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Li L, Hayashi-Okada Y, Falkner KL, Cervi S, Andrusz S, Shimizu Y, Zambon JJ, Kirkwood KL, Schifferle RE, Diaz PI. Randomized Trial to Test a Chemo-Mechanical Antiplaque Regimen as Adjunct to Periodontal Therapy. JDR Clin Trans Res 2024; 9:160-169. [PMID: 37148266 DOI: 10.1177/23800844231167065] [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: 05/08/2023] Open
Abstract
BACKGROUND The control of dental biofilm regrowth after nonsurgical periodontal therapy is associated with better clinical outcomes. However, many patients have difficulty achieving optimal plaque control. Subjects with diabetes, in which immune and wound-healing responses are typically impaired, may benefit from intensive antiplaque control regimens after scaling and root planing (SRP). OBJECTIVES This study aimed to evaluate the effects of an intensive, at-home, chemical, and mechanical antiplaque regimen as an adjunct to SRP for the treatment of moderate to severe periodontitis. A secondary objective was to compare responses in subjects with type 2 diabetes and nondiabetics. METHODS This was a 6-mo, single-center, parallel-group, randomized trial. The test group received SRP and oral hygiene instructions, and subjects were instructed to use a 0.12% chlorhexidine gluconate mouthrinse twice a day for 3 mo and utilize rubber interproximal bristle cleaners twice a day for 6 mo. The control group received SRP and oral hygiene instructions. The main outcome was change in mean probing depth (PD) from baseline to 6 mo. Secondary outcomes included change in sites with deep PDs, mean clinical attachment level, bleeding on probing, plaque index, hemoglobin A1C, fasting blood glucose, C-reactive protein, and taste assessment. This study was registered at ClinicalTrials.gov as NCT04830969. RESULTS In total, 114 subjects were randomized to either treatment. Eighty-six subjects completed the trial with no missing visits. Neither an intention-to-treat nor a per-protocol analysis showed statistically significant differences between treatment groups in mean PD at 6 mo. In a subgroup analysis, subjects with diabetes in the test group showed a statistically significant greater reduction in mean PD at 6 mo when compared to subjects with diabetes receiving the control treatment (Δ = 0.15, P = 0.04), while there were no differences within nondiabetics (Δ = 0.02, P = 0.75). CONCLUSION Outcomes in subjects with diabetes may be improved by chemo-mechanical antiplaque measures after nonsurgical periodontal therapy. KNOWLEDGE TRANSFER STATEMENT This study suggests diabetic subjects may benefit from an intensive, at-home, chemical, and mechanical antiplaque regimen to improve nonsurgical periodontal therapy outcomes.
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Affiliation(s)
- L Li
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | | | - K L Falkner
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
| | - S Cervi
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
| | - S Andrusz
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
| | | | - J J Zambon
- Department of Periodontics and Endodontics, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - K L Kirkwood
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - R E Schifferle
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Periodontics and Endodontics, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - P I Diaz
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
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Radhika B, Shivaswamy SW, Walvekar A, Dhingra K, Pattanshetty RS, Shashidara R. Comparative evaluation of thermal impact of 980nm diode laser on soft tissue using irrigation and non-irrigation systems: A histomorphometric study. J Indian Soc Periodontol 2024; 28:91-98. [PMID: 38988963 PMCID: PMC11232811 DOI: 10.4103/jisp.jisp_218_23] [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: 04/28/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 07/12/2024] Open
Abstract
Background Diode laser is one of the most captivating technologies in dental practice. In periodontics, when used at appropriate settings, it possesses the best properties for selective surgical and nonsurgical procedures such as subgingival calculus removal without a thermal change of the root surface, and also provides tissue surface sterilization. However, lasers always produce a certain amount of thermal damage to the soft tissues. Therefore, this study aimed to comparatively evaluate the thermal impact of 980-nm diode laser incisions, when used with irrigation versus nonirrigation systems. Materials and Methods The study was conducted on 24 gingival tissue samples obtained from the goat's mandible and maxilla. The samples were divided into two groups of 12 samples each, and laser incisions were given in 4 power settings, using 980-nm diode laser in super short pulse mode, with and without saline irrigation. Martius Scarlet Blue staining technique was used to prepare the histological slides. Then, slides were examined under a research microscope (Olympus CX 21), and the pictures of the slides were taken by mounting the camera onto the microscope mobile mount. The microscopic images hence obtained were analyzed for the depth and width of the incisions, area of carbonization, necrosis, and reversible damage, using the Digimizer image analysis software. Results The results of this study demonstrated that the mean incision depth was higher (592.49 ± 180.97, P < 0.05), with less carbonization (25.52 ± 29.21, P = 0.00) and less necrosis (311.63 ± 156.441, P < 0.05) in the laser incisions with irrigation, as compared to the laser incisions given without irrigation system. Conclusion Within the limitations of this study, it can be concluded that using an irrigation system causes less collateral damage while maintaining the incising efficiency of the diode laser. Further studies with a higher sample size, controlled irrigation systems, and incision techniques are needed to evaluate the efficiency of diode lasers for the clinical explanation of the results.
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Affiliation(s)
- Bharmappa Radhika
- Department of Periodontics and Implantology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Sharath Wodeyar Shivaswamy
- Department of Periodontics and Implantology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Amit Walvekar
- Department of Periodontics and Implantology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Kunaal Dhingra
- Department of Periodontics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Raju Shashidara
- Department of Oral Pathology and Microbiology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
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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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Feres M. Anne Haffajee: An inspirational role model. Oral Dis 2023; 29 Suppl 1:907-911. [PMID: 36630194 DOI: 10.1111/odi.14497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/24/2022] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
This article honors Dr. Anne Haffajee's career, her highest research standards, scholarly integrity, and inspirational mentorship. Anne-as she liked to be called-was one of the most productive clinical scientists of her time. Gifted with the unique combination of knowledge in the fields of clinical research, oral ecology, data analysis, and computer programing, her work triggered unprecedented advances in the diagnosis, progression, and treatment of periodontitis. Anne's pivotal clinical trials elucidated the effects of non-surgical and surgical periodontal therapies. In addition to her scholarly achievements, Anne played an important role in mentoring young scientists, many of whom have developed independent leadership careers in periodontal research. She always found time to help her mentees, and ultimately became a warm-hearted friend to many of them, including myself. Anne was consistently devoted to contributing to the future of clinical investigation, and more specifically concerned about the lack of interest by (1) funding agencies in supporting such studies and by (2) the new generation of investigators in pursuing a career in the area. She passed away prematurely, in 2013, at the age of 65. Undoubtedly, her work and legacy assured the continuity of high-standard clinical studies in periodontics and the survival of a whole generation of clinical researchers.
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Affiliation(s)
- Magda Feres
- Department of Periodontology, Guarulhos University (Brazil), São Paulo, Guarulhos, Brazil.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine (USA), Boston, Massachusetts, USA.,Forsyth Institute (USA), Cambridge, Massachusetts, USA
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Radulescu V, Boariu MI, Rusu D, Roman A, Surlin P, Voicu A, Didilescu AC, Jentsch H, Siciliano VI, Ramaglia L, Vela O, Kardaras G, Sculean A, Stratul SI. Clinical and microbiological effects of a single application of sodium hypochlorite gel during subgingival re-instrumentation: a triple-blind randomized placebo-controlled clinical trial. Clin Oral Investig 2022; 26:6639-6652. [PMID: 35829773 DOI: 10.1007/s00784-022-04618-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/05/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study is to assess the clinical and microbiological effects of a single subgingival administration of sodium hypochlorite gel (NaOCl) and compare it with 1% chlorhexidine (CHX) gel and a placebo gel following mechanical re-instrumentation during supportive periodontal therapy (SPT). MATERIALS AND METHODS Sixty-two patients who had been treated for stage III-IV periodontitis and enrolled in SPT were included in the study based on following criteria: (1) active periodontal therapy completed at least 6 months before enrollment in the study, (2) presence of at least 4 non-adjacent sites with probing pocket depths (PPDs) ≥ 4 mm with bleeding on probing (BOP), or presence of 5-8 mm PPDs with or without BOP. All sites presenting PPD ≥ 4 mm and BOP at baseline and 3-, 6-, and 9-month follow-up timepoints were subgingivally re-instrumented with ultrasounds. Selected patients were randomly assigned into three groups and treated additionally with a single subgingival administration of NaOCl gel (group A); 1% CHX gel (group B); and placebo gel (group C). Main outcome variable was pocket closure at 12 months. Secondary outcome variables were changes in mean PPD, BOP, and clinical attachment level (CAL) along with changes in the numbers of the following five keystone bacterial pathogens: Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythia (T.f.), and Treponema denticola (T.d.). RESULTS At 12 months, pocket closure was obtained in 77.5% in the NaOCl treated sites. The reduction in PPD was higher with CHX than with NaOCl, although a statistically significant adjunctive effect for NaOCl (P = 0.028) was only observed in comparison with placebo only. Mean CAL improved in all groups and at all timepoints, compared to the baseline (P < 0.05). However, after 6 months, CAL gain was statistically significantly higher in the NaOCl treated group than following application of CHX (P = 0.0026). CONCLUSION In SPT patients, a single adjunctive use of a NaOCl gel may provide benefits in controlling inflammation and residual pockets. TRIAL REGISTRATION ISRCTN Registry of Clinical Trials (ISRCTN11387188). CLINICAL RELEVANCE A baseline single application of NaOCl gel in conjunction with mechanical debridement may achieve substantial pocket closure in patients enrolled in SPT; treatment time, cost, and applicability considerations should be taken into account when selecting this therapy.
