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Roberto PFA, Luís HS, Oliveira SA. In vitro evaluation of surface roughness of titanium abutments after air polishing with different abrasive powders. Int J Dent Hyg 2024. [PMID: 38852151 DOI: 10.1111/idh.12838] [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: 06/13/2023] [Revised: 05/02/2024] [Accepted: 05/04/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVES The purpose of this study was to evaluate the effects of air polishing with sodium bicarbonate and erythritol powders on surface roughness and morphological changes in titanium abutments. METHODS A total of 45 grade V titanium discs were divided in three groups: Group A (Control) air polished with air/water; Group B, air polished with sodium bicarbonate powder; and Group C, air polished with erythritol powder. After air polishing, the samples' roughness (Sa) in micrometres were analysed with an optical profilometer. The samples' surface morphology study was conducted via scanning electronic microscope (SEM). Data were described using mean and standard deviation of roughness values (Sa). Inferential analysis was performed using the ANOVA multiple comparison test followed by Tukey's post hoc test. Both tests used a 5% level of significance. RESULTS After air polishing, average roughness of group A, B and C were 0.036, 0.046 and 0.037 μm, respectively, with statistically significant differences between groups A and B (p < 0.05). No statistically significant differences were found between group A and group C, as well as between group B and C (p > 0.05). As for the morphology analysis, damages to the titanium surface were only observed in group B. CONCLUSIONS The study indicates that air polishing with erythritol powder maintains titanium abutment integrity better than sodium bicarbonate, which increased surface roughness and caused damage. Erythritol is preferable for minimizing surface alterations and maintaining morphological stability.
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Affiliation(s)
- Pedro Francisco Almeida Roberto
- Faculdade de Medicina Dentária, Rede de Higienistas Orais para o Desenvolvimento da Ciência (RHODes), Universidade de Lisboa, Lisbon, Portugal
| | - Henrique Soares Luís
- Faculdade de Medicina Dentária, Rede de Higienistas Orais para o Desenvolvimento da Ciência (RHODes), Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
- Centro de Inovação em Tecnologias e Cuidados da Saúde (ciTechCare), Politécnico de Leiria, Leiria, Portugal
| | - Sofia Arantes Oliveira
- Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
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Alsuwaidi S, Almatrooshi A, Shah M, Hakam A, Tawse-Smith A, Alsabeeha NHM, Atieh MA. Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial. J Periodontol 2024. [PMID: 38830779 DOI: 10.1002/jper.24-0099] [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: 02/09/2024] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 06/05/2024]
Abstract
BACKGOUND The aim of this randomized controlled trial was to assess clinical and patient-reported outcomes of subgingival instrumentation (SI) with adjunctive use of erythritol airflowing (EAF) compared to SI alone in the treatment of periodontitis. METHODS Twenty-six participants with Stage III/IV periodontitis requiring nonsurgical periodontal treatment were randomly allocated into two treatment groups: SI with EAF or SI alone. Clinical parameters of percentage of probing pocket depths (PPDs) of ≥5 mm, full mouth bleeding and plaque scores (FMBS and FMPS), and PPD values were recorded at baseline, and at 3 and 6 months posttreatment. A visual analogue scale was used to evaluate postoperative participants' perception of pain, swelling, bleeding, bruising, and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at six months. RESULTS A total of 26 participants with Stage III/IV periodontitis completed the 6-month follow-up. SI with or without EAF resulted in a statistically significant reductions in the FMBS, FMPS, PPDs, and percentage of PPDs of ≥5 mm at the 3- and 6-month follow-up visits. There was no statistically significant difference between the two treatment groups for any time interval. Participants receiving SI/EAF exhibited a higher reduction in FMBS compared to those in SI alone group at 3 (SI/EAF: 19.4 ± 11.9, SI alone: 30.1 ± 20.5; P = 0.12) and 6 months (SI/EAF: 14.3 ± 9.6, SI alone: 24.5 ± 18.2; P = 0.09). A lower percentage of sites with deep PPDs (≥5 mm) was also noted amongst participants in the SI/EAF group compared to SI alone at 3 months (SI/EAF: 14.3 ± 14.1, SI alone: 19.2 ± 20.3; P = 0.48) and 6 months (SI/EAF: 8.3 ± 10.0, SI alone: 15.4 ± 17.4; P = 0.22). Patient-reported outcomes showed no significant differences between the two treatment groups, except in the psychosocial domain of the GOHAI at 6 months favoring the SI/EAF group (P = 0.03). CONCLUSIONS Within the limitations of the study, the adjunctive use of EAF in addition to SI in the treatment of Stage III/IV periodontitis did not result in a significant improvement in clinical parameters. Limited improvement in the QoL with EAF could be achieved.
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Affiliation(s)
- Salem Alsuwaidi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | | | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | - Abeer Hakam
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
| | - Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- School of Dentistry, University of Jordan, Amman, Jordan
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Liu CC, Dixit N, Hatz CR, Janson TM, Bastendorf K, Belibasakis GN, Cosgarea R, Karoussis IK, Mensi M, O'Neill J, Spahr A, Stavropoulos A, Schmidlin PR. Air powder waterjet technology using erythritol or glycine powders in periodontal or peri-implant prophylaxis and therapy: A consensus report of an expert meeting. Clin Exp Dent Res 2024; 10:e855. [PMID: 38345462 PMCID: PMC10860664 DOI: 10.1002/cre2.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/02/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri-implant diseases. MATERIAL AND METHODS In the first step, a modified one-round online Delphi survey including 44 five-point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively. RESULTS An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long-term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept. CONCLUSIONS In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri-implant therapy and prophylaxis is patient compliant and efficient.
