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Alsakr A, Gufran K, Alqahtani AS, Alasqah M, Alnufaiy B, Alzahrani HG, Alahmari AA, Alhumaidani FK, Alhumaidani RK, Althobiti MJ. Ozone Therapy as an Adjuvant in the Treatment of Periodontitis. J Clin Med 2023; 12:7078. [PMID: 38002690 PMCID: PMC10672703 DOI: 10.3390/jcm12227078] [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: 10/04/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023] Open
Abstract
The current study aimed to assess the efficacy of ozone therapy in the treatment of stage II and stage III periodontitis. This prospective split-mouth study selected patients who were diagnosed with either stage II or stage III periodontitis. All patients were treated with scaling and root-planing (SRP) on the control side and SRP with ozone therapy on the test side. Probing depth (PD), clinical attachment loss (CAL), O'Leary plaque index (PI), and bleeding on probing (BOP) scores were recorded at baseline and six weeks after the SRP treatment. A total of 46 patients were selected for this study, including 31 males and 15 females. All periodontal variables (PD, CAL, PI, and BOP) showed significant changes (p < 0.0001) from baseline to six weeks. Moreover, significant changes (PD = 0.0001, CAL = 0.0001, PI = 0.042 and BOP = 0.0001) were also observed between the control and test sides. Gender showed no significance on periodontal variables (p > 0.05) except PD on the test side (p = 0.030). In addition, periodontal stages and grades showed no significant changes (p > 0.05) in any periodontal variables on both sides. Ozone therapy significantly improves the periodontal condition compared to SRP treatment alone. However, the stages and grades of periodontitis do not influence the outcome of ozone therapy.
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Affiliation(s)
- Abdulaziz Alsakr
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Abdullah Saad Alqahtani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Mohammed Alasqah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Banna Alnufaiy
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Hanadi Ghurmallah Alzahrani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Ali Ayidh Alahmari
- Dental Intern, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.A.A.); (F.K.A.); (R.K.A.)
| | - Faisal Khaled Alhumaidani
- Dental Intern, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.A.A.); (F.K.A.); (R.K.A.)
| | - Rakan Khaled Alhumaidani
- Dental Intern, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.A.A.); (F.K.A.); (R.K.A.)
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Ortíz de Urbina Comerón P, Zubizarreta-Macho Á, Lobo Galindo AB, Montiel-Company JM, Lorenzo-Gómez MF, Flores Fraile J. Relationship between Prostate Inflammation and Periodontal Disease-A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6070. [PMID: 37763009 PMCID: PMC10531617 DOI: 10.3390/jcm12186070] [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: 08/07/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this systematic review and meta-analysis was to analyze the association between periodontal disease and prostate inflammation with a null hypothesis stating that periodontal disease does not increase the incidence of prostate inflammation. MATERIALS AND METHODS A systematic literature review and meta-analysis of longitudinal observational cohort and case-control studies that evaluated the odds ratio or hazard ratio and confidence interval was undertaken based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations (2020). A total of four databases were consulted in the literature search: PubMed-Medline, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and quantitative analyses. RESULTS Four observational cohort studies and three observational cohort case-control studies were included in the meta-analysis. The four observational cohort studies were combined using the random effects model to estimate a hazard ratio of 1.32 with a confidence interval of 95% between 0.87 and 1.77. The meta-analysis presented high heterogeneity (Q test = 56.1; p value < 0.001; I2 = 94.9%). Moreover, the three observational case-control studies were combined using the random effects model to estimate an odds ratio of 1.62 with a confidence interval of 95% between 1.41 and 1.84. The meta-analysis presented high heterogeneity (Q test = 1.07; p value = 0.782; I2 = 0%). CONCLUSIONS The incidence of periodontal disease does not increase the risk of the incidence of prostate inflammation.
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Affiliation(s)
- Pablo Ortíz de Urbina Comerón
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain;
| | - Ana Belén Lobo Galindo
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain;
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - María-Fernanda Lorenzo-Gómez
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
- Servicio de Urología del Hospital, Universitario de Salamanca, 37007 Salamanca, Spain
| | - Javier Flores Fraile
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
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Lee Y, Jung BH, Yoo KY, Lim HJ, Shin KJ, Lee JK. Lactobacillus fermentum attenuates the alveolar bone loss in ligature-induced periodontitis in mice. Oral Dis 2023. [PMID: 37724481 DOI: 10.1111/odi.14739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE This study investigated the effects of Lactobacillus fermentum BELF11 on periodontitis in mice (LIP). METHODS Sixty mice were randomly assigned to a control group (CTL), LIP/PBS group (LIP and PBS applied), or LIP/BELF11 group (LIP and L. fermentum BELF11 applied). For 14 days, PBS or L. fermentum BELF11 was applied twice daily to the mice in the LIP/PBS or LIP/BELF11 group, respectively. After 14 days, radiographic, histological, and pro-inflammatory cytokine assessments were conducted. RESULTS The LIP/PBS and LIP/BELF11 groups demonstrated greater alveolar bone loss than the CTL group (p < 0.05). The LIP/BELF11 group showed significantly reduced alveolar bone loss on the mesial side compared to the LIP/PBS group. Histologically, the LIP/BELF11 group showed consistent patterns of connective tissue fiber arrangement, lower levels of inflammatory infiltration, less alveolar bone loss, and higher alveolar bone density than the LIP/PBS group, despite showing more signs of destruction than the CTL group. The LIP/BELF11 group also exhibited significantly lower levels of pro-inflammatory cytokines than the LIP/PBS group. CONCLUSIONS L. fermentum BELF11 inhibits alveolar bone loss and periodontitis progression by regulating pro-inflammatory cytokine production. These findings suggest that L. fermentum BELF11 may be a potential adjunctive therapy in periodontal treatment.
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Affiliation(s)
- Yuni Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
| | - Bo Hyun Jung
- Department of Anatomy and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
| | - Ki-Yeon Yoo
- Department of Anatomy and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
| | - Hye Ji Lim
- R&D Center, Hecto Healthcare Co., Ltd, Seoul, Republic of Korea
| | - Kum-Joo Shin
- R&D Center, Hecto Healthcare Co., Ltd, Seoul, Republic of Korea
| | - Jae-Kwan Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
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Jambhekar S, Soman M, Shrivastava R, Ventrapragada R, Sarate S, Kodem T. Comparative Evaluation of Tetracycline Hydrochloride Fiber and Simvastatin Gel as an Adjunct to Scaling and Root Planing in Periodontitis Patients. Cureus 2023; 15:e42314. [PMID: 37621803 PMCID: PMC10445047 DOI: 10.7759/cureus.42314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Inflammation of oral soft tissues, caused by periodontal disease, results in the loss of attachment to supporting therapy and is a severe threat to dental health. Although there are a number of therapeutic options available, mechanical debridement continues to be the gold standard. Scaling and root planing is the gold standard therapy for periodontitis, but this research aims to examine the efficacy of tetracycline fibers and simvastatin gel as local drug delivery methods. We evaluated 60 sites, splitting them into three groups: 20 sites received just scaling and root planing; 20 sites received scaling and root planing plus simvastatin gel; and 20 sites received scaling and root planing plus tetracycline fibers. Clinical indicators such as the gingival index, the modified sulcular bleeding index, and the probing depth were measured at the start of the study, after one week, after one month, after three months, and after six months. After six months, the simvastatin group reduced the gingival index and modified sulcular bleeding index more than the tetracycline group, whereas the tetracycline group reduced probing depth more than the simvastatin group.
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Affiliation(s)
- Samidha Jambhekar
- Department of Periodontics, Dr. DY Patil Dental College and Hospital, Mumbai, IND
| | - Mrunmayee Soman
- Department of Dentistry, Dr. DY Patil Dental College and Hospital, Pimpri, IND
| | - Ratika Shrivastava
- Department of Periodontology, Rishiraj College of Dental Science & Research Center, Bhopal, IND
| | - Roja Ventrapragada
- Department of Periodontology, Partha Dental Skin Hair Clinic, Mangalagiri, IND
| | - Shweta Sarate
- Department of Periodontology, People's College of Dental Sciences, Bhopal, IND
| | - Tejaswi Kodem
- Department of Periodontology, Gitam Dental College and Hospital, Visakhapatnam, IND
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Ochôa C, Castro F, Bulhosa JF, Manso C, Fernandes JCH, Fernandes GVO. Influence of the Probiotic L. reuteri on Periodontal Clinical Parameters after Nonsurgical Treatment: A Systematic Review. Microorganisms 2023; 11:1449. [PMID: 37374951 DOI: 10.3390/microorganisms11061449] [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: 05/20/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023] Open
Abstract
The aim of this systematic review was to evaluate the actual efficacy of Lactobacillus reuteri (L. reuteri) on the periodontal clinical parameters when used concomitantly to the nonsurgical periodontal treatment. Searches were conducted through PubMed Central, Online Knowledge Library, Science Direct, Scielo, and Cochrane databases from 2012 to 2022. The focused question was "In patients with periodontitis, will the probiotic L. reuteri, when administrated as an adjunct to nonsurgical periodontal treatment, compared to the nonsurgical periodontal treatment alone, result in better clinical outcomes?" The following information was extracted from the articles: author and year of publication, type of study, follow-up, sample size and number of defects, and clinical characteristics and details. All included studies were qualitatively assessed using the Critical Appraisal tools according to the Joanna Briggs Institute. Twenty-four articles were full-text reading, but only 9 articles were included. The number of patients enrolled was 287, aged between 18 and 56 years. All periodontal parameters were evaluated. The "follow-up" varied (14, 40, 84, 90, 180, and 360 days). Most articles supported the clinical benefits of L. reuteri as an adjunct to SRP compared to SRP alone. A common finding at the beginning period was thatno statistically different results were observed between the test and control groups; otherwise, at the last period, a significant improvement was found in favor of the probiotic use (p = 0.001) for all the clinical parameters. The use of L. reuteri as an adjunct to nonsurgical periodontal treatment may result in significantly better clinical outcomes than nonsurgical periodontal treatment alone; but the conclusion must be carefully interpreted because of the heterogeneity found among the studies.