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Affiliation(s)
- Viorelia Radulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Marius Ion Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Applicative Periodontal Regeneration Research Unit, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Craiova, Romania
| | - Adrian Voicu
- Department of Informatics and Medical Biostatistics, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Andreea Cristiana Didilescu
- Department of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | - Holger Jentsch
- Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | - Vincenzo Iorio Siciliano
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Naples, Italy
| | - Luca Ramaglia
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Naples, Italy
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Giorgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
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Durgapal S, Shetty M. Magnification in Periodontics: An Overview. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1747911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractA plethora of changes in the concept and the techniques in dental sciences and an increase in patient awareness have spawned demand in advanced dental treatment encompassing elimination of disease with more precision and less discomfort. The use of magnification systems like microscopes is widespread in the medical field, and now it has successfully spread its wings in dentistry. Visual enhancement by using loupes or surgical microscopes can render refinement in the basic surgical procedures. Magnification periodontics refers to the wide range of procedures performed by the use of magnification systems like loupes and microscopes that allow convergence of ideas and efforts, which can make a huge impact on patients. Periodontal procedures are being increasingly performed nowadays that have enabled enhanced outcomes, which were difficult to achieve with the macrosurgery procedures when wound healing and tissue trauma are in consideration. The surgical operating microscope works within the microsurgical triad that includes illumination increased precision and magnification. The incorporation of smaller instruments and sutures and better visualization of the operating site enhance the surgical skills of the clinician. In the past decade, various periodontal procedures from the removal of calculus to the placement of dental implants have been performed using the surgical microscope, which have invariably provided favorable results. It is a topic of interest in the future of periodontal therapy.
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Affiliation(s)
- Surabhi Durgapal
- Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Mangalore, Karnataka, India
| | - Mamatha Shetty
- Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Mangalore, Karnataka, India
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Hussain B, Karaca EO, Kuru BE, Gursoy H, Haugen HJ, Wohlfahrt JC. Treatment of residual pockets using an oscillating chitosan device versus regular curettes alone-A randomized, feasibility parallel-arm clinical trial. J Periodontol 2022; 93:780-789. [PMID: 34710240 DOI: 10.1002/jper.21-0496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND A brush made of chitosan has shown to be an effective and harmless device for non-surgical treatment of mild to moderate peri-implantitis. To date, no study has evaluated the use of a chitosan brush in the non-surgical treatment of residual pockets in periodontal treatment. METHODS Seventy-eight patients with periodontitis were included in this multicenter, randomized, examiner-blind clinical trial of 6 months duration. Patients with residual probing pocket depth (PPD) of ≥5 mm and ≤7 mm following previous active periodontal treatment were included. Patients were assigned either subgingival treatment with curettes (control) or an oscillating chitosan brush (test). Changes in bleeding on probing (BoP) and PPD between baseline and terminal evaluation at 6 months were evaluated. RESULTS A significant reduction in both PPD and BoP was seen within both groups. There was no significant difference in BoP between test and control groups after 6 months, but the reduction in PPD was significantly improved in the test group (P ≤ 0.01). The combined outcome of no BOP and PPD ≤4 mm was significantly better in the test group (P ≤ 0.01). No adverse reactions were seen. CONCLUSION Treatment of residual periodontal pockets (PPD = 5 to 7 mm) with a chitosan brush disclosed equal or better clinical results as compared to regular curettes. This study supports that a chitosan brush can be used for subgingival biofilm removal and soft tissue curretage in the treatment of periodontitis.
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Affiliation(s)
- Badra Hussain
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Ebru Ozkan Karaca
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Bahar Eren Kuru
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Hare Gursoy
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Johan Caspar Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.,Bjerke Tannmedisin, Oslo, Norway
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Byrne SJ, Chang D, Adams GG, Butler CA, Reynolds EC, Darby IB, Dashper SG. Microbiome profiles of non-responding and responding paired periodontitis sites within the same participants following non-surgical treatment. J Oral Microbiol 2022; 14:2043595. [PMID: 35295980 PMCID: PMC8920355 DOI: 10.1080/20002297.2022.2043595] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim Periodontitis is a site-specific, chronic disease treated by non-surgical debridement of subgingival plaque. We aimed to determine the microbiome of sites that did not respond to this treatment (NR) compared with paired good responding (GR) sites before and after treatment. Materials and methods In a longitudinal cohort study, clinical parameters of disease and biological samples were taken prior to and 3 months after treatment. Twelve NR sites from six participants were paired with GR sites within the same participant. Subgingival plaque samples were subjected to bacterial community analysis using 16S rRNA gene sequencing. Results There were no significant differences in clinical parameters and microbial communities at baseline between GR and NR sites. Bacterial communities in deep pockets were dominated by a small number of species, notably Porphyromonas gingivalis and Treponema denticola. In NR sites three months after treatment there was no significant change in bacterial composition whilst there was a collapse in the abundance of pathobionts in GR sites. Conclusion NR sites were not identifiable prior to treatment by clinical or microbiological parameters. Treatment failed to disrupt pathogenic bacterial community in NR sites. Targeted suppression of particular species should be considered to initiate community collapse and aid disease resolution.
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Affiliation(s)
- SJ Byrne
- Centre for Oral Health Research, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - D Chang
- Centre for Oral Health Research, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - GG Adams
- Centre for Oral Health Research, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - CA Butler
- Centre for Oral Health Research, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - EC Reynolds
- Centre for Oral Health Research, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - IB Darby
- Centre for Oral Health Research, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
| | - SG Dashper
- Centre for Oral Health Research, Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia
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Shrivastava D, Natoli V, Srivastava KC, Alzoubi IA, Nagy AI, Hamza MO, Al-Johani K, Alam MK, Khurshid Z. Novel Approach to Dental Biofilm Management through Guided Biofilm Therapy (GBT): A Review. Microorganisms 2021; 9:microorganisms9091966. [PMID: 34576863 PMCID: PMC8468826 DOI: 10.3390/microorganisms9091966] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Dental biofilm plays a very crucial role in the etiopathogenesis of periodontal andperi-implant diseases. Over the past decade, tremendous research has been carried outto know the structure of biofilm and the mechanism by which it causes the destruction of supporting tissues of tooth or implant. Periodontal or peri-implant therapy usually begins with primarily removing thebiofilm and is considered as non-surgical mechanical debridement. Although scaling and root planing (SRP) is regarded as a gold standard for mechanical plaque debridement, various other means of biofilm removal have constantly been evolving. These may vary from different scaling systems such as vector systems to decontamination of pockets with LASER therapy. Nowadays, a new concept has emerged known as “guided biofilm therapy” (GBT). It is beneficial in removing the biofilm around the tooth and implant structures, resulting in better or comparable clinical outcomes than SRP. These results were substantiated with the reduction in the microbial load as well as the reduction in the inflammatory cytokines. This review will highlight the various aspects of GBT used in periodontal and peri-implant disease.
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Affiliation(s)
- Deepti Shrivastava
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
- Correspondence: ; Tel.: +966-500-782-498
| | - Valentino Natoli
- Department of Dentistry, School of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain;
- Private Dental Practice, 72015 Fasano, Italy
| | - Kumar Chandan Srivastava
- Oral Medicine Radiology, Department of Oral Maxillofacial Surgery Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ibrahim A Alzoubi
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ahmed Ismail Nagy
- Oral Surgery, Department of Oral Maxillofacial Surgery Diagnostic Sciences, Jouf University, Sakaka 72345, Saudi Arabia;
| | - May Othman Hamza
- Department of Prosthodontics, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Khalid Al-Johani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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Curtis DA, Lin GH, Rajendran Y, Gessese T, Suryadevara J, Kapila YL. Treatment planning considerations in the older adult with periodontal disease. Periodontol 2000 2021; 87:157-165. [PMID: 34463978 DOI: 10.1111/prd.12383] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Periodontal health in the elderly is influenced by numerous factors, including systemic conditions, patient compliance, age-associated changes, and restorative procedures. The numerous comorbidities seen in the elderly necessitate individualized approaches for treatment planning. In this paper, we review how age, comorbidities, oral hygiene, and restorative dental procedures collectively influence the treatment and management of the periodontium in the elderly. The elderly population is predicted to double in 30 years, which will have an economic impact the dental profession needs to plan for. Preventative and noninvasive treatment, supportive periodontal therapy, and patient-specific maintenance plans are imperative to maintaining oral health in the older population. Multiple coexisting changes, including xerostomia, altered wound healing, altered bone physiology, altered microbiome, and diminished plaque control, can add complexity to periodontal management. Considerations of the patient's general health, the selected periodontal treatment plan, and the selected completed restorative procedures need to be considered. The influence of caries, fixed prosthodontics, partial dentures, shortened dental arch, and implant therapy can have unintended impacts on periodontal health in the elderly. Adverse periodontal outcomes in the elderly can be minimized by carefully assessing the patient's medical history, impact of medications, functional needs, properly finishing and contouring restorations to avoid plaque accumulation, and designing restorations to allow access for hygiene. Partial dentures can be a source of plaque accumulation leading to periodontal disease, caries, and recession around abutment teeth. A shortened dental arch should be considered as a functional and cost-effective alternative to partial dentures. With dental implants, the patient's tissue phenotype, keratinized tissue quantity, risk of peri-implantitis, and patient access for maintaining adequate oral hygiene are all important to consider. Implant risk-assessment tools show promise by providing a systematic approach for early diagnosis to avoid future complications.
