Abstracts from Other Journals

Dunegan KA, Deas DE, Powell CA, Ruparel NB, Kotsakis GA, Mealey BL

Subgingival scaling and root planing during minimally invasive periodontal surgery: a randomized controlled split-mouth trial. J Periodontol. 2024;95(1):9-16. doi:10.1002/JPER.23-0198

Background: The purpose of this randomized, controlled split-mouth study was to evaluate a videoscope as a visual adjunct to scaling and root planing when utilized in combination with minimally invasive surgery. Methods: Twenty-five pairs (89 interproximal surfaces) of periodontally hopeless teeth planned for extraction were scaled and root planed with minimal surgical access using surgical loupes (control) or adjunctive use of a videoscope (test). Teeth were extracted with minimal trauma, stained with methylene blue, and photographed with a digital microscope for analysis. The primary outcome of residual calculus was calculated as a percentage of the total interproximal area of interest. Secondary outcomes included treatment time, as well as residual calculus according to probing depth, tooth location, and treatment date. Data were analyzed using Student's paired t-tests, two-way analyses of variance, and Spearman's correlation tests. Results: Residual calculus area was 2.61% on control and 2.71% on test surfaces with no significant difference between groups. Subgroup analysis showed no difference in residual calculus between groups at moderate or deep sites. Treatment time per surface was significantly longer in the test group compared to the control group. Treatment order, tooth location, and operator experience did not significantly affect the primary outcome. Conclusions: Though the videoscope provided excellent visual access, it did not improve the efficacy of root planing for flat interproximal surfaces during minimally invasive periodontal surgery. Small amounts of calculus remain after instrumentation even with minimal surgical access and when root surfaces appear visually clean and tactilely smooth.

Fine N, Barbour A, Kaura K, et al

Effects of a stabilized stannous fluoride dentifrice on clinical, immunomodulatory, and microbial outcomes in a human experimental gingivitis model. J Periodontol. 2024;95(5):421-443. doi:10.1002/JPER.22-0710

Background: Stannous fluoride dentifrice is well established for its beneficial clinical effects. In this study, we evaluated the effects of stannous fluoride on inflammation and oral microbiome. Methods: In this randomized, parallel-arm, double-blind, controlled clinical trial, we compared clinical resolution of experimental gingivitis by evaluating bleeding on probing, gingival index, and plaque index between stannous fluoride stabilized with zinc phosphate (test) and sodium fluoride (control) dentifrices. Further, these groups were compared for oral neutrophil counts, systemic priming of neutrophils, gingival crevicular fluid (GCF) expression of inflammatory markers, and the oral microbiome. Results: We found significant reduction in bleeding on probing in the test group compared to the control group in experimental gingivitis when participants used the test dentifrice prior to induction of experimental gingivitis. The test group also showed significant reductions in GCF levels of inflammatory markers (matrix metalloproteinase 8 [MMP8], receptor activator of nuclear factor kappa-Β ligand [RANKL]), oral polymorphonuclear neutrophil (PMN) counts, and systemic neutrophil priming (CD11b expression) during experimental gingivitis. Further, significant reductions in the gram-negative genera Porphyromonas, Tannerella, and Treponema were noted in the test group. Conclusion: The stannous fluoride stabilized with zinc phosphate dentifrice formulation demonstrated clinical reduction in gingival inflammation and a beneficial effect on microbiome and immune markers. This intervention should be explored as a preventive aid in the progression of plaque-induced gingivitis to periodontitis.

Lee J-H, Mun S-J

Relationship between C-reactive protein level and periodontitis and systemic diseases. J Periodontol. 2024;95(5):494-501. doi:10.1002/JPER.23-0008

Background: Periodontitis affects systemic disease risk, although the relationship thereof in the context of different C-reactive protein (CRP) levels is not clear. This study investigated the association of periodontitis with systemic diseases according to high-sensitivity CRP (hs-CRP) level and sought to identify the risk of systemic diseases in patients with periodontitis. Methods: We used data from the seventh (2016-2018) Korea National Health and Nutrition Examination Survey. In a total of 16489 subjects, the hs-CRP group was classified into the hs-CRP low-risk group and the hs-CRP high-risk group. Propensity score matching (PSM) is used for 1:1 matching of confounding variables (eg, age, gender, income, and education) between hs-CRP low-risk and hs-CRP at-risk groups to analyze the final 5316 subjects. The association between general characteristics and prevalence of systemic diseases was analyzed using descriptive statistics and the chi-squared test. The associations between hs-CRP level and systemic and periodontitis were analyzed using logistic regression analyses. Results: Within the hs-CRP group, the presence of periodontitis was associated with a significantly increased prevalence of hypertension, diabetes mellitus, and stroke. In the hs-CRP risk group, periodontitis significantly increased the risk of hypertension and diabetes mellitus by 2.1 and 2.4 times, respectively. Conclusions: The presence of periodontitis significantly increases the prevalence of systemic diseases and more so in individuals with higher hs-CRP levels. This indicates the significance of maintaining oral health in reducing the risk of systemic diseases.

