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Background: The severity of furcation involvement (FI) directly affected tooth prognosis and influenced treatment approaches. However, assessing, diagnosing, and treating molars with FI was complicated by anatomical and morphological variations. Cone-beam computed tomography (CBCT) enhanced diagnostic accuracy for detecting FI and measuring furcation defects. Despite its advantages, the high cost and radiation dose associated with CBCT equipment limited its widespread use. The aim of this study was to evaluate the performance of the Vision Transformer (ViT) in comparison with several commonly used traditional deep learning (DL) models for classifying molars with or without FI on panoramic radiographs. Methods: A total of 1,568 tooth images obtained from 506 panoramic radiographs were used to construct the database and evaluate the models. This study developed and assessed a ViT model for classifying FI from panoramic radiographs, and compared its performance with traditional models, including Multi-Layer Perceptron (MLP), Visual Geometry Group (VGG)Net, and GoogLeNet. Results: Among the evaluated models, the ViT model outperformed all others, achieving the highest precision (0.98), recall (0.92), and F1 score (0.95), along with the lowest cross-entropy loss (0.27) and the highest accuracy (92%). ViT also recorded the highest area under the curve (AUC) (98%), outperforming the other models with statistically significant differences (p < 0.05), confirming its enhanced classification capability. The gradient-weighted class activation mapping (Grad-CAM) analysis on the ViT model revealed the key areas of the images that the model focused on during predictions. Conclusion: DL algorithms can automatically classify FI using readily accessible panoramic images. These findings demonstrate that ViT outperforms the tested traditional models, highlighting the potential of transformer-based approaches to significantly advance image classification. This approach is also expected to reduce both the radiation dose and the financial burden on patients while simultaneously improving diagnostic precision. [ABSTRACT FROM AUTHOR]

Background: The aging population is increasingly affected by periodontal disease, a condition often overlooked due to its asymptomatic nature. Despite its silent onset, periodontitis is linked to various systemic conditions, contributing to severe complications and a reduced quality of life. With over a billion people globally affected, periodontal diseases present a significant public health challenge. Current diagnostic methods, including clinical exams and radiographs, have limitations, emphasizing the need for more accurate detection methods. This study aims to develop AI-driven models to enhance diagnostic precision and consistency in detecting periodontal disease. Methods: We analyzed 2,000 panoramic radiographs using image processing techniques. The YOLOv8 model segmented teeth, identified the cemento-enamel junction (CEJ), and quantified alveolar bone loss to assess stages of periodontitis. Results: The teeth segmentation model achieved an accuracy of 97%, while the CEJ and alveolar bone segmentation models reached 98%. The AI system demonstrated outstanding performance, with 94.4% accuracy and perfect sensitivity (100%), surpassing periodontists who achieved 91.1% accuracy and 90.6% sensitivity. General practitioners (GPs) benefitted from AI assistance, reaching 86.7% accuracy and 85.9% sensitivity, further improving diagnostic outcomes. Conclusions: This study highlights that AI models can effectively detect periodontal bone loss from panoramic radiographs, outperforming current diagnostic methods. The integration of AI into periodontal care offers faster, more accurate, and comprehensive treatment, ultimately improving patient outcomes and alleviating healthcare burdens. [ABSTRACT FROM AUTHOR]

Aim: To develop a multiclass non‐clinical screening tool for periodontal disease and assess its accuracy for differentiating periodontal health, gingivitis and different stages of periodontitis. Materials and Methods: A cross‐sectional diagnostic study on a convenience sample of 408 consecutive subjects was conducted by applying three non‐clinical index tests estimating different features of the periodontal health–disease spectrum: a self‐administered questionnaire, an oral rinse activated matrix metalloproteinase‐8 (aMMP‐8) point‐of‐care test (POCT) and determination of gingival bleeding on brushing (GBoB). Full‐mouth periodontal examination was the reference standard. The periodontal diagnosis was made on the basis of the 2017 classification of periodontal diseases and conditions. Logistic regression and random forest (RF) analyses were performed to predict various periodontal diagnoses, and the accuracy measures were assessed. Results: Four‐hundred and eight subjects were enrolled in this study, including those with periodontal health (16.2%), gingivitis (15.2%) and stage I (15.9%), stage II (15.9%), stage III (29.7%) and stage IV (7.1%) periodontitis. Nine predictors, namely 'gum disease' (Q1), 'a rating of gum/teeth health' (Q2), 'tooth cleaning' (Q3a), the symptom of 'loose teeth' (Q4), 'use of floss' (Q7), aMMP‐8 POCT, self‐reported GBoB, haemoglobin and age, resulted in high levels of accuracy in the RF classifier. High accuracy (area under the ROC curve > 0.94) was observed for the discrimination of three (health, gingivitis and periodontitis) and six classes (health, gingivitis, stages I, II, III and IV periodontitis). Confusion matrices showed that the misclassification of a periodontitis case as health or gingivitis was less than 1%–2%. Conclusions: Machine learning‐based classifiers, such as RF analyses, are promising tools for multiclass assessment of periodontal health and disease in a non‐clinical setting. Results need to be externally validated in appropriately sized independent samples (ClinicalTrials.gov NCT03928080). [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to assess whether computer- assisted periodontal diagnosis can improve the accuracy and homogeneity of classification results obtained by dental students using the 2017 classification of periodontal diseases. Method and materials: All final year predoctoral dental students from two dental schools were invited to participate in the study. Participants who volunteered for the study were randomly div ided into two groups for digital or manual diagnosis, and each participant classified 48 cases. A group of three experienced periodontists provided the reference or gold standard diagnosis. Results: Overall, 27 students completed the evaluation of all cases; 14 students comprised the digital application group and 13 the manual group. The accuracy of the classification results compared with the gold standard committee was 82% for the digital group compared to 50% of the manual group in terms of the extent of gingivitis; 71% vs 56% for the stage of periodontitis; 67% vs 62% for grade of periodontitis; 76% vs 63% for extent of periodontitis; and 43% vs 30% for overall diagnosis accuracy of periodontitis cases respectively. Conclusions: Computer-assisted classification using newly developed software, within the boundaries of this study, was shown to be a sensible support tool for dental practitioners to use when diagnosing periodontal disease. This digital tool can the clinicians' accuracy of diagnosis primarily in the extent and staging of periodontitis. [ABSTRACT FROM AUTHOR]

