The present study examined the impact of interruptions during the COVID-19 pandemic on the periodontal status of patients undergoing periodontal maintenance therapy (PMT). De-identified data on demographic and periodontal characteristics of patients undergoing PMT seen at the University of Colorado School of Dental Medicine from January 1, 2018, to May 31, 2022, were extracted from the institutional dental database. Independent associations of the length of time between pre- and post-pandemic PMT visits with clinical attachment loss (CAL), bleeding on probing (BOP), and plaque were assessed using linear or logit mixed models. Associations between the number of teeth lost in the interval between the pre- and post-pandemic PMT visits and patient characteristics were tested using a negative binomial model. The null hypothesis was tested at a significance level α < 0.05. Among 279 subjects who met the inclusion criteria, the interval between pre- and post-pandemic visits was 12−23, 24−35, and ≥36 months in 33.3%, 49.8%, and 16.8% of the subjects, respectively. Plaque was significantly associated with a longer period between pre- and post-pandemic PMT visits ( p  = 1.54 × 10 −3 ), whereas no association was observed for CAL and BOP ( p  = 0.39 and 0.10, respectively). Male sex ( p  = 0.023) and current smoking ( p  = 5.23 × 10 −3 ) positively correlated with the number of missing teeth in the interval between the visits, whereas the number of pre-pandemic PMT visits ( p  = 1.20 × 10 −4 ) had the opposite correlation. COVID-19−related PMT interruptions adversely affected plaque control, underscoring the importance of uninterrupted maintenance care. The COVID-19 pandemic had a major impact on patients who visit their dental professionals to maintain healthy gums and stable teeth. Usually, the more compliant these patients are, the better results they can achieve. However, during the pandemic, many patients could not come to get their teeth and gums cleaned as regularly as they could before the pandemic. The present study looked at whether the health of the teeth and gums of patients was affected by the amount of time that passed until a patient came for a dental visit after the pandemic at the University of Colorado. The study results showed that some criteria used to examine tooth and gum health were affected, but others were not. The authors concluded that overall, the length of the interruption to receive dental care after the COVID-19 pandemic caused damage to tooth and gum health. The study results stress the importance of regular dental visits.

BACKGROUND:The present study examined the impact of interruptions during the COVID-19 pandemic on the periodontal status of patients undergoing periodontal maintenance therapy (PMT). METHODS:De-identified data on demographic and periodontal characteristics of patients undergoing PMT seen at the University of Colorado School of Dental Medicine from January 1, 2018, to May 31, 2022, were extracted from the institutional dental database. Independent associations of the length of time between pre- and post-pandemic PMT visits with clinical attachment loss (CAL), bleeding on probing (BOP), and plaque were assessed using linear or logit mixed models. Associations between the number of teeth lost in the interval between the pre- and post-pandemic PMT visits and patient characteristics were tested using a negative binomial model. The null hypothesis was tested at a significance level α < 0.05. RESULTS:Among 279 subjects who met the inclusion criteria, the interval between pre- and post-pandemic visits was 12-23, 24-35, and ≥36 months in 33.3%, 49.8%, and 16.8% of the subjects, respectively. Plaque was significantly associated with a longer period between pre- and post-pandemic PMT visits (p = 1.54 × 10-3), whereas no association was observed for CAL and BOP (p = 0.39 and 0.10, respectively). Male sex (p = 0.023) and current smoking (p = 5.23 × 10-3) positively correlated with the number of missing teeth in the interval between the visits, whereas the number of pre-pandemic PMT visits (p = 1.20 × 10-4) had the opposite correlation. CONCLUSION:COVID-19-related PMT interruptions adversely affected plaque control, underscoring the importance of uninterrupted maintenance care. PLAIN LANGUAGE SUMMARY:The COVID-19 pandemic had a major impact on patients who visit their dental professionals to maintain healthy gums and stable teeth. Usually, the more compliant these patients are, the better results they can achieve. However, during the pandemic, many patients could not come to get their teeth and gums cleaned as regularly as they could before the pandemic. The present study looked at whether the health of the teeth and gums of patients was affected by the amount of time that passed until a patient came for a dental visit after the pandemic at the University of Colorado. The study results showed that some criteria used to examine tooth and gum health were affected, but others were not. The authors concluded that overall, the length of the interruption to receive dental care after the COVID-19 pandemic caused damage to tooth and gum health. The study results stress the importance of regular dental visits.