Pereira R, Sabri H, Pereira P, Wang H-L

Associated risks with periodontal x-rays or CBCT scans: are there any? Clin Adv Periodontics. 2024;14(2):121-126. doi:10.1002/cap.10261

Periodontal and implant radiography, mainly including intra-oral peri-apical and cone beam computed tomography images, are crucial in the diagnosis and treatment planning process. However, radiation safety concerns have been a chronic concern over the years, leading to uncomfortable situations. It is therefore crucial to understand the actual radiation exposure to determine if the patients’ fear of necessary diagnostic exams is justified. In this perspective article, we aimed to provide concise information on dental imaging exposure, risks, and benefits, comparing them to that of absorbed radiation from daily life activities; and secondarily, to help periodontists choose the best option for each case and become more confident in addressing patients’ concerns and providing a summary of safety guidelines as a reference for them.

Sabeti MA, Ihsan MS, Adami D, et al

Cell-based regenerative endodontics for the treatment of irreversible pulpitis: an in vivo investigation. J Endod. 2024;50(3):344-350. doi:10.1016/j.joen.2023.11.014

Introduction: This study aims to investigate the ability of umbilical cord mesenchymal stem cells (UC-MSC) to enhance the regeneration of pulp-dentin complex in immature permanent teeth with irreversible pulpitis. Methods: A total of 32 mandibular premolar teeth with immature apices in 5 dogs were used in this in-vivo randomized controlled trial (RCT). Eight healthy teeth without pre-existing pathosis served as the positive control samples and received no treatment, while in another 8 teeth, the pulp was completely extirpated (negative control). Class V cavities were prepared to induce inflammation in the remaining 16 teeth (groups 3 and 4) and the pulp was extirpated 2-4mm short of the radiographic apex. Of the 16, the 8 teeth in group 4 received 1mL of cord blood stem cells with a hydrogel scaffold. Blood clots were covered with mineral trioxide aggregates at the cementoenamel junction in the experimental groups, and teeth were filled with RMGI and composite. Three months later, block sections were removed for histologic evaluations for the evaluation of postoperative apical closure, degree of inflammation, and presence of normal pulp tissue. The data were statistically analyzed with the chi-square test (P < .05). Results: All teeth with complete pulp extirpation demonstrated pulpal necrosis with no postoperative closure of their apices, while apical closure was seen in all the teeth in the remaining groups. There was a statistically significant (P < .001) difference in the presence of inflammation and normal pulp tissue between the experimental groups. The teeth in group 3 showed normal pulp tissue extending to the level of MTA, but there was inflammation within the canal space. In contrast, the teeth in the UC-MSC group demonstrated organized, normal pulp tissue with no inflammation. Conclusion: Based on these results, the regeneration of the pulp-dentin complex is possible with no inflammation when UC-MSCs are used and 2-4mm of the apical pulp remains intact in immature teeth with irreversible pulpitis.

Song M, Lee S-M, Bang J-Y, Kim RH, Kwak SW, Kim H-C

Chemomechanical properties and biocompatibility of various premixed putty-type bioactive ceramic cements. J Endod. 2023;49(12):1713-1721.