Aim: This review is intended to adapt the current conceptual framework in dental education based on four domains to propose a set of competences, learning outcomes and methods of teaching, learning and assessment for undergraduate education in periodontology. Review: Based on the current framework of competences and learning outcomes recommended by the Association for Dental Education in Europe (ADEE), undergraduate education in periodontology has been updated using the classification and clinical practice guidelines for the diagnosis and treatment of periodontal and peri‐implant diseases. Conclusions: Specific learning outcomes have been proposed within each competence area, that is in Domain I (n = 10), Domain II (n = 13), Domain III (n = 33) and Domain IV (n = 12). Teaching methods and learning activities based on the different dimensions of the cognitive process have been proposed. Additionally, 10 key learning outcomes have been proposed as exit outcomes, which implies their accomplishment within the final assessment of any graduating student. [ABSTRACT FROM AUTHOR]

A 48-year-old female patient referred to the Birmingham Dental Hospital for generalized periodontitis presented with a residual 8-mm pocket and infrabony defect around her LL2 after Step 1 and 2 of therapy. Following discussion of treatment options, a minimally invasive non-surgical technique was completed alongside the addition of a biologic, a therapeutic agent applied to enhance regenerative or reparative effects during wound healing and in this case, enamel matrix derivative. At 6 months, pocket closure was evident, as well as radiographic evidence of bony infill. The patient remains in ongoing supportive periodontal therapy at 3-monthly intervals. CPD/Clinical Relevance: Addition of biologics traditionally used during surgical therapy may provide improvements when used alongside minimally invasive non-surgical treatment. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) and periodontal disease (PD) are both characterized by an inflammatory reaction. Anti-cyclic citrullinated peptide (anti-CCP) is a common diagnostic test for RA. Anti-CCP is proposed to be used as a serological biomarker to detect PD in patients with RA. Methods: A case-control study was designed for 94 subjects; 42 patients with RA and 52 without RA. PD and its types were investigated among these subjects. An enzyme-linked immunosorbent assay (ELISA) test was used to measure anti-CCP levels in these subjects. Results: Subjects were recategorized into four groups after PD diagnosis: group 1 for RA with PD (34.04%); group 2 for RA only (10.63%); group 3 for PD only (30.85%); and group 4 for individuals without RA and PD (24.46%). Anti-CCP may be considered an effective biomarker for predicting the development of PD in RA patients based on five current results found in group 1 compared to other groups. These included the detection of significantly higher anti-CCP levels, a high sensitivity (63.15%), low specificity (50%), higher cut-off value (58.53 U/ml), high positive predictive value (94.73%), and low negative predictive value (8.69%) of anti-CCP. Chronic periodontitis is the most common and has a significant association with elevated levels of anti-CCP. Conclusion: Measuring the anti-CCP level in RA patients may be a good indicator for PD diagnosis based on the suggested cut-off value. The sensitivity of the test is sufficiently reliable to produce true positive results. Anti-CCP may also be useful in the diagnosis of PD type, especially chronic periodontitis. [ABSTRACT FROM AUTHOR]

Tooth auto transplantation is becoming a predictable method to replace a missing tooth, especially in young patients, with many benefits. This case report presents a 14-year-old male with an un restorable, decayed mandibular first molar with bifurcation and periapical lesions. After the extraction, the socket was debrided and prepared for an immediate auto transplantation of the immature mandibular third molar. Radiologic and clinical follow‑up for 1 year showed periodontal healing with the absence of any complications despite the auto transplantation into an infected site. Thus, third-molar auto transplantation was a good solution to replace an un restorable first molar with a satisfactory result. Despite the existence of periradicular lesion, the curettage, debridement, and irrigation were enough to perform successful immediate tooth auto transplantation in this case. [ABSTRACT FROM AUTHOR]

Periodontitis (PD) remains a global public health problem. Evidence revealed that PD contributes to the development of systemic diseases, including effects on men's sexual health such as erectile dysfunction (ED). Objective: To review and explore the association between PD and ED. Methods: Following PRISMA guidelines, a systematic review of studies published in Scopus, PubMed, ScienceDirect, and Google Scholar was conducted. A comprehensive literature search until February 2024 by combining several keywords and applying eligibility criteria was performed. JBI critical appraisal checklist was employed for quality assessment. Results: A total of 15 studies involving 216,753 subjects aged between 18 and 85 years old were included. The included articles consisted of 9 cross-sectional studies, 5 case-control studies, and 1 RCT. Of the 15 studies, 13 of them statistically demonstrated a significant association between PD and ED, and the other two did not; however, they showed that there is a significant relationship between the severity of PD and the severity of ED. Six studies reported odds ratios (OR) ranging from 1.60 to 3.35. Most of the PD diagnostic methods used are objective, and only one study used color Doppler ultrasound to diagnose ED. Summary: According to the findings, a significant association between PD and ED is evident. Additionally, dentists and general practitioners must be aware of the interconnection between these diseases, enabling them to provide comprehensive education to patients, particularly concerning the prevention and management of periodontal disease. [ABSTRACT FROM AUTHOR]

Background: A new classification for Periodontal and Peri-implant Diseases and Conditions was introduced in the 2017 World Workshop. In the past the 1999 Armitage Classification was commonly used in practice. This study aimed to assess the ease and practicability of retroactively diagnosing a subset of patients formerly diagnosed using the 1999 AAP/CDC classification with the 2017 AAP/EFP disease classification. Methods: A random subset of 10% of all patients referred over a 7-year period (2011–2018) to the Post-Doctoral Periodontics Clinic at Columbia University College of Dental Medicine were reviewed by accessing the Electronic Health Records (EHRs) on axiUm. Patients diagnosed with periodontal disease based on the 1999 AAP/CDC classification (including chronic and aggressive Periodontitis) were reclassified using the 2017 classification (stage: I, II, III and grade: A, B, C). Results: A sample of 336 patient records were examined. 132 were diagnosed with gingivitis, and 204 with periodontitis. Of these 204 patients, 68 (33.3%) were diagnosed with aggressive and 136 (66.7%) with chronic periodontitis. Patients diagnosed with aggressive periodontitis, 10% were reclassified as stage II, 47% as stage III, and 43% as stage IV periodontitis, and 100% were reclassified as grade C. Among patients with chronic periodontitis, 7% were reclassified as stage I, 65% as stage II, 21% as stage III, and 7% as stage IV; 11% of these were reclassified as grade A, 63% grade B, and 26% grade C. Conclusions: The majority of those originally diagnosed with aggressive (90%) and chronic (80%) periodontitis were reclassified as either molar/incisor pattern stage III grade C or stage IV grade C periodontitis, and stage II or III periodontitis, respectively. The study demonstrated that it is practical to retroactively reassign a diagnosis according to the new 2017 classification using available information included in dental EHRs. Learning objectives: To understand the importance of properly documenting clinical data in the Dental setting. To further understand the 2017 Periodontal Disease Classification and the significance of the staging and grading systems. To determine what clinical parameters should be recorded and to discuss how to use them to assign staging and grading and accurately diagnose our patients correctly. To recognize the practicability of retroactively applying the 2017 Periodontal Disease Classification criteria to patients formerly diagnosed using the 1999 classification to improve patient care. To assess clinical data and determine whether surgical treatment is recommended for the treatment of periodontal disease. [ABSTRACT FROM AUTHOR]

