1
|
Scribante A, Gallo S, Pascadopoli M, Frani M, Butera A. Ozonized gels vs chlorhexidine in non-surgical periodontal treatment: A randomized clinical trial. Oral Dis 2024; 30:3993-4000. [PMID: 38047757 DOI: 10.1111/odi.14829] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/12/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To evaluate the efficacy of newly introduced ozonated gels compared with conventional chlorhexidine gel in the home management of periodontal patients. MATERIALS AND METHODS 30 patients with bilateral periodontal disease (severity I, complexity II) were enrolled (split-mouth study design). After nonsurgical mechanical periodontal debridement, the teeth were randomly divided into two groups: teeth in the Control group were treated with a chlorhexidine-based gel to aid oral hygiene maneuvers for 2 weeks after the first visit, while teeth in the Test group were treated in the same way with ozone-based gels. After the baseline assessment, the follow-up included assessments at 1, 2, and 6 months. The variables evaluated were clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BoP), plaque control record (PCR), recession (R), and tooth mobility (TM). RESULTS For CAL, PPD, BoP, and PCR, significant intragroup differences were found for both groups (p < 0.05), in contrast to intergroup differences (p > 0.05). No significant differences were found for R and TM. CONCLUSION Nonsurgical mechanical periodontal debridement with adjunctive use of ozone and chlorhexidine was found to be effective in periodontal treatment. Ozone could be suggested as an alternative to chlorhexidine.
Collapse
Affiliation(s)
- Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Monica Frani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
2
|
Pham TAV, Nguyen MD. Subgingival 0.75% boric acid vs 1% povidone-iodine adjunctive to subgingival instrumentation in stage II and III periodontitis-A double-blind randomized clinical trial. Int J Dent Hyg 2024. [PMID: 38764161 DOI: 10.1111/idh.12819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 04/21/2024] [Accepted: 04/28/2024] [Indexed: 05/21/2024]
Abstract
PURPOSE To compare the effects of subgingival irrigation with 0.75% boric acid (BA) and 1% povidone-iodine (PVP-I) as an adjunct to scaling and root planing (SRP) on clinical and microbiologic parameters in the management of patients with periodontitis after a 12-month follow-up. METHODS Sixty systemically healthy individuals diagnosed with periodontitis were included in this double-blind randomised clinical trial. The patients were randomly allocated to treatment groups: (1) SRP plus 0.75% BA and (2) SRP plus 1% PVP-I. Whole-mouth periodontals were clinically examined, and the counts of bacteria including Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), Solobacterium moorei (Sm) and Streptococcus salivarius (Ss) were tested by real-time polymerase chain reaction (PCR). RESULTS All periodontal parameters and the counts of Aa, Fn, Pg, Td, Tf, Sm and Ss in both groups showed statistically significant reductions at T3, T6 and T12 compared to T0. Whole-mouth or moderate or severe PD and CAL improvements were significantly found in the 0.75% BA group compared to the 1% PVP-I group at T3, T6 and T12. The reduction in Aa or Fn and the reduction in Ss were significantly higher in the 0.75% BA group at T6 and T12 than in the 1% PVP-I group. CONCLUSION This study shows that subgingival irrigation with 0.75% BA may be an alternative to 1% PVP-I because it promotes greater PD reductions and CAL gain, particularly up to 12 months after treatment.
Collapse
Affiliation(s)
- Thuy Anh Vu Pham
- School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam
- Vietnam National University, Ho Chi Minh City, Vietnam
| | - Minh Duc Nguyen
- School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam
- Vietnam National University, Ho Chi Minh City, Vietnam
- Hospital of Odonto-Stomatology, Ho Chi Minh City, Vietnam
| |
Collapse
|
3
|
Ilyes I, Boariu M, Rusu D, Iorio-Siciliano V, Vela O, Boia S, Radulescu V, Șurlin P, Jentsch H, Lodin A, Stratul SI. Comparative Study of Systemic vs. Local Antibiotics with Subgingival Instrumentation in Stage III-IV Periodontitis: A Retrospective Analysis. Antibiotics (Basel) 2024; 13:430. [PMID: 38786158 PMCID: PMC11117343 DOI: 10.3390/antibiotics13050430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
To improve the clinical and microbiological outcomes of non-surgical mechanical periodontal therapy, the adjunctive use of antimicrobials has been utilized in treating moderate-to-severe periodontitis. In our study, the retrospective design included previously collected health-related patient data, obtained from the printed and digital charts of patients who received systemic or local antibiotic adjuncts to SI (subgingival instrumentation). A total of 34 patients (diagnosed with generalized Stage III/IV periodontitis) met the inclusion and exclusion criteria and were evaluated. The samples were tested for the following bacterial strains: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), Prevotella intermedia (P. intermedia), Tanererella forsythia (T. forsythia), and Treponema denticola (T. denticola). The inter-group comparisons of the bacterial species did not show statistically significant differences between groups. The present study aimed to evaluate the clinical effects after SI and the adjunctive use of systemically administered (SA) AMX (amoxicillin) + MET (metronidazole) (administered for 7 days), with locally delivered (LDD) piperacillin + tazobactam in step 2 of periodontal therapy. Results: Overall, all parameters were improved in the groups, with a significant difference in inter-group comparison regarding the full-mouth bleeding score (FMBS) (p < 0.05) in favor of the SA group, and the p-value < 0.05 was considered to be statistically significant. Statistically significant PPD (probing pocket depth) reductions and CAL (clinical attachment level) gains were observed in both groups at the 3-month follow-up. In conclusion, within the limitations, the outcomes of this study suggest that SI, with adjunctive local or systemic antibiotic therapy, provided comparable clinical improvements. Systemic AMX + MET protocols were more efficacious with regard to the reduction in FMBS. Follow-up studies with larger patient numbers are needed to further investigate this effect.
Collapse
Affiliation(s)
- Ioana Ilyes
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | | | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Viorelia Radulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania;
| | - Holger Jentsch
- Medical Faculty, University of Leipzig, 04103 Leipzig, Germany;
| | - Alexandru Lodin
- Department Basis of Electronics, Faculty of Electronics, Telecommunications and Information Technology, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania;
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.I.); (D.R.); (O.V.); (S.B.); (V.R.); (S.-I.S.)
| |
Collapse
|
4
|
Zhou K, Xie J, Su Y, Fang J. Lactobacillus reuteri for chronic periodontitis: focus on underlying mechanisms and future perspectives. Biotechnol Genet Eng Rev 2024; 40:381-408. [PMID: 36856460 DOI: 10.1080/02648725.2023.2183617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023]
Abstract
Chronic periodontitis is a common oral disorder caused by pathogenic bacteria. Despite the wide use of antibiotics as the conventional adjunctive treatment, the challenges of increased antibiotic resistance and limited therapeutic effect receive considerable attention and the developments of alternative treatments gain increasing consideration. Growing evidence showed that Lactobacillus reuteri (LR) may represent a promising alternative adjunct for chronic periodontitis. It can attenuate inflammation and reduce tissue disruption. LR-assisted treatment has been shown to be effective and relatively safe in multiple clinical trials, and accumulating evidence suggests its significant biological roles. In the current review, we focus on capturing the underlying mechanisms of LR involved in chronic periodontitis, thereby representing a scientific foundation for LR-assisted therapy. Furthermore, we point out the challenges and future directions for further clinical trials to improve the clinical applicability for LR.
Collapse
Affiliation(s)
- Keyi Zhou
- Department of Pediatric Dentistry, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Jiaman Xie
- Department of Pediatric Dentistry, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Yuan Su
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Jingxian Fang
- Department of Pediatric Dentistry, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| |
Collapse
|
5
|
Jao Y, Ding SJ, Chen CC. Antimicrobial photodynamic therapy for the treatment of oral infections: A systematic review. J Dent Sci 2023; 18:1453-1466. [PMID: 37799910 PMCID: PMC10548011 DOI: 10.1016/j.jds.2023.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 06/30/2023] [Indexed: 10/07/2023] Open
Abstract
Oral infection is a common clinical symptom. While antibiotics are widely employed as the primary treatment for oral diseases, the emergence of drug-resistant bacteria has necessitated the exploration of alternative therapeutic approaches. One such modality is antimicrobial photodynamic therapy (aPDT), which utilizes light and photosensitizers. Indeed, aPDT has been used alone or in combination with other treatment options dealing with periodontal disease for the elimination of biofilms from bacterial community to achieve bone formation and/or tissue regeneration. In this review article, in addition to factors affecting the efficacy of aPDT, various photosensitizers, the latest technology and perspectives on aPDT are discussed in detail. More importantly, the article emphasizes the novel design and clinical applications of photosensitizers, as well as the synergistic effects of chemical and biomolecules with aPDT to achieve the complete eradication of biofilms and even enhance the biological performance of tissues surrounding the treated oral area.
Collapse
Affiliation(s)
- Ying Jao
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
| | - Shinn-Jyh Ding
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Cheng Chen
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| |
Collapse
|
6
|
Yukna RA. Clinical evaluation of Laser-Assisted New Attachment Procedure ® (LANAP ®) surgical treatment of chronic periodontitis: a retrospective case series of 1-year results in 22 consecutive patients. J Periodontal Implant Sci 2023; 53:173-183. [PMID: 36468483 PMCID: PMC10315259 DOI: 10.5051/jpis.2202580129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/14/2022] [Accepted: 10/12/2022] [Indexed: 07/30/2023] Open
Abstract
PURPOSE Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure® (LANAP®) surgery as a single treatment modality. METHODS As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. RESULTS All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. CONCLUSIONS Within the limits of this case series, LANAP® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.
