1
|
Sabri H, Alhachache S, Saxena P, Dubey P, Nava P, Rufai SH, Sarkarat F. Microsurgery in periodontics and oral implantology: a systematic review of current clinical applications and outcomes. Evid Based Dent 2024:10.1038/s41432-024-01024-4. [PMID: 38867104 DOI: 10.1038/s41432-024-01024-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/03/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES The aim of this systematic review was to comprehensively explore the current trends and therapeutic approaches in which an operating microscope (OM) is used in periodontics and dental implant surgeries. MATERIALS AND METHODS A systematic search strategy was built to detect studies including various surgical techniques performed under an OM. PubMed, EMBASE, and SCOPUS databases were searched. No limitations in terms of time and language were applied. The data regarding the study design, type of procedure, treatment groups, and surgical outcomes were collected and analyzed descriptively. In addition, a bibliometric analysis was performed concerning the co-authorship and keyword co-occurrence network. RESULTS Out of 1985 articles, finally, 55 met the inclusion criteria. Current periodontal and implant microsurgery trends consist of: periodontal therapy, dental implant microsurgery, soft tissue grafting and periodontal plastic surgery, bone augmentation, ridge preservation, and ortho-perio microsurgery. The bibliometric analysis revealed "guided tissue regeneration", "periodontal regeneration" and "root coverage" being the most repeated keywords (landmark nodes). 132 authors within 29 clusters were identified, publishing within the frameworks of "periodontal and implant microsurgery". CONCLUSION Within its limitations, this systematic review provides an overview of the latest trends in periodontal and implant microsurgery when considering the use of an OM as the magnification tool. Also, it discusses the reported success and outcomes of the mentioned procedures.
Collapse
Affiliation(s)
- Hamoun Sabri
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
| | - Sara Alhachache
- Department of Periodontics, University of Louisville School of Dental Medicine, Louisville, KY, USA
| | - Pramiti Saxena
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Prerana Dubey
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Paolo Nava
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Syed Hanan Rufai
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Farzin Sarkarat
- Department of Oral and Maxillofacial Surgery, Gulf Medical University, Ajman, United Arab Emirates
| |
Collapse
|
2
|
Romanenko N, Tarasenko S, Davtyan A, Serezhnikova N, Djidjavadze S, Derevyankin A, Shchetinina E, Deryugin A, Burlak A. The features of the reparative regeneration of an oral mucosa wound created under the exposure of a laser at a wavelength of 445 nm (a pilot study). Lasers Med Sci 2024; 39:152. [PMID: 38849656 DOI: 10.1007/s10103-024-04105-z] [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: 11/11/2023] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
In clinical practice, an innovative laser technology that provides contactless preparation of soft tissues with a wavelength of 445 nm has been introduced. This study aimed to investigate the morphological changes in the oral mucosa when exposed to laser radiation at a wavelength of 445 nm in the ablation mode.An experimental study was conducted to analyze the dynamics of reparative regeneration in the wound caused by that particular type of radiation, utilizing the procedure of lower lip frenuloplasty as an illustration. 48 sexually mature male laboratory rats were chosen as the research object. The procedure of preparing the oral vestibule was executed by employing a contactless laser beam with a wavelength of 445 nm and a power of 0.7 W in continuous mode (CW) and an uninitiated fiber.Histological examination showed that 25 min after the surgery, there were large areas of coagulation necrosis in the oral mucosa in the area affected by the blue laser. In 48 h, the area of necrosis decreased both in size and depth. By the 7th day after the surgery, the necrotic masses had grown into the connective tissue, while marginal regeneration of the epithelium was noted. By the 14th day, the wound surface was completely epithelialized, represented by fibrous scar tissue. Clinically, around the mandibular incisors, there was a wide area of attached keratinized gingiva.The findings of histological examination indicate a necrosis of coagulation type in the region of tissue ablation and also show the absence of phase II of the inflammatory response (the stage of exudation), which expedites the process of epithelialization of the oral mucosa wound.
