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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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Herz MM, Hoffmann N, Braun S, Lachmann S, Bartha V, Petsos H. Periodontal pockets: Predictors for site-related worsening after non-surgical therapy-A long-term retrospective cohort study. J Clin Periodontol 2024; 51:680-690. [PMID: 38385991 DOI: 10.1111/jcpe.13957] [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: 06/23/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/23/2024]
Abstract
AIM To evaluate site-related changes in periodontal pocket depth (PPD) after non-surgical periodontal therapy and to identify predictors for PPD changes in a retrospective patient data analysis. MATERIALS AND METHODS PPD, clinical attachment level, bleeding on probing, tooth mobility (TM), furcation involvement (FI), abutment status, adherence to supportive periodontal care (SPC) and SPC follow-ups were obtained from fully documented patient data before periodontal therapy (baseline, T0), after active periodontal therapy (APT, T1) and during SPC (T2). PPD changes were classified into deteriorated or unchanged/improved at the site level. Multi-level logistic regression analysis was performed to identify factors influencing PPD changes during SPC. RESULTS This retrospective study included 51 females and 65 males (mean T0 age: 54.8 ± 10.1 years, 25 smokers, 12 diabetics) suffering from Stage III/IV periodontitis. Evaluation outcome: T0/16,044 sampling sites/2674 teeth; T1/15,636/2606; T2/14,754/2459. During 9.0 ± 2.3 years SPC, PPD decreased (-1.33 ± 0.70 mm) by 21.8% of the sites, remained unchanged by 41.4% and increased (1.40 ± 0.78 mm) by 36.8%. Distopalatal FI (p < .001, odds ratio [OR]: 0.252, 95% confidence interval [CI] for OR: 0.118-0.540), residual pockets (p < .001, OR: 0.503, 95% CI: 0.429-0.590) and TM Degrees I-III (Degree I: p = .002, OR: 0.765, 95% CI: 0.646-0.905; Degree II: p = .006, OR: 0.658, 95% CI: 0.489-0.886; Degree III: p = .023, OR: 0.398, 95% CI: 0.180-0.879) correlated significantly with increasing PPD. CONCLUSIONS Over 75% of PPD remained unchanged or increased during SPC. Distopalatal FI, TM Degrees I-III and residual pockets after APT lead to worsening of periodontal pockets.
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Affiliation(s)
- Marco M Herz
- Department for Conservative Dentistry, University Hospital of Tuebingen, Tuebingen, Germany
| | | | | | | | - Valentin Bartha
- Department for Conservative Dentistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Hari Petsos
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt am Main, Germany
- Private Practice, Butzbach, Germany
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Najm KK, Gul SS, Abdulkareem AA. Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial. Clin Pract 2024; 14:954-964. [PMID: 38804408 PMCID: PMC11130800 DOI: 10.3390/clinpract14030076] [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: 03/15/2024] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). METHODS This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. RESULTS PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). CONCLUSIONS Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.
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Affiliation(s)
- Kashan Kamal Najm
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq;
| | - Sarhang Sarwat Gul
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq;
- Medical Laboratory Department, College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaymaniyah 46001, Iraq
| | - Ali Abbas Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad 10011, Iraq;
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Ng E, Tay JRH, Boey SK, Laine ML, Ivanovski S, Seneviratne CJ. Antibiotic resistance in the microbiota of periodontitis patients: an update of current findings. Crit Rev Microbiol 2024; 50:329-340. [PMID: 37140235 DOI: 10.1080/1040841x.2023.2197481] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/16/2023] [Indexed: 05/05/2023]
Abstract
Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global concern. This review aims to explore the current understanding and insight related to antibiotic resistance in the subgingival microbiota of periodontitis patients. A search of MEDLINE (PubMed) was carried out from 1 January 2012 to 25 November 2021 for studies related to antibiotic resistance in periodontitis patients. Of the 90 articles identified, 12 studies were selected for inclusion. A significant incidence of antibiotic resistant isolates was reported for Porphyromonas gingivalis, Prevotella intermedia, Prevotella denticola, Prevotella melaninogenica, Fusobacterium nucleatum, Tanerella forsythia, Aggretibacter actinomycetemcomitans, Streptococcus constellatus, Streptococcus intermedius, and Parvimonas micra, but resistance to specific antibiotics did not reach above 10% of isolates in most studies except for amoxicillin resistance in Aggretibacter actinomycetemcomitans. The highest frequency of resistance across all bacterial species was for amoxicillin, clindamycin, and metronidazole. However, resistance patterns were widely variable across geographical locations, and the high heterogeneity between antibiotic-resistant isolates across studies precludes any clinical recommendations from this study. Although antibiotic resistance has yet to reach critical levels in periodontitis patients, an emphasis on antibiotic stewardship interventions such as point-of-care diagnostics and education for key stakeholders is needed to curb a growing problem.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - Sean Kuan Boey
- Discipline of Periodontics, National University of Singapore, Singapore
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sašo Ivanovski
- School of Dentistry, The University of Queensland, Brisbane, Australia
- School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, Australia
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, Australia
- School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
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Chen X, Xu C, Wu Y, Zhao L. The survival of periodontally treated molars in long-term maintenance: A systematic review and meta-analysis. J Clin Periodontol 2024; 51:631-651. [PMID: 38317331 DOI: 10.1111/jcpe.13951] [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: 03/21/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024]
Abstract
AIM This systematic review and meta-analysis aimed to determine the survival of periodontally treated molars during maintenance care and identify the risk factors associated with molar loss among patients with periodontitis who received professional periodontal therapy and maintenance. MATERIALS AND METHODS Longitudinal studies with a minimum follow-up duration of 5 years published until 28 August 2023 were retrieved from the following databases: the Cochrane Library, Embase, MEDLINE and Web of Science. All included studies reported data on molar retention. Meta-analysis was performed using Review Manager 5.4. A modified version of the Newcastle-Ottawa Scale was used to evaluate the study quality. Statistical results of analyses of the overall survival rate and molar loss are presented as estimated standardized mean differences, whereas the results of the analyses of risk factors are presented as risk ratios with 95% confidence intervals (95% CIs). RESULTS From among the 1323 potentially eligible reports, 41 studies (5584 patients, 29,908 molars retained at the beginning of maintenance therapy, mean follow-up duration of 14.7 years) were included. The pooled survival rate of the molars during maintenance therapy was 82% (95% CI: 80%-84%). The average loss of molars was 0.05 per patient per year (95% CI: 0.04-0.06) among the patients receiving long-term periodontal maintenance (PM) therapy. Fifteen factors were examined in this meta-analysis. Six patient-related factors (older age, lack of compliance, smoking, bruxism, diabetes and lack of private insurance) and five tooth-related factors (maxillary location, high probing pocket depth, furcation involvement, higher mobility and lack of pulpal vitality) were identified as risk factors for molar loss during maintenance therapy. CONCLUSIONS The findings of the present study suggest that the long-term retention of periodontally compromised molars can be achieved. The average number of molars lost per decade was <1 among the patients receiving long-term PM therapy. Older age, noncompliance, smoking, bruxism, diabetes, lack of private insurance coverage, maxillary location, furcation involvement, higher mobility, increase in the probing pocket depth and loss of pulpal vitality are strong risk factors for the long-term prognosis of molars.
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Affiliation(s)
- Xiao Chen
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chunmei Xu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yafei Wu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Sonnenschein SK, Kilian S, Ruetters M, Ciardo A, Kim TS. Changes in periodontal parameters of splinted versus non-splinted posterior teeth during ten years of supportive periodontal therapy - A retrospective evaluation. Clin Oral Investig 2024; 28:283. [PMID: 38683397 PMCID: PMC11058677 DOI: 10.1007/s00784-024-05679-2] [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: 12/14/2023] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES To compare periodontal parameters of splinted posterior teeth versus control teeth over ten years of supportive periodontal therapy (SPT) and to assess the survival rate of splints. MATERIAL AND METHODS Retrospective data of 372 SPT-patients was screened for splints (composite/fiberglass-reinforced composite) in the posterior (molars/premolars) which were inserted at least ten years before due to increased tooth mobility. For each splinted tooth (test), a corresponding control tooth had to be present at the first SPT-session after splint insertion (T1). Data was assessed at T1 and ten years later (T2). Possible influencing covariates for splint survival (mobility degree/Eichner class) were tested by Cox regression. The change in clinical attachment level (ΔCAL), probing pocket depth (ΔPPD) and the testing of possible influencing covariates was analyzed by using mixed linear regression. RESULTS Twenty-four patients (32 splints, 58 splinted teeth) were included. Ten test and two control teeth were lost. No differences were observed between ΔCAL and ΔPPD of test teeth compared to control teeth (ΔCAL -0.38 ± 1.90 vs. 0.20 ± 1.27 mm; ΔPPD -0.17 ± 1.18 vs. 0.10 ± 1.05 mm). Twenty-two splints fractured during the observation period (survival-rate: 31%). Mobility degree and Eichner class did not influence time until fracture. CONCLUSIONS Splinting of periodontally compromised and mobile posterior teeth does not have any disadvantage regarding the clinical periodontal situation when regular SPT is applied. However, splint fractures occur very often. CLINICAL RELEVANCE Splinting of posterior teeth is a treatment option in addition to active periodontal therapy when patients are disturbed by tooth mobility but splints have a high susceptibility to fracture.
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Affiliation(s)
- Sarah K Sonnenschein
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Samuel Kilian
- Heidelberg University, Institute of Medical Biometry, Heidelberg, Germany
| | - Maurice Ruetters
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Antonio Ciardo
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Ti-Sun Kim
- Heidelberg Faculty of Medicine, Department of Conservative Dentistry, Heidelberg University, Clinic for Oral-, Dental- and Maxillofacial Diseases, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Ponnaiyan D, Rughwani RR, Shetty G, Mahendra J, Victor DJ, Thakare KS, Reddy NS. Exploring the Potential Consortium of Migraine and Periodontitis. Int J Dent 2024; 2024:3559500. [PMID: 38699683 PMCID: PMC11065492 DOI: 10.1155/2024/3559500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/04/2024] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
Objectives Various researches have shown periodontitis to share common pathophysiological pathways with systemic diseases such as diabetes, cardiovascular diseases, and osteoporosis and recently neurological disorders. This article provides a narrative review summarizing the various linking mechanisms and the nature of association between two multifactorial diseases-periodontitis and migraine. Materials and Methods A literature search was performed for articles related to periodontitis and migraine up till the year 2023 which yielded totally 14 articles. There were only three randomized controlled clinical trials; therefore, we were unable to conduct a systematic review and focused on a narrative review. The keywords searched were "migraine", "periodontitis" and "biomarkers" in PubMed/Medline, Web of Science, and Embase databases. Any article related to the association of periodontitis and migraine and the dental management of subjects with headache disorders were included and studies with migraine and other dental diseases were excluded. Results It is found that the occurrence of periodontitis and migraine are associated with each other. There is reasonable evidence to believe that periodontitis and migraine are linked by direct and indirect mechanisms which can eventually lead to chronic inflammatory conditions like periodontitis worsening neurovascular conditions such as migraine. However, upon detailed analysis it was found that the strength of association is weak owing to the presences of various common confounding and risk factors. Conclusions The association between periodontitis and migraine cannot be denied, however, not all the criteria are fulfilled while examining the nature of association and future long-term studies are required to prove the same. Clinical Relevance. Various studies have reported poor periodontal health in patients with migraine. The risk of exacerbation of migraine also increases in subject undergoing dental therapy if the triggering factors are manipulated. Hence, knowing the precise pathophysiologic mechanisms linking both the diseases would be favorable in planning treatment protocols for subjects with migraine.