Collapse
Affiliation(s)
- Raymond A Yukna
- Advanced Periodontal Therapies, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Anschutz Medical Center, Aurora, CO, USA.
| |
Collapse
|
7
|
Nahas P, Houeis S, Chamboredon R, Heysselaer D, Zeinoun T, Nammour S. Assessment of the Periodontal Cementum Ablation Depth during Root Planing by an Er:YAG Laser at Different Energy Densities: An Ex Vivo Study. Dent J (Basel) 2023; 11:dj11050116. [PMID: 37232767 DOI: 10.3390/dj11050116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION An important and non-adapted delivered energy of Er:YAG laser can eliminate the total thickness of root cementum during root planing. Conversely, the preservation of a partial layer of cementum covering the roots is vital for any periodontal ligament regeneration. Thus, the assessment of the cementum ablation depth produced by each energy density of Er:YAG laser is essential before considering its use for the periodontal planing and treatment of the cementum and root surfaces. AIM OF THE STUDY Assessment of the cementum ablation depth at different energy densities of the Er:YAG laser is the aim of this study. MATERIALS AND METHODS A total of 48 human caries free molars were collected and used in this study. Areas to be irradiated were delimited by two longitudinal grooves (0.5 mm depth). Roots were divided randomly into four groups (4 × n = 12). An Er:YAG laser (2.94 µm) was used with a side-firing tip (R600T) with a 600 µm diameter and a frequency of 20 Hz combined with a cooling system of air 6 mL/min and water 4 mL/min. We used a super short pulse mode (SSP: pulse duration: 50 μs). We used a single irradiation passage backward from apex to cervical parts at 1 mm/s with a slight contact and at an angle of 15° to 30° between the tip and the root surface. Different energies were selected: 30 mJ, 40 mJ, 50 mJ, and 60 mJ. RESULTS Microscopic observations showed that the average of the ablation depth increased with the increase of the delivered energy from 30 mJ to 60 mJ. Mean values of the ablation depths were respectively as follows: 43.75 ± 4.89 µm for the energy of 30 mJ, 50.05 ± 3.72 µm for 40 mJ, 65.56 ± 10.35 µm for 50 mJ, and 74.80 ± 15.23 µm for 60 mJ. A statistically significant difference existed between the ablation depth of all groups. CONCLUSION Based on our results, the depth of cementum debridement is related to the level of the delivered energy. The lowest energy levels (30 mJ and 40 mJ) can ablate the root cementum surface for a variable depth from 43.75 ± 4.89 μm to 50.05 ± 3.72 μm.
Collapse
Affiliation(s)
- Paul Nahas
- Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Lebanese University, Hadath campus, Beirut 1003, Lebanon
| | - Saad Houeis
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Remi Chamboredon
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Daniel Heysselaer
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Toni Zeinoun
- Department of Oral and Maxillo-Facial Surgery, Dean of Faculty of Dental Medicine, Lebanese University, Beirut 1003, Lebanon
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| |
Collapse
|
8
|
Al-Hamoudi N, Ahmed Y, Al Rifaiy MQ, Alwithanani N, Vohra F, Abduljabbar T. Efficacy of surgical periodontal treatment with and without photobiomodulation in the treatment of severe periodontitis: An evaluation of periodontal, microbiological, and cytokine levels. Photodiagnosis Photodyn Ther 2023; 42:103494. [PMID: 36871808 DOI: 10.1016/j.pdpdt.2023.103494] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
AIM To compare the efficacy of surgical periodontal treatment (SPT) alone and PDT-assisted surgery in participants with severe periodontitis MATERIAL AND METHODS: The present clinical trial was completed by 64 participants (n=32 each). The selection was made according to predefined inclusion and exclusion criteria. Patients in group A were treated with SPT only and participants in group B were treated with SPT adjunct to PDT. Microbiological assessment of P.Gingivalis; T. Forsythia and T.Denticola were evaluated using cultural analysis and periodontal parameters plaque score (PSc), bleeding on probing (BoP) periodontal depth (PD), and clinical attachment loss (CAL) at baseline and post-treatment at 6 months and 12 months were performed. The gingival crevicular fluid (GCF) was collected for the estimation of IL-1β and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay (ELISA). For intra-group comparison and post hoc correction, Student's t-test along with Bonferroni was used. For the difference between follow-ups, an analysis of variance (ANOVA) multiple rank tests were incorporated. RESULTS The mean age of participants in the SPT group was 55.25±4.6yrs. Whereas, participants treated with PDT adjunct to SPT were 54.88±3.6yrs. Periodontal parameters (BoP, PD, PSc, CAL) showed no significant difference at baseline. At 6 months and 12 months follow-up, a significant difference in all parameters (BoP, PD, PSc, and CAL) was found in participants treated with SPT alone and PDT adjunct to SPT (p<0.05). Inflammatory biomarkers at 6-month and 12-month follow-ups, a statistically significant difference in the level of biomarkers (IL-1β and TNF-α) were observed in both groups from baseline (p<0.05). However, at baseline, no significant difference was noted in both groups (p> 0.05). The microbiological assessment showed a significant drop in the bacterial count in participants treated with both regimes i.e., SPT alone and PDT adjunct to SPT. CONCLUSION Photodynamic therapy (PDT) adjunct to surgical periodontal treatment (SPT) in severe periodontitis improves microbiological and periodontal parameters and lowers the level of proinflammatory cytokines.
Collapse
Affiliation(s)
- Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Yassir Ahmed
- Department of General Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Q Al Rifaiy
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Naif Alwithanani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Taif University, Taif, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
| |
Collapse
|
9
|
Namour M, Nammour S, Rompen E. Laser-Assisted Periodontitis and Peri-Implantitis Treatments: Update and the State of the Art. Photobiomodul Photomed Laser Surg 2022; 40:157-158. [DOI: 10.1089/photob.2021.0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Melanie Namour
- Department of Periodontology, University Hospital Sart Tilman, Faculty of Medicine, University of Liège, Liege, Belgium
| | - Samir Nammour
- Department of Dentistry, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Eric Rompen
- Department of Periodontology, University Hospital Sart Tilman, Faculty of Medicine, University of Liège, Liege, Belgium
| |
Collapse
|
10
|
Vinel A, Al Halabi A, Roumi S, Le Neindre H, Millavet P, Simon M, Cuny C, Barthet JS, Barthet P, Laurencin-Dalicieux S. Non-surgical Periodontal Treatment: SRP and Innovative Therapeutic Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:303-327. [DOI: 10.1007/978-3-030-96881-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
11
|
Miyashita Y, Kuraji R, Ito H, Numabe Y. Wound healing in periodontal disease induces macrophage polarization characterized by different arginine-metabolizing enzymes. J Periodontal Res 2021; 57:357-370. [PMID: 34918843 DOI: 10.1111/jre.12965] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/09/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Macrophages play important roles from the initiation of inflammation to wound healing. Two phenotypes of macrophages, namely pro-inflammatory type macrophages (M1-MΦ) and anti-inflammatory type macrophages (M2-MΦ), have been reported. Two contrasting metabolic enzymes that use arginine as a substrate, inducible nitric oxide synthase (iNOS), and arginase-1 (Arg-1), have been identified as M1-MΦ and M2-MΦ markers, respectively. The purpose of this study was to elucidate the temporal dynamics of the macrophage phenotype during the progression and healing phases of experimental periodontitis in mice. MATERIAL AND METHODS A total of 63 C57BL/6J mice were divided into the following 3 groups: control (C), periodontitis (P), and healing (H). To induce periodontitis, a silk ligature was placed around the maxillary bilateral second molars of mice in the periodontitis and healing groups. In the healing group, the ligature was removed 3 days after ligation to induce tissue healing. Maxillary tissue was collected on day 0 for the control group, days 1, 3, 5, and 7 for the periodontitis group (P1, P3, P5, and P7), and days 5 and 7 for the healing group (H5 and H7: 3 days with the ligation + 2 days or 4 days following ligature removal). The left side of the maxilla was subjected to bone structure analysis using micro-computed tomography and gene expression analysis using polymerase chain reaction. On the right side, immunohistochemistry was performed to histopathologically evaluate the localization of macrophages by phenotype in the periodontal tissue. RESULTS In the alveolar bone structure analysis, the linear distance of bone height increased significantly in the P5 and P7 groups, whereas bone volume fraction and bone mineral density decreased over time after ligature placement; in the healing group (H5 and H7), these parameters improved significantly compared with the periodontitis group (P5 and P7). Expression of genes encoding pro-inflammatory cytokines and iNOS increased in the periodontitis group, and expression of anti-inflammatory cytokine genes and Arg-1 increased in the healing group. Furthermore, the iNOS/Arg-1 expression ratio increased with ligation, whereas the ratio in the healing groups (H5 and H7) significantly decreased compared with the periodontitis groups (P5 and P7). Immunofluorescence staining revealed a significant increase in the number of iNOS-positive macrophages in the periodontitis group and decrease in the healing group. In contrast, the number of Arg-1-positive macrophages decreased in the periodontitis group and increased in the healing group. CONCLUSION The results of the present study suggest that wound healing in periodontal disease induces macrophage polarization from M1-MΦ to M2-MΦ characterized by iNOS and Arg-1.
Collapse
Affiliation(s)
- Yukihiro Miyashita
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Ryutaro Kuraji
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan.,Department of Life Science Dentistry, The Nippon Dental University, Tokyo, Japan
| | - Hiroshi Ito
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| |
Collapse
|
12
|
Shenbakam, Rao RJ, Prabhu S, Srirangarajan S, Rudresh V. Influence of antibacterial effects of tetracycline, laser, and photodynamic therapy on cell viability, cell damage, and virulence of Porphyromonas gingivalis. Photodiagnosis Photodyn Ther 2021; 36:102617. [PMID: 34740837 DOI: 10.1016/j.pdpdt.2021.102617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/18/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study compares and evaluates the efficacy of tetracycline, laser and photodynamic therapy on bacterial counts, cell damage, cell viability and neutralization of gingipains. MATERIAL AND METHODS P.gingivalis (ATCC 33,277) was cultured anaerobically. The minimal inhibitory concentration (MIC) for 50% inhibition of P.gingivalis by tetracycline, laser, and toluidine blue (TB) was determined using spectrophotometry. The antibacterial effects, cell viability, cell damage and neutralization of gingipains of the treated groups was evaluated by microbial culture and counting, 2,3 Bis 2 Methyloxy-4 Nitro-5 Sulphophenyl 2 H tetrazolium-5-Carboxaanilide (MTT) assay, lactate dehydrogenase (LDH) assay, and gingipain assay (BAPNA). RESULTS The MIC of tetracycline, toulidine, diode laser (810nmm; 0.5 Watts) is 1 µg/mL, 50 µg/mL and 15 s respectively. Comparative analysis for bacterial colony reduction was highest in tetracycline followed by PDT and then laser group at p < 0.01. MTT assay shows a significantly lesser number of viable cells in the tetracycline and PDT group when compared to laser group p < 0.01. Comparative analysis for cell damage using LDH shows the highest results for PDT followed by tetracycline and laser at p < 0.01. The highest neutralization of the gingipains is seen in the PDT group followed by tetracycline and laser groups at p < 0.01. CONCLUSION PDT shows highest antibacterial activity, gingipain neutralization, cell damage, and least number of viable cells in comparison with tetracycline and laser.
