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Zanatta FB, Antoniazzi RP, Oliveira LM, Lietzan AD, Miguez PA, Susin C. The efficacy of combining adjuvants with non-surgical periodontal therapy in individuals with type 2 diabetes: A Bayesian network meta-analysis. J Clin Periodontol 2024; 51:610-630. [PMID: 38342946 PMCID: PMC11023812 DOI: 10.1111/jcpe.13946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/24/2023] [Accepted: 01/01/2024] [Indexed: 02/13/2024]
Abstract
AIM This Bayesian network meta-analysis of randomized controlled trials assessed the effect of adjuvant periodontal treatment in both periodontal and HbA1c outcomes in adult individuals with type 2 diabetes (T2DM). MATERIALS AND METHODS A systematic search was done up to February 2023 comparing sub-gingival debridement (SD) in combination with local or systemic adjuvant treatment with SD alone for individuals with T2DM. The primary outcomes were changes in absolute HbA1c levels and full-mouth probing depth reported at 3- to 6-month post-treatment. RESULTS Seventy-two eligible publications evaluating 27 adjuvant treatments were retrieved. The combination of SD and systemic antibiotic metronidazole or SD and antioxidant alpha lipoic acid provided, respectively, 1.4% (95% credible interval [CrI] 0.48; 2.20) and 2.4% (95% CrI 1.50; 3.30) more significant improvement on HbA1c levels, and 0.89 mm (95% CrI 0.23; 1.50) and 0.92 mm (95% CrI 0.02; 0.92) greater periodontal probing depth reductions. Other adjuvant treatments provided added benefit to the periodontal outcomes without discernible effects on HbA1c. CONCLUSIONS Adjuvant use of metronidazole or alpha lipoic acid was the best adjunct option to provide clinically meaningful HbA1c levels and probing depth reductions. However, no strong recommendation can be drawn due to the scarcity of studies for each adjuvant treatment and the low certainty of the resultant evidence.
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Affiliation(s)
- Fabrício Batistin Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry - Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Raquel Pippi Antoniazzi
- Department of Stomatology, Postgraduate Program in Dentistry - Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Leandro Machado Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry - Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Adam D Lietzan
- Department of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Patricia A Miguez
- Department of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cristiano Susin
- Department of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Al-Aali KA, Alzaid AA, Alsaloum M, Alanazi KK, Almujel SH. Clinical, Bacterial, and Prosthodontic Parameters After Implant Abutment Disinfection Using Nd:YAG, Er,Cr:YSGG, Chlorhexidine, and Conventional Steam Before Prosthesis Delivery. Photobiomodul Photomed Laser Surg 2023; 41:703-709. [PMID: 38011738 DOI: 10.1089/photob.2023.0076] [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] [Indexed: 11/29/2023] Open
Abstract
Objective: This 1-year prospective clinical trial was designed to assess the microbial, clinical, radiographic, and prosthetic parameters after disinfection of the implant abutment connection using Er,Cr:YSGG (erbium, chromium-doped: yttrium, scandium, gallium, and garnet) and Nd:YAG (neodymium-doped yttrium, aluminum, garnet). Materials and methods: All the patients were divided into four groups; Group I: Nd:YAG laser, Group II: Er,Cr:YSGG laser, Group III: 0.2% chlorhexidine (CHx), and Group IV: steam disinfection. Peri-implant parameters assessed included peri-implant bleeding scores (PIBS), peri-implant plaque scores (PIPS), peri-implant pocket depth (PIPD), and crestal bone loss (CBL). The peri-implant plaque samples were acquired to perform microbiological analysis to assess Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, respectively. All measurements were completed at baseline, 6 months, and 12 months postsurgery. Multiple groups were compared with the help of the Bonferroni post-hoc adjustment test (p < 0.01). Logistic regression models were utilized to assess the association between age, oral hygiene practices (brushing and flossing), and duration of implant function. Results: At the baseline level, there were no discernible differences in the peri-implant parameters between the study groups (p > 0.05). At the 6-month (p < 0.01) and 12-month (p < 0.001) follow-ups, all four study groups demonstrated a significant improvement in PIPS and PIBS, with no significant differences between the groups at baseline (p > 0.05). Based on an intergroup comparison, Group I (Nd:YAG) showed a significant decrease in PIBS when compared with the other groups. Group II showed a considerable decrease in PIPD and enhancements in CBL when compared with Groups I, III, and IV (p < 0.01). At the 6- and 12-month follow-up periods, P. gingivalis and T. denticola reduction were found to be statistically higher in Group II, whereas P. gingivalis and T. forsythia mean log CFU/mL were found to be statistically higher in Group I. Conclusions: Nd:YAG and Er,Cr:YSGG lasers both outperformed CHx and steam disinfection in terms of clinical, peri-implant, and prosthetic results when used to clean implant abutments.
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Affiliation(s)
- Khulud A Al-Aali
- Prosthodontics, Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdulaziz A Alzaid
- Department of Restorative and Prosthetic Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammad Alsaloum
- Department of Restorative and Prosthetic Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Khalid K Alanazi
- Department of Conservative Dental Science, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Saad Hamad Almujel
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Oliveira VB, Costa FWG, Haas AN, Júnior RMM, Rêgo RO. Effect of subgingival periodontal therapy on glycaemic control in type 2 diabetes patients: Meta-analysis and meta-regression of 6-month follow-up randomized clinical trials. J Clin Periodontol 2023; 50:1123-1137. [PMID: 37257917 DOI: 10.1111/jcpe.13830] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/05/2023] [Accepted: 05/06/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Periodontitis worsens the hyperglycaemia in patients with type 2 diabetes mellitus (T2DM). Subgingival instrumentation, with or without surgical access, is the gold-standard treatment for periodontitis. The aim was to summarize the evidence on the effect of subgingival instrumentation (with or without open flap) on the reduction of glycosylated haemoglobin (HbA1c). METHODS Nine electronic databases were searched up to 15 February 2023. Twelve randomized controlled trials with at least 6 months of follow-up were included. Studies using systemic or local-delivery antimicrobial therapies were excluded. Meta-analyses were performed using the random-effects model. The sources of heterogeneity were assessed by applying linear meta-regression. Risk of bias was assessed by RoB 2, and certainty of evidence by GRADE. RESULTS Eleven studies were included in the quantitative analyses (1374 patients). Subgingival instrumentation resulted in 0.29% lower HbA1c (95% confidence interval: 0.10-0.47; p = .03) compared with non-active treatment. DISCUSSION None of the 12 studies were assessed as having low risk of bias. The percentage of females and the time of diabetes diagnosis significantly explained the high level of heterogeneity. Subgingival periodontal therapy results in a significant and clinically relevant improvement in glycaemic control over 6 months in patients with T2DM and periodontitis. The grade of evidence was moderate.