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Affiliation(s)
- Carlota Ochôa
- FP-I3ID, FCS, Fernando Pessoa University, 4249-004 Porto, Portugal
| | - Filipe Castro
- FP-I3ID, FCS, Fernando Pessoa University, 4249-004 Porto, Portugal
| | | | - Conceição Manso
- FP-I3ID, FCS, Fernando Pessoa University, 4249-004 Porto, Portugal
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Li J, Zhao G, Zhang HM, Zhu FF. Probiotic adjuvant treatment in combination with scaling and root planing in chronic periodontitis: a systematic review and meta-analysis. Benef Microbes 2023; 14:95-108. [PMID: 36856123 DOI: 10.3920/bm2022.0056] [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: 03/02/2023]
Abstract
This systematic review and meta-analysis assessed the impact of probiotic supplementation on treating chronic periodontal (CP) disease based on clinical and microbiological findings. Four databases were searched: Medline, Embase, Cochrane Library, and the Web of Science databases. The references to relevant studies were also manually searched. Analyses were conducted using the Review Manager 5.2 software, while the quality of randomised controlled trials was assessed with the Cochrane Risk of Bias tool. In total, 19 studies were included in the meta-analysis. Pooled results revealed that the adjuvant use of probiotics in the treatment of patients with periodontal disease was largely associated with good clinical efficacy. Resulting in statistically significant improvements in plaque index (P<0.05), periodontal probing depth (P<0.05), clinical attachment level (P<0.05), gingival index (P<0.05), bleeding on probing (P<0.05), deep probing depth (P<0.05), and levels of subgingival microbes (P<0.05) following probiotic supplementation. In summary, the results of this meta-analysis suggest that the administration of probiotics together with scaling and root planing can somewhat improve CP patient clinical outcomes and reduce levels of periodontal pathogens. However, more comprehensive experiments are needed to standardise probiotics and maximise their adjuvant therapy.
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Affiliation(s)
- J Li
- Jiamusi University, Jiamusi City 154000, Heilongjiang Province, China P.R
- Jiamusi University Affiliated Stomatological Hospital, Jiamusi City 154004, Heilongjiang Province, China P.R
| | - G Zhao
- Jiamusi University Affiliated Stomatological Hospital, Jiamusi City 154004, Heilongjiang Province, China P.R
| | - H M Zhang
- Jiamusi University, Jiamusi City 154000, Heilongjiang Province, China P.R
| | - F F Zhu
- Jiamusi University, Jiamusi City 154000, Heilongjiang Province, China P.R
- Jiamusi University Affiliated Stomatological Hospital, Jiamusi City 154004, Heilongjiang Province, China P.R
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Gonde NP, Rathod SR, Kolte AP. Comparative evaluation of 1% melatonin gel in the treatment of intrabony defect: A randomized controlled clinical trial. J Periodontol 2022; 93:1878-1888. [PMID: 35238041 DOI: 10.1002/jper.21-0515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/28/2022] [Accepted: 02/24/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The present study aims to evaluate and compare the efficacy of locally delivered 1% melatonin gel as an adjunct to non-surgical periodontal therapy (NSPT) in treatment of intrabony defect in Stage III periodontitis, clinically, and radiographically using cone-beam computed tomography (CBCT). METHODS This split-mouth clinical trial randomly allotted 44 bilateral intrabony defect (in 22 patients) into two groups where Group I was treated with NSPT with locally delivered placebo gel while Group II was treated with NSPT with 1% melatonin gel. The intrabony defect fill measured from cemento-enamel junction (CEJ)-base of the defect (BD), and the difference in the measurement values of CEJ-BD from baseline to 6 months denoting the bone fill and bone volume evaluated at 6 months using CBCT were the primary outcome measures. Secondary outcome measures were change in probing depth (PD), clinical attachment level (CAL), plaque index, and modified sulcus bleeding index recorded at baseline, 3 months, and 6 months. RESULTS Both the study groups showed improvements in assessed parameters, however, a significant gain in intrabony defect fill was observed in Group II (1.46 ± 0.58) as compared with Group I (0.50 ± 0.38) and change in bone volume for Group I was 21.4645 ± 8.8980 mm3 and for Group II was 51.8418 ± 30.2329 mm3 with P < 0.0001.The mean reduction in PD and gain in CAL was 3.90 ± 0.78 and 2.94 ± 0.80 in Group II and in Group I it was 3.23 ± 0.90 and 1.96 ± 0.80 (P < 0.0001). CONCLUSION The use of 1% melatonin gel as an adjunct to NSPT is more beneficial in achieving better clinical and radiographic outcome at 6 months which indicates that adjunct use of melatonin gel to NSPT as a local drug delivery is preferred when compared with NSPT and placebo gel alone.
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Affiliation(s)
- Noopur P Gonde
- Department of Periodontics & Implantology, VSPM Dental College and Research Center, Nagpur, India
| | - Surekha R Rathod
- Department of Periodontics & Implantology, VSPM Dental College and Research Center, Nagpur, India
| | - Abhay P Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Center, Nagpur, India
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Impact of Three Nonsurgical, Full-Mouth Periodontal Treatments on Total Bacterial Load and Selected Pathobionts. Antibiotics (Basel) 2022; 11:antibiotics11050686. [PMID: 35625330 PMCID: PMC9138013 DOI: 10.3390/antibiotics11050686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/21/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
For the treatment of periodontitis stage III/IV, a quadrant/week-wise debridement (Q-SRP) was compared with three full-mouth approaches: full-mouth scaling (FMS, accelerated Q-SRP within 24 h), full-mouth scaling with chlorhexidine-based disinfection (FMD), and FMD with adjuvant erythritol air polishing (FMDAP). The objective of this prospective, randomized study (a substudy of ClinicalTrials.gov, identifier: NCT03509233) was to compare the clinical and microbiological effects of the treatments. In total, 105 patients were randomized to one of the four aforementioned treatment groups, with n = 25, 28, 27, and 25 patients allocated to each group, respectively. At baseline and 3 and 6 months after treatment, the clinical parameters, including the pocket probing depths, clinical attachment level, and bleeding on probing, were recorded, and the prevalence of the total bacteria and four periodontal pathobionts (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia) was determined using real-time quantitative PCR. Concerning the clinical outcomes, all the treatment modalities were effective, but the full-mouth approaches, especially FMDAP, were slightly superior to Q-SRP. Using the FMD approach, the reduction in the bacterial load and the number of pathobionts was significantly greater than for FMS, followed by Q-SRP. FMDAP was the least effective protocol for microbial reduction. However, after a temporary increase 3 months after therapy using FMDAP, a significant decrease in the key pathogen, P. gingivalis, was observed. These findings were not consistent with the clinical results from the FMDAP group. In conclusion, the dynamics of bacterial colonization do not necessarily correlate with clinical outcomes after full-mouth treatments for periodontitis stage III/IV.
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Kommerein N, Vierengel N, Groß J, Opatz T, Al-Nawas B, Müller-Heupt LK. Antiplanktonic and Antibiofilm Activity of Rheum palmatum against Streptococcus oralis and Porphyromonas gingivalis. Microorganisms 2022; 10:microorganisms10050965. [PMID: 35630409 PMCID: PMC9143743 DOI: 10.3390/microorganisms10050965] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/24/2022] [Accepted: 05/01/2022] [Indexed: 01/27/2023] Open
Abstract
Periodontitis and peri-implantitis are inflammatory conditions with a high global prevalence. Oral pathogens such as Porphyromonas gingivalis play a crucial role in the development of dysbiotic biofilms associated with both diseases. The aim of our study was to identify plant-derived substances which mainly inhibit the growth of “disease promoting bacteria”, by comparing the effect of Rheum palmatum root extract against P. gingivalis and the commensal species Streptococcus oralis. Antiplanktonic activity was determined by measuring optical density and metabolic activity. Antibiofilm activity was quantified using metabolic activity assays and live/dead fluorescence staining combined with confocal laser scanning microscopy. At concentrations of 3.9 mg/L, R. palmatum root extract selectively inhibited planktonic growth of the oral pathogen P. gingivalis, while not inhibiting growth of S. oralis. Selective effects also occurred in mature biofilms, as P. gingivalis was significantly more stressed and inhibited than S. oralis. Our studies show that low concentrations of R. palmatum root extract specifically inhibit P. gingivalis growth, and offer a promising approach for the development of a potential topical agent to prevent alterations in the microbiome due to overgrowth of pathogenic P. gingivalis.
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Affiliation(s)
- Nadine Kommerein
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany;
| | - Nina Vierengel
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10–14, 55128 Mainz, Germany; (N.V.); (J.G.); (T.O.)
| | - Jonathan Groß
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10–14, 55128 Mainz, Germany; (N.V.); (J.G.); (T.O.)
| | - Till Opatz
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10–14, 55128 Mainz, Germany; (N.V.); (J.G.); (T.O.)
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany;
| | - Lena Katharina Müller-Heupt
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany;
- Correspondence: ; Tel.: +49-6131-175086
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Mirzaeei S, Ezzati A, Mehrandish S, Asare-Addo K, Nokhodchi A. An overview of guided tissue regeneration (GTR) systems designed and developed as drug carriers for management of periodontitis. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103341] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Ariel H, Kahn A, Hila ZO, Anton S, Natan G, Kolerman R. A thermosensitive gel with an active hyaluronic acid ingredient that contains an octenidine preservation system as an adjunct to scaling and root planning: a randomized prospective clinical study. Clin Oral Investig 2022; 26:3721-3733. [PMID: 34997360 DOI: 10.1007/s00784-021-04344-2] [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: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the adjunctive effect of a thermosensitive gel formulation that contains 0.8% oligo hyaluronic acid (HA) combined with a preservation system of octenidine HCl 0.625% and phenoxyethanol to scaling and root planing (SRP) as compared with SRP alone in the treatment of residual pockets of patients with stage 3 periodontitis. MATERIALS AND METHODS Thirty-four patients (21 males and 13 females) aged 29-78 years (51.3 ± 13.1) with stage 3 periodontitis were recruited to participate in the present split-mouth study. None of the patients has been previously treated for periodontitis. Plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were evaluated at baseline and at 3 and 6 months post treatment. Full-mouth SRP was performed in all residual pockets ≥ 5 mm. Treatment was performed by means of ultrasonic and hand instruments and lasted 45-60 min. The gel was applied subgingivally in the test sites immediately after SRP (baseline) and 1 month later. The paired t-test for two means was applied to test the statistical significance of the change from baseline within each arm and determine the difference between groups. The level of significance was set at 0.05 for all tests. RESULTS Mean PD reductions between baseline and 3 and 6 months were 1.98 mm and 2.79 mm for the test and 1.22 mm and 1.50 mm for the control group, respectively. Comparisons between the test and control groups revealed that SRP + gel yielded statistically significantly higher PD reductions compared to SRP alone (p < 0.0001). Compared to baseline, CAL and BOP values improved statistically significantly in both groups, although the test group presented statistically significantly higher CAL gains and BOP reductions than the control group (P < 0.0001). CONCLUSION In residual pockets of stage 3 periodontitis patients, the local application of a thermosensitive gel with an active HA ingredient and a preservation system of octenidine HCl 0.625% in conjunction with SRP may additionally improve the clinical outcomes obtained with SRP alone. CLINICAL RELEVANCE A novel HA and octenidine containing thermosensitive gel effectively improved the clinical parameters in stage 3 periodontitis patients over a 6-month period.