Collapse
Affiliation(s)
- Shenbakam
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate research center, 5/3, Hosur road; Next to NIMHANS Convention center, Bangalore, Karnataka 560089, India
| | - Ravi J Rao
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate research center, 5/3, Hosur road; Next to NIMHANS Convention center, Bangalore, Karnataka 560089, India
| | - Srikumar Prabhu
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate research center, 5/3, Hosur road; Next to NIMHANS Convention center, Bangalore, Karnataka 560089, India
| | - S Srirangarajan
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate research center, 5/3, Hosur road; Next to NIMHANS Convention center, Bangalore, Karnataka 560089, India.
| | - Vinaya Rudresh
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate research center, 5/3, Hosur road; Next to NIMHANS Convention center, Bangalore, Karnataka 560089, India
| |
Collapse
|
13
|
Doğan B, Kemer Doğan ES. The Effects of Omega‐3 Supplementation on Serum Oxidative Stress Parameters in Experimental Periodontitis in an Animal Model. EUR J LIPID SCI TECH 2021. [DOI: 10.1002/ejlt.202100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Burak Doğan
- Department of Periodontology, Faculty of Dentistry Hatay Mustafa Kemal University Hatay 31001 Turkey
| | - Esra Sinem Kemer Doğan
- Department of Periodontology, Faculty of Dentistry Hatay Mustafa Kemal University Hatay 31001 Turkey
| |
Collapse
|
14
|
Davidovich NV, Solovieva NV, Galieva AS, Lepeshkin SY, Bashilova EN, Pisareva SN, Bazhukova TA. Role of antimicrobial peptides system in inflammatory periodontal diseases non-specific oral cavity protection. Klin Lab Diagn 2021; 66:422-427. [PMID: 34292685 DOI: 10.51620/0869-2084-2021-66-7-422-427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The system of antimicrobial peptides (AMP) is one of the most ancient mechanisms of the macroorganism resistance to infectious pathogens invasion. The aim of the study was to determine the role of the antimicrobial peptides system and periodontal pathogenic markers in the development and progression of inflammatory periodontal diseases. Gingival pocket washes (91 samples in total) for the research were received from patients with inflammatory periodontal diseases (chronic periodontitis and gingivitis) and intact periodontium. Using ELISA, the content of antimicrobial peptides was determined: human alpha-defensin (HNP 1-3), beta-defensin (HBD 1-3) and cathelicidin (LL-37). Periodontal pathogenic markers were isolated during RT-PCR. The study revealed differences in AMP concentrations by groups: level of HBD 2 in patients with chronic periodontitis was 1,36 times higher than those in the group of patients with chronic gingivitis (p=0,023) and 2,39 times higher than those in the control group (p<0,001), the content of HNP 1-3 in the group of patients with chronic periodontitis was reduced by 1,23 times compared with the indicators of the group of patients with gingivitis (p=0,045) and by 1,97 times compared with the indicators of the control group (p<0,001). The frequency of detection of periodontal pathogenic bacteria genes was 88,0% in patients with periodontitis, 76,92% in patients with gingivitis and 33,3% in the group with intact periodontium. HBD 2 content moderately correlated with the definition of P. gingivalis (r=0,612; p=0,022), T. forsythensis (r= 0,434; p=0,015), A. actinomycetemcomitans (r=0,483; p=0,006), a moderate negative correlation was detected between the content of HNP 1-3 and the release of periodontal pathogens in associations (P. gingivalis with T. forsythensis and T. denticola) (r=-0,388; p=0,031) in the group of patients with chronic periodontitis. Thus, the revealed relationships and correlations indicate shifts in the processes of reparative regeneration of the oral cavity and the regulation of local immunity in response to microbial invasion.
Collapse
Affiliation(s)
- N V Davidovich
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - N V Solovieva
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - A S Galieva
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - S Yu Lepeshkin
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - E N Bashilova
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - S N Pisareva
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - T A Bazhukova
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| |
Collapse
|
15
|
Clinical efficacy of single and multiple applications of antimicrobial photodynamic therapy in periodontal maintenance: A systematic review and network meta-analysis. Photodiagnosis Photodyn Ther 2021; 36:102435. [PMID: 34245916 DOI: 10.1016/j.pdpdt.2021.102435] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND At present the clinical efficacy of single (S) versus multiple (M) applications of antimicrobial photodynamic therapy (aPDT) is controversially discussed. AIM To systematically evaluate the clinical efficacy of adjunctive S and M applications of aPDT to subgingival debridement (SD) in the treatment of residual periodontal pockets. METHODS An electronic search was carried out for randomized controlled clinical trials (RCTs) reporting on SD with the adjunctive use of S- or M-aPDT applications. RESULTS Statistically significantly higher improvement in bleeding on probing (BOP) and probing depth (PD) reduction was found for SD + S-aPDT versus SD, with Mean difference (MD) = -16.8 (95% CI: -30.7 to -2.91; p = 0.02) and 0.4, (95% CI: 0.02 to 0.78, p = 0.04), respectively. Regarding BOP, there was also a statistically significant difference when SD + M-aPDT was compared with SD alone, with a MD of -5.13 (95% CI: -7.20 to -3.07; p < 0.00001). For all parameters, SD + S-aPDT demonstrated the best treatment ranking of probability results, followed by SD + M-aPDT and SD alone. CONCLUSIONS Within their limits, the present data indicate that in periodontal patients enrolled in maintenance: a) single and multiple adjunctive applications of aPDT following SD resulted in statistically significant BOP reduction compared to SD alone, and b) repeated applications of aPDT did not seem to result in superior outcomes compared to single applications.
Collapse
|
16
|
Chen Z, Guo Z, Lin H, Tian Y, Zhang P, Chen H, Wang Y, Shen Y. The feasibility of phage therapy for periodontitis. Future Microbiol 2021; 16:649-656. [PMID: 34098742 DOI: 10.2217/fmb-2020-0161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Periodontitis, a chronic progressive inflammation caused by plaque biofilm, is the main cause of tooth loss in adults. For certain refractory periodontitis cases, it is difficult to achieve a good curative effect using the existing periodontal treatment approaches, which may be due to periodontal pathogenic mechanism in the affected periodontal tissue that the host cannot resist and eliminate. Various pieces of evidence collectively revealed that most studies are focusing on phages in periodontal disease. Several studies have reported periodontitis treatment using phage therapy, highlighting its features including specificity, rapid propagation, and effectiveness on bacteriophage biofilms. In this study, we focus on these reports, aiming to lay the foundation for improved periodontal treatment approaches.
Collapse
Affiliation(s)
- Zhen Chen
- Department of Periodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key laboratory of Basic & Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, 510182, China
| | - Zhimin Guo
- Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, 130021, China
| | - Hongbing Lin
- Department of Periodontics, School and hospital of Stomatology, Jilin University, Jilin Province, Changchun, 130021, China
| | - Yue Tian
- Department of Periodontics, School and hospital of Stomatology, Jilin University, Jilin Province, Changchun, 130021, China
| | - Peipei Zhang
- Department of Periodontics, School and hospital of Stomatology, Jilin University, Jilin Province, Changchun, 130021, China
| | - Huishan Chen
- Department of Periodontics, School and hospital of Stomatology, Jilin University, Jilin Province, Changchun, 130021, China
| | - Yawei Wang
- Department of Periodontics, School and hospital of Stomatology, Jilin University, Jilin Province, Changchun, 130021, China
| | - Yuqin Shen
- Department of Periodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key laboratory of Basic & Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, 510182, China
| |
Collapse
|
17
|
Liu HJ, Wang B, Wang AC, Zhang DH, Mao C, Li QH. Prognostic factors affecting the short-term efficacy of non-surgical treatment of chronic periodontitis: a multilevel modeling analysis. Eur J Med Res 2021; 26:50. [PMID: 34074306 PMCID: PMC8170789 DOI: 10.1186/s40001-021-00520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study is aimed to analyze the prognostic factors affecting the short-term efficacy of non-surgical treatment of patients in periodontitis from stage II to stage IV by the multilevel modeling analysis. MATERIALS AND METHODS A total of 58 patients with chronic periodontitis were included in this study. Patients were clinically explored before and 3 months after the treatment and the difference in probing depth was determined [Reduction of probing depth (Δ PD) = baseline PD - finial probing depth (FPD)] which is considered as the therapeutic evaluation. Three different levels were analyzed: patients, teeth and sites to construct a multi-layer linear model. RESULTS Probing depth (PD) improved significantly compared with that before treatment (p < 0.05), in which FPD was (3.90 ± 1.39) mm, and the ΔPD was (1.79 ± 0.97) mm. Compared with the mesial sites and distal sites of the multi-rooted teeth, the number of PD ≥ 5 mm or PD < 5 mm after the treatment was significantly different (P < 0.05), and the proportion of PD < 5 mm was higher in mesial sites. The null model showed that Δ PD varied greatly between groups at various levels (P < 0.001), with prediction variable of site level, tooth level, and patient level accounted for 66%, 18%, and 16% of the overall difference, respectively. The complete model showed that the Δ PD of smokers was significantly lower than that of non-smokers (P < 0.001). The Δ PD of the mesial and distal sites was larger than that of the buccolingual central site (P < 0.001). The Δ PD of single-rooted teeth was larger than that of multi-rooted teeth (P < 0.001). The baseline PD, tooth mobility (TM), bleeding index (BI), clinical attachment loss (CAL) were significantly negatively correlated with Δ PD (P < 0.001). CONCLUSIONS Patients with periodontitis from stage II to stage IV, who were non-smoking, have good compliance, good awareness of oral health, and low percentage sites with PD ≥ 5 mm at baseline, single-rooted teeth with hypomobility, less clinical attachment loss and lower bleeding index and sites of mesial or distal can obtain an ideal short-term efficacy of non-surgical treatment.
