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Liu CC, Dixit N, Hatz CR, Janson TM, Bastendorf K, Belibasakis GN, Cosgarea R, Karoussis IK, Mensi M, O'Neill J, Spahr A, Stavropoulos A, Schmidlin PR. Air powder waterjet technology using erythritol or glycine powders in periodontal or peri-implant prophylaxis and therapy: A consensus report of an expert meeting. Clin Exp Dent Res 2024; 10:e855. [PMID: 38345462 PMCID: PMC10860664 DOI: 10.1002/cre2.855] [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: 08/30/2023] [Revised: 01/02/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri-implant diseases. MATERIAL AND METHODS In the first step, a modified one-round online Delphi survey including 44 five-point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively. RESULTS An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long-term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept. CONCLUSIONS In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri-implant therapy and prophylaxis is patient compliant and efficient.
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Affiliation(s)
- Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Neha Dixit
- Department of Clinical Affairs and Medical EducationElectro Medical Systems SANyonSwitzerland
| | - Christian R. Hatz
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Tobias M. Janson
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | | | - Georgios N. Belibasakis
- Department of Dental Medicine, Division of Oral DiseasesKarolinska InstitutetStockholmSweden
| | - Raluca Cosgarea
- Department of Periodontology, Cariology and Preventive DentistryUniversity of BonnBonnGermany
| | - Ioannis K. Karoussis
- Department of Periodontology, Faculty of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Magda Mensi
- Section of Periodontics, Department of Surgical Specialities, Radiological Science and Public Health, School of DentistryUniversity of BresciaBresciaItaly
| | - Jessica O'Neill
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of OdontologyUniversity of MalmöMalmöSweden
- Division of Conservative Dentistry and PeriodontologyUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
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Gheorghe DN, Bennardo F, Silaghi M, Popescu DM, Maftei GA, Bătăiosu M, Surlin P. Subgingival Use of Air-Polishing Powders: Status of Knowledge: A Systematic Review. J Clin Med 2023; 12:6936. [PMID: 37959401 PMCID: PMC10647465 DOI: 10.3390/jcm12216936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/07/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Effective subgingival biofilm removal is crucial for achieving positive and stable outcomes in periodontal therapy, forming an indispensable part of any periodontal treatment approach. The development of air-polishing tools has emerged as a promising alternative to hand and ultrasonic scalers for dental biofilm removal. The objective of this systematic review was to assess existing literature regarding the subgingival use of various types of air-polishing powders, as an effective method of subgingival biofilm control. For this, 55 articles on this subjected were sourced from searched databases and subjected to an evaluation process of their contained information, which was subsequently structured and compiled into this manuscript. The existing literature acknowledges that good subgingival biofilm control is essential for the success of periodontal therapy, including through subgingival air-polishing, as an adjunctive procedure. This approach has the potential to enhance patient comfort during and after subgingival mechanical plaque removal, thereby mitigating damage to periodontal structures. Consequently, it may lead to improved healing capabilities within the periodontal tissues and the formation of a more stable reparative gingival junctional epithelium.
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Affiliation(s)
- Dorin Nicolae Gheorghe
- Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.-M.P.); (P.S.)
| | - Francesco Bennardo
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Margarita Silaghi
- Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Dora-Maria Popescu
- Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.-M.P.); (P.S.)
| | - George-Alexandru Maftei
- Department of Dento-Alveolar Surgery and Oral Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
| | - Marilena Bătăiosu
- Department of Pedodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Petra Surlin
- Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.-M.P.); (P.S.)
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Martins O, Costa A, Silva D. The efficacy of air polishing devices in supportive periodontal therapy: Clinical, microbiological and patient-centred outcomes. A systematic review. Int J Dent Hyg 2023; 21:41-58. [PMID: 36300683 DOI: 10.1111/idh.12635] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/14/2022] [Accepted: 10/24/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this review was to compare air polishing devices with conventional periodontal therapy (hand instrumentation and/or ultrasonic debridement), in terms of their clinical, microbiological and patient-related outcomes in patients undergoing periodontal maintenance therapy. METHODS An online database search was performed to identify randomized controlled trials (RCTs) published between January 1987 and March 2021. Selection, data extraction and assessment risk of individual bias were conducted by two independent reviewers. The PICO method was employed to formulate the question: "In patients undergoing periodontal maintenance therapy/supportive periodontal therapy, do air polishing systems result in better clinical, microbiological and patient related outcomes than ultrasonic instrumentation or hand instrumentation?" Primary outcomes were bleeding on probing, gingival index and/or bleeding index. Secondary outcomes were probing depth, clinical attachment level, plaque index, microbiological counts and/or patient tolerance. The risk of bias was evaluated and the systematic review protocol was registered in PROSPERO. RESULTS The electronic search yielded 501 references of which 14 were included in this review. A meta-analysis was not performed due to great heterogeneity within the studies. Air polishing devices and conventional periodontal therapy presented identical results in the 14 studies analysed; however, air polishing devices presented better antimicrobial behaviour and better patient-related outcomes. CONCLUSIONS Both air polishing devices and conventional techniques demonstrated no difference in terms of clinical efficacy; however, air polishing devices seem to present improved antimicrobial results. In addition, they are also a safer, faster and more comfortable option for patients undergoing supportive periodontal therapy.