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Affiliation(s)
| | | | | | - Jaideep Mahendra
- Meenakshi Academy of Higher Education and Research, Chennai, India
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Radu CM, Radu CC, Arbănaşi EM, Hogea T, Murvai VR, Chiș IA, Zaha DC. Exploring the Efficacy of Novel Therapeutic Strategies for Periodontitis: A Literature Review. Life (Basel) 2024; 14:468. [PMID: 38672739 PMCID: PMC11050937 DOI: 10.3390/life14040468] [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: 02/28/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Periodontitis, a prevalent oral condition, is facing difficulties in therapeutic approaches, sometimes leading to failure. This literature review was conducted to investigate the diversity of other therapeutic approaches and their potential contributions to the successful management of the disease. This research scrutinized the alterations in microbial diversity and imbalances in crucial microbial species, which contribute significantly to the pathogenesis of periodontitis. Within the limitations of this study, we highlight the importance of understanding the treatment plan's role in periodontitis disease, opening the way for further research and innovative treatment plans to mitigate the impact of periodontitis on oral health. This will aid both healthcare professionals and patients in preventing and effectively treating periodontitis, ultimately improving oral health outcomes and overall systemic health and well-being.
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Affiliation(s)
- Casandra-Maria Radu
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania
| | - Carmen Corina Radu
- Department of Forensic Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
- Institute of Forensic Medicine, 540141 Targu Mures, Romania
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Emil-Marian Arbănaşi
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania
- Department of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
| | - Timur Hogea
- Department of Forensic Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
- Institute of Forensic Medicine, 540141 Targu Mures, Romania
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Viorela Romina Murvai
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq, 410028 Oradea, Romania
| | - Ioana-Andreea Chiș
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania
| | - Dana Carmen Zaha
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq, 410028 Oradea, Romania
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Hussein HR, Abdulkareem AA, Milward MR, Cooper PR. Ability of gingival crevicular fluid volume, E-cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients. J Periodontal Res 2024; 59:289-298. [PMID: 38009442 DOI: 10.1111/jre.13213] [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: 09/17/2023] [Revised: 10/26/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES To determine the potential of gingival crevicular fluid (GCF) volume, E-cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients. BACKGROUND NSPT is the gold-standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis-associated tissue destruction is evidenced by the increased level of soluble E-cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of NSPT. MATERIALS AND METHODS Patients with periodontitis (n = 24) were included in this clinical trial and full-mouth periodontal charting was recorded for each patient. GCF samples from periodontal pockets with probing pocket depth (PPD) 4-6 mm from the interproximal surfaces of anterior and premolar teeth were obtained. These sites subsequently received NSPT and were clinically re-evaluated after 1 and 3 months. Levels of GCF E-cadherin and TAC levels were assayed using ELISA. RESULTS All clinical periodontal parameters were significantly improved 3 months after completion of NSPT. These outcomes were associated with a significant decrease in E-cadherin levels and GCF volume, while TAC levels were significantly increased in samples obtained in follow-up appointments. Binary regression model analysis showed that PPD, GCF volume, E-cadherin, and TAC levels could significantly (p < .05) predict the outcomes of NSPT. The cut-off points for PPD, GCF volume, E-cadherin and TAC were 5 mm, 4 × 10-3, 1267.97 pg/mL and 0.09 μmol/g, respectively. CONCLUSION NSPT improved clinical parameters along with increased antioxidants capacity and epithelial pocket lining integrity. Discrimination of favorable/unfavorable responsiveness of periodontally diseased sites to NSPT could be possible by using GCF volume, PPD, E-cadherin and TAC level assessments.
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Affiliation(s)
- Hind R Hussein
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
- Al-Noor Dental Center, Ministry of Health, Baghdad, Iraq
| | - Ali A Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Mike R Milward
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - Paul R Cooper
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Wong I, Ton A, Cassidy AJ, Fozzard N, Sharma LA, Love RM, Sharma A. A retrospective study on the prognostic factors and success, survival, and failure outcomes of treated endodontic-periodontal lesions. Clin Exp Dent Res 2024; 10:10.1002/cre2.848. [PMID: 38345476 PMCID: PMC10832312 DOI: 10.1002/cre2.848] [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: 08/30/2023] [Revised: 12/27/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The objective of this retrospective study was to determine possible prognostic factors of endodontic-periodontal lesions and to compare success, survival, and failure outcomes of treated endodontic-periodontal lesions across different treatment modalities, demographic variables, and anatomical tooth variations. MATERIALS AND METHODS Data was collected from patient records in the patient management system (Salud, Titanium Solutions) from the Griffith University Dental Clinic between January 2008 and December 2021. The search strategy used the terms "endodontic periodontal lesion," "periodontal endodontic lesion," "endo perio lesion," "perio endo lesion," and "EPL." The 88 cases which met inclusion and exclusion criteria were analyzed. RESULTS The overall success rate was 46.6%, with 21.6% of teeth surviving and 31.8% of teeth failing. Bone loss extending to the apical third (OR = 0.3, 95% CI [0.104, 0.866]), and probing depths of 5-7 mm (OR = 0.147, 95% CI [0.034, 0.633]) and 8-10 mm (OR = 0.126, 95% CI [0.029, 0.542]) were associated with a statistically significant lower odds of success (p < .05). A history of no periodontal disease (OR = 7.705, 95% CI [1.603, 37.037]) was associated with a statistically significant higher odds of success (p < .05). CONCLUSION Practitioners should be aware of bone loss to the apical third, deep probing depths, and a history of periodontal disease as possible prognostic factors that can affect the success rate when treating endodontic-periodontal lesions. Further research with more stringent control over operator factors should be done to investigate these variables.
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Affiliation(s)
- Ingar Wong
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - An Ton
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Amiel J. Cassidy
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Nicolette Fozzard
- School of Pharmacy and Medical SciencesGriffith UniversitySouthportAustralia
| | | | - Robert M. Love
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
| | - Ajay Sharma
- School of Medicine and DentistryGriffith UniversitySouthportAustralia
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11
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Ponnaiyan D, Rughwani RR, Victor DJ, Shetty G. Stem Cells in the Periodontium-Anatomically Related Yet Physiologically Diverse. Eur J Dent 2024; 18:1-13. [PMID: 36588293 PMCID: PMC10959637 DOI: 10.1055/s-0042-1759487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Periodontitis is a complex chronic disease discernible by the deterioration of periodontal tissue. The goal of periodontal therapy is to achieve complete tissue regeneration, and one of the most promising treatment options is to harness the regenerative potential of stem cells available within the periodontal complex. Periodontal ligament stem cells, gingival mesenchymal stem cells, oral periosteal stem cells, and dental follicle stem cells have structural similarities, but their immunological responses and features differ. The qualities of diverse periodontal stem cells, their immune-modulatory effects, and variances in their phenotypes and characteristics will be discussed in this review. Although there is evidence on each stem cell population in the periodontium, understanding the differences in markers expressed, the various research conducted so far on their regenerative potential, will help in understanding which stem cell population will be a better candidate for tissue engineering. The possibility of selecting the most amenable stem cell population for optimal periodontal regeneration and the development and current application of superior tissue engineering treatment options such as autologous transplantation, three-dimensional bioengineered scaffolds, dental stem cell-derived extracellular vesicles will be explored.
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Affiliation(s)
- Deepa Ponnaiyan
- Department of Periodontics and Oral Implantology, SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
| | - Roshan R. Rughwani
- Department of Periodontics and Oral Implantology, SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
| | - Dhayanand John Victor
- Department of Periodontics and Oral Implantology, SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
| | - Ganesh Shetty
- Dental and Orthodontic Clinic, Bangalore, Karnataka, India
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12
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Alasqah MN. Efficacy of Adjunctive Fotoenticine Photodynamic Therapy and Sapindus mukorossi Therapy on Clinical, Radiographic, and Cytokine Profile of Diabetics with Peri-Implantitis. Photobiomodul Photomed Laser Surg 2024; 42:174-181. [PMID: 38301210 DOI: 10.1089/photob.2023.0164] [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: 02/03/2024] Open
Abstract
Objective: To evaluate effectiveness of Fotoenticine (FTC)-mediated photodynamic therapy (PDT) and Sapindus mukorossi (SM) as adjunct to mechanical debridement (MD) on peri-implant clinical parameters and levels of proinflammatory cytokines among diabetics. Background: FTC has exhibited robust photodynamic impact against Streptococcus mutans (i.e., an established caries-associated bacterium); however, its efficacy against periodontal pathogens is not known. Methods: One hundred six diabetics with peri-implantitis were randomly categorized into three groups: Group I consisted of 37 participants who were treated with only MD; group II comprised 35 participants who were treated with FTC-mediated PDT, in addition to MD; and group III consisted of 34 participants who were treated with SM, in addition to MD. Peri-implant clinical parameters [plaque index (PI), bleeding on probing (BOP), and probing depth (PD)] and radiographic outcomes [crestal bone loss (CBL)] (PI, BOP, and PD), together with peri-implant sulcular fluid (PISF) interleukin (IL)-1β and IL-6 levels were measured at baseline and 6-month follow-up. Results: In group I (n = 37; 24 males +13 females), group II (n = 35; 20 males +15 females), and group III (n = 34; 17 males +17 females), the mean age of participants was 54.3 ± 4.6, 52.0 ± 5.5, and 50.8 ± 4.5 years, respectively. Significant improvement was observed in the scores of peri-implant PI (p = 0.01), BOP (p = 0.01), and PD (p = 0.02) at the 6-month follow-up among all study groups. Significant improvement in peri-implant CBL among group I subjects at 6-month follow-up compared to baseline (p < 0.05) was observed. PISF levels of IL-1β and IL-6 improved at 6 months. Conclusions: As an adjunct to conventional MD, FTC-mediated PDT and SM might be used as potential therapeutic modalities among diabetics with peri-implantitis.
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Affiliation(s)
- Mohammed N Alasqah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
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13
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Spinell T, Kröger A, Freitag L, Würfl G, Lauseker M, Hickel R, Kebschull M. Dental implant material related changes in molecular signatures in peri-implantitis - A systematic review of omics in-vivo studies. Dent Mater 2023; 39:1150-1158. [PMID: 37839998 DOI: 10.1016/j.dental.2023.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/22/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Titanium particles have been shown in in-vitro studies to lead to the activation of specific pathways, this work aims to systematically review in- vivo studies examining peri-implant and periodontal tissues at the transcriptome, proteome, epigenome and genome level to reveal implant material-related processes favoring peri-implantitis development investigated in animal and human trials. METHODS Inquiring three literature databases (Medline, Embase, Cochrane) a systematic search based on a priori defined PICOs was conducted: '-omics' studies comparing molecular signatures in healthy and infected peri-implant sites and/or healthy and periodontitis-affected teeth in animals/humans. After risk of bias assessments, lists of differentially expressed genes and results of functional enrichment analyses were compiled whenever possible. RESULTS Out of 2187 screened articles 9 publications were deemed eligible. Both healthy and inflamed peri-implant tissues showed distinct gene expression patterns compared to healthy/diseased periodontal tissues in animal (n = 4) or human studies (n = 5), with immune response, bone metabolism and oxidative stress being affected the most. Due to the lack of available re-analyzable data and inconsistency in methodology of the eligible studies, integrative analyses on differential gene expression were not applicable CONCLUSION: The differences of transcriptomic signatures in between peri-implant lesions compared to periodontal tissue might be related to titanium particles arising from dental implants and are in line with the in-vitro data recently published by our group. Nevertheless, limitations emerge from small sample sizes of included studies and insufficient publication of re-analyzable data.