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Affiliation(s)
- Victor Bento Oliveira
- Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Fábio Wildson Gurgel Costa
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Alex Nogueira Haas
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rodrigo Otávio Rêgo
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
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Laser treatments as an adjunct to non-surgical periodontal therapy in subjects with periodontitis and type 2 diabetes mellitus: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:1311-1327. [PMID: 36849595 PMCID: PMC10101891 DOI: 10.1007/s00784-023-04873-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/22/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVES Periodontal disease and diabetes have an extensively investigated bidirectional correlation. Non-surgical periodontal treatment (NSPT) was proven to contribute to glycemic control. Moreover, it may benefit from the association of adjunctive therapies. The aim of the present systematic review is to assess the clinical efficacy of NSPT in association with laser (LT) or photodynamic therapy (PDT) in controlled or uncontrolled diabetic patients, and to grade the level of evidence. MATERIALS AND METHODS Randomized controlled clinical trials with at least 3-month follow-up were searched in MEDLINE via OVID, EMBASE, and Cochrane Central, screened for inclusion, and grouped based on the performed treatments, follow-up time, type of diabetes, and level of glycemic control. RESULTS Eleven RCTs with 504 total subjects were included. The adjunct of PDT showed a statistically significant 6-month difference in PD changes (with low certainty of evidence), but not in CAL changes, while a significant difference in 3-month PD and CAL changes was found with the adjunct of LT (low certainty of evidence). Patients treated with PDT registered a higher decrease in HbA1c levels at 3 months, but no significant difference was noted at 6 months; LT also led to better HbA1c changes at 3 months with a moderate certainty of evidence. CONCLUSION Despite the promising short-term HbA1c decrease, the results should be interpreted with caution due to the small effect sizes and the statistical heterogeneity, and further evidence from well-designed RCTs is needed to support the routine use of PDT or LT in adjunct to NSPT.
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Detection of invisible dental biofilm using light-induced autofluorescence in adult patients - a systematic review. Photodiagnosis Photodyn Ther 2022; 39:102916. [DOI: 10.1016/j.pdpdt.2022.102916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/20/2022]
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Is a single session of antimicrobial photodynamic therapy as an adjuvant to non-surgical scaling and root planing effective in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in patients with periodontitis? Photodiagnosis Photodyn Ther 2022; 38:102847. [PMID: 35367618 DOI: 10.1016/j.pdpdt.2022.102847] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim was to assess the influence of a single session of antimicrobial photodynamic therapy (aPDT) as an adjunct to non-surgical scaling and root planing (SRP) in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis (P. gingivalis) and Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) in patients with periodontitis. METHODS Patients diagnosed with periodontitis were included. Information regarding age and gender was recorded using a questionnaire. All patients underwent full mouth non-surgical SRP and the following parameters were assessed at baseline: (a) marginal bone loss (MBL); (b) probing depth (PD) (c) clinical attachment loss (CAL); and (d) presence of supra-and subgingival bleeding and plaque (GI and PI). Identification of A. actinomycetemcomitans and P. gingivalis was performed using polymerase chain reaction. For aPDT (test-group), methylene-blue (MB) (0.005%) was used as photosensitizer and it was applied over and inside the buccal pockets of teeth. Using a Diode laser at 660 nm and 150 mW, irradiation was performed All clinical parameters except for MBL and microbiological evaluations were re-assessed at 3-months of follow-up. Level of significance was set at P<0.05. RESULTS At 3-months of follow-up A. actinomycetemcomitans and P. gingivalis were identified in significantly lower number of patients in groups 1 and 2 compared with their respective baseline values. Number of patients in whom A. actinomycetemcomitans and P. gingivalis were identified at 3-months of follow-up were similar in both groups. At baseline, there was no statistically significant difference in PI, GI, PD, CAL and MBL among patients in groups 1 and 2. In groups 1 and 2, scores of PI (P<0.001), GI (P<0.001) and PD (P<0.001) were significantly higher at baseline compared with their respective 3-months' follow-up scores. CONCLUSION One application of aPDT with non-surgical SRP is ineffective in managing periodontal inflammation and presence of P. gingivalis and A. actinomycetemcomitans in periodontitis patients.
