1
|
Laforgia A, Inchingolo AD, Piras F, Colonna V, Giorgio RV, Carone C, Rapone B, Malcangi G, Inchingolo AM, Inchingolo F, Palermo A, Dipalma G. Therapeutic Strategies and Genetic Implications for Periodontal Disease Management: A Systematic Review. Int J Mol Sci 2024; 25:7217. [PMID: 39000324 PMCID: PMC11242487 DOI: 10.3390/ijms25137217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/23/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
The objective of this review is to identify the microbiological alterations caused by various therapy modalities by critically analyzing the current findings. We limited our search to English-language papers published between 1 January 2004 and 7 May 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "microbio*" AND "periodontitis" were used. A total of 5152 papers were obtained from the databases Web of Science (2205), PubMed (1793), and Scopus (1154). This resulted in 3266 articles after eliminating duplicates (1886), and 1411 entries were eliminated after their titles and abstracts were examined. The qualitative analysis of the 22 final articles is included in this study. Research on periodontal disease shows that periodontitis alters the oral microbiome and increases antibiotic resistance. Treatments like scaling and root planing (SRP), especially when combined with minocycline, improve clinical outcomes by reducing harmful bacteria. Comprehensive mechanical debridement with antibiotics, probiotics, EMD with bone grafts, and other adjunctive therapies enhances periodontal health. Personalized treatment strategies and advanced microbial analyses are crucial for effective periodontal management and antibiotic resistance control.
Collapse
Affiliation(s)
- Alessandra Laforgia
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Valeria Colonna
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Roberto Vito Giorgio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Claudio Carone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, CoMD Birmingham Campus, Birmingham B4 6BN, UK
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| |
Collapse
|
2
|
Chakravarthy Reddy YS, Koppolu P, Alotaibi DH, Alsinaidi AA, Mukhtar AH, Kakti AA, Abdelrahim RK, Lingam AS. Quantification and comparison of salivary neutrophils in periodontal health and disease. Niger J Clin Pract 2023; 26:1283-1289. [PMID: 37794540 DOI: 10.4103/njcp.njcp_3_23] [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: 10/06/2023]
Abstract
Background Neutrophils continuously migrate into the oral cavity from various sources like gingival crevicular fluid and saliva both in health and in inflammation. The migration of the neutrophils into the various tissues and into the oral cavity occurs when the host microbial interplay tips the balance favoring the initiation of the inflammatory and immune reactions which depending on the amount of the microbial load results in the development of acute and chronic infections in the susceptible host. Aim The present study was designed to quantify and compare the oral salivary neutrophil levels in patients with gingivitis and chronic and aggressive periodontitis as well as in healthy controls, before and after scaling and root planing (SRP) and to compare the difference within the selected study groups. Materials and Methods Forty subjects were classified into four groups, that is, healthy controls, gingivitis, and chronic and aggressive periodontitis. Oral rinse samples were collected using Hank's balanced salt solution from each patient before and after phase I periodontal therapy. Cells in the rinse samples were stained with Acridine orange, and neutrophil counts were carried out using a fluorescence microscope and a hemocytometer. Results Baseline oral salivary neutrophil levels were maximum in the chronic periodontitis group followed by the aggressive group and then the gingivitis group. Oral salivary neutrophil levels also positively correlated to probing pocket depth, plaque index, calculus index, and gingival index in all four study groups. Maximum reduction in the oral salivary neutrophil levels after phase I periodontal therapy was seen in the gingivitis group. Conclusion From our study, we conclude that the oral salivary neutrophil levels decreased significantly after SRP. Estimation of changes in the oral salivary neutrophil levels has the potential to aid in monitoring treatment outcomes. Thus, it suggests that it could be used as a simple, noninvasive laboratory technique to monitor the periodontal status and disease progression.
