Thomas Dietrich

University of Birmingham · Oral Surgery

The aim of this study was to develop and externally validate a score for use in dental settings to identify those at risk of undiagnosed nondiabetic hyperglycemia (NDH) or type 2 diabetes (T2D). The Studies of Health in Pomerania (SHIP) project comprises 2 representative population-based cohort studies conducted in northeast Germany. SHIP-TREND-0,...

Background Point of care testing (POCT) devices have been developed to facilitate immediate results with the potential to aid screening for new disease and enable patients to self-monitor their disease. Non-communicable diseases (NCDs) are the major cause of mortality globally and are increasing in prevalence as the population ages. Allied health c...

Aims Patients with chronic kidney disease (CKD) are also susceptible to periodontitis. The causal link between periodontitis and CKD may be mediated via systemic inflammation/oxidative stress. Using structural equation modelling (SEM), this cross‐sectional study aimed to explore the causal relationship between periodontal inflammation (PI) and rena...

Background Non-communicable diseases [NCDs] are the major cause of mortality globally and are increasing in prevalence. Different healthcare professionals’ access different population groups; and engaging allied healthcare professionals in risk-driven early case detection of certain NCDs may be beneficial, especially those who have not been tested...

Objectives: The associations between oral and systemic conditions are becoming increasingly important for clinicians, policy makers and patients. Periodontitis has been associated with several chronic inflammatory conditions including diabetes, cardiovascular disease and rheumatoid arthritis (RA). Most studies to date have focused on clinical outco...

Purpose of Review Type 2 diabetes (T2DM) presents a growing global health and economic burden. Dental settings have been employed to identify individuals who may be at high risk of diabetes, who exhibit non-diabetic hyperglycaemia (NDH – also termed “prediabetes”) and who already unknowingly have the condition, through the use of targeted risk-asse...

Background: In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affe...

Background: In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affe...

Background Minimally invasive vertical extraction devices have been developed to minimise the need for flap surgery and trauma to alveolar bone during tooth extraction. The objective of this study was to measure the forces required for vertical tooth extraction and evaluate the determinants of these forces. Methods The investigators coupled a prec...

Background: Porphyromonas gingivalis (P.g) is unique among pathogens due to its ability to generate citrullinated proteins in an inflammatory milieu, potentially mediating the loss of immune tolerance, the production of anticitrullinated protein antibodies (ACPAs), and subsequently the development of rheumatoid arthritis (RA). Based on this hypothe...

Rheumatoid arthritis (RA) and chronic periodontitis are common chronic inflammatory diseases that share numerous clinical and pathobiological characteristics. Due to their similarities, despite manifesting at anatomically distinct sites, the relationship between these two diseases has been investigated for many years. This review attempts to summar...

Rheumatoid arthritis (RA) and periodontitis (PD) are inflammatory diseases characterised by an exacerbated immune-inflammatory reaction that leads to the destruction of bone and other connective tissues that share numerous similarities. Although a significant and independent association between these two conditions has been described, the pathophys...

Introduction Children requiring a general anaesthetic (GA) for caries-related dental extractions are at high risk of developing new dental caries. It is therefore important to maximise opportunities for prevention. Aim To explore the use and scope for fissure sealants among children requiring caries-related dental extractions under GA and investiga...

Background: The aim of this study was to develop a patient-reported questionnaire that is suitable to detect periodontitis (PD) in patients with rheumatoid arthritis (RA). Methods: A self-reported questionnaire containing 12 items potentially relevant to PD and dentists' semiquantitative assessment of PD (no/mild/moderate/severe) was obtained fr...

Aims We have conducted a survey of administrative data, aiming to investigate the reported provision of dental extraction under general anaesthesia in the NHS for adults in secondary care in the following aspects: 1) anaesthetic data accessibility by NHS organisations; 2) the number and proportion of dental extraction episodes by anaesthetic modali...

Surgical extrusion is a recognised treatment option for teeth that have insufficient coronal tooth structure remaining due to deep caries, resorption or traumatic injury. However, the technique has not been widely adopted, arguably because extraction of a severely compromised tooth may be difficult to achieve in a gentle and predictable way. In thi...