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Chava V, Kamatham S. Comparison of salivary calprotectin levels in periodontitis associated with diabetes mellitus after low-level laser therapy as an adjunct to scaling and root planing: A randomized clinical trial. J Indian Soc Periodontol 2022; 26:143-150. [PMID: 35321295 PMCID: PMC8936012 DOI: 10.4103/jisp.jisp_149_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/08/2021] [Accepted: 09/05/2021] [Indexed: 11/24/2022] Open
Abstract
Context and Aims: Calprotectin is a myeloid protein, exerting pro-inflammatory effects on various cells and are shown to be elevated in inflammatory diseases. Periodontal therapy has been shown to decrease the levels of calprotectin in body fluids. Hence, the present study was aimed at assessing salivary calprotectin levels in periodontitis associated with diabetes mellitus after low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP). Materials and Methods: Sixty-four participants were divided into Groups A (periodontitis) and B (periodontitis associated with type 2 diabetes mellitus [T2DM]) based on probing depth of ≥5 mm, clinical attachment level (CAL) of >2 mm, and history of T2DM. Based on assigned treatments, the groups were subdivided into A1, A2, B1, and B2 where A1 and B1 were subjected to SRP alone and A2 and B2 received LLLT as an adjunct to SRP, respectively. The parameters assessed included probing pocket depth, CAL, bleeding on probing (BOP), plaque index (PI), and salivary calprotectin. All the values were subjected for comparison at baseline and 8 weeks. Statistical Analysis Used: Multiple group comparisons were done using analysis of variance; intragroup comparisons were made using t-test. The level of significance was assessed at P < 0.05 for all tests. Results: All parameters showed a significant difference within the groups from baseline to 8 weeks. Intergroup comparison of PI, BOP, and salivary calprotectin showed a significant difference (P < 0.05). Conclusions: Reduction in calprotectin levels was noticed with LLLT when used as an adjunct to SRP. Calprotectin may be used as a prognostic marker for periodontitis.
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Feng C, Ding Y, Tang L, Gui Y, Shen X, He L, Lu X, Leung WK. Adjunctive Er:YAG laser in non-surgical periodontal therapy of patients with inadequately controlled type 2 diabetes mellitus: A split-mouth randomized controlled study. J Periodontal Res 2021; 57:63-74. [PMID: 34610151 DOI: 10.1111/jre.12938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/02/2021] [Accepted: 09/17/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Limited studies are available comparing the outcomes of non-surgical periodontal therapy (NSPT) with or without adjunctive Er:YAG laser (ERL) in patients with type 2 diabetes mellitus (T2DM). This study evaluated the effects of ERL adjunctive NSPT on single-rooted teeth of inadequately controlled T2DM patients with periodontitis. METHODS Twenty-two inadequately controlled T2DM participants with periodontitis were recruited. Adopting a double-blinded split-mouth design and under block randomization, we investigated the effects of ERL in calculus removal then degranulation mode, or a sham treatment, adjunct NSPT, which included two visits of full-mouth root surface debridement delivered within 4-10 days, to test or control single-rooted teeth (Wuxi Stomatology Hospital, trial 2017-016). We followed periodontal parameters (plaque %, bleeding on probing [BOP] %, probing pocket depth [PPD], probing attachment level [PAL]) and selected systemic parameters (fasting plasma glucose [FPG], glycosylated hemoglobin [HbA1c%], high sensitivity C-reactive protein) at baseline, one, three, and six months after periodontal treatment. RESULTS The study was completed as planned. Periodontal parameters, FPG and HbA1c% of the 22 participants appeared significantly improved at six months (p < 0.001). The 44 ERL treated, compared to 44 sham treated single-rooted teeth exhibited significant improvement in BOP, mean PPD, and mean PAL at various postoperative follow-up time points (effect size ≥0.44; p < 0.001). No adverse event was reported. CONCLUSION Periodontal treatment outcomes in the T2DM patients with inadequate glycemic control were better in the single-rooted teeth received ERL adjunct NSPT. Further studies are warranted to confirm the observations reported in this short-term clinical study.
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Affiliation(s)
- Chenchen Feng
- Department of Periodontology, Wuxi Stomatology Hospital, Wuxi, Jiangsu Province, China
| | - Yi Ding
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liqin Tang
- Department of Periodontology, Wuxi Stomatology Hospital, Wuxi, Jiangsu Province, China
| | - Yong Gui
- Department of Periodontology, Wuxi Stomatology Hospital, Wuxi, Jiangsu Province, China
| | - Xiaoyun Shen
- Department of Periodontology, Wuxi Stomatology Hospital, Wuxi, Jiangsu Province, China
| | - Linlin He
- Department of Periodontology, Wuxi Stomatology Hospital, Wuxi, Jiangsu Province, China
| | - Xinyan Lu
- Department of Periodontology, Wuxi Stomatology Hospital, Wuxi, Jiangsu Province, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Jayash SN, Habash G, Kamal M. Non-conventional method of pontic site preservation with laser-assisted bone regeneration. Clin Case Rep 2021; 9:e04483. [PMID: 34295495 PMCID: PMC8283858 DOI: 10.1002/ccr3.4483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/02/2021] [Accepted: 05/11/2021] [Indexed: 11/07/2022] Open
Abstract
This report presents an alternative method to the removal of failing implant and using a bone graft to preserve ridge which needs several months to heal and it is a costly technique. The pontic site was preserved by covering the failing implant with connective tissue and laser-assisted peri-implant defect regeneration.