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Affiliation(s)
- Hirsch Ariel
- Periodontology, Private Clinic, Tel-Aviv, Israel
| | - Adrian Kahn
- Department of Oral and Maxillofacial Surgery, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ziv-On Hila
- Department of Oral Pathology and Oral Medicine,the Maurice and Gabriela Goldschleger School of Dental Medicine,Tel-Aviv University, Tel-Aviv, Israel
| | - Sculean Anton
- Chair,Department of Periodontology, University of Berne, Bern, Switzerland
| | - Gadoth Natan
- Department of Neurology, Maynei-Hayeshua Medical Center Bnei Brak, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Roni Kolerman
- Department of Periodontology and Dental Implantology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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12
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El-Bagoory GKM, El-Guindy HM, Shoukheba MYM, El-Zamarany EA. The adjunctive effect of probiotics to nonsurgical treatment of chronic periodontitis: A randomized controlled clinical trial. J Indian Soc Periodontol 2021; 25:525-531. [PMID: 34898919 PMCID: PMC8603793 DOI: 10.4103/jisp.jisp_114_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/28/2021] [Accepted: 07/11/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Probiotics catch more attention as adjunctive periodontal therapy. This study was conducted to assess the benefit of locally delivered Lactobacillus reuteri (L. reuteri) probiotic as an adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis clinically and microbiologically. Materials and Methods: Bacterial cultures and clinical evaluation were recorded in 20 sites of chronic periodontitis in 12 patients and followed up at 3 and 6 months from the start of intervention using clinical attachment level, probing pocket depth, plaque index (PI), bleeding on probing, and microbiologically for Porphyromonas gingivalis (P. gingivalis) load. Patients meeting the inclusion criteria were scheduled within 1 week for two sessions of SRP. After SRP, oral hygiene measures were reassured, and sites were divided randomly into two groups 10 sites each. Group I received SRP only, while Group II received SRP and subgingival delivery of 1 ml of probiotic L. reuteri suspension at baseline and 1, 2, and 4 weeks using a blunt syringe. A periodontal pack was applied after the placement of the drug. Results: We found noticeable variation between the two groups in all evaluation aspects at 3 and 6-month follow-up periods except PI at 6 months in which there was no significant difference between both groups. Conclusions: The results proved the antimicrobial benefit of L. reuteri probiotic as a promising adjunctive therapy in improving periodontal parameters. However, further long-term studies with large sample size are needed to evaluate the extent of the added value of L. reuteri suspension.
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Affiliation(s)
| | - Hoda Mohamed El-Guindy
- Department of Periodontology, Oral Medicine, Oral Diagnosis and Radiology, Faculty of Dentistry, Tanta, Egypt
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Kollmuss M, Tolksdorf K, Wuersching SN, Hickel R, Huth KC. Effect of polyhexanide as antiseptic mouth rinse against oral pathogens in an in vitro biofilm model. Acta Odontol Scand 2021; 79:506-513. [PMID: 33721544 DOI: 10.1080/00016357.2021.1899280] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the anti-biofilm effect of polyhexanide mouth rinses against oral pathogens in vitro. MATERIAL AND METHODS Biofilms of Candida albicans, Streptococcus mutans, Actinomyces naeslundii, Aggregatibacter actinomycetemcomitans, methicillin-resistant Staphylococcus aureus and Fusobacterium nucleatum were grown on 10 mm diameter hydroxyapatite discs for 5 days. Biofilms were exposed to test substances for 30 s (ProntOral, polyhexanide 0.15%, chlorhexidine 0.2%). Another test set simulating blood contamination in the oral cavity was performed by submerging the discs in defibrinated sheep blood prior to antimicrobial exposure. Biofilm mass was determined via crystal violet staining. The proliferation potency of the cells after antimicrobial exposure was evaluated by plating serially diluted suspensions from extracted biofilms on agar plates and determining the number of colony-forming units (CFU/ml). Mann-Whitney-U, Kruskal-Wallis and Dunn's test were used for statistical analyses. RESULTS Regardless of blood contamination ProntOral led to a significant reduction of biofilm mass in all strains. Chlorhexidine and polyhexanide reduced biofilm mass in five out of six strains and in only four strains after blood contamination. All agents significantly reduced CFU/ml from S. mutans, A. actinomycetemcomitans and F. nucleatum biofilms. C. albicans and S. aureus biofilms were only affected by ProntOral and polyhexanide. None of the antiseptics significantly reduced the CFU/ml for A. naeslundii biofilms. After blood contamination ProntOral and polyhexanide significantly reduced CFU/ml in all strains, whereas CHX tended to increase the CFU/ml. CONCLUSIONS Polyhexanide mouth rinses seem to be suitable disinfectants against oral pathogens without their anti-biofilm potential being impaired by blood.
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Affiliation(s)
- Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Konrad Tolksdorf
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, University Hospital, FSU Jena, Jena, Germany
| | - Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Karin Christine Huth
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
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14
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Bertoldi C, Generali L, Cortellini P, Lalla M, Luppi S, Tomasi A, Zaffe D, Salvatori R, Bergamini S. Influence of Tooth-Brushing on Early Healing after Access Flap Surgery: A Randomized Controlled Preliminary Study. MATERIALS 2021; 14:ma14112933. [PMID: 34072369 PMCID: PMC8198661 DOI: 10.3390/ma14112933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023]
Abstract
In the present study, the clinical outcomes obtained using three different protocols of post-operative plaque control for the 4 weeks after surgery were compared. Thirty healthy subjects, presenting at least one periodontal pocket requiring resective surgery, were selected and randomly distributed to three different groups corresponding to respective post-surgical protocols: (A) toothbrushes + chlorhexidine + anti-discoloration system (ADS + CHX); (B) toothbrushes + chlorhexidine (CHX); (C) only toothbrushes. The full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing pocket depth (PPD), recession depth (REC), clinical attachment level (CAL), and bleeding on probing (BoP) were measured in six aspects per tooth (mesio-buccal (MB), buccal (B), disto-buccal (DB), disto-lingual (DL), lingual (L), and mesio-lingual (ML)) at baseline, 3 months, and 6 months after surgery. FMPS and FMBS did not significantly change (p > 0.05), whereas PPD and CAL significantly decreased, and REC significantly increased in all groups during the study (p < 0.05). Clinical results were satisfactory in all cases, with no significant differences between groups 3 months after surgery. Six months after surgery, only PPD-MB was significantly different in the three groups (p < 0.05). Nevertheless, this value was not clinically relevant because the value of PPD-B (about 2 mm) in group C was physiologic. The mechanical plaque control was proven to be fundamental and sufficient in all the six aspects per tooth to guarantee an excellent clinical outcome without the need of chemical plaque control.
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Affiliation(s)
- Carlo Bertoldi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (S.B.)
- Correspondence: (C.B.); (L.G.); (D.Z.)
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (S.B.)
- Correspondence: (C.B.); (L.G.); (D.Z.)
| | - Pierpaolo Cortellini
- The European Research Group on Periodontology (ERGOPerio), 3855 Brienz-Bern, Switzerland;
| | - Michele Lalla
- Department of Economics Marco Biagi, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Sofia Luppi
- Independent Researcher, 41124 Modena, Italy;
| | - Aldo Tomasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (S.B.)
| | - Davide Zaffe
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Correspondence: (C.B.); (L.G.); (D.Z.)
| | - Roberta Salvatori
- Biomaterials Laboratory, Department of Medical and Surgical Sciences of Children and Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Stefania Bergamini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (S.B.)
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15
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Silva H. Tobacco Use and Periodontal Disease-The Role of Microvascular Dysfunction. BIOLOGY 2021; 10:441. [PMID: 34067557 PMCID: PMC8156280 DOI: 10.3390/biology10050441] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022]
Abstract
Periodontal disease consists in highly prevalent wide-ranging inflammatory conditions that affect the supporting apparatus of teeth. Tobacco use is the most important risk factor for periodontal disease as it increases disease severity and periodontal surgery complications. Tobacco use is harmful for the vasculature by causing microvascular dysfunction, which is known to negatively affect periodontal disease. To the author's knowledge this paper is the first comprehensive review on the mechanisms by which tobacco use affects oral microcirculation and impacts the pathophysiology of periodontal disease. In healthy subjects, acute nicotine administration or tobacco use (smoking/smokeless forms) increases the blood flow in the oral mucosa due to local irritation and increased blood pressure, which overcome neural- and endocrine-mediated vasoconstriction. Chronic tobacco smokers display an increased gingival microvascular density, which is attributed to an increased capillary recruitment, however, these microcirculatory units show higher tortuosity and lower caliber. These morphological changes, together with the repetitive vasoconstrictive insults, contribute to lower gingival perfusion in chronic smokers and do not completely regress upon smoking cessation. In periodontal disease there is considerable gingival inflammation and angiogenesis in non-smokers which, in chronic smokers, are considerably suppressed, in part due to local immune suppression and oxidative stress. Tobacco exposure, irrespective of the form of use, causes long-term microvascular dysfunction that increases the risk of complications due to the natural disease course or secondary therapeutic strategies.
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Affiliation(s)
- Henrique Silva
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam;
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam
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16
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Kevadia V, Kothiwale S. Assessment of benzyl isothiocyanate as an adjunct to conventional periodontal therapy. J Indian Soc Periodontol 2021; 25:34-40. [PMID: 33642739 PMCID: PMC7904019 DOI: 10.4103/jisp.jisp_418_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/30/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Conventional nonsurgical periodontal therapy eliminates the pathogenic microbes, yet residual deposits promote the recurrence of the disease. As antimicrobials may pose undesirable effects, alternate therapies are probed. Aim: The aim of the study is to evaluate the efficacy of locally delivered benzyl isothiocyanate (BITC) as an adjunct to scaling and root planing to treat patients with chronic periodontitis. Materials and Methods: The study included 30 patients diagnosed with chronic periodontitis. Test (scaling and root planing along with BITC intervention) and control (scaling and root planing) sites were randomly assigned to each patient. These sites were in the contralateral quadrants, having a probing depth of 4–6 mm. The plaque index (PI), gingival index (GI), pocket probing depth (PPD), clinical attachment level (CAL), and microbial load (colony forming unit [CFU]) were assessed at baseline, 1-week, and 6-week time interval. Data were analyzed by ANOVA/Friedman test, Mann–Whitney U-test, pairwise paired t-test, and Wilcoxon test, with P ≤ 0.05 set as statistically significant. Results: The scores of PI, GI, PPD, and CAL from baseline to 6-week follow-up within both the test and control sites were noted to be statistically significant (P < 0.0001). The CFU showed a significant reduction (P = 0.0229) within the test site at varying time intervals. The change in the mean PI score from baseline to 6-week time interval between the test and control site was noted to be statistically significant (P = 0.0039). Conclusion: The local application of BITC chips effectively reduced the PI, GI, PPD, and CFU, subsequently with the gain in CAL, and improved the tissue integrity and thereby oral hygiene.