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Affiliation(s)
- Donald A Curtis
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Yogalakshmi Rajendran
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Tsegazeab Gessese
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Jyotirmaie Suryadevara
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Navy Dental Corps, Naval Medical Leader and Professional Development Command, Bethesda, Maryland, USA
| | - Yvonne L Kapila
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
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11
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Albonni H, Alseirafi W, Tekleh H, Abo Orabi F, Alhaj M, Almasri D, Hamadh H, Sawaf H. Clinical outcomes of using erythritol powder by means of air polishing with ultrasonic debridement in the treatment of initial periodontal pockets in hand of dental students: A split-mouth, randomized, comparative, controlled study. Part I. Int J Dent Hyg 2021; 19:262-272. [PMID: 34013650 DOI: 10.1111/idh.12519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/07/2021] [Accepted: 05/16/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The purpose of this trial was to evaluate the clinical efficacy and patient acceptance of using the erythritol powder air polishing with mechanical debridement in non-surgical periodontal therapy. METHODS The trial was conducted as a split-mouth design study of 6 weeks' duration including 13 patients with gingivitis and stage I periodontitis with grade A. Each patient received ultrasonic debridement and polishing (UD+P) on one side, whereas the contralateral side was treated by erythritol powder air polishing and ultrasonic instrumentation (EPAP+UI) when required. Clinical variables were as follows: papillary bleeding index (PBI), bleeding on probing (BOP), full mouth plaque index (FMPI), calculus index (CI), modified gingival index (MGI), probing pocket depth (PPD), the time needed and rate the pain for each group. RESULTS The FMPI, MGI, CI, PBL and BOP parameters improved significantly for both treatment procedures; however, there were no statistically significant differences between the two groups at any of the examinations intervals, except for MGI and CI which showed a significant reduction at 2 weeks compared with baseline. PPD was significantly decreased in EPAP+UI group. Perceived pain intensity was lower for EPAP+UI group than UD+P group without any significant difference during follow-up periods between the two groups. Seven patients favoured air polishing. The treatment's time was (24.92 ± 9.260 and 34.08 ± 9.106) minutes for the test and control side, respectively. CONCLUSION This study generally revealed no significant differences in clinical outcomes between two groups for gingivitis and stage I periodontitis treatment. However, EPAP+UI had higher patient's preference and less time-consuming compared with UD+P.
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Affiliation(s)
- Hala Albonni
- Periodontology Department, Faculty of Dental Medicine, Damascus University, Damascus, Syria.,Periodontology Department, Faculty of Dentistry-Syrian Private University, Daraa, Syria
| | - Walaa Alseirafi
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hiba Tekleh
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Feras Abo Orabi
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Mouaaid Alhaj
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Dima Almasri
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hussen Hamadh
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hazem Sawaf
- Periodontology Department, Faculty of Dentistry-Syrian Private University, Daraa, Syria
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12
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Dalvi S, Benedicenti S, Sălăgean T, Bordea IR, Hanna R. Effectiveness of Antimicrobial Photodynamic Therapy in the Treatment of Periodontitis: A Systematic Review and Meta-Analysis of In Vivo Human Randomized Controlled Clinical Trials. Pharmaceutics 2021; 13:pharmaceutics13060836. [PMID: 34200078 PMCID: PMC8228221 DOI: 10.3390/pharmaceutics13060836] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/25/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023] Open
Abstract
This systematic review and meta-analysis evaluated antimicrobial photodynamic therapy (aPDT) efficacy in periodontitis. The review protocol was conducted in accordance with PRISMA statements, Cochrane Collaboration recommendations and is registered in PROSPERO (CRD 42020161516). Electronic and hand search strategies were undertaken to gather data on in vivo human RCTs followed by qualitative analysis. Differences in probing pocket depth (PPD) and clinical attachment level (CAL) were calculated with 95% confidence intervals and pooled in random effects model at three and six months. Heterogeneity was analyzed, using Q and I2 tests. Publication bias was assessed by visual examination of the funnel plot symmetry. Sixty percent of 31 eligible studies showed a high risk of bias. Meta-analysis on 18 studies showed no additional benefit in split mouth studies in terms of PPD reduction (SMD 0.166; 95% CI −0.278 to 0.611; P = 0.463) and CAL gain (SMD 0.092; 95% CI −0.013 to 0.198; P = 0.088). Similar findings noted for parallel group studies; PPD reduction (SMD 0.076; 95% CI −0.420 to 0.573; P = 0.763) and CAL gain (SMD 0.056; 95% CI −0.408 to 0.552; P = 0.745). Sensitivity analysis minimized heterogeneity for both outcome variables; however, intergroup differences were not statistically significant. Future research should aim for well-designed RCTs in order to determine the effectiveness of aPDT.
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Affiliation(s)
- Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy; (S.B.); (R.H.)
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur 441110, India
- Correspondence: (S.D.); (T.S.); Tel.: +39-0-103-537-446 (S.D.); +40-744-707-371 (T.S.)
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy; (S.B.); (R.H.)
| | - Tudor Sălăgean
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
- Correspondence: (S.D.); (T.S.); Tel.: +39-0-103-537-446 (S.D.); +40-744-707-371 (T.S.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania;
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy; (S.B.); (R.H.)
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
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13
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Hsiao T, Ho Y, Chen M, Lee S, Sun C. Disease activation maps for subgingival dental calculus identification based on intelligent dental optical coherence tomography. TRANSLATIONAL BIOPHOTONICS 2021. [DOI: 10.1002/tbio.202100001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Tien‐Yu Hsiao
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
| | - Yi‐Ching Ho
- School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan, ROC
- Department of Stomatology Taipei Veterans General Hospital Taipei Taiwan, ROC
| | - Mei‐Ru Chen
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
| | - Shyh‐Yuan Lee
- School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan, ROC
- Department of Stomatology Taipei Veterans General Hospital Taipei Taiwan, ROC
- Department of Dentistry Yangming Branch of Taipei City Hospital Taipei Taiwan, ROC
| | - Chia‐Wei Sun
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
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14
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Hugo J, Koldsland OC, Aass AM, Tiainen H. Development and initial testing of an in vitro model simulating class II furcation defects. Clin Exp Dent Res 2021; 7:179-188. [PMID: 33283478 PMCID: PMC8019757 DOI: 10.1002/cre2.346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/10/2020] [Accepted: 09/19/2020] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To compare surface topography of porcine and human root dentin and to develop a new in vitro model for class II furcation defects. The hypothesis for this study was that porcine mandible blocks can function as a model for class II furcation defects. BACKGROUND Treatment of mandibular class II furcation defects is unpredictable. There is a need for in vitro models to investigate new treatment methods. METHODS A model to investigate the surface topography of porcine and human root dentin was developed and the two tissues compared by SEM imaging and profilometer. A novel method for studying class II furcation defects was then tested. Blocks of porcine mandibles with molar 3 were prepared. Buccal class II furcation defects were created. The furcation area was isolated and bioluminescent Staphylococcus epidermidis Xen43 was used to form a biofilm in the furcation area to test the functionality of the novel furcation model. RESULTS Micromechanical damage caused by debridement on porcine and human root dentin showed similar pattern. No significant difference in the surface morphological parameters was observed between the corresponding porcine and human samples. The model allowed for assessment of the root surface inside the furcation area. While the number of viable bacteria in the furcation following debridement could be quantified, no significant difference between the treatment groups was detected, likely due to bacterial colonization within the periodontal ligament space. CONCLUSION Porcine and human root dentin show similar surface topography following surface debridement. Porcine mandible blocks can function as a model for class II furcation defects. However, further development and refinement of the novel in vitro model is warranted.
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Affiliation(s)
- Jørgen Hugo
- Department of Periodontology, Institute of Clinical DentistryUniversity of OsloOsloNorway
- Department of Biomaterials, Institute of Clinical DentistryUniversity of OsloOsloNorway
| | - Odd Carsten Koldsland
- Department of Periodontology, Institute of Clinical DentistryUniversity of OsloOsloNorway
| | - Anne Merete Aass
- Department of Periodontology, Institute of Clinical DentistryUniversity of OsloOsloNorway
| | - Hanna Tiainen
- Department of Biomaterials, Institute of Clinical DentistryUniversity of OsloOsloNorway
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15
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Mamajiwala AS, Sethi KS, Raut CP, Karde PA, Mamajiwala BS. Clinical and radiographic evaluation of 0.8% hyaluronic acid as an adjunct to open flap debridement in the treatment of periodontal intrabony defects: randomized controlled clinical trial. Clin Oral Investig 2021; 25:5257-5271. [PMID: 33598778 DOI: 10.1007/s00784-021-03834-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/08/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Present study aimed to evaluate and compare the clinical and radiographic efficacy of 0.8% hyaluronic acid (HA) gel as an adjunct to open flap debridement (OFD) versus open flap debridement (OFD) alone in the treatment of periodontal intrabony defects. MATERIALS AND METHODS This randomized, controlled, split-mouth, clinical trial included 20 chronic periodontitis (stage II or III (grades A to B)) patients, having at least two contralateral intrabony defects. Forty bilateral intrabony defects (20 in each group) were randomly divided into test (0.8% HA gel + OFD) and control (OFD + placebo) groups. Clinical parameters evaluated at baseline, 6-months, and 12-months were plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and gingival recession (GR). Using cone beam computed tomography (CBCT), radiographic parameters were evaluated at baseline and 12 months. This included bone defect fill (DF), alveolar crest changes (ACC), and defect resolution (DR). CAL served as the primary outcome variable. RESULTS After 12 months, the test group showed significantly greater CAL gain (5.1 ± 1.2 versus 4.05 ± 1.19 mm) and bone defect fill (DF) (5.67 ± 2.01 versus 4.49 ± 1.78 mm) compared to the control group. Mean PD reduction in the test group (5.3 ± 1.2 versus 4.35 ± 0.81 mm) was statistically significant compared to the control group at 12-month period. The control group showed statistically significant increase in GR (1.2 ± 0.76 versus 0.7 ± 0.73 mm) compared to the test group after 12 months. CONCLUSION Application of hyaluronic acid gel in conjunction with open flap debridement resulted in enhanced clinical and radiographic outcomes compared to open flap debridement alone. CLINICAL RELEVANCE Adjunctive application of HA gel in open flap debridement may improve clinical and radiographic outcomes. CLINICAL TRIAL REGISTERED NUMBER CTRI/2018/03/012334.