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Affiliation(s)
- Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Neha Dixit
- Department of Clinical Affairs and Medical EducationElectro Medical Systems SANyonSwitzerland
| | - Christian R. Hatz
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Tobias M. Janson
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | | | - Georgios N. Belibasakis
- Department of Dental Medicine, Division of Oral DiseasesKarolinska InstitutetStockholmSweden
| | - Raluca Cosgarea
- Department of Periodontology, Cariology and Preventive DentistryUniversity of BonnBonnGermany
| | - Ioannis K. Karoussis
- Department of Periodontology, Faculty of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Magda Mensi
- Section of Periodontics, Department of Surgical Specialities, Radiological Science and Public Health, School of DentistryUniversity of BresciaBresciaItaly
| | - Jessica O'Neill
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of OdontologyUniversity of MalmöMalmöSweden
- Division of Conservative Dentistry and PeriodontologyUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
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Gong J, Huang X, Yuan S. Comparative study on the effects of different polishing methods on tooth surface microstructure and roughness following initial periodontal treatment. Clin Exp Dent Res 2024; 10:e851. [PMID: 38345489 PMCID: PMC10828915 DOI: 10.1002/cre2.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To investigate the effects of different polishing methods on the surface microstructure and roughness of teeth following initial periodontal treatment. METHODS Teeth were divided into three groups (silica onegloss, polishing disc, and polishing strip) in vitro. Tooth surface microstructure was characterized via scanning electron microscopy. Roughness was measured by profilometry and laser scanning confocal microscopy (LSCM). According to the in vitro results, one group was chosen for further clinical trials. Effects of the chosen polishing method on patient plaque control and satisfaction were assessed via plaque staining and visual analog scale (VAS). RESULTS Electron microscopy results revealed that the polishing disc group had smoother roots and crowns than did the other two groups. Roughness analysis revealed that the crown roughness with the polishing disc and silica onegloss was lower, and the root roughness with the polishing disc was the lowest (p < .05) The LSCM results showed that the pigment deposition depth with the polishing disc and silicon onegloss in the crowns and roots were significantly lower than those with the other two methods (p = .000). The polishing effect of the polishing disc was best among the three groups. Clinical trials were performed to verify the polishing disc effects. Plaque staining results showed that the decrease in plaque in the polishing disc group was greater than that of the rubber cup group (p = .020), which was similar to the results of LSCM. The VAS results showed that the polishing disc made teeth feel smoother, similar to the results of the roughness detection, and the procedure was more comfortable (p < .05). However, there was no significant difference between the two groups regarding foreign body sensation during pronunciation (p = .178). CONCLUSION Combining in vitro and in vivo evaluations, the use of a polishing disc following periodontal treatment yielded superior polishing effects on teeth and was better accepted by patients.
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Affiliation(s)
- Jingjue Gong
- Dental DepartmentShanghai Jing‐an Dental ClinicShanghaiChina
| | - Xin Huang
- Dental DepartmentShanghai Jing‐an Dental ClinicShanghaiChina
| | - Shuang Yuan
- Dental DepartmentShanghai Jing‐an Dental ClinicShanghaiChina
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Ratzka P, Zaslansky P, Jost-Brinkmann PG. Scanning electron microscopy evaluation of enamel surfaces using different air-polishing powders in the orthodontic setting: an in vitro study. J Orofac Orthop 2023:10.1007/s00056-023-00466-2. [PMID: 37145307 DOI: 10.1007/s00056-023-00466-2] [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: 06/27/2022] [Accepted: 02/02/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The aim of this in vitro study was to quantify and compare changes of the enamel surface caused by periodical use of different air-polishing powders during multibracket therapy. METHODS Bovine high-gloss polished enamel specimens were air-polished using an AIR-FLOW® Master Piezon with maximum powder and water settings. Each specimen was blasted with sodium bicarbonate (AIR-FLOW® Powder Classic, Electro Medical Systems, Munich, Germany) and erythritol (AIR-FLOW® Powder Plus, Electro Medical Systems). Blasting duration was adapted to the powders' cleaning efficacy and corresponded to 25 air-polishing treatments in a patient with braces. A spindle apparatus ensured uniform guidance at a distance of 4 mm and a 90° angle. Qualitative and quantitative assessments were performed with the use of low vacuum scanning electron microscopy. Following external filtering and image processing, arithmetical square height (Sa) and root mean square height (Sq) were determined. RESULTS Both prophy powders caused a significant increase in enamel roughness. Surfaces blasted with sodium bicarbonate (Sa = 64.35 ± 36.65 nm; Sq = 80.14 ± 44.80 nm) showed significantly (p < 0.001) higher roughness than samples treated with erythritol (Sa = 24.40 ± 7.42 nm; Sq = 30.86 ± 9.30 nm). The observed defects in enamel structure caused by sodium bicarbonate extended across prism boundaries. Prism structure remained intact after air-polishing with erythritol. CONCLUSION Both applied air-polishing powders led to surface alterations. Despite shorter treatment times, sodium bicarbonate was significantly more abrasive than erythritol. Clinicians must compromise between saving time and abrasively removing healthy enamel.
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Affiliation(s)
- Philipp Ratzka
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Paul Zaslansky
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
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Martins O, Costa A, Silva D. The efficacy of air polishing devices in supportive periodontal therapy: Clinical, microbiological and patient-centred outcomes. A systematic review. Int J Dent Hyg 2023; 21:41-58. [PMID: 36300683 DOI: 10.1111/idh.12635] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/14/2022] [Accepted: 10/24/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this review was to compare air polishing devices with conventional periodontal therapy (hand instrumentation and/or ultrasonic debridement), in terms of their clinical, microbiological and patient-related outcomes in patients undergoing periodontal maintenance therapy. METHODS An online database search was performed to identify randomized controlled trials (RCTs) published between January 1987 and March 2021. Selection, data extraction and assessment risk of individual bias were conducted by two independent reviewers. The PICO method was employed to formulate the question: "In patients undergoing periodontal maintenance therapy/supportive periodontal therapy, do air polishing systems result in better clinical, microbiological and patient related outcomes than ultrasonic instrumentation or hand instrumentation?" Primary outcomes were bleeding on probing, gingival index and/or bleeding index. Secondary outcomes were probing depth, clinical attachment level, plaque index, microbiological counts and/or patient tolerance. The risk of bias was evaluated and the systematic review protocol was registered in PROSPERO. RESULTS The electronic search yielded 501 references of which 14 were included in this review. A meta-analysis was not performed due to great heterogeneity within the studies. Air polishing devices and conventional periodontal therapy presented identical results in the 14 studies analysed; however, air polishing devices presented better antimicrobial behaviour and better patient-related outcomes. CONCLUSIONS Both air polishing devices and conventional techniques demonstrated no difference in terms of clinical efficacy; however, air polishing devices seem to present improved antimicrobial results. In addition, they are also a safer, faster and more comfortable option for patients undergoing supportive periodontal therapy.