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Affiliation(s)
- Vidhi Kevadia
- Department of Periodontics, KLE Vishwanath Katti Institute of Dental Sciences, KLE University, Belagavi, Karnataka, India
| | - Shaila Kothiwale
- Department of Periodontics, KLE Vishwanath Katti Institute of Dental Sciences, KLE University, Belagavi, Karnataka, India
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17
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Stutz C, Batool F, Petit C, Strub M, Kuchler-Bopp S, Benkirane-Jessel N, Huck O. Influence of parathyroid hormone on periodontal healing in animal models: A systematic review. Arch Oral Biol 2020; 120:104932. [PMID: 33113458 DOI: 10.1016/j.archoralbio.2020.104932] [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: 04/26/2020] [Revised: 07/10/2020] [Accepted: 09/21/2020] [Indexed: 12/09/2022]
Abstract
OBJECTIVES The purpose of this systematic review was to determine the potential interest of parathyroid hormone (PTH) as an adjunct to periodontal treatment based on studies performed in rodents. MATERIALS & METHODS Electronic databases (MEDLINE, Web of Science) were searched up to December 2019. Studies assessing the impact of PTH administration in experimental periodontitis in rodents have been identified. RESULTS Amongst the 247 identified articles, 10 met the inclusion criteria and were included in this systematic review. Experimental periodontitis was mainly induced by ligature placement or surgically with a dental bur. All studies considered bone healing after PTH administration at different frequencies as primary outcome. Results showed that an intermittent administration of PTH promoted bone healing and neovascularization. Nevertheless, a decrease of soft tissue inflammation was also observed. CONCLUSION Intermittent administration of PTH appears to enhance significantly periodontal healing and to promote alveolar bone regeneration. However, due to the risk of side effects, the development of scaffolds allowing its local and time-controlled delivery is of importance.
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Affiliation(s)
- Céline Stutz
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Fareeha Batool
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Catherine Petit
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France; Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Marion Strub
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France; Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sabine Kuchler-Bopp
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Nadia Benkirane-Jessel
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Olivier Huck
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France; Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
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18
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Desai H, Mahmoud MY, Tan J, Minooei F, Demuth DR, Steinbach-Rankins JM. Assessment of CafA Targeted BAR-Encapsulated Nanoparticles against Oral Biofilms. Pharmaceutics 2020; 12:E835. [PMID: 32882864 PMCID: PMC7557775 DOI: 10.3390/pharmaceutics12090835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/13/2020] [Accepted: 08/26/2020] [Indexed: 02/07/2023] Open
Abstract
Porphyromonas gingivalis adherence to Streptococcus gordonii is a crucial initial event that facilitates the colonization of P. gingivalis, a key pathogen in periodontal disease. As such, blocking these early interactions may present a potential avenue to limit P. gingivalis colonization. Nanoparticles encapsulating a synthetic peptide BAR (BAR-encapsulated NPs) inhibit P. gingivalis/S. gordonii biofilm formation 1.8-fold more potently relative to free BAR. However, BAR-encapsulated NPs, like many orally delivered formulations, may benefit from a strategy that improves their retention in an open flow environment. Here, we sought to enhance the efficacy of BAR-encapsulated NPs by modifying their surfaces with coaggregation factor A (CafA), a fimbrial protein expressed by the early colonizer, Actinomyces oris. We demonstrate that the targeting moiety, CafA, enhances NP binding and exhibits specificity of adherence to S. gordonii, relative to other oral bacterial species. Furthermore, CafA-modified NPs release inhibitory concentrations of BAR for 12 h, a time frame relevant to oral dosage form delivery. Lastly, CafA-modified NPs potently inhibit P. gingivalis/S. gordonii biofilm formation for up to 12 h and are non-toxic at therapeutically-relevant concentrations. These results suggest that CafA-modified NPs represent a novel and efficacious delivery vehicle for localized, targeted delivery of BAR to P. gingivalis preferred niches.
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Affiliation(s)
- Hetal Desai
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA; (H.D.); (J.T.)
- Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Mohamed Y. Mahmoud
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA;
- Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA;
- Department of Toxicology, Forensic Medicine and Veterinary Regulations, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt
| | - Jinlian Tan
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA; (H.D.); (J.T.)
| | - Farnaz Minooei
- Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA;
- Department of Chemical Engineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA
| | - Donald R. Demuth
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA; (H.D.); (J.T.)
- Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Jill M. Steinbach-Rankins
- Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, KY 40202, USA
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA;
- Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA;
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA
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19
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Teughels W, Feres M, Oud V, Martín C, Matesanz P, Herrera D. Adjunctive effect of systemic antimicrobials in periodontitis therapy: A systematic review and meta‐analysis. J Clin Periodontol 2020; 47 Suppl 22:257-281. [DOI: 10.1111/jcpe.13264] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Wim Teughels
- Department of Oral Health Sciences KU Leuven & Dentistry (Periodontology) University Hospitals Leuven Leuven Belgium
| | - Magda Feres
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos Brazil
| | - Valerie Oud
- Department of Oral Health Sciences KU Leuven & Dentistry (Periodontology) University Hospitals Leuven Leuven Belgium
| | - Conchita Martín
- BIOCRAN (Craniofacial Biology) Research Group University Complutense Madrid Spain
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
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20
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Zhao H, Hu J, Zhao L. Adjunctive subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis. BMC Oral Health 2020; 20:34. [PMID: 32005169 PMCID: PMC6995104 DOI: 10.1186/s12903-020-1021-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/23/2020] [Indexed: 01/27/2023] Open
Abstract
Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of systematic review and meta-analysis justifying the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP. Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained. Results Seventeen studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth ≥ 4 mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15 mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP. Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites in NSPT appears to provide slight benefits in PPD reduction compared to NSPT alone for CP. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.
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Affiliation(s)
- Han Zhao
- Multi-disciplinary Treatment Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li Number.4, Beijing, 100050, China.,Department of Periodontology, Witten/Herdecke, University, Alfred-Herrhausen-Str. 45, 58445, Witten, Germany
| | - Jingchao Hu
- Department of Periodontology, Witten/Herdecke, University, Alfred-Herrhausen-Str. 45, 58445, Witten, Germany.,Department of Periodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li Number 4, Beijing, 100050, China
| | - Li Zhao
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 400015, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 400015, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 400015, China.
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21
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OLIVEIRA EHDS, SAKAMOTO MY, CARNEIRO G, RANKEL VM, SOARES GMS, SCHWARTZ-FILHO HO. Análise físico-química da superfície de titânio após tratamento químico de descontaminação com clorexidina: estudo in vitro. REVISTA DE ODONTOLOGIA DA UNESP 2020. [DOI: 10.1590/1807-2577.07520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Introdução Tratamentos têm sido propostos para a peri-implantite com o objetivo de descontaminar a superfície dos implantes, removendo microrganismos que podem estar associados à doença. Objetivo O objetivo deste estudo foi avaliar a ação in vitro de diferentes métodos de aplicação de digluconato de clorexidina (CLX) na descontaminação de discos de titânio (Ti) com microtopografia e seu efeito físico-químico sobre a superfície. Material e método Vinte discos de Ti foram expostos a inóculo de Escherichia coli por 24 horas. Foram distribuídos em quatro grupos de descontaminação (n=5): 1 - um minuto de exposição à solução de CLX 0,12%; 2 - dois minutos de exposição à solução de CLX 0,12%; 3 - esfregaço durante um minuto com gel de CLX 1%; 4 - esfregaço durante um minuto com gel de CLX 2%. O produto de cada disco foi diluído e plaqueado individualmente. Após 24 horas, realizou-se contagem das unidades de colônias formadas (UFC). Resultado O grupo com o menor número de crescimento de UFC foi o grupo 4 (0,20±0,37), com apenas UFC em uma das amostras. Seguido do grupo 2 (0,40±0,73), grupo 1 (18,60±33,96). O grupo 3 apresentou as maiores quantidades de UFC (36,07±41,39). Em todas as amostras, foi possível observar uma diminuição estatisticamente significante da concentração superficial de Ti, assim como um aumento de Oxigênio. Conclusão Pode-se concluir que o uso de CLX gel a 2% em superfícies de Ti com microtopografia contaminadas com E. coli propicia a eliminação das UFC e que sua aplicação resulta em diminuição do percentual de Ti e aumento do teor de O.
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22
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Tan OL, Safii SH, Razali M. Commercial Local Pharmacotherapeutics and Adjunctive Agents for Nonsurgical Treatment of Periodontitis: A Contemporary Review of Clinical Efficacies and Challenges. Antibiotics (Basel) 2019; 9:E11. [PMID: 31905889 PMCID: PMC7169417 DOI: 10.3390/antibiotics9010011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022] Open
Abstract
Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to provide insights into the clinical efficacy of local drug delivery and adjunctive agents used in nonsurgical management of periodontitis. Electronic (PubMed/MEDLINE, CENTRAL, and EMBASE) and bibliographic searches of past systematic reviews were carried out to identify previous publications on the topic. Only relevant literature and randomized controlled trials published in English were selected. In addition, a literature review was developed based on the selected articles. Experimental drugs or agents were excluded. This review highlights the clinically proven and commercially available therapeutic agents related to the management of periodontal disease with comparisons of their clinical efficacies and challenges. A vast array of commercial local pharmacotherapeutic agents had been clinically tested, but the methodologies and clinical results varied within and between each agent used, causing difficulty in drawing conclusions and providing support to the superiority of one agent over another. Considering the benefit-cost ratio with the modest clinical results, the long-term usefulness of these agents remains debatable.
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Affiliation(s)
- Oi Leng Tan
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Syarida Hasnur Safii
- Faculty of Dentistry, Department of Restorative Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
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Benli M, Petit C, Tenenbaum H, Huck O. In vitro Assessment of Peri-implantitis Treatment Procedures: A Review. Open Dent J 2019. [DOI: 10.2174/1874210601913010267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The prevalence of peri-implantitis is increasing continuously and such a biological complication significantly decreases implant survival and success. Although various treatment modalities have been identified for peri-implantitis, no completely efficient method has yet been established.
Objective:
The aim of this review was to evaluate the scientific literature regarding the in vitro effects of peri-implantitis treatment.
Methods:
A review of the literature was performed by using Google Scholar, PubMed/ MEDLINE and Science Direct databases. In vitro studies on peri-implantitis treatment modalities were selected. The search strategy identified 57 eligible studies. After selection, 21 articles met all the inclusion criteria and were included in the present review.
Results:
Included in vitro studies evaluated different types of peri-implantitis treatment modalities such as mechanical, chemical, combination and laser therapies. Combination therapies with the aid of adjuvants were found to be more effective compared to the studies that used only one type of treatment modality. Laser systems were also tested and displayed interesting results in terms of surface decontamination with a variability associated with selected parameters.
Conclusion:
This review was performed to evaluate the efficacy of the treatment modalities used for peri-implantitis in vitro. Although there are various effective treatment methods, none has been completely successful in removing the biofilms related to peri-implantitis. The findings imply the need for further studies to develop more effective antimicrobial treatment procedures.