Video‑assisted instruction can enhance the teaching and learning of periodontal instrumentation when visualization and content quality support clear demonstration of technique. This study aimed to describe the development of high‑resolution instructional videos demonstrating armamentarium and techniques on a typodont with simulated calculus, and to evaluate perceived usefulness among predoctoral dental students. The institutional review board determined that the study was exempt. Instructional videos were recorded in 8K resolution and demonstrated instrument selection, ergonomics, adaptation, angulation, and activation of strokes on a typodont with transparent gingiva and simulated supra‑ and subgingival calculus deposits. Perceived usefulness was evaluated through a brief anonymous survey with optional open-ended feedback. The same cohort was invited to evaluate both video sets, but anonymous responses could not be linked across surveys. Proportions were summarized with 95% Wilson score confidence intervals (CIs). Due to the study's descriptive design, no formal hypothesis testing was performed. Sixteen students completed the survey evaluating the previously used instructional videos; 37.5% rated them "Extremely useful" (95% CI [18.5, 61.4%]), and 50% rated them "Very useful." Fourteen students completed the survey evaluating the new videos; 64.3% rated them "Extremely useful" (9/14; 95% CI [38.8, 83.7%]), 28.6% "Very useful" (4/14), 7.1% "Slightly useful" (1/14), and no participant chose "Moderately useful" or "Not at all useful." All participants indicated they would refer to the new videos in the future. Descriptive categorization of 27 comments identified five recurring themes: clarity, zoom, technique, realism, and accessibility. Students valued improved resolution and close‑up views, while suggestions emphasized captions/written explanations and demonstrations on natural teeth. The findings further support the role of high-resolution instructional videos as useful adjuncts to preclinical periodontal instruction. Future studies should evaluate objective performance outcomes and explore additional content and accessibility features.

BACKGROUND:The aim of the present study was to examine whether age and sex affected the prevalence and severity of periodontal conditions in patients attending an academic dental clinic. METHODS:Electronic health record (EHR) data on the demographic characteristics and periodontal conditions of patients presented for a comprehensive periodontal evaluation were extracted from the institutional dental EHR database. Retrospective analysis of independent associations of age, sex, and other subject characteristics with periodontal conditions was determined using multinomial logistic regression. The null hypothesis stating that age and sex were not associated with the increased prevalence and/or severity of periodontal conditions was tested at a significance level α < 0.05. RESULTS:A total of 5027 subjects met the inclusion criteria. Clinical gingival health (CGH), gingivitis, and periodontitis were diagnosed in 4.2%, 5.2%, and 55.8% of patients, respectively. Severe periodontitis was diagnosed in 84.6% of the 4302 patients with periodontitis and was significantly associated with each year of age increase (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.11, 1.15) and male sex (OR 2.02; 95% CI 1.30, 3.15). The combined effect of a 15-year age increase and male sex was reflected in the increased odds of severe periodontitis (OR 12.63; 95% CI 9.57, 16.67). The combined effect of older age and male sex is shown by the increased odds of severe periodontitis (OR 12.63; 95% CI 9.57, 16.67). Similar associations were found between age, male sex, and total periodontitis, but not CGH and gingivitis. CONCLUSION:Increasing age and male sex significantly correlated with increased odds of total and severe periodontitis. PLAIN LANGUAGE SUMMARY:Periodontitis, or inflammatory gum disease, affects many adults in the United States and worldwide. Various factors, such as smoking and diabetes mellitus, increase the risk of periodontitis and the severity of its symptoms. To determine if periodontitis occurs more commonly and is more severe according to patient age and sex, the study used health records from almost 8,000 patients attending dental clinics at the University of Texas School of Dentistry (Houston, TX) from 2007 to 2020. The results demonstrated that adult patients who were older or males had periodontitis more often than those who were younger or female, respectively. Periodontitis was also more severe in older or male patients. These results show that older adults and males can be considered vulnerable individuals when it comes to diagnosing periodontitis. Therefore, dentists should pay more attention to these patients, and individualized treatment methods need to be considered for providing dental care to the gums of these patients.