Collapse
Affiliation(s)
- Hui-Jie Liu
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.,Medical Department of Graduate School, Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Bo Wang
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China
| | - Ao-Chen Wang
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, 110122, Liaoning, China
| | - Dan-Hong Zhang
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.,Medical Department of Graduate School, Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Cui Mao
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.,Medical Department of Graduate School, Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Qiu-Hong Li
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.
| |
Collapse
|
18
|
Effect of vitamin E on periodontitis: Evidence and proposed mechanisms of action. J Oral Biosci 2021; 63:97-103. [PMID: 33864905 DOI: 10.1016/j.job.2021.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Periodontitis is a noncommunicable inflammatory disease of the soft tissue and bone surrounding the teeth in the jaw, which affects susceptible individuals with poor oral hygiene. A growing interest has been seen in the use of dietary supplements and natural products for the treatment and prevention of periodontitis. Vitamin E consists of two major groups, namely tocopherols and tocotrienols, which are botanical lipophilic compounds with excellent anti-inflammatory and antioxidant properties. HIGHLIGHT This review aimed to summarize the preclinical and clinical findings on the effects of vitamin E on periodontitis. The current literature suggests that vitamin E could improve the periodontal status by correcting redox status imbalance, reducing inflammatory responses, and promoting wound healing, thus highlighting the potential of vitamin E in the management of periodontitis. CONCLUSION Direct evidence for the use of vitamin E supplementation or treatment of periodontitis in humans is still limited. More well-designed and controlled studies are required to ascertain its effectiveness.
Collapse
|
19
|
Tan OL, Safii SH, Razali M. Clinical Efficacy of Single Application Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review and Network Meta-Analysis. Pharmaceutics 2020; 12:E1086. [PMID: 33198248 PMCID: PMC7698182 DOI: 10.3390/pharmaceutics12111086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022] Open
Abstract
This review aimed to rank the clinical efficacy of commercially available single-application local drug delivery and adjunctive agents (LDAs) compared with subgingival mechanical debridement (SMD) in nonsurgical periodontal therapy (NSPT). Randomized controlled clinical trials that compared LDAs against SMD alone or with placebo in adults (aged at least 18 years) diagnosed with periodontitis with a minimum of 6 months follow-up were included. A frequentist approach to random-effects network meta-analysis was implemented. The efficacies of the LDAs measured by probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were reported as mean difference (MD) with 95% confidence intervals (CIs). The treatments were ranked according to their P-score. Four network meta-analyses suggested that sulfonic/sulfuric acid gel (PPD MD -1.13 mm, 95% CI -1.74 to -0.53, P-score 0.91; CAL MD -1.09 mm, 95% CI -1.58 to -0.61, P-score 0.95) and doxycycline hyclate gel (PPD MD -0.90 mm, 95% CI -1.50 to -0.30, P-score 0.93; CAL MD -0.84 mm, 95% CI -1.40 to -0.28, P-score 0.92) were the most effective in reducing PPD and gaining CAL in split-mouth and parallel studies, respectively (moderate certainty of evidence). LDAs have differing efficacies, but they present with possible clinical significance over SMD alone in NSPT.
Collapse
Affiliation(s)
- Oi Leng Tan
- Centre for Restorative Dentistry, Unit of Periodontology, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Centre for Restorative Dentistry, Unit of Periodontology, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| |
Collapse
|
20
|
Al-Zawawi AS, Bukhari IA, Bello-Correa FO, Sheikh SA, Albaijan R, Vohra F. Influence of root debridement with adjunct photodynamic therapy on periodontal parameters and gingival crevicular fluid cortisol levels among patients with and without type-2 diabetes mellitus. Photodiagnosis Photodyn Ther 2020; 32:102076. [PMID: 33152543 DOI: 10.1016/j.pdpdt.2020.102076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of the present study was to assess the influence of scaling and root planing (SRP) with adjunct antimicrobial photodynamic therapy (aPDT) on periodontal parameters and gingival crevicular fluid (GCF) cortisol levels in type-2 diabetic and non-diabetic patients with periodontitis. METHODS One hundred and twenty-eight patients with periodontitis (64 with and 64 without type-2 diabetes mellitus, respectively) were included. In the test- and control-groups, patients underwent SRP with and without aPDT, respectivey. In both groups, plaque and gingival indices (PI and GI), probing depth (PD), clinical attachment loss (CAL), marginal bone loss (MBL) and GCF volume and cortisol levels were assessed at baseline and three and six-months after SRP with or without aPDT. The aPDT was performed at baseline using methylene blue and photobiomodulation. The Kruskall-Wallis test was used to assess data normality; and group-comparisons were done. P-values, which were below 0.01 indicated statistical significance. RESULTS Sixty-four type-2 diabetic patients with and 64 non-diabetic patients with periodontitis were included. All individuals had Stage-III/Grade-C periodontitis. Among patients with type-2 diabetes mellitus (DM), there was no statistically significant difference in hemoblobin A1c, PI, GI, PD, CAL and MBL at baseline and at 3- and 6-months intervals. Amongst diabetic patietns, there was no difference in the GCF volume and cortisol levels in the test- and control-groups at all time intervals. In non-diabetic patients, there was a significqnt reductionin GCF volume and cortisol levels when SRP was done with aPDT than when SRP was carried out as the sole treatment strategy CONCLUSION: Among non-diabetic patients, SRP with aPDT helps reduce periodontal inflammation and GCF cortisol levels for up to 6-months; however poorly-controlled DM compromises the beneficial effects of this treatment strategy.
Collapse
Affiliation(s)
- Abeer S Al-Zawawi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ishfaq A Bukhari
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fernanda O Bello-Correa
- Department of Dentistry, Life Sciecnes Institute, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
| | - Saeed A Sheikh
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Refal Albaijan
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| |
Collapse
|
21
|
Enigk K, Jentsch H, Rodloff AC, Eschrich K, Stingu CS. Activity of five antimicrobial peptides against periodontal as well as non-periodontal pathogenic strains. J Oral Microbiol 2020; 12:1829405. [PMID: 33133417 PMCID: PMC7580719 DOI: 10.1080/20002297.2020.1829405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Due to the increasing emergence of multi-resistant bacteria the search for alternative antimicrobial substances is of high interest. Promising agents are antimicrobial peptides which are host defense molecules of the innate immune system in a wide range of different species. Objectives: The aim of this study was to assess the activity of nisin, melittin, lactoferrin, parasin-1 and LL-37 against 35 oral bacteria and Candida albicans employing the gold standard method for anaerobic susceptibility testing. Methods: The activity of the peptides was determined by an agar dilution method under anaerobic and aerobic conditions. The test media contained final peptide concentrations between 0.125 µg/ml and 8 µg/ml (melittin, lactoferrin, parasin-1, LL-37) and between 0.125 µg/ml and 128 µg/ml (nisin). Results: Nisin completely inhibited the growth of Megasphaera sp., Bifidobacterium longum, Parvimonas micra, Actinomyces israelii, Actinomyces naeslundii, Actinomyces odontolyticus, Prevotella intermedia, Streptococcus anginosus, Streptococcus constellatus and Staphylococcus aureus. Melittin and lactoferrin reduced the growth of Megasphaera sp., P. micra, B. longum (melittin) and Selenomonas flueggei (lactoferrin). Parasin-1 and LL-37 showed no activity. Conclusion: AMPs, especially nisin and to a smaller degree lactoferrin, might be promising alternatives to antibiotics because of their antimicrobial activity, high resistance to environmental conditions and partially low costs.
Collapse
Affiliation(s)
- Katharina Enigk
- Institute for Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital of Leipzig, Leipzig, Germany
| | - Holger Jentsch
- Center for Periodontology, Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Arne C. Rodloff
- Institute for Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital of Leipzig, Leipzig, Germany
| | - Klaus Eschrich
- Institute of Biochemistry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Catalina-Suzana Stingu
- Institute for Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital of Leipzig, Leipzig, Germany
| |
Collapse
|
22
|
Delatola C, Loos BG, Laine ML. Three periodontitis phenotypes: Bone loss patterns, antibiotic-surgical treatment and the new classification. J Clin Periodontol 2020; 47:1371-1378. [PMID: 32767568 PMCID: PMC7693056 DOI: 10.1111/jcpe.13356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 07/03/2020] [Accepted: 07/27/2020] [Indexed: 12/18/2022]
Abstract
AIM To compare three periodontitis clusters (A, B and C) for alveolar bone loss (ABL) patterns, antibiotic prescriptions and surgeries and to relate them to the new classification of periodontitis. MATERIALS AND METHODS ABL patterns, prescription of systemic antibiotics and the number of surgeries were retrieved for all patients (n = 353) in the clusters. Comparisons and possible predictors for antibiotics were assessed, and results also evaluated in relation to the new classification. RESULTS Cluster A is characterized by angular defects often affecting the first molars and localized stage III/IV grade C periodontitis. Cluster B contains mainly localized or generalized stage III/IV, grade C patients. Cluster C contains mainly patients with generalized stage III/IV grade C periodontitis. Patients in cluster A received significantly more antibiotics compared to B and C (78% vs. 23% and 17%); the predictors for antibiotic prescription were young age and localized ABL. No differences in numbers of periodontal surgeries were observed between clusters (A = 1.0 ± 1.4, B = 1.3 ± 1.4 and C = 1.3 ± 1.5). CONCLUSIONS Within stage III/IV grade C periodontitis, we could detect three clusters of patients. The distinct localized ABL pattern and younger age in cluster A presumably prompted clinicians to prescribe antibiotics.