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Affiliation(s)
- Thomas Spinell
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany.
| | - Annika Kröger
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK; NIHR Birmingham Biomedical Research Centre, Birmingham, UK
| | - Lena Freitag
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | | | - Michael Lauseker
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | - Moritz Kebschull
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University Collegeof Dental Medicine, New York, NY, United States
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14
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Salviatto LTC, Prates RA, Pavani C, Bussadori SK, Deana AM. The influence of growth medium on the photodynamic susceptibility of Aggregatibacter actinomycetemcomitans to antimicrobial blue light. Lasers Med Sci 2023; 38:274. [PMID: 37993626 DOI: 10.1007/s10103-023-03937-5] [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: 08/07/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
The aim of this study was to investigate whether antimicrobial blue light (aBL) can cause the death of Aggregatibacter actinomycetemcomitans (A.a) and to determine the influence of different culture media, specifically brain heart infusion and blood agar, on bacterial survival fraction. An LED emitting at 403 ± 15 nm, with a radiant power of 1W, irradiance of 588.2 mW/cm2, and an irradiation time of 0 min, 1 min, 5 min, 10 min, 30 min, and 60 min, was used. The plates were incubated in microaerophilic conditions at 37 °C for 48 h, and the colony-forming units were counted. The photosensitizers were investigated using spectroscopy and fluorescence microscopy. There was no significant difference between the culture media (p > 0.05). However, a statistical reduction in both media was observed at 30 min (1058 J/cm2) (p < 0.05). The findings of this study suggest that aBL has the potential to kill bacteria regardless of the culture media used. Light therapy could be a promising and cost-effective strategy for preventing periodontal disease when used in combination with mechanical plaque control.
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Affiliation(s)
| | - Renato Araujo Prates
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
| | - Christiane Pavani
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
| | - Alessandro Melo Deana
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
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15
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Yang X, Liu P, Fan X, Yu S, Chen C, Pan Y, Lin L, Tang X, Li C. Distribution and influencing factors on residual pockets of the teeth in patients with periodontitis following non-surgical periodontal treatment: a retrospective observational study. BMC Oral Health 2023; 23:736. [PMID: 37814304 PMCID: PMC10561464 DOI: 10.1186/s12903-023-03248-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/23/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Periodontitis is a chronic and multi-factorial infectious disease. A notable difference exists in the prognosis of patients with severe periodontitis after non-surgical periodontal treatment. Thus, a retrospective study was conducted to identify common and specific factors that impact the prognosis of patients with periodontitis stage III-IV following non-surgical periodontal treatment at different tooth sites. METHODS A total of 977 teeth were included in the study, comprising 266 patients diagnosed with periodontitis stage III-IV. This sample included 330 anterior teeth, 362 maxillary posterior teeth, and 285 mandibular posterior teeth. Following treatment, the teeth were categorized into two groups based on residual pocket depth [probing depth (PD) ≥ 5 mm] at 3 months post-treatment. The prognosis of periodontitis stage III-IV was assessed through multivariate analysis employing logistic regression to determine the association of various risk factors. RESULTS The PD values of each site and the deepest PD values of each tooth significantly decreased at 3 months post-treatment. Residual pockets were predominantly found in the mesio/disto-buccal and mesio/disto-lingual regions. Multivariate analysis revealed that gender, PD, sulcus bleeding index (SBI) and plaque index (PLI) at baseline, and crown-root ratio in anterior teeth had a significant influence on periodontitis stage III-IV (P < 0.05). Smoking, PD, PLI and furcation involvement (FI) at baseline, PLI at 3 months post-treatment, grades of periodontitis, and crown-root ratio were prediction factors for maxillary posterior teeth. Factors such as PD, PLI and FI at baseline, PLI at 3 months post-treatment, and crown-root were significant in mandibular posterior teeth. CONCLUSIONS The outcome of non-surgical treatment varies depending on the tooth positions for patients with periodontitis stage III-IV. Dentists must accurately identify the affected teeth that have periodontal pockets of more than 5 mm, taking into consideration the positions of the affected teeth, as well as various local and systemic factors. This comprehensive assessment will enable dentists to develop a customized and effective treatment plan.
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Affiliation(s)
- Xue Yang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
- School of Stomatology, Dalian Medical University, Dalian, Liaoning, China
| | - Peicheng Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
- Department of Stomatology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaomiao Fan
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Shiwen Yu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Chen Chen
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Yaping Pan
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Li Lin
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Xiaolin Tang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China
| | - Chen Li
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, No.117 Nanjing North Street, Heping District, Shenyang, Liaoning, 110002, China.
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Roldan L, Montoya C, Solanki V, Cai KQ, Yang M, Correa S, Orrego S. A Novel Injectable Piezoelectric Hydrogel for Periodontal Disease Treatment. ACS APPLIED MATERIALS & INTERFACES 2023; 15:43441-43454. [PMID: 37672788 DOI: 10.1021/acsami.3c08336] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Periodontal disease is a multifactorial, bacterially induced inflammatory condition characterized by the progressive destruction of periodontal tissues. The successful nonsurgical treatment of periodontitis requires multifunctional technologies offering antibacterial therapies and promotion of bone regeneration simultaneously. For the first time, in this study, an injectable piezoelectric hydrogel (PiezoGEL) was developed after combining gelatin methacryloyl (GelMA) with biocompatible piezoelectric fillers of barium titanate (BTO) that produce electrical charges when stimulated by biomechanical vibrations (e.g., mastication, movements). We harnessed the benefits of hydrogels (injectable, light curable, conforms to pocket spaces, biocompatible) with the bioactive effects of piezoelectric charges. A thorough biomaterial characterization confirmed piezoelectric fillers' successful integration with the hydrogel, photopolymerizability, injectability for clinical use, and electrical charge generation to enable bioactive effects (antibacterial and bone tissue regeneration). PiezoGEL showed significant reductions in pathogenic biofilm biomass (∼41%), metabolic activity (∼75%), and the number of viable cells (∼2-3 log) compared to hydrogels without BTO fillers in vitro. Molecular analysis related the antibacterial effects to be associated with reduced cell adhesion (downregulation of porP and fimA) and increased oxidative stress (upregulation of oxyR) genes. Moreover, PiezoGEL significantly enhanced bone marrow stem cell (BMSC) viability and osteogenic differentiation by upregulating RUNX2, COL1A1, and ALP. In vivo, PiezoGEL effectively reduced periodontal inflammation and increased bone tissue regeneration compared to control groups in a mice model. Findings from this study suggest PiezoGEL to be a promising and novel therapeutic candidate for the treatment of periodontal disease nonsurgically.
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Affiliation(s)
- Lina Roldan
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania 19140, United States
- Bioengineering Research Group (GIB), Universidad EAFIT, Medellín 050037, Colombia
| | - Carolina Montoya
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania 19140, United States
| | - Varun Solanki
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania 19140, United States
| | - Kathy Q Cai
- Histopathology Facility, Fox Chase Cancer, Temple University, Philadelphia, Pennsylvania 19140, United States
| | - Maobin Yang
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania 19140, United States
- Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania 19140, United States
| | - Santiago Correa
- Bioengineering Research Group (GIB), Universidad EAFIT, Medellín 050037, Colombia
| | - Santiago Orrego
- Department of Oral Health Sciences, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania 19140, United States
- Bioengineering Department, College of Engineering, Temple University. Philadelphia, Pennsylvania 19122, United States
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17
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Nong Z, Ya Z, Zheng J, Yong X, Tao R. The efficacy of subgingival air polishing and subgingival debridement in periodontal support therapy: a meta-analysis. Evid Based Dent 2023; 24:142-143. [PMID: 37433921 DOI: 10.1038/s41432-023-00910-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/30/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE To assess whether there is sufficient evidence of a difference in efficacy between subgingival air polishing (SubAP) and subgingival debridement as periodontal support treatment. The systematic review protocol was registered in the PROSPERO database under no. CRD42020213042. METHODS A comprehensive search was conducted using eight online databases to develop straightforward clinical questions and search strategies, from their inception to 27 January 2023. The references of identified reports were also retrieved for inclusion in the analysis. The risk-of-bias of the included studies was evaluated using the Revised Cochrane Risk-of-Bias tool (RoB 2). A meta-analysis was performed on five clinical indicators using the Stata 16 software. RESULTS Twelve randomized controlled trials were ultimately included, and most included studies had varying degrees of risk-of-bias. The results of the meta-analysis indicated that there was no significant difference between SubAP and subgingival scaling in terms of improving probing depth (PD), clinical attachment loss (CAL), plaque index (PLI), and bleeding on probing% (BOP%). The results of the visual analogue scale score analysis indicated that SubAP produced less discomfort than did subgingival scaling. DISCUSSION SubAP can provide better treatment comfort than subgingival debridement. There was no significant difference in the efficacy of the two modalities in improving PD, CAL, and BOP% in supportive periodontal therapy. CONCLUSION Currently, evidence for assessing the difference in the efficacy of SubAP and subgingival debridement in improving the PLI is insufficient, and further high-quality clinical studies are needed.
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Affiliation(s)
- Zuwei Nong
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Zuke Ya
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China.
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China.
| | - Jiali Zheng
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Xiangzhi Yong
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Renchuan Tao
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
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18
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Nasiri K, Masoumi SM, Amini S, Goudarzi M, Tafreshi SM, Bagheri A, Yasamineh S, Alwan M, Arellano MTC, Gholizadeh O. Recent advances in metal nanoparticles to treat periodontitis. J Nanobiotechnology 2023; 21:283. [PMID: 37605182 PMCID: PMC10440939 DOI: 10.1186/s12951-023-02042-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
The gradual deterioration of the supporting periodontal tissues caused by periodontitis, a chronic multifactorial inflammatory disease, is thought to be triggered by the colonization of dysbiotic plaque biofilms in a vulnerable host. One of the most prevalent dental conditions in the world, periodontitis is now the leading factor in adult tooth loss. When periodontitis does develop, it is treated by scraping the mineralized deposits and dental biofilm off the tooth surfaces. Numerous studies have shown that non-surgical treatment significantly improves clinical and microbiological indices in individuals with periodontitis. Although periodontal parameters have significantly improved, certain bacterial reservoirs often persist on root surfaces even after standard periodontal therapy. Periodontitis has been treated with local or systemic antibiotics as well as scaling and root planning. Since there aren't many brand-new antibiotics on the market, several researchers are currently concentrating on creating alternate methods of combating periodontal germs. There is a delay in a study on the subject of nanoparticle (NP) toxicity, which is especially concerned with mechanisms of action, while the area of nanomedicine develops. The most promising of them are metal NPs since they have potent antibacterial action. Metal NPs may be employed as efficient growth inhibitors in a variety of bacteria, making them useful for the treatment of periodontitis. In this way, the new metal NPs contributed significantly to the development of efficient anti-inflammatory and antibacterial platforms for the treatment of periodontitis. The current therapeutic effects of several metallic NPs on periodontitis are summarized in this study. This data might be used to develop NP-based therapeutic alternatives for the treatment of periodontal infections.
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Affiliation(s)
- Kamyar Nasiri
- Department of Dentistry, Islamic Azad University, Tehran, Iran
| | | | - Sara Amini
- School of Science and Engineering, Duquesne University, Pittsburgh, PA, USA
| | - Mina Goudarzi
- School of Dentistry, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mobin Tafreshi
- School of Dentistry, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bagheri
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical, Yazd, Iran
| | - Saman Yasamineh
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mariem Alwan
- Medical Technical College, Al-Farahidi University, Baghdad, Iraq
| | | | - Omid Gholizadeh
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran.