PURPOSE:To examine whether a typodont model-based periodontal surgical experience enhanced the dental students' comprehension of periodontal surgical procedures. METHODS:A hands-on session was developed to demonstrate esthetic and functional crown lengthening (ECL and FCL, respectively), free soft tissue autograft (FSTA), and extraction site preservation (ESP) procedures using a commercially available typodont which allows students to replicate the steps of these surgical procedures. Fourth-year dental students (DS4) completed pre- and post-module surveys to self-evaluate their knowledge of periodontal surgical procedures before and after the session. A summary of the pre- and post-survey responses was reported. RESULTS:Forty-seven DS4 completed the pre-module survey and participated in the model-based hands-on exercise. Thirty-one DS4 completed the post-module survey. Following the session, 83.87%, 80.64%, 80.64%, and 78.12% of participants strongly agreed that the session improved their comprehension of ECL, FCL, FSTA, and ESP, respectively. With knowledge-based questions, the percentage of correct responses increased for ECL, FCL, and FSTA (65.22 vs. 93.55%, 41.30 vs. 100%, and 56.52 vs. 100% in pre- and post-module survey, respectively), but not for ESP. More participants strongly agreed that they felt more confident (i) to communicate with periodontists and (ii) to refer their prospective patients to periodontists than before the session (58.06 vs. 42.55%, respectively). Also, more students strongly agreed the session should be included in the dental school curriculum. CONCLUSIONS:The typodont model-based hands-on session provided valuable experience to DS4 in various aspects of predoctoral periodontics training, highlighting the importance of such educational experience in the dental school curriculum.

The present study examined the role of age and sex in the outcomes of non-surgical periodontal therapy (NSPT). De-identified demographic and periodontal characteristics of patients who presented for baseline periodontal evaluation, NSPT, and periodontal re-evaluation were abstracted from electronic health records. Independent associations of age and sex with severe periodontitis defined as ≥ 5 mm clinical attachment loss (CAL) and ≥ 6 mm probing depth (PD) were determined using multinomial logistic regression. The null hypothesis was rejected at α < 0.05. A total of 2866 eligible subjects were included in the analysis. Significantly lower odds of CAL ≤ 4 mm than CAL ≥ 5 mm (reference) were observed in adults aged 35–64 (odds ratio, OR, 0.19; 95% confidence interval, CI 0.13, 0.29) and ≥ 65 years (OR 0.13; 95% CI 0.07, 0.25) compared to those aged 18–34 years. Odds of PD < 4 mm versus PD ≥ 6 mm (reference) were lower in adults aged 35–64 years than those aged 18–34 years (OR 0.71; 95% CI 0.55, 0.90) and higher in females compared to males (OR 1.67; 95% CI 1.14, 2.44). These results suggest more compromised post-NSPT outcomes in older adults and males compared to the respective populations and highlight the need for personalized therapeutic strategies in these populations.

The study aimed to determine the accuracy of diagnosing periodontal conditions using the developed web-based PocketPerio application and evaluate the user’s perspective on the use of PocketPerio. First, 22 third-year dental students (DS3) diagnosed ten cases without PocketPerio (control) and with PocketPerio (test) during a mock examination. Then, 105 DS3, 13 fourth-year dental students (DS4), and 32 senior second-year International Standing Program students (ISP2) used PocketPerio chairside. Statistical analysis was performed using a non-parametric paired two-tailed test of significance with the Wilcoxon matched-pairs signed rank test. The null hypothesis that PocketPerio did not increase the accuracy of periodontal diagnoses was rejected at α < 0.01. Periodontal diagnoses made using PocketPerio correlated with those made by periodontics faculty (“gold standard") in all cases. During the mock examination, PocketPerio significantly increased the accuracy of periodontal diagnoses compared to the control (52.73 vs. 13.18%, respectively). Chairside, PocketPerio significantly increased the accuracy of primary (100 vs. 40.0%) and secondary (100 vs. 14.25%) periodontal diagnoses compared to the respective controls. Students regardless of their training year felt more confident in diagnosing periodontal conditions using PocketPerio than their current tools, provided positive feedback on its features, and suggested avenues for its further development.