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Affiliation(s)
| | - Ghassan Habash
- Deanship of Scientific ResearchAl‐Quds UniversityAl‐QudsPalestine
- University of Health Sciences LahoreLahorePakistan
| | - Mudar Kamal
- Prosthodontic DepartmentFaculty of DentistryAl‐Quds UniversityAl‐QudsPalestine
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Soi S, Bains VK, Srivastava R, Madan R. Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser. Lasers Med Sci 2021; 36:1307-1315. [PMID: 33521870 DOI: 10.1007/s10103-021-03261-w] [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: 05/26/2020] [Accepted: 01/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Periodontal treatment in diabetic patients reduces systemic inflammatory burden and hence should be closely coordinated with the patient's overall clinical diabetic management. OBJECTIVE To evaluate the effectiveness of diode laser (DL) (Biolase EpicTM, 940 nm, Irvine, CA, USA) as an adjunct to scaling root and planing (SRP) on periodontal health and glycated hemoglobin (HbA1c) level of type 2 diabetes mellitus (T2DM) patients suffering from generalized chronic periodontitis (CP), currently, stage II or above/grade B or C periodontitis. MATERIALS AND METHODOLOGY After initial screening of 55 T2DM patients, a total of 44 T2DM-CP patients (between the age group of 30 and 65 years) were selected and randomly assigned into two groups. The groups were divided into control group (n=22), treated with scaling and root planing alone (SRP alone), and experimental group (n=22), treated with scaling and root planing along with laser therapy (SRP + DL). Laser irradiation was accomplished at perio pocket setting of 0.8 W (average) in a pulse interval of 1.0 ms and pulse length of 1.0 ms delivering 24 J of energy using a 300-μm fiber optic delivery system. RESULTS Thirty-seven out of 44 enrolled T2DM-CP patients completed the study. Both treatment modalities, i.e., SRP alone and SRP+DL resulted in mean significant (p < 0.001) improvement in periodontal health parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL)) and glycemic level (RBS, FBS, and HbA1c) in T2DM-CP patients after 6 months, and was higher in SRP+DL group in comparison to SRP alone. Among the periodontal health parameters, the mean PPD reduction and CAL gain were 51.78% and 48.26% in control as compared to 61.56% and 62.54% in experimental group respectively, whereas the mean significant reduction in HbA1c was 13.8% in SRP alone and 22.52% in SRP+DL group after 6 months (p < 0.05). CONCLUSION Periodontal treatment involving SRP+DL contributes to improved periodontal health parameters and HbA1c level in T2DM-CP patients.
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Affiliation(s)
- Sunakshi Soi
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
| | - Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India.
| | - Ruchi Srivastava
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
| | - Rohit Madan
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
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Abuderman AWA, Muzaheed. Antibacterial effectiveness of scaling and root planing with and without photodynamic therapy against Campylobacter rectus counts in the oral biofilm of patients with periodontitis. Photodiagnosis Photodyn Ther 2021; 33:102170. [PMID: 33401024 DOI: 10.1016/j.pdpdt.2020.102170] [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] [Received: 09/28/2020] [Revised: 12/02/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is hypothesized that scaling and root planning (SRP) with adjunct photodynamic therapy (PDT) is more effective in reducing Campylobacter rectus (C. rectus) from the oral biofilm (OB) among patients with periodontitis, than SRP alone. The objective was to compare the effectiveness of SRP with and without adjunct PDT in reducing OB C. rectus counts of patients with periodontitis. METHODS Chronic gastritis patients diagnosed with periodontitis were included. Therapeutically, the patients were divided into 2-groups. Patients in the test- and control-groups underwent SRP with and without adjunct PDT, respectively. In both groups, full-mouth plaque index (PI), bleeding on probing (BOP), probing depth (PD) and marginal bone loss (MBL) were measured and subgingival OB counts of C. rectus were measured at baseline and 12-weeks after treatment. Data normality was assessed and group-comparisons were done using the paired t-test and Man-Whitney U tests. A type-1 error rate of 5 % was used. RESULTS Thirty patients with periodontitis were included. All patients had Grade-B/Stage-II periodontitis. All participants were male with no significant difference in age. At baseline PI, BOP, PD and MBL were comparable in both groups. Counts of C. rectus in the subgingival OB samples were similar in both groups at baseline. At 12-weeks of follow-up, PI (P < 0.01), GI (P < 0.01) and PD (P < 0.01) were significantly higher in the control- compared with the test-group compared with baseline. The percentages of C. rectus -positive individuals were higher in the control- than the test-group at 12-weeks' (P < 0.01). At 12-weeks' follow-up the percentages of C. rectus -positive patients were comparable with their respective baseline percentages in the control-group. CONCLUSION Compared with SRP alone, adjuvant use of PDT is more efficient in eliminating C. rectus in the OB and reducing clinical parameters in patients with grade-B/Stage-II periodontitis.
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Affiliation(s)
- Abdul Wahab Ali Abuderman
- Department of Basic Medical Science, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
| | - Muzaheed
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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The effectiveness of photodynamic and antibiotic gel therapy as an adjunct to mechanical debridement in the treatment of peri-implantitis among diabetic patients. Photodiagnosis Photodyn Ther 2020; 32:102077. [DOI: 10.1016/j.pdpdt.2020.102077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022]
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13
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Effectiveness of single versus multiple sessions of photodynamic therapy as adjunct to scaling and root planing on periodontopathogenic bacteria in patients with periodontitis. Photodiagnosis Photodyn Ther 2020; 32:102035. [PMID: 33011399 DOI: 10.1016/j.pdpdt.2020.102035] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/05/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022]
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14
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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.
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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.
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Influence of body fat in patients with dental implant rehabilitation treated with adjunctive photodynamic therapy. Photodiagnosis Photodyn Ther 2020; 31:101831. [DOI: 10.1016/j.pdpdt.2020.101831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 12/28/2022]
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16
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Keceli HG, Ercan N, Karsiyaka Hendek M, Kisa U, Mesut B, Olgun E. The effect of the systemic folic acid intake as an adjunct to scaling and root planing on clinical parameters and homocysteine and C-reactive protein levels in gingival crevicular fluid of periodontitis patients: A randomized placebo-controlled clinical trial. J Clin Periodontol 2020; 47:602-613. [PMID: 32109317 DOI: 10.1111/jcpe.13276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 02/14/2020] [Accepted: 02/24/2020] [Indexed: 01/09/2023]
Abstract
AIM To evaluate clinical and biochemical effects of adjunctive systemic folic acid (FA) intake with scaling and root planing (SRP) in periodontitis treatment. MATERIALS AND METHODS Sixty periodontitis subjects (30 per group) were randomly assigned into study groups and treated with either SRP + placebo (SRP + P) or SRP + folic acid (SRP + F). In addition to clinical parameters (plaque index [PI], gingival index [GI], probing pocket depth [PPD], clinical attachment level [CAL] and gingival recession [GR]), gingival crevicular fluid (GCF) samples were obtained at baseline and post-treatment (PT) periods (one (PT-1), three (PT-3) and six (PT-6) months) for C-reactive protein (CRP) and homocysteine (Hcy) evaluation. RESULTS Significant time-dependent reduction was detected at all clinical parameters for both groups (p < .001). Compared to SRP + P, CAL was lower in SRP + F at PT-1 (p = .004) and PT-3 (p = .035), whereas GR was lower at only PT-1 (p = .015). GCF volume and CRP did not show inter-group differences, whereas Hcy was higher in SRP + F at PT-3 (p = .044) and PT-6 (p = .041). GCF volume and Hcy showed reduction after treatment in both groups (p < .001). CONCLUSION Both modalities exhibited clinical improvement and change in biochemical parameters. Adjunctive systemic FA intake may be recommended adjunctive to periodontitis treatment to reveal better outcomes. However, its impact mechanisms should be further enlightened.
