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Laky M, Laky B, Arslan M, Lettner S, Müller M, Haririan H, Husejnagic S, Rausch-Fan X, Wimmer G, Moritz A, Gregor R. Effectiveness of a 655-nm InGaAsP diode laser to detect subgingival calculus in patients with periodontal disease. J Periodontol 2020; 92:547-552. [PMID: 32786077 DOI: 10.1002/jper.19-0663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/24/2020] [Accepted: 07/13/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Previous in vitro studies have proven laser fluorescence measurement using a 655-nm Indium Gallium Arsenide Phosphide (InGaAsP) based diode laser radiation to be a useful tool to detect subgingival calculus. The aim of this prospective study was to evaluate the 655-nm InGaAsP diode laser in detecting subgingival calculus in patients with periodontal disease compared with photographic assessment during periodontal surgery. METHODS Twelve patients (six women, six men) aged between 21 and 75 years with periodontitis scheduled for periodontal surgery were included in this prospective study. All laser fluorescence measurements were made before periodontal surgery. Intraoperatively a mucoperiostal flap was performed, subgingival calculus was visualized, and photographic images were taken. The presence of calculus was recorded for each evaluated site. RESULTS A total of 115 tooth surface sites of 32 teeth from the 12 patients were evaluated before (laser) and during surgery (image). Compared with image evaluation the laser assessment showed a sensitivity of 0.70 (CI0 .025 0.53 to CI0.975 0.83) and a specificity of 0.97 (CI0.025 0.85 to CI0.975 0.99). The overall probability to correctly detect subgingival calculus with the laser (accuracy) was 0.82 (CI0.025 0.74 to CI0.975 0.88). CONCLUSIONS The 655-nm diode laser was able to detect subgingival calculus. Hence, the 655 nm diode laser may be used as an additional tool for calculus detection in non-surgical periodontal therapy.
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Affiliation(s)
- Markus Laky
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Brenda Laky
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Muazzez Arslan
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Michael Müller
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Hady Haririan
- Department of Periodontology, Medical Faculty, Sigmund Freud Private University Vienna, Vienna, Austria
| | - Selma Husejnagic
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Gernot Wimmer
- Division of Restorative Dentistry, Periodontology and Prosthodontics, Medical University of Graz, Graz, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
| | - Rene Gregor
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Dassatti L, Manicone PF, Lauricella S, Pastorino R, Filetici P, Nicoletti F, D'Addona A. A comparative scanning electron microscopy study between the effect of an ultrasonic scaler, reciprocating handpiece, and combined approach on the root surface topography in subgingival debridement. Clin Exp Dent Res 2020; 6:470-477. [PMID: 32573120 PMCID: PMC7453770 DOI: 10.1002/cre2.299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/08/2020] [Accepted: 04/16/2020] [Indexed: 01/06/2023] Open
Abstract
Objective This study aimed to analyze the effectiveness of root‐shape inserts mounted on a reciprocating handpiece during the procedure of root surface debridement (RSD) on extracted teeth. Three different approaches were compared: ultrasonic scaling, employment of root‐shape inserts mounted on a reciprocating handpiece, and a combination of both. Materials and Methods A total of 51 extracted teeth were divided into three groups. The first group was instrumented with an ultrasonic scaler, the second group with flexible root‐shape inserts mounted on a reciprocating handpiece (grain size 40, 15, and 4 μm), whereas the final group underwent a combination of both approaches. The time required for the instrumentation was taken. The specimens were subjected to optical and scanning electron microscopy (SEM), and the photographs were evaluated by three examiners who were blinded to the study. The parameters included were: SEM roughness index (SRI) for the roughness calculation, remaining calculus Index (RCI) to evaluate the residual calculus deposits, and loss of tooth substance index (LTSI) to evaluate the loss of tooth substance caused by instrumentation. Result The results revealed that the time taken for the instrumentation was on average longer when the root‐shape inserts were employed alone, meanwhile the combined approach did not show significant difference in comparison with the ultrasonic scaling. The lower average RCI was obtained with a combined approach. The use of root‐shape inserts seems to cause a moderate increase in LTSI, especially in a combined approach, whereas it resulted in a better average SRI. Conclusion The employment of root‐shape inserts seems to be effective in the RSD for its ability to obtain a smooth and calculus‐free instrumented surface, especially when used in combination with an ultrasonic scaler, and their use can so represent a valid approach to be tested in further in vivo studies.