Background: Machine learning (ML) through artificial intelligence (AI) could provide clinicians and oral pathologists to advance diagnostic problems in the field of potentially malignant lesions, oral cancer, periodontal diseases, salivary gland disease, oral infections, immune-mediated disease, and others. AI can detect micro-features beyond human eyes and provide solution in critical diagnostic cases. Objective: The objective of this study was developing a software with all needed feeding data to act as AI-based program to diagnose oral diseases. So our research question was: Can we develop a Computer-Aided Software for accurate diagnosis of oral diseases based on clinical and histopathological data inputs? Method: The study sample included clinical images, patient symptoms, radiographic images, histopathological images and texts for the oral diseases of interest in the current study (premalignant lesions, oral cancer, salivary gland neoplasms, immune mediated oral mucosal lesions, oral reactive lesions) total oral diseases enrolled in this study was 28 diseases retrieved from the archives of oral maxillofacial pathology department. Total 11,200 texts and 3000 images (2800 images were used for training data to the program and 100 images were used as test data to the program and 100 cases for calculating accuracy, sensitivity& specificity). Results: The correct diagnosis rates for group 1 (software users), group 2 (microscopic users) and group 3 (hybrid) were 87%, 90.6, 95% respectively. The reliability for inter-observer value was done by calculating Cronbach's alpha and interclass correlation coefficient. The test revealed for group 1, 2 and 3 the following values respectively 0.934, 0.712 & 0.703. All groups showed acceptable reliability especially for Diagnosis Oral Diseases Software (DODS) that revealed higher reliability value than other groups. However, The accuracy, sensitivity & specificity of this software was lower than those of oral pathologists (master's degree). Conclusion: The correct diagnosis rate of DODS was comparable to oral pathologists using standard microscopic examination. The DODS program could be utilized as diagnostic guidance tool with high reliability & accuracy. [ABSTRACT FROM AUTHOR]

Aim: To develop and validate an automated electronic health record (EHR)‐based algorithm to suggest a periodontal diagnosis based on the 2017 World Workshop on the Classification of Periodontal Diseases and Conditions. Materials and Methods: Using material published from the 2017 World Workshop, a tool was iteratively developed to suggest a periodontal diagnosis based on clinical data within the EHR. Pertinent clinical data included clinical attachment level (CAL), gingival margin to cemento‐enamel junction distance, probing depth, furcation involvement (if present) and mobility. Chart reviews were conducted to confirm the algorithm's ability to accurately extract clinical data from the EHR, and then to test its ability to suggest an accurate diagnosis. Subsequently, refinements were made to address limitations of the data and specific clinical situations. Each refinement was evaluated through chart reviews by expert periodontists at the study sites. Results: Three‐hundred and twenty‐three charts were manually reviewed, and a periodontal diagnosis (healthy, gingivitis or periodontitis including stage and grade) was made by expert periodontists for each case. After developing the initial version of the algorithm using the unmodified 2017 World Workshop criteria, accuracy was 71.8% for stage alone and 64.7% for stage and grade. Subsequently, 16 modifications to the algorithm were proposed and 14 were accepted. This refined version of the algorithm had 79.6% accuracy for stage alone and 68.8% for stage and grade together. Conclusions: Our findings suggest that a rule‐based algorithm for suggesting a periodontal diagnosis using EHR data can be implemented with moderate accuracy in support of chairside clinical diagnostic decision making, especially for inexperienced clinicians. Grey‐zone cases still exist, where clinical judgement will be required. Future applications of similar algorithms with improved performance will depend upon the quality (completeness/accuracy) of EHR data. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present research is to evaluate the salivary levels of leucine‐rich alpha‐2 glycoprotein (LRG) and C‐reactive protein (CRP) in periodontal health and disease (gingivitis and stage III periodontitis) and also to compare the discriminative efficiencies of both biomarkers in periodontal disease. Background: LRG is a new acute‐phase protein whose functions are still being investigated. LRG and CRP are both biomarkers that are increased by inflammation. No clinical study has yet investigated the comparison of the level of LRG and CRP in periodontal health, gingivitis and periodontitis in saliva samples. Methods: A total of 60 individuals, including 20 periodontally healthy (control group/group C), 20 with gingivitis (group G), and 20 with Stage III periodontitis (group P), who were systemically healthy and non‐smokers, participated in this study. Periodontal charts were used for recording clinical periodontal parameters and saliva LRG and CRP levels were measured by ELISA. Analyzing the area under the curve (AUC) was performed by the receiver‐operating characteristics curve. Results: Salivary levels of LRG and CRP were significantly higher in disease groups than in group C (p <.05). Positive statistically significant correlations were observed between both biomarkers and clinical parameters (p <.05). There was also a strong positive correlation between two biomarkers (p <.05). In distinguishing periodontal disease from periodontal health, LRG (AUC = 0.833) and CRP (AUC = 0.826) were found to have similar accuracy (p =.923). Conclusion: LRG and CRP may be useful and similarly effective biomarkers in the diagnosis of periodontal diseases based on the findings of this study. [ABSTRACT FROM AUTHOR]

Background and Objective: As elsewhere in the world, the prevalence of periodontitis in stages I–II is high in the Latin American population, this scenario emphasizes the need for identification of urgent needs for allocating adequate resources to provide diagnosis, prevention, and treatment of these diseases. The aim of this Delphi study was to predict the trends in periodontology/periodontics in the Latin American region by the year 2030. Methods: A steering committee and an advisory group of experts in periodontology/periodontics were selected from 16 countries. An open questionnaire of 60 questions was validated and used following the Delphi methodology. Results: Two hundred and twenty‐five experts from Latin America answered the two rounds of the questionnaire. Moderate to strong consensus was reached on 45 questions (75%). The prediction was that the prevalence of gingivitis and periodontitis in stages I and II will be maintained, the importance of the link with systemic diseases will increase, and the impact of prevention and periodontal treatment will also increase, mainly in the private sector. There was a strong consensus that plastic and regenerative surgical procedures will increase, as well as the demand for training in the specialty of periodontology. Conclusions: The present study has provided relevant and useful information on predictions in periodontology/periodontics in Latin America, with important level of consensus among experts. It has been predicted that periodontitis will still be a highly prevalent disease, and its links with other medical conditions should demand more attention by health authorities to develop adequate prevention and management policies and strategies. [ABSTRACT FROM AUTHOR]