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Stazić P, Jurić D, Turić A, Šošić A, Marušić A, Roguljić M. Reporting characteristics of nonsurgical periodontal therapy trials registered in ClinicalTrials.gov: an observational study. J Comp Eff Res 2023; 12:e230058. [PMID: 37418255 PMCID: PMC10508296 DOI: 10.57264/cer-2023-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023] Open
Abstract
Aim: To evaluate the completeness of the description of nonsurgical periodontal therapy interventions in clinical trials registered in ClinicalTrials.gov and correspondence of registered information for trial participants and outcome measures with published articles. Materials & methods: We retrieved data from ClinicalTrials.gov and corresponding publications. The completeness of intervention reporting was assessed using the Template for Intervention Description and Replication (TIDieR) checklist for oral hygiene instructions (OHI), professional mechanical plaque removal (PMPR), and subgingival instrumentation, antiseptics and antibiotics. The completeness of registration of trial protocol information was assessed according to the WHO Trial Registration DataSet for participant information (enrollment, sample size calculation, age, gender, condition) and primary/secondary outcome measures. Results: 79 included trials involved OHI (n = 38 trials, 48.1%), PMPR (n = 19, 24.1%), antiseptics (n = 11, 12.7%), or antibiotics (n = 11, 12.7%). There was a great variety in the terms used to describe these interventions. Most of the analyzed trials (93.7%) were completed and did not provide any data on study phase (74.7%). The description of intervention in the registry in ClinicalTrials.gov was inadequate for all analyzed interventions, with description inconsistencies in matching publications. There were also discrepancies in registered and published outcomes: for 39 trials with published results, 18 had different registered and reported primary outcomes, and 29 different registered and reported secondary outcomes. Conclusion: The completeness of the description of nonsurgical therapy of periodontitis in clinical trials is unsatisfactory, reducing the quality of translation of the new evidence and procedures into clinical practice. Significant discrepancy in registered and reported trial outcomes calls into question the validity of reported results and relevance for practice.
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Affiliation(s)
- Petra Stazić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Diana Jurić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Antonela Turić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Antonio Šošić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Ana Marušić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
| | - Marija Roguljić
- University of Split School of Medicine, Šoltanska 2, Split, 21000, Croatia
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20
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Song B, Xian W, Sun Y, Gou L, Guo Q, Zhou X, Ren B, Cheng L. Akkermansia muciniphila inhibited the periodontitis caused by Fusobacterium nucleatum. NPJ Biofilms Microbiomes 2023; 9:49. [PMID: 37460552 DOI: 10.1038/s41522-023-00417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 07/04/2023] [Indexed: 07/20/2023] Open
Abstract
Periodontitis is the most important cause of tooth loss in adults and is closely related to various systemic diseases. Its etiologic factor is plaque biofilm, and the primary treatment modality is plaque control. Studies have confirmed that Fusobacterium nucleatum can cause periodontitis through its virulence factors and copolymerizing effects with other periodontal pathogens, such as the red complex. Inhibiting F. nucleatum is an essential target for preventing periodontitis. The time-consuming and costly traditional periodontal treatment, periodontal scaling, and root planing are a significant burden on individual and public health. Antibiotic use may lead to oral microbial resistance and microbiome imbalance, while probiotics regulate microbial balance. Akkermansia muciniphila is a critical probiotic isolated from the human intestine. It can protect the integrity of the epithelial barrier, regulate and maintain flora homeostasis, improve metabolism, and colonize the oral cavity. Its abundance is inversely correlated with various diseases. We hypothesized that A. muciniphila could inhibit the effects of F. nucleatum and alleviate periodontitis. Bacterial co-culture experiments showed that A. muciniphila could inhibit the expression of the virulence gene of F. nucleatum. After treating gingival epithelial cells (GECs) with F. nucleatum and A. muciniphila, transcriptome sequencing and ELISA experiments on medium supernatant showed that A. muciniphila inhibited the inflammatory effect of F. nucleatum on GECs by inhibiting TLR/MyD88/NF-κB pathway modulation and secretion of inflammatory factors. Finally, animal experiments demonstrated that A. muciniphila could inhibit F. nucleatum-induced periodontitis in BALB/c mice.
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Affiliation(s)
- Bingqing Song
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, 610041, Chengdu, China
| | - Wenpan Xian
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, 610041, Chengdu, China
| | - Yan Sun
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, 610041, Chengdu, China
| | - Lichen Gou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China
| | - Qiang Guo
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, 610041, Chengdu, China
| | - Biao Ren
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China.
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, 610041, Chengdu, China.
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, 610041, Chengdu, China.
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21
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Yukna RA. Clinical evaluation of Laser-Assisted New Attachment Procedure ® (LANAP ®) surgical treatment of chronic periodontitis: a retrospective case series of 1-year results in 22 consecutive patients. J Periodontal Implant Sci 2023; 53:173-183. [PMID: 36468483 PMCID: PMC10315259 DOI: 10.5051/jpis.2202580129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/14/2022] [Accepted: 10/12/2022] [Indexed: 07/30/2023] Open
Abstract
PURPOSE Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure® (LANAP®) surgery as a single treatment modality. METHODS As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. RESULTS All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. CONCLUSIONS Within the limits of this case series, LANAP® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.
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Affiliation(s)
- Raymond A Yukna
- Advanced Periodontal Therapies, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Anschutz Medical Center, Aurora, CO, USA.
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22
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Citterio F, Kanmaz B, Baima G, Romano F, Buduneli N, Aimetti M. Pocket closure in stage III-IV grade C periodontitis: A multilevel analysis following non-surgical periodontal therapy. Int J Dent Hyg 2023. [PMID: 37154234 DOI: 10.1111/idh.12688] [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: 08/11/2022] [Revised: 01/30/2023] [Accepted: 04/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Risk of disease progression and tooth loss is higher in cases where deep probing pocket depths (PPDs) and bleeding on probing (BOP) persist after active periodontal treatment. This study aimed to investigate the efficacy of non-surgical periodontal therapy on pocket closure (PC), defined as PPD ≤4 mm without BOP (PC1) or PPD ≤4 mm solely (PC2) 3 months after non-surgical periodontal treatment and to compare PC between smokers and non-smokers. METHODS This cohort study is a secondary analysis from a controlled clinical trial consisting of systemically healthy patients with stage III or IV grade C periodontitis. All the sites with baseline PPD ≥5 mm are included as diseased sites and PC at 3 months after completion of non-surgical periodontal treatment was calculated. PC was compared between smokers and non-smokers at site and patient levels. Multilevel analysis is used to investigate factors at patient, tooth and site levels affecting PPD changes and the probability of PC. RESULTS A total of 1998 diseased sites in 27 patients were included in the analysis. The rates of PC1 and PC2 were 58.4% and 70.2% and were significantly correlated to smoking habits at site level (r (1) = 7.03, p = 0.008; r (1) = 36.17, p < 0.001). Tooth type, mobility, clinical attachment level (CAL) and PPD at baseline significantly affected PC. CONCLUSIONS The present findings indicate that non-surgical periodontal treatment is effective in PC, but its performance is influenced by baseline PPD and CAL and residual pockets may remain.
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Affiliation(s)
- Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Burcu Kanmaz
- Department of Periodontology, School of Dentistry, İzmir Demokrasi University, İzmir, Turkey
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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23
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Zheng X, Xie T, Sun S, Sun L. Application of periodontal tissue regeneration combined with orthodontics in oral prosthodontics and its influence and significance on the expressions of IL-1β, TNF-α and IL-5 in periodontal tissue. Biotechnol Genet Eng Rev 2023:1-13. [PMID: 37036953 DOI: 10.1080/02648725.2023.2199242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
The aim is to investigate the application of periodontal tissue regeneration combined with orthodontics in oral restoration, and explore its effect and significance on the expressions of Interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-5 (IL-5) in periodontal tissue. The patients in observation group were treated with orthodontics combined with periodontal tissue regeneration, and the control group was treated with periodontal tissue regeneration. The total effective rate, adverse reactions, recurrence rate and treatment satisfaction were compared. The masticatory function, language function, aesthetic level, VAS score, quality of life, gingival index (GI), plaque index (PLI), periodontal pocket probing depth (PD), sulcus bleeding index (SBI), IL-1β, TNF-α and IL-5 levels were compared. The recurrence rate of observation group was lower than control group, while the treatment satisfaction was higher after treatment. After treatment, the scores of masticatory, language, aesthetics, physiological, social, emotional, cognitive, and emotional functions and overall health score were higher than before treatment. After treatment, the scores of masticatory and language functions, aesthetics and quality of life of observation group were significantly higher than control group. After treatment, the VAS score, GI, PLI, SBI, PD, IL-1β, TNF-α and IL-5 levels were lower than before. The VAS score, GI, PLI, SBI, PD levels, IL-1β, TNF-α and IL-5 levels of observation group were lower after treatment. Orthodontics combined with periodontal tissue regeneration can help improve the periodontal condition of patients with periodontitis, reduce inflammatory response, improve the level of efficacy and overall safety, and further improve patients' quality of life and treatment satisfaction.
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Affiliation(s)
- Xiumei Zheng
- Department of Implantology, Stomatological Hospital of Xiamen Medical College and Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Tian Xie
- Department of Neurology (I), Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Shaoni Sun
- Department of Emergency Centre, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Lizhi Sun
- Department of Medical Laboratory Diagnosis Center, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
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24
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Shaheen MY, Al-Zawawi AS, Divakar DD, Aldulaijan HA, Basudan AM. Role of Chlorhexidine and Herbal Oral Rinses in Managing Periodontitis. Int Dent J 2023; 73:235-242. [PMID: 35907673 PMCID: PMC10023587 DOI: 10.1016/j.identj.2022.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this research was to assess the effect of 0.12% chlorhexidine (CHX) and a Salvadora persica-based mouthwash on whole salivary tumour necrosis factor-alpha (TNF-α) levels and periodontal inflammation in patients with type 2 diabetes mellitus (T2DM). METHODS Patients with and without medically diagnosed T2DM were included. Patients' medical records were evaluated to confirm the diagnosis of T2DM. All patients underwent nonsurgical periodontal therapy (NSPT). Patients were divided into 2 subgroups. In the test and control group, patients were advised to rinse with an S persica-based mouthwash and a non-alcoholic 0.12% CHX after NSPT twice daily for 2 weeks, respectively. Demographic data were collected. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were measured, and whole salivary TNF-α levels were gauged at baseline and at 3-month follow-up. Haemoglobin A1c (HbA1c) levels were measured in all patients at baseline and at 3-month follow-up. Sample size estimation was done, and group comparison was performed. Level of significance was set at P < .01. RESULTS Twenty-one nondiabetic individuals and 21 patients with T2DM were included. At baseline, there was no significant difference in clinical and radiographic periodontal parameters amongst in patients with and without T2DM. At 3-month follow-up, HbA1c, TNF-α, PI, PD, and clinical AL were comparable with their respective baseline values in the test and control groups amongst patients with T2DM. In nondiabetic individuals, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01), and TNF-α (P < .01) at 3-month follow-up in the test and control groups compared with their respective baseline scores. CONCLUSIONS In the short term, NSPT with 0.12% CHX or S persica-based mouthwashes is more effective in reducing periodontal inflammation and whole salivary TNF-α levels in nondiabetic individuals than in patients with T2DM with periodontal inflammation.
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Affiliation(s)
- Marwa Y Shaheen
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Abeer S Al-Zawawi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Darshan Devang Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University, Ministry of Health, Lusaka, Zambia
| | - Hajer A Aldulaijan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Amani M Basudan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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25
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Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review. J Funct Biomater 2023; 14:jfb14030142. [PMID: 36976066 PMCID: PMC10055991 DOI: 10.3390/jfb14030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more “simplified approach” based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.