Collapse
Affiliation(s)
- Y Shs Chakravarthy Reddy
- Department of Periodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - P Koppolu
- Dental School, The University of Western Australia, Perth, WA, Australia
| | - D H Alotaibi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, KSA
| | - A A Alsinaidi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, KSA
| | - A H Mukhtar
- Periodontics Division, Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, KSA
| | - A A Kakti
- Pedodontics Division, Department of Preventive dentistry, College of Dentistry, Riyadh Elm University, Riyadh, KSA
| | - R K Abdelrahim
- Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - A S Lingam
- Department of Surgical and Diagnostic Sciences, Dar Al Uloom University, Riyadh, Saudi Arabia
| |
Collapse
|
3
|
Grusovin MG, Pispero A, Del Fabbro M, Sangiorgi M, Simion M, Stefanini M, Varoni EM. Antibiotics as Adjunctive Therapy in the Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2022; 11:1766. [PMID: 36551424 PMCID: PMC9774402 DOI: 10.3390/antibiotics11121766] [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: 11/06/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
The role of antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis is uncertain. The aim of this systematic review of randomized controlled trials was to assess the efficacy of antibiotic therapy, local or systemic, as an adjunctive to the non-surgical therapy of peri-implantitis. Primary outcomes were: implant success rate and complications, changes in radiographic bone level, probing pocket depth (PPD), probing attachment level (PAL), bleeding on probing (BOP) and peri-implantitis resolution. Six studies were included: two using topical and four systemic antibiotics. Adjunctive local antibiotics improved PPD (mean difference (MD) = 0.6 mm; 95% CI 0.42-0.78), BOP (MD = 0.15% (95% CI 0.10, 0.19)) and the success rate (risk ratio = 9.89; 95% CI 2.39-40.84). No significant difference in bone level and success rate were found with the use of systemic antibiotics, although they appeared to improve PPD (MD = 1.15 mm; 95% CI 0.31-1.99) and PAL (MD = 1.10 mm; 95% CI 0.13-2.08). Within the limitations of this review, the adjunctive local antibiotics showed improved outcomes in terms of success rate, PPD and BOP, while adjunctive systemic antibiotics improved PPD and PAL only. Peri-implantitis resolution was about 20-30% using adjunctive local antibiotics, whilst it ranged from 2% to 65% with adjunctive systemic antibiotics. Findings are still controversial, since they are based on few studies with high heterogeneity, at the uncertain or high risk of bias and involve few patients. Non-surgical debridement and maintenance periodontal support therapy remain pivotal and the adjunctive use of antibiotics for peri-implantitis cannot be routinely recommended, even considering the increasing concern on antibiotic resistance.
Collapse
Affiliation(s)
- Maria Gabriella Grusovin
- Dipartimento Odontoiatria, Università Vita Salute “S. Raffaele”, 20132 Milan, Italy
- Libera Professionista in Gorizia (Dental Private Practice), 34170 Gorizia, Italy
| | - Alberto Pispero
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
- IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Matteo Sangiorgi
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna,40123 Bologna, Italy
| | - Massimo Simion
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Martina Stefanini
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna,40123 Bologna, Italy
| | - Elena Maria Varoni
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Swami RK, Kolte AP, Bodhare GH, Kolte RA. Bone replacement grafts with guided tissue regeneration in treatment of grade II furcation defects: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:807-821. [PMID: 33438084 DOI: 10.1007/s00784-021-03776-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/04/2021] [Indexed: 11/27/2022]
Abstract
AIM The present systematic review appended with meta-analysis aimed to evaluate the efficacy of bone replacement graft (BRG) with guided tissue regeneration (GTR) over BRG or open flap debridement (OFD) alone in the treatment of grade II furcation defects. MATERIALS AND METHODS An electronic literature search of PubMed, Cochrane Library and Google Scholar databases accompanied with manual searching was done. Randomized controlled trials (RCTs) up to October 2019, comparing BRG+GTR with BRG or OFD in grade II furcation defects, were identified. Clinical attachment level (CAL) gain, changes in gingival marginal level (GML), vertical defect fill (VDF), horizontal defect fill (HDF) and reduction in defect volume were the outcome parameters. RESULTS Of a total of 12, 9 studies compared BRG+GTR vs BRG while 3 compared BRG+GTR vs OFD. Meta-analysis was carried out for CAL gain, VDF, HDF and GML changes. In the BRG+GTR vs BRG comparison group, out of 9 studies, 6 RCTs showed standardized mean difference (SMD) of 0.513 for VDF, 9 RCTs showed SMD of 0.83 for HDF and 2 RCTs showed SMD of 0.651 for CAL gain, whereas only 2 studies in the same group reported reduction in defect volume. Three studies of the BRG+GTR vs OFD group exhibited significant VDF and CAL gain with SMD of 2.002 and 1.161 respectively. However, no significant change was recorded for GML in both groups. CONCLUSION The present systematic review indicates supplemental benefits of combination therapy of BRG+GTR over monotherapy in resolving grade II furcation defects. CLINICAL RELEVANCE In our quest to achieve maximum regeneration in grade II furcation defects, combination therapies such as BRG+GTR have been accepted as treatment choices over other modalities. Clinical situations warranting near-complete regeneration of the tissues in such defects are better suited for combination therapies.