Collapse
Affiliation(s)
- Natalia Romanenko
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation.
| | - Svetlana Tarasenko
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation
| | - Albert Davtyan
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation
| | - Natalia Serezhnikova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation
| | - Sofiko Djidjavadze
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation
| | - Alexandre Derevyankin
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation
| | - Ekaterina Shchetinina
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation
| | - Anton Deryugin
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mozhaisky Val, 121059, Moscow, Russian Federation
| | - Anastasiya Burlak
- Patrice Lumumba Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| |
Collapse
|
3
|
Mallappa J, Patil L, Mani AD, Gowda TM. Novel biomaterial advanced platelet-rich fibrin plus block for multiple gingival recession. Clin Adv Periodontics 2024; 14:63-69. [PMID: 37417683 DOI: 10.1002/cap.10257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/15/2023] [Accepted: 07/04/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND The study was aimed to assess and compare hard and soft tissue augmentation clinicoradiographically with and without advanced platelet-rich fibrin + (A-PRF+) block for the treatment of multiple gingival recession using vestibular incision subperiosteal tunnel access (VISTA). METHODS A total of 24 patients, exhibiting multiple Miller's Class I or II recessions in the maxillary esthetic zone were included. Participants were divided into two groups, Group 1 was treated with VISTA & A-PRF+ block whereas Group 2 was with VISTA technique alone. Clinical parameters probing depth, width of keratinized gingiva, gingival biotype, recession depth, and clinical attachment level were recorded at baseline and the end of 6 months. The radiographic cone beam computed tomography measurements of labial plate thickness were taken at baseline and 6 months postoperatively. RESULTS From baseline to 6 months both the groups showed a clinical and statistical improvement in the parameters. However, a statistically significant difference between the treatment modalities was not observed. In the inter-group comparison radiographically, labial plate thickness was statistically significant at the end of 6 months when compared to the baseline. CONCLUSION A-PRF+ block along with the VISTA technique can be an alternative effective root coverage procedure for the management of multiple gingival recessions in the maxillary esthetic zone. KEY POINTS Why is this study new information? To the best of our knowledge, this is the first study using advanced platelet-rich fibrin plus block for the treatment of multiple gingival recession with a thin labial plate. What are the keys to the successful management of these types of cases? Minimally invasive vestibular incision subperiosteal tunnel access technique, and avoidance of second surgical site morbidity are important factors for treatment and for patient compliance. What are the primary limitations of this study? Short study duration, small sample size, and no histological correlation can be considered as limitations of the study.
Collapse
Affiliation(s)
- Jayasheela Mallappa
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| | - Leena Patil
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| | - Adi Deepika Mani
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| | - Triveni M Gowda
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| |
Collapse
|
4
|
Shi J, Wang J, Yang Z, Li J, Lei L, Li H. A novel periodontal endoscopy-aided non-incisional periodontal regeneration technique in the treatment of intrabony defects: a retrospective cohort study. BMC Oral Health 2023; 23:962. [PMID: 38044459 PMCID: PMC10693706 DOI: 10.1186/s12903-023-03674-9] [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: 09/25/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Gingival recession and post-operation discomfort are still a problem for patients receiving the periodontal regeneration surgery for intra-bony defects. To further reduce the trauma and the post-operation gingival recession, a novel periodontal endoscopy-aided non-incisional regeneration technique (NIT) was proposed in the treatment of intra-bony defects. METHODS Retrospective analysis of 21 subjects treated with NIT and 21 subjects with periodontal endoscopy-aided scaling and root planing (PSRP) at baseline and 1-year evaluation was conducted. After removing the subgingival calculus and granulation tissue, bone grafting materials were placed into intrabony defects with the assistance of a gingival retractor in the NIT group. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), as well as the distance between bone crest (BC) level and base of the defect (BD) (intrabony defect depth, IBD) were evaluated at baseline and 1 year after treatment. RESULTS At 1-year follow-up, the value of CAL, PD and IBD were statistically significant different compared with baseline in both two groups (p<0.001). CAL gain (p = 0.012) and PD reduction (p = 0.004) was greater in the NIT than PSRP. However, no difference in the IBD reduction was found between the NIT group and PSRP. Better CAL gain and PD reduction was achieved in the 1-year term in the NIT when compared with PSRP. CONCLUSION NIT have resulted in significant gains in both clinical and radiographic parameters. NIT might be utilized as an alternative of the surgical treatment for periodontal intrabony defects. TRIAL REGISTRATION This clinical trial registration was registered retrospectively (August 3, 2023) and the number is ChiCTR2300074317.