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Affiliation(s)
- Orlando Martins
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Costa
- DDM, Private Practice, Vila Real, Portugal
| | - Daniela Silva
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythritol or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctively. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time.
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Tan SL, Grewal GK, Mohamed Nazari NS, Mohd-Dom TN, Baharuddin NA. Efficacy of air polishing in comparison with hand instruments and/or power-driven instruments in supportive periodontal therapy and implant maintenance: a systematic review and meta-analysis. BMC Oral Health 2022; 22:85. [PMID: 35321688 PMCID: PMC8944123 DOI: 10.1186/s12903-022-02120-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant placement. This systematic review aimed to assess clinical outcomes, patients' perception, and cost-effectiveness of repeated periodontal therapy with air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments (conventional interventions) in SPT and implant maintenance. METHODS Electronic search for randomised controlled clinical trials with minimum 6 months follow-up for SPT and implant maintenance programme was conducted for data published from 01 January 2000 to 30 April 2020 using multiple databases and hand searching. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). RESULTS A total of 823 articles were screened. 4 SPT and 2 implant maintenance studies were eligible for inclusion. For SPT, repeated APDs interventions revealed no statistically significant difference when compared to the conventional interventions (weighted mean difference [WMD] 0.11 mm, p = 0.08). Likewise, no statistical difference was noted in terms of percentage of bleeding on probing (BOP) and clinical attachment level (CAL) gain. APDs were associated with lower pain score (based on Visual Analogue Scale) and higher patient acceptance in SPT studies. For implant maintenance, APDs resulted in reduction in PPD and percentage of BOP. However, CAL gain was comparable between the two groups. In terms of patient reported outcomes, no implant maintenance studies recorded any forms of patient reported outcomes. In addition, no studies reported on economic evaluation of APDs in both SPT and implant maintenance. CONCLUSION Within the limitations of this systematic review and meta-analysis, repeated subgingival debridement using APDs in SPT resulted in similar clinical outcomes but better patients' comfort when compared to the conventional interventions. For implant maintenance, there is limited evidence to show that repeated application of APDs leads to improved clinical outcomes when compared to conventional treatments.
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Affiliation(s)
- Shiuan Lee Tan
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Galvinderjeet Kaur Grewal
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Nor Shafina Mohamed Nazari
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Tuti Ningseh Mohd-Dom
- Department of Family Oral Health Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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Kruse AB, Wölki BJ, Woelber JP, Frisch E, Vach K, Ratka-Krüger P. Subgingival air polishing with trehalose powder during supportive periodontal therapy: use of a conical shaped tip during a randomized clinical trial. BMC Oral Health 2022; 22:70. [PMID: 35282825 PMCID: PMC8918077 DOI: 10.1186/s12903-022-02109-1] [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: 11/08/2021] [Accepted: 03/07/2022] [Indexed: 08/21/2023] Open
Abstract
Background This study investigated clinical parameters using a new air-polishing device compared to sonic scaling for subgingival biofilm removal during supportive periodontal therapy. The aim was to evaluate noninferiority of air-polishing compared to sonic scaling in deeper periodontal pockets with respect to pocket depth (PD).
Methods In 44 participants, 2 single-rooted teeth [(PD) ≥ 5 mm] were treated using a split-mouth design. While a new air polishing device with a conical shaped tip was used for the experimental group, sonic scaling was performed in the control group. PD, clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at baseline, (T0) after 3 months (T1) and 6 months (T2). Pain perception was rated using a visual analog scale (VAS; 0 = no pain, 100 = maximum pain). Results PD and CAL decreased significantly for both groups, while no intergroup differences were found (PD [mean, mm] control T0 5.96, T2 4.75; experimental T0 5.96, T2 4.8; intergroup p = 0.998; CAL [mean, mm] control T0 7.38, T2 5.84; experimental T0 7.28, T2 6.34; intergroup p = 0.368). For BOP, no intergroup differences were found from T0 to T2 (reduction control 42.5%; experimental 46.5% p = 0.398). Pain perception was significantly lower for air polishing (VAS [mean, mm] control 28.8, experimental 12.56; p = 0.006). Conclusion None of the two treatment procedures showed inferior clinical effects with regard to PD, CAL and BOP with air polishing being more comfortable to patients. Trial registration The study was registered in an international trial register on August 14/08/2019, before the start of recruitment (German Clinical Trial Register number DRKS00017844).