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24
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Haywood VB, Al Farawati F. Bleaching update and the future impact on prosthodontics. Br Dent J 2019; 226:753-760. [DOI: 10.1038/s41415-019-0314-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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25
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Alamoudi NM, Baik AM, El-Housseiny AA, Abu Haimed TS, Bakry AS. Influence of povidone-iodine on micro-tensile bonding strength to dentin under simulated pulpal pressure. BMC Oral Health 2018; 18:178. [PMID: 30373571 PMCID: PMC6206633 DOI: 10.1186/s12903-018-0645-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies had reported that bond strength deteriorate over time following the dentin surface pretreatment with chlorhexidine. Therefore, further investigations are needed to evaluate the effect of other materials such as povidone iodine. The purpose of this study was to investigate the effects of 10% povidone-iodine pretreatment on the resin-dentin micro-tensile bond strength of a single bond adhesive system in permanent teeth over time, and compare it with 2% chlorhexidine. Methods Flat dentin surfaces were prepared in 63 extracted permanent teeth. Teeth were randomly assigned to a 10% povidone-iodine pretreatment, a 2% chlorhexidine pretreatment, or a control group. Composite resin blocks were built up over treated surfaces under pulp pressure simulation. The prepared specimens were assigned to three storage time, 24 h, 1 week, and 2 months. Samples were vertically sectioned to obtain specimens of 0.7 to 1.2 mm2 cross-sectional area. Results No significant reduction of bond strength of povidone iodine group was found among the three storage times (p = 0.477). A significant reduction of bond strength for both chlorhexidine and control groups was found in the three storage times (p < 0.001). Conclusion Povidone iodine pretreatment of etched dentin was effective in reducing the loss of bond strength over time, while the chlorhexidine pretreatment and negative control showed significant deterioration in micro-tensile bond strength over time in permanent teeth.
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Affiliation(s)
- Najlaa M Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Saudi Arabia.
| | - Alaa M Baik
- Pediatric Dentistry Department, King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia
| | - Azza A El-Housseiny
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Saudi Arabia.,Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Tariq S Abu Haimed
- Biomaterial Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed S Bakry
- Operative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Peri-Implant Bone Resorption during Healing Abutment Placement: The Effect of a 0.20% Chlorhexidine Gel vs. Placebo-A Randomized Double Blind Controlled Human Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5326340. [PMID: 30410934 PMCID: PMC6206572 DOI: 10.1155/2018/5326340] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/23/2018] [Accepted: 09/27/2018] [Indexed: 02/07/2023]
Abstract
Introduction Peri-implant marginal bone loss (MBL) seems to be more pronounced in the first year of loading despite all the studies and changes implemented to reduce it. Among the different causes, the presence of a microgap makes the interface between fixture and abutment colonizable by bacteria, causing an inflammatory response and consequent bone resorption. To reduce this several local antiseptics like chlorhexidine digluconate (CHX) were used after surgical procedures. Aim The objective was to radiologically compare the MBL when a 0.20% CHX gel or a placebo gel was applied to the implant-abutment interface during all surgical and prosthetic phases and for a follow-up period up to 12 months. Method 32 patients (16 for each Group A and B) were enrolled and rehabilitated with a single implant (Cortex classic, Cortex, Shalomi, Israel). During each of the clinical stages a gel containing 0.20% CHX (Plak ®Gel; Polifarma Wellness Srl, Rome, Italy) or a placebo gel (Placebo, Polifarma Wellness Srl, Rome, Italy) was used as indicated by the randomization chart. In order to compare radiographic modification intraoral radiographs was taken. Also, clinical data regarding implant or prosthetic failure and gingival index were recorded. Data were presented as means and standard deviations (SD) and used for the statistical analysis. Results All implants showed no bleeding on probing and a very small plaque score at the 1 year of follow-up. MBL was statistically significantly different between the groups in every stage. Conclusion Results obtained showed that the use of CHX gel inside the connection significantly reduces MBL during the first year. A rigid disinfection protocol with 0.20% CHX from the time of implant insertion to crown delivery is recommended to reduce host inflammatory response and consequently MBL. This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT03431766).
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Uraz A, Karaduman B, Isler SÇ, Gönen S, Çetiner D. Ozone application as adjunctive therapy in chronic periodontitis: Clinical, microbiological and biochemical aspects. J Dent Sci 2018; 14:27-37. [PMID: 30988877 PMCID: PMC6445981 DOI: 10.1016/j.jds.2018.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/30/2018] [Indexed: 12/01/2022] Open
Abstract
Background/purpose The application of ozone as an adjunctive treatment represents a new approach in the management of chronic periodontitis. The purpose of this study was to evaluate the clinical, biochemical and microbiological efficacy of ozone treatment as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis (GCP) patients. Materials and methods Eighteen patients (9 males and 9 females; aged from 28 to 47 years, mean age of 40 ± 6.51 years) with GCP were recruited in the study. In a split mouth design, two quadrants in each patient were randomly allocated to SRP-alone or SRP-ozone therapy (SRP + OT) groups by coin toss method. Subgingival plaque and gingival crevicular fluid (GCF) samples were collected at baseline, following 1st and 3rd months. The clinical parameters were monitored at baseline and after 3 months. Microbiological parameters were analyzed by quantitative-PCR and GCF biomarkers were determined by ELISA. Results were analyzed statistically. Results Statistically significant improvements in all clinical parameters were accompanied by a reduction in microbiological and biochemical parameters in both treatment groups. SRP treatment resulted in a significant reduction of Porphyromonas gingivalis (Pg) at 1st month and Tannerella forsythia (Tf) and Prevotella intermedia (Pi) at 3 months. Following SRP treatment the interleukin (IL)-8 levels were significantly reduced at month 1. There were no significant differences between two treatments for any of the parameters. Conclusion Within the limitations of this study, adjunctive ozone therapy did not provide additional benefits to clinical, microbiological and biochemical parameters over SRP in chronic periodontitis patients.
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Affiliation(s)
- Ahu Uraz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Burcu Karaduman
- Department of Periodontology, Faculty of Dentistry, Biruni University, İstanbul, Turkey
| | - Sila Çagri Isler
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sevim Gönen
- Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Deniz Çetiner
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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28
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Tsobgny-Tsague NF, Lontchi-Yimagou E, Nana ARN, Tankeu AT, Katte JC, Dehayem MY, Bengondo CM, Sobngwi E. Effects of nonsurgical periodontal treatment on glycated haemoglobin on type 2 diabetes patients (PARODIA 1 study): a randomized controlled trial in a sub-Saharan Africa population. BMC Oral Health 2018; 18:28. [PMID: 29482543 PMCID: PMC5828384 DOI: 10.1186/s12903-018-0479-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 01/29/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND There is a burglar association between diabetes and periodontitis. Many studies has shown that periodontitis treatment can help improving glycemic control in diabetes patients but little evidence of non-surgical treatment benefit is available in sub Saharan african diabetes patients. We aimed to assess the effects of non-surgical periodontal treatment (NSPT) of chronic periodontitis on glycaemic control in poorly controlled type 2 diabetes patients (T2D) in a sub-Saharan Africa urban setting. METHODS A total of 34 poorly controlled T2D patients with chronic periodontitis aged 51.4 ± 8.8 years (mean ± SD), with known duration of diabetes of 55.5 ± 42.6 months, and HbA1c of 9.3 ± 1.3% were randomly assigned to two groups. The treatment group (Group 1, n = 17) received immediate ultrasonic scaling, scaling and root planning along with subgingival 10% povidone iodine irrigation, whereas the control group (Group 2, n = 17) was assigned to receive delayed periodontal treatment 3 months later. Pharmacological treatment was unchanged and all participants received the same standardized education session on diabetes management and dental hygiene. The primary outcome was the 3-month change in HbA1c from baseline. Plaque index (PI), gingival bleeding index (GBI), pocket depth (PD), clinical attachment loss (CAL) were also assessed prior to, at 6 and 12 weeks after enrolment. RESULTS Two subjects in each group were excluded from the study. Data were analyzed on thirty patients (15 per group). Non-surgical periodontal treatment with education for better dental hygiene (group 1) significantly improved all periodontal parameters whereas education only (group 2) improved only the plaque index among all periodontal parameters. Immediate non-surgical periodontal treatment induced a reduction of HbA1c levels by 3.0 ± 2.4 points from 9.7 ± 1.6% at baseline to 6.7 ± 2.0% 3 months after NSPT, (p ˂ 0.001) but the change was not significant in group 2, from mean 8.9 ± 0.9% at baseline vs 8.1 ± 2.6% after 3 months (p = 0.24). CONCLUSION Non-surgical periodontal treatment markedly improved glycaemic control with an attributable reduction of 2.2 points of HbA1c in poorly controlled T2D patients in a sub Saharan setting. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02745015 Date of registration: July 17, 2016 'Retrospectively registered'.
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Affiliation(s)
- Nadia-Flore Tsobgny-Tsague
- Department of periodontology, oral and maxillofacial surgery, Faculty of Medicine and Biomedical Sciences of The University of Yaoundé 1, Yaoundé, Cameroon
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Eric Lontchi-Yimagou
- Diabetes Research and Training Center, Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon
| | - Arnel Redon Nana Nana
- Department of periodontology, oral and maxillofacial surgery, Faculty of Medicine and Biomedical Sciences of The University of Yaoundé 1, Yaoundé, Cameroon
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Aurel T Tankeu
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Internal Medicine and specialties, Faculty of Medicine and Biomedical Sciences of The University of Yaoundé 1, Yaoundé, Cameroon
| | - Jean Claude Katte
- Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon
- Department of Public Health, Faculty of Medicine and Biomedical Sciences of The University of Yaoundé 1, Yaoundé, Cameroon
| | - Mesmin Y Dehayem
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Internal Medicine and specialties, Faculty of Medicine and Biomedical Sciences of The University of Yaoundé 1, Yaoundé, Cameroon
| | - Charles Messanga Bengondo
- Department of periodontology, oral and maxillofacial surgery, Faculty of Medicine and Biomedical Sciences of The University of Yaoundé 1, Yaoundé, Cameroon
- Dental surgery Unit, Yaoundé Teaching Hospital, Yaoundé, Cameroon
| | - Eugene Sobngwi
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon.
- Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon.
- Department of Internal Medicine and specialties, Faculty of Medicine and Biomedical Sciences of The University of Yaoundé 1, Yaoundé, Cameroon.
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29
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Treatment of severe periodontitis with a laser and light-emitting diode (LED) procedure adjunctive to scaling and root planing: a double-blind, randomized, single-center, split-mouth clinical trial investigating its efficacy and patient-reported outcomes at 1 year. Lasers Med Sci 2018; 33:991-1002. [PMID: 29349511 DOI: 10.1007/s10103-018-2441-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
Broad methodological heterogeneity makes the literature on the clinical effects of laser treatment in periodontitis, both as monotherapy and adjunct to non-surgical therapy, which is difficult to interpret. The present split-mouth study was performed: (i) to determine the efficacy and safety of a photoablative-photodynamic diode laser therapy, including antiseptic LED irradiation, in adjunct to scaling and root planing (iPAPD+SRP) vs. sham-treatment+SRP for the treatment of diffuse severe periodontitis and (ii) to estimate the patient-reported outcomes. Twenty-four patients with severe periodontitis were treated with iPAPD+SRP or sham-treatment+SRP. iPAPD+SRP consisted of the following: (1) intra-/extra-pocket de-epithelization with photoablative λ 810 nm laser, (2) disinfection with λ 405 nm LED, (3) SRP, and (4) 10 weekly antiseptic/anti-inflammatory photodynamic treatments with λ 635 nm laser and 0.1% toluidine blue as photosensitizer. Clinical and cytofluorescent periodontal markers and patient-reported results were analyzed. At 1-year follow-up, both groups showed a significant reduction of several severity markers of periodontitis, namely probing depth (PD) and bleeding on probing (BoP), as well as of bacteria, polymorphonuclear cells, erythrocytes and damaged epithelial cells in exfoliative samples, as compared with day 0. The quadrants subjected to iPAPD+SRP showed significantly better values of these parameters as well as of clinical attachment level (CAL) as compared with those undergoing sham-treatment+SRP. The patients' perceived pain/discomfort, and overall liking was also in favor of the iPAPD+SRP treatment. This study confirms the efficacy of combined phototherapy in adjunct to SRP which had emerged from previous clinical trials, extending its field of application to severe periodontitis.