Collapse
Affiliation(s)
- Chryssa Delatola
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Nammour S, El Mobadder M, Maalouf E, Namour M, Namour A, Rey G, Matamba P, Matys J, Zeinoun T, Grzech-Leśniak K. Clinical Evaluation of Diode (980 nm) Laser-Assisted Nonsurgical Periodontal Pocket Therapy: A Randomized Comparative Clinical Trial and Bacteriological Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 39:10-22. [PMID: 32865464 DOI: 10.1089/photob.2020.4818] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Mechanical debridement is the gold standard in the periodontitis therapy. However, it is suggested that adjunctive use of lasers can result in a more effective treatment outcome. Objective: Evaluate the efficiency of diode laser-assisted nonsurgical therapy of periodontitis as adjunctive to scaling and root planing (SRP). Methods: One hundred sixty vertical bone defects [pocket depth (PD) at baseline ≥6 mm] had been randomly allocated to receive SRP alone (group C) or SRP coupled to a diode laser (980 nm) protocol (group C+L): SRP, irrigation with hydrogen peroxide solution (3%), de-epithelization of the internal and external gingiva followed by blood stabilization, and coagulation by laser beam were made. Beam parameters: 10 μsec/pulse duration, 10 kHz, pick power of 10 W, average power of 1 W, and fiber diameter of 400 μm. Plaque index (PI), bleeding on probing, gingival recession (GR), clinical attachment level (CAL), and PD were measured at baseline, at 6 weeks, 12 weeks, 18 weeks, 6 months, and 12 months. Microbiological data were collected randomly from 26 pockets from both groups at baseline, 6 weeks, 12 weeks, and 6 months after treatment. Results: At all periods of follow-up, there was a significant difference between both groups in all clinical parameters except in GR. In group C+L, 76% of pockets had PD ≤3 mm after 12 months of follow-up and an average of PD = 1.77 ± 0.46 mm, while 56% of pockets in group control (C) had an average of PD = 5.00 ± 0.83 mm after 12 months of follow-up. Total bacteria count in group C + L was significantly lower compared to group C only at 12 weeks and 6 months of follow-up. Furthermore, there was high significant decrease in the number of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia at all the follow-up periods. Conclusions: As adjunctive to SRP, diode laser-assisted nonsurgical therapy of periodontitis has significantly improved clinical parameters of PI and POB and has significantly reduced the clinical attachment loss (CAL) and PD compared to the control group after 1 year of follow-up. A significant reduction in periodontal pathogens has been observed in group C + L only at 12 weeks and 6 months of follow-up.
Collapse
Affiliation(s)
- Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Marwan El Mobadder
- Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Elie Maalouf
- Faculty of Dentistry, Lebanese University, Beirut, Lebanon
| | - Melanie Namour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Amaury Namour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Gerard Rey
- Service formation continue Universités Paris 7 Garancière et Montpellier UFR, Agde, France
| | - Patrick Matamba
- Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Jacek Matys
- Laser Laboratory, Department of Dental Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Toni Zeinoun
- Faculty of Dentistry, Lebanese University, Beirut, Lebanon
| | - Kinga Grzech-Leśniak
- Laser Laboratory, Department of Dental Surgery, Wroclaw Medical University, Wroclaw, Poland.,Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
24
|
Shi SW, Jiao J, Zhang L, Lu RF, Meng HX, Cao ZQ, Shi D, Song Y. Influence of local anesthesia on the outcomes of non-surgical periodontal treatment. Chin Med J (Engl) 2020; 133:1908-1914. [PMID: 32826453 PMCID: PMC7462207 DOI: 10.1097/cm9.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes. METHODS Data from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared. RESULTS A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P < 0.001). A significantly higher probability of decreases was found in the LA group in BI (percentages of teeth with BI > 1 and BI > 2) for all teeth (16.7% vs. 13.8%, t = 3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm. CONCLUSIONS LA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.
Collapse
Affiliation(s)
- Shu-Wen Shi
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Jian Jiao
- Department of Periodontology, Peking University Hospital of Stomatology First Clinic Division, Beijing 100034, China
| | - Li Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Rui-Fang Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Huan-Xin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhan-Qiang Cao
- Information Center, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Dong Shi
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö 20213, Sweden
| |
Collapse
|
25
|
Coluzzi D, Anagnostaki E, Mylona V, Parker S, Lynch E. Do Lasers Have an Adjunctive Role in Initial Non-Surgical Periodontal Therapy? A Systematic Review. Dent J (Basel) 2020; 8:dj8030093. [PMID: 32824321 PMCID: PMC7558016 DOI: 10.3390/dj8030093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/31/2022] Open
Abstract
(1) Background: dental lasers have numerous applications for periodontal therapy which include surgical procedures of soft tissue and osseous structures, and non-surgical treatments such as pathogen reduction, removal of surface accretions, and photobiomodulation. The aim of this review was to evaluate the scientific literature to ascertain whether lasers have a beneficial role when used adjunctively in initial non-surgical periodontal therapy. (2) Methods: A PubMed search was performed specifically for randomized clinical trials where a dental laser was used adjunctively for initial periodontal therapy on human patients published from January 2010–April 2020. The first search identified 1294 eligible studies. After additional criteria and filters were applied, 20 manuscripts were included in this review. (3) Results: The chosen manuscripts reported on investigations into initial therapy for patients diagnosed with chronic periodontitis. After periodontal charting, conventional instrumentation such as hand and ultrasonic scaling was performed on all patients in the studies, and then a test group or groups of patients were treated adjunctively with a laser. That adjunctive laser group’s periodontal findings showed various degrees of improved health compared to the group treated with only conventional methods. (4) Conclusion: This systematic review found that 70% of the included studies reported significantly better outcomes in certain clinical parameters, but no improvement in others. The remaining 30% of the manuscripts reported no significant difference in any of the measurements. With consideration to correct parametry, lasers have an adjunctive role in initial non-surgical periodontal therapy.
Collapse
Affiliation(s)
- Donald Coluzzi
- School of Dentistry, University of California, San Francisco, CA 94143, USA
- Correspondence:
| | - Eugenia Anagnostaki
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Valina Mylona
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Steven Parker
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
- School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV 89106, USA
| |
Collapse
|
26
|
Song Y, Lin J, Zhang Z, Xu B, Bi L. Antimicrobial effect of photodynamic therapy using sinoporphyrin sodium and 390-400 nm light-emitting diode on Porphyromonas gingivalis in vitro. Lasers Med Sci 2020; 36:153-164. [PMID: 32621127 DOI: 10.1007/s10103-020-03067-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/09/2020] [Indexed: 01/10/2023]
Abstract
This study aims to investigate the effect of antimicrobial photodynamic therapy (a-PDT) using a novel combination of sinoporphyrin sodium (DVDMS) and light-emitting diode (LED) with a wavelength of 390-400 nm on Porphyromonas gingivalis in vitro. Absorption spectrum of DVDMS was determined by spectrometer for selecting suitable wavelength light source. The uptake of DVDMS by P. gingivalis was evaluated according to fluorescence intensity detected by a spectrometer. Then effects of DVDMS alone, 390-400 nm LED alone, and photodynamic therapy produced by 10, 20, 40, and 80 μg/mL DVDMS and 390-400 nm LED on the suspension of P. gingivalis were evaluated by counting the number of colony forming units (CFU) after incubation. In the experiment, the LED illumination time was 30, 60, 90, 120, 180, 240, and 360 s, respectively, and the corresponding energy density was 1, 2, 3, 4, 6, 8, and 12 J/cm2, respectively. According to the absorption spectrum of DVDMS, the 390-400-nm light emitted by the LED was selected as the light source. The fluorescence intensity of DVDMS on P. gingivalis increased significantly at 5 min, and with the extension of time, it decreased at 30 min. DVDMS alone did not produce a significant toxicity on P. gingivalis compared with PBS (p = 0.979). While 390-400 nm LED alone had a certain bactericidal effect on P. gingivalis, the bactericidal effect was more obvious as the light dose increased (p < 0.001). The effect of a-PDT produced by 20, 40, and 80 μg/mL DVDMS and 390-400 nm LED were significantly better than that of 390-400 nm LED alone (p < 0.05). Both DVDMS concentration and light dose could enchance the bactericidal effect. The strongest photo-killing effect was generated by 80 μg/mL DVDMS with 360 s illumination (energy density is 12 J/cm2), and the log reduction of bacteria was 5.69 ± 1.70. a-PDT using the combination of DVDMS with 390-400 nm LED shows promise as a new treatment modality for pathogens elimination in periodontal therapy.
Collapse
Affiliation(s)
- Yuqi Song
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China
| | - Jiang Lin
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China.,Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhiguo Zhang
- Department of Applied Physics, School of Instrument Science and Engineering, Harbin Institute of Technology, Harbin, China
| | - Bin Xu
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China
| | - Liangjia Bi
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China.
| |
Collapse
|
27
|
Trajano VCDC, Brasileiro CB, Henriques JADS, Cota LDM, Lanza CR, Cortés ME. Doxycycline encapsulated in β-cyclodextrin for periodontitis: a clinical trial. Braz Oral Res 2020; 33:e112. [PMID: 31939496 DOI: 10.1590/1807-3107bor-2019.vol33.0112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 04/08/2019] [Indexed: 11/22/2022] Open
Abstract
This clinical trial compared the efficacy of doxycycline (DOX) in β-cyclodextrin (DOX)/βCD) with DOX- alone in gel on thirty-three subjects with periodontitis. Patients were randomized to group 1 GI; 10% DOX + scaling and root planning (SRP); group 2 (GII (10% DOX /β-CD + SRP), and group 3 (GIII; SRP). Gels were applied in GI and GII at baseline (T0) and 30 days later (T1). Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and Visible Plaque Index (VPI) were evaluated at (T0), 30 days (T1) and 60 days after T0 (T2). Bone density was analyzed after 18 months (T3). GII showed the most significant reduction of PPD (2.62 mm; p <0.003), and greatest gain in CAL (2.54 mm p <0.003) at T2. BOP and the VPI had a strong reduction in all groups at T2 (p <0.05), both decreased by ≥5 times and 2 times, respectively, in all groups at T1. Bone density increased in all groups in radiographs (T3). The use of DOX encapsulated in β-CD gel with SRP resulted in significant improvements in clinical periodontal parameters; such molecular inclusion of doxycycline into β-CD in gel for local application is relatively simple and useful in dentistry.