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Atieh MA, Almatrooshi A, Shah M, Hannawi H, Tawse-Smith A, Alsabeeha NHM. Airflow for initial nonsurgical treatment of peri-implantitis: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:196-210. [PMID: 35156296 DOI: 10.1111/cid.13072] [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: 11/12/2021] [Revised: 12/13/2021] [Accepted: 01/23/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Nonsurgical treatment of peri-implantitis may help in reducing microbial load and inflammatory parameters. The potential clinical benefits of using different treatment approaches, in the initial nonsurgical treatment phase, particularly the airflow, are still not clear. The aim of this systematic review and meta-analyses was to evaluate the outcomes of nonsurgical treatment of peri-implantitis using airflow method in terms of changes in periodontal parameters, peri-implant marginal bone level, postoperative pain/discomfort, and patient satisfaction. METHODS Electronic databases were searched to identify randomized controlled trials (RCTs) that compared airflow with mechanical debridement using ultrasonic/curettes. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program. RESULTS A total of 316 studies were identified, of which, five RCTs with 288 dental implants in 174 participants were included. Overall meta-analysis showed more reduction in probing pocket depths at 1-3 months (mean difference [MD] -0.23; 95% confidence interval [CI] -0.50-0.05; p = 0.10) and 6 months (MD -0.04; 95% CI -0.34 to 0.27; p = 0.80) in favor of airflow, but the difference was not statistically significant. The use of airflow was associated with significant reduction in bleeding on probing and increase in peri-implant mucosal recession. The differences in plaque score, peri-implant marginal bone level changes, and patient reported outcomes between airflow and mechanical debridement were not statistically significant. CONCLUSIONS The short-term clinical and radiographic outcomes following nonsurgical treatment of peri-implantitis using airflow or mechanical debridement were comparable. The airflow has short-term positive effects on reducing bleeding on probing. Further evidence from RCTs are still required to substantiate the current findings.
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Affiliation(s)
- Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates.,Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Aisha Almatrooshi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Haifa Hannawi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates.,Director of Dental Services Department, Emirates Health Services, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Ras Al-Khaimah Dental Center, Ministry of Health and Prevention, Ras al Khaimah, United Arab Emirates
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Antimicrobial Impact of Different Air-Polishing Powders in a Subgingival Biofilm Model. Antibiotics (Basel) 2021; 10:antibiotics10121464. [PMID: 34943676 PMCID: PMC8698523 DOI: 10.3390/antibiotics10121464] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/18/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
Subgingival air-polishing devices (SAPD) can reduce bacterial biofilms and thus support periodontal healing. The authors of this study evaluated the effectiveness of the glycine-based and trehalose-based air-polishing powders in removing pathogenic bacteria in a subgingival biofilm model. We treated 56 subgingival pockets in porcine jaws with SAPD. Subgingival air polishing was performed in three groups of 13 pockets each: I, glycine-based powder; II, trehalose-based powder; and III, water alone. Another group (IV) served as untreated controls. Prior to air polishing, inoculated titanium bars were inserted into the pockets containing periopathogenic bacteria such as Porphyromonas gingivalis and Tannerella forsythia. Remaining bacteria were evaluated using real-time PCR. The numbers of remaining bacteria depended on the treatment procedure, with the lowest number of total bacteria in group I (median: 1.96 × 106 CFU; min: 1.46 × 105; max: 9.30 × 106). Both polishing powders in groups I and II (median: 1.36 × 107 CFU; min: 5.22 × 105; max: 7.50 × 107) showed a statistically significantly lower total bacterial load in comparison to both group IV (median: 2.02 × 108 CFU; min: 5.14 × 107; max: 4.51 × 108; p < 0.05) and group III (median: 4.58 × 107 CFU; min: 2.00 × 106; max: 3.06 × 108; p < 0.05). Both subgingival air-polishing powders investigated can reduce periopathogenic bacteria and thus support antimicrobial therapy approaches in periodontal treatment regimens.
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Eggmann F, Schiavone F, Amato J, Vahle A, Weiger R, Zitzmann NU. Effect of repeated ultrasonic instrumentation on single-unit crowns: a laboratory study. Clin Oral Investig 2021; 26:3189-3201. [PMID: 34820725 DOI: 10.1007/s00784-021-04301-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/13/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This laboratory study aimed to assess the effects of ultrasonic instrumentation, simulating 10 years of supportive periodontal therapy (SPT), on single-unit crowns. MATERIALS AND METHODS Standardized crowns were fabricated from porcelain-fused-to-metal (PFM) (n = 12), zirconia (ZrO2) (n = 12), lithium disilicate (LDS) (n = 12), feldspar ceramic (FSFC) (n = 6), and polymer-infiltrated ceramic network material (PICN) (n = 6). The crowns, luted on PICN abutments with resin-based luting material (RBLM), and if applicable glass ionomer cement (GILC), underwent thermal cycling and trimonthly ultrasonic instrumentation. After 1 and 10 years of simulated SPT, restoration quality assessments were performed, comprising profilometric surface roughness measurements, marginal integrity evaluations, and scores for luting material remnants and visible cracks. The statistical analysis included multiple logistic regressions with nested designs (α = 0.05). RESULTS During simulated SPT, bulk fractures (n = 2) and a de-cementation failure (n = 1) of LDS and ZrO2 crowns were observed. No significant change in roughness was detected after 10 years (p = 0.078). Over time, marginal defects increased (p = 0.010), with PFM crowns showing the highest rate of chippings at sites with a narrow shoulder. Fewer marginal defects were detectable on crowns luted with RBLM compared with GILC (p = 0.005). Luting material remnants decreased during SPT (p < 0.001). Ultrasonic instrumentation caused cracks in most crown materials, in particular at sites with a narrow shoulder and in PFM crowns. CONCLUSIONS Repeated ultrasonic instrumentation may damage single-unit crowns. PFM crowns with a narrow, all-ceramic margin are especially prone to defects. CLINICAL RELEVANCE Frequent ultrasonic instrumentation of restoration margins of fixed dental prostheses, PFM crowns in particular, ought to be avoided.