Background: The objective of the present survey is to assess the knowledge about the relationship between oral health and diabetes and to identify the practice behaviors of Swiss endocrinologists and general practitioners regarding oral health in diabetic patients. Methods: A thirty- item questionnaire was mailed to 428 internists and 99 endocrinologists working in the French speaking part of Switzerland. Participants were asked about their awareness of the relationship between diabetes and periodontal disease, their practice behaviors as well as their willingness for an interdisciplinary education and collaboration with oral health professionals. The questions were answered according to a three-point or five-point Likert scale. Results: The response rate was 23%. All participants were aware of the inflammatory and infectious nature of periodontal disease. They all agreed that good periodontal health is important for overall health. However, most of the practitioners responded that only rarely received information during their education curricula on the link between systemic and oral health or concerning periodontal problems in diabetic patients (60.9% for endocrinologists and 54.1% for general physicians); thus, only a minority of health practitioners addresses oral health care to their patients (13% and 15.3%, respectively). Both endocrinologists and general health physicians agreed that an oral health screening could be included in their practice (79% for both groups). Conclusions: An interdisciplinary education and collaboration among medical and dental health providers should be established to effectively prevent, manage, and control both diabetes and periodontal disease in diabetic patients. [ABSTRACT FROM AUTHOR]

Objective: Nucleotide‐binding and oligomerization domain (NOD)‐like receptor family CARD domain‐containing protein 4 (NLRC4) has a critical role in the regulation of interleukin‐1β (IL‐1β), an important cytokine in the pathogenesis of the periodontal diseases. In this study, we aimed to evaluate levels of salivary NLRC4 inflammasomes in different periodontal clinical statuses. Methods: The individuals with 20 periodontally healthy (healthy), 20 gingivitis, and 20 periodontitis were periodontally examined. Saliva samples were collected, after the clinical measurements (plaque index, gingival index, gingival bleeding index, probing depth, and clinical attachment level). The levels of salivary NLRC4, IL‐1β, and interleukin 10 (IL‐10) were examined by enzyme‐linked immunosorbent assay. Results: The results demonstrated that levels of salivary NLRC4 (p < 0.01), and IL‐1β (p < 0.001) were significantly higher in gingivitis and periodontitis than in the healthy group. No significant difference was salivary IL‐10 levels between the groups (p > 0.05). Positive significant correlations among NLRC4 and IL‐1β salivary levels and clinical parameters were detected (p < 0.05). Conclusion: The findings of this study suggest that the NLRC4 is elevated in periodontal disease. Larger randomized controlled clinical studies are needed to use salivary NLRC4 levels as a potential marker for detecting the presence and/or severity of the periodontal disease. [ABSTRACT FROM AUTHOR]

Aim: To assess the differential molecular profiling of gingival crevicular fluid (GCF) from infrabony and suprabony periodontal defects compared with healthy sites. Materials and Methods: Seventy‐five samples from 25 patients with untreated periodontitis stage III–IV were included. Clinical and radiological parameters as well as GCF samples were collected from an infrabony defect, a suprabony defect and a periodontally healthy site per patient. A multiplex bead immunoassay was performed to assess the level of 18 biomarkers associated with inflammation, connective tissue degradation and regeneration/repair. Results: GCF volume was higher in periodontal sites compared with healthy sites, with no significant difference between infrabony and suprabony defects. Fourteen biomarkers were elevated in infrabony and suprabony sites compared with healthy sites (p <.05). Only interleukin‐1α levels were increased in infrabony compared with suprabony sites, whereas there was no difference in probing pocket depth. Conclusions: Although the GCF molecular profile clearly differentiates periodontally affected sites from healthy sites, the different architecture between infrabony and suprabony defects is not reflected in GCF biomarker changes. [ABSTRACT FROM AUTHOR]

Objective: This article describes the importance of identifying inflammation‐inducing conditions in the dental office that are prevalent in the population and have significant systemic health risks for the patient. The role of the dental biofilm will be presented, as will the clinical protocols for treating an unhealthy biofilm. Methods for testing and maintaining a healthy biofilm are also presented. Clinical Considerations: Periodontal disease, dental caries, and periapical infections are inflammation‐inducing diseases that can be identified in the dental office. Additionally, sleep apnea has been linked to chronic systemic inflammation. Dentists can identify risk factors and provide treatments that lower the risk of serious systemic outcomes, such as atherosclerosis, cardiac arrest, and stroke. Conclusions: A thorough dental examination, including a comprehensive periodontal evaluation, can provide important information that can be used to improve or maintain a patient's systemic health. Treatments provided to improve oral health have been shown to improve systemic indicators of cardiovascular health. This is the basis of integrative oral medicine, a collaboration between the medical and dental providers, which can offer patients the best opportunity for improved health outcomes. Clinical Significance: Periodontal disease, caries, periapical infections, and sleep apnea all have negative systemic health consequences for the patient (DiMatteo, Inside Dent, 2017, 13, 30; Nakano, Oral Microbiol Immunol, 2009, 24, 64; El Ouarti, BMC Oral Health, 2021, 21, 124; Lamberg, Steve). Periodontal disease, caries, and root end infections influence the health of the oral biofilm. If the biofilm becomes pathogenic the host inflammatory response can be stimulated, resulting in a cascade of inflammatory processes that damage the supporting structures of the teeth and harm the patient's overall health. A thorough dental exam that includes a comprehensive periodontal evaluation will identify patients with active inflammation or oral conditions that contribute to chronic inflammation. Dentists can integrate this information into treatment strategies that reduce the inflammatory burden and assist in better overall health outcomes. [ABSTRACT FROM AUTHOR]