Collapse
Affiliation(s)
- Renuka K Swami
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Digdoh Hills, Hingna Road, Nagpur, 440019, India
| | - Abhay P Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Digdoh Hills, Hingna Road, Nagpur, 440019, India.
| | - Girish H Bodhare
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Digdoh Hills, Hingna Road, Nagpur, 440019, India
| | - Rajashri A Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Digdoh Hills, Hingna Road, Nagpur, 440019, India
| |
Collapse
|
6
|
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
| |
Collapse
|
7
|
Polak D, Wilensky A, Antonoglou GN, Shapira L, Goldstein M, Martin C. The efficacy of pocket elimination/reduction compared to access flap surgery: A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22:303-319. [PMID: 31912516 DOI: 10.1111/jcpe.13246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/17/2019] [Accepted: 12/17/2019] [Indexed: 01/22/2023]
Abstract
AIM To assess the efficacy and adverse effects of resective surgery compared to access flap in patients with periodontitis. METHODS Randomized controlled trials with a follow-up ≥6 months were identified in ten databases. Screening, data extraction, and quality assessment were conducted by two reviewers. The primary outcome was probing pocket depth, and the main secondary outcome was clinical attachment level. Data on adverse events were collected. Meta-analysis was used to synthesize the findings of trials. RESULTS A total of 880 publications were identified. Fourteen publications from nine clinical trials met the inclusion criteria and were included for analysis. Meta-analysis was carried out using all available results. The results indicated superior pocket depth reduction following resective surgery compared to access flap after 6-12 months of follow-up (weighted mean difference 0.47 mm; confidence interval 0.7-0.24; p = .010). After 36-60 months of follow-up, no differences were found between the two treatments in pocket depth and attachment level. The prevalence of adverse effects was not different between the groups. Post-operative recession tended to be more severe for the resective approaches. CONCLUSION Resective surgical approach was superior to access flap in reducing pocket depth 6-12 months post-surgery, while no differences between the two modalities were found at 36-60 months of follow-up.
Collapse
Affiliation(s)
- David Polak
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
| | - Asaf Wilensky
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
| | | | - Lior Shapira
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
| | - Moshe Goldstein
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
| | | |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
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: 32] [Impact Index Per Article: 5.3] [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.