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Affiliation(s)
- H Gencay Keceli
- Periodontology Department, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Nuray Ercan
- Oral Health and Dental Care Centre, Duzce, Turkey
| | | | - Ucler Kisa
- Biochemistry Department, Faculty of Medicine, Kirikkale University, Kırıkkale, Turkey
| | - Burcu Mesut
- Pharmaceutical Technology Department, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - Ebru Olgun
- Periodontology Department, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
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Seitz MW, Listl S, Bartols A, Schubert I, Blaschke K, Haux C, Van Der Zande MM. Current Knowledge on Correlations Between Highly Prevalent Dental Conditions and Chronic Diseases: An Umbrella Review. Prev Chronic Dis 2019; 16:E132. [PMID: 31560644 PMCID: PMC6795069 DOI: 10.5888/pcd16.180641] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction Studies have investigated the relationships between chronic systemic and dental conditions, but it remains unclear how such knowledge can be used in clinical practice. In this article, we provide an overview of existing systematic reviews, identifying and evaluating the most frequently reported dental–chronic disease correlations and common risk factors. Methods We conducted a systematic review of existing systematic reviews (umbrella review) published between 1995 and 2017 and indexed in 4 databases. We focused on the 3 most prevalent dental conditions and 10 chronic systemic diseases with the highest burden of disease in Germany. Two independent reviewers assessed all articles for eligibility and methodologic quality using the AMSTAR criteria and extracted data from the included studies. Results Of the initially identified 1,249 systematic reviews, 32 were included for qualitative synthesis. The dental condition with most frequently observed correlations to chronic systemic diseases was periodontitis. The chronic systemic disease with the most frequently observed correlations with a dental condition was type 2 diabetes mellitus (T2DM). Most dental–chronic disease correlations were found between periodontitis and T2DM and periodontitis and cardiovascular disease. Frequently reported common risk factors were smoking, age, sex, and overweight. Using the AMSTAR criteria, 2 studies were assessed as low quality, 26 studies as moderate quality, and 4 studies as high quality. Conclusion The quality of included systematic reviews was heterogeneous. The most frequently reported correlations were found for periodontitis with T2DM and for periodontitis with cardiovascular disease. However, the strength of evidence for these and other disease correlations is limited, and the evidence to assess the causality of these disease correlations remains unclear. Future research should focus on the causality of disease links in order to provide more decisive evidence with respect to the design of intersectoral care processes.
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Affiliation(s)
- Max W Seitz
- Institute of Medical Biometry and Informatics, University of Heidelberg, Marsilius-Arkaden Turm West, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany. E-mail:
| | - Stefan Listl
- Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany.,Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Healthcare, Nijmegen, The Netherlands
| | - Andreas Bartols
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany.,Christian-Albrechts-University Kiel, Clinic for Conservative Dentistry and Periodontology, Kiel, Germany
| | - Ingrid Schubert
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Katja Blaschke
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christian Haux
- University of Heidelberg, Institute of Medical Biometry and Informatics, Heidelberg, Germany
| | - Marieke M Van Der Zande
- Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany.,Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Healthcare, Nijmegen, The Netherlands
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Alonaizan FA, AlFawaz YF. Is phototherapy effective in the management of post-operative endodontic pain? A systematic review of randomized controlled clinical trials. Photodiagnosis Photodyn Ther 2019; 26:53-58. [DOI: 10.1016/j.pdpdt.2019.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 02/25/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
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Efficacy of phototherapy in the adhesive bonding of different dental posts to root dentin: A systematic review. Photodiagnosis Photodyn Ther 2019; 27:111-116. [PMID: 31146012 DOI: 10.1016/j.pdpdt.2019.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/26/2019] [Accepted: 05/20/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aim of the current systematic review was to evaluate the efficacy of phototherapy in the adhesive bonding of different dental posts to root dentin. METHODS The outline of this systematic review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Searches in both electronic and manual literature were performed in the main databases 'MEDLINE' and 'EMBASE' up to March 2019 using the following terms: (Phototherapy) AND (push out test) AND (bond strength) AND (post) OR (fibre) OR (metal) AND (smear layer). RESULTS Six in-vitro studies were included and processed for data extraction. All studies incorporated the use of fiber posts. The mean shear bond strength for test group ranged from 2.23 to 15.17 MPa while mean shear bond strength for control group ranged from 2.93 to 9.38 MPa. The wavelengths of diode lasers ranged from 660 to 2940 nm (nm). Power was reported in 5 studies ranging from 0.075 W to 3 W. All studies compared shear bond strength of phototherapy in the adhesive bonding of different dental posts to root dentin. In all the included studies, greater bond strength achieved by phototherapy compared to nonirradiated group. CONCLUSION Within the limits, this study shows that the dentin to post bond strength was significantly enhanced by phototherapy.