Collapse
Affiliation(s)
| | - Cláudia Borges Brasileiro
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Jonathas Antônio de Souza Henriques
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Luís de Miranda Cota
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Célia Regina Lanza
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Maria Esperanza Cortés
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil
| |
Collapse
|
28
|
Tan OL, Safii SH, Razali M. Commercial Local Pharmacotherapeutics and Adjunctive Agents for Nonsurgical Treatment of Periodontitis: A Contemporary Review of Clinical Efficacies and Challenges. Antibiotics (Basel) 2019; 9:E11. [PMID: 31905889 PMCID: PMC7169417 DOI: 10.3390/antibiotics9010011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022] Open
Abstract
Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to provide insights into the clinical efficacy of local drug delivery and adjunctive agents used in nonsurgical management of periodontitis. Electronic (PubMed/MEDLINE, CENTRAL, and EMBASE) and bibliographic searches of past systematic reviews were carried out to identify previous publications on the topic. Only relevant literature and randomized controlled trials published in English were selected. In addition, a literature review was developed based on the selected articles. Experimental drugs or agents were excluded. This review highlights the clinically proven and commercially available therapeutic agents related to the management of periodontal disease with comparisons of their clinical efficacies and challenges. A vast array of commercial local pharmacotherapeutic agents had been clinically tested, but the methodologies and clinical results varied within and between each agent used, causing difficulty in drawing conclusions and providing support to the superiority of one agent over another. Considering the benefit-cost ratio with the modest clinical results, the long-term usefulness of these agents remains debatable.
Collapse
Affiliation(s)
- Oi Leng Tan
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Syarida Hasnur Safii
- Faculty of Dentistry, Department of Restorative Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| |
Collapse
|
29
|
Radafshar G, Movahedi Amiri M. Impact of One-Stage Full Mouth Disinfection and Periodontal Surgery on Oral Health-Related Quality of Life. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2019. [PMID: 31875175 DOI: 10.30476/dentjods.2019.77748.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Statement of the Problem Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited. Purpose This study sought to compare patients' perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment. Materials and Method A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21. Results 38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p< 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p< 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. Conclusion Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.
Collapse
Affiliation(s)
- Golpar Radafshar
- Dental Sciences Research Center, Dept. of Periodontology, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Marziyeh Movahedi Amiri
- Dental Sciences Research Center, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
30
|
The potential of dendrimer in delivery of therapeutics for dentistry. Heliyon 2019; 5:e02544. [PMID: 31687479 PMCID: PMC6820096 DOI: 10.1016/j.heliyon.2019.e02544] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/25/2019] [Accepted: 09/26/2019] [Indexed: 12/29/2022] Open
Abstract
Dendrimers are hyperbranched nanoparticle structures along with its surface modifications can to be used in dental biomaterials for biomimetic remineralisation of enamel and dentin. The review highlights the therapeutic applications of dendrimers in the field of dentistry. It addresses the possible mechanisms of enhancement of mechanical properties of adhesives and resins structure. Dendrimers due to its unique construction of possessing inner hydrophobic and outer hydrophilic structure can act as drug carrier for delivery of antimicrobial drugs for treatment of periodontal diseases and at peripheral dental implant areas. Dendrimers due to its hyperbranched structures can provides a unique drug delivery vehicle for delivery of a drug at specific site for sustained release for therapeutic effects. Thus, dendrimers can be one of the most important constituents which can be incorporated in dental biomaterials for better outcomes in dentistry.
Collapse
|
31
|
Sulijaya B, Yamada‐Hara M, Yokoji‐Takeuchi M, Matsuda‐Matsukawa Y, Yamazaki K, Matsugishi A, Tsuzuno T, Sato K, Aoki‐Nonaka Y, Takahashi N, Kishino S, Ogawa J, Tabeta K, Yamazaki K. Antimicrobial function of the polyunsaturated fatty acid KetoC in an experimental model of periodontitis. J Periodontol 2019; 90:1470-1480. [DOI: 10.1002/jper.19-0130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/26/2019] [Accepted: 05/14/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Benso Sulijaya
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Department of PeriodontologyFaculty of DentistryUniversitas Indonesia Jakarta Indonesia
| | - Miki Yamada‐Hara
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Research Center for Advanced Oral ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Mai Yokoji‐Takeuchi
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Yumi Matsuda‐Matsukawa
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Kyoko Yamazaki
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Aoi Matsugishi
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Takahiro Tsuzuno
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Keisuke Sato
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Yukari Aoki‐Nonaka
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Naoki Takahashi
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Research Center for Advanced Oral ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Shigenobu Kishino
- Division of Applied Life SciencesGraduate School of AgricultureKyoto University Kyoto Japan
| | - Jun Ogawa
- Division of Applied Life SciencesGraduate School of AgricultureKyoto University Kyoto Japan
| | - Koichi Tabeta
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| |
Collapse
|
32
|
Ivanaga CA, Miessi DMJ, Nuernberg MAA, Claudio MM, Garcia VG, Theodoro LH. Antimicrobial photodynamic therapy (aPDT) with curcumin and LED, as an enhancement to scaling and root planing in the treatment of residual pockets in diabetic patients: A randomized and controlled split-mouth clinical trial. Photodiagnosis Photodyn Ther 2019; 27:388-395. [PMID: 31301434 DOI: 10.1016/j.pdpdt.2019.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/26/2019] [Accepted: 07/08/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Residual pockets represent a risk factor for periodontal disease progression. Diabetes Mellitus (DM) may impair prognosis after cause-related therapy, mainly due to the chronic hyperglycemia that negatively influences tissue repair. This study evaluated the clinical efficacy of antimicrobial photodynamic therapy (aPDT) with curcumin (CUR) solution (100 mg/L) and LED irradiation (465-485 nm), as an adjunctive therapy to scaling and root planing (SRP), in the treatment of residual pockets in type 2 diabetic patients. METHODS Individuals with type 2 DM and chronic periodontitis presenting at least one residual pocket per quadrant were selected (n = 25). In each patient, all residual pockets with probing depth (PD) ≥5 mm and bleeding on probing (BOP) were allocated to receive, according to quadrant: 1) SRP (SRP group); 2) SRP and irrigation with CUR solution (100 mg/L) (CUR group); 3) SRP and LED irradiation (InGaN, 465-485 nm, 0.78 cm², 78 mW, 100 mW/cm², 60 s) (LED group); 4) SRP, irrigation with CUR solution (100 mg/L), one minute of pre-irradiation, and LED irradiation (InGaN, 465-485 nm, 60 s) (aPDT group). Clinical parameters of PD, gingival recession (GR), clinical attachment level (CAL), BOP and visible plaque index (PI) were evaluated at baseline, three and six months post-therapies. Differences between the examination periods in each group were analyzed by Friedman's test for non-parametric data, while parametric data were submitted to analysis of variance (One-way ANOVA), followed by Tukey's test. Intergroup comparisons were performed by Kruskal-Wallis test. RESULTS In an intergroup comparison, the mean values for PD, GR, CAL, BOP and PI were not different at baseline, three and six months (p > 0.05). The intragroup comparison evidenced reduction in PD and BOP in all treatment groups at three and six months (p < 0.05). Significant CAL gain was notable only for the aPDT and LED groups at three months in comparison to baseline data (p < 0.05). CONCLUSION Treatment of residual pockets in patients with type 2 DM through association of SRP with aPDT (CUR solution 100 mg/L and LED irradiation) or LED irradiation may yield short-term (three months) clinical benefits regarding CAL gain.
Collapse
Affiliation(s)
- Camila Ayumi Ivanaga
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Daniela Maria Janjacomo Miessi
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Marta Aparecida Alberton Nuernberg
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Marina Módolo Claudio
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Valdir Gouveia Garcia
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Leticia Helena Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
| |
Collapse
|
33
|
LOBÃO WALDERJ, CARVALHO ROSANACDE, LEITE SANDRAA, RODRIGUES VANDILSONP, BATISTA JOSÉEDUARDO, GOMES-FILHO ISAACS, PEREIRA ANTONIOL. Relationship between periodontal outcomes and serum biomarkers changes after non-surgical periodontal therapy. ACTA ACUST UNITED AC 2019; 91:e20170652. [DOI: 10.1590/0001-3765201920170652] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/10/2018] [Indexed: 11/22/2022]
|
34
|
Prevention of Periodontitis by the Addition of a Bactericidal Particulate Glass/Glass-Ceramic to a Dental Resin: A Pilot Study in Dogs. COATINGS 2018. [DOI: 10.3390/coatings8080259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the study is to evaluate, in a ligature-induced periodontitis model, the efficacy of a commercially available dental resin containing different antimicrobial glass/glass-ceramic additions (0–26 wt.%). It has been proved that a 26 wt.% glass addition to a conventional dental resin matrix does not alter neither its workability nor its adhesion to the surface of teeth; however, it does confer notable antimicrobial properties when tested in vitro. Moreover, in vivo tests in Beagle dogs demonstrated the prevention of bone loss in ligature-induced plaque accumulation around teeth. Particularly, the glass-ceramic filler resin composite has shown excellent antimicrobial control since it displays the same bone loss as that of the negative control. The results obtained in the present investigation have shown that a conventional dental resin containing a fraction of glass/glass-ceramic (≥26 wt.%) can prevent periodontitis, which is considered to be a most serious dental disease.