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30
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Lin JH, Feng F, Yu MC, Wang CH, Chang PC. Modulation of periodontitis progression using pH-responsive nanosphere encapsulating metronidazole or N-phenacylthialzolium bromide. J Periodontal Res 2017; 53:22-28. [PMID: 28795395 DOI: 10.1111/jre.12481] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE This study aimed to develop pH-responsive polylactide-glycolic acid co-polymer and chitosan (PLGA/chitosan) nanosphere as an inflammation-responsive vehicle and evaluate the potential of the nanosphere encapsulating metronidazole, an antibiotic, and N-phenacylthiazolium bromide (PTB), a host modulator, for treating periodontitis. MATERIAL AND METHODS PLGA/chitosan nanospheres were fabricated using oil-in-water emulsion method. Experimental periodontitis was induced on the rat maxillae, and the sites were randomly allocated to four treatment categories, including periodontitis alone (PR), periodontitis with nanospheres alone, nanospheres encapsulating metronidazole (MT) and nanospheres encapsulating PTB (PB). The ligature was retained until the animals were killed, and the treatment outcome was evaluated by the progression of periodontal bone loss (PPBL), inflammatory cell infiltration and collagen deposition. RESULTS The encapsulated drug was released rapidly from the nanospheres without significant initial burst release at pH 5.5. Compared with group PR, PPBL was significantly reduced in groups MT and PB on day 4 (P<.05). On day 21, PPBL was significantly lower in group PB (P<.05). In groups MT and PB, inflammation was significantly reduced in groups MT and PB relative to groups PR and periodontitis with nanospheres alone (P<.05), and collagen deposition was significantly greater relative to group PR (P<.05). CONCLUSION PLGA/chitosan nanospheres encapsulating metronidazole or PTB showed potential for modulating periodontitis progression.
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Affiliation(s)
- J-H Lin
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - F Feng
- Department of Chemical and Biomolecular Engineering, National University of Singapore, Singapore City, Singapore
| | - M-C Yu
- School of Dentistry, Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - C-H Wang
- Department of Chemical and Biomolecular Engineering, National University of Singapore, Singapore City, Singapore
| | - P-C Chang
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,School of Dentistry, Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
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Pereira TC, Vasconcelos LRSMD, Graeff MSZ, Duarte MAH, Bramante CM, Andrade FBD. Intratubular disinfection with tri-antibiotic and calcium hydroxide pastes. Acta Odontol Scand 2017; 75:87-93. [PMID: 27866468 DOI: 10.1080/00016357.2016.1256427] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to compare the in vitro intradentinal antimicrobial ability of the calcium hydroxide and tri-antibiotic pastes. MATERIALS AND METHODS Standard bovine dentin tubes were sterilized and then infected with Enterococcus faecalis by a new contamination protocol of great depths of dentin. The specimens were filled with the medications, divided into two test-groups: calcium hydroxide (Group 1) and tri-antibiotic (Group 2) pastes. After 15 days, the teeth were evaluated by microbiological culture and confocal laser scanning microscopy (CLSM) with viability dye assay LIVE/DEAD inside dentinal tubules. In experiment of culture, the bacterial collection of the dentin fragments was done for counting the colony-forming units. RESULTS The tri-antibiotic paste had a slightly greater antimicrobial effect; however, there was no statistical difference between the groups. CONCLUSIONS It was concluded that the tri-antibiotic paste and the calcium hydroxide paste exercise the same effect on intra-tubular decontamination against E. faecalis. So, due the multiples advantages, the calcium hydroxide paste can be the choice for dentinal decontamination in regenerative procedures.
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Affiliation(s)
- Thais Cristina Pereira
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | | | - Marcia Sirlene Zardin Graeff
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Clóvis Monteiro Bramante
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Flaviana Bombarda De Andrade
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
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Takenaka S, Oda M, Domon H, Ohsumi T, Suzuki Y, Ohshima H, Yamamoto H, Terao Y, Noiri Y. Vizantin inhibits bacterial adhesion without affecting bacterial growth and causes Streptococcus mutans biofilm to detach by altering its internal architecture. Biochem Biophys Res Commun 2016; 480:173-179. [PMID: 27742478 DOI: 10.1016/j.bbrc.2016.10.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/09/2016] [Indexed: 12/14/2022]
Abstract
An ideal antibiofilm strategy is to control both in the quality and quantity of biofilm while maintaining the benefits derived from resident microflora. Vizantin, a recently developed immunostimulating compound, has also been found to have antibiofilm property. This study evaluated the influence on biofilm formation of Streptococcus mutans in the presence of sulfated vizantin and biofilm development following bacterial adhesion on a hydroxyapatite disc coated with sulfated vizantin. Supplementation with sulfated vizantin up to 50 μM did not affect either bacterial growth or biofilm formation, whereas 50 μM sulfated vizantin caused the biofilm to readily detach from the surface. Sulfated vizantin at the concentration of 50 μM upregulated the expression of the gtfB and gtfC genes, but downregulated the expression of the gtfD gene, suggesting altered architecture in the biofilm. Biofilm development on the surface coated with sulfated vizantin was inhibited depending on the concentration, suggesting prevention from bacterial adhesion. Among eight genes related to bacterial adherence in S. mutans, expression of gtfB and gtfC was significantly upregulated, whereas the expression of gtfD, GbpA and GbpC was downregulated according to the concentration of vizantin, especially with 50 μM vizantin by 0.8-, 0.4-, and 0.4-fold, respectively. These findings suggest that sulfated vizantin may cause structural degradation as a result of changing gene regulation related to bacterial adhesion and glucan production of S. mutans.
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Affiliation(s)
- Shoji Takenaka
- Division of Cariology, Operative Dentistry and Endodontics, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
| | - Masataka Oda
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hisanori Domon
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Tatsuya Ohsumi
- Division of Cariology, Operative Dentistry and Endodontics, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Yuki Suzuki
- Division of Cariology, Operative Dentistry and Endodontics, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hayato Ohshima
- Division of Anatomy and Cell Biology of Hard Tissue, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hirofumi Yamamoto
- Department of Chemistry and Functional Molecule, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, 770-8514, Japan
| | - Yutaka Terao
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Yuichiro Noiri
- Division of Cariology, Operative Dentistry and Endodontics, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
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33
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Matsubara VH, Bandara HMHN, Ishikawa KH, Mayer MPA, Samaranayake LP. The role of probiotic bacteria in managing periodontal disease: a systematic review. Expert Rev Anti Infect Ther 2016; 14:643-55. [PMID: 27224284 DOI: 10.1080/14787210.2016.1194198] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The frequent recolonization of treated sites by periodontopathogens and the emergence of antibiotic resistance have led to a call for new therapeutic approaches for managing periodontal diseases. As probiotics are considered a new tool for combating infectious diseases, we systematically reviewed the evidences for their effectiveness in the management of periodontitis. AREAS COVERED An electronic search was performed in the MEDLINE, SCOPUS and Cochrane Library databases up to March 2016 using the terms 'periodontitis', 'chronic periodontitis', 'probiotic(s)', 'prebiotic(s)', 'symbiotic(s)', 'Bifidobacterium and 'Lactobacillus'. Only randomized controlled trials (RCTs) were included in the present study. Analysis of 12 RCTs revealed that in general, oral administration of probiotics improved the recognized clinical signs of chronic and aggressive periodontitis such as probing pocket depth, bleeding on probing, and attachment loss, with a concomitant reduction in the levels of major periodontal pathogens. Continuous probiotic administration, laced mainly with Lactobacillus species, was necessary to maintain these benefits. Expert commentary: Oral administration of probiotics is a safe and effective adjunct to conventional mechanical treatment (scaling) in the management of periodontitis, specially the chronic disease entity. Their adjunctive use is likely to improve disease indices and reduce the need for antibiotics.
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Affiliation(s)
- Victor Haruo Matsubara
- a School of Dentistry , The University of Queensland, (UQ Oral Health Centre) , Brisbane , Australia.,b Department of Microbiology, Institute of Biomedical Sciences , University of São Paulo , São Paulo , Brazil.,c School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - H M H N Bandara
- a School of Dentistry , The University of Queensland, (UQ Oral Health Centre) , Brisbane , Australia
| | - Karin Hitomi Ishikawa
- b Department of Microbiology, Institute of Biomedical Sciences , University of São Paulo , São Paulo , Brazil
| | - Marcia Pinto Alves Mayer
- b Department of Microbiology, Institute of Biomedical Sciences , University of São Paulo , São Paulo , Brazil
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Krishna R, De Stefano JA. Ultrasonic vs. hand instrumentation in periodontal therapy: clinical outcomes. Periodontol 2000 2016; 71:113-27. [DOI: 10.1111/prd.12119] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 11/29/2022]
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Rodríguez-Pulido J, Quiroga-Zúñiga N, Martínez-Sandoval G. Clinical diagnosis and treatment of necrotizing ulcerative gingivitis in the orthodontic patient. A case report. JOURNAL OF ORAL RESEARCH 2016. [DOI: 10.17126/joralres.2016.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nagarakanti S, Gunupati S, Chava VK, Reddy BVR. Effectiveness of Subgingival Irrigation as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis: A Systematic Review. J Clin Diagn Res 2015; 9:ZE06-9. [PMID: 26393230 DOI: 10.7860/jcdr/2015/13862.6210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 06/02/2015] [Indexed: 11/24/2022]
Abstract
AIM Subgingival applications of various chemotherapeutic agents have been used as an adjunct to nonsurgical periodontal treatment and preventive periodontal therapy. Their use in regular clinical practice, however, is less, perhaps due to concerns about clinical success or probably due to a lack of knowledge of their effectiveness or cost. The aim of this systematic review is to obtain overall quantitative estimate of effectiveness of subgingival irrigation (SI) in the treatment of chronic periodontitis. MATERIALS AND METHODS A literature search of electronic database was performed for articles published through December 31, 2014, followed by manual search of dental journals. Randomized controlled trails (RCTs) assessing the effect of SI as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis evaluated by changes in the clinical and microbiological outcomes were included. RESULTS This literature search yielded only two randomized, placebo-controlled studies that evaluated the efficacy of SI as an adjunct to SRP in patients with chronic periodontitis. The studies were methodologically not perfect (in terms of mediocre quality) with a risk of bias to come to any final conclusions to be reached. These studies didn't clearly mention about randomization, allocation concealment, blinding, dosage and formulation of irrigants, severity of periodontal disease, patient-centered outcomes and results data. CONCLUSION Due to insufficient evidence supporting the efficacy of SI as an adjunct to SRP in treating chronic periodontitis, more rigorous scientific research is required to assess the efficacy of SI as an adjunct to SRP in the treatment of periodontal diseases.