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Affiliation(s)
- Alefiya S Mamajiwala
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India
| | - Kunal S Sethi
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India
| | - Chetan P Raut
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India.
| | - Prerna A Karde
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India
| | - Batul S Mamajiwala
- Department of Public Health Dentistry, Government Dental College and Hospital, Mumbai, India
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16
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Özdemir H, Gündoğar H, Akpınar A. Photobiomodulation Therapy by 820 nm Diode Laser on Nonsurgical Periodontal Treatment of Smoker and Nonsmoker Patients: A Single-Blind Parallel Randomized Clinical Trial. Photochem Photobiol 2021; 97:860-864. [PMID: 33547665 DOI: 10.1111/php.13394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
The effect of smoking on nonsurgical periodontal treatment (SRP) is known, but the adjunct use of photobiomodulation (PBMT) to SRP has not been fully investigated in smokers. This study aimed to assess the effect of 820 nm diode laser on SRP in smoker/nonsmoker. Sixty patients (smokers/n = 30, nonsmokers/n = 30) were enrolled in this parallel-arm clinical study. All patients were divided into two main groups: SRP and PBMT + SRP. In PMBT + SRP groups, 7.96 J cm-2 energy was applied by 820nm diode laser at baseline and first, second and third weeks after SRP. Periodontal pocket depth (PPD), gingival index (GI), plaque index (PI) and clinical attachment level (CAL) were recorded, and also gingival crevicular fluid (GCF) samples were collected at baseline and 6w after SRP. Total antioxidant capacity (TAOC) and total oxidative status (TOS) in GCF were analyzed. PBMT + SRP groups showed a statistically significant decrease in PPD and CAL, not in GI and PI compared with SRP alone. There were no statistically significant differences between smokers and nonsmokers in clinical data at six weeks after treatment. Although TAOC levels were increased in PMBT groups, TOS levels were decreased in all groups at the comparison of baseline and 6w after SRP. Adjunct use of 820 nm diode laser on SRP may improve the clinical parameters in smoker or nonsmoker patient with periodontitis.
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Affiliation(s)
- Hakan Özdemir
- Department of Periodontology, Faculty of Dentistry, University of Osmangazi, Eskişehir, Turkey
| | - Hasan Gündoğar
- Department of Periodontology, Faculty of Dentistry, University of Gaziantep, Gaziantep, Turkey.,Deparment of Medical Biochemistry, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey
| | - Aysun Akpınar
- Department of Periodontology, Faculty of Dentistry, University of Uludağ, Bursa, Turkey
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17
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Ng E, Tay JRH, Balan P, Ong MMA, Bostanci N, Belibasakis GN, Seneviratne CJ. Metagenomic sequencing provides new insights into the subgingival bacteriome and aetiopathology of periodontitis. J Periodontal Res 2021; 56:205-218. [PMID: 33410172 DOI: 10.1111/jre.12811] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/29/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022]
Abstract
"Open-ended" molecular techniques such as 16S rRNA sequencing have revealed that the oral bacteriome of subgingival plaque is more diverse than originally thought. 16S rRNA analysis has demonstrated that constituents of the overall bacterial community are qualitatively similar in health and disease, differing mainly in their relative proportions with respect to each other. Species in low abundance can also act as critical species, leading to the concept of global community dysbiosis which relates to shifts in community structure, rather than shifts in membership. Correlation analysis suggests that coordinated interactions in the community are essential for incipient dysbiosis and disease pathogenesis. The subgingival bacteriome also provides biomarkers that are useful for disease detection and management. Combined with clinical and biological parameters, these may assist clinicians in developing and implementing effective treatment strategies to restore microbial homeostasis and monitor disease. Identification of higher risk groups or poor responders to treatment using unique subgingival bacteriome signatures may also lead to early intervention.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore, Singapore
| | - John R H Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore, Singapore
| | - P Balan
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, SingHealth, Singapore, Singapore
| | - Marianne M A Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore, Singapore.,Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Chaminda J Seneviratne
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, SingHealth, Singapore, Singapore.,Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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18
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Nayyar A, C. S, J. S, Almansour N, Almalaq S, Alnasrallah F, Alshammari TN, Alshammari M. Comparison of Commercially Available 0.12% And 0.2% Chlorhexidine Mouthrinses on Plaque and Gingiva: A Randomized Controlled Trial. DENTAL HYPOTHESES 2021. [DOI: 10.4103/denthyp.denthyp_62_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Farhad S, Reisie B, Sadeh S. Evaluation and comparison number of gingival fibroblast and osteosarcoma cell (MG-63 cell line) adhesive to mocugraft, alloderm, and collagen membrane with or without advanced platelet-rich fibrin. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.328750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Medara N, Lenzo JC, Walsh KA, Holden JA, Reynolds EC, Darby IB, O'Brien-Simpson NM. Peripheral memory T-cell profile is modified in patients undergoing periodontal management. J Clin Periodontol 2020; 48:249-262. [PMID: 33131124 DOI: 10.1111/jcpe.13399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/23/2020] [Accepted: 10/25/2020] [Indexed: 11/28/2022]
Abstract
AIMS T-cells are known to have a role in periodontitis, however, the effect of periodontal therapy on peripheral memory T-cells is unclear. This study evaluated variation in peripheral memory T-cells and red complex bacteria in sub-gingival plaque in patients undergoing periodontal management. METHODS Peripheral blood mononuclear cells and sub-gingival plaque were collected from 54 periodontitis patients at baseline, 3-, 6- and 12-months post-therapy and 40 healthy controls. Periodontitis patients were divided into treatment outcome (TxO) groups based on prevalence of sites with probing depth ≥5 mm as good (<10% of sites), moderate (10-20%) or poor (>20%) at study conclusion. Naïve (TN -CCR7+ CD45RA+ ), central memory (TCM -CCR7+ CD45RA- ), effector memory (TEM -CCR7- CD45RA- ) and effector memory T-cells re-expressing CD45RA (TEMRA -CCR7- CD45RA+ ) were phenotyped using flow cytometry in CD4+ , CD8+ , CD4+ CD8+ and CD4- CD8- T-cells and red complex bacteria were quantified using qPCR. RESULTS At baseline, periodontitis subjects had significantly greater mean probing depths and Porphyromonas gingivalis proportions, lower TN but higher CD4+ TCM , CD8+ TCM , CD4+ CD8+ TEM and CD4- CD8- TEM cell proportions compared to health. Periodontal therapy decreased mean probing depths, P. gingivalis proportions, TEM and CD4+ and CD8+ TCM cells, but increased TN and CD4+ and CD8+ TEMRA cells. The T-cell profile in the good TxO group showed therapy-related changes in CD4+ TEM , and CD8+ TN and TEM cells, whereas, no changes were observed in the poor TxO group. CONCLUSION Management and the reduction in red complex bacteria were associated with changes in peripheral memory T-cells in periodontitis.
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Affiliation(s)
- Nidhi Medara
- Melbourne Dental School, The University of Melbourne, Carlton, Vic., Australia
| | - Jason C Lenzo
- Melbourne Dental School, The University of Melbourne, Carlton, Vic., Australia.,The Centre for Oral Health Research, The University of Melbourne, Carlton, Vic., Australia
| | | | - James A Holden
- Melbourne Dental School, The University of Melbourne, Carlton, Vic., Australia.,The Centre for Oral Health Research, The University of Melbourne, Carlton, Vic., Australia
| | - Eric C Reynolds
- Melbourne Dental School, The University of Melbourne, Carlton, Vic., Australia.,The Centre for Oral Health Research, The University of Melbourne, Carlton, Vic., Australia
| | - Ivan B Darby
- Melbourne Dental School, The University of Melbourne, Carlton, Vic., Australia
| | - Neil M O'Brien-Simpson
- Melbourne Dental School, The University of Melbourne, Carlton, Vic., Australia.,The Centre for Oral Health Research, The University of Melbourne, Carlton, Vic., Australia
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21
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Dalvi S, Benedicenti S, Hanna R. Effectiveness of Photobiomodulation as an Adjunct to Nonsurgical Periodontal Therapy in the Management of Periodontitis- A Systematic Review of in vivo Human Studies. Photochem Photobiol 2020; 97:223-242. [PMID: 33098680 DOI: 10.1111/php.13348] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/04/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022]
Abstract
Photobiomodulation therapy (PBMT) has anti-inflammatory, analgesic and regenerative properties. This systematic review aimed to critically appraise the published data of in vivo human randomized clinical trials (RCTs), and present a comprehensive overview of the efficacy of PBMT, as an adjunct to the nonsurgical periodontal therapy (NSPT) in the management of periodontitis. The systematic review protocol is registered in the Prospective Register Of Systematic Reviews (PROSPERO) (www.crd.york.ac.uk/PROSPERO/; ref CRD 42020169108). With the help of the appropriate key words, structured electronic and manual search strategies were applied to gather the relevant published data on in vivo human RCTs based on this topic. Seventeen papers that met the eligibility criteria were included in this review and subjected to a qualitative assessment. Current evidence lacks adequate information regarding the photobiomodulation (PBM) dosimetry, which is fundamental in establishing a standardized and replicable protocol for future researches. Furthermore, substantial discrepancies in the study methodology and a high risk of bias, arising from the majority of the included papers, abet to the inferior quality of these studies. Ultimately, there is an urgent necessity to conduct further well-designed RCTs in order to determine the effectiveness of PBMT, if any, by taking into consideration the abovementioned confounding factors.
