, whereas treatment failure varied from 3% to 15% for different treatments.ConclusionsCompared to single probing measurements, COM seems (1) more accurate in capturing the overall benefit of the regenerative procedure and (2) to better identify which factor (CAL gain, residual pocket) mainly contributed to determine a treatment failure.