Periodontal disease is an infectious-inflammatory disease caused by the presence of bacteria in the dental biofilm, leading in many cases to tooth loss. The objective of this work is to report a clinical case of generalized periodontal disease. Female patient, sought the Dental Clinic of the University of Passo Fundo, complaining that her upper dental arch was increasingly "crooked" and felt a little "mobility"., being diagnosed with stage II periodontitis, due to the pandemic, the patient was only able to return to the Dental Clinic after 5 months, when new exams were carried out, with an increase in the probing depth reaching 7mm in some sites, having a new diagnosis periodontal disease, periodontitis stage III of the disease. The patient's treatment plan consisted of adapting the oral environment, through oral hygiene guidance, prophylaxis, supragingival and subgingival scaling. After 6 months of follow-up, it can be noted that the proposed treatment it was not satisfactory, because, after doing a new periogram, there was no regression of the disease. as for oral hygiene, the patient did not cooperate with the treatment and the installation of orthodontic appliances was not recommended. Periodontal maintenance along with the patient's cooperation is essential to achieve successful periodontal treatment, but in the following case report there was no success in periodontal therapy, and the patient's lack of cooperation could be one of the reasons. [ABSTRACT FROM AUTHOR]

This article describes the combined use of the immediate dentoalveolar restoration (IDR) technique and the osseodensification implant site preparation method to improve immediate implant primary stability in periodontally compromised extraction sites. Positioning of soft and hard tissues was evaluated in two clinical cases in which the IDR technique and the osseodensification implant site preparation method were used to replace teeth at sites with severe alveolar bone loss. The results were analyzed by clinical assessment, photography, radiography, and computed tomography scans. Based on this preliminary study, the use of osseodensification can enhance the results achieved using the IDR technique due to improved primary implant stability, as measured by higher insertion torque. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the healing of periodontal intrabony defects treated using enamel matrix derivative (EMD) after at least 5 years of follow-up. Six patients with seven intrabony defects were included in the study. Treatment with EMD yielded a mean clinical attachment level gain of 4.3 ± 2.4 mm, a mean probing depth reduction of 4.7 ± 2.1 mm, and a mean gingival recession increase of 0.7 ± 1.8 mm. Reentry measurements showed a complete resolution of the intrabony defect in five cases, while in two cases a residual intrabony component was recorded. The present study indicates that treatment using EMD provided good clinical outcomes maintained in most cases over a period of at least 5 years. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to compare levels of the biomarkers lactate dehydrogenase (LDH) and free hemoglobin in the saliva of different groups of smokers for early diagnosis of periodontitis and their clinical relevance for use as a screening tool. Method and materials: Eighty cigarette smokers were divided into light (< 10 cigarettes/day) moderate (10 to 19 cigarettes/day) and heavy (≥ 20 cigarettes/day) smokers. Stimulated saliva samples were obtained by the expectoration method and evaluated for LDH and free hemoglobin levels. Clinical parameters were recorded after saliva collection using the modified Community Periodontal Index (CPI). Results: Salivary free hemoglobin level was higher in light smokers compared to heavy smokers (mean 363.89 ± 295 μmol/L in light vs mean 79.55 ± 37.41 μmol/L in heavy, P = .001) and positively correlated with CPI score. There was no control group to prevent bias with free hemoglobin results in healthy individuals. Salivary LDH levels were higher in light smokers (411.24 ± 18.62 IU/L) compared to heavy smokers (313.26 ± 23.98 IU/L). However, a significant correlation between free hemoglobin, LDH, and CPI score (clinical parameters) was seen between the three groups of smokers (P < .01). Conclusions: Within the limitations of this observational study, there was a progressive reduction in free hemoglobin and LDH levels from light smokers to heavy smokers. However, the severity of periodontal disease conditions increased as the severity of smoking habit increased. [ABSTRACT FROM AUTHOR]

Objectives: Chronic kidney disease (CKD) is a public health problem worldwide. Currently, the link between oral health status, dialysis modality, and dialysis vintage is still not clear. The aim of this study was to evaluate periodontal disease, dental caries, and Candida colonization among patients under hemo dialysis (HD) therapy, peritoneal dialysis (PD) therapy, and PD with previous history of HD (HD/PD). Method and materials: The clinical history, smoking, and oral hygiene habits were recorded. Decayed, missing, or filled teeth (DMFT) index, Visible Plaque Index (VPI), clinical attachment level (CAL), bleeding on probing, saliva flow rate, saliva pH, and oral yeast colonization were assessed. Results: HD/PD patients were generally submitted to longer periods of dialysis therapy than the other groups. The number of decayed and filled teeth did not differ between groups; HD patients presented a higher number of teeth, but poor periodontal status. Among the three groups, HD patients presented higher VPI, CAL, and oral Candida colonization, independently of the time under dialysis therapy. Candida albicans (HD and PD), Candida krusei (HD), and Candida carpophila (PD) were isolated in these patients. Conclusion: HD presented a more adverse impact on oral health than PD, particularly periodontal disease and oral Candida colonization; however, this impact on oral health appears to be reduced or ameliorated when patients change from HD to PD therapy. [ABSTRACT FROM AUTHOR]

Objective: Osteoporosis (OP) and periodontal disease (PD) are two common health issues that threaten the older population and potentially connected each other in the context of type 2 diabetes mellitus (T2DM). Dysregulated expression of microRNAs (miRNAs) may contribute to the development and progression of both OP and PD among elderly T2DM patients. The present study aimed to evaluate the accuracy of miR-25-3p expression for the detection of OP and PD when compared to a mixed group of patients with T2DM. Methods: The study recruited 45 T2DM patients with normal bone mineral density (BMD) and healthy periodontium, 40 type 2 diabetic osteoporosis patients coexistent with PD, 50 type 2 diabetic osteoporosis patients with healthy periodontium, and 52 periodontally healthy individuals. miRNA expression measurements in the saliva were determined by real-time PCR. Results: The salivary expression of miR-25-3p was higher in type 2 diabetic osteoporosis patients than patients with T2DM only and healthy individuals (P < 0.05). Among type 2 diabetic osteoporosis patients, those with PD exhibited a higher salivary expression of miR-25-3p than those with healthy periodontium (P < 0.05). Among type 2 diabetic patients with healthy periodontium, a higher salivary expression of miR-25-3p was noted in those with OP than those without (P < 0.05). We also found a higher salivary expression of miR-25-3p in T2DM patients than healthy individuals (P < 0.05). It was revealed that the salivary expression of miR-25-3p was increased as the T scores of BMD of patients were lowered, the PPD and CAL values of patients were enhanced. The salivary expression of miR-25-3p used as a test to predict a diagnosis of PD among type 2 diabetic osteoporosis patients, a diagnosis of OP among type 2 diabetic patients, and a diagnosis of T2DM among healthy individuals produced AUC of 0.859. 0.824, and 0.886, respectively. Conclusion: The findings obtained from the study support salivary miR-25-3p confers non-invasive diagnostic potential for PD and OP among a cohort of elderly T2DM patients. [ABSTRACT FROM AUTHOR]