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Affiliation(s)
- Sreenivas Nagarakanti
- Associate Professor, Department of Periodontics, Narayana Dental College & Hospital , Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - Sumanth Gunupati
- Senior Lecturer, Department of Periodontics, Narayana Dental College & Hospital , Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - Vijay Kumar Chava
- Professor & Head, Department of Periodontics, Narayana Dental College & Hospital , Chinthareddypalem, Nellore, Andhra Pradesh, India
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John P, Lazarus F, George JP, Selvam A, Prabhuji MLV. Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study. J Clin Diagn Res 2015; 9:ZC70-4. [PMID: 26155567 DOI: 10.7860/jcdr/2015/11534.5965] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/25/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. AIM The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). SETTINGS AND DESIGN The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. MATERIALS AND METHODS In a split-mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. RESULTS In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. CONCLUSION The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis.
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Affiliation(s)
- Priya John
- Senior Lecturer, Mar Baselious Dental College , Kothamangalam, Kerala, India
| | - Flemingson Lazarus
- Former Professor and HOD, Department of Periodontology, Best Dental College , Madurai, India
| | - Joann Pauline George
- Professor, Department of Periodontics, Krishnadevaraya College of Dental Sciences , Bangalore, India
| | - Arul Selvam
- Professor and HOD, Department of Microbiology, Krishnadevaraya College of Dental Sciences , Bangalore, India
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Tekce M, Ince G, Gursoy H, Dirikan Ipci S, Cakar G, Kadir T, Yılmaz S. Clinical and microbiological effects of probiotic lozenges in the treatment of chronic periodontitis: a 1-year follow-up study. J Clin Periodontol 2015; 42:363-72. [DOI: 10.1111/jcpe.12387] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 01/07/2023]
Affiliation(s)
- Merve Tekce
- Faculty of Dentistry; Department of Periodontology; Yeditepe University; Goztepe Istanbul Turkey
| | - Gizem Ince
- Faculty of Dentistry; Department of Periodontology; Yeditepe University; Goztepe Istanbul Turkey
| | - Hare Gursoy
- Faculty of Dentistry; Department of Periodontology; Yeditepe University; Goztepe Istanbul Turkey
| | - Sebnem Dirikan Ipci
- Faculty of Dentistry; Department of Periodontology; Yeditepe University; Goztepe Istanbul Turkey
| | - Gokser Cakar
- Faculty of Dentistry; Department of Periodontology; Yeditepe University; Goztepe Istanbul Turkey
| | - Tanju Kadir
- Faculty of Dentistry; Department of Microbiology; Marmara University; Nisantasi Istanbul Turkey
| | - Selçuk Yılmaz
- Faculty of Dentistry; Department of Periodontology; Yeditepe University; Goztepe Istanbul Turkey
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Ohsumi T, Takenaka S, Wakamatsu R, Sakaue Y, Narisawa N, Senpuku H, Ohshima H, Terao Y, Okiji T. Residual structure of Streptococcus mutans biofilm following complete disinfection favors secondary bacterial adhesion and biofilm re-development. PLoS One 2015; 10:e0116647. [PMID: 25635770 PMCID: PMC4312048 DOI: 10.1371/journal.pone.0116647] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/11/2014] [Indexed: 01/21/2023] Open
Abstract
Chemical disinfection of oral biofilms often leaves biofilm structures intact. This study aimed to examine whether the residual structure promotes secondary bacterial adhesion. Streptococcus mutans biofilms generated on resin-composite disks in a rotating disc reactor were disinfected completely with 70% isopropyl alcohol, and were again cultured in the same reactor after resupplying with the same bacterial solution. Specimens were subjected to fluorescence confocal laser scanning microscopy, viable cell counts and PCR-Invader assay in order to observe and quantify secondarily adhered cells. Fluorescence microscopic analysis, particularly after longitudinal cryosectioning, demonstrated stratified patterns of viable cells on the disinfected biofilm structure. Viable cell counts of test specimens were significantly higher than those of controls, and increased according to the amount of residual structure and culture period. Linear regression analysis exhibited a high correlation between viable and total cell counts. It was concluded that disinfected biofilm structures favored secondary bacterial adhesion.
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Affiliation(s)
- Tatsuya Ohsumi
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shoji Takenaka
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- * E-mail:
| | - Rika Wakamatsu
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuuki Sakaue
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Narisawa
- Department of Food Bioscience and Biotechnology, College of Bioresource Sciences, Nihon University, Kanagawa, Japan
| | - Hidenobu Senpuku
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hayato Ohshima
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Terao
- Division of Microbiology and Infectious Diseases, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takashi Okiji
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Rosenberg DR, Andrade CX, Chaparro AP, Inostroza CM, Ramirez V, Violant D, Nart J. Short-term effects of 2% atorvastatin dentifrice as an adjunct to periodontal therapy: a randomized double-masked clinical trial. J Periodontol 2015; 86:623-30. [PMID: 25630627 DOI: 10.1902/jop.2015.140503] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The pleiotropic effects of statins, such as immunomodulation and anti-inflammatory effects, may also improve periodontal conditions. The aim of the present study is to assess the effectiveness of a dentifrice medicated with 2% atorvastatin in improving clinical periodontal parameters as a complement to non-surgical periodontal treatment (NSPT). METHODS A randomized, double-masked clinical trial was performed with two parallel groups: 1) atorvastatin group (NSPT plus medicated 2% atorvastatin dentifrice) and 2) placebo group (NSPT plus placebo dentifrice). The effectiveness of these treatments was assessed using periodontal measurements obtained at baseline and 1 month later. The measurements were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), and periodontal inflamed surface area (PISA). Multiple linear regression models were used to compare outcome variables after adjusting for sex, diabetes, and tobacco use. RESULTS A total of 36 individuals participated in this study (atorvastatin group, n = 18; placebo group, n = 18). Both groups showed improvements in periodontal parameters. The atorvastatin group showed a decrease of 297.63 mm(2) in PISA (95% confidence interval = 76.04 to 519.23; P = 0.01), which was significantly greater than the reduction observed in the placebo group. There was also a significantly greater reduction in mean PD, percentage of sites with PD ≥5 mm, mean CAL, percentage of sites with CAL ≥5 mm, BOP, and GI in the atorvastatin group compared with the placebo group. CONCLUSION NSPT plus 2% atorvastatin medicated dentifrice was more effective in improving clinical periodontal parameters than NSPT plus a placebo dentifrice.
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Affiliation(s)
- David R Rosenberg
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Los Andes, Santiago, Chile
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Sinha S, Kumar S, Dagli N, Dagli RJ. Effect of tetracycline HCl in the treatment of chronic periodontitis - A clinical study. J Int Soc Prev Community Dent 2014; 4:149-53. [PMID: 25374831 PMCID: PMC4209612 DOI: 10.4103/2231-0762.142011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This study was aimed to evaluate the efficacy of the adjunctive use of tetracycline fibers (Periodontal Plus AB(®)) as a local drug delivery with scaling and root planing, as compared with the results of one episode of scaling and root planing for the treatment of chronic periodontitis. MATERIALS AND METHODS The effectiveness of Periodontal Plus AB (tetracycline fiber) was assessed in 100 patients suffering from chronic periodontitis using split-mouth technique. STATISTICAL ANALYSIS The relative efficacy of the two treatment modalities was evaluated using the paired Student's t-test, and the comparative evaluation between the two groups was done using the independent Student's t-test. RESULTS Significant improvement was found in all the variables, including reduction in pocket depth and gain in clinical attachment level, in both test and control groups in 3 months, which was statistically significant. Mean reduction in pocket depth and gain in clinical attachment level were more in test than in control group. CONCLUSION Tetracycline fiber therapy along with scaling and root planing improves the healing outcome, namely, reduction in pocket depth and gain in clinical attachment level, when compared to scaling and root planing alone.
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Affiliation(s)
- Sachin Sinha
- Department of Periodontics, Awadh Dental College and Hospital, Jamshedpur, Jharkand, India
| | - Santosh Kumar
- Department of Periodontics, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Namrata Dagli
- Editor-in-Chief, Journal of Health Research and Review, Ahmedabad, Gujarat, India
| | - Rushabh J Dagli
- Department of Preventive and Community Dentistry, Vyas Dental College, Jodhpur, Rajasthan, India
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Özdemir B, Uraz A, İşcan D, Bozkurt Ş, Tuncer BB, Engin D, Pehlivan S, İşcan H. Influence of Cervitec gel on periodontal health of patients wearing fixed orthodontic appliances. J Dent Sci 2014. [DOI: 10.1016/j.jds.2013.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Yaghini J, Shahabooei M, Aslani A, Zadeh MR, Kiani S, Naghsh N. Efficacy of a local-drug delivery gel containing extracts of Quercus brantii and Coriandrum sativum as an adjunct to scaling and root planing in moderate chronic periodontitis patients. J Res Pharm Pract 2014; 3:67-71. [PMID: 25114940 PMCID: PMC4124683 DOI: 10.4103/2279-042x.137076] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: Recent advances in the field of alternative medicine introduced various herbal products for the treatment of periodontitis. The purpose of this study was to evaluate the effects of combined extracts from Quercus brantii and Coriandrum sativum on periodontal indices in adult periodontitis patients. Methods: In this randomized, double-blinded clinical trial, performed in Isfahan Dental School in 2012, a new herbal medicament containing combined extracts from Q. brantii and C. sativum was formulated in the gel form for subgingival application. Following scaling and root planing (SRP), both herbal and placebo gels were delivered at the experimental and control sites, respectively. Periodontal pocket depth, clinical attachment level, papilla bleeding index, and plaque index were measured at baseline, 1 month and 3 months later. Both intra-and inter-groups changes were registered. The obtained data were analyzed by SPSS software, using repeated measure analysis of variance, paired t-test, Mann-Whitney, Friedman, and Wilcoxon tests. Differences with P < 0.05 were considered to be significant. Findings: Both groups indicated statistically significant improvements in the periodontal indices (P < 0.05), but there were no significant differences between two study groups with this regard. Conclusion: The herbal gel does not have considerable advantages over SRP alone as an adjunct in periodontal treatment.