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20
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Castro dos Santos N, Andere NMRB, Miguel MMV, dos Santos LM, Santamaria M, Mathias IF, Jardini MAN, Santamaria MP. Photobiomodulation for the treatment of periodontal pockets in patients with type 2 diabetes: 1-year results of a randomized clinical trial. Lasers Med Sci 2019; 34:1897-1904. [DOI: 10.1007/s10103-019-02799-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/29/2019] [Indexed: 01/30/2023]
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Alsahhaf A, Alshiddi IF, Alshagroud RS, Al-Aali KA, Vohra F, Abduljabbar T. Clinical and radiographic indices around narrow diameter implants placed in different glycemic-level patients. Clin Implant Dent Relat Res 2019; 21:621-626. [PMID: 31037825 DOI: 10.1111/cid.12778] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/03/2019] [Accepted: 04/07/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Studies assessing peri-implant clinical and marginal bone resorption (MBR) around narrow diameter implants (NDIs) placed in different glycemic levels are uninvestigated. OBJECTIVE The present 3-year retrospective follow-up investigation was designed to explore clinical and radiographic status of NDIs placed in individuals with different glycemic control levels. MATERIALS AND METHODS Patients with serum hemoglobin A1c (HbA1c) levels ≥6.5% (Group-1), 5.7%-6.4% (Group-2), and 4.0%-5.0% (Group-3) were included. Clinical indices evaluating bleeding on probing (BOP), plaque scores (PI), peri-implant probing depth (PD), and MBR were recorded around NDIs at 1-, 2-, and 3-year follow-up. Serum HbA1c test was carried out for all patients to assess the profile of glycosylated hemoglobin at 1 and 3 years of follow-up. RESULTS A significant reduction in mean HbA1c levels from year 1 to year 3 follow-up period was seen in Group-1 only. PI varied from 0.40 in Group 1 at 2 year and 0.42 at 3-year follow-up to 0.18 at 2-year (P = 0.032) and 0.17 at 3-year (P = 0.018) follow-up, respectively. Greater BOP was noted in Group 1 (0.53) as compared with Group 2 (0.42) and Group 3 (0.21) (P = 0.048) at 3-year follow-up. PD after 3 year ranged from 2.04 mm in Group 3 to 2.32 mm in Group 1 that showed statistically significant difference (P = 0.037). No statistical significant differences were observed in MBR at any time point between the groups. CONCLUSION The results of this short-term follow-up study indicate that NDIs show clinical and radiographic stability, provided oral cleanliness and glycemic levels are relatively maintained. Further long-term clinical studies are needed to evaluate implant stability over the period along with controlled glycemic status.
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Affiliation(s)
- Abdulaziz Alsahhaf
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ibraheem F Alshiddi
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Rana Saud Alshagroud
- Department of Oral Medicine and Diagnostic Science, King Saud University, Riyadh, Saudi Arabia
| | - Khulud Abdulrahman Al-Aali
- Department of Clinical Dental Sciences, College Of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Al-Hamdan RS. Does bond integrity of bleached enamel increases with phototherapy? A systematic review. Photodiagnosis Photodyn Ther 2019; 25:401-405. [DOI: 10.1016/j.pdpdt.2019.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
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Al-Shibani N. Low-intensity laser for harvesting palatal graft for the treatment of gingival recession: A systematic review. ACTA ACUST UNITED AC 2018; 10:e12368. [DOI: 10.1111/jicd.12368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 07/01/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Nouf Al-Shibani
- Department of Periodontics and Community Dentistry; King Saud University; Riyadh Saudi Arabia
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24
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Al-Aali KA. Effect of phototherapy on shear bond strength of resin cements to zirconia ceramics: A systematic review and meta-analysis of in-vitro studies. Photodiagnosis Photodyn Ther 2018; 23:58-62. [DOI: 10.1016/j.pdpdt.2018.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 12/13/2022]
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Akram Z. How effective is adjunctive antimicrobial photodynamic therapy in treating deep periodontal pockets in periodontal disease? A systematic review. ACTA ACUST UNITED AC 2018; 9:e12345. [DOI: 10.1111/jicd.12345] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 03/19/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Zohaib Akram
- Department of Periodontology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
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26
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Akram Z, Vohra F, Javed F. Locally delivered metformin as adjunct to scaling and root planing in the treatment of periodontal defects: A systematic review and meta-analysis. J Periodontal Res 2018; 53:941-949. [DOI: 10.1111/jre.12573] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Z. Akram
- Department of Periodontology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| | - F. Vohra
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - F. Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
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Is adjunctive photodynamic therapy more effective than scaling and root planing alone in the treatment of periodontal disease in hyperglycemic patients? A systematic review. Photodiagnosis Photodyn Ther 2018; 22:1-6. [DOI: 10.1016/j.pdpdt.2018.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 02/13/2018] [Accepted: 02/16/2018] [Indexed: 01/14/2023]
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Ikram S, Hassan N, Raffat MA, Mirza S, Akram Z. Systematic review and meta-analysis of double-blind, placebo-controlled, randomized clinical trials using probiotics in chronic periodontitis. ACTA ACUST UNITED AC 2018; 9:e12338. [PMID: 29604177 DOI: 10.1111/jicd.12338] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 02/13/2018] [Indexed: 12/26/2022]
Abstract
AIM The aim of the present study was to evaluate the efficacy of probiotics as an adjunct to scaling and root planning (SRP) in the treatment of chronic periodontitis (CP). METHODS The focused question of the study was: Does adjunctive use of probiotics yield better clinical periodontal outcomes compared to placebo/no treatment group in the treatment of CP? Electronic and manual literature searches were conducted up to December 2017 using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register. Forest plots were computed reporting weighted mean difference (WMD) of outcomes and 95% confidence intervals (CI). RESULTS Seven clinical studies were included. Four studies showed additional benefits in reducing periodontal probing depth (PPD) and gaining clinical attachment level (CAL), whereas, three studies showed comparable clinical periodontal outcomes between probiotics and SRP/placebo. Significant heterogeneity was observed for PPD reduction and CAL gain. The overall mean difference for CAL gain between probiotics and placebo/SRP was significant (WMD = 1.41, 95% CI = 0.15-2.67, P = .028) at follow up. CONCLUSION Adjunctive probiotics could result in additional benefits in CAL gain in CP. Nevertheless, further high-quality randomized clinical trials with microbiological outcomes are warranted to obtain strong conclusions in this regard.