BACKGROUND:Periodontal diseases (PD) have been increasingly associated with several systemic conditions such as cardiovascular disease (CVD), diabetes mellitus (DM), rheumatoid arthritis (RA), and Alzheimer's disease (AD). This study aimed to gain insight into patients' awareness of the association between PD and systemic diseases. METHODS:A survey was developed to analyze patient awareness of the association between PD and systemic diseases. Descriptive and categorical variables were summarized with counts and percentages. Chi-squared tests were used to evaluate differences between variables. A linear logistical regression model was used to assess the simultaneous, independent association between each variable. RESULTS:Data from 161 completed surveys were analyzed. The majority of the participants (61.49%) reported awareness of symptoms of PD, but only 36.36% identified all its major symptoms. Individuals reporting awareness of the association between PD and systemic diseases was 48.4%, 31.7%, 14.9%, and 9.9% for CVD, DM, RA, and AD, respectively. Patients aged ≥51 years and males were more aware of the association between PD and CVD. Increased awareness of an association between PD and DM was observed among patients who had a higher frequency of dental visits and those with a self-reported history of DM. CONCLUSIONS:This study provides insight that, even with the vast amount of scientific knowledge on the inter-relationships that exist between PD and systemic diseases, most patients are still unaware of these associations. This research identified that improvement of health literacy surrounding PD, their symptoms, and their association with systemic diseases may be warranted.

Peripheral ossifying fibroma (POF) is a benign swelling of the gingival connective tissue commonly associated with dental biofilm and biofilm-retentive dental appliances. In the present case report, we described three cases of POF with different clinical presentations and treatment approaches. The treatment consisted of the removal of supra- and subgingival calculus, followed by a flap surgery with excision of the entire lesion ensuring the inclusion of the periosteal bed. The first patient developed POF during her pregnancy that remained clinically noticeable postpartum. The second case represented a rare case of POF appearing on the palatal aspect of the anterior maxilla of an African American male. The third case represented POF that developed on the mandible, and contrary to the first two cases, it was excised using a diode laser and not a scalpel blade. All patients showed uneventful healing during follow-up appointments; however, poor patient compliance did not allow for evaluation of long-term healing responses and possible recurrence of the lesion. Within the limitations of this clinical report, it is evident that the periodontal surgical approach was effective in managing POF with stable short-term clinical outcomes.

Journal of Dental EducationVolume 87, Issue S3 p. 1769-1771 ISSUE INFORMATIONFree Access Journal of Dental Education Volume 87 Number S3/December 2023 First published: 26 December 2023 https://doi.org/10.1002/jdd.13006AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Volume87, IssueS3Supplement: Advancing Through InnovationDecember 2023Pages 1769-1771 RelatedInformation

Journal of Dental EducationEarly View ADVANCING THROUGH INNOVATION The “Oral Hygiene Challenge” session as an approach to improve the quality of oral hygiene instructions Karo Parsegian, Corresponding Author Karo Parsegian [email protected] orcid.org/0000-0002-5440-6036 Division of Periodontics, Department of Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA Correspondence Karo Parsegian, Division of Periodontics, Department of Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17th Ave, Rm 130J, Aurora, CO 80045-2532, Mail Stop F847, USA. Email: [email protected]Search for more papers by this authorBing-Yan Wang, Bing-Yan Wang Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USASearch for more papers by this authorKhairunisa Hashmani, Khairunisa Hashmani Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USASearch for more papers by this authorNikola Angelov, Nikola Angelov Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USASearch for more papers by this author Karo Parsegian, Corresponding Author Karo Parsegian [email protected] orcid.org/0000-0002-5440-6036 Division of Periodontics, Department of Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA Correspondence Karo Parsegian, Division of Periodontics, Department of Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17th Ave, Rm 130J, Aurora, CO 80045-2532, Mail Stop F847, USA. Email: [email protected]Search for more papers by this authorBing-Yan Wang, Bing-Yan Wang Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USASearch for more papers by this authorKhairunisa Hashmani, Khairunisa Hashmani Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USASearch for more papers by this authorNikola Angelov, Nikola Angelov Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USASearch for more papers by this author First published: 18 October 2023 https://doi.org/10.1002/jdd.13398Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat REFERENCES 1van der Weijden F, Slot DE. Oral hygiene in the prevention of periodontal diseases: the evidence. Periodontol 2000. 2011; 55(1): 104-123. 2Lertpimonchai A, Rattanasiri S, Arj-Ong Vallibhakara S, Attia J, Thakkinstian A. The association between oral hygiene and periodontitis: a systematic review and meta-analysis. Int Dent J. 2017; 67(6): 332-343. 3Garyga V, Pochelu F, Thivichon-Prince B, et al. GoPerio—impact of a personalized video and an automated two-way text-messaging system in oral hygiene motivation: study protocol for a randomized controlled trial. Trials. 2019; 20(1): 699. 4Williams KA, Mithani S, Sadeghi G, Palomo L. Effectiveness of oral hygiene instructions given in computer-assisted format versus a self-care instructor. Dent J. 2018; 6(1): 2. 5Underwood B, Birdsall J, Kay E. The use of a mobile app to motivate evidence-based oral hygiene behaviour. Br Dent J. 2015; 219(4): E2. Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