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Affiliation(s)
- Leonardo Dassatti
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Paolo Francesco Manicone
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Selenia Lauricella
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Pierfrancesco Filetici
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Fabrizio Nicoletti
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio D'Addona
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
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Megally A, Zekeridou A, Cancela J, Giannopoulou C, Mombelli A. Short ultrasonic debridement with adjunctive low-concentrated hypochlorite/amino acid gel during periodontal maintenance: randomized clinical trial of 12 months. Clin Oral Investig 2019; 24:201-209. [PMID: 31079243 DOI: 10.1007/s00784-019-02949-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/03/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the benefit of repeated subgingival cleaning with a low-concentrated hypochlorite/amino acid gel in subjects in maintenance care with residual pockets ≥ 5 mm. MATERIAL AND METHODS Examiner masked, randomized two-arm parallel design. Thirty-two adult periodontal patients in maintenance phase, > 3 months after periodontal therapy, with at least one residual periodontal pocket ≥ 5 mm, were randomly assigned to treatment by subgingival ultrasonic debridement with the gel or ultrasonic debridement only. At months 0, 4, and 8, all sites presenting with a probing depth (PD) ≥ 5 mm were treated. Six sites were monitored on each tooth. The primary end point was the presence or absence of PD ≥ 5 mm after 12 months. Secondary clinical outcomes were oral tissue safety; patient acceptance; changes in PD; bleeding on probing; recession after 4, 8, and 12 months; and the presence or absence of six target microorganisms in treated pockets at baseline, after 7 days and 4 months. RESULTS A total of 365 sites in 32 patients with PD ≥ 5 mm were treated at baseline. At the final evaluation at month 12, 47% of these sites in the test and 49% in the control group were still in this PD category. The difference between baseline and month 12 was significant in both groups (p < 0.01), whereas the difference between groups was not. Repeated short ultrasonic instrumentation with adjunctive administration of the test product resulted in a clinical attachment level (CAL) gain of 1.02 mm (p < 0.01) and led to - 0.97 mm of pocket reduction (p < 0.01) without inducing further recession. However, repeated short ultrasonic debridement without the gel led to a similar clinical outcome (p < 0.01). No adverse events were recorded. CONCLUSIONS Short ultrasonic instrumentation of residual pockets with PD ≥ 5 mm during maintenance visits resulted in a clinically relevant CAL gain and PD reduction in the order of 1 mm in 1 year, without inducing further recession. CLINICAL RELEVANCE This study corroborates the benefit of regular maintenance care after periodontal therapy, including short debridement of the residual pockets.
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Affiliation(s)
- Andrew Megally
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - Alkisti Zekeridou
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - José Cancela
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - Catherine Giannopoulou
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - Andrea Mombelli
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland.
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Hofer D, Meier A, Sener B, Guggenheim B, Attin T, Schmidlin PR. In vitro evaluation of a novel biofilm remover. Int J Dent Hyg 2014; 13:246-53. [PMID: 25421848 DOI: 10.1111/idh.12113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate a novel device for its efficacy in removing experimental biofilm from root surfaces and its potential for concomitantly removing/roughening the surface substance. METHODS AND MATERIALS A novel acrylic rotary device (biofilm remover, BR) was tested in vitro in three experiments: surface loss, surface roughness [positive controls: Perioset (PS) and Proxoshape (PR)] and biofilm removal [positive controls: ultrasonic (US) and PS]. Surface loss/surface roughness was evaluated for dentin samples instrumented for three 20 s periods. The calcium removed during instrumentation was analysed after each interval and cumulatively, using atomic absorption spectrophotometry (AAS). Surface roughness was measured using profilometric analysis. Biofilm removal was evaluated on dentin specimens coated with a 64.5 h 6-species in vitro formed biofilm, after one 20 s treatment. Surface loss was analysed using anova with Scheffé post hoc test, and surface roughness/biofilm removal was analysed using Mann-Whitney test (all P ≤ 0.05). RESULTS Significantly less substance loss [μg (± 1 SD)] was observed with the novel device at all time points, both interval and cumulative (1.0 (± 0.5) versus 9.3 (± 3.2) PS and 9.9 (± 1.9) PR at 60 s). Surface roughness [μm (95% CI)] was significantly lower for BR than for PS and PR [0.00 (-0.01, 0.08) 0.20 (0.16, 0.27) and 0.21 (0.19, 0.24) at 60 s]. Significantly less biofilm bacteria remained after treatment with both BR 4.5 (-0.1, 16.2) and US 1.9 (-0.2, 14.3), compared to PS 52 (27.9, 82.1). CONCLUSIONS The novel biofilm remover was less damaging to dentin surfaces, while removing biofilm at least as effectively as devices used in this study.
