The clinical data were retrospectively extracted from the patients' documentation. All patients received the same treatment and diagnostic tests during their SPT appointments. During the clinical examination, the decayed-, missing-, and filled-teeth index (DMF-T) was obtained [22 ]. Before the periodontal examination was performed, the modified sulcus bleeding index (mSBI) [23 (link)] was measured on vestibular surfaces in the first and third quadrants and on oral surfaces in the second and fourth quadrants by slightly probing the gingival margin using a periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA). Periodontal status included PPD and BOP at 6 measurement points per tooth using a millimeter-scaled periodontal probe (PCP 15, Hu-Friedy). Subsequently, a modified BOP was assessed, which only considered bleeding in cases where the pocket depth was ≥5 mm. Plaque accumulation was recorded after plaque staining with mira-II-ton® (Hager & Werken GmbH & Co. KG, Duisburg, Germany) and evaluation using the approximal plaque index (API) at the oral sides in the first and third quadrants and the vestibular sides in the second and fourth quadrants [24 (link)].
Pcp 15
Manufactured by Hu-Friedy
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The PCP 15 is a lab equipment product manufactured by Hu-Friedy. It serves as a core function for laboratory applications.
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Lab products found in correlation
16 protocols using pcp 15
1
Comprehensive Dental Assessment Protocol
2
Evaluation of Periodontal Inflammation and Treatment Needs
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Assessment of gingival inflammation was performed with Papilla bleeding index (PBI) using a periodontal probe (PCP 15; Hu-Friedy, Chicago, IL, USA); PBI ranged from score 0 (no bleeding/inflammation-free gingiva) to 4 (profuse bleeding/severe inflammation) [23 ]. To investigate periodontal situation a periodontal status was executed, including periodontal probing depth (PPD) and bleeding on probing (BOP: positive) as well as clinical attachment loss (CAL) at 6 measurement points per tooth using a millimeter-scaled periodontal probe (PCP 15; Hu-Friedy, Chicago, IL, USA). According to the definition of Page and Eke [24 (link)] periodontitis was determined in three categories: 1) severe periodontitis, 2) moderate periodontitis or 3) no/mild periodontitis [24 (link)]. The periodontal treatment need was determined by the results of the periodontal status according the periodontal screening index (PSR®/PSI); periodontal treatment need: PSR®/PSI scores of 3 (PPD: 3.5–5.5 mm) and 4 (PPD: > 5,5 mm) [25 (link)–27 ].
3
Comprehensive Oral Health Evaluation in RA
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All RA patients (rheumatology clinic) and healthy subjects (private dental practice) were examined under standardized conditions by one skilled, nonblinded dentist (JJ). The investigation included dental findings, the evaluation of the periodontal situation, and the assessment of oral hygiene:
& Dental findings (DMF-T): The DMF-T was assessed visually with a mirror and probe. Based on the findings of number of decayed (D-T), missing (M-T), and filled teeth (F-T), the DMF-T index was determined; the DMF-T generally reflects the caries experience of the person examined [24] . & Periodontal situation: For the investigation of the periodontal status, periodontal probing depths (PPDs), bleeding on probing (BOP: positive), as well as clinical attachment loss (CAL) were assessed on six measurement points per tooth using a millimeter-scaled periodontal probe (PCP 15; Hu-Friedy, Chicago, IL, USA). According to the definition of Page and Eke (2007) , periodontitis was defined by three categories: (1) severe periodontitis, (2) moderate periodontitis, or (3) no/mild periodontitis [25] . & Oral hygiene: The status of gingival inflammation was recorded using a periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA) and classified to the papillary bleeding index (PBI) [26] . The PBI scores ranged from 0 (no bleeding/inflammation-free gingiva) to 4 (profuse bleeding/severe inflammation).
& Dental findings (DMF-T): The DMF-T was assessed visually with a mirror and probe. Based on the findings of number of decayed (D-T), missing (M-T), and filled teeth (F-T), the DMF-T index was determined; the DMF-T generally reflects the caries experience of the person examined [24] . & Periodontal situation: For the investigation of the periodontal status, periodontal probing depths (PPDs), bleeding on probing (BOP: positive), as well as clinical attachment loss (CAL) were assessed on six measurement points per tooth using a millimeter-scaled periodontal probe (PCP 15; Hu-Friedy, Chicago, IL, USA). According to the definition of Page and Eke (2007) , periodontitis was defined by three categories: (1) severe periodontitis, (2) moderate periodontitis, or (3) no/mild periodontitis [25] . & Oral hygiene: The status of gingival inflammation was recorded using a periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA) and classified to the papillary bleeding index (PBI) [26] . The PBI scores ranged from 0 (no bleeding/inflammation-free gingiva) to 4 (profuse bleeding/severe inflammation).