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Affiliation(s)
- Sana Ikram
- Department of Oral Biology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Nuzhat Hassan
- Department of Anatomy, Faculty of Basic Health Sciences, Ziauddin University, Karachi, Pakistan
| | - Muhammad A Raffat
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Sana Mirza
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
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Akram Z, Vohra F, Javed F. Low-level laser therapy as an adjunct to connective tissue graft procedure in the treatment of gingival recession defects: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2018; 30:299-306. [PMID: 29582585 DOI: 10.1111/jerd.12377] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to systematically evaluate the effectiveness of low level laser therapy (LLLT) as an adjunct to connective tissue graft (CTG) procedure for the treatment of gingival recession (GR). MATERIALS AND METHODS The addressed PICO question was; "In patients with Miller Class I or II recession defects (Population), what is the effect of LLLT as adjunct to CTG (Intervention) in comparison to CTG alone (Comparison) on gingival recession depth (Outcome)" Electronic databases were searched up to December 2017. Primary outcomes included gingival recession depth (GRD), whereas secondary outcomes were width of keratinized tissue (WKT) and relative clinical attachment level gain (RCAL). The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. RESULTS Four randomized clinical studies were included. Two studies showed significantly greater improvements with LLLT whereas, 2 studies showed comparable outcomes between LLLT and CTG group. Considering the effects of adjunctive LLLT as compared to CTG, a high degree of heterogeneity for GRD (Q value = 9.40, P = .02, I2 =68.11%) and WKT ((Q value = 16.04, P = .001, I2 =81.31%) was noticed among both the groups. Meta-analysis showed a statistically significant GRD (WMD= -0.61, 95% CI= -1.23 to 0.004, P = .05) for LLLT + CTG treatment versus CTG alone only. CONCLUSIONS LLLT improves clinical and patient-centered outcomes of CTG procedures for the treatment of GR remains debatable. However, due to the small number of included studies and high heterogeneity in the laser parameters, precautions must be exercised when interpreting the results of the present systematic review. CLINICAL SIGNIFICANCE Gingival recessions in dentistry are of major esthetic concern. Minimal gingival recessions can be treated by flap operations, but the predictability and stability of the outcomes is debatable. In the present review, low level laser therapy (LLLT) adjunct to connective tissue graft (CTG) depicted a significant improvement in the predictability and stability of root coverage outcomes compared with CTG alone.
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Affiliation(s)
- Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - 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, 14620
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Efficacy of photodynamic therapy or low level laser therapy against steroid therapy in the treatment of erosive-atrophic oral lichen planus. Photodiagnosis Photodyn Ther 2018; 21:404-408. [DOI: 10.1016/j.pdpdt.2018.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 01/23/2018] [Accepted: 02/01/2018] [Indexed: 01/11/2023]
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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]
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32
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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
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Akram Z, Vohra F, Javed F. Efficacy of statin delivery as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A meta-analysis. ACTA ACUST UNITED AC 2017; 9:e12304. [PMID: 29119729 DOI: 10.1111/jicd.12304] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 08/30/2017] [Indexed: 12/21/2022]
Abstract
The action of statins in stimulating bone formation and having other pleiotropic effects, such as anti-inflammatory and immunomodulatory effects, has justified their use as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). The aim of the present study was to evaluate the efficacy of statin delivery as an adjunct to SRP in the treatment of CP. Electronic searches were conducted using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, up until July 2017. The primary outcome was probing depth (PD), while the secondary outcomes were changes in clinical attachment level (CAL) and bone defect (BD) fill. Eleven studies were included, and all showed significant PD reduction, CAL gain, and BD fill with adjunctive statin delivery compared to SRP alone. The meta-analysis showed significant improvement in periodontal parameters for atorvastatin (PD: weighted mean difference [WMD] = -1.84, -2.56 to -1.12, P < .001; CAL: WMD = -2.31, -3.58 to -1.03, P < .001; BD fill: WMD = 2.66, -3.92 to -1.39, P < .001), simvastatin (PD: WMD = -1.91, -2.27 to -1.55, P < .001; CAL: WMD = -1.91, -2.27 to -1.55, P = .001; BD: WMD = -1.52, -2.20 to -0.85, P < .001), and rosuvastatin (PD: WMD = -0.94, -1.32 to -0.55, P < .001; CAL: WMD = -1.00, -1.41 to -0.60, P < .001; BD fill: WMD = -1.30, -1.80 to -0.79, P < .001). Adjunctive statin delivery appears to be effective in reducing PD, CAL gain, and BD fill in CP, and therefore, these drugs could be a promising therapeutic option for periodontal regeneration in future.
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Affiliation(s)
- Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - 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, Rochester, New York, USA
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Singhal R, Agarwal V, Rastogi P, Khanna R, Tripathi S. Efficacy of Acacia arabica gum as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A randomized controlled clinical trial. Saudi Dent J 2017; 30:53-62. [PMID: 30166872 PMCID: PMC6112319 DOI: 10.1016/j.sdentj.2017.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/25/2017] [Accepted: 10/30/2017] [Indexed: 11/29/2022] Open
Abstract
Aim The aim of the present study was to explore the adjunctive use of Acacia arabica gel in the treatment of chronic periodontitis. Methods Single centre, randomised, triple blind, controlled trial on mild to moderate chronic periodontitis patients; Group I (SRP + Acacia arabica, n = 40) and Group II (SRP + placebo, n = 40); were analysed for clinical improvements in periodontal pocket depth (PPD) and clinical attachment levels (CAL) at baseline, 15 and 90 days on application of gels. Gingival index and plaque index were assessed as secondary parameters. Results Statistically significant PPD reduction (p < .05) and CAL gain (p < .05) was observed with use of Acacia arabica gel. The reduction in sites with moderate PPD was observed more among Group I than Group II and the difference was statistically significant (p = .001). Secondary outcome variables; Plaque Index and Gingival Index showed better resolution with Acacia arabica gel. Conclusion Acacia arabica leads to better clinical outcomes in patients with mild to moderate chronic periodontitis with effective antiplaque and anti-gingivitis action. It may be recommended adjunct to SRP for maintenance in patients with mild to moderate chronic periodontitis.