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Affiliation(s)
- Orlando Martins
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Costa
- DDM, Private Practice, Vila Real, Portugal
| | - Daniela Silva
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythritol or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctively. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time.
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Effectiveness and Clinical Performance of Erythritol Air-Polishing in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials. Medicina (B Aires) 2022; 58:medicina58070866. [PMID: 35888585 PMCID: PMC9319203 DOI: 10.3390/medicina58070866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background and objectives: The purpose of the present systematic review was to analyze the effectiveness of erythritol-based air-polishing in non-surgical periodontal therapy. Materials and methods: The protocol details were registered in the PROSPERO database (CRD42021267261). This review was conducted under the PRISMA guidelines. The electronic search was performed in PubMed, Scopus, and Web of Science databases to find relevant clinical trials published until January 2022. The inclusion criteria consisted of human clinical trials which reported the use of non-surgical periodontal treatment and erythritol air-polishing compared to non-surgical periodontal treatment alone in patients with good systemic health requiring treatment for periodontal disease. Results: 810 studies were imported into the Covidence Platform. Of these, seven clinical trials met the inclusion criteria. In active periodontal therapy, for PD (probing depth), CAL (clinical attachment level), and BOP (bleeding on probing), no statistical significance was achieved at 6 months follow-up. In supportive periodontal therapy for PD, CAL, and BOP, no statistical significance was achieved at 3 months follow-up. Conclusions: The findings suggest that erythritol air-polishing powder did not determine superior improvements of periodontal parameters compared to other non-surgical periodontal therapies. Future randomized clinical trials (RCTs) with calibrated protocols for diagnosis, therapeutic approaches, and longer follow-up are needed to draw a clear conclusion about the efficiency of erythritol air-polishing powder.
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Tan SL, Grewal GK, Mohamed Nazari NS, Mohd-Dom TN, Baharuddin NA. Efficacy of air polishing in comparison with hand instruments and/or power-driven instruments in supportive periodontal therapy and implant maintenance: a systematic review and meta-analysis. BMC Oral Health 2022; 22:85. [PMID: 35321688 PMCID: PMC8944123 DOI: 10.1186/s12903-022-02120-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant placement. This systematic review aimed to assess clinical outcomes, patients' perception, and cost-effectiveness of repeated periodontal therapy with air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments (conventional interventions) in SPT and implant maintenance. METHODS Electronic search for randomised controlled clinical trials with minimum 6 months follow-up for SPT and implant maintenance programme was conducted for data published from 01 January 2000 to 30 April 2020 using multiple databases and hand searching. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). RESULTS A total of 823 articles were screened. 4 SPT and 2 implant maintenance studies were eligible for inclusion. For SPT, repeated APDs interventions revealed no statistically significant difference when compared to the conventional interventions (weighted mean difference [WMD] 0.11 mm, p = 0.08). Likewise, no statistical difference was noted in terms of percentage of bleeding on probing (BOP) and clinical attachment level (CAL) gain. APDs were associated with lower pain score (based on Visual Analogue Scale) and higher patient acceptance in SPT studies. For implant maintenance, APDs resulted in reduction in PPD and percentage of BOP. However, CAL gain was comparable between the two groups. In terms of patient reported outcomes, no implant maintenance studies recorded any forms of patient reported outcomes. In addition, no studies reported on economic evaluation of APDs in both SPT and implant maintenance. CONCLUSION Within the limitations of this systematic review and meta-analysis, repeated subgingival debridement using APDs in SPT resulted in similar clinical outcomes but better patients' comfort when compared to the conventional interventions. For implant maintenance, there is limited evidence to show that repeated application of APDs leads to improved clinical outcomes when compared to conventional treatments.
