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Our aim was to compare the prevalence and load of nine pathobionts in subgingival samples of healthy individuals and periodontitis patients from four different countries. Five hundred and seven subgingival biofilm samples were collected from healthy subjects and periodontitis patients in Belgium, Chile, Peru and Spain. The prevalence and load of Eubacterium brachy, Filifactor alocis, Fretibacterium fastidiosum, Porphyromonas endodontalis, Porphyromonas gingivalis, Selenomonas sputigena, Treponema denticola, Tannerella forsythia and Treponema socranskii were measured by quantitative PCR. The association with periodontitis of all species, except for T. socranskii, was confirmed in all countries but Peru, where only P. endodontalis, P. gingivalis and T. denticola were found to be significantly associated. Moreover, most species showed higher loads at greater CAL and PPD, but not where there was BOP. Through Principal Component Analysis, samples showed clearly different distributions by diagnosis, despite observing a smaller separation in Peruvian samples. Unlike prevalence, relative load was found to be a reliable variable to discriminate the association of the species with periodontitis. Based on this, F. alocis, P. endodontalis, P. gingivalis, T. denticola and T. forsythia may be biomarkers of disease in Belgium, Chile and Spain, due to their significantly higher abundance in periodontitis patients.

Objectives Systematically review the available literature regarding the caries-preventive effect of probiotics. Data, sources and study selection An electronic search was conducted in three databases (PubMed MEDLINE, ISI Web of Science and Cochrane Library) to identify all suitable studies. The outcomes had to be presented as the effect of probiotics on the incidence of caries or on the levels of mutans streptococci and/or Lactobacillus species. Human studies, written in English, with at least 15 participants, comparing a probiotic product with a placebo/no probiotic were included. Where possible, a meta-analysis was performed to obtain quantitative data. Results Since only two articles presented useful data on the caries incidence, we focused on the surrogate endpoints: mutans streptococci and/or Lactobacillus counts. The meta-analysis showed that when the probiotic and control group are compared after treatment, significantly more patients in the probiotic group had low mutans streptococci (<10 5  CFU/ml) counts and significantly less patients had high (>10 6  CFU/ml) counts. Regarding the Lactobacillus counts, comparing the probiotic and control group at the end of the probiotic use, no significant differences could be observed, neither in low (<10 4  CFU/ml) nor in high Lactobacillus (>10 6  CFU/ml) counts. Conclusions Within the limitations of the available data, it may be concluded that probiotics decrease the mutans streptococci counts. This suggests that probiotics could have a positive effect in the prevention of caries. Clinical relevance There is insufficient evidence that probiotics can prevent caries, but they can reduce the mutans streptococci counts.

Abstract ObjectivesTo gather practice-based information about instrumentation during the second stage of periodontal therapy among the members of the European Federation of Periodontology.MethodsThis survey was conducted to investigate periodontal instrumentation (e.g., frequency, instruments, their maintenance) during the second stage of periodontal therapy.ResultsQuestionnaires from 2008 responders actively involved in periodontal therapy (general dental practitioners, periodontists, and dental hygienists) were analyzed. The frequency of use of hand and mechanical instruments was similar during the second stage of periodontal therapy and 94.4% of the participants combined both. The most popular hand instruments were Gracey curettes, and the preferred mechanical devices were ultrasonic scalers. For the latter, mostly the combination of standard and micro/slim inserts was preferred (42.4%) over solely standard inserts (32.1%) or micro/slim inserts (25.5%). The wear of hand instruments was sytematically checked by 46.1% of the respondents and the wear of the inserts by 41.3%. The more experienced the dental professional, the more frequent the wear of the instruments and inserts was checked.ConclusionThe most popular periodontal instrumentation technique in clinical practice during the second stage of periodontal therapy is a combination of hand and mechanical instruments.Clinical relevanceClinicians should check the wear of their instruments systematically to have the most performant instruments possible for periodontal instrumentation. Scientists should see the results of this questionnaire as an incentive to set up studies investigating whether the combination of hand and mechanical instruments, the preferred treatment method of clinicians, is better than either of these instruments alone.

ObjectivesThe objective of this study was to investigate the screening and referral behaviour of Flemish dentists concerning periodontitis and more specific, the use of the Dutch Periodontal Screening Index (DPSI).Materials and methodsAn online questionnaire was electronically distributed through the different professional dental societies. It consisted of two parts: the first aimed at describing the profile of the dentist. The second part inquired the screening method, when this was applied, periodontal risk factors and referral behaviour.ResultsOne thousand fifty dentists attended to the questionnaire. One hundred fifty-nine questionnaires were excluded since they did not match the target audience. Sixty-four percent of Flemish dentists used DPSI as a periodontal screening method, 28% screened based on probing pocket depth, 4% used solely radiographs and 4% had no screening method at all. The usage of DPSI is influenced by the year of graduation: the longer the dentists were graduated, the less they used DPSI. No influence of sex, education centre and location was found. Referral behaviour is influenced by different patient- and dentist-related factors.ConclusionsRegarding the screening behaviour, there seems a consensus among Flemish dentists that a periodontal probe should be used. For referral, there is no consensus about if and when to refer to a specialist.Clinical relevanceIt is encouraging that 92% of the Flemish general dental practitioners use a probe when screening for periodontitis. However, DPSI is mainly used by younger dentists. An effort should be made to encourage all dentists to use this, so that in every patient, periodontitis can be detected timely, securing the best treatment outcome.