Introduction: This study aimed to evaluate the chemomechanical properties and biocompatibility of recently introduced premixed putty-type bioactive ceramic cements (PPBCs). Methods: Including ProRoot MTA (PMTA) as a control, BC RRM fast-set putty (BCPT), Well-Root PT (WRPT), One-Fil PT (OFPT), and Endocem MTA premixed (ECPM) were compared to evaluate setting time, radiopacity, pH change, and microhardness. Biocompatibility on human dental pulp cells was compared using CCK-8 assay. Mineralization potential was evaluated using alkaline phosphatase activity, Alizarin Red S (ARS) staining, and quantitative real-time polymerase chain reaction with odontogenic gene marker. For data analysis, 1-way analysis of variance and Tukey's post hoc test were used at the significance level of 95%. Results: Among the PPBCs, BCPT presented the longest (552 ± 27) setting time (minutes) and others showed significantly shorter time than PMTA (334 ± 22) (P < .05). WRPT (6.2 0 ± 0.54) and OFPT (5.82 ± 0.50) showed significantly higher radiopacity values (mm Al) and others showed similar value compared with PMTA (P > .05). All PPBCs showed high alkaline pH from fresh materials and tended to increase according to time periods from 30 min to 12 h. ECPM showed the highest value of microhardness (81.62 ± 5.90), WRPT showed similar, and others showed lower than PMTA (P < .05). All PPBCs showed biocompatibility in CCK-8 assay. All PPBCs showed similar or better value compared with PMTA in ALP and ARS staining, and ALP and DSPP marker expression (P < .05). Conclusions: The PPBCs showed clinically acceptable chemomechanical properties and favorable mineralization potential.

Minei S, Auriemma E, Bonacini S, Kent MS, Gracis M

Normal variation of clinical mobility of the mandibular symphysis in cats. Front Vet Sci. 2024;11:1338623. doi:10.3389/fvets.2024.1338623

Introduction: The primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in cats and possible associations with bodyweight, age, sex, sexual status, breed, and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were evaluated. Materials and Methods: Two hundred and sixteen cats of 15 different breeds that underwent maxillofacial, oral, and dental procedures from April 2015 to December 2021 were included. Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified on the occlusal radiographic view of the rostral mandibles as fused or open and with parallel or divergent margins. Results: Bodyweight ranged from 2.2 to 12.5kg (median 4.0kg), age from 4 months to 17 years and 4 months (median 6 years and 4 months). At the first evaluation, DV symphyseal mobility was 0 in 177 cases (82%), 1 in 32 cases (14.8%) and 2 in 7 cases (3.2%), LM mobility was 0 in 61 cases (28.3%), 1 in 110 cases (50.9%) and 2 in 45 cases (20.8%). 81.1% of the radiographs were included in the statistical analysis. Three symphyses (1.6%) were classified as fused and 190 (98.4%) as open, 129 (68.8%) having divergent margins and 61 (31.6%) parallel. One hundred and forty-eight cases (76.7%) did not show the presence of odontoclastic replacement resorption on the canine teeth (TR subgroup 1), 23 (11.9%) showed stage ≤3 lesions (TR subgroup 2) and 22 (11.4%) stage 4 lesions (TR subgroup 3). Logistic regression models exploring factors that affected DV and LM mobility were statistically significant (P < .0001; P < .0001) with an increase in LM mobility predicting an increase in DV mobility, and vice versa. An increase in DV mobility was associated with an increase in age and in having resorptive lesions. A decrease in LM symphyseal mobility was associated with being brachycephalic. Conclusion: The great majority of cases showed some degree of LM symphyseal mobility, and 18% showed DV mobility. Symphyseal bony fusion is rare but possible.

Chrostek E, Peralta S, Fiani N

Morphological study of pulp cavity anatomy of canine teeth in domestic cats using micro-computed tomography. Front Vet Sci. 2024;11:1373517. doi:10.3389/fvets.2024.1373517

An understanding of the pulp cavity anatomy of individual teeth is essential for success during endodontic therapy. The objective of this study was to document pulp cavity anatomy and summarize numerical data of maxillary and mandibular canine teeth of domestic cats using micro-computed tomography (micro-CT). Thirty-nine canine teeth from eleven domestic cat cadaveric specimens were extracted and prepared for scanning. Segmentation of the pulp cavity was performed using the Avizo (v2022.2) software package. The morphological features of the pulp cavity including overall shape, configuration, presence of apical deltas, and lateral canals were recorded. A quantitative analysis was performed on thirty-one teeth to explore associations between pulp cavity volume and length, apical delta length, maximum apical delta foramina number, and cusp-to-tip length using a linear mixed model. Correlation between pertinent continuous variables was assessed using Pearson's correlation test. Most pulp cavities exhibited varying curvature and ranged from a cylindrical configuration in the coronal third to an ovoid configuration in the middle to apical third. A ribbon-like flattened canal was observed in 6/31 teeth (19%). All canine teeth depicted an apical delta with various configurations except for two teeth that showed a single canal exiting at the apex. In 15/31 teeth (48%), the primary root canal within the apical delta could be clearly identified and in 16/31 (52%) the primary root canal was indiscernible. The results showed that the pulp cavities of maxillary canine teeth were significantly larger and longer and the cusp-to-tip length was longer, when compared to mandibular teeth. The apical delta length was negatively correlated to the volume of the pulp cavity. No specimens depicted lateral canals. This study revealed that the anatomy of the canine tooth pulp cavity in cats can vary considerably and should be a consideration when performing thorough debridement, shaping, and obturation of the endodontic system.