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Affiliation(s)
- Florin Eggmann
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, CH-4058, Basel, Switzerland.
| | - Fabio Schiavone
- Department of Reconstructive Dentistry, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Julia Amato
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, CH-4058, Basel, Switzerland
| | - Annika Vahle
- VITA Zahnfabrik H. Rauter GmbH & Co. KG, Bad Säckingen, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, CH-4058, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
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13
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Mensi M, Scotti E, Sordillo A, Dalè M, Calza S. Clinical evaluation of air polishing with erythritol powder followed by ultrasonic calculus removal versus conventional ultrasonic debridement and rubber cup polishing for the treatment of gingivitis: A split-mouth randomized controlled clinical trial. Int J Dent Hyg 2021; 20:371-380. [PMID: 34275193 PMCID: PMC9292536 DOI: 10.1111/idh.12537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 05/24/2021] [Accepted: 06/26/2021] [Indexed: 01/03/2023]
Abstract
Objectives To evaluate the clinical efficacy in the short‐term resolution of gingivitis of a novel protocol involving full‐mouth erythritol powder air polishing followed by ultrasonic calculus removal. Methods Forty‐one healthy patients completed the study. Following a split‐mouth design, quadrants 1–4 and 2–3 were randomly allocated to receive air polishing followed by ultrasonic calculus removal (A+US) or traditional full‐mouth ultrasonic debridement followed by polishing with a rubber cup and prophylactic paste (US+P). Bleeding on probing (BoP) and plaque index (PI) were collected at baseline and 2 and 4 weeks. Moreover, the residual plaque area (RPA), treatment time and patient comfort/satisfaction were evaluated at the end of the treatment. Results Both treatments showed a significant reduction in BoP and PI. At 4 weeks, A+US seems to reach a statistically significant lower BoP (8.7% [6.9; 10.9] vs. 11.6%[9.3; 14.4], p < 0.0001) and PI (10.7% [8.9; 13.0] vs. 12.3% [10.2; 14.9], p = 0.033). Moreover, A+US treatment time lasted on average 9.2% less than US+P (p < 0.0001) and was the preferred treatment for a significantly higher number of patients (73.2% vs. 17.1%, p = 0.0001). Conclusion The A+US protocol is suitable for the short‐term resolution of plaque‐induced gingivitis.
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Affiliation(s)
- Magda Mensi
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.,U.O.C. Odontostomatologia - ASST degli Spedali Civili di Brescia, Brescia, Italy
| | - Eleonora Scotti
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.,U.O.C. Odontostomatologia - ASST degli Spedali Civili di Brescia, Brescia, Italy
| | - Annamaria Sordillo
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Matteo Dalè
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
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14
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Vouros I, Antonoglou GN, Anoixiadou S, Kalfas S. A novel biofilm removal approach (Guided Biofilm Therapy) utilizing erythritol air-polishing and ultrasonic piezo instrumentation: A randomized controlled trial. Int J Dent Hyg 2021; 20:381-390. [PMID: 34218516 DOI: 10.1111/idh.12533] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 05/20/2021] [Accepted: 06/19/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of biofilm removal of a treatment protocol combining an air-abrasive device using erythritol powder (AIRFLOW®) and an ultrasonic piezon instrumentation (Guided Biofilm Therapy/GBT) compared with the conventional mechanical approach (Scaling and Root Planing/SRP) during supportive periodontal treatment (SPT). MATERIALS AND METHODS Fifty patients, scheduled for supportive periodontal treatment at the Department of Preventive Dentistry, Periodontology and Implant Biology of the Aristotle University of Thessaloniki were randomly assigned to either a GBT (group A: 24 participants) or a SRP (Group B: 26 participants) treatment protocol. Therapeutic interventions and clinical measurements were performed at baseline and repeated at 6 weeks. Oral hygiene instructions were reinforced at each visit. A questionnaire was handed to the participants for evaluation of patient perception of both utilized approaches. RESULTS At 6 weeks, the two groups showed statistically significant reduction in plaque score and in gingival bleeding index compared with baseline. GBT required approximately 15% less chair-time than SRP with a mean difference of 5.1 min, which was statically significant (p = 0.049). Patient perception was more favourable for GBT than SRP. CONCLUSIONS Biofilm removal using erythritol AIRFLOW® and ultrasonic piezo-electric instruments (GBT) can be considered equally efficient compared with the conventional SRP. Moreover, GBT seemed to require shorter treatment time and to exhibit a more favourable patient perception than the conventional approach.
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Affiliation(s)
- Ioannis Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios N Antonoglou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Styliani Anoixiadou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Kalfas
- Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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15
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Albonni H, Alseirafi W, Tekleh H, Abo Orabi F, Alhaj M, Almasri D, Hamadh H, Sawaf H. Clinical outcomes of using erythritol powder by means of air polishing with ultrasonic debridement in the treatment of initial periodontal pockets in hand of dental students: A split-mouth, randomized, comparative, controlled study. Part I. Int J Dent Hyg 2021; 19:262-272. [PMID: 34013650 DOI: 10.1111/idh.12519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/07/2021] [Accepted: 05/16/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The purpose of this trial was to evaluate the clinical efficacy and patient acceptance of using the erythritol powder air polishing with mechanical debridement in non-surgical periodontal therapy. METHODS The trial was conducted as a split-mouth design study of 6 weeks' duration including 13 patients with gingivitis and stage I periodontitis with grade A. Each patient received ultrasonic debridement and polishing (UD+P) on one side, whereas the contralateral side was treated by erythritol powder air polishing and ultrasonic instrumentation (EPAP+UI) when required. Clinical variables were as follows: papillary bleeding index (PBI), bleeding on probing (BOP), full mouth plaque index (FMPI), calculus index (CI), modified gingival index (MGI), probing pocket depth (PPD), the time needed and rate the pain for each group. RESULTS The FMPI, MGI, CI, PBL and BOP parameters improved significantly for both treatment procedures; however, there were no statistically significant differences between the two groups at any of the examinations intervals, except for MGI and CI which showed a significant reduction at 2 weeks compared with baseline. PPD was significantly decreased in EPAP+UI group. Perceived pain intensity was lower for EPAP+UI group than UD+P group without any significant difference during follow-up periods between the two groups. Seven patients favoured air polishing. The treatment's time was (24.92 ± 9.260 and 34.08 ± 9.106) minutes for the test and control side, respectively. CONCLUSION This study generally revealed no significant differences in clinical outcomes between two groups for gingivitis and stage I periodontitis treatment. However, EPAP+UI had higher patient's preference and less time-consuming compared with UD+P.