4
Periodontal Phenotype and Clinical Outcomes
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All measurements were made with a 1-mm graduated periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA) by one calibrated and masked clinician. Presence/absence of plaque, presence/absence of BoP and PD were measured at 6 points on the treated teeth at baseline, 3 and 6 months post-surgery. FMPS and FMBS were also recorded.
The distance of the gingival margin (GMD) and the amount of KT were measured using individual acrylic stent, used as fixed-reference mark, at the end of the surgical session, 1 month, 3 and 6 months post-surgery at interdental and buccal aspects [10 (link), 11 (link)]. The intra-class correlation coefficients were 0.94 for GMD and 0.86 for KT.
Periodontal phenotype was determined before surgery using a 25 endodontic reamer at the mid-buccal aspect of the experimental tooth, 1 mm apically to the gingival margin level. If there was no attached gingiva, the same measurement was made on the alveolar mucosa [16 (link)]. Phenotype was classified as thin if gingival thickness was less than 1 mm, normal if equal to 1 mm, and thick if more than 1 mm [17 (link)].
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All measurements were made with a 1-mm graduated periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA) by one calibrated and masked clinician. Presence/absence of plaque, presence/absence of BoP and PD were measured at 6 points on the treated teeth at baseline, 3 and 6 months post-surgery. FMPS and FMBS were also recorded.
The distance of the gingival margin (GMD) and the amount of KT were measured using individual acrylic stent, used as fixed-reference mark, at the end of the surgical session, 1 month, 3 and 6 months post-surgery at interdental and buccal aspects [10 (link), 11 (link)]. The intra-class correlation coefficients were 0.94 for GMD and 0.86 for KT.
Periodontal phenotype was determined before surgery using a 25 endodontic reamer at the mid-buccal aspect of the experimental tooth, 1 mm apically to the gingival margin level. If there was no attached gingiva, the same measurement was made on the alveolar mucosa [16 (link)]. Phenotype was classified as thin if gingival thickness was less than 1 mm, normal if equal to 1 mm, and thick if more than 1 mm [17 (link)].
5
Periodontal Status Evaluation and NSPT
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Periodontal status was evaluated by two calibrated examiners (V.F.C. and T.A.S.), who used a periodontal probe [model PCP15, Hu-Friedy®; Chicago, IL, USA] at three time points (T0, T1, and T2). Weighted kappa agreement tests for periodontal clinical parameters revealed intra- and inter-examiner values ≥ 92%. The following parameters were recorded: plaque index, probing depth, clinical attachment loss (CAL), and bleeding on probing (BOP). Participants were classified as individuals without periodontitis or with mild, moderate, and severe periodontitis [29 (link)]. In T1, a single session of NSPT (full-mouth scaling and root planing) was performed with ultrasound and manual Gracey curettes in all individuals. Oral hygiene instructions were also provided.
6
Comprehensive Periodontal and Musculoskeletal Evaluation
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Periodontal assessment included probing depth (PD), clinical attachment level (CAL), dental plaque, bleeding on probing, and the number of teeth. For a number of teeth all fully erupted natural teeth were assessed excluding the third molars. The periodontal examination was carried out on either the left- or right-side quadrants and the examination side was changed from participant to participant. CAL and PD were assessed at mesiobuccal, distobuccal, midbuccal and midlingual aspects on each selected tooth probe PCP 15, HuFriedy, Chicago IL).
Head-neck MRI scans were part of a whole-body examination assessed on a 1.5-T system (MAGNETOM® Avanto, Siemens Erlangen, Germany). MRI technique for scanning the masseter and pterygoid muscles and for analysing the MRI head images were described elsewhere [14 (link)]. The cross-sectional areas of the masseter, medial and lateral pterygoid muscles were registered in cm2 of both muscle sides and the maximum area of either side was used. Chewing muscle’s strength is closely related to its cross-sectional area as used in this study [16 (link)]. Standardized whole-body MRI measurements were taken covering the full abdomen [14 (link)] enabling quantification of subcutaneous and visceral fat volumes (liter) employing the automatic tissue analysis software ATLAS (Scientific Software Development, Berlin, Germany).