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Affiliation(s)
- Shiuan Lee Tan
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Galvinderjeet Kaur Grewal
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Nor Shafina Mohamed Nazari
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Tuti Ningseh Mohd-Dom
- Department of Family Oral Health Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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Mohd-Said S, Mohd-Dom TN, Suhaimi N, Rani H, McGrath C. Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review. Front Med (Lausanne) 2021; 8:600769. [PMID: 34179030 PMCID: PMC8222587 DOI: 10.3389/fmed.2021.600769] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Aerosol-producing dental procedures are of concern in the spread of infections, especially during the COVID-19 pandemic. Periodontal prophylaxis is the most common aerosol-producing procedure conducted in dental practice globally. During COVID-19, many national and international organizations advocated the use of pre-procedural mouth rinsing to prevent the spread of infections from aerosol-generating procedures in the dental setting; however, many questioned the scientific basis for such recommendations. Objective: This systematic review aimed to evaluate the effectiveness of pre-procedural rinsing when preforming periodontal prophylaxis in reducing aerosol contamination in the dental setting. Methods: A comprehensive standardized search strategy was employed, informed by a defined PICO question across four electronic databases. The review of the literature was conducted using the PRISMA framework. Agreement between assessors was determined throughout. Synthesis of study characteristics and key outcomes were conducted. Cochrane's risk-of-bias tool for randomized trials (RoB 2) was employed to assess the quality/bias among studies. Results: The initial search yielded 731 citations across the four databases; 95 potentially effective studies were identified, with 56 effective studies found. Thirty randomized control trial studies were identified, 21 with a focus on effectiveness of pre-procedural mouth rinsing, involving 984 participants (aged 18-70). Agreement between assessors was high (Kappa >0.80). Various pre-procedural mouth rinses were tested, most frequently chlorhexidine (CHX) in 18 studies. The concentrations, volume, and prescribed duration of rinsing varied among studies, hampering meta-analyses. Nonetheless, all studies identified significant reductions in bacterial contamination, as measured by colony forming units (cfu). The effectiveness of CHX over other agents was evident with more than half of the studies (7/15) reporting over a 70% reduction in bacterial contamination (cfu). There were concerns over the risk of bias in most studies (76.2%); 19.0% had a high risk of bias and 4.8% were of low risk of bias. Conclusion: There is substantial evidence to support pre-procedural mouth rinsing, such as with chlorohexidine, to effectively reduce aerosol contamination when performing periodontal prophylaxis compared to mouth rinsing with water or not rinsing.
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Affiliation(s)
- Shahida Mohd-Said
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Tuti Ningseh Mohd-Dom
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Nawal Suhaimi
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Haslina Rani
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Colman McGrath
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
- Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong
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Use of air polishing for supra- and subgingival biofilm removal for treatment of residual periodontal pockets and supportive periodontal care: a systematic review. Clin Oral Investig 2021; 25:779-795. [PMID: 33464417 DOI: 10.1007/s00784-020-03762-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
AIM To systematically review the literature to compare the efficacy of air polishing to hand or ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care. METHODS Electronic searches were performed in five different databases, and two databases were used to capture the "grey literature partially." Clinical trials that compared the use of an air-polishing device to either conventional scaling and root planing (hand and/or ultrasonic instrumentation) or no treatment during periodontal therapy were included without restriction of year and publication status. The Joanna Briggs Institute instrument for clinical trials was used to appraise the studies critically. The results were submitted to qualitative descriptive analysis. The systematic review protocol was registered in PROSPERO (CRD420220156176). RESULTS Electronic searches found 1100 hits published between 2008 and 2019. Thirteen studies were included in the review, out of which four had a follow-up longer than 180 days. Results indicated no differences between the efficacy of air polishing and hand or ultrasonic instruments to reduce periodontal inflammation. CONCLUSIONS Our findings suggest that there is no difference in the efficacy of air polishing and hand or ultrasonic instrumentation to control biofilm and reduce periodontal inflammation. However, these findings must be carefully interpreted owing to methodological issues, including a short follow-up, and a potential conflict of interest related to industry funding. CLINICAL RELEVANCE Air polishing for biofilm control may be used as an alternative to hand and ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care.
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Petersilka G, Koch R, Vomhof A, Joda T, Harks I, Arweiler N, Ehmke B. Retrospective analysis of the long-term effect of subgingival air polishing in supportive periodontal therapy. J Clin Periodontol 2020; 48:263-271. [PMID: 33098121 DOI: 10.1111/jcpe.13392] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/16/2022]
Abstract
AIM Glycine powder air polishing (GPAP) procedure has become popular. Aim of the analysis was to compare the clinical outcomes during supportive periodontal therapy (SPT) of subgingival application of GPAP with those using sole conventional mechanical debridement (SC). MATERIAL AND METHODS Over a median SPT period of 5.3 years (re-evaluation through last observation), the GPAP cohort (n = 263) received supra- and subgingival biofilm removal with GPAP. Supragingival calculus was removed using curets and sonic scalers here. Patients in the SC cohort (n = 264) were treated with sonic scalers, curets and rubber cup polishing only. Changes in, that is pocket probing depth (PPD) and furcation involvement were assessed retrospectively. A bootstrapping equivalence testing method in line with the principle of the two one-sided tests (TOST) procedure was used to compare clinical outcomes. RESULTS The GPAP procedure was statistically equivalent to SC regarding the number of sites with stable PPDs (83.3%; IQR 68.8%, 91.0% vs. 84.0%; IQR 77.8%, 90.0%). However, in the GPAP cohort, a trend towards deterioration in furcation status (no equivalence) was noted. CONCLUSIONS In periodontal maintenance, the use of GPAP instead of mechanical plaque removal does not improve the clinical outcome. It seems to be contraindicated to treat furcation defects with GPAP only.
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Affiliation(s)
- Gregor Petersilka
- Private Practice, Würzburg, Germany.,Department of Periodontology, Philipps University of Marburg, Marburg, Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Muenster, Münster, Germany
| | - Anna Vomhof
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
| | - Tim Joda
- Department of Reconstructive Dentistry, University of Basel, Basel, Switzerland
| | - Inga Harks
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
| | - Nicole Arweiler
- Department of Periodontology, Philipps University of Marburg, Marburg, Germany
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
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