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Affiliation(s)
- Hala Albonni
- Periodontology Department, Faculty of Dental Medicine, Damascus University, Damascus, Syria.,Periodontology Department, Faculty of Dentistry-Syrian Private University, Daraa, Syria
| | - Walaa Alseirafi
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hiba Tekleh
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Feras Abo Orabi
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Mouaaid Alhaj
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Dima Almasri
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hussen Hamadh
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hazem Sawaf
- Periodontology Department, Faculty of Dentistry-Syrian Private University, Daraa, Syria
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Mohd-Said S, Mohd-Dom TN, Suhaimi N, Rani H, McGrath C. Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review. Front Med (Lausanne) 2021; 8:600769. [PMID: 34179030 PMCID: PMC8222587 DOI: 10.3389/fmed.2021.600769] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Aerosol-producing dental procedures are of concern in the spread of infections, especially during the COVID-19 pandemic. Periodontal prophylaxis is the most common aerosol-producing procedure conducted in dental practice globally. During COVID-19, many national and international organizations advocated the use of pre-procedural mouth rinsing to prevent the spread of infections from aerosol-generating procedures in the dental setting; however, many questioned the scientific basis for such recommendations. Objective: This systematic review aimed to evaluate the effectiveness of pre-procedural rinsing when preforming periodontal prophylaxis in reducing aerosol contamination in the dental setting. Methods: A comprehensive standardized search strategy was employed, informed by a defined PICO question across four electronic databases. The review of the literature was conducted using the PRISMA framework. Agreement between assessors was determined throughout. Synthesis of study characteristics and key outcomes were conducted. Cochrane's risk-of-bias tool for randomized trials (RoB 2) was employed to assess the quality/bias among studies. Results: The initial search yielded 731 citations across the four databases; 95 potentially effective studies were identified, with 56 effective studies found. Thirty randomized control trial studies were identified, 21 with a focus on effectiveness of pre-procedural mouth rinsing, involving 984 participants (aged 18-70). Agreement between assessors was high (Kappa >0.80). Various pre-procedural mouth rinses were tested, most frequently chlorhexidine (CHX) in 18 studies. The concentrations, volume, and prescribed duration of rinsing varied among studies, hampering meta-analyses. Nonetheless, all studies identified significant reductions in bacterial contamination, as measured by colony forming units (cfu). The effectiveness of CHX over other agents was evident with more than half of the studies (7/15) reporting over a 70% reduction in bacterial contamination (cfu). There were concerns over the risk of bias in most studies (76.2%); 19.0% had a high risk of bias and 4.8% were of low risk of bias. Conclusion: There is substantial evidence to support pre-procedural mouth rinsing, such as with chlorohexidine, to effectively reduce aerosol contamination when performing periodontal prophylaxis compared to mouth rinsing with water or not rinsing.
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Affiliation(s)
- Shahida Mohd-Said
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Tuti Ningseh Mohd-Dom
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Nawal Suhaimi
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Haslina Rani
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
| | - Colman McGrath
- Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
- Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong
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17
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Hihara H, Tagaino R, Washio J, Laosuwan K, Wicaksono DP, Izumita K, Koide R, Takahashi N, Sasaki K. Effectiveness and safety of a new dental plaque removal device utilizing micro mist spray for removing oral biofilm in vitro. BMC Oral Health 2021; 21:286. [PMID: 34088301 PMCID: PMC8176685 DOI: 10.1186/s12903-021-01647-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background Removal of oral biofilm from the oral mucosa is essential for preventing risk of respiratory and gastrointestinal infection in elderly people. Currently, no device is available which can remove oral biofilm from oral mucosa effectively and safely. Therefore, the effectiveness and safety of the Micro Scale Mist UNIT (MSM-UNIT), a newly developed dental plaque removal device utilizing high speed sprays of fine water droplets, were evaluated for biofilm removal, including the rate and surface roughness for simulated tooth surface and mucous membrane. Methods Simulated tooth and oral mucosa coated with an artificial biofilm of Streptococcus mutans were used for evaluation of effectiveness, with uncoated substrates as the controls. The MSM-UNIT and a conventional air ablation device were operated under recommended instructions. The effectiveness was evaluated from the rate of removal of the biofilm, and the safety was evaluated from the damage observed by scanning electron microscope and surface roughness. Results The biofilm removal rate of the MSM-UNIT was significantly higher than that of AIRFLOW. Little damage was observed in the area treated by the MSM-UNIT. The surface roughness of the MSM-UNIT treated area on simulated tooth surface and oral mucosa showed no significant difference to the control area. In contrast, cracks and powder were observed in the area treated by AIRFLOW. In particular, the surface roughness of the AIRFLOW treated area for Toughsilon was significantly larger than that of the control. Conclusions The MSM-UNIT could be used safely and effectively for removing biofilm not only on simulated tooth surfaces but also simulated mucous membrane. The MSM-UNIT has no harmful effect on teeth or oral mucosa, and may be used for comprehensive oral care for patients during nursing care and the perioperative period.