Collapse
|
35
|
Feres M, Retamal-Valdes B, Mestnik MJ, de Figueiredo LC, Faveri M, Duarte PM, Fritoli A, Faustino E, Souto MLS, de Franco Rodrigues M, Giudicissi M, Nogueira BCL, Saraiva L, Romito GA, Pannuti CM. The ideal time of systemic metronidazole and amoxicillin administration in the treatment of severe periodontitis: study protocol for a randomized controlled trial. Trials 2018; 19:201. [PMID: 29587808 PMCID: PMC5869787 DOI: 10.1186/s13063-018-2540-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 02/12/2018] [Indexed: 12/18/2022] Open
Abstract
Background The combination of systemic metronidazole (MTZ) and amoxicillin (AMX) with scaling and root planing (SRP) has shown to be an effective periodontal treatment. However, some essential issues associated with the use of these antibiotics remain unanswered, such as the ideal time of administration during the course of periodontal treatment. Although these agents are often prescribed after the healing phase of the SRP procedure, there is biological plausibility to support its use in conjunction with the mechanical treatment. However, to date, no placebo controlled randomized clinical trial (RCT) has directly compared these two protocols. Therefore, the aim of this RCT is to compare the clinical, microbiological and immunological effects of the adjunctive systemic MTZ + AMX administered in different phases of the treatment of severe periodontitis. Methods Subjects with severe periodontitis (n = 180) are being randomly assigned into three groups (n = 60/group): (i) SRP-only (control group), SRP in combination with 400 mg MTZ + 500 mg AMX, starting (ii) at the first SRP session (active phase group), or (iii) after 3 months of its completion (healing phase group). All volunteers are receiving clinical and microbiological evaluation at baseline, 3, 6 and 12 months, and immunological assessment at baseline and 12 months post-therapy. Nine subgingival biofilm samples are being collected per subject and analyzed for counts and proportions of 40 bacterial species by checkerboard DNA-DNA hybridization, and six gingival crevicular fluid samples are being collected and analyzed for the levels of 20 chemokines by multiplex immunoassay. The primary outcome variable is the number of volunteers reaching the clinical endpoint for treatment (≤ 4 sites with probing depth ≥5 mm) at 1 year post-therapy. Differences in clinical, microbiological and immunological parameters among groups and over time will be evaluated using analysis of variance, analysis of covariance and the Chi-square and Tukey tests. Microbiological and immunological analyses will be performed using adjustments for multiple comparisons. Statistical significance will be set at 5%. Trial registration ClinicalTrials.gov, NCT02954393. Registered on 3 November 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2540-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
| | - Belén Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Maria Josefa Mestnik
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | - Marcelo Faveri
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Poliana M Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Aretuza Fritoli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Elisangela Faustino
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Maria Luisa Silveira Souto
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Michelle de Franco Rodrigues
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Marcela Giudicissi
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Bárbara Campos Lara Nogueira
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Luciana Saraiva
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Giuseppe Alexandre Romito
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Cláudio Mendes Pannuti
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| |
Collapse
|
36
|
Short-term effects of adjunctive antimicrobial photodynamic therapy in obese patients with chronic periodontitis: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2018; 21:10-15. [DOI: 10.1016/j.pdpdt.2017.10.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 12/12/2022]
|
37
|
Microbiological analysis and the outcomes of periodontal treatment with or without adjunctive systemic antibiotics—a retrospective study. Clin Oral Investig 2018; 22:3031-3041. [DOI: 10.1007/s00784-018-2392-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 02/14/2018] [Indexed: 02/06/2023]
|
38
|
Al-Hamoudi N, Abduljabbar T, Mirza S, Al-Sowygh ZH, Vohra F, Javed F, Akram Z. Non-surgical periodontal therapy reduces salivary adipocytokines in chronic periodontitis patients with and without obesity. ACTA ACUST UNITED AC 2018; 9:e12314. [DOI: 10.1111/jicd.12314] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/08/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Sana Mirza
- Department of Oral Pathology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| | - Zeyad H. Al-Sowygh
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; New York NY USA
| | - Zohaib Akram
- Department of Periodontology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| |
Collapse
|
39
|
Activity of taurolidine gels on ex vivo periodontal biofilm. Clin Oral Investig 2017; 22:2031-2037. [DOI: 10.1007/s00784-017-2297-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/06/2017] [Indexed: 12/27/2022]
|
40
|
Meseli SE, Kuru B, Kuru L. Relationships between initial probing depth and changes in the clinical parameters following non-surgical periodontal treatment in chronic periodontitis. J Istanb Univ Fac Dent 2017; 51:11-17. [PMID: 29114425 PMCID: PMC5624140 DOI: 10.17096/jiufd.40993] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 09/22/2016] [Indexed: 12/26/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the relationship between initial probing depth (IPD) and changes in clinical parameters following
non-surgical periodontal treatment (NPT) in chronic periodontitis patients. Subjects and Methods: A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT
consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD), clinical attachment level, gingival recessions
(GR) were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth. Results: Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001). Attachment gains (AG) were
significant in all single-rooted teeth (p<0.001) again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm≤IPD≤9mm
(p<0.05). Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001). Furthermore, positive correlations
were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001), but there was no correlation between IPD and AG. Conclusion: NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.
Collapse
Affiliation(s)
- Suleyman Emre Meseli
- Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University Turkey
| | - Bahar Kuru
- Department of Periodontology, Faculty of Dentistry, Yeditepe University Turkey
| | - Leyla Kuru
- Department of Periodontology, Faculty of Dentistry, Marmara University Turkey
| |
Collapse
|
41
|
Baek K, Ji S, Choi Y. Complex Intratissue Microbiota Forms Biofilms in Periodontal Lesions. J Dent Res 2017; 97:192-200. [PMID: 28945499 DOI: 10.1177/0022034517732754] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Periodontitis is caused by dysbiotic subgingival bacterial communities that may lead to increased bacterial invasion into gingival tissues. Although shifts in community structures associated with transition from health to periodontitis have been well characterized, the nature of bacteria present within the gingival tissue of periodontal lesions is not known. To characterize microbiota within tissues of periodontal lesions and compare them with plaque microbiota, gingival tissues and subgingival plaques were obtained from 7 patients with chronic periodontitis. A sequencing analysis of the 16S rRNA gene revealed that species richness and diversity were not significantly different between the 2 groups. However, intersubject variability of intratissue communities was smaller than that of plaque communities. In addition, when compared with the plaque communities, intratissue communities were characterized by decreased abundance of Firmicutes and increased abundance of Fusobacteria and Chloroflexi. In particular, Fusobacterium nucleatum and Porphyromonas gingivalis were highly enriched within the tissue, composing 15% to 40% of the total bacteria. Furthermore, biofilms, as visualized by alcian blue staining and atomic force microscopy, were observed within the tissue where the degradation of connective tissue fibers was prominent. In conclusion, very complex bacterial communities exist in the form of biofilms within the gingival tissue of periodontal lesions, which potentially serve as a reservoir for persistent infection. This novel finding may prompt new research on therapeutic strategies to treat periodontitis.
Collapse
Affiliation(s)
- K Baek
- 1 Department of Immunology and Molecular Microbiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - S Ji
- 2 Department of Periodontology, Anam Hospital, Korea University, Seoul, Korea.,3 Department of Periodontology, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Y Choi
- 1 Department of Immunology and Molecular Microbiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| |
Collapse
|
42
|
Laleman I, Cortellini S, De Winter S, Rodriguez Herrero E, Dekeyser C, Quirynen M, Teughels W. Subgingival debridement: end point, methods and how often? Periodontol 2000 2017; 75:189-204. [DOI: 10.1111/prd.12204] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
43
|
Cobb CM. Lasers and the treatment of periodontitis: the essence and the noise. Periodontol 2000 2017; 75:205-295. [DOI: 10.1111/prd.12137] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
44
|
Jepsen K, Jepsen S. Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis. Periodontol 2000 2017; 71:82-112. [PMID: 27045432 DOI: 10.1111/prd.12121] [Citation(s) in RCA: 179] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 02/06/2023]
Abstract
This review gives an update of the current scientific evidence on the efficacy of the adjunctive use of systemic and local antibiotics/antimicrobials in the treatment of periodontitis. In particular, it addresses whether their use can improve the results of nonsurgical mechanical therapy in mild-to-moderate forms of the disease. Large numbers of randomized clinical trials and systematic reviews with meta-analyses have clearly established that adjunctive systemic antibiotics, combined with mechanical debridement, offer clinical improvements additional to those obtained with scaling and root planing alone. These effects are more pronounced in aggressive periodontitis and in initially deep pockets, whereas more limited additional improvements, of 0.3 mm for additional pocket reduction and 0.2 mm for additional clinical attachment gain, have been documented for moderately deep sites (4-6 mm) in patients with chronic periodontitis. The marginal clinical benefit in patients with moderate disease has to be balanced against possible side effects. Notably, it has to be realized that an increasing number of warnings have been articulated against the unrestricted use of antibiotics in treating periodontal diseases because of the emerging global public health issue of bacterial resistance. The effects of the adjunctive local administration of antimicrobials have also been very well documented in several systematic reviews. Overall, in persistent or recurrent localized deep sites, the application of antimicrobials by sustained-delivery devices may offer a benefit of an additional 0.4 mm in pocket depth reduction and 0.3 mm in clinical attachment level gain. In conclusion, the slight additional benefits of adjunctive antimicrobials, which were shown for moderate forms of periodontitis, have to be balanced against their side effects and therefore their prescription should be limited as much as possible.
