Iowa intermediate care facilities: An evaluation of care providers’attitudes toward oral hygiene care

This study investigated the oral hygiene care (OHC) activities and attitudes of care providers in Intermediate Care Facilities for the Mentally Retarded (ICF/MR) in the state of Iowa. Questionnaires were distributed to care providers employed at three ICF/MRs. About 98% of the staff ranked OHC as important to extremely important for residents. Twenty‐three percent disliked OHC occasionally or more frequently. Lack of time and lack of staff were the main reasons preventing care providers from assisting residents with OHC. Residents’ behaviors resulted in inadequate OHC for 64.9%, and 49% of residents required complete assistance with OHC. Most common OHC difficulties reported were residents biting the toothbrush, refusing OHC, or not opening their mouths. Subjects reported spending 3.0 minutes brushing a resident's teeth and 3.0 minutes cleaning dentures. Care providers experienced significant behavioral and physical difficulties while providing OHC, but still found OHC important. Training programs for care providers are needed to address these difficulties.     

Soft Tissue Attachment to Titanium Implants Coated with Growth Factors

Background: Enhancing the connective tissue seal around dental implants may be an important factor in implant survival. Purpose: The objective of the study was to investigate the effect of implant surface modification with either platelet‐derived growth factor (PDGF) or enamel matrix derivative (EMD) on connective tissue attachment to titanium implants. Materials and Methods: Eighteen implants (Branemark® Mk III Groovy NP (3.3 mmØ × 10 mm, Nobel Biocare) were implanted subcutaneously into 12 rats. Six implants each were coated with either PDGF or EMD immediately prior to implantation and six implants were left uncoated. Implants were retrieved at 4 and 8 weeks and assessed histologically to compare the soft tissue adaptation to the implant surfaces. Results: Ingrowth by soft connective tissue into the threads of all implants was noted at 4 and 8 weeks. Coating with growth factors did not alter the orientation of fibroblasts and collagen fibers. The depth of connective tissue penetration into the implant grooves was significantly greater for the implants coated with PDGF at 4 weeks. The thickness of the connective tissue in growth was significantly less for the implants coated with PDGF at 8 weeks. Conclusion: Coating of the implant surface with rhPDGF‐BB or EMD can increase the speed and quantity of soft tissue healing around the implant surface.     

Intrusion of migrated incisors with infrabony defects in adult periodontal patients

This report describes the orthodontic treatment of 10 adult patients who had severe periodontal disease, with migration and radiological evidence of an infrabony defect on a maxillary central incisor. Orthodontic tooth movement, using light and continuous forces, was initiated 7 to 10 days after periodontal surgical therapy. Mean orthodontic treatment time was 10 months. Before surgery and at the end of orthodontic treatment, the following parameters were registered clinically and with standardized intraoral radiographs: probing depth, clinical crown length, marginal bone level, bone defect radiological dimension, and root length. Comparison of pre- and posttreatment values showed a statistically significant improvement for all parameters without a remarkable decrease of root length. The mean residual probing depth was 2.80 mm, and the mean intrusion of the incisors was 2.05 mm. Moreover, radiographs showed a reduction of the infrabony defects. These results show the efficacy of a combined orthodontic-periodontal approach. Intrusive movement, after proper periodontal surgical therapy, can positively modify both the alveolar bone and the soft periodontal tissues.