INTRODUCTION: Patients with rheumatoid arthritis (RA) present a higher incidence and severity of periodontitis than the general population. Our study, Outcomes of Periodontal Treatment in Patients with Rheumatoid Arthritis (OPERA), was a randomized waiting-list controlled trial using mixed methods. Patients randomized to the intervention arm receiv...

Case report A case of a 59-year-old female patient who attended with a history of periodontitis, who had been successfully treated and maintained for several years, is described. Following a full periodontal assessment, the patient was diagnosed with 'generalised periodontitis; stage IV; grade C; currently stable'. Conclusion The present case repor...

The objective of this case report is to illustrate the diagnosis and classification of periodontitis, according to the 2017 classification system, as recommended in the British Society of Periodontology (BSP) implementation plan. A 37-year-old female was diagnosed with periodontitis (molar-incisor pattern), stage III, grade C, currently unstable. S...

Objectives To compare efficacy/safety of oral tramadol 75 mg/dexketoprofen 25 mg (TRAM/DKP) and TRAM 75 mg/paracetamol 650 mg (TRAM/paracetamol) in moderate to severe pain following surgical removal of impacted lower third molar. Design Multicentre, randomised, double-blind, placebo-controlled, phase IIIb study. Participants Healthy adult patient...

This case report is the fourth in a series that illustrates the application of the BSP implementation plan for diagnosing periodontitis patients according to the 2017 classification. It demonstrates the diagnostic approach and disease classification for a previously treated patient who presented with a diagnosis of unstable generalised periodontiti...

The objective of this case report is to illustrate the diagnosis and classification of periodontitis according to the 2017 classification system as recommended in the British Society of Periodontology (BSP) implementation plan. We describe a case of a patient who was diagnosed with 'localised periodontitis; stage II, grade B; currently unstable'. T...

The 2017 World Workshop Classification system for periodontal and peri-implant diseases and conditions was developed in order to accommodate advances in knowledge derived from both biological and clinical research, that have emerged since the 1999 International Classification of Periodontal Diseases. Importantly, it defines clinical health for the...

The objective of this case report is to illustrate the diagnosis and classification of periodontitis according to the 2017 classification system as recommended in the British Society of Periodontology (BSP) implementation plan. We describe two cases in the form of a pair of siblings, who developed periodontitis very early in life. A 19-year-old fem...

Objective Non-communicable diseases (NCDs) impose a significant health and economic burden. This study aimed to assess the differential attendance patterns of public to different healthcare professionals and gauge the opinions of key stakeholders towards screening of NCDs by allied healthcare professionals. Design Questionnaires were designed pilo...

Aims To explore the associations between periodontal status and patient reported outcomes (PROs) in a large cohort of patients based in non‐specialist general dental practice. Materials and methods Analysis was conducted using data from 14,620 patients, in 233 non‐specialist dental practices across the UK. As part of routine clinical care, data on...

Aim To simulate the exposure misclassification bias potential in studies of perio‐systemic disease associations due to the use of PMR protocols. Methods Using data from 640 participants in the Dental Longitudinal Study, we evaluated distributions of clinical periodontitis parameters to simulate hypothetical outcome probabilities using bootstrap sa...

A new periodontitis classification scheme has been adopted, in which forms of the disease previously recognized as “chronic” or “aggressive” are now grouped under a single category (“periodontitis”) and are further characterized based on a multi‐dimensional staging and grading system. Staging is largely dependent upon the severity of disease at pre...

Statement of problem: Clinical studies evaluating the feasibility of a novel technique for the surgical extrusion of nonrestorable teeth with subgingival caries are lacking. Purpose: The purpose of this clinical study was to investigate the success rate and incidence of biological and technical complications after tooth extrusion with an atrauma...

Background: Minimally invasive vertical tooth extraction techniques have evolved in light of the limitations of conventional tooth extraction techniques and flap surgery in preserving the alveolar bone. The authors conducted a study to obtain data on the performance of a vertical extraction system. This included comparing the need for flap surgery...