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Affiliation(s)
- Hiroki Hihara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Ryo Tagaino
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Jumpei Washio
- Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Kittipong Laosuwan
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, T. Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Dimas Prasetianto Wicaksono
- Faculty of Dental Medicine, Department of Pediatric Dentistry, Universitas Airlangga, St. Mayjen Prof. Dr. Moestopo No. 47, Surabaya, 60132, Indonesia
| | - Kuniyuki Izumita
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Rie Koide
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Nobuhiro Takahashi
- Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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18
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Hentenaar DFM, De Waal YCM, Stewart RE, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol airpolishing in the non-surgical treatment of peri-implantitis: A randomized controlled trial. Clin Oral Implants Res 2021; 32:840-852. [PMID: 33844373 PMCID: PMC8360148 DOI: 10.1111/clr.13757] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/13/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022]
Abstract
Objectives To compare erythritol air polishing with piezoelectric ultrasonic scaling in the non‐surgical treatment of peri‐implantitis. Material and methods Eighty patients (n = 139 implants) with peri‐implantitis (probing pocket depth (PPD) ≥5 mm, marginal bone loss (MBL) ≥2 mm as compared to bone level at implant placement, bleeding, and/or suppuration on probing (BoP/SoP)) were randomly allocated to air polishing or ultrasonic treatment. The primary outcome was mean BoP (%) at 3 months after therapy (T3). Secondary outcomes were mean SoP (%), plaque score (Plq) (%), PPD (mm), MBL (mm), full mouth periodontal scores (FMPS) (%), levels of 8 classical periodontal pathogens, and treatment pain/discomfort (Visual Analog Scale, VAS). Patients who were considered successful at T3 were additionally assessed at 6, 9, and 12 months. Differences between both groups were analyzed using multilevel statistics. Results Three months after therapy, no significant difference in mean BoP (%) between the air polishing and ultrasonic therapy was found (crude analysis β (95% CI) −0.037 (−0.147; 0.073), p = .380). Neither secondary outcomes SoP (%), Plq (%), PPD (mm), MBL (mm), FMPS (%), and periodontal pathogens showed significant differences. Treatment pain/discomfort was low in both groups (VAS score airpolishing group 2.1 (±1.9), ultrasonic 2.6 (±1.9); p = .222). All successfully treated patients at T3 (18.4%) were still considered successful at 12‐month follow‐up. Conclusions Erythritol air polishing seems as effective as piezoelectric ultrasonic scaling in the non‐surgical treatment of peri‐implantitis, in terms of clinical, radiographical, and microbiological parameters. However, neither of the proposed therapies effectively resolved peri‐implantitis. Hence, the majority of patients required further surgical treatment.
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Affiliation(s)
- Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roy E Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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19
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Aloy-Prósper A, Pellicer-Chover H, Peñarrocha-Oltra D, Peñarrocha-Diago M. Effect of a single initial phase of non-surgical treatment of peri-implantitis: Abrasive air polishing versus ultrasounds. A prospective randomized controlled clinical study. J Clin Exp Dent 2020; 12:e902-e908. [PMID: 33154790 PMCID: PMC7600210 DOI: 10.4317/jced.56653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background Non-surgical treatment of peri-implantitis includes a correct mechanical debridement of the implant surface to reduce the inflammation and recondition the soft tissues. The aim of the study was to evaluate the results of a single phase of non-surgical therapy by comparing the effect of curettes and ultrasounds versus curettes and abrasive air polisher (Air-Flow) in the peri-implant tissue conditions, and patient satisfaction.
Material and Methods A double-blind randomized and controlled prospective clinical study was conducted on patients in peri-implant maintenance phase diagnosed of peri-implantitis treated in the Oral Surgery Unit of the Stomatology Department of the Faculty of Medicine and Dentistry of the University of Valencia, between September of 2017 and May of 2018. They were divided into 2 groups: Group 1: curettes and ultrasounds, and Group 2: curettes and Air-Flow. The clinical and radiological baseline parameters were evaluated after 3-weeks of treatment, as well as patient satisfaction.
Results The sample included 34 patients. Group 1 (17 patients, 38 implants) and Group 2 (17 patients, 32 implants). All the variables improved statistically significantly after treatment in both groups, with the exception of recessions and keratinized mucosa and bone loss that did not vary. When comparing both groups, the type of treatment did not influence the majority of the variables, with the exception of the plaque index (p=0.011) and modified bleeding index from the palatine (p=0.048), which reduced statistically significant in the group 2, as well as the patient satisfaction which was higher in the group 2 (p<0.001).
Conclusions An initial phase of non-surgical treatment achieves an improvement of the peri-implant clinical parameters, thought the method of debridement used seems not to influence. Key words:Peri-implantitis, peri-implant disease, non-surgical treatment, air-abrasive device, mechanical debridement.
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Affiliation(s)
- Amparo Aloy-Prósper
- Assistant Professor of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Hilario Pellicer-Chover
- Collaborating Professor of the Master in Oral Surgery and Implant Dentistry, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - David Peñarrocha-Oltra
- Doctor Assistant of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Chairman of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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20
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Effects of subgingival air-polishing with trehalose powder on oral biofilm during periodontal maintenance therapy: a randomized-controlled pilot study. BMC Oral Health 2020; 20:123. [PMID: 32321490 PMCID: PMC7178568 DOI: 10.1186/s12903-020-01111-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background This pilot study was part of a larger study which compared the effect of subgingival air-polishing using trehalose powder with sonic scaling on clinical parameters during supportive periodontal therapy. Within this microbiological part of the investigation subgingival samples were taken from 10 participants to analyze the survival of different bacterial species after the two different treatments as a proof of principle. Methods In 10 participants two non-adjacent, single-root teeth requiring treatment (PD =5 mm with bleeding on probing (BOP) or > 5 mm) were selected following a split-mouth design and were treated either with a sonic scaler or air-polishing device and trehalose powder. For persistent pockets (PD =4 mm and BOP or > 4 mm), treatment was repeated after 3 months. Subgingival biofilm samples were taken at baseline (BL), subsequently and three and six months after treatment. After determination of the bacterial counts (TBL), isolated bacteria were identified by MALDI-TOF-MS. If unsuccessful, PCR and 16S rDNA sequencing were performed. Results In both treatment groups, TBL decreased immediately after treatment remaining at a lower level. This confirms the findings of the larger study regarding clinical parameters showing a comparable effect on PD, BOP and CAL. Immediately after treatment, the diversity of detected species decreased significantly more than in the sonic group (p = 0.03). After 3 months, the proportion of Gram-positive anaerobic rods was lower in the air-polishing group (powder/ sonic 7%/ 25.9%, p = 0.025). Also, there was a greater reduction of Gram-negative aerobic rods for this group at this time (air-polishing/ sonic − 0.91 / -0.23 Log10 cfu/ ml, p = 0.020). Conclusion Within the limitations of this study air-polishing and sonic treatment seem to have a comparable effect on the subgingival oral biofilm during supportive periodontal treatment. Trial registration The study was registered in an international trial register (German Clinical Trial Register number DRKS 00006296) on 10th of June 2015. HTML&TRIAL_ID = DRKS00006296.