Collapse
|
45
|
Apicella A, Heunemann P, Dejace L, Marascio M, Plummer CJG, Fischer P. Scaffold requirements for periodontal regeneration with enamel matrix derivative proteins. Colloids Surf B Biointerfaces 2017; 156:221-226. [PMID: 28531879 DOI: 10.1016/j.colsurfb.2017.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 11/18/2022]
Abstract
Periodontitis affects the attachment of natural teeth, and infection or inflammation associated with periodontitis may affect peri-implant tissues. Enamel matrix derivative (EMD) proteins provide stimulation for self-regeneration of the damaged tissue when applied to wide intrabony defects as part of a mixture with bone graft material. As a first step of the process enhancing cell proliferation and ligament formation, we demonstrated that EMD protein precipitation depends strongly on the physical and chemical characteristics of the bone grafts used in the mixture. To guarantee optimum protein-stimulated self-regulation, the pH of the initial EMD formulation must therefore be adjusted between 3.9 and 4.2 in order to compensate the change in pH induced by the bone graft. Moreover, the interaction between the two components resulted in precipitates of different shape and size differently covering the grafts. This outcome might potentially have clinical implications on cell attachment and periodontal ligament extension, which deserve further in vitro and in vivo tests.
Collapse
Affiliation(s)
- Alessandra Apicella
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Peggy Heunemann
- Institute of Food, Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
| | - Laurent Dejace
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Matteo Marascio
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Christopher J G Plummer
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.
| | - Peter Fischer
- Institute of Food, Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland.
| |
Collapse
|
46
|
Van der Sluijs M, Van der Sluijs E, Van der Weijden F, Slot DE. The effect on clinical parameters of periodontal inflammation following non-surgical periodontal therapy with ultrasonics and chemotherapeutic cooling solutions: a systematic review. J Clin Periodontol 2016; 43:1074-1085. [DOI: 10.1111/jcpe.12613] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Marjolein Van der Sluijs
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Eveline Van der Sluijs
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Fridus Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| |
Collapse
|
47
|
Pinto G, Silva MD, Peddey M, Sillankorva S, Azeredo J. The role of bacteriophages in periodontal health and disease. Future Microbiol 2016; 11:1359-1369. [PMID: 27633580 DOI: 10.2217/fmb-2016-0081] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The human periodontium health is commonly compromised by chronic inflammatory conditions and has become a major public health concern. Dental plaque, the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea, protozoa, fungi and viruses. Viruses that specifically infect bacteria - bacteriophages - are most common in the oral cavity. Despite this, their role in the progression of periodontal disease remains poorly explored. This review aims to summarize how bacteriophages interact with the oral microbiota, their ability to increase bacterial virulence and mediate the transfer of resistance genes and suggests how bacteriophages can be used as an alternative to the current periodontal disease therapies.
Collapse
Affiliation(s)
- Graça Pinto
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Maria Daniela Silva
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Mark Peddey
- Mark Peddey Pty Ltd, 65 Glenhuntly Road, Elwood, VIC, Australia
| | - Sanna Sillankorva
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Joana Azeredo
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| |
Collapse
|
48
|
Hans VM, Grover HS, Deswal H, Agarwal P. Antimicrobial Efficacy of Various Essential Oils at Varying Concentrations against Periopathogen Porphyromonas gingivalis. J Clin Diagn Res 2016; 10:ZC16-ZC19. [PMID: 27790572 DOI: 10.7860/jcdr/2016/18956.8435] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 06/23/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Porphyromonas gingivalis (P.gingivalis) is a notorious perio-pathogen with the ability to evade host defense mechanism and invade into the periodontal tissues. Many antimicrobial agents have been tested that curb its growth, although these agents tend to produce side effects such as antibiotic resistance and opportunistic infections. Therefore search for naturally occurring anti-microbials with lesser side effects is the need of the hour. AIM The aim of this study was to substantiate the antimicrobial activity of various essential oils; eucalyptus oil, chamomile oil, tea tree oil and turmeric oil against P. gingivalis. MATERIALS AND METHODS Pure cultures of P. gingivalis were grown on selective blood agar. Antimicrobial efficacy of various concentrations of essential oils (0%, 25%, 50% and 100%) was assessed via disc diffusion test. Zone of inhibition were measured around disc after 48 hours in millimeters. RESULTS Zones of inhibition were directly proportional to the concentration of essential oils tested. At 100% concentration all the tested oils possess antimicrobial activity against P.gingivalis with eucalyptus oil being most effective followed by tea tree oil, chamomile oil and turmeric oil. CONCLUSION All essential oils tested were effective against P.gingivalis. After testing for their clinical safety they could be developed into local agents to prevent and treat periodontitis.
Collapse
Affiliation(s)
- Veenu Madaan Hans
- Reader, Department of Periodontology, Faculty of Dental Sciences, SGT University , Gurgaon, Delhi-NCR, India
| | - Harpreet Singh Grover
- Professor, Department of Periodontology, Faculty of Dental Sciences, SGT University , Gurgaon, Delhi-NCR, India
| | - Himanshu Deswal
- Post Graduate Student, Department of Periodontology, Faculty of Dental Sciences, SGT University , Gurgaon, Delhi-NCR, India
| | - Preeti Agarwal
- Microbiologist, Department of Microbiology, Faculty of Medicine and Health Sciences, SGT University , Gurgaon, Delhi-NCR, India
| |
Collapse
|
49
|
Dakic A, Boillot A, Colliot C, Carra MC, Czernichow S, Bouchard P. Detection of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans after Systemic Administration of Amoxicillin Plus Metronidazole as an Adjunct to Non-surgical Periodontal Therapy: A Systematic Review and Meta-Analysis. Front Microbiol 2016; 7:1277. [PMID: 27594851 PMCID: PMC4990718 DOI: 10.3389/fmicb.2016.01277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/02/2016] [Indexed: 12/29/2022] Open
Abstract
Objective: To evaluate the variations in the detection of Porphyromonas gingivalis and/or Aggregatibacter actinomycetemcomitans before and after systemic administration of amoxicillin plus metronidazole in association with non-surgical periodontal therapy (NSPT). Background: The adjunctive use of antibiotics has been advocated to improve the clinical outcomes of NSPT. However, no systematic review has investigated the microbiological benefit of this combination. Materials and Methods: An electronic search was conducted up to December 2015. Randomized clinical trials comparing the number of patients testing positive for P. gingivalis and/or A. actinomycetemcomitans before and after NSPT with (test group) or without (control group) amoxicillin plus metronidazole were included. The difference between groups in the variation of positive patients was calculated using the inverse variance method with a random effects model. Results: The frequency of patients positive for A. actinomycetemcomitans was decreased by 30% (p = 0.002) and by 25% (p = 0.01) in the test group compared to the control group at 3- and 6-month follow-up, respectively. Similar findings were observed when considering the frequency of patients positive for Porphyromonas gingivalis, with a reduction by 28% (p < 0.0001), 32% (p < 0.0001), and 34% (p = 0.03) in the test group compared to the control group at 3-, 6-, and 12-month follow-up, respectively. Conclusion: The systemic administration of amoxicillin plus metronidazole as an adjunct to NSPT significantly decreased the number of patients positive for P. gingivalis and A. actinomycetemcomitans compared with periodontal therapy alone or with a placebo.
Collapse
Affiliation(s)
- Aleksandar Dakic
- Department of Periodontology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, Paris Diderot University Paris, France
| | - Adrien Boillot
- Department of Periodontology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, Paris Diderot UniversityParis, France; UMS 011, Population-based Epidemiologic Cohorts Unit, Institut National de la Santé et de la Recherche MédicaleVillejuif, France
| | - Cyrille Colliot
- Department of Periodontology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, Paris Diderot University Paris, France
| | - Maria-Clotilde Carra
- Department of Periodontology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, Paris Diderot UniversityParis, France; UMS 011, Population-based Epidemiologic Cohorts Unit, Institut National de la Santé et de la Recherche MédicaleVillejuif, France
| | - Sébastien Czernichow
- UMS 011, Population-based Epidemiologic Cohorts Unit, Institut National de la Santé et de la Recherche MédicaleVillejuif, France; Department of Nutrition, Hôpital Européen Georges Pompidou, AP-HP, Paris Descartes UniversityParis, France
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, Paris Diderot UniversityParis, France; EA 2496, U.F.R. of Odontology, Paris Descartes UniversityMontrouge, France
| |
Collapse
|
50
|
Freire MO, Devaraj A, Young A, Navarro JB, Downey JS, Chen C, Bakaletz LO, Zadeh HH, Goodman SD. A bacterial-biofilm-induced oral osteolytic infection can be successfully treated by immuno-targeting an extracellular nucleoid-associated protein. Mol Oral Microbiol 2016; 32:74-88. [PMID: 26931773 DOI: 10.1111/omi.12155] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2016] [Indexed: 02/06/2023]
Abstract
Periodontal disease exemplifies a chronic and recurrent infection with a necessary biofilm component. Mucosal inflammation is a hallmark response of the host seen in chronic diseases, such as colitis, gingivitis, and periodontitis (and the related disorder peri-implantitis). We have taken advantage of our recently developed rat model of human peri-implantitis that recapitulates osteolysis, the requirement of biofilm formation, and the perpetuation of the bona fide disease state, to test a new therapeutic modality with two novel components. First we used hyperimmune antiserum directed against the DNABII family of proteins, now known to be a critical component of the extracellular matrix of bacterial biofilms. Second we delivered the antiserum as cargo in biodegradable microspheres to the site of the biofilm infection. We demonstrated that delivery of a single dose of anti-DNABII in poly(lactic-co-glycolic acid) (PLGA) microspheres induced significant resolution of experimental peri-implantitis, including marked reduction of inflammation. These data support the continued development of a DNABII protein-targeted therapeutic for peri-implantitis and other chronic inflammatory pathologies of the oral cavity in animals and humans.
Collapse
Affiliation(s)
- M O Freire
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, USA.,Department of Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - A Devaraj
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - A Young
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - J B Navarro
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - J S Downey
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - C Chen
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - L O Bakaletz
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - H H Zadeh
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.,Laboratory for Immunoregulation and Tissue Engineering (LITE), University of Southern California, Los Angeles, CA, USA
| | - S D Goodman
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| |
Collapse
|