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Affiliation(s)
- Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Oral Surgery, University of Genoa and King's College, London, UK
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22
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Hassan FW, Mohd N. Periodontal management in a primary polycythemia rubra vera patient: A case report. SPECIAL CARE IN DENTISTRY 2020; 41:92-97. [PMID: 33125720 DOI: 10.1111/scd.12537] [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: 06/29/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM Polycythemia rubra vera (PRV) is a myeloproliferative disease, which is characterized by the proliferation of all three major hematopoietic groups (erythrocytes, leucocytes and platelets). This hematological condition presented with different clinical manifestations depending on the thrombohemorrhagic status of the patient. It is suggested patient with preexisting PRV may suffer complication during periodontal treatment. Thus, this case would therefore demonstrate periodontal management outcome in PRV patient. CASE PRESENTATION A 60-year-old Malay gentleman presented to the Periodontic Clinic, Universiti Kebangsaan Malaysia. He was a known case of primary PRV for the past 5 years. Intraoral examination showed generalized periodontal deep pockets ranging from 5 to 10 mm. He was diagnosed as Stage III Grade C periodontitis. Nonsurgical periodontal therapy was provided, followed by surgical correction of residual periodontal deep pockets on teeth 17, 11, and 23. He was reviewed at 4-month intervals for supportive periodontal therapy after stabilization of his periodontal condition. CONCLUSION Polycythemia rubra vera (PRV) patients should have preoperative therapeutic control for more than 4 months and have been treated with myelosuppressive agents prior to periodontal surgery. Good oral hygiene and periodical supportive periodontal therapy are the key factors for successful periodontal treatment outcomes in well-controlled PRV patients.
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Affiliation(s)
- Farah Wahida Hassan
- Periodontic Unit, Cahaya Suria Dental Clinic, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nurulhuda Mohd
- Unit of Periodontology, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Malaysia
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23
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Bollain J, Pulcini A, Sanz-Sánchez I, Figuero E, Alonso B, Sanz M, Herrera D. Efficacy of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse in reducing inflammation around the teeth and implants: a randomized clinical trial. Clin Oral Investig 2020; 25:1729-1741. [PMID: 32737664 DOI: 10.1007/s00784-020-03474-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the efficacy of a 0.03% chlorhexidine (CHX) and 0.05% cetylpyridinium chloride (CPC) mouth rinse, as an adjunct to professional plaque removal (PPR) and mechanical hygiene, in the treatment of peri-implant mucositis (PiM) and gingivitis. MATERIAL AND METHODS Patients displaying PiM in, at least, one implant were included in this randomized, double-blinded, clinical trial. Subjects received PPR (at baseline and 6-month visits) and were instructed to rinse, twice daily, during 1 year with the tested mouth rinse or a placebo. Clinical and patient-reported outcomes were recorded at baseline and 6 and 12 months. RESULTS Fifty-four patients were included in the study and 46 attended the final visit. In the teeth and implants with inflammation, a higher reduction in BOP was observed in the test group. Statistically significant differences between groups were only observed in the lingual sites of the teeth with gingivitis (mean difference = 11.96%; 95% confidence interval [1.09; 22.83]; p = 0.03). Overall, compliance and satisfaction were good, even though staining were higher for the test group (p < 0.05). CONCLUSIONS The combined use of mechanical debridement with a 0.03% CHX and 0.05% CPC mouth rinse may have adjunctive benefits in the management of gingivitis, and it is associated with a higher degree of staining. CLINICAL RELEVANCE The control of gingivitis can be improved, after professional mechanical debridement, with toothbrushing and the supplementary use of a 0.03% CHX and 0.05% CPC mouth rinse at home. CLINICAL TRIAL REGISTRATION NUMBER NCT03533166.
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Affiliation(s)
- Juan Bollain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Alberto Pulcini
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Elena Figuero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain. .,Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, 28040, Madrid, Spain.
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
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Sanz‐Sánchez I, Montero E, Citterio F, Romano F, Molina A, Aimetti M. Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta‐analysis. J Clin Periodontol 2020; 47 Suppl 22:282-302. [DOI: 10.1111/jcpe.13259] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Ignacio Sanz‐Sánchez
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group University Complutense Madrid Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group University Complutense Madrid Spain
| | - Filippo Citterio
- 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
| | - Ana Molina
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group University Complutense Madrid Spain
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
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Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population-A Prospective Cohort Study. Dent J (Basel) 2020; 8:dj8020054. [PMID: 32466149 PMCID: PMC7344508 DOI: 10.3390/dj8020054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/01/2020] [Accepted: 05/20/2020] [Indexed: 11/17/2022] Open
Abstract
While periodontitis deteriorates patients’ quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients’ perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters.
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Erbil D, Nazaroglu K, Baser U, İssever H, Mese S, İsik AG. Clinical and Immunological Effects of Er,Cr:YSGG Laser in Nonsurgical Periodontal Treatment: A Randomized Clinical Trial. Photobiomodul Photomed Laser Surg 2020; 38:316-322. [PMID: 32427555 DOI: 10.1089/photob.2019.4748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: The aim of this study was to compare the clinical and immunological results of nonsurgical periodontal treatment with or without the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. Background data: As lasers have begun to be used in dentistry, the Er,Cr:YSGG laser has started to attract attention in the field of periodontology. Materials and methods: Fifty-nine nonsmoking patients with advanced chronic periodontitis were randomly allocated to a test group (full-mouth ultrasonic supra- and subgingival debridement+Er,Cr:YSGG laser application) and a control group (full-mouth ultrasonic supra- and subgingival debridement+root planing with Gracey curettes). The laser parameters were set as follows: 1.5 W output power, pulse mode H (pulse duration of 140 μs), pulse frequency of 20 Hz, and an air-water spray ratio of 10% air and 15% water. The instrumentation was performed until the operator felt that the root surfaces were adequately debrided. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index, interleukin-1 beta (IL-1β), matrix metalloproteinase-8 (MMP-8), tissue inhibitor metalloproteinase-1 (TIMP-1), and MMP-8/TIMP-1 levels in gingival crevicular fluid were evaluated at baseline, 6 weeks, and 3 months postoperatively. Results: There were statistically significant differences in PD, which was our primary outcome, and BOP between the groups at both examinations [p < 0.001 and p < 0.001 (for PD) and p = 0.048 and p < 0.001 (for BOP), respectively], in favor of the laser group. However, there were no significant differences among groups at any time for CAL gain (p = 563 and p = 369, respectively). No significant differences in MMP-8, TIMP-1, and MMP-8/TIMP-1 levels were detected among groups. There was a statistically significant difference for IL-1β levels among groups at 3-month evaluations in favor of the laser group. Conclusions: Using the Er,Cr:YSGG laser instead of hand instruments in nonsurgical periodontal treatment has shown additional improvements in terms of pocket reduction and gingival bleeding compared with traditional nonsurgical therapy.
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Affiliation(s)
- Deniz Erbil
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | | | - Ulku Baser
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Halim İssever
- Department of Public Health, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Mese
- Department of Virology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Aysen G İsik
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Panda S, Purkayastha A, Mohanty R, Nayak R, Satpathy A, DAS AC, Kumar M, Mohanty G, Panda S, Fabbro MD. Plasma rich in growth factors (PRGF) in non-surgical periodontal therapy: a randomized clinical trial. Braz Oral Res 2020; 34:e034. [PMID: 32321052 DOI: 10.1590/1807-3107bor-2020.vol34.0034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 02/12/2020] [Indexed: 12/27/2022] Open
Abstract
The aim of this split mouth, double blinded, randomized clinical trial was to evaluate the clinical efficacy of use of Plasma rich in growth factors (PRGF) as an adjunct to scaling and root planing (SRP) in the treatment of periodontal pockets. Twenty six patients (15 males, 11 females) diagnosed with generalized periodontitis with Pocket Depth > 5mm and plaque index score < 1.5, were randomly allocated by using computer generated random sequence, into two groups, one treated with intra-pocket application of PRGF adjunct to SRP and other with SRP alone. The clinical outcomes like pocket depth (PD), relative attachment level (RAL) and sulcus bleeding index (SBI) were assessed at baseline, 3 months and 6 months. Twenty two patients (44 sites) were analyzed at the end of 6 month follow-up, using SPSS 20.0v software. There was a significant statistical difference observed between both the groups favouring SRP +PRGF group in terms of PD (p = 0.007) and RAL (p = 0.021) at the end of 6 month follow-up. Also there was a statistical significant difference (< 0.001) at all time points compared to baseline, for all parameters in intra-group comparison. Moreover, the sites with PD>4mm necessitating further treatment after 6-month follow-up were significantly lesser for SRP+PRGF group. The use of PRGF technology in non-surgical periodontal therapy, by single intra-pocket application in to periodontal pockets as an adjunct to SRP, in chronic periodontitis patients, was found to be effective in reduction of pocket depth and gain in clinical attachment level.
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Affiliation(s)
- Saurav Panda
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | - Adrita Purkayastha
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | - Rinkee Mohanty
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | - Rashmita Nayak
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | - Anurag Satpathy
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | - Abhaya Chandra DAS
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | - Manoj Kumar
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | - Gatha Mohanty
- Siksha O Anusandhan University, Institute of Dental Sciences, Department of Periodontics & Oral implantology, Bhubaneswar, Odisha, India
| | | | - Massimo Del Fabbro
- University of Milan, Department of Biomedical, Surgical & Dental Sciences, Milano, Italy
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Fatima F, Taha Mahmood H, Fida M, Hoshang Sukhia R. Effectiveness of antimicrobial gels on gingivitis during fixed orthodontic treatment: A systematic review and meta-analysis. Int Orthod 2020; 18:10-21. [DOI: 10.1016/j.ortho.2019.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
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Chen MH, Yin HJ, Chang HH, Kao CT, Tu CC, Chen YW. Baseline probing depth and interproximal sites predict treatment outcomes of non-surgical periodontal therapy. J Dent Sci 2020; 15:50-58. [PMID: 32257000 PMCID: PMC7109495 DOI: 10.1016/j.jds.2019.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/26/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND/PURPOSE The efficacy of non-surgical periodontal therapy (NSPT) has been well discussed. The aim of this study was to investigate whether the baseline clinical periodontal parameters, radiographic defect angle, and interproximal site predict the treatment outcome of NSPT. MATERIALS AND METHODS A total of 39 patients who were diagnosed with generalized chronic periodontitis and met the inclusion criteria were enrolled in this study. All patients received full-mouth periodontal examination by two well-trained periodontists. Clinical periodontal parameters, including probing depth (PD), recession (Rec), and clinical attachment level (CAL), were recorded, and vertical bitewing radiographs were taken as baseline data. Revaluation was performed after 4 weeks of non-surgical periodontal treatment. Pearson's correlation coefficient and multivariate logistic regression were performed to examine the association between favorable treatment outcome (PD reduction ≥ 3 mm) and various clinical parameters. RESULTS A significant improvement was observed in PD reduction and CAL gain after NSPT. The radiographic defect angle was strongly correlated with baseline Rec, baseline CAL, and interproximal sites in teeth with a deeper PD. Baseline PD and interproximal sites emerged as significant prediction factors for favorable treatment outcome with a PD reduction of ≥3 mm. CONCLUSION Our study is the first to report that distal sites show wider radiographic angles with shallow infrabony defects and that pocket reduction is more obvious at distal sites than at mesial sites. These data provide evidence that baseline PD and interproximal sites may predict the treatment outcome of NSPT.