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Affiliation(s)
- D Hofer
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - A Meier
- Institute of Oral Biology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - B Sener
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - B Guggenheim
- Institute of Oral Biology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - T Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Abstract
Non-surgical periodontal treatment has traditionally been based on the notion that bacterial plaque (dental biofilm) penetrates and infects dental cementum. Removal of this infected cementum via scaling and root planing (SRP) was considered essential for re-establishing periodontal health. In the 1980s the concept of SRP was questioned because several in vitro studies showed that the biofilm was superficially located on the root surface and its disruption and removal could be relatively easily achieved by ultrasonic instrumentation of the root surface (known as root surface debridement (RSD). Subsequent in vivo studies corroborated the in vitro findings. There is now sufficient clinical evidence to substantiate the concept that the deliberate removal of cementum by SRP is no longer warranted or justified, and that the more gentle and conservative approach of RSD should be implemented in daily periodontal practice.
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Ioannou I, Dimitriadis N, Papadimitriou K, Sakellari D, Vouros I, Konstantinidis A. Hand instrumentationversusultrasonic debridement in the treatment of chronic periodontitis: a randomized clinical and microbiological trial. J Clin Periodontol 2009; 36:132-41. [DOI: 10.1111/j.1600-051x.2008.01347.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Christgau M, Männer T, Beuer S, Hiller KA, Schmalz G. Periodontal healing after non-surgical therapy with a new ultrasonic device: a randomized controlled clinical trial. J Clin Periodontol 2007; 34:137-47. [PMID: 17309588 DOI: 10.1111/j.1600-051x.2006.01031.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to compare the clinical and microbiological healing outcomes following non-surgical periodontal therapy using the new Vector ultrasonic system versus scaling and root planing (S/RP) with Gracey curettes. MATERIAL AND METHODS The study comprised 20 chronic periodontitis patients. Using a split-mouth design, both treatment modalities were randomly applied to one quadrant of the upper and the lower jaws each. Clinical and microbiological parameters were assessed at baseline, 4 weeks, and 6 months after treatment. Furthermore, post-operative hypersensitivity was assessed. The Wilcoxon signed rank test (alpha=0.05) was used for statistical analysis. RESULTS Both therapies provided statistically significant clinical and microbiological improvements of periodontal conditions after 4 weeks and 6 months. Hypersensitive teeth were found only 4 weeks after S/RP. Besides a significantly better bleeding on probing reduction in deep S/RP sites, no other clinical and microbiological parameters revealed significant differences between the sites treated with the Vector system or S/RP. CONCLUSION Both the Vector system and S/RP provided favourable periodontal healing results, although in deep pockets S/RP appeared to achieve a better resolution of inflammation.
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Affiliation(s)
- M Christgau
- Department of Operative Dentistry and Periodontology, University of Regensburg, Germany.
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Christgau M, Männer T, Beuer S, Hiller KA, Schmalz G. Periodontal healing after non-surgical therapy with a modified sonic scaler: a controlled clinical trial. J Clin Periodontol 2006; 33:749-58. [PMID: 16889629 DOI: 10.1111/j.1600-051x.2006.00981.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to compare the clinical and microbiological healing outcomes following non-surgical periodontal therapy using a modified sonic scaler system versus scaling and root planing (S/RP) with hand instruments. MATERIAL AND METHODS The study comprised 20 chronic periodontitis patients. Using a split-mouth design, both treatment modalities were randomly applied to one quadrant of the upper and lower jaws. Clinical and microbiological parameters were assessed at baseline, 4 weeks, and 6 months after treatment. Furthermore, post-operative hypersensitivity was investigated. The Wilcoxon signed-rank test (alpha = 0.05) was used for statistical analysis. RESULTS With both therapy methods, periodontal conditions showed statistically significant clinical and microbiological improvements after 4 weeks and 6 months. Hypersensitive teeth were found only 4 weeks after S/RP. Besides a significantly better bleeding on probing reduction in deep S/RP sites and less time required for root instrumentation by the sonic scaler, no other clinical and microbiological parameters revealed significant differences between sites treated with the sonic scaler or S/RP. CONCLUSION The sonic scaler system and S/RP seem to provide similarly favourable periodontal healing results, although in deep pockets S/RP appeared to achieve a better resolution of inflammation.
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Affiliation(s)
- M Christgau
- Department of Operative Dentistry and Periodontology, University of Regensburg, Regensburg, Germany.
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