The purposes of this article are to report the clinical case of a patient who exhibited a foreign body reaction associated with the use of bone wax after extraction of an impacted third molar and to present an integrative literature review addressing the possible influences of this hemostatic agent on bone healing. A 26-year-old woman who underwent the extraction of her mandibular right third molar developed intense alveolar bleeding during surgery, requiring the use of bone wax. In the 2-month postoperative period, the patient presented with intraoral edema and discharge of a purulent secretion via the alveolar route. After cone beam computed tomographic images revealed increased hyperdensity inside the alveolus, alveolar curettage was performed and the material that was obtained was submitted to histopathologic examination. The results of the histopathologic analysis proved conclusive for an inflammatory foreign body reaction associated with exogenous material. A search of the PubMed, SciELO, and LILACS databases identified 22 studies that evaluated the influence of this hemostatic agent on bone healing, and an integrative review involving 367 animals and 75 humans was compiled. Bone wax is a nonresorbable material capable of negatively influencing bone healing. It is suggested that the product be used cautiously in amounts that are just enough to promote the sealing of the bone channels. [ABSTRACT FROM AUTHOR]

Introduction: Bidirectional relationship between diabetes and periodontal diseases has been recognized and accepted in the literature for a long time and shown to influence each other in both development and disease progression. Age, obesity, stress, smoking, and genetic predisposition are considered risk factors for diabetes and periodontal diseases. Aims: The objective of this questionnaire study was to assess the awareness of diabetic patients regarding the bidirectional relationship between diabetes, periodontal diseases, and risk factors. Materials and Methods: A cross-sectional questionnaire study was conducted on diabetic patients in the Asir region of Saudi Arabia between 18 and 70 years-age group individuals. A self-administrated questionnaire, which contained four sections of close-ended questions, was used. The sections included demographic characteristics, knowledge, and awareness regarding the relationship between diabetics and periodontal disease and knowledge and understanding of oral hygiene. SPSS version 20 was used to analyze the collected data, and descriptive statistical analysis was done. Results and Discussion: This study included 221 diabetic patients. The overall knowledge regarding the bidirectional relationship was high among 43%, whereas the knowledge regarding oral hygiene was high among 58.8%. The duration of diabetes (P = 0.006), medication for controlling blood sugar (P = 0.03), type of medication (P = 0.004), and the state of diabetes (P = 0.01) significantly affected the knowledge regarding the bidirectional relationship. There was a significant correlation between the understanding of oral hygiene and the knowledge of the bidirectional relationship (P = 0.0001). Conclusions: The study participants had low knowledge and awareness regarding the bidirectional relationship between diabetes and periodontal disease. However, those who had a high knowledge of oral hygiene also had an increased knowledge regarding the bidirectional correlation. Medical and dental professionals must create awareness about the importance of maintaining good oral health and influencing overall general health in diabetic patients, regardless of the presence or absence of the recognized risk factors. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of peri-implantar and periodontal relies mainly on a set of clinical measures and the evaluation of radiographic images. However, these clinical settings alone are not sufficient to determine, much less predict, periimplant bone loss or future implant failure. Early diagnosis of periimplant diseases and its rate of progress may be possible through biomarkers assessment. Once identified, biomarkers of peri-implant and periodontal tissue destruction may alert the clinicians before clinical signs show up. Therefore, it is important to consider developing chair-side diagnostic tests with specificity for a particular biomarker, indicating the current activity of the disease. Methods: A search strategy was created at Pubmed and Web of Science to answer the question: "How the molecular point-of-care tests currently available can help in the early detection of peri-implant diseases and throws light on improvements in point of care diagnostics devices?" Results: The PerioSafe® PRO DRS (dentognostics GmbH, Jena) and ImplantSafe® DR (dentognostics GmbH, Jena ORALyzer® test kits, already used clinically, can be a helpful adjunct tool in enhancing the diagnosis and prognosis of periodontal/peri-implantar diseases. With the advances of sensor technology, the biosensors can perform daily monitoring of dental implants or periodontal diseases, making contributions to personal healthcare and improve the current status quo of health management and human health. Conclusions: Based on the findings, more emphasis is given to the role of biomarkers in diagnosing and monitoring periodontal and peri-implant diseases. By combining these strategies with traditional protocols, professionals could increase the accuracy of early detection of peri-implant and periodontal diseases, predicting disease progression, and monitoring of treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that diagnostic salivary tests measuring inflammatory biomarkers are being developed to assess inflammatory status for early detection, prevention, and progression of periodontal disease. Therefore, the aim of the present study was to investigate and identify the salivary biomarker that can predict the inflammatory status of periodontal disease. Methods: A total of 36 patients (28 women and 8 men) with an average age of 57 years were investigated. Unstimulated saliva was collected from the recruited subjects and analyzed using SillHa, a saliva-testing device that measures bacteria count, saliva buffer capacity, acidity, leukocyte esterase, protein, and ammonia. Periodontal parameters were then obtained by clinical examination and initial periodontal therapy was performed. Data obtained with SillHa were compared with clinical periodontal parameters at baseline, re-examination (three months from baseline), and final examination (six months from re-examination). Results: Leukocyte esterase activity in saliva measured by SillHa; BOP and PCR measured by clinical examination showed a significant difference between baseline and final examination and between re-examination and final examination. Patients in the lower median group (group 1) had a significant difference in leukocyte esterase activity between baseline and final examination and re-examination and final examination. In addition, patients in Group 1 had significantly lower BOP between baseline and final examination. While patients in the higher median group (group 2) showed a modest decrease in leukocyte esterase activity, which was significant only between baseline and final examination, no significant changes were observed concerning BOP. Furthermore, the associated systemic disease was observed in 30% and 81.2% of group 1 and 2 patients, respectively. Conclusion: The results suggest that leukocyte esterase activity in saliva measured by SillHa could serve as a reliable diagnostic marker for monitoring inflammatory status in periodontal disease. [ABSTRACT FROM AUTHOR]