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Affiliation(s)
- Mu-Hsiung Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Huei-Jyun Yin
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- Division of Dentistry, Renai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Hsuan-Hao Chang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Ting Kao
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Che-Chang Tu
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Wen Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
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Rajula P, Mahalakshmi MR, Leela R, Yadalam P, Vadivelu S. Estimation of red-complex bacteria in diode laser treated chronic periodontitis patients: A clinical and microbiological study. J Pharm Bioallied Sci 2020; 12:S140-S145. [PMID: 33149445 PMCID: PMC7595557 DOI: 10.4103/jpbs.jpbs_45_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/24/2020] [Accepted: 03/09/2020] [Indexed: 11/29/2022] Open
Abstract
Context: Laser has been widely accepted as a substitute to traditional periodontal treatment. Only a finite number of studies are available based on the use of diode laser as a supplement to scaling and root planing (SRP) in the reduction of red-complex bacteria. Aim: This split-mouth study was aimed to determine the clinical and microbiological effects of diode laser as a supplement to SRP. Materials and Methods: For this split-mouth study, systemically healthy 34 patients with chronic periodontitis were selected. In the test quadrant, SRP + laser therapy was carried out, whereas in control quadrants, SRP alone was performed. Clinical and microbiological data were acquired at baseline and 3 months postoperative, and statistical analysis was carried out on the findings. Results: The results showed that both the treatment modalities were impelling. Considerable reduction in the mean probing depth and a notable improvement in the attachment level were observed in both groups in comparison to baseline, with a statistically significant reduction in the laser group. Microbiological analysis results showed more reduction in red-complex bacteria in the laser group compared to the SRP group, but they were statistically insignificant. Conclusion: Within the limitation of this study, it is recommended that both the SRP and SRP + laser are effective in chronic periodontitis management, but using laser with SRP has propitious results. Thus, in the forthcoming years, clinical experiments with a greater sample size may be chosen to further analyze the fringe benefits of laser as a supplement to SRP.
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Radafshar G, Movahedi Amiri M. Impact of One-Stage Full Mouth Disinfection and Periodontal Surgery on Oral Health-Related Quality of Life. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2019. [PMID: 31875175 DOI: 10.30476/dentjods.2019.77748.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Statement of the Problem Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited. Purpose This study sought to compare patients' perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment. Materials and Method A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21. Results 38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p< 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p< 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. Conclusion Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.
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Affiliation(s)
- Golpar Radafshar
- Dental Sciences Research Center, Dept. of Periodontology, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Marziyeh Movahedi Amiri
- Dental Sciences Research Center, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol 2019; 89 Suppl 1:S159-S172. [PMID: 29926952 DOI: 10.1002/jper.18-0006] [Citation(s) in RCA: 1091] [Impact Index Per Article: 218.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Authors were assigned the task to develop case definitions for periodontitis in the context of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The aim of this manuscript is to review evidence and rationale for a revision of the current classification, to provide a framework for case definition that fully implicates state-of-the-art knowledge and can be adapted as new evidence emerges, and to suggest a case definition system that can be implemented in clinical practice, research and epidemiologic surveillance. METHODS Evidence gathered in four commissioned reviews was analyzed and interpreted with special emphasis to changes with regards to the understanding available prior to the 1999 classification. Authors analyzed case definition systems employed for a variety of chronic diseases and identified key criteria for a classification/case definition of periodontitis. RESULTS The manuscript discusses the merits of a periodontitis case definition system based on Staging and Grading and proposes a case definition framework. Stage I to IV of periodontitis is defined based on severity (primarily periodontal breakdown with reference to root length and periodontitis-associated tooth loss), complexity of management (pocket depth, infrabony defects, furcation involvement, tooth hypermobility, masticatory dysfunction) and additionally described as extent (localized or generalized). Grade of periodontitis is estimated with direct or indirect evidence of progression rate in three categories: slow, moderate and rapid progression (Grade A-C). Risk factor analysis is used as grade modifier. CONCLUSIONS The paper describes a simple matrix based on stage and grade to appropriately define periodontitis in an individual patient. The proposed case definition extends beyond description based on severity to include characterization of biological features of the disease and represents a first step towards adoption of precision medicine concepts to the management of periodontitis. It also provides the necessary framework for introduction of biomarkers in diagnosis and prognosis.
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Affiliation(s)
- Maurizio S Tonetti
- Periodontology, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR China
| | - Henry Greenwell
- Graduate Periodontics, School of Dentistry, University of Louisville, Louisville, KY, USA
| | - Kenneth S Kornman
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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The effect of photobiomodulation therapy on nonsurgical periodontal treatment in patients with type 2 diabetes mellitus: a randomized controlled, single-blind, split-mouth clinical trial. Lasers Med Sci 2019; 35:497-504. [DOI: 10.1007/s10103-019-02897-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 09/29/2019] [Indexed: 10/25/2022]
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Impact of tooth-related factors on photodynamic therapy effectiveness during active periodontal therapy: A 6-months split-mouth randomized clinical trial. Photodiagnosis Photodyn Ther 2019; 27:167-172. [DOI: 10.1016/j.pdpdt.2019.05.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022]
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Aggarwal G, Verma S, Gupta M, Nagpal M. Local Drug Delivery Based Treatment Approaches for Effective Management of Periodontitis. CURRENT DRUG THERAPY 2019. [DOI: 10.2174/1574885514666190103112855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Periodontal disease is an immuno-inflammatory condition of
tissues that surround and hold the teeth. It is the disease which succeeds in all races,
groups and both genders. Almost 10 to15% of the global population gets suffered from
severe periodontitis as per WHO reports. Periodontal disease may likely cause other systemic
diseases such as cardiovascular disease and pre-term low birth weight infants. Mechanical
removal of plaques and calculus deposits from supra and subgingival environment
is the backbone of periodontal treatment till date whereas complete elimination of
these deleterious agents is quite unrealistic as the pocket depth increases.
Recent Approaches:
Recently controlled local drug delivery application is more encouraging
in comparison to systemic approach as it mainly targets to enhance the therapeutic
efficacy by maintaining site-specificity, avoiding first pass metabolism, reduction in gastrointestinal
(GI) side effects and decreasing the dose. Several drugs such as antiseptics
and antibiotics alongwith various carriers are being formulated as local drug delivery systems
for effective management of the disease. Various local delivery systems reported are
fibers, films, strips, compacts, injectables, microparticles, vesicular carriers, gels and
nanoparticles. These local carriers provide effective prolonged treatment at the site of
infection at reduced doses. This review enlightens detailed pathophysiology and various
phases of periodontitis, challenges in treatment of disease and various antimicrobial
agents (along with their marketed formulations) used. The main emphasis of the review is
to cover all carrier systems developed so far for local delivery application in the effective
management of periodontitis, as a patient compliant drug therapy.
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Affiliation(s)
- Geeta Aggarwal
- Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, Sector-3 MB Road, New Delhi-110017, India
| | - Sonia Verma
- Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, Sector-3 MB Road, New Delhi-110017, India
| | - Madhu Gupta
- Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, Sector-3 MB Road, New Delhi-110017, India
| | - Manju Nagpal
- Chitkara College of Pharmacy, Chitkara University, Chandigarh-Patiala National Highway, Rajpura, Patiala-140401, India
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Effects of Er,Cr:YSGG and Diode Lasers on Clinical Parameters and Gingival Crevicular Fluid IL-1 β and IL-37 Levels in Generalized Aggressive Periodontitis. Mediators Inflamm 2019; 2019:2780794. [PMID: 31308830 PMCID: PMC6594306 DOI: 10.1155/2019/2780794] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/26/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022] Open
Abstract
Aim The objective of the current study is to analyze the correlation between cytokine levels and periodontal parameters in aggressive periodontitis patients before and after periodontal treatment that was performed by using two different laser therapies. Materials and Methods Twenty-six generalized aggressive periodontitis patients were treated with three different methods (SRP, SRP+diode laser, and SRP+Er,Cr:YSGG laser) applied to three different half-jaws in the same patients. Pre- and posttreatment clinical periodontal parameters and GCF IL-1β and IL-37 levels were measured. Results There was a statistically significant decrease (p < 0.05) between pretreatment and posttreatment clinical periodontal parameters and IL-1β and IL-37 levels. When the reduction rates of IL-37 and IL-1β levels after treatment were evaluated, the decrease in IL-37 and IL-1β levels after treatment was lowest in the SRP group and highest in the SRP+Er,Cr:YSGG group. In addition, the amount of decrease in IL-1β in SRP+diode and SRP+Er,Cr:YSGG groups was found to be higher than that in IL-37. Furthermore, there was a positive correlation between IL-37 and IL-1β in all groups (p < 0.01). Conclusion Er,Cr:YSGG laser is more effective than diode laser for the treatment of aggressive periodontitis. IL-37 and IL-1β are cytokines that function together and thus must be evaluated together.