Collapse
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
| |
Collapse
|
10
|
Cadore UB, Reis MBL, Martins SHL, Invernici MDM, Novaes AB, Taba M, Palioto DB, Messora MR, Souza SLS. Multiple sessions of antimicrobial photodynamic therapy associated with surgical periodontal treatment in patients with chronic periodontitis. J Periodontol 2018; 90:339-349. [DOI: 10.1002/jper.18-0373] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/19/2018] [Accepted: 10/19/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Uislen B. Cadore
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Marília B. L. Reis
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Sergio H. L. Martins
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Marcos de M. Invernici
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Arthur B. Novaes
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Mario Taba
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Daniela B. Palioto
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Michel R. Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| | - Sergio L. S. Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental SchoolUniversity of São Paulo‒USP Ribeirão Preto São Paulo Brazil
| |
Collapse
|
11
|
Chang PC, Chen YW, Tu CC, Yen-Ping Kuo M, Liu CM, Wang CY. Association of initial mucogingival status with clinical outcome of non-surgical periodontal therapy: A retrospective analysis of 204 patients. J Formos Med Assoc 2018; 118:932-938. [PMID: 30409741 DOI: 10.1016/j.jfma.2018.10.005] [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: 07/23/2018] [Revised: 08/14/2018] [Accepted: 10/03/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND/PURPOSE This study was conducted to evaluate the influence of mucogingival parameters, including keratinized mucosa (KM) and attached gingiva (AG), on the outcome of non-surgical periodontal therapy (NSPT). METHODS A total of 204 non-smoking patients with generalized chronic periodontitis who received NSPT between 2012 and 2014 were included. The Mantel-Haenszel chi-square test was used to assess the associations between initial mucogingival parameters and initial clinical parameters on the buccal aspect, and the associations between initial mucogingival parameters and outcome clinical parameters on the buccal aspect of the sites with severe periodontal destruction. The generalized liner model was used to evaluate the contribution of initial clinical parameters to the outcome of NSPT. RESULTS KM ≥ 3 mm was associated with greater probing pocket depth (PD), less gingival recession (REC), and less clinical attachment level (CAL), and AG < 1 mm was associated with greater PD, REC, and CAL before NSPT. At the sites with severe periodontal destruction, KM ≥ 3 mm was associated with greater PD reduction (0.25 ± 0.08 mm) and CAL gain (0.25 ± 0.09 mm), and AG < 1 mm was associated with greater CAL gain (0.15 ± 0.08 mm) after NSPT. Initial PD ≥ 7 mm and non-molar teeth showed greater contribution to the outcome of NSPT. CONCLUSION Less AG (<1 mm) was associated with greater periodontal destruction at baseline. At the sites with severe periodontal destruction, greater KM (≥3 mm) and less AG (<1 mm) resulted in better outcomes of NSPT.
Collapse
Affiliation(s)
- Po-Chun Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taiwan; Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taiwan; Department of Dentistry, School of Dentistry, National Taiwan University, Taiwan
| | - Yi-Wen Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taiwan; Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taiwan; Department of Dentistry, School of Dentistry, National Taiwan University, Taiwan
| | - Che-Chang Tu
- Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taiwan
| | - Mark Yen-Ping Kuo
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taiwan; Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taiwan
| | - Cheing-Meei Liu
- Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taiwan
| | - Chen-Ying Wang
- Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taiwan; Department of Dentistry, School of Dentistry, National Taiwan University, Taiwan.
| |
Collapse
|
12
|
Sharma P, Grover HS, Masamatti SS, Saksena N. A clinicoradiographic assessment of 1% metformin gel with platelet-rich fibrin in the treatment of mandibular grade II furcation defects. J Indian Soc Periodontol 2018; 21:303-308. [PMID: 29456305 PMCID: PMC5813345 DOI: 10.4103/jisp.jisp_292_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: Management of furcation defects is challenging, and constantly newer therapeutic strategies are evolving. Platelet-rich fibrin (PRF) is successfully used alone and in combination with various agents in the furcation defects. Lately, metformin (MF), a second generation biguanide has gained popularity owing to its osteogenic potential. Aims and Objectives: The aim of the present study was to evaluate the clinical and radiographic effectiveness of open flap debridement (OFD) and PRF when compared to OFD + PRF + 1% MF gel in the management of mandibular Grade II furcation defects. Materials and Methods: Thirty mandibular grade II furcation defects were stratified into two groups; in one group OFD and PRF is used, and the other group had an additional MF gel with PRF in OFD. Clinical parameters such as plaque index, modified sulcus bleeding index, probing pocket depth (PD), relative vertical attachment level (RVAL), and relative horizontal attachment level (RHAL) were recorded at baseline and at 6 months. Radiovisiography and ImageJ software were used to evaluate the intrabony defect depth. Results: The OFD + PRF + MF group showed significantly higher probing PD reduction, RVAL and RHAL gain than the OFD + PRF group. Conclusions: PRF when combined with a potential osteogenic agent like MF can provide a better therapeutic benefit to a furcation involved tooth.