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26
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Megavath S, Nagarakanti S, Chava VK. Effect of nonsurgical periodontal therapy on salivary melatonin levels in patients with periodontal disease. J Indian Soc Periodontol 2023; 27:154-159. [PMID: 37152461 PMCID: PMC10159097 DOI: 10.4103/jisp.jisp_392_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 02/24/2022] [Accepted: 02/27/2022] [Indexed: 05/09/2023] Open
Abstract
Context Periodontitis is an inflammatory disease in which periodontal tissues are damaged as a result of an imbalance in the oxidant/antioxidant systems. Melatonin is one hormone that controls circadian rhythms and is also an antioxidant and immune modulator. Aim The present study was aimed to evaluate the effect of scaling and root planing (SRP) on salivary melatonin levels (SM) in patients with periodontal disease. Settings and Design A single-center clinical trial was conducted to evaluate the effect of SRP on SM levels in patients with periodontal disease. Materials and Methods Forty-five participants of age 30-60 years were equally divided into three groups: 15 healthy participants, 15 participants with gingivitis, and 15 participants with periodontitis. Unstimulated salivary samples were collected from all the participants at baseline and 1 month after SRP from participants of gingivitis and periodontitis group and SM levels were determined by commercially available ELISA kit. Statistical Analysis Used Group comparisons were made using t-test. The level of significance was set at a P < 0.05 for all tests. Results SM levels were significantly lower in the chronic periodontitis group. There was a significant improvement in clinical parameters and SM levels in both chronic periodontitis and gingivitis groups after SRP. Conclusion This study determined that there is a negative correlation between SM levels and the severity of periodontal disease and showed a significant increase in SM levels after SRP, suggesting that melatonin might have a protective role against periodontal disease and can be considered as an effective biomarker.
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Affiliation(s)
- Sravani Megavath
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Sreenivas Nagarakanti
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Vijay Kumar Chava
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Elkerbout TA, Slot DE, Rijnen ME, van der Weijden GAF. Change in oral hygiene behaviour after non-surgical periodontal therapy - A retrospective analyses. Int J Dent Hyg 2023; 21:259-271. [PMID: 35286771 PMCID: PMC10083970 DOI: 10.1111/idh.12593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 01/12/2023]
Abstract
AIM This retrospective analysis investigates changes in daily oral hygiene behaviour after the initial phase of non-surgical periodontal therapy (NSPT). MATERIALS AND METHODS This retrospective study includes 189 consecutive periodontitis patients treated for moderate to severe periodontitis. The authors used the oral hygiene behaviour questionnaire (OHB-9) to assess and evaluate the oral hygiene self-care practices at both intake and evaluation after an active phase of NSPT which consisted of repeated oral hygiene instruction (OHI), supra- and subgingival debridement and polishing. In addition, data on pocket probing depth and bleeding upon pocket probing (BOP) were extracted and PISA and PESA scores were collected. All these parameters are descriptive of the periodontal status at intake and the clinical response to NSPT. RESULTS The OHB-9 showed an increased oral hygiene self-care level after the active phase of NSPT. At the evaluation, 85% of patients used a power toothbrush (PTB), representing an increase of 26% as compared with the intake. In addition, 64% reported brushing 3 min or longer, representing an increase of 33%. The use of woodsticks (WS) and interdental brushes (IDB) at least once a day increased with 15% and 40% respectively. The distribution changes on the answering scale were significant for IDB, WS and brushing duration. However, no significant relationship was found between oral hygiene behaviour at the evaluation and the improvement of the gingival inflammation evaluated by BOP percentage. CONCLUSION The finding of the OHB-9 questionnaire reported was an increase of patients who brushed longer and used the PTB, WS and IDB on a daily basis. The observed improvements in gingival inflammation assessed as bleeding on probing tendency were not significantly associated with oral hygiene behaviour at the evaluation of NSPT.
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Affiliation(s)
- Therese A Elkerbout
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - G A Fridus van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Periodontology Utrecht, Utrecht, The Netherlands
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28
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Salivary Biomarkers in Periodontitis Post Scaling and Root Planing. J Clin Med 2022; 11:jcm11237142. [PMID: 36498715 PMCID: PMC9736688 DOI: 10.3390/jcm11237142] [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: 10/08/2022] [Revised: 11/14/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES This study was conducted to evaluate the levels of salivary uric acid and arginase in patients with periodontitis, generalized gingivitis, and in healthy individuals. Then, the effects of non-surgical periodontal therapy on levels of salivary arginase and uric acid were also investigated. METHODS A total of 60 subjects were divided into three groups based on periodontal health: group I comprised 20 healthy individuals; group II comprised 20 subjects who had generalized gingivitis; group III comprised 20 subjects who had generalized periodontitis. On day 0, the clinical examination of periodontal status was recorded, following which saliva samples were collected. Group II and group III subjects underwent non-surgical periodontal therapy. These patients were recalled on day 30 to collect saliva samples. The periodontal parameters were reassessed on day 90, and saliva samples were collected for analysis of salivary arginase and uric acid levels. RESULTS Group II and group III showed improvement in clinical parameters following non-surgical periodontal therapy on the 90th day. The MGI score, PPD, and CAL showed improvement. On day 0, at baseline, salivary arginase levels in group III and group II were higher than those in healthy subjects, whereas on day 0, salivary uric acid levels in group III and group II were lower than those in healthy subjects. Both on day 0 and day 90, the salivary arginase level showed a positive correlation with the periodontal parameters, whereas the salivary uric acid level was positively correlated with the periodontal parameters on day 90. CONCLUSION the level of salivary arginase was a pro-inflammatory marker and a raised level of salivary uric acid was an anti-inflammatory marker following periodontal therapy, suggesting their pivotal role in assessing periodontal status and evaluation of treatment outcome.
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29
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Rossi R, Rispoli L, Lopez MA, Netti A, Petrini M, Piattelli A. Photodynamic Therapy by Mean of 5-Aminolevulinic Acid for the Management of Periodontitis and Peri-Implantitis: A Retrospective Analysis of 20 Patients. Antibiotics (Basel) 2022; 11:antibiotics11091267. [PMID: 36140046 PMCID: PMC9495362 DOI: 10.3390/antibiotics11091267] [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: 08/23/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Periodontitis and peri-implantitis are common in the population worldwide. Periodontal diseases affect approximately 50% of adults, while mucositis affects 80% of patients with implants, turning into peri-implantitis at a rate varying from 28 to 58%. If standardized treatments for all degrees and variety of periodontal diseases are known and codified, a consensus on the treatment of peri-implantitis still has to be found. Photodynamic therapy (PDT) has been used successfully in the medical field and was recently introduced as supportive therapy in dentistry. This paper reviews the results on 20 patients, 10 affected by periodontal disease (grades II to III) and 10 by peri-implantitis. Application of 5% 5-aminolevulinic acid gel (ALAD), as a support of causal therapy, in periodontal pockets and areas of peri-implantitis favored the maintenance of severely compromised teeth and significantly improved compromised implant conditions. Between baseline and 6 months, all teeth and implants remained functional. All patients confirmed that the scaling and root planning (SRP)+ALAD-PDT was not painful, and all perceived a benefit after the treatment at all timing points. For periodontal patients, a significant decrease in PPD after 3 (p < 0.001) and 6 months after SRP+ALAD-PDT respect baseline values were observed. For the implant patients, the SRP+ALAD-PDT was correlated to a decrease in PPD and BOP, and a slight increase in the number of exposed threads. However, the results were statistically significant only for PPD (p < 0.001).
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Affiliation(s)
| | - Lorena Rispoli
- Department of Periodontology, Humanitas Dental Center, Humanitas Research Hospital, Rozzano, 20089 Milano, Italy
| | - Michele Antonio Lopez
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica Sacro Cuore, 00168 Rome, Italy
- Correspondence: ; Tel./Fax: +39-06-3015-4079
| | - Andrea Netti
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66013 Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
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30
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Ribeiro LSFE, Araujo NS, Zilli Vieira CL, Dos Santos JN, Cury PR. Impact of serum vitamin D levels on periodontal healing outcomes: a preliminary cohort study. Int J Dent Hyg 2022; 21:291-297. [PMID: 36048921 DOI: 10.1111/idh.12619] [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: 06/17/2021] [Revised: 08/02/2022] [Accepted: 08/29/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluated the relationship between serum vitamin D levels and periodontal healing outcomes in patients with mild or moderate periodontitis. METHODS Serum vitamin D levels and periodontal pockets and gingival bleeding were evaluated in 51 patients before and six months after non-surgical periodontal treatment. A t-test and chi-square test were used to analyze the data (p ≤ 0.05). RESULTS The mean reduction of periodontal pocket depth was statistically significant higher in patients with vitamin D ≥ 30 ng/mL compared to those with < 30 ng/mL (CI= -0.23 - 0.42, p= 0.05), but not clinically significant. Vitamin D level was not associated with the percentage of sites gingival bleeding on probing at the final evaluation (OR= 0.58, 95% CI= 0.17-1.99, p= 0.39). CONCLUSION Lower serum vitamin D level was associated with a slightly reduced periodontal healing after non-surgical periodontal therapy, which should be further investigated in a larger population.
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Affiliation(s)
- Lívia Silva Figueiredo E Ribeiro
- Postgraduate Program in Health and Dentistry, School of Dentistry, Federal University of Bahia, Federal University of Bahia, Salvador, - Bahia, Brazil
| | - Nara Santos Araujo
- Postgraduate Program in Health and Dentistry, School of Dentistry, Federal University of Bahia, Federal University of Bahia, Salvador, - Bahia, Brazil
| | | | - Jean Nunes Dos Santos
- Department of Oral Pathology, School of Dentistry, Federal University of Bahia, Salvador, - Bahia, Brazil
| | - Patricia Ramos Cury
- Department of Periodontics, School of Dentistry, Federal University of Bahia, Salvador, - Bahia, Brazil
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31
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Sayar F, Hashemi S, Chiniforush N, Seyed Jafari E, Jandaghi A. Effects of diode and erbium lasers as an adjunct to scaling and root planing on clinical and immunological parameters in non-surgical periodontal treatment: a split-mouth randomized controlled clinical trial-"effects of lasers on immunological parameters". Lasers Med Sci 2022; 37:3021-3030. [PMID: 35718807 DOI: 10.1007/s10103-022-03596-y] [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: 12/27/2021] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
This study evaluated the effects of diode and erbium lasers, as an adjunct to scaling and root planing (SRP), on clinical and immunological parameters in non-surgical periodontal therapy. In this split-mouth randomized controlled clinical trial, 17 participants with at least one periodontally involved tooth in each quadrant received oral hygiene instruction and full-mouth SRP. At baseline, probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and full-mouth plaque index (FMPI) were measured, and gingival crevicular fluid (GCF) sampling was performed. Next, one random quadrant in each participant received 940 nm diode laser (1 W, continuous-wave), and another quadrant received 2780 nm Er,Cr:YSGG laser (1.5 W, 30 Hz) irradiation. The GCF levels of interleukin (IL)-10 and matrix metalloproteinase (MMP)-13 were measured at baseline, and after 2 and 6 months using ELISA. The clinical parameters were also measured. Data were analyzed by repeated measures ANOVA. Significant clinical improvement was noted in all groups (P < 0.05). CAL in the control group was higher at 6 months than 2 months. The increase in IL-10 in erbium group was significantly greater than that in other groups (P < 0.001). The MMP-13 level was significantly lower in laser groups with greater reduction in erbium group (P < 0.001). Application of 940 nm diode and 2780 nm Er,Cr:YSGG lasers as an adjunct to SRP significantly decreased the GCF level of MMP-13, with no significant clinical advantage over SRP monotherapy. Application of 2780 nm Er,Cr:YSGG laser in addition to SRP increased the GCF level of IL-10.Trial registration numbers: IRCT20140318017053N11 and IRCT20140318017053N9.