PURPOSE:Previous studies demonstrated that the exposure of primary dental pulp (DP) cultures to fibroblast growth factor 2 (FGF2) between days 3-7 exerted significant and long-lasting stimulatory effects on odontoblast differentiation and Dspp expression. These effects involved the increased expression of components of bone morphogenetic protein (BMP) signaling and were reverted by a BMP inhibitor noggin. FGF2 also transiently stimulated osteoblast differentiation and the expression of Ibsp and Dmp1. The present study aimed to further explore interactions between BMP and FGF signaling during odontoblast and osteoblast differentiation in DP cultures.MATERIALS AND METHODS:Cultures were established using DP tissue isolated from non-transgenic and fluorescent reporter (DSPP-Cerulean, BSP-GFP, and DMP1-mCherry) transgenic mice and exposed to BMP2, FGF2, SU5402 (an FGF receptor inhibitor), and noggin between days 3-7. Mineralization, gene expression, fluorescent protein expression, and odontoblast formation were examined using xylenol orange, quantitative PCR, fluorometric analysis, and immunocytochemistry, respectively.RESULTS:BMP2 activated SMAD1/5/8 but not ERK1/2 signaling, whereas FGF2 exerted opposite effects. BMP2 did not affect mineralization, the expression of Ibsp and Dmp1, and the percentage of DSPP-Cerulean+ odontoblasts but significantly increased Dspp and DSPP-Cerulean. In cultures exposed to BMP2 and FGF2, respectively, both SU5402 and noggin led to long-lasting decreases in Dspp and DSPP-Cerulean and transient decreases in Dmp1 and DMP1-mCherry without affecting Ibsp and BSP-GFP.CONCLUSION:BMP2 and FGF2 exerted reciprocal stimulatory effects on odontoblast differentiation, whereas their effects on osteoblast differentiation were mediated independently. These data will further elucidate the perspectives of using BMP2 and FGF2 for dentin regeneration/repair.

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Periodontitis and chronic kidney disease are chronic conditions with high community prevalence across the world. Patients with chronic kidney disease have been noted to have a high burden of periodontitis, and several shared risk factors have been associated with the prevalence and severity of both conditions. However, the precise relationship between the two conditions, and the extent to which each may contribute to the development of the other, remains a matter of debate. The goals of the present work were to: (a) provide the most current and relevant literature overview of the association between periodontitis and chronic kidney disease; (b) explore mechanisms underlying this association; and (c) determine if evidence exists for an independent association between these conditions. We also assessed whether improved oral hygiene and periodontal treatment could reduce the risk of developing chronic kidney disease and, if so, what protocols these strategies involve. Finally, we aimed to reveal gaps in our current knowledge to delineate the directions of future research. Although the exact relationship between these two conditions has not yet been defined, we highlight the importance of the interprofessional interaction between dental practitioners and the nephrology team and the importance of oral health assessment in the management of chronic kidney disease.