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Sanz-Martín I, Cha JK, Yoon SW, Sanz-Sánchez I, Jung UW. Long-term assessment of periodontal disease progression after surgical or non-surgical treatment: a systematic review. J Periodontal Implant Sci 2019; 49:60-75. [PMID: 31098328 PMCID: PMC6494769 DOI: 10.5051/jpis.2019.49.2.60] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/18/2019] [Accepted: 04/14/2019] [Indexed: 12/14/2022] Open
Abstract
The primary aim of this systematic review was to assess the evidence on periodontal disease progression after treatment in patients receiving supportive periodontal therapy (SPT) and to identify predictors of clinical attachment level (CAL) loss. A protocol was developed to answer the following focused question: In adult patients treated for periodontitis, what is the disease progression in terms of CAL loss after surgical or non-surgical treatment? Randomized controlled clinical trials, prospective cohort studies, and longitudinal observational human studies with a minimum of 5 years of follow-up after surgical or non-surgical treatment that reported CAL and probing depth changes were selected. Seventeen publications reporting data from 14 investigations were included. Data from 964 patients with a follow-up range of 5-15 years was evaluated. When the CAL at the latest follow-up was compared to the CAL after active periodontal therapy, 10 of the included studies reported an overall mean CAL loss of ≤0.5 mm, 3 studies reported a mean CAL loss of 0.5-1 mm, and 4 studies reported a mean CAL loss of >1 mm. Based on 7 publications, the percentage of sites showing a CAL loss of ≥2 mm varied from 3% to 20%, and a high percentage of sites with CAL loss was associated with poor oral hygiene, smoking, and poor compliance with SPT. The outcomes after periodontal therapy remained stable over time. Disease progression occurred in a reduced number of sites and patients, mostly associated with poor oral hygiene, poor compliance with SPT, and smoking.
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Affiliation(s)
- Ignacio Sanz-Martín
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung-Wook Yoon
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Preus HR, Maharajasingam N, Rosic J, Baelum V. Oral hygiene phase revisited: How different study designs have affected results in intervention studies. J Clin Periodontol 2019; 46:548-551. [PMID: 30974490 DOI: 10.1111/jcpe.13109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/21/2019] [Accepted: 03/31/2019] [Indexed: 11/28/2022]
Abstract
Every periodontal researcher have been taught, and every textbook in periodontics have advocated, that a phase in which the patient is meticulously motivated and instructed in proper oral hygiene-the oral hygiene phase-must be included in any periodontal intervention. However, how is this oral hygiene phase actually portrayed in periodontal intervention studies, and how much space have this important phase received in the planning and carry-through of intervention studies? The purpose of this letter to the editor was to review current literature in the period 1975/01/01-2017/12/31 on periodontal, mechanical intervention studies in order to see what focus the oral hygiene phase had received in these articles. The result showed that the oral hygiene phase is variable in length and content, variable in claimed result, insufficiently described, and invariably amalgamated with the scaling and root planing which is the intervention or part of an intervention. The consequences of these findings are discussed and suggestions proposed for more harmonized and calibrated oral hygiene phase introduced to avoid biased and inflated results of interventions.
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Affiliation(s)
- Hans R Preus
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Nisha Maharajasingam
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Jovana Rosic
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Vibeke Baelum
- Section for Oral Epidemiology and Public Health, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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40
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Affiliation(s)
- Andrea Mombelli
- Division of Periodontology School of Dental Medicine University of Geneva Geneva Switzerland
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41
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Lang NP, Salvi GE, Sculean A. Nonsurgical therapy for teeth and implants-When and why? Periodontol 2000 2019; 79:15-21. [PMID: 30887589 DOI: 10.1111/prd.12240] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As periodontal and peri-implant diseases represent opportunistic infections, antiinfective therapy is the method of choice. Correctly performed, the treatment outcomes will include resolution of the inflammation concomitant with shrinkage of the tissues, reflected in reduced probing depths. Depending on the patient data obtained after initial antiinfective therapy, further - mostly surgical - treatment may be rendered to reach the goals of a healthy periodontium and peri-implant tissues. Patient compliance is as important as operator skills for optimal treatment outcomes. Regenerative therapy may be applied in compliant patients and for appropriate defects. This article depicts the historical development of periodontal therapy during the 20th century and addresses the various outcome parameters to be used in daily decision making. Obviously, nonsurgical therapy has gained clinical relevance, resulting in highly satisfactory treatment outcomes in many cases. The critical probing depth above which positive attachment gain is registered varies from one treatment modality to another. It is a concept that helps facilitate decision making for additional therapeutic measures after initial therapy. Treatment of peri-implant mucositis prevents development of peri-implantitis. Hence, nonsurgical treatment of mucositis is frequently performed during the continuous monitoring of oral implants. This chapter of Periodontology 2000 presents evidence for the prevention and therapy of peri-implant diseases.
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Affiliation(s)
- Niklaus P Lang
- Department of Periodontology, University of Berne, Berne, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Berne, Berne, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Berne, Berne, Switzerland
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Abstract
This volume of Periodontology 2000, entitled "Treatment Trends in Periodontics", evaluates the importance of nonsurgical periodontal therapy and defines its role as the key etiologic treatment of the disease. The need for scaling and root planing is mandatory step during the initial phase of therapy, as is self-care by the patient. Only after reevaluation of the outcome achieved by nonsurgical procedures should surgery be considered, and the concept of "critical probing depth" is emphasized. The chapters in this volume discuss different aspects of periodontal surgery, including regeneration and plastic periodontal procedures, and, looking toward the future, cell therapy in periodontics is explored. The impact of periodontal therapy on systemic diseases is reviewed, and the role of occlusion in periodontal disease is revisited and discussed. Topics on implants include their placement in fresh extraction sockets, socket healing with or without implant placement, and research on osseointegration. The important topic of maintenance care of teeth and implants for long-term therapeutic success is thoroughly evaluated, as is the efficacy of dentifrices in oral hygiene. The editors convey a nutshell review of the concepts of what periodontal treatment should entail, based on scientific evidence generated during half-a-century of work in periodontics.
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Affiliation(s)
- Raúl G Caffesse
- Postgraduate Periodontics, Faculty of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Josė J Echeverría
- Periodontics, Faculty of Dentistry, University of Barcelona, Barcelona, Spain
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Utilisation of antimicrobial photodynamic therapy as an adjunctive tool for open flap debridement in the management of chronic periodontitis: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2019; 25:440-447. [PMID: 30684674 DOI: 10.1016/j.pdpdt.2019.01.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) has proved to be an effective adjunctive modality with potential benefits in the management of chronic periodontitis. The combination of photothermal and photodynamic effects of Indocyanine green (ICG) dye, when it is photoactivated with a diode laser of 810 nm wavelength, has been well documented in literature. AIM This study was conducted to evaluate whether a single session of antimicrobial photodynamic therapy using ICG dye-810 nm diode laser combination can provide a substantial benefit when it is utilised as an adjunct to open flap debridement (OFD) in the management of chronic periodontitis. MATERIALS AND METHOD Following thorough scaling and root planing, a comparative split mouth randomized controlled clinical trial was carried out on 20 recruited subjects who provided one test (OFD + aPDT) and one control site (OFD alone) each (total 40 treatment sites). The test group was subjected to a single episode of aPDT using ICG photosensitiser dye (1 mg/ml) activated with 810 nm diode laser. The laser was used in a continuous wave, non-contact mode at a power output of 100 mW applied for 30 s/spot (the total of 4 spots per tooth) and delivered by 400 μm fibre, to provide a fluence (energy density) value of 0.0125 J/cm² per spot and generate a total energy of 3 J. The following clinical parameters were assessed at baseline and 3 months: probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), plaque index (PI), gingival index (GI), and gingival bleeding index (GBI). Intragroup and intergroup comparison was performed using paired t-test and independent samples t-test respectively. RESULTS Intragroup comparison revealed a statistically significant improvement from baseline visit (p < 0.05). Intergroup comparison showed a statistically significant improvement in RAL, RGML and GI in the test group (p < 0.05). CONCLUSION Utilisation of ICG dye activated with 810 nm diode laser, which mediated aPDT, has demonstrated surplus clinical improvement following OFD in the management of chronic periodontitis.
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Iviglia G, Kargozar S, Baino F. Biomaterials, Current Strategies, and Novel Nano-Technological Approaches for Periodontal Regeneration. J Funct Biomater 2019; 10:E3. [PMID: 30609698 PMCID: PMC6463184 DOI: 10.3390/jfb10010003] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/07/2018] [Accepted: 12/17/2018] [Indexed: 12/14/2022] Open
Abstract
Periodontal diseases involve injuries to the supporting structures of the tooth and, if left untreated, can lead to the loss of the tooth. Regenerative periodontal therapies aim, ideally, at healing all the damaged periodontal tissues and represent a significant clinical and societal challenge for the current ageing population. This review provides a picture of the currently-used biomaterials for periodontal regeneration, including natural and synthetic polymers, bioceramics (e.g., calcium phosphates and bioactive glasses), and composites. Bioactive materials aim at promoting the regeneration of new healthy tissue. Polymers are often used as barrier materials in guided tissue regeneration strategies and are suitable both to exclude epithelial down-growth and to allow periodontal ligament and alveolar bone cells to repopulate the defect. The problems related to the barrier postoperative collapse can be solved by using a combination of polymeric membranes and grafting materials. Advantages and drawbacks associated with the incorporation of growth factors and nanomaterials in periodontal scaffolds are also discussed, along with the development of multifunctional and multilayer implants. Tissue-engineering strategies based on functionally-graded scaffolds are expected to play an ever-increasing role in the management of periodontal defects.
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Affiliation(s)
| | - Saeid Kargozar
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad 917794-8564, Iran.
| | - Francesco Baino
- Institute of Materials Physics and Engineering, Department of Applied Science and Technology, Politecnico di Torino, 10129 Torino, Italy.