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Affiliation(s)
- Ferena Sayar
- Department of Periodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | | | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Ehsan Seyed Jafari
- Department of Biotechnology, College of Sciences, University of Tehran, Tehran, Iran
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32
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Targeting Nrf2 with Probiotics and Postbiotics in the Treatment of Periodontitis. Biomolecules 2022; 12:biom12050729. [PMID: 35625655 PMCID: PMC9139160 DOI: 10.3390/biom12050729] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is a destructive disease of the tooth-surrounding tissues. Infection is the etiological cause of the disease, but its extent and severity depend on the immune–inflammatory response of the host. Immune cells use reactive oxygen species to suppress infections, and there is homeostasis between oxidative and antioxidant mechanisms during periodontal health. During periodontitis, however, increased oxidative stress triggers tissue damage, either directly by activating apoptosis and DNA damage or indirectly by activating proteolytic cascades. Periodontal treatment aims to maintain an infection and inflammation-free zone and, in some cases, regenerate lost tissues. Although mechanical disruption of the oral biofilm is an indispensable part of periodontal treatment, adjunctive measures, such as antibiotics or anti-inflammatory medications, are also frequently used, especially in patients with suppressed immune responses. Recent studies have shown that probiotics activate antioxidant mechanisms and can suppress extensive oxidative stress via their ability to activate nuclear factor erythroid 2-related factor 2 (Nrf2). The aim of this narrative review is to describe the essential role of Nrf2 in the maintenance of periodontal health and to propose possible mechanisms to restore the impaired Nrf2 response in periodontitis, with the aid of probiotic and postbiotics.
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The Quantification of Salivary Flow and pH and Stomatognathic System Rehabilitation Interference in Patients with Oral Diseases, Post-Radiotherapy. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Xerostomia is a common complication post-radiotherapy in patients with oral cancer. The acute and long-term side effects can considerably reduce the patient’s quality of life. The aim of our study was to perform analysis of salivary flow and pH in patients after radiotherapy. Methodology: Clinical and laboratory evaluations were conducted in the 2014–2019 period; out of a total 58 subjects aged between 45 and 84, 28 individuals with oral cancer were selected from St. Spiridon Hospital, Clinic of Maxillo-facial Surgery and Oncology Hospital, Iasi post-radiotherapy. Results: Significant downsized mean values of the hydrogen ion concentration (pH) in saliva (p < 0.001) were recorded in patients after radiotherapy, pH value = 4.580 (±1.051). The mean value of resting salivary flow (MRSF) was significantly lower for the group of patients with radiotherapy (MRSF) = 0.145 mL/min. In 89.29% of cases (25 post-radiotherapy cases), in order to perform oral complex rehabilitation treatment, several endodontic and periodontal treatments were performed. A total of 78.57% of the cases received complex oral rehabilitation as mobile or hybrid prostheses or fixed solutions. Conclusion: Understanding post-radiotherapy salivary biochemic modifications in patients with oral cancer could be of critical importance, in view of related oral disorder prevention.
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Lu F, Qi GG, Fang W, Zhang X, Zhou J, Yu XF, Li XJ. Causes of Emergency Bleeding after Nonsurgical Periodontal Therapy in Adult Periodontitis Patients: A Retrospective Analysis. Appl Bionics Biomech 2022; 2022:1579574. [PMID: 35392359 PMCID: PMC8983271 DOI: 10.1155/2022/1579574] [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: 02/18/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background Emergency gingival uncontrollable bleeding after nonsurgical periodontal therapy (NSPT) could be caused by a variety of factors; local oral factors are the main cause of gingival bleeding in most patients. Because the doctor will do a good job of evaluating the patient's physical condition before nonsurgical periodontal therapy. This study is subjected to evaluate the possible factors associated with emergency uncontrollable bleeding within 24-48 hours after NSPT. Material and Methods. A total of fifty-eight patients with emergency bleeding after NSPT in the past four years were enrolled. The related factors in patients, such as age, gender, clotting function, systemic diseases, and baseline periodontitis severity, were analyzed. The site-related factors, such as tooth type, tooth distribution, and alveolar bone resorption at the bleeding site, were compared. The possible relationship of the parameters to the causes of emergency bleeding with NSPT was also evaluated. Results Gingival bleeding after NSPT was registered. In this retrospective study, a total of 58 patients were selected. There were 29 males and 29 females, aged from 20 to 67 years old, with an average age of 35.21 ± 10.09 years. Among them, 8.6% were over 50 years old, and 91.4% were under 50 years old. Completed evaluations were performed in 15.5% gingivitis and 84.5% periodontitis. The causes of emergency bleeding after nonsurgical periodontal therapy in this study were residual subgingival calculus or granulation tissue in 63.79% of cases: severe gingival inflammation, 29.32%; gum trauma, 3.45%; and poor compliance, 3.45%. The therapy method before bleeding includes supragingival scaling accounted for 72.4% and subgingival scaling accounted for 27.6%. 23 cases of horizontal absorption at the bleeding site accounted for 39.66%, and 35 cases of angular absorption accounted for 60.34%. Bleeding of maxillary posterior teeth accounted for 34.48%; mandibular anterior teeth accounted for 15.52%; mandibular anterior teeth accounted for 8.62%; and mandibular posterior teeth accounted for 18.97%; multiple sites accounted for 22.41%; eliminating residual subgingival calculus and granulation tissue were the main and most effective hemostatic methods, 86.21%. Conclusion Residual subgingival calculus or granulation tissue and severe gingival inflammation were the main causes of emergency gingival bleeding after nonsurgical periodontal therapy. Severe gingival inflammation causing emergency bleeding was more common in maxillary posterior teeth areas. Angular alveolar bone resorption was more likely to cause bleeding than horizontal resorption. Careful debridement of residual subgingival calculus and granulation tissue was the main hemostatic method.
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Affiliation(s)
- Fei Lu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Gang-Gang Qi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Wen Fang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Xin Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Jing Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Xue-Fen Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Xiao-Jun Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
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Bartold PM, Ivanovski S. P4 Medicine as a model for precision periodontal care. Clin Oral Investig 2022; 26:5517-5533. [PMID: 35344104 PMCID: PMC9474478 DOI: 10.1007/s00784-022-04469-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022]
Abstract
Objectives P4 Medicine is based on a proactive approach for clinical patient care incorporating the four “pillars” of prediction, prevention, personalization, and participation for patient management. The purpose of this review is to demonstrate how the concepts of P4 medicine can be incorporated into the management of periodontal diseases (particularly periodontitis) termed P4 periodontics. Methods This is a narrative review that used current literature to explore how P4 periodontics can be aligned with the 2018 Classification of Periodontal Diseases, current periodontal treatment paradigms, and periodontal regenerative technologies. Results The proposed model of P4 periodontics is highly aligned with the 2018 Classification of Periodontal Diseases and represents a logical extension of this classification into treatment paradigms. Each stage of periodontitis can be related to a holistic approach to clinical management. The role of “big data” in future P4 periodontics is discussed and the concepts of a treat-to-target focus for treatment outcomes are proposed as part of personalized periodontics. Personalized regenerative and rejuvenative periodontal therapies will refocus our thinking from risk management to regenerative solutions to manage the effects of disease and aging. Conclusions P4 Periodontics allows us to focus not only on early prevention and intervention but also allow for personalized late-stage reversal of the disease trajectory and the use of personalized regenerative procedures to reconstruct damaged tissues and restore them to health. Clinical Significance P4 Periodontics is a novel means of viewing a holistic, integrative, and proactive approach to periodontal treatment.
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Affiliation(s)
- P Mark Bartold
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia.
| | - Sašo Ivanovski
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia
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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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Photodynamic Therapy Using 5-Aminolevulinic Acid (Ala) for the Treatment of Chronic Periodontitis: A Prospective Case Series. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12063102] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aim: The objective of this study was to compare the efficacy of supportive periodontal therapy (i.e., scaling and root planning, SRP) alone versus ALADENT medical device used in association with SRP in the treatment of chronic periodontitis in adult patients. Materials and Methods: A total of 20 patients with a diagnosis of chronic periodontitis (40 localized chronic periodontitis sites) aged between 35 and 55 were selected. None of these patients previously received any surgical or non-surgical periodontal therapy, and they presented radiographic evidence of moderate bone loss. Two non-adjacent sites in different quadrants were identified and observed in each patient, analyzing treatment effectiveness (split-mouth design). Clinical pocket depth, clinical attachment loss, and bleeding on probing were evaluated at time 0 and after 6 months, while microbial analysis (MA) was conducted at baseline and after 15 days. Significant differences were calculated using SPSS program and paired simple statistic t-test. Results: Total bacteria loadings had a statistically significant reduction before and after treatment with SRP (left site) (total average decrease of 27%). The sites treated with SRP plus ALADENT (right) showed a significantly reduced total bacterial loading compared to the untreated sites (right) (total average decrease of 75%). Mean values of CAL/PD and percentages data of BOP, recorded after SRP + ALADENT therapy, showed a higher reduction (CAL = 2.42, PD = 2.87 mm, 90% of sites with no bleeding) than those obtained after SRP treatment (CAL = 4.08 mm, PD = 4.73 mm, 70% of sites with no bleeding). Conclusion: The treatment of moderate and severe chronic periodontitis should include, beside SRP, the use of ALADENT medical device, which has been proved to be a useful adjuvant therapy.
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Wang C, Li Y, Hou Y, Jin L, Chen M. Effects of Emodin on Alveolar Bone Resorption via the IL-23/Th17 Inflammatory Axis in Rats with Periodontitis. J HARD TISSUE BIOL 2022. [DOI: 10.2485/jhtb.31.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chunfeng Wang
- Department of Stomatology, Hunan University of Medicine
| | - Yuxian Li
- Teaching and Research Office of Diagnostics, Medical College, Hunan University of Medicine
| | - Yepo Hou
- Department of Stomatology, Hunan University of Medicine
| | - Ling Jin
- Teaching and Research Office of Diagnostics, Medical College, Hunan University of Medicine
| | - Minmin Chen
- Department of Endodontics, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University & Hunan Key Laboratory of Oral Health Research
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Fang F, Gao B, He T, Lin Y. Efficacy of root canal therapy combined with basic periodontal therapy and its impact on inflammatory responses in patients with combined periodontal-endodontic lesions. Am J Transl Res 2021; 13:14149-14156. [PMID: 35035760 PMCID: PMC8748124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/10/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the effect of root canal and basic periodontal therapies on the efficacy and inflammatory response in patients with pulpal-periodontal disease. METHODS Clinical data of 103 patients with combined periodontal-endodontic lesions were retrospectively analyzed. The patients were divided into a control group (n=50, treated with conventional root canal therapy) and an observation group (n=53, treated with root canal and basic periodontal therapies). The clinical efficacy after treatment, as well as the probing pocket depth (PD), periodontal indices, inflammatory factors release, and pain level (visual analogue scale) before and after treatment were compared between the two groups. The status of diseased teeth and adverse reactions after treatment were recorded. RESULTS After 1 month of treatment, the observation group had lower incidences of loosening of teeth, periodontitis and total adverse reactions, as well as higher tooth retention rate and effective rate as compared with the control group (all P<0.05). The PD, BI, PLI, GI and serum levels of interleukin-6 (IL-6) and interleukin-1β (IL-1β) all decreased in both groups after 1 month of treatment, and the decreases were more in the observation group than those in the control group (all P<0.05). Compared with before treatment, scores of visual analogue scale decreased in both groups 48 hours after the drug was sealed and 1 month after treatment, and the decreases were more in the observation group than those in the control group (all P<0.05). CONCLUSION Root canal and basic periodontal therapies can significantly reduce the pain, control the progression of oral inflammation, improve periodontal health and increase the retention rate of affected teeth in patients with combined periodontal-endodontic lesions, showing safety and efficacy.