Kwon D, Yoo DS, Kang SS, Jang K, Kim SE

Outcomes of root canal treatments with three different sealers for 120 fractured maxillary fourth premolar teeth in small- to medium-sized dogs. Front Vet Sci. 2024;11:1382645. doi:10.3389/fvets.2024.1382645

Introduction: Tooth fracture is one of the most common traumatic maxillofacial injuries in dogs and cats. For fractures with pulp exposure occurring in functionally important teeth, the literature indicates that root canal treatment (RCT) is an effective therapy option that may be the remedy of choice before extraction. The most commonly reported fractures in the United States involve canine teeth; however, fractures of the maxillary fourth premolars are more common in Korea, where there are many small- and medium-sized dogs. RCT mechanically and chemically removes pulp tissue and bacteria (cleaning and shaping) from the infected root canal, and obturates the root canal with filling material to restore tooth functionality without inflammation. Various techniques, instruments, and materials used in humans have been modified for application in veterinary dentistry. Methods: This study analyzed the results of RCT of the maxillary fourth premolar in 120 small- and medium-sized dogs (weighing less than 25kg) using three different sealers (silicone-based sealer, bioceramic sealer, and calcium hydroxide-based sealer) through a simple application of the single-cone technique. Results: The overall success rate of RCT in maxillary fourth premolars was 90.83%, with 8.33% no evidence of failure (NEF) and 0.83% failure. Discussion: There were no significant differences between the three different sealers. Furthermore, preexisting periapical lesion (PAL) was reconfirmed as a factor in reducing the success rate of RCT. In addition, the working length and master apical file of each root were analyzed in our study as a novel reference for endodontic veterinarians.

Vesterinen S, Lönnberg L, Junnila JJT, Luotonen N, Kuntsi H

Clinical and histopathological study of 279 dentigerous cysts in 192 dogs (2012-2022). Front Vet Sci. 2024;11:1412089. doi:10.3389/fvets.2024.1412089

Unerupted teeth in dogs are fairly common and may develop an odontogenic cyst that causes destruction of the surrounding bone and affect adjacent teeth. We analyzed histological reports of cysts associated with unerupted teeth in a large population of dogs. Medical records and histopathological results of cysts associated with unerupted teeth were evaluated from all dogs treated at a private referral veterinary dental clinic over a 10-year period (2012-2022). A total of 192 dogs with 279 cysts associated with one or more unerupted teeth were included in the study. Brachycephalic breeds were overrepresented. The most affected were Tibetan Spaniels with 58 dogs (30%) and Boxers with 48 dogs (25%). The most common affected tooth was the mandibular first premolar tooth with 238 (84%) cysts. Of the total of 279 cysts, 208 (75%) were histopathologically examined. None of the cysts examined contained malignant changes. Based on these 208 cysts, the probability of finding a cyst with malignant changes in a population of dogs is 0%–1.4% (confidence interval 95%).

Enlund KB, Jönsson B, Abrahamsson KH, Pettersson A

Long-term effects of motivational interviewing vs. traditional counseling on dog owners’ adherence to veterinary dental home care: a three-year follow-up study. Front Vet Sci. 2024;26:11:1296618. doi:10.3389/fvets.2024.1296618

Introduction: Periodontal disease is one of the most common health issues in dogs. However, disease is largely preventable by eliminating dental plaque, best achieved by daily tooth brushing. Unfortunately, owner adherence is low to the recommendation of daily tooth brushing in dogs. Objective: This study aimed to evaluate the impact of various communication strategies, traditional advice (TA) versus motivational interviewing (MI), and compare them to a control group receiving no additional communication (CG), on dog owners’ performance of dental home care and the oral health of their dogs. Methods: The study was conducted as a longitudinal clinical intervention study spanning 3 years, and involved 75 dog owners with young dogs who were randomly assigned to one of three groups: TA, MI, or CG. Intervention groups received annual telephone consultations based on their assigned methodology. A questionnaire was administered twice to all groups, and the dental health of the dogs was assessed at the study's conclusion. Result: Tooth brushing frequency demonstrated a significant increase in the MI group compared to the CG group (P < .01), albeit with a relatively low occurrence of daily brushing among owners. Dental health assessment revealed a significantly lower plaque index in the MI group compared to the CG group (P < .05), and a lower calculus index in the TA group compared to the CG group (P < .01). No statistically significant differences were observed between the MI and TA groups in terms of dental health. Conclusion: Regular veterinary communication appears to have a positive influence on dog owner adherence to veterinary recommendations concerning dental care in dogs. Communication with veterinarians (MI and traditional advice) improved owner knowledge, attitude, and decreased frequency of not brushing. Although dental health parameters improved, the effect size was small, suggesting the complexity of adherence. Personalized calls to dog owners offer potential for dental health improvement, warranting further comparison of MI with traditional advice.