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Affiliation(s)
- Jaber Yaghini
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Shahabooei
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abolfazl Aslani
- Department of Pharmaceutics and Novel Drug Delivery Systems Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mozhgan Reza Zadeh
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Kiani
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Naghsh
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Raheja J, Tewari S, Tewari S, Duhan J. Evaluation of efficacy of chlorhexidine intracanal medicament on the periodontal healing of concomitant endodontic-periodontal lesions without communication: an interventional study. J Periodontol 2014; 85:1019-26. [PMID: 24835418 DOI: 10.1902/jop.2014.130430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Treatment of concomitant endodontic-periodontal lesions remains a challenge in clinical practice and requires effective endodontic and regenerative periodontal therapy. Among other factors, cross seeding and recolonization of flora may affect the outcome of periodontal therapy. Intracanal medicaments have been shown to exert antimicrobial activity on the external root surface, and local delivery of antimicrobials has been suggested to be a complementary approach in the management of periodontitis. Therefore, the objective of this study is to determine the influence of chlorhexidine (CHX) intracanal medicament on the clinical outcomes of therapy. METHODS Thirty-one patients were divided into two treatment groups: 1) open flap debridement (OFD) in endodontically treated teeth (control); and 2) OFD in endodontically treated teeth with CHX placed in the coronal space (test). The clinical variables evaluated were probing depth (PD), clinical attachment level (CAL), and percentage of sites with PD ≥5 mm. Reevaluation was performed at 3 and 6 months post-surgery. RESULTS Both treatments resulted in improvement in all the clinical variables evaluated. Postoperative measurements from test and control groups showed reductions in mean PD of 2.22 ± 1.27 and 0.91 ± 0.81 mm, mean CAL gains of 2.16 ± 1.12 and 0.60 ± 0.93 mm, and 43.33% ± 31.37% and 17.71% ± 14.23% reduction in sites with PD ≥5 mm. Significantly more PD reduction, CAL gain, and percentage reduction in sites with PD ≥5 mm were observed in the test group at 6 months (P <0.05). CONCLUSION CHX may be used as an effective intracanal medicament for promoting periodontal healing in concomitant endodontic-periodontal lesions.
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Affiliation(s)
- Jyoti Raheja
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Charalampakis G, Ramberg P, Dahlén G, Berglundh T, Abrahamsson I. Effect of cleansing of biofilm formed on titanium discs. Clin Oral Implants Res 2014; 26:931-936. [PMID: 24734854 DOI: 10.1111/clr.12397] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 03/12/2014] [Accepted: 03/18/2014] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To study the combined effect of mechanical and chemical cleansing on a 4-day biofilm grown intra-orally on titanium discs with different surface characteristics. MATERIAL AND METHODS Twenty subjects used a splint with two metal plates in the upper jaw. Each plate was placed in the premolar-molar region and carried four titanium discs with four different surface characteristics (OsseoSpeed(™), TiOblast(™), experimental and turned surface). After 4 days of biofilm growth, the discs were cleaned mechanically and chemically with saline or chlorhexidine. Following cleansing, microbial samples were obtained and analysed by culture. The titanium discs were processed for scanning electron microscope (SEM) analysis. The experiment was repeated 3 days later using delmopinol or a mixture of essential oils during cleansing. RESULTS The combination of mechanical and chemical cleansing was ineffective in complete biofilm removal from all four titanium discs. The microbiological analysis did not reveal any statistically significant differences between surface types or between cleaning agents regarding logarithmic mean counts of CFU for specific bacteria, aerobes, anaerobes or the TVC. Aerobes were more numerous than anaerobes on all surface types. The SEM analysis disclosed that the remaining biofilm on moderately rough surfaces (OsseoSpeed(™), TiOblast(™) and experimental) was complex and firmly attached, while the biofilm on turned surface had a pattern of spread bacteria forming less clusters. CONCLUSIONS Cleansing may call for prolonged time of chemomechanical debridement and/or more effective disinfectants to suppress biofilms on dental implant surfaces.
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Affiliation(s)
- Georgios Charalampakis
- Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Per Ramberg
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Dahlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ingemar Abrahamsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Teughels W, Durukan A, Ozcelik O, Pauwels M, Quirynen M, Haytac MC. Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol 2013; 40:1025-35. [PMID: 24164569 PMCID: PMC3908359 DOI: 10.1111/jcpe.12155] [Citation(s) in RCA: 190] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 01/17/2023]
Abstract
AIM The aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing (SRP). MATERIAL AND METHODS Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks. RESULTS At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group. CONCLUSIONS The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.
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Affiliation(s)
- Wim Teughels
- Periodontology Section Department of Oral Sciences Faculty of Medicine, Catholic University LeuvenLeuven, Belgium
- Periodontology Section Dentistry, University Hospitals LeuvenLeuven, Belgium
- Fund for Scientific Research Flanders (FWO)Brussels, Belgium
| | - Andaç Durukan
- Department of Periodontology Faculty of Dentistry, Cukurova UniversityAdana, Turkey
| | - Onur Ozcelik
- Department of Periodontology Faculty of Dentistry, Cukurova UniversityAdana, Turkey
| | - Martine Pauwels
- Periodontology Section Department of Oral Sciences Faculty of Medicine, Catholic University LeuvenLeuven, Belgium
| | - Marc Quirynen
- Periodontology Section Department of Oral Sciences Faculty of Medicine, Catholic University LeuvenLeuven, Belgium
- Periodontology Section Dentistry, University Hospitals LeuvenLeuven, Belgium
| | - Mehmet Cenk Haytac
- Department of Periodontology Faculty of Dentistry, Cukurova UniversityAdana, Turkey
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Microbiological effect of essential oils in combination with subgingival ultrasonic instrumentation and mouth rinsing in chronic periodontitis patients. Int J Dent 2013; 2013:146479. [PMID: 24171000 PMCID: PMC3792545 DOI: 10.1155/2013/146479] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/04/2013] [Accepted: 08/11/2013] [Indexed: 11/23/2022] Open
Abstract
Thirty chronic periodontitis patients were randomly assigned to 3 groups: control, saline, and essential oil-containing antiseptic (EO). Subgingival plaque was collected from a total of 90 pockets across all subjects. Subsequently, subgingival ultrasonic instrumentation (SUI) was performed by using EO or saline as the irrigation agent. After continuous mouth rinsing at home with EO or saline for 7 days, subgingival plaques were sampled again. Periodontopathic bacteria were quantified using the modified Invader PLUS assay. The total bacterial count in shallow pockets (probing pocket depth (PPD) = 4-5 mm) was significantly reduced in both saline (P < 0.05) and EO groups (P < 0.01). The total bacterial count (P < 0.05) and Porphyromonas gingivalis (P < 0.01) and Tannerella forsythia (P < 0.05) count in deep pockets (PPD ≥6 mm) were significantly reduced only in the EO group. In comparisons of the change ratio relative to baseline value of total bacteria counts across categories, both the saline and EO groups for PPD 4-5 mm and the EO group for PPD 6 mm showed a significantly low ratio (P < 0.05). The adjunctive use of EO may be effective in reducing subgingival bacterial counts in both shallow and deep pockets. This trial is registered with UMIN Clinical Trials Registry UMIN000007484.
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Sağlam M, Arslan U, Buket Bozkurt Ş, Hakki SS. Boric Acid Irrigation as an Adjunct to Mechanical Periodontal Therapy in Patients With Chronic Periodontitis: A Randomized Clinical Trial. J Periodontol 2013; 84:1297-308. [DOI: 10.1902/jop.2012.120467] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Henderson E, Schneider S, Petersen FC, Haugen HJ, Wohlfahrt JC, Ekstrand K, Ekfeldt A. Chemical debridement of contaminated titanium surfaces: an in vitro study. Acta Odontol Scand 2013; 71:957-64. [PMID: 23140518 DOI: 10.3109/00016357.2012.734423] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the efficacy of different chemical solutions when used for chemical debridement of biofilm contaminated titanium surfaces in an in-vitro experimental study. MATERIALS AND METHODS Commercially pure titanium discs with a diameter of 6.2 mm and height of 2 mm, mirror-polished with a measured surface amplitude value SA = 0.037 μm ± 0.009 were used as test-surfaces. A biofilm was simulated with multi-layers of Staphylococcus epidermidis ATCC359844 covering the entire titanium surface. The chemical agents tested were: 3% H2O2, 0.2% Chlorhexidine, 24% EDTA-gel, 3% H2O2 mixed with 1.6 g/L TiO2 and sterile saline solution. The decontamination effect was evaluated by optical density analysis using spectrophotometry and with scanning electron microscopy (SEM) images of the remaining biofilm. RESULTS The suspensions of 3% H2O2 and 1.6 g/L TiO2 or 3% H2O2 alone were the most effective in removing S. epidermidis biofilms (p < 0.05), whereas 0.2% chlorhexidine or 24% EDTA gel had no significant effects. SEM images of the remaining biofilms supported the quantitative results indicating the higher efficacy of 3% H2O2 and 1.6 g/L TiO2 or 3% H2O2 alone. It also revealed that EDTA, despite a non-significant effect on reducing the amount of established biofilms, was able to alter the biofilm architecture, as demonstrated by increased interspaced regions. CONCLUSIONS In this in vitro study the decontamination potential of a suspension of 3% H2O2 and 1.6 g/L TiO2 or 3% H2O2 alone were encouraging. Whether such procedures would have a similar effect in vivo remains to be determined.
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Affiliation(s)
- Elisabet Henderson
- Department of Prosthetic Dentistry and Oral Function, Faculty of Dentistry,University of Oslo, Blindern, Oslo, Norway
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Chaturvedi TP, Srivastava R, Srivastava AK, Gupta V, Verma PK. Evaluation of metronidazole nanofibers in patients with chronic periodontitis: A clinical study. Int J Pharm Investig 2013; 2:213-7. [PMID: 23580938 PMCID: PMC3618638 DOI: 10.4103/2230-973x.107007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Prevention of periodontal disease progression is the primary goal of periodontal therapy. When conventional therapy is found to be inadequate in achieving periodontal health in chronic periodontitis, local antimicrobial agents are used as an adjunct to scaling and root planing (SRP), which produces encouraging results. In the present study, an attempt was made to develop a low-dose controlled-release delivery system for the treatment of periodontal infections. A new sustained release drug system of poly e-caprolactone (PCL) nanofibers containing metronidazole (MET) was successfully electrospun and evaluated clinically for periodontal diseases. The retentive nanofibres were shown to provide a controlled delivery of the drugs. MATERIALS AND METHODS Nanofibers were prepared with MET in PCL by electrospinning technique. The drug-coated nanofibers provided sustained effect up to a period of 11 days (264 h) and followed first-order release. Forty sites in seven patients (four females and three males) with chronic periodontitis (5-8 mm probing depth) were allocated in two experimental treatment groups: Group A treated with SRP + MET nanofibers and Group B treated with SRP alone (control group). All these patients were evaluated clinically for probing depth (PD), plaque index (PI), and gingival index (GI). RESULTS Both the treatment groups were found to be efficacious in the treatment of periodontal disease as demonstrated by improvement in PD, PI, and GI. CONCLUSION Combination of SRP + MET nanofibers (Group A) resulted in added benefits, compared to the control group.
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