Collapse
Affiliation(s)
- Jiahong Shi
- Department of Periodontics, Nanjing Stomatological Hospital, Affiliated Hospital of medical School, Nanjing University, Nanjing, China
| | - Jinmeng Wang
- Department of Periodontics, Nanjing Stomatological Hospital, Affiliated Hospital of medical School, Nanjing University, Nanjing, China
| | - Zhiyu Yang
- Department of Periodontics, Nanjing Stomatological Hospital, Affiliated Hospital of medical School, Nanjing University, Nanjing, China
| | - Jingwen Li
- Department of Periodontics, Nanjing Stomatological Hospital, Affiliated Hospital of medical School, Nanjing University, Nanjing, China
| | - Lang Lei
- Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of medical School, Nanjing University, Nanjing, China.
| | - Houxuan Li
- Department of Periodontics, Nanjing Stomatological Hospital, Affiliated Hospital of medical School, Nanjing University, Nanjing, China.
| |
Collapse
|
5
|
Theodoridis K, Arampatzis AS, Liasi G, Tsalikis L, Barmpalexis P, Christofilos D, Assimopoulou AN. 3D-Printed Antibacterial Scaffolds for the Regeneration of Alveolar Bone in Severe Periodontitis. Int J Mol Sci 2023; 24:16754. [PMID: 38069075 PMCID: PMC10706713 DOI: 10.3390/ijms242316754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Current clinical treatment of periodontitis alleviates periodontal symptoms and helps to keep the disease under control for extended periods. Despite this, a significant destruction of the tooth's underlying bone tissue often takes place progressively. Herein, we present a two-way therapeutic approach for local delivery of antibacterial agents and bone tissue regeneration, incorporating ~1% w/w tetracycline hydrochloride (TCH) into a 3D-printed scaffold composed of poly(ε-caprolactone) (PCL). Samples were assessed for their morphological, physicochemical, pharmacokinetic, and antibacterial properties. Furthermore, osteoprecursor cells (MC3T3-E1) were employed to evaluate the osteoinductive potential of the drug-loaded scaffolds. Cell proliferation, viability, and differentiation were determined on all cell-seeded scaffolds. At the end of the culture, PCL-TCH scaffolds promoted abundant collagen organic matrix, demonstrating augmented alkaline phosphatase (ALP) activity and areas of accumulated mineralised bone tissue, despite their belayed cell proliferation. Based on the observed effectiveness of the PCL-TCH scaffolds to inhibit Staphylococcus aureus, these constructs could serve as an alternative bioactive implant that supports bacterial inhibition and favours a 3D microenvironment for bone tissue regeneration in severe periodontitis.
Collapse
Affiliation(s)
- Konstantinos Theodoridis
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
| | - Athanasios S. Arampatzis
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
- Natural Products Research Center of Excellence (NatPro-AUTH), Center for Interdisciplinary Research and Innovation of Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
| | - Georgia Liasi
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
| | - Lazaros Tsalikis
- School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Panagiotis Barmpalexis
- Laboratory of Pharmaceutical Technology, Division of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Dimitrios Christofilos
- School of Chemical Engineering & Physics Laboratory, Faculty of Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Andreana N. Assimopoulou
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
- Natural Products Research Center of Excellence (NatPro-AUTH), Center for Interdisciplinary Research and Innovation of Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
| |
Collapse
|
6
|
Hangyasi DB, Körtvélyessy G, Blašković M, Rider P, Rogge S, Siber S, Kačarević ŽP, Čandrlić M. Regeneration of Intrabony Defects Using a Novel Magnesium Membrane. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2018. [PMID: 38004067 PMCID: PMC10672749 DOI: 10.3390/medicina59112018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Due to their specific morphology, the regeneration of intrabony defects (IBDs) represents one of the greatest challenges for clinicians. Based on the specific properties of a magnesium membrane, a new approach for the surgical treatment of IBD was developed. The surgical procedure was described using a series of three cases. Materials and Methods: The patients were healthy individuals suffering from a severe form of periodontitis associated with IBD. Based on radiographic examination, the patients had interproximal bone loss of at least 4 mm. Due to its good mechanical properties, it was easy to cut and shape the magnesium membrane into three different shapes to treat the specific morphology of each IBD. In accordance with the principles of guided bone regeneration, a bovine xenograft was used to fill the IBD in all cases. Results: After a healing period of 4 to 6 months, successful bone regeneration was confirmed using radiological analysis. The periodontal probing depth (PPD) after healing showed a reduction of 1.66 ± 0.29 mm. Conclusions: Overall, the use of the different shapes of the magnesium membrane in the treatment of IBD resulted in a satisfactory functional and esthetic outcome.