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Clinical and microbiological effect of frequent subgingival air polishing on periodontal conditions: a split-mouth randomized controlled trial. Odontology 2020; 108:688-696. [DOI: 10.1007/s10266-020-00493-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
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The Clinical Efficacy of Subgingival Debridement by Ultrasonic Instrumentation Compared With Subgingival Air Polishing During Periodontal Maintenance: A Systematic Review. J Evid Based Dent Pract 2019; 19:101314. [DOI: 10.1016/j.jebdp.2019.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/18/2019] [Accepted: 02/04/2019] [Indexed: 01/03/2023]
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Hongsathavij R, Kuphasuk Y, Rattanasuwan K. Clinical comparison of the stain removal efficacy of two air polishing powders. Eur J Dent 2019; 11:370-375. [PMID: 28932149 PMCID: PMC5594968 DOI: 10.4103/ejd.ejd_152_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: Air polishing with sodium bicarbonate powders with a grain size of 40 μm is recommended for patient comfort. However, the efficacy of small grain size on stain removal has not been adequately studied. This study aimed to compare the stain removal efficacy of sodium bicarbonate powders with grain sizes of 65 and 40 μm and to evaluate patient acceptance and operator opinion after using both air polishing powders. Materials and Methods: A double-blind, randomized, split-mouth study was conducted with 35 participants with moderate to heavy dental staining on both sides of the upper teeth. Removal of dental stains on the index teeth was performed using sodium bicarbonate powders with a grain size of either 65 or 40 μm. The time taken to completely remove all dental stains was recorded. After treatment, a questionnaire was used to evaluate patient acceptance and the operator's opinion. Results: The average time for the removal of all stains by powder was 4.5 ± 3.6 min with a grain size of 65 μm and 4.4 ± 3.8 min with a grain size of 40 μm. The difference in the average time between the two groups was not significant (P = 0.461). The operator's opinions of the two powders were identical, and patient acceptance did not differ significantly between the two types of powders. Conclusions: The 40 μm sodium bicarbonate powder removed dental stains as efficiently as the 65-μm powder. Powder handling and patient acceptance were comparable between grain sizes of 65 and 40 μm.
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Affiliation(s)
- Rosalin Hongsathavij
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Yosvimol Kuphasuk
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Kanyawat Rattanasuwan
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
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Kruse AB, Akakpo DL, Maamar R, Woelber JP, Al-Ahmad A, Vach K, Ratka-Krueger P. Trehalose powder for subgingival air-polishing during periodontal maintenance therapy: A randomized controlled trial. J Periodontol 2018; 90:263-270. [PMID: 30311948 DOI: 10.1002/jper.17-0403] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Air-polishing appears to be a promising procedure for subgingival biofilm removal in periodontal treatment. The aim of this study was to compare trehalose powder for subgingival air-polishing with sonic debridement in residual periodontal pockets during maintenance therapy. METHODS In this blinded, randomized, controlled clinical trial conducted over 6 months with a split-mouth design, single-rooted teeth in 44 participants with residual pocket depths of 5 mm and bleeding or >5 mm with and without bleeding were included in this study. Subgingival debridement was carried out using either trehalose powder with an air-polishing device (test) or a sonic device (control). The reduction in the probing depths after 3 and 6 months was defined as the primary endpoint. A visual analog scale was used to evaluate the discomfort of both procedures. RESULTS Both procedures showed statistically significant intragroup reductions in probing depths (test baseline [BL] 5.52 ± 0.93, 6 months 3.66 ± 0.81, control BL 5.55 ± 0.9, 6 months 3.68 ± 0.86, P < 0.001), clinical attachment level (test BL 6.93 ± 1.5, 6 months 5.3 ± 1.52, control BL 7.27 ± 1.8, 6 months 5.84 ± 1.71, P < 0.001), and bleeding on probing (test BL 86%, 6 months 41%, control BL 89%, 6 months 34%, P < 0.001) after 6 months with no significant intergroup differences (P > 0.05, respectively). The visual analog scale showed a significantly lower incidence of discomfort for air-polishing compared with sonic scaling (test 2.33 ± 2.14, control 4.91 ± 2.65, P < 0.001). CONCLUSIONS Subgingival air-polishing with trehalose powder showed comparable clinical outcomes to sonic scaling. Sonic scaling evoked more discomfort compared with air-polishing.
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Affiliation(s)
- Anne B Kruse
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Dodji L Akakpo
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Rabie Maamar
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Johan P Woelber
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Ali Al-Ahmad
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Kirstin Vach
- Department of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Freiburg, Germany
| | - Petra Ratka-Krueger
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
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Lupi SM, Granati M, Butera A, Collesano V, Rodriguez Y Baena R. Air-abrasive debridement with glycine powder versus manual debridement and chlorhexidine administration for the maintenance of peri-implant health status: a six-month randomized clinical trial. Int J Dent Hyg 2016; 15:287-294. [DOI: 10.1111/idh.12206] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 01/22/2023]
Affiliation(s)
- SM Lupi
- Section of Dentistry; Department of Clinico Surgical; Diagnostic and Pediatric Sciences; University of Pavia; Pavia Italy
| | - M Granati
- Section of Dentistry; Department of Clinico Surgical; Diagnostic and Pediatric Sciences; University of Pavia; Pavia Italy
| | - A Butera
- Section of Dentistry; Department of Clinico Surgical; Diagnostic and Pediatric Sciences; University of Pavia; Pavia Italy
| | - V Collesano
- Section of Dentistry; Department of Clinico Surgical; Diagnostic and Pediatric Sciences; University of Pavia; Pavia Italy
| | - R Rodriguez Y Baena
- Section of Dentistry; Department of Clinico Surgical; Diagnostic and Pediatric Sciences; University of Pavia; Pavia Italy
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