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Affiliation(s)
- Fang Fang
- Department of Stomatology, Chinese PLA General HospitalBeijing 100000, China
| | - Bo Gao
- Department of Stomatology, Chinese PLA General HospitalBeijing 100000, China
| | - Tianrong He
- Department of Stomatology, Chinese PLA General HospitalBeijing 100000, China
| | - Yunqi Lin
- Department of Head and Neck Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial HospitalFuzhou 350001, Fujian Province, China
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Abstract
Technological innovations in cellular and molecular aspects of tissue engineering --scaffolds, stem cells and 3D printed tissues --have been dramatically increased in the last decade. However, regenerative treatment still has challenges in translation to clinic. This is partly due to failure of addressing an essential element of wound healing, inflammation. It is now well-recognized that inflammation is an active process. This paradigm shift opened up a new avenue of therapeutic approaches called "host-modulation." Host-modulation therapies capable of modulating inflammatory response at multiple levels and mimicking the natural sequence of wound healing offer a new direction and promising clinical translation.
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Cosola S, Oldoini G, Giammarinaro E, Covani U, Genovesi A, Marconcini S. The effectiveness of the information-motivation model and domestic brushing with a hypochlorite-based formula on peri-implant mucositis: A randomized clinical study. Clin Exp Dent Res 2021; 8:350-358. [PMID: 34677005 PMCID: PMC8874111 DOI: 10.1002/cre2.487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 08/17/2021] [Accepted: 08/24/2021] [Indexed: 11/06/2022] Open
Abstract
Objective Management of mucositis is essential for the long‐term maintenance of dental implants. This study determined the efficacy, in terms of clinical parameters, of an adjunctive domiciliary agent paired with non‐surgical periodontal therapy (NSPT) for patients with peri‐implant mucositis. Materials and methods Patients involved in a periodontal maintenance program were randomly distributed to the domestic use of a chlorhexidine toothpaste and mouthwash (control) or a hypochlorite‐based formula brushing solution (test) after diagnosis of peri‐implant mucositis. A modified approach towards NSPTwas performed after 10 days of domestic use of the assigned maintenance product in both groups. Clinical and patient‐related outcomes were recorded during a 90‐day follow‐up period. Results Forty patients completed the three‐month study (20 patients per group). Both groups showed relevant clinical and patient outcome improvements after the NSPT (T2) and between T1 and T2 (p < 0 0.01), except for PPD. For the test group, the clinical improvement was significantly greater than that for the control group at the seventh‐day evaluation (T1) in the gingival index (0–3) and FMBS (%). Favorable outcomes were maintained during the entire follow‐up period. Conclusion The present study showed that the modified NSPT paired with the domestic use of nitradine‐based formula helps resolve peri‐implant mucositis and that nitradine might represent an alternative to chlorhexidine in these cases. Clinical relevance The gold standard for nonsurgical maintenance is full‐mouth disinfection. A previous decontamination of the oral cavity with chlorhexidine or nitradine domiciliary for 10 days could reduce plaque and inflammation, resulting in a painless operative session. This protocol may help reduce airborne contamination and the risk of cross‐infection, and during the pandemic, the protocol is safer for clinicians. In the same clinical cases, nitradine may be more efficient than chlorhexidine, and the former has no side effects such as discolouration.
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Affiliation(s)
- Saverio Cosola
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy.,Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Giacomo Oldoini
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy
| | - Enrica Giammarinaro
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy.,Department of Stomatology, Saint Camillus International University of Health Sciences (UniCamillus), Rome, Italy
| | - Annamaria Genovesi
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy
| | - Simone Marconcini
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy.,Department of Stomatology, Saint Camillus International University of Health Sciences (UniCamillus), Rome, Italy
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Seidel M, Borenius H, Schorr S, Christofzik D, Graetz C. Results of an experimental study of subgingival cleaning effectiveness in the furcation area. BMC Oral Health 2021; 21:381. [PMID: 34340674 PMCID: PMC8327450 DOI: 10.1186/s12903-021-01736-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sufficient biofilm removal in the furcation area (FA) is a major challenge in the clinical practice of supportive periodontal therapy. The aim of the present experimental study was to simulate subgingival cleaning of the FA using a powered scaler (sonic scaler (AIR), ultrasonic scaler (US)) for conventional mechanical debridement versus two air polishing with nonabrasive powder (LAPA-1: glycine powder, LAPA-2: erythritol powder) and different nozzles for supra-/subgingival cleaning for each device. METHODS Seven trained and calibrated operators with ≥ 2 years each of professional experience in treating periodontitis used the instruments to clean 3D-printed replicas of six molars with through-and-through FA (four 3-rooted and two 2-rooted teeth) in a manikin head. AIR and US were used in the control group; air polishing instruments were used in the test group. For reproducible evaluation, the test teeth were separated vertically into two or three parts, illuminated with ultraviolet light, photographed and evaluated planimetrically. Treatment time (TrT, in s) and relative cleaning efficacy (RCE, in %) were measured. RESULTS Overall, 3-rooted molars (RCE in the entire FA, 23.19 ± 20.98%) could be cleaned significantly less effectively than 2-rooted molars (53.04 ± 28.45%, p < 0.001), regardless of the instrument used. In the cleaning of the entire FA, significantly higher RCE values were achieved with conventional mechanical debridement (AIR/US: 46.04 ± 25.96%/39.63 ± 22.02%; AIR vs. US: p > 0.05) than with air polishing (LAPA-1/LAPA-2: 34.06 ± 29.48%/17.09 ± 18.85%; LAPA-1 vs. LAPA-2: p < 0.001) regardless of whether a supra- or subgingival cleaning nozzle used (p < 0.001). Only LAPA-1 with a subgingival nozzle showed RCE values comparable to those of US (41.07 ± 28.95% vs. 39.63 ± 22.02%, p > 0.05). TrT was longest for US (299.40 ± 120.69 s) and shortest for LAPA-1 with a supragingival nozzle (129.67 ± 60.92 s, p < 0.001). CONCLUSIONS All of the examined instruments were effective to some degree in removing the simulated biofilm from the FA, but they differed substantially in cleaning efficacy. Only one air polishing device (LAPA-1) with a rigid subgingival nozzle was able to achieve RCE values similar to those of US. The current investigation confirmed that conventional mechanical debridement with powered scalers were most effective, but treatment took longer with these devices than air polishing.
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Affiliation(s)
- Miriam Seidel
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
| | - Hannah Borenius
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
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Mai T, Lv D, Fu N. The curative effect of ultrasonic subgingival curettage combined with Xipayi gingival rinse on patients with chronic periodontitis. Am J Transl Res 2021; 13:8094-8101. [PMID: 34377292 PMCID: PMC8340207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/11/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES We explored and analyzed the effect and masticatory function of ultrasonic subgingival curettage combined with rinsing and gargling of Xipayi gingival rinse on patients with moderate to severe chronic periodontitis. METHODS We selected 98 patients with moderate to severe chronic periodontitis admitted to our hospital, and randomly divided them into observation group and control group (n=49 in each group). The control group was treated with ultrasonic subgingival curettage. The observation group received ultrasonic subgingival curettage with Xipayi gingival rinse, and continued to use-Xipayi gingival rinse for 4 weeks. The changes of periodontal index, inflammatory degree of gingival crevicular fluid, occlusal and masticatory efficiency before and after treatment were compared. RESULTS The periodontal indexes and the degree of inflammatory factors in gingival crevicular fluid of the two groups post-treatment decreased critically than those of pre-treatment (P<0.05), and the periodontal index and the degree of inflammatory factors in gingival crevicular fluid of the observation group was remarkably lower than those of the control group (P<0.05). The occlusal time and the balance of occlusal force of the two groups decreased significantly post-treatment compared with those of pre-treatment (P<0.05), and the indexes in observation group were dramatically lower than those in control group (P<0.05). The standard deviation of masticatory efficiency in the two groups decreased remarkably post-treatment than that of pre-treatment (P<0.05), and the index in observation group was obviously lower than that in control group (P<0.05). CONCLUSION The combined therapy of ultrasonic subgingival curettage and Xipayi gingival rinse can effectively cure moderate to severe chronic periodontitis. Through this treatment, patients can improve periodontal condition and inhibit periodontal inflammation. Meanwhile, patients can improve the stability of occlusion and increase the bite force, thus improving the chewing efficiency. Therefore, the application of this method is worthy of clinical application.
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Affiliation(s)
- Tingting Mai
- Department of Stomatology, Haikou Longhua Mai Tingting Dental ClinicHaikou 570105, Hainan, China
| | - Dongmei Lv
- Department of Stomatology, First Clinical Division, Peking University School and HospitalBeijing 100034, China
| | - Ning Fu
- Department of Stomatology, Haikou Longhua Mai Yamei Dental ClinicHaikou 570105, Hainan, China
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Dzampaeva ZV, Datieva FS, Esenova ZS, Takoeva EA. Efficacy of Complex Phytoadaptogens as an Adjunct to Non-surgical Treatment of Chronic Periodontitis: A Randomized Clinical Trial. J Int Soc Prev Community Dent 2021; 11:348-356. [PMID: 34268198 PMCID: PMC8257011 DOI: 10.4103/jispcd.jispcd_56_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Many herbal formulas are used in dentistry in the complex treatment and prevention of periodontitis, but it is not always possible to achieve a long-term remission and stimulate regeneration of periodontal structures. Aim: The aim of this randomized clinical trial was to assess the efficacy of chronotherapy with complex phytoadaptogens (CFA) as an adjunct to non-surgical periodontal treatment (NSPT) and to achieve long-term remission. Materials and Methods: Forty systemically healthy patients with chronic generalized periodontitis (probing pocket depth ≥5 mm) were randomly divided into two groups: patients in one group received treatment with NSPT alone (group 2), whereas patients in another group received CFA in addition to NSPT (group 3). Twenty individuals with healthy periodontium (group 1) composed a control group. The clinical outcomes, Simplified Oral Hygiene Index (OHI-S), Sulcus Bleeding Index (SBI), Periodontal Index (PI), and Doppler ultrasound results, were assessed on baseline, after treatment, and 6 months after treatment. Results: There was a statistically significant difference between groups 2 and 3, in favor of group 3 in terms of microcirculation parameters—S (P = 0.03), M (P = 0.02), D (P = 0.03), and RI (P = 0.005); indicators of PI (P = 0.005), SBI (P = 0.03), and OHI-S (P = 0.006) were closer to the normal values during 6-month follow-up. Also there was a statistical difference (P < 0.05) at all time points compared with controls, for several parameters in intragroup comparison. Conclusion: The data obtained confirm the hypothesis that CFA application in chronic periodontitis treatment is more than appropriate for long-term prevention due to their immunomodulatory, anti-inflammatory, antioxidant, stress-limiting, chronotropic effects.