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Affiliation(s)
- Rameshwari Singhal
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, UP, India
| | - Vivek Agarwal
- Department of Medicine, Mayo Institute of Medical Sciences, Barabanki, UP, India
| | - Pavitra Rastogi
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, UP, India
| | - Richa Khanna
- Department of Pediatric Dentistry, Faculty of Dental Sciences, King George's Medical University, Lucknow, UP, India
| | - Shuchi Tripathi
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, UP, India
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Al-Hamoudi N. Is antimicrobial photodynamic therapy an effective treatment for chronic periodontitis in diabetes mellitus and cigarette smokers: a systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2017; 19:375-382. [DOI: 10.1016/j.pdpdt.2017.05.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 05/21/2017] [Accepted: 05/24/2017] [Indexed: 12/22/2022]
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Akram Z, Abduljabbar T, Vohra F, Javed F. Efficacy of low-level laser therapy compared to steroid therapy in the treatment of oral lichen planus: A systematic review. J Oral Pathol Med 2017; 47:11-17. [DOI: 10.1111/jop.12619] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Zohaib Akram
- Department of Periodontology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
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Abduljabbar T, Vohra F, Akram Z, Ghani SMA, Al-Hamoudi N, Javed F. Efficacy of surgical laser therapy in the management of oral pigmented lesions: A systematic review. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017. [PMID: 28641206 DOI: 10.1016/j.jphotobiol.2017.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Oral pigmentation, especially in the gingiva poses esthetic problems. Laser therapy has been widely used for cosmetic therapy in dentistry. The aim of the present study was to systematically review the efficacy of surgical laser therapy (SLT) in the management of oral pigmented lesions (OPL). MATERIALS AND METHODS The addressed focused question was "Is SLT effective in the management of OPL?" Databases (MEDLINE via PubMed; EMBASE; Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched from 1970 up to and including February 2017. RESULTS Ten studies were included. The reported number of OPL ranged between 8 and 140. Oral pigmented sites included, gingiva, buccal and labial mucosa, alveolar mucosa and lips. Lasers used in the studies included Q-switched alexandrite, Neodymium-doped yttrium aluminium garnet, diode, Erbium: yttrium aluminium garnet and carbon dioxide laser. Laser wavelength, power output and number of irradiations were 635-10,600nm, 1-10W and 1 to 9 times, respectively. The follow up period ranged from 6 to 24months. All studies reported SLT to be effective in the treatment of OPL. In five studies, recurrence of OPL occurred which ranged from 21.4% to 45%. CONCLUSIONS Lasers are effective in the management of OPL including physiologic gingival pigmentation, smokers' melanosis and pigmentation in Laugier-Hunziker syndrome. Different laser types (CO2, Er:YAG and Diode) showed comparable outcomes in the treatment of OPL.
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Affiliation(s)
- Tariq Abduljabbar
- 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
| | - Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan.
| | - Siti Mariam Ab Ghani
- Department of Restorative Dentistry, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
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Al-Maweri SA, Kalakonda B, Al-Soneidar WA, Al-Shamiri HM, Alakhali MS, Alaizari N. Efficacy of low-level laser therapy in management of symptomatic oral lichen planus: a systematic review. Lasers Med Sci 2017; 32:1429-1437. [DOI: 10.1007/s10103-017-2233-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/12/2017] [Indexed: 12/21/2022]
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Akram Z, Abduljabbar T, Kellesarian SV, Abu Hassan MI, Javed F, Vohra F. Efficacy of bisphosphonate as an adjunct to nonsurgical periodontal therapy in the management of periodontal disease: a systematic review. Br J Clin Pharmacol 2016; 83:444-454. [PMID: 27718252 DOI: 10.1111/bcp.13147] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 12/31/2022] Open
Abstract
AIMS The aim of this systematic review was to assess the efficacy of bisphosphonate therapy as an adjunct to scaling and root planing (SRP) in the management of periodontitis. METHODS Databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched up to and including July 2016. The primary outcome was probing depth (PD), and the secondary outcomes were changes in clinical attachment level (CAL) and bone defect (BD) fill. The mean differences (MD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. RESULTS Eight clinical studies were included. Seven studies used alendronate as an adjunct to SRP; of these, four studies used topical application and three used oral alendronate. Considering the effects of adjunctive bisphosphonates as compared to SRP alone, a high degree of heterogeneity for PD (Q value = 39.6, P < 0.0001, I2 = 87.38%), CAL (Q value = 13.65, P = 0.008, I2 = 70.71%), and BD fill (Q value = 53.26, P < 0.0001, I2 = 92.49%) was noticed among both the groups. Meta-analysis showed a statistically significant PD reduction (MD = -1.18, 95% CI = -1.91 to -0.44, P = 0.002), CAL gain (MD = -0.69, 95% CI = -1.20 to -0.18, P = 0.008) and BD fill (MD = -2.36, 95% CI = -3.64 to -1.08, P < 0.001) for SRP + bisphosphonate treatment vs. SRP alone. CONCLUSIONS Adjunctive bisphosphonate therapy appears to be effective in managing periodontitis, however, due to the potential risk of osteonecrosis of the jaws and short-term follow-up of the studies, their clinical application is debatable.
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Affiliation(s)
- Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, 75600, Pakistan
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sergio Varela Kellesarian
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York, 14620, USA
| | | | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York, 14620, USA
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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