To compare the average values of fractal and radiomorphometric analysis measurements in patients using overdenture prostheses supported by two or three imp

Objective: Toothbrushing recommendations published by the American Dental Association (ADA) and the European Federation of Periodontology (EFP) are widely accepted in preventive dentistry. However, their real-life applicability and long-term sustainability in routine clinical practice remain unclear. This study aimed to evaluate dentists’ awareness, clinical implementation, and perceptions regarding the applicability and sustainability of ADA/EFP toothbrushing recommendations. Material and Methods: A cross-sectional online survey was conducted among 208 dentists in Türkiye. The questionnaire assessed guideline awareness, oral hygiene education practices, clinical applicability, perceptions of sustainability, and preferred toothbrushing techniques. Descriptive statistics were used to summarize participant characteristics and survey responses. Categorical variables were presented as frequencies and percentages. Results: Only 15.9% of participants reported directly reading the ADA/EFP guidelines. Among dentists familiar with the guidelines, 64.0% considered the recommendations clinically applicable and 68.0% considered them understandable for patients. Overall, 81.8% agreed that increasing technique complexity reduced patient compliance, while 81.8% believed that simpler techniques were more sustainable. The circular/sweeping combination was the most frequently recommended brushing technique (40.4%), whereas simple circular movements were perceived as the most sustainable approach (42.8%). More than half of the participants (53.4%) supported simplifying current guideline recommendations, and 62.0% favored the developing a simpler standardized toothbrushing method. Conclusion: Although dentists generally accept ADA/EFP toothbrushing recommendations, concerns regarding long-term patient adherence and sustainability remain substantial. Dentists appear to favor simpler, patient-centered toothbrushing approaches that may improve long-term compliance. These findings suggest that behavioral sustainability and motor adaptability should be considered alongside technical efficacy when developing future oral hygiene recommendations.

Objective: Glanzmann thrombasthenia is a rare inherited platelet function disorder characterized by impaired platelet aggregation and mucocutaneous bleeding. Gingival bleeding is frequently observed in affected patients and is often attributed solely to the underlying hematologic disorder. However, local inflammatory factors may significantly influence bleeding severity. Case presentation: A patient with Glanzmann thrombasthenia presented with severe gingival inflammation and persistent gingival bleeding. Baseline periodontal examination revealed a plaque index of 1.9, a gingival index of 2.5, and bleeding on probing at 70% of sites. Prior to periodontal treatment, 6000 µg of recombinant factor VIIa was administered prophylactically. Treatment followed World Federation of Hemophilia recommendations. Non-surgical periodontal therapy including Scaling and Root Planing was performed. Despite administration of an additional 4000 µg factor VIIa post-procedure, severe gingival bleeding occurred. The patient’s hemoglobin level decreased from 9 g/dL to 3.3 g/dL and hospitalization was required for three days. During hospitalization the patient received 7 units of platelet and plasma transfusion and 6 units of packed red blood cells. After recovery and strict plaque control, periodontal parameters improved significantly, with plaque index decreasing to 0.4, gingival index to 0.5, and bleeding on probing to 8%. Conclusion: This case suggests that periodontal inflammation may exacerbate gingival bleeding in patients with Glanzmann thrombasthenia and may reduce the effectiveness of hemostatic therapy. Control of periodontal inflammation may therefore play an important role in the management of gingival bleeding in patients with platelet function disorders.