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Affiliation(s)
- Zhanna Valerevna Dzampaeva
- Institute of Biomedical Investigations-The Affiliate of Vladikavkaz Scientific Centre of Russian Academy of Sciences, Vladikavkaz, Russia
| | - Fatima Sergeevna Datieva
- Institute of Biomedical Investigations-The Affiliate of Vladikavkaz Scientific Centre of Russian Academy of Sciences, Vladikavkaz, Russia
| | - Zaira Savelevna Esenova
- Moscow State University of Medicine and Dentistry Named After A.I. Evdokimov, Moscow, Russia
| | - Elena Astanovna Takoeva
- Institute of Biomedical Investigations-The Affiliate of Vladikavkaz Scientific Centre of Russian Academy of Sciences, Vladikavkaz, Russia
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Schoenmakers MGP, Willems EJS, Slot DE, Van der Weijden GAF. Success of supportive periodontal therapy in periodontitis patients - A retrospective analysis. Int J Dent Hyg 2021; 20:318-327. [PMID: 34013646 PMCID: PMC9292265 DOI: 10.1111/idh.12521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 04/09/2021] [Accepted: 05/14/2021] [Indexed: 11/28/2022]
Abstract
Objective The aim of this retrospective analysis was to evaluate, in adult patients treated for periodontitis, the periodontal stability during supportive periodontal therapy (SPT). Methods Data were collected and analyzed retrospectively for periodontitis patients aged ≥36 years who underwent active periodontal therapy (APT) and were following an SPT programme. The stability of the APT success, defined as a probing pocket depth (PPD) of ≤5 mm, was the main outcome parameter. Analyses were performed in which PPD, tooth loss (TL), bleeding on probing (BOP), periodontal epithelium surface area (PESA), and the effects of age, gender, smoking status, and the number of years in SPT were evaluated. The annual TL and BOP of <10% in addition to a PPD of ≤5 mm were considered to be secondary outcome variables. Results In total, 993 patients were included, in 36% of whom a PPD ≤5 mm was found at the evaluation of APT. If the outcome was defined as a BOP of <10% in addition to a PPD of ≤5 mm, this was present in only 16% of the patients. During SPT, a small overall increase in clinical parameters for the total population and an annual average TL of 0.15 per patient was observed. Patients of male gender and smokers negatively affected the success of SPT. Conclusion The periodontal clinical status remained ‘fairly’ stable during SPT in chronic periodontitis patients aged ≥36 years. Smoking negatively affects the outcome of APT and periodontal stability during SPT.
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Affiliation(s)
- Max G P Schoenmakers
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eveline J S Willems
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G A Fridus Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Periodontology, Utrecht, The Netherlands
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Paurobally N, Kruger E, Tennant M. Oral Health Behaviour and Predictors of Oral Health Behaviour Among Patients With Diabetes in the Republic of Mauritius. Int Dent J 2021; 72:106-115. [PMID: 33875276 PMCID: PMC9275285 DOI: 10.1016/j.identj.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To investigate the oral care habits and assess the determinants of oral care behaviour among people with diabetes in the Republic of Mauritius. METHODS The present study draws on data collected from 589 dentate persons with diabetes by means of a close-ended questionnaire. Multivariate logistic regression analyses were used to estimate the association of different demographic and clinical factors with recommended dental hygiene practices. RESULTS The majority of the participants brushed at least twice daily (84.2%), never flossed (88.6%), attended dental clinics on need only (87.1%), and did not monitor their blood glucose levels regularly (69.9%). Neither awareness about the increased risk of periodontal disease and xerostomia nor receiving advice from diabetes care providers was found to be associated with good oral hygiene or increased service utilisation. The experience of oral diseases did not encourage recommended oral health practice, with participants without experience with periodontal disease being 3 times more likely to floss (odds ratio [OR], 2.9; P = .045). Regular dental visits were strongly associated with self-reported type 1 diabetes (OR, 7.8; P = .025). Participants from urban areas were more than twice as likely to visit their dental care provider at least once annually (OR, 2.3; P = .006). Regular dental attendance (OR, 3.7; P = .011) and flossing (OR, 4.5; P = .012) were strongly associated with one another. CONCLUSION There is widespread noncompliance with regular flossing and dental service utilisation. Our findings highlight the need for an emphasis on preventive care through the provision of integrated medical and dental interventions to high-risk individuals suffering from both diabetes and chronic periodontitis.
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Affiliation(s)
- Nesha Paurobally
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Australia.
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Australia
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Comparison of three qPCR-based commercial tests for detection of periodontal pathogens. Sci Rep 2021; 11:6141. [PMID: 33731742 PMCID: PMC7969924 DOI: 10.1038/s41598-021-85305-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/03/2021] [Indexed: 12/27/2022] Open
Abstract
In periodontal practice microbial results of periodontal test kits for identification of key pathogens are an aid in the treatment planning. Information on the performance of commercially available test kits is therefore essential for the clinician. In this retrospective analysis three commercially available qPCR kits for detection and quantification of selected periodontal bacterial species were compared, using 100 clinical samples from patients with untreated periodontitis. The analysis involved two separate comparisons in which kit A (LabOral Diagnostics, The Netherlands) was compared with kit B (Advanced Dental Diagnostics, The Netherlands), and with kit C (OralDent diagnostics, The Netherlands). Analytic procedures for detection and quantification of selected periodontal bacterial species were carried out according to the instructions of the laboratories. Kit A detected target species more often, and absolute numbers of bacterial cells were higher than with kit B. A high degree of similarity was found between the test outcomes by kit A and kit C. All three kits performed satisfactory but small and significant differences exist between kits.
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Akkermansia muciniphila and Its Pili-Like Protein Amuc_1100 Modulate Macrophage Polarization in Experimental Periodontitis. Infect Immun 2020; 89:IAI.00500-20. [PMID: 33020212 DOI: 10.1128/iai.00500-20] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
Periodontitis is a chronic inflammatory disease triggered by dysbiosis of the oral microbiome. Porphyromonas gingivalis is strongly implicated in periodontal inflammation, gingival tissue destruction, and alveolar bone loss through sustained exacerbation of the host response. Recently, the use of other bacterial species, such as Akkermansia muciniphila, has been suggested to counteract inflammation elicited by P. gingivalis In this study, the effects of A. muciniphila and its pili-like protein Amuc_1100 on macrophage polarization during P. gingivalis infection were evaluated in a murine model of experimental periodontitis. Mice were gavaged with P. gingivalis alone or in combination with A. muciniphila or Amuc_1100 for 6 weeks. Morphometric analysis demonstrated that the addition of A. muciniphila or Amuc_1100 significantly reduced P. gingivalis-induced alveolar bone loss. This decreased bone loss was associated with a proresolutive phenotype (M2) of macrophages isolated from submandibular lymph nodes as observed by flow cytometry. Furthermore, the expression of interleukin 10 (IL-10) at the RNA and protein levels was significantly increased in the gingival tissues of the mice and in macrophages exposed to A. muciniphila or Amuc_1100, confirming their anti-inflammatory properties. This study demonstrates the putative therapeutic interest of the administration of A. muciniphila or Amuc_1100 in the management of periodontitis through their anti-inflammatory properties.
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Huang H, Chen D, Lippuner K, Hunziker EB. Induced Experimental Periimplantitis and Periodontitis: What are the Differences in the Inflammatory Response ? J ORAL IMPLANTOL 2020; 47:359-369. [PMID: 33259586 DOI: 10.1563/aaid-joi-d-19-00362] [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: 11/22/2022]
Abstract
This preliminary study investigates the differences between experimental periodontitis and periimplantitis in a dog model, with a focus on the histopathology, the inflammatory responses and specific immunoregulatory activities, driven by Th1/Th2 positive cells. Twelve dental implants were inserted into the edentulated posterior mandibles of six Beagle dogs and were given twelve weeks time for osseointegration. Experimental periimplantitis and periodontitis (first mandible molar) was then induced using cotton-floss ligatures. Twelve weeks later, alveolar bones were quantitated by cone beam-computer tomography. Histopathological analysis of the inflamed gingiva and of the periodontal tissues was performed by light microscopy, and the Th1/ Th2 cell populations were investigated by flow cytometry. Periimplantitis as well as periodontitis were both found to be associated with pronounced bone resorption effects, both to a similar degree vertically, but with a differential bone resorption pattern mesio-distally, and with a significantly higher and consistent bone resorption result in periimplantitis; however, with a higher variance of bone resorption in periodontitis. The histological appearances of the inflammatory tissues were identical. The percentages of Th1/ Th2 cells in the inflamed gingival tissues of both experimental periimplantitis and periodontitis were also found to be similar. Experimental periodontitis and periimplantitis in the dog model show essentially the same cellular pathology of inflammation. However, bone resorption was found to be significantly higher in periimplantitis; the histopathological changes in the periodontal tissues were similar in both groups, but showed a higher inter-individual variation in periodontitis, and appeared more uniform in periimplantitis. This preliminary study indicates that more focused experimental in-vivo inflammation models need to be developed to better simulate the human pathology in the two different diseases, and in order to have a valuable tool to investigate more specifically how novel treatments/prevention approaches may heal the differential adverse effects on bone tissue and on periodontium in periodontitis and in periimplantitis.
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Affiliation(s)
- Hairong Huang
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Gustav Mahlerlaan 3004, 1081LA Amsterdam, Nord-Holland, the Netherlands
| | - Dong Chen
- State Key Laboratory of Basic Science of Stomatology, Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Kurt Lippuner
- Department of Osteoporosis, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010 Bern, Switzerland
| | - Ernst Bruno Hunziker
- Inselspital Universitatsspital Bern Research Head Osteoporosis and Othopaedic Research Freiburgstrasse 3 SWITZERLAND Bern Bern 3010 +41860794446551 +41794446551 Departments of Osteoporosis and Orthopaedic Surgery, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010 Bern, Switzerland
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Petersilka G, Koch R, Vomhof A, Joda T, Harks I, Arweiler N, Ehmke B. Retrospective analysis of the long-term effect of subgingival air polishing in supportive periodontal therapy. J Clin Periodontol 2020; 48:263-271. [PMID: 33098121 DOI: 10.1111/jcpe.13392] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/16/2022]
Abstract
AIM Glycine powder air polishing (GPAP) procedure has become popular. Aim of the analysis was to compare the clinical outcomes during supportive periodontal therapy (SPT) of subgingival application of GPAP with those using sole conventional mechanical debridement (SC). MATERIAL AND METHODS Over a median SPT period of 5.3 years (re-evaluation through last observation), the GPAP cohort (n = 263) received supra- and subgingival biofilm removal with GPAP. Supragingival calculus was removed using curets and sonic scalers here. Patients in the SC cohort (n = 264) were treated with sonic scalers, curets and rubber cup polishing only. Changes in, that is pocket probing depth (PPD) and furcation involvement were assessed retrospectively. A bootstrapping equivalence testing method in line with the principle of the two one-sided tests (TOST) procedure was used to compare clinical outcomes. RESULTS The GPAP procedure was statistically equivalent to SC regarding the number of sites with stable PPDs (83.3%; IQR 68.8%, 91.0% vs. 84.0%; IQR 77.8%, 90.0%). However, in the GPAP cohort, a trend towards deterioration in furcation status (no equivalence) was noted. CONCLUSIONS In periodontal maintenance, the use of GPAP instead of mechanical plaque removal does not improve the clinical outcome. It seems to be contraindicated to treat furcation defects with GPAP only.
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Affiliation(s)
- Gregor Petersilka
- Private Practice, Würzburg, Germany.,Department of Periodontology, Philipps University of Marburg, Marburg, Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Muenster, Münster, Germany
| | - Anna Vomhof
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
| | - Tim Joda
- Department of Reconstructive Dentistry, University of Basel, Basel, Switzerland
| | - Inga Harks
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
| | - Nicole Arweiler
- Department of Periodontology, Philipps University of Marburg, Marburg, Germany
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
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