Morita M

Use of an intraoral scanner to evaluate orthodontic treatment for dental malocclusion in a dog. J Am Vet Med Assoc. 2023;262(3):1-4. doi:10.2460/javma.23.09.0532

Objective: In human dental practice, intraoral scanners (IOSs) are increasingly used to evaluate the oral cavity. However, there have been no reports concerning evaluation of the canine oral cavity using IOSs in veterinary dentistry. In this case, optical impressions obtained with an IOS were used for 3-D evaluation of the orthodontic treatment outcome. Additionally, few reports have addressed the optimal orthodontic force for canine teeth. Therefore, this case explored whether sufficient tooth movement into the extraction site could be achieved with a lighter orthodontic force than previously reported. Animal: An 8-month-old spayed female dog. Clinical Presentation, Progression, and Procedures: A retained right maxillary third deciduous incisor (503) caused distoversion of the right maxillary third permanent incisor (103), leading to dental malocclusion that involved contact between 103 and the right mandibular canine teeth. Treatment and Outcome: All retained deciduous teeth were extracted. Mesial tipping movement of 103 into the extraction site of 503 was achieved with light orthodontic force using an elastomeric chain. An IOS was used to construct 3-D optical impression data from oral stone models taken before and after treatment, and tooth movement was evaluated. The results showed that 103 had sufficient tipping movement and no anchorage loss; comfortable occlusion was achieved. In addition to crown length extension, labioversion and mesioversion of maxillary incisors (other than 103) were observed. Clinical Relevance: Detailed intraoral evaluation with optical impressions was beneficial in the orthodontic treatment of a dog. Light orthodontic force may be sufficient for movement into the extraction site.

Kim SE

Dental erosion following clopidogrel administration in a dog: a case-based study. Vet Med Sci. 2024;10(2):e31384. doi:10.1002/vms3.1384

A 10-year-old neutered male Chihuahua presented with unilateral dental erosion that occurred after several months of oral medications mixed with honey. A pH test was performed on all oral medications administered to the dogs to determine the cause of enamel erosion. Among the medications, the only acidic medication was clopidogrel (pH 2.65). To evaluate the effect of clopidogrel on the tooth surface under the same conditions as in the present patient, an additional preliminary study was designed in which two extracted teeth of another dog were immersed in a clopidogrel-honey mixture or only in honey. After a 3-week soaking of the extracted tooth in the clopidogrel-honey mixture, field-emission scanning electron microscope analysis revealed a rougher surface, whereas energy-dispersive X-ray spectroscopy analysis showed a reduced Ca/C ratio compared to the control tooth. In this case, prolonged exposure of the tooth surface to clopidogrel may be a cause of dental erosion.

Wang L, Liu X, Tang Y, et al

Effect of dental chew on reducing dental plaque, dental calculus and halitosis in beagle dogs. Res Vet Sci. 2024;174:105304. doi:10.1016/j.rvsc.2024.105304

Periodontosis is the most common clinical disease in adult dogs, which is mainly caused by plaque accumulation and seriously endangers the oral health of dogs and even cause kidney, myocardial, and liver problems in severe cases. The aim of this study was to determine the clinical efficacy of dental chew (Cature Brushing Treats product) with mechanical and chemical properties in beagles. The dogs in the experimental group were fed with a dental chew twice a day after meals; The control group had no treatment. Dental plaque was evaluated on the 14th day and 29th day, respectively. The concentration of volatile sulfur compounds (VSC) in the breath and dental calculus were also evaluated on the 29th day. The results showed that there was no significant difference in the indexes of dental plaque on the 14th day. While they had significantly reduced accumulation of plaque (37.63%), calculus (37.61%), and VSC concentration (81.08%) compared to when receiving no chew on the 29th day.