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OSUNA LGG, OLIVEIRA GJPLD, TEIXEIRA LHDS, MARQUEZ CO, IRIE MS, SOARES PBF. The effect of a 3% hydroxyapatite paste prophylaxis after different root-scaling procedures in periodontics. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.04019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Root-scaling procedures on the root surface show to increase root surface roughness during instrumentation. The use of a prophylactic paste reduces the roughness. Objetive This study evaluated the influence of prophylaxis paste on the surface roughness of root dentin after hand instruments (HI), ultrasonic scalers (US) and rotational instruments (RI) were applied to root surfaces. Material and method Fifty bovine roots were prepared and randomly divided into 10 groups (n=5) in which instrumentation with HI, US, or RI was carried out with or without prophylaxis using either conventional or 3% hydroxyapatite paste; additionally, a control group without treatment was included. The Ra and Rz roughness values were measured using a perfilometer. The morphological aspects of the root surfaces were analysed qualitatively by scanning electron microscopy (SEM). Data were analysed using two-way ANOVA followed by Tukey’s test (α = 0.05). Result The scaling method and the prophylaxis procedure significantly influenced (p < 0.05) root surface roughness. Treatment with US and prophylaxis with 3% hydroxyapatite paste resulted in lower values of Ra (0.14 μm ± 0.02 μm) and Rz (0.89 μm ± 0.18 μm) compared to the other groups. SEM analysis showed smoother and more homogeneous surfaces in the groups with prophylaxis compared to the groups without prophylaxis. There were no substantial differences between the results of applying different pastes. Conclusion The prophylaxis procedure performed with the experimental paste containing 3% hydroxyapatite reduced the roughness of root surfaces treated with HI, US and RI at the same level as the conventional prophylactic paste.
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46
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Bodhare GH, Kolte AP, Kolte RA, Shirke PY. Clinical and radiographic evaluation and comparison of bioactive bone alloplast morsels when used alone and in combination with platelet-rich fibrin in the treatment of periodontal intrabony defects-A randomized controlled trial. J Periodontol 2018; 90:584-594. [PMID: 30488952 DOI: 10.1002/jper.18-0416] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The present study aims to evaluate and compare the clinical and radiographic changes obtained through Bioactive Glass (BG) with and without autologous platelet-rich fibrin (PRF) in the treatment of intrabony defects in chronic periodontitis patients. METHODS The present study was a split-mouth randomized controlled clinical trial comprising 20 chronic periodontitis patients (mean age: 35.9 years) having at least one pair of bilateral intrabony defect. Group 1 included 20 sites treated with a combination of BG and autologous PRF whereas 20 sites in Group 2 were treated with BG alone. Probing pocket depth (PPD), clinical attachment level (CAL) and gingival recession (GR) were evaluated at 3 and 6 months and bone fill at 6 months by using cone beam computed tomography (CBCT) analysis. Primary study outcomes were changes in PPD, CAL, GR, and bone fill. RESULTS CAL gain was greater in Group 1 (5.05 ± 1.09 mm) when compared with Group 2 (4.2 ± 1.70 mm). Furthermore, a significantly greater bone fill was found in Group 1. At 6 months, statistically significant reduction in PPD in Group 1 and Group 2 was evident. CONCLUSION BG morsel when used in combination with PRF is found to be more effective in gain in CAL, reduction in PPD and achieving greater bone fill as compared with treatment with BG alone in periodontal intrabony defects and is indicative of enhanced periodontal regeneration.
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Affiliation(s)
- Girish H Bodhare
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Abhay P Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Rajashri A Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Prerna Y Shirke
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
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Geisinger ML, Ogdon D, Kaur M, Valiquette G, Geurs NC, Reddy MS. Toss the Floss? Evidence-Based Oral Hygiene Recommendations for the Periodontal Patient in the Age of "Flossgate". Clin Adv Periodontics 2018; 9:83-90. [PMID: 31498572 DOI: 10.1002/cap.10048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/04/2018] [Indexed: 12/12/2022]
Abstract
FOCUSED CLINICAL QUESTION What are the key considerations for effective delivery of oral hygiene home care to best manage or prevent periodontal diseases? BACKGROUND Plaque control is critical for the management of periodontal diseases, but not all patients demonstrate the same risk for disease progression and challenges differ based upon clinical findings. This report seeks to present evidence-based oral hygiene recommendations for a variety of common periodontal diseases. SUMMARY Accurate diagnosis, risk assessment, and individualized delivery of oral hygiene instruction is necessary to ensure that patients can provide adequate home care to promote health and maintain the benefits of periodontal therapy. CONCLUSIONS Oral hygiene techniques and recommendations should vary based upon patients' clinical presentation and risk assessment. Utilization of evidence-based strategies to deliver personalized care will allow for optimal wellness for patients.
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Affiliation(s)
- Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Dorothy Ogdon
- Lister Hill Library, University of Alabama at Birmingham, Birmingham, AL
| | - Maninder Kaur
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Nicolaas C Geurs
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Michael S Reddy
- University of California, School of Dentistry, San Francisco, CA
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48
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Park EJ, Kwon EY, Kim HJ, Lee JY, Choi J, Joo JY. Clinical and microbiological effects of the supplementary use of an erythritol powder air-polishing device in non-surgical periodontal therapy: a randomized clinical trial. J Periodontal Implant Sci 2018; 48:295-304. [PMID: 30405937 PMCID: PMC6207796 DOI: 10.5051/jpis.2018.48.5.295] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 12/16/2022] Open
Abstract
Purpose This study was undertaken to evaluate the clinical and microbiological effects of an erythritol powder air-polishing device (EPAP) as a supplement to scaling and root planing (SRP) therapy in patients with moderate chronic periodontitis. Methods Clinical and microbiological evaluations were performed at 21 sites treated with SRP (control) and 21 sites treated with SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Results There were no significant clinical differences between the test group and the control group. Microbiological analysis revealed that the relative expression level of Porphyromonas gingivalis was significantly lower in the test group than in the control group at 1 month after treatment. Clinical and microbiological results showed improvements at 1 month compared to baseline; in contrast, the results at 3 months after treatment were worse than those at 1 month after treatment. Conclusions In this study, both SRP and SRP+EPAP were clinically and microbiologically effective as non-surgical periodontal treatments. In particular, the SRP+EPAP group showed an antimicrobial effect on P. gingivalis, a keystone bacterium associated with the onset of chronic periodontitis, in a short-term period. Periodic periodontal therapy, at intervals of at least every 3 months, is important for sustaining the microbiological effects of this treatment.
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Affiliation(s)
- Eon-Jeong Park
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Eun-Young Kwon
- Dental Clinic Center, Pusan National University Hospital, Busan, Korea
| | - Hyun-Joo Kim
- Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Ju-Youn Lee
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Jeomil Choi
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Ji-Young Joo
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
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Debnath K, Chatterjee A. Treatment of horizontal defect with and without platelet-rich fibrin matrix: A randomized comparative clinical study. J Indian Soc Periodontol 2018; 22:406-413. [PMID: 30210189 PMCID: PMC6128136 DOI: 10.4103/jisp.jisp_129_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/14/2018] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of the present study was to assess the clinical and radiographical parameters in horizontal bone defects in patients with chronic periodontitis. MATERIALS AND METHODS In this randomized, controlled clinical trial study, nine individuals with 94 sites having moderate to deep periodontitis were selected and distributed to Group A - open flap debridement (OFD), Group B - open flap debridement and intra marrow penetration (OFD + IMP) and Group C - Open flap debridement + Intramarrow penetration + platelet rich fibrin matrix (OFD + IMP + PRFM). Plaque index (PI) and gingival index (GI) were evaluated at baseline, 6 months, and 9 months after surgery. Probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and 9 months after surgery. Radiographic assessment was carried out to measure the periodontal defect depth and defect fill percentage (DF%) at baseline and 9 months after the surgery using radiovisiography. RESULTS The statistical evaluation obtained after 9 months showed no significant difference between PI and GI at 9 months interval. Intergroup comparison of PPD and CAL has shown significant difference in Group C as compared to Group A and B with P < 0.05. The defect depth was statistically significant at 9 months in all the groups, and DF percentage (DF%) has shown statistically significant results in Group C as compared to A and B with P = of 0.001. CONCLUSION The addition of PRFM to horizontal type of periodontal defects has shown promising results over a 9-month follow-up period.
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Affiliation(s)
- Koel Debnath
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Anirban Chatterjee
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
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Jiao J, Zhang L, Meng HX, Shi D, Lu RF, Xu L, Feng XH, Cao ZQ. Clinical performance of non-surgical periodontal therapy in a large Chinese population with generalized aggressive periodontitis. J Clin Periodontol 2018; 45:1184-1197. [PMID: 29974483 DOI: 10.1111/jcpe.12981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/18/2018] [Accepted: 07/01/2018] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to evaluate clinical performance of non-surgical periodontal treatment (NSPT) and its influential factors in a large Chinese population with generalized aggressive periodontitis (GAgP). MATERIAL AND METHODS Longitudinal periodontal examination data of 1,004 GAgP patients (numbers of patients with observation periods 6 weeks~, 3 months~, 6 months~, 1 year~, 3 years~ and >5 years were 203, 310, 193, 205, 70 and 23, respectively) were extracted from a hospital-based electronic periodontal charting record system and analysed by multilevel analysis. RESULTS Mean probing depth (PD) and attachment loss (AL) reductions at patient level were 1.17 mm and 1.07 mm, respectively. Multilevel analysis demonstrated PD reductions after maintenance were mainly influenced by frequency of supportive periodontal treatment (FSPT), gender, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD and bleeding index reductions were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline AL, baseline mobility, tooth type and baseline PD. CONCLUSION The clinical performance of NSPT on patients with GAgP was proved in the large Chinese population. Outcomes of NSPT were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD.
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Affiliation(s)
- Jian Jiao
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Zhang
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huan-Xin Meng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Dong Shi
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Rui-Fang Lu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Xu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiang-Hui Feng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zhan-Qiang Cao
- Information Center, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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