Collapse
Affiliation(s)
- David Botond Hangyasi
- Department of Periodontology, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66, H-6720 Szeged, Hungary;
| | - Győző Körtvélyessy
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66, H-6720 Szeged, Hungary;
| | - Marko Blašković
- Department of Oral Surgery, Faculty of Dental Medicine Rijeka, University of Rijeka, Krešimirova 40/42, 51 000 Rijeka, Croatia;
| | - Patrick Rider
- Botiss Biomaterials GmbH, 15806 Zossen, Germany; (P.R.); (S.R.)
| | - Svenja Rogge
- Botiss Biomaterials GmbH, 15806 Zossen, Germany; (P.R.); (S.R.)
| | - Stjepan Siber
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia;
| | - Željka Perić Kačarević
- Botiss Biomaterials GmbH, 15806 Zossen, Germany; (P.R.); (S.R.)
- Department of Anatomy, Histology, Embryology, Pathologic Anatomy and Pathologic Histology, J.J. Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia
| | - Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia;
| |
Collapse
|
7
|
Ribeiro FV, Mehta JJ, Monteiro MF, Moore J, Casati MZ, Nibali L. Minimal invasiveness in nonsurgical periodontal therapy. Periodontol 2000 2023; 91:7-19. [PMID: 36661203 DOI: 10.1111/prd.12476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 01/21/2023]
Abstract
Periodontal treatment is quickly moving towards a philosophy consisting of a less invasive approach. In this context, minimally invasive nonsurgical therapy (MINST) is a promising option. This paper reviews the concepts behind minimal invasiveness in nonsurgical periodontology and reports the state-of the art evidence for this topic. Instruments used and protocols suggested for these applications are introduced and discussed. The original papers reviewed show probing pocket depth (PPD) reductions and clinical attachment level (CAL) gains ranging from 2 to 4 mm between baseline and 6 months to 5 years posttreatment for intrabony defects and from 1.5 to 3 mm between baseline and 2-6 months of follow-up for full-mouth results. These clinical outcomes are accompanied by statistically significant reductions in radiographic bone defect depth and increases in intrabony defect angles posttreatment. Wound healing mechanisms following MINST are presented, and clinical applications and directions for future research are suggested.
Collapse
Affiliation(s)
- Fernanda V Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - Jaimini J Mehta
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Mabelle F Monteiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil.,Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Jatinder Moore
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Marcio Z Casati
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil.,Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| |
Collapse
|
8
|
Patila T, Y SS, Vivekanandan G, Shetty RM, Rahman B, Al Shehadat S, Shetty SR. Comparison of clinical outcomes of non-surgical adjunctive use of the 980-nm diode laser to conventional periodontal flap procedure-a randomised controlled split-mouth clinical trial. Lasers Med Sci 2022; 37:3213-3220. [PMID: 35867285 DOI: 10.1007/s10103-022-03605-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Abstract
Lasers have been found to be effective as an adjunctive in periodontal therapy. The objective of the study was to compare the outcomes of non-surgical adjunctive use of 980-nm diode laser to that of conventional flap surgery in terms of clinical outcome measures and radiographic osseous defect depths. This study was designed as a double-blinded split-mouth randomised controlled clinical trial. A total of fifteen patients (30 quadrants) with generalised periodontitis stage III grade B were randomly assigned test group (diode laser) and control group (conventional flap surgery). Both test and control groups had 15 quadrants each. At 3 months, the probing pocket depth (PPD) was 3.46 ± 0.19 mm (test) and 4.20 ± 0.20 mm (control), with a statistically significant difference between the groups (p = 0.01). Similarly, at 6 months re-evaluation, PPD was 1.46 ± 0.12 mm (test) and 2.33 ± 0.13 mm (control) with a highly significant statistical difference (p = 0.001). Plaque index showed a difference between both test and control groups at baseline, 3 months and 6 months (p = 0.001) while gingival index, modified sulcular bleeding index and radiographic osseous defect depth showed a difference at 3 months and 6 months (p = 0.001). Within the study's limitations, 980-nm diode laser can result in significant improvements in the clinical and radiographic parameters and is very well tolerated by the subjects.