The study aimed to determine whether inhibitory effects of fibroblast growth factor 2 (FGF2) on mineralisation in dental pulp (DP) cultures were associated with changes in the expression of genes regulating phosphate balance (Enpp1, Ank, Slc20a2, Alpl, Phospho1, and Xpr1). DP cultures growing under mineralisation-inducing conditions were exposed to FGF2 and inhibitors of the FGFR and MEK/ERK1/2 signaling pathways. Mineralisation, culture cellularity, and gene expression were examined at various time points. Statistical analysis was performed using analysis of variance followed by the Holm-Šídák test. Control cultures exhibited transient increases in Enpp1 and Ank, continuous increases in Alpl, Phospho1, and Xpr1, and continuous decreases in Slc20a2. FGF2 increased Enpp1, Ank, and Slc20a2 and decreased Alpl, Phospho1, and Xpr1, whereas the FGF2 withdrawal and inhibition of FGFR and MEK/ERK1/2 exerted opposite effects. These changes suggest that FGF2-mediated decreases in mineralisation could be functionally coupled to the altered regulation of phosphate formation and transport.

Chapter 16 Renal Diseases Karo Parsegian DMD, MDSc, PhD, Search for more papers by this authorRuchir Trivedi MD, MSc, MRCP (UK), Search for more papers by this authorEffie Ioannidou DDS, MDSc, Search for more papers by this author Karo Parsegian DMD, MDSc, PhD, Search for more papers by this authorRuchir Trivedi MD, MSc, MRCP (UK), Search for more papers by this authorEffie Ioannidou DDS, MDSc, Search for more papers by this author Book Editor(s):Michael Glick DMD, FDS RCSEd, Center for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorMartin S. Greenberg DDS, FDS RCSEd, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USASearch for more papers by this authorPeter B. Lockhart DDS, FDS RCSEd, FDS RCPS, Atrium Health's Carolinas Medical Center, Charlotte, NC, USASearch for more papers by this authorStephen J. Challacombe PhD, DSc, FRCPath, FDS RCSEd, FDS RCS, FMedSci, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UKSearch for more papers by this author First published: 25 June 2021 https://doi.org/10.1002/9781119597797.ch16 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Summary The traditional view of kidney function is limited and focuses on its regulation of excretory, endocrine, acid–base, and electrolytes domains. This chapter provides a comprehensive and evidencebased overview of the renal structure, function, and diagnostic tools for impaired renal function, and oral symptoms and signs observed in patients with chronic kidney disease prior to and during in-center hemodialysis, patients undergoing peritoneal dialysis, and those received a kidney transplant. Acute kidney injury (AKI) is not a single disease, but rather a loose collection of diverse syndromes such as sepsis, cardiorenal syndrome, and urinary tract obstruction. AKI are often divided into three diagnostic categories: prerenal failure, postrenal failure, and acute intrinsic renal failure. Studies have started to examine the role of recreational drug use in chronic kidney injury progression. Patients with renal disease present with various oral manifestations and pathologic lesions of soft and hard tissues and teeth. Burket's Oral Medicine, Thirteenth Edition RelatedInformation

Background:In 2017, the American Academy of Periodontology and the European Federation of Periodontology updated the classification of periodontal and peri-implant diseases and conditions. The goal of the present crossover study was to develop straightforward, illustrative flowcharts and determine their impact on the accuracy and speed of diagnosing periodontal conditions by predoctoral dental students (DS) and dental hygiene students (DHS). Methods:Two flowcharts (a decision-tree flowchart and one based on the periodontal disease/condition entity) were developed using updated diagnostic determinants proposed by the 2017 classification. A total of 26 second-, third-, and fourth-year DS (DS2, DS3, and DS4, respectively) and second-year DHS (DHS2) took a mock examination consisting of 10 periodontal clinical cases. The participants first diagnosed periodontal conditions using only their curricula-based knowledge (control) and then using the flowcharts (test). They also completed an optional post-examination questionnaire to provide feedback on the flowcharts. Statistical significance was detected at p ≤ 0.05. Results:Combined test groups had significantly higher accuracy in diagnosing periodontal conditions compared to controls (73.5% vs 50.0%, respectively), with the most substantial improvement in DS2 (66.3% vs 30%, respectively) and DHS2 (70.0% vs 41.4%, respectively). Combined test groups also completed the examination more quickly compared to controls (14.92 vs 20.85 minutes, respectively). The participants provided positive feedback and constructive criticism on the flowcharts, and also suggested converting them into application software. Conclusion:The flowcharts significantly improved the accuracy of diagnosing periodontal conditions in academic settings, especially among junior, less experienced participants.