The 'Guidelines for periodontal screening and management of children and adolescents under 18 years of age' was updated by the British Society of Periodontology and Implant Dentistry and the British Society of Paediatric Dentistry in September 2021. The updated guidance acknowledged changes outlined in the 2017 World Workshop Classification of Periodontal Diseases and Conditions. The guideline outlines the use of the simplified BPE (sBPE) as a screening tool for periodontal disease in children, with treatment and management recommendations determined by sBPE codes 0–4*. It is an essential tool in primary dental care. CPD/Clinical Relevance: The dental team should be aware of the recent changes in national guidance and carry out periodontal screening in children appropriately. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the proximal contact alterations between implant-supported restorations and adjacent natural teeth with the passage of time. In addition, potential factors influencing proximal contact loss were also evaluated. Materials and Methods: Patients in need of implant-supported restorations in the posterior region were included. Proximal contact was divided into the following three groups: tight (group T), appropriate (group A), and open (group O). It was judged by dental floss (OralB, Essentialfloss) at restoration insertion and 1-year follow-up. In addition, patients' age, sex, implant sites, restoration type, retention type, and parafunction were recorded. Results: At 1-year follow-up, 74 patients with 144 proximal contacts were included. After 1-year follow-up, the proximal contact loss rate was 24.3%, and 45.1% of proximal contacts did not show any alterations. The proximal contact loss rates in group T at baseline were significantly lower than those in group A at baseline (12.9% and 32.9%, respectively; P = .03). The proximal contact loss rates in the mandible were significantly higher than those in the maxilla (37.2% and 9.1%, respectively; P < .01). Other variables did not show a significant effect on proximal contact loss. Conclusion: Based on the current evidence, the proximal contact loss between implant-supported restorations and the adjacent teeth was frequent in the short term. It is helpful to reduce the proximal contact loss rate in the short term by making the proximal contact slightly tense at restoration insertion. Evaluation of proximal contact should be monitored carefully, especially in the mandible. [ABSTRACT FROM AUTHOR]

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Objective: This article describes a surgical crown lengthening double guide, which was digitally obtained to improve diagnosis, treatment outcome, and follow‐up. Clinical considerations: The rehabilitation of anterior dental esthetics should involve interdisciplinary and facially driven planning for achieving pleasant long‐term outcomes. Surgical crown lengthening is one of the most common periodontal surgery, which can be assisted by digital tools to improve surgical planning and follow‐up. Conclusion: The double guide for surgical crown lengthening allows the proper management of hard and soft tissues for achieving a predefined goal based on biological requirements and facially driven planning. In addition, the digital quality control allows the follow‐up compared with the pre‐operative condition and planned treatment plan. Clinical significance: The use of digital tools allow the clinician to develop a facially driven planning with proper communication with the team and patient, leading to a shorter, more predictable, and less invasive surgical technique, reducing postoperative inflammation and increasing patient comfort. [ABSTRACT FROM AUTHOR]

A case of squamous cell carcinoma of the gingiva (GSCC) in the left anterior maxilla in a 64-year-old woman that was treated for almost 5 years as suspected periodontal lesion prior to establishing the final diagnosis of oral cancer is presented in this case report. GSCCs have a variable clinical appearance, ranging from an exophytic mass to ulcerative lesions. They have been reported to pose a diagnostic challenge and are not infrequently initially misdiagnosed as periodontal disease. A delay in diagnosis and extraction of teeth in the vicinity of GSCCs has been demonstrated to increase the risk for lymph node metastasis and thus result in a lower 5-year survival rate. To avoid misdiagnosis and delay of the appropriate treatment, a proper histopathologic evaluation is mandatory whenever an incisional biopsy is performed. Furthermore, referral to a specialist in oral medicine or oral and maxillofacial surgery is indicated when a gingival lesion is nonresponsive to treatment, recurring, or rapidly growing in size. [ABSTRACT FROM AUTHOR]

A cemental tear is a rare form of root surface fracture whereby a fragment of cementum partially or completely detaches from the root surface at the cemento-dentinal junction or within the body of cementum. Tears are most prevalent in incisors and lead to the breakdown of periodontal issues. Owing to challenges involved in diagnosis, cemental tears may be misdiagnosed because associated clinical and radiographic features closely resemble those seen in vertical root fractures, periodontal abscesses and endo-periodontal lesions. If incorrectly diagnosed, inappropriate and delayed management may result in treatment failure and tooth loss. CPD/Clinical Relevance: Correct diagnosis and timely management of cemental tears can prevent further destruction of periodontal tissues, improve treatment outcomes and increase tooth survival. [ABSTRACT FROM AUTHOR]

Background: Our objective was to develop and test a combined Raman microspectroscopy (RMS) and micro‐optical coherence tomography (μOCT) approach for chairside quantification of gingival collagen, DNA, epithelium, and connective tissue. We hypothesized that a high‐resolution RMS/μOCT can characterize healthy and inflamed periodontal tissues for diagnosis and disease activity monitoring. Methods: A prototype instrument was developed, tested ex vivo on gingival specimens and optimized for in vivo intraoral use. The primary outcome measures were the ratios of oral epithelium to connective tissue thickness (OE:CT) and the amount of DNA to collagen type I (DNA/Col 1), and the thickness of sulcular epithelium (SE). For ex vivo testing, eight subjects with healthy periodontal tissues or with Stage II to IV periodontitis were included in the study and underwent crown‐lengthening or periodontal surgical procedures, respectively. Gingival biopsies were scanned by RMS/μOCT and histometric analyses were performed. The proof‐of‐concept study included OE/CT, DNA/Col 1, and SE assessed in six volunteers with or without signs of gingival inflammation (n = 3/group). Results: The spatially co‐registered RMS spectra revealed opposing changes in the collagen and DNA peaks of inflamed compared with healthy tissues (P <0.05). Combined RMS/μOCT analysis showed that OE/CT, DNA/Col, and SE are significantly different between healthy and inflamed sites (P <0.05). Histological assessments confirmed the differences detected by RMS/μOCT. Qualitative analysis of DNA/Col 1 ratios indicated Col I content as the main distinguishing feature for health and DNA content for periodontitis. Conclusion: Results suggest that combined RMS/μOCT chairside imaging may distinguish between healthy and diseased sites by evaluating marginal periodontal morphological and biochemical features. [ABSTRACT FROM AUTHOR]

Diagnosis of periodontal disease depends on conventional clinical parameters. In periodontitis with extensive bone defects, radiographs play a crucial role in arriving at a proper diagnosis. The emergence of cone-beam computed tomography (CBCT) became a boon in oral radiology. Limitations of conventional two-dimensional (2D) radiographs include inadequate visualization of bone defects, lamina dura, and furcation involvement. CBCT generates 3D images of anatomical structures necessary for the periodontal diagnosis of furcation involvement, intrabony defects, and implant placement. CBCT, thus, imparts various potential applications in the field of periodontics which serves to arrive at better diagnostic conclusions. [ABSTRACT FROM AUTHOR]