Objectives: Studies that demonstrate an association between rheumatoid arthritis (RA) and dysbiotic oral microbiomes are often confounded by the presence of extensive periodontitis in these individuals. Therefore, the present investigation sought to investigate the role of RA in modulating the periodontal microbiome by comparing periodontally heal...

Neutrophil extracellular traps (NETs) are DNA-based antimicrobial web-like structures whose release is predominantly mediated by reactive oxygen species (ROS); their purpose is to combat infections. However, unbalanced NET production and clearance is involved in tissue injury, circulation of auto-antibodies and development of several chronic diseas...

Aim: To evaluate the assumptions underlying the use of partial-mouth recording (PMR) protocols and the associated mechanisms of potential misclassification of periodontal disease. Methods: Using data from 640 participants in the VA Dental Longitudinal Study, we compared tooth-specific and site-specific clinical measures, and calculated sensitivi...

Diclofenac sodium is a widely used nonsteroidal anti-inflammatory drug (NSAID) for relief of inflammatory pain. A recent formulation combines this drug with hydroxypropyl-β-cyclodextrin (HPβCD) to improve its solubility and to enable subcutaneous administration. Previous studies confirmed the efficacy of this combination. This study’s aim was to ev...

Background Patients with chronic kidney disease (CKD) exhibit increased morbidity and mortality which is associated with an increased systemic inflammatory burden. Identifying and managing comorbid diseases that contribute to this load may inform novel care pathways that could have a beneficial impact on the morbidity/mortality associated with CKD....

Aim: As periodontitis may contribute to the pathogenesis of diabetes, the effects of periodontitis on diabetes incidence and HbA1c change was quantified in a prospective cohort. Methods: Data from an 11-year follow-up of the Study of Health in Pomerania were analyzed to evaluate the effects of periodontitis on incident diabetes and long-term HbA...

Introduction: This is the first long-term randomized controlled trial to evaluate dentin-like glass fiber posts (GFPs) compared with rather rigid titanium posts (TPs) for post-endodontic restoration of severely damaged endodontically treated teeth with 2 or fewer remaining cavity walls. Methods: Ninety-one subjects in need of post-endodontic res...

Background & aims: Surgical trauma leads to an inflammatory response that causes surgical morbidity. Reduced antioxidant micronutrient (AM)(a) levels and/or excessive levels of Reactive Oxygen Species (ROS)(b) have previously been linked to delayed wound healing and presence of chronic wounds. We aimed to evaluate the effect of pre-operative suppl...

Background: Sjögren's syndrome is one of the more common inflammatory rheumatological diseases, with a prevalence of at least 0.4% in Germany. Methods: This review is based on pertinent articles retrieved by a selective search in PubMed. Special attention is drawn to updated classification criteria and current treatment recommendations. Results...

Aim This paper reports on one review of four rapid reviews undertaken to explore the relationships between oral health and general medical conditions, in order to support teams within Public Health England, health practitioners and policy makers. This review aimed to explore the most contemporary evidence on whether poor oral health and cardiovascu...

Background: Dental caries and periodontitis are the most common oral diseases and major causes of tooth loss. Aim: To perform a review of global prevalence and incidence of dental caries and periodontitis. Methodology: Inclusion and exclusion criteria were developed. MEDLINE database and EMBASE database were used to search for eligible publica...

Background: The non-communicable diseases dental caries and periodontal diseases pose an enormous burden on mankind. The dental biofilm is a major biological determinant common to the development of both diseases, and they share common risk factors and social determinants, important for their prevention and control. The remit of this working group...

Current evidence indicates the effects of periodontitis on diabetes as well as mortality, for which diabetes itself represents a risk factor. However, the possible interaction of these 2 chronic conditions regarding mortality has not yet been investigated. Therefore, the purpose of this study was to evaluate whether periodontal destruction interact...

Vitamin D spielt in zahlreichen physiologischen Prozessen eine wichtige Rolle. Obwohl ein Vitamin-D-Mangel mit einem erhöhten Risiko für zahlreiche Erkrankungen assoziiert ist, besteht nach wie vor Unklarheit über den Einfluss des Vitamin-D-Status' auf parodontale Erkrankungen. Während epidemiologische Studien eine Assoziation mit Parodontitis und/...