Head-neck MRI scans were part of a whole-body examination assessed on a 1.5-T system (MAGNETOM® Avanto, Siemens Erlangen, Germany). MRI technique for scanning the masseter and pterygoid muscles and for analysing the MRI head images were described elsewhere [14 (link)]. The cross-sectional areas of the masseter, medial and lateral pterygoid muscles were registered in cm2 of both muscle sides and the maximum area of either side was used. Chewing muscle’s strength is closely related to its cross-sectional area as used in this study [16 (link)]. Standardized whole-body MRI measurements were taken covering the full abdomen [14 (link)] enabling quantification of subcutaneous and visceral fat volumes (liter) employing the automatic tissue analysis software ATLAS (Scientific Software Development, Berlin, Germany).
7
Periodontal Assessment and Treatment Need
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Assessment of periodontal probing depth and clinical attachment loss was executed at six measurement points per tooth with a periodontal probe (PCP 15; Hu‐Friedy, Chicago, IL, USA). According to American Academy of Periodontology/Centers for Disease Control, periodontitis was classified into no/mild and moderate or severe periodontitis.17 Periodontal treatment need was defined by the presence of periodontal probing depth ≥ 3.5 mm in at least two different sextants.18 , 19 The presence of dental and/or periodontal treatment need was summarized as overall dental treatment need.
8
Measuring Peri-Implant Tissue Health
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Similarly, a millimeter-scale periodontal probe (PCP 15, Hu-Friedy) was used to measure the PPD at 4 sites per implant (mesio-buccal, disto-buccal, mesio-oral, and disto-oral), and BOP was documented 30 seconds after probing. Furthermore, the presence/absence of keratinized mucosa was assessed on the mid-buccal area of every implant site. Differences in color, texture, and mobility served as markers for mucogingival junction detection (presence: >0.5 mm of keratinized mucosa, absence: ≤0.5 mm of keratinized mucosa) [12 (link)].
To differentiate between peri-implant mucositis and peri-implantitis, available panoramic radiographs were analyzed. During the survey period, radiographs were obtained only for routine diagnostic purposes.
To differentiate between peri-implant mucositis and peri-implantitis, available panoramic radiographs were analyzed. During the survey period, radiographs were obtained only for routine diagnostic purposes.
9
Periodontal Disease Assessment and Treatment Needs
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A periodontal examination was performed at each recall appointment to assess the overall burden of periodontal disease and/or the patient's need for periodontal treatment at the remaining teeth. The PPD and BOP were assessed at 4 measurement points per tooth using a periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA), [13 (link)]. Furthermore, the clinical attachment loss (CAL) was recorded as the distance between the cemento-enamel junction and the bottom of the periodontal pocket. The need for periodontal treatment was defined in accordance with a Periodontal Screening and Recording (PSR) index score of 3 or 4 (PPD >3.5 mm) [14 (link)]. For each patient, the maximum value of the PSR index was used to classify their need for treatment. Specifically, patients with PSR index scores of ≤2 were classified as not needing periodontal treatment, while patients with maximum PSR index scores of 3 or 4 were classified as needing periodontal treatment.
10
Oral Health Assessment in LVAD Patients
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Two experienced and calibrated dentists (kappa > 0.8) performed the oral examinations at the University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany, under standardized conditions. An antibiotic prophylaxis (2 g amoxicillin or 600 mg clindamycine) according to the recent guidelines was performed for patients with LVAD prior to clinical oral examination [22 (link)].
Within a dental examination, the decayed- (D-T), missing- (M-T) and filled-teeth (F-T) index (DMF-T) was assessed visually with mirror and probe in accordance to WHO [23 ]. Furthermore, the number of remaining teeth (total number of all teeth in the oral cavity), remaining front teeth and remaining molars/premolars was recorded. Within a periodontal examination, periodontal probing depth (PPD) and clinical attachment loss (CAL) was measured with a periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA). Thereby, a number of teeth with PPD ≥ 5 mm and CAL ≥ 5 mm were recorded, respectively.
Within a dental examination, the decayed- (D-T), missing- (M-T) and filled-teeth (F-T) index (DMF-T) was assessed visually with mirror and probe in accordance to WHO [23 ]. Furthermore, the number of remaining teeth (total number of all teeth in the oral cavity), remaining front teeth and remaining molars/premolars was recorded. Within a periodontal examination, periodontal probing depth (PPD) and clinical attachment loss (CAL) was measured with a periodontal probe (PCP 15, Hu-Friedy, Chicago, IL, USA). Thereby, a number of teeth with PPD ≥ 5 mm and CAL ≥ 5 mm were recorded, respectively.
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