Background and Objective: There is a limited number of studies on the performance assessment of the 2017 AAP/EFP classification and the CDC/AAP case definition among pregnant females. This study evaluated the agreement between these two systems and explored a practical tool for screening maternal periodontal diseases by general dentists. Materials and Methods: Totally, 204 systemically healthy females at different phases of pregnancy underwent a full‐mouth periodontal examination. Demographic characteristics, lifestyles, and systemic conditions were recorded. Referring to the CDC/AAP definition, the diagnostic performance of the AAP/EFP classification was evaluated by the area under the ROC curve (AUC) and statistical tests (e.g., Youden's index and kappa coefficient). Additionally, a modified scoring system of the FDI Periodontal Diseases Chairside Guide (FDI‐CG) was formulated with the addition of pregnancy for testing accordingly. Results: Overall, there were 22.1% of the participants in early phase of pregnancy (7–13 weeks) and 77.9% in late phase (34–36 weeks). The majority of them were below 35 years and non‐smokers without gestational diabetes. Notably, 30.9% of subjects presented with Moderate/Severe periodontitis (CDC/AAP), and 35.8% with Stages II‐IV periodontitis (AAP/EFP). Referring to the CDC/AAP definition, the AUC, Youden's index, and κ of the AAP/EFP classification were 0.979, 0.890, and 92.9%, respectively. The modified FDI‐CG system improved the AUC (0.815), Youden's index (63.0%), and κ (0.544) with reference to the original one. Conclusions: This study shows that the AAP/EFP classification is in high agreement with the CDC/AAP definition among the pregnant women. The phases of pregnancy‐integrated FDI scoring system may serve as a convenient screening tool for maternal periodontal diseases in general dental practice. [ABSTRACT FROM AUTHOR]

To evaluate the differences between the survival rates of implants placed in patients with no history of periodontal disease (NP) and in patients with a history of chronic periodontal disease (CP). Materials and Methods: A retrospective cohort study was conducted in which all consenting patients treated with dental implants in a private clinic in Oporto, Portugal, from November 2, 2002 through February 11, 2011 were included. All patients were treated consecutively by the same experimental operator. This study aimed to analyze how the primary outcomes (presence of disease, time of placement, and time of loading) and the secondary outcomes (severity-generalized periodontitis, brand, implant length, prosthesis type, prosthesis metal-ceramic extension) influence the survival rate of dental implants. The survival analysis was performed through the Kaplan-Meier method, and the equality of survival distributions for all groups was tested with the log-rank test with a significance level of .05 for all comparisons. Results: The sample consisted of 202 patients (47% NP and 53% CP) and 689 implants (31% NP and 69% CP). The survival rate in the NP and CP groups showed no statistically significant differences (95.8% versus 93.1%; P + .05). Implants were lost before loading in 54.9% of the cases. The majority of the implants were lost in the first year and stabilized after the second year. Survival rates in the NP and CP patients showed no statistically significant differences when comparing the following factors: subclassification of the disease, implant brands, implant length (short/ standard), type of prosthesis, extension of the prosthesis metal-ceramic, and time of placement and loading (P + .05). Conclusion: This work disclosed no statistically significant differences in terms of survival rates when compared with the control group. Placing implants in patients with a history of periodontal disease appears to be viable and safe. [ABSTRACT FROM AUTHOR]

The article discusses the relationship between orthodontic treatment and periodontal health, highlighting the importance of managing periodontal tissues during orthodontic procedures.

Background and Objectives: Assessment of biomarkers, specifically active matrix metalloproteinase‐8 (aMMP‐8), in saliva/oral rinses is a promising diagnostic approach for periodontal health and disease. Different oral fluids have specific advantages and limitations. This study investigates the effect of sampling different fluids on the accuracy of an aMMP‐8 point of care test (POCT). Methods: Unstimulated whole saliva, a first, and a second oral rinse were sequentially taken from 95 consecutive adults. aMMP‐8 was quantitatively determined with a lateral flow immunoassay (index test). A full‐mouth periodontal examination was used to establish a diagnosis according to the 2017 World Workshop classification of periodontal diseases (reference standard). Diagnostic measures of the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were assessed and compared. Results: In all oral fluid samples, periodontitis patients (N = 61) had significantly elevated aMMP‐8 levels and increased test positivity rates compared with subjects with periodontal health or gingivitis (N = 34). The intra‐individual comparison showed that aMMP‐8 levels were significantly higher in 1st oral rinse compared with other samples (1st oral rinse > saliva = 2nd oral rinse, p =.007). The aMMP‐8 test using 1st oral rinse exhibited the best accuracy for detecting periodontitis with a sensitivity of 80.3%, a specificity of 67.8% and an AUROC of 0.740. Conclusions: A 30‐second oral rinse with water omitting the prerinse provided the best accuracy to discriminate periodontal health and disease with an aMMP‐8 POCT. This regimen seems promising for further studies in large representative populations to verify the current findings. [ABSTRACT FROM AUTHOR]

Introduction: Inflammation and infection can spread from the dental pulp to the periodontal tissue and from the periodontium to the pulp. Given the challenging nature of diagnosing endodontic-periodontal lesions and the importance of appropriate treatment to improve dental prognosis, this study was performed to evaluate the knowledge of dental students about the diagnosis of pulp and periodontal lesions. Materials & Methods: In this analytical observational study, a questionnaire was designed to assess knowledge on pulp and periapical lesions in three areas of theoretical knowledge, knowledge in diagnosis and knowledge in treatment in the second semester of the academic year 2021 and filled out by 400 dental students representing 15 cities of Iran. Data analysis was performed by Friedman, Wilcoxon and Mann-Whitney tests (α = 0.05). Results: Percentage of correct answer of dental students to the questions related to theoretical knowledge 65.70 ± 18.39, percentage of correct answer to the questions of students' diagnostic knowledge 50.75 ± 33.28, percentage of correct answer to the questions of treatment knowledge 52.13 ± 23.93 and the percentage of correct answers to the questions of knowledge in total was 56.68 ± 16.35, which is statistically significant in terms of knowledge in the three areas studied (p value < 0.001). Conclusion: In the present study, it was shown that the highest level of appropriate knowledge in students is in the field of theoretical knowledge of endodontic-periodontal lesions and the least level of appropriate knowledge was in the field of diagnosis of these diseases. The overall knowledge of students in this study about endodonticperiodontal lesions was shown to be moderate. [ABSTRACT FROM AUTHOR]