Die aktuelle Ausgabe der PARODONTOLOGIE ist dem Mitbegründer der Zeitschrift, dem langjährigen Chefredakteur und Visionär der Parodontologie - Herrn Prof. Dr. Dr. Jean-Pierre Bernimoulin - gewidmet. Zum Erscheinungsdatum jährt sich zum ersten Mal des Todestag des exzellenten Klinikers und international anerkannten Wissenschaftlers. An der inhaltlic...

The role of risk factors and risk assessment in the prediction of clinical periodontal outcomes, and thus in patient management, continues to be a subject of high professional interest and clinical relevance globally. Advances in our understanding of periodontal disease causality and the role of risk factors as predictors of future disease risk hav...

Objective: To investigate prevalence and patient-reported outcomes of dental implants in patients with Sjögren syndrome (SS). Methods: A total of 205 female patients from an observational cohort study answered oral health questionnaires about periodontal signs and symptoms, dentures, dental implants, comorbidities, and therapies that may interfe...

Figure S1. Cox PH regression graphs for all‐cause mortality in individuals with periodontitis/edentulism and CKD by age category

Figure S2 Cox PH regression graphs for CVD mortality in individuals with periodontitis/edentulism and CKD by age category.

Table S1 Numbers of participants (and percentage) with missing data in variables included in statistical model. Table S2 Exploring the interactions between CKD (stage 3–5), periodontal variables and age, gender and diabetes status for all‐cause mortality. Table S3 Hazard ratios (95% CI) and 10‐year survival (95% CI) of all‐cause mortality by subg...

This clinical report describes the use of an “atraumatic” vertical extraction system to facilitate the restorative treatment of a tooth that would otherwise be considered unrestorable because of subgingival caries. Minimally invasive surgical root extrusion was undertaken using the Benex extraction system, which can provide controlled tooth extrusi...

Introduction: Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease (CKD), thereby contributing to an increased morality rate. This study aimed to determine the association between periodontitis and mortality rate (all-cause and cardiovascular disease- related) in individuals with stage 3-5 CKD, hithe...

Combination analgesics are effective in acute pain, and a theoretical framework predicts efficacy for combinations. The combination of dexketoprofen and tramadol is untested, but predicted to be highly effective. This was a randomised, double-blind, double-dummy, parallel-group, placebo-controlled, single-dose trial in patients with moderate or sev...

Aims: 1. to assess the prevalence of periodontitis among patients with primary Sjögren's syndrome (pSS) and comparator groups of patients with rheumatoid arthritis (RA) and osteoarthritis (OA). 2. To perform a pilot study to compare serum antibody responses to 10 oral/periodontal bacteria in these patient groups and a historical comparator group o...

Aim: To investigate the association of serum vitamin B12 with the progression of periodontitis and risk of tooth loss in a prospective cohort study. Materials and methods: In the Study of Health in Pomerania 1,648 participants were followed from 2002-2006 to 2008-2012 (mean duration 5.9 years). Serum vitamin B12 was measured by chemiluminescent...

Background: The relation between the number of teeth and low-grade systemic inflammation is deserving of consideration within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study since the association between number of teeth and myocardial infarction has been established. Methods: Two subsamples (2439 and 728) we...

The aim of this study was to investigate the association between cigarette smoking and smoking cessation and the prevalence and incidence of tooth loss in a large cohort study in Germany. We analyzed data of 23,376 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study recruited between 1994 and 1998 f...

Maxillary sinus augmentation procedures with bone replacement grafts aimed to increase bone height in the posterior maxilla. During healing, bone particles are partially resorbed and replaced by the patient's own bone. Vitamin D plays an essential role in calcium homeostasis and is critical for bone formation and remodeling. This randomized, double...

Background Periodontal disease is a common chronic inflammatory disease that has been associated with rheumatoid arthritis and a potential causal role has been suggested. However, data on the prevalence of periodontal disease in patients with systemic lupus erythematosus (SLE) are scarce. Objectives To investigate the prevalence of periodontal dise...

There is growing evidence of an association between oral health, specifically dental status, and chronic systemic diseases. However, varying measures of dental status across different populations and low study sample has made comparison of studies and conclusion of findings unclear. Our aim is to examine whether the number of teeth as a measure of...