Collapse
Affiliation(s)
- Thaneshwar Patila
- Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, India
| | - Sunaina Shetty Y
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
| | - Gopinath Vivekanandan
- Department of Periodontology, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
| | - Raghavendra M Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE.,Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE.,Adjunct Faculty, Dept. of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India
| | - Betul Rahman
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Saaid Al Shehadat
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Shishir Ram Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| |
Collapse
|
9
|
Dortaj D, Bassir SH, Hakimiha N, Hong H, Aslroosta H, Fekrazad R, Moslemi N. Efficacy of Nd:YAG laser-assisted periodontal therapy for the management of periodontitis: A double-blind split-mouth randomized controlled clinical trial. J Periodontol 2022; 93:662-672. [PMID: 34411291 DOI: 10.1002/jper.21-0242] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study aimed to explore the efficacy of Nd:YAG laser-assisted periodontal therapy for management of patients with stage II-IV periodontitis. METHODS Patients who presented with residual periodontal pockets were enrolled. After non-surgical periodontal therapy (NSPT), test sites received Nd:YAG laser (first entrance to pocket: 3 W, 100 μs, 20 Hz; second entrance: 4 W, 600 μs, 20 Hz) and control sites received placebo (laser off). Periodontal probing depth (PPD), clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), and plaque index (PI) were recorded at baseline and 1, 2, 3, 4 and 6-month visits. RESULTS Twenty patients completed the 6-month period. Significant reductions in PPD, CAL, BOP, and PI values and a significant increase in GR at all follow-up visits compared to the baseline (all P < 0.001) were revealed in both groups. Test sites showed significantly greater improvement in PPD (P = 0.0002) and greater increase in GR (P < 0.0001) compared to the control sites at 6-month visit. There was no difference between two groups regarding CAL gain through the study period (P = 0.23). CONCLUSION NSPT+Nd:YAG laser with the current protocol results in greater PPD reduction compared to NSPT alone. However, this reduction is likely because of greater GR rather than attachment gain. Therefore, the adjunction of Nd:YAG laser (with the current setting) to the NSPT for the treatment of residual periodontal pockets did not ameliorate the clinical outcomes (ClinicalTrials.gov ID: NCT03365167).
Collapse
Affiliation(s)
- Dorara Dortaj
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Operative Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Bassir
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Neda Hakimiha
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Houlin Hong
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Hoori Aslroosta
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, School of Dentistry, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Neda Moslemi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Ng E, Tay JRH, Ong MMA. Minimally Invasive Periodontology: A Treatment Philosophy and Suggested Approach. Int J Dent 2021; 2021:2810264. [PMID: 34257659 PMCID: PMC8245214 DOI: 10.1155/2021/2810264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 01/20/2023] Open
Abstract
Severe periodontitis is a highly prevalent dental disease. With the advent of implant dentistry, teeth are often extracted and replaced. Periodontal surgery, where indicated, could also result in increased trauma to the patient. This literature review discusses different treatment modalities for periodontitis and proposes a treatment approach emphasizing maximum preservation of teeth while minimizing morbidity to the patient. Scientific articles were retrieved from the MEDLINE/PubMed database up to January 2021 to identify appropriate articles that addressed the objectives of this review. This was supplemented with hand searching using reference lists from relevant articles. As tooth prognostication does not have a high predictive value, a more conservative approach in extracting teeth should be abided by. This may involve repeated rounds of nonsurgical periodontal therapy, and adjuncts such as locally delivered statin gels and subantimicrobial-dose doxycycline appear to be effective. Periodontal surgery should not be carried out at an early phase in therapy as improvements in nonsurgical therapy may be observed up to 12 months from initial treatment. Periodontal surgery, where indicated, should also be minimally invasive, with periodontal regeneration being shown to be effective over 20 years of follow-up. Biomarkers provide an opportunity for early detection of disease activity and personalised treatment. Quality of life is proposed as an alternative end point to the traditional biomedical paradigm focused on the disease state and clinical outcomes. In summary, minimally invasive therapy aims to preserve health and function of the natural dentition, thus improving the quality of life for patients with periodontitis.
Collapse
Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - Marianne Meng Ann Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| |
Collapse
|