Previous experimental models suggest that vitamin E may ameliorate periodontitis. However, epidemiologic studies show inconsistent evidence in supporting this plausible association. We investigated the association between serum α-tocopherol (αT) and γ-tocopherol (γT) and periodontitis in a large cross-sectional US population. This study included 47...

Periodontal diseases are common and their prevalence varies in different populations. However, prevalence estimates are influenced by the methodology used, including measurement techniques, case definitions, and periodontal examination protocols, as well as differences in oral health status. As a consequence, comparisons between populations are sev...

AimsIn spite of the remarkable success of current preventive efforts, periodontitis remains one of the most prevalent diseases of mankind. The objective of this workshop was to review critical scientific evidence and develop recommendations to improve: i) plaque control at the individual and population level (oral hygiene), ii) control of risk fact...

Objective: The aim of this study was to evaluate the determinants of time until onset of pain in the third molar pain model. Method: We conducted a secondary analysis of pooled data from 448 patients enrolled in two randomised, double-blind, parallel-group phase III multicentre clinical trials investigating the efficacy and tolerability of a nove...

Objective: To assess reliability and validity of periodontal diagnosis based on routine dental radiographs in an epidemiological study of early rheumatoid arthritis (RA). Method: From a national cohort of 1316 RA patients, 756 completed a follow-up questionnaire about their RA status and oral health. Their general dental practitioners (GDP) w...

Objective: To evaluate the evidence for the use of cryotherapy to reduce postoperative morbidity after lower third molar (LM3) removal. Method: PubMed, Medline, PROSPERO, The Cochrane Library, OpenGrey and the ISRCTN register and reference lists of articles were searched to find studies reporting on the association between cryotherapy and LM3 mor...

Objective: The aim of this study was to evaluate the applicability and limitations of a novel minimally invasive extraction system (Benex®). Method: Patients with grossly carious teeth or roots not suitable for forceps extraction were consecutively recruited. Molar teeth were excluded from the study. The teeth were extracted with the use of the B...

Objectives: The aim of this study is to present the methods, recruitment and sample characteristics of the FAVOURITE trial. Methods: The FAVOURITE study is a monocentre, randomised, double blind, placebo controlled, 2 arm clinical trial to investigate the efficacy of adjunctive encapsulated fruit and vegetable powder concentrate (Juice plus)(...

Purpose: In longitudinal studies, the onset of the index condition (e.g. exposure) does not always coincide with the start of a study's observation period, leading to the possibility of bias in estimation that derives from studying prevalent exposure rather than new exposure. We investigate the possible role of this bias in the relationship betwee...

Background In experimental animal studies, pulsing the CO2 laser beam has been shown to reduce the thermal damage zone of excised oral mucosal tissue. However, there is still controversy over whether this is borne out under clinical conditions.Objective To compare the outcome following excisional biopsies of fibrous hyperplasias using a pulsed (cf)...

Patients with chronic kidney disease (CKD) exhibit a decrease in estimated glomerular filtration rate (eGFR) and/or proteinuria, both of which associate with an increase in all cause and cardiovascular mortality. A substantial component of the excess mortality and morbidity in CKD cannot be accounted for by traditional CKD risk factors. We have dem...

Objective: To explore the association of concentration of serum 25-hydroxy vitamin D and incidence of tooth loss, incidence of changes of mean clinical attachment loss (CAL)≥3 mm, and incidence of caries in a population-based five-year longitudinal study. Method: We analyzed data from 1904 participants from the Study of Health in Pomerania (SHIP)...

Background: We have previously demonstrated that periodontitis associates with declining kidney function expressed as estimated glomerular filtration rate (e-GFR), and decreased vascular elasticity, in chronic kidney disease (CKD). One plausible mechanism for this association relates to the elevations in C-Reactive protein (CRP) reported in periodo...

Background The relationship between periodontitis (PD) and rheumatoid arthritis (RA) is well established but there is a lack of (large observational studies including) validated measurements of PD. Objectives To evaluate a patient reported PD-module that can be used to investigate the PD-status in large epidemiological studies. Methods For 353 pati...