Collapse
Affiliation(s)
- Parul Sharma
- Department of Periodontology, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
| | - Harpreet Singh Grover
- Department of Periodontology, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
| | | | - Neha Saksena
- Department of Periodontology, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
| |
Collapse
|
13
|
Everett JD, Rossmann JA, Kerns DG, Al-Hashimi I. Laser Assisted Non-surgical Periodontal Therapy: A Double Blind, Randomized Clinical Trial. Open Dent J 2017; 11:79-90. [PMID: 28357001 PMCID: PMC5345326 DOI: 10.2174/1874210601711010079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/18/2016] [Accepted: 12/22/2016] [Indexed: 12/04/2022] Open
Abstract
The objective of this study was to examine potential benefits of using laser therapy for secular decontamination in conjunction with scaling and root planing in the treatment of chronic periodontitis. The study was performed on 173 teeth in 14 patients in a split-mouth design, one side received scaling and root planing followed by laser therapy using a carbon dioxide (CO2) laser with an ablative handpiece (test group); the contralateral side received scaling and root planing without laser (control group). Clinical and laboratory parameters were evaluated prior to treatment and at 3 and 6 months following therapy; clinical measurements were performed by two blinded examiners. The clinical parameters included measurement of gingival recession (REC), bleeding on probing (BOP), clinical attachment level (CAL), pocket depth (PD), furcation involvement (FUR), and tooth mobility (MOB). Laboratory testing to determine the levels of periodontal pathogens was performed using PCR techniques. The results of the study revealed statistically significant differences in clinical and laboratory parameters at 3 and 6 months after therapy for both test and control groups, but no significant difference was observed between the two groups. However, sites receiving laser therapy tended to show a greater decrease in probing depths, gain in clinical attachment level, and reduced bacterial levels. In conclusion, the overall results of the study suggest a potential benefit of using laser therapy in conjunction with scaling and root planing for the treatment of chronic periodontitis.
Collapse
Affiliation(s)
- Joseph D. Everett
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - Jeffrey A. Rossmann
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - David G. Kerns
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - Ibtisam Al-Hashimi
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| |
Collapse
|
14
|
Mailoa J, Lin GH, Khoshkam V, MacEachern M, Chan HL, Wang HL. Long-Term Effect of Four Surgical Periodontal Therapies and One Non-Surgical Therapy: A Systematic Review and Meta-Analysis. J Periodontol 2015; 86:1150-8. [DOI: 10.1902/jop.2015.150159] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
15
|
Roos-Jansåker AM, Almhöjd US, Jansson H. Treatment of peri-implantitis: clinical outcome of chloramine as an adjunctive to non-surgical therapy, a randomized clinical trial. Clin Oral Implants Res 2015; 28:43-48. [DOI: 10.1111/clr.12612] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ulrica S. Almhöjd
- Department of Cariology; Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Henrik Jansson
- Oral Health Centre of Expertise in Eastern Norway; Oslo Norway
- Department of Periodontology; Centre for Oral Health Sciences; Malmö University; Malmö Sweden
- Center for Oral Health; Department of Natural Science and Biomedicine; School of Health Sciences; Jönköping University; Jönköping Sweden
| |
Collapse
|
16
|
Wang SH, Hung HC, Tsai CC, Huang MC, Ho KY, Wu YM, Wang YY, Lin YC. Plasma polyunsaturated fatty acids and periodontal recovery in Taiwanese with periodontitis: a significant relationship. Arch Oral Biol 2014; 59:800-7. [PMID: 24859767 DOI: 10.1016/j.archoralbio.2014.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 03/19/2014] [Accepted: 04/13/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Plasma levels of polyunsaturated fatty acids (PUFAs) are different before and after periodontal treatment. Asians and Westerners have significantly different baseline levels of plasma PUFAs. However, no Asian study has reported the effects of nonsurgical treatment on the correlation between periodontal condition and plasma levels of PUFAs. We analyzed whether recovery from periodontitis was correlated with the elevation of plasma fatty acids 3 months after the nonsurgical intervention and with no recommended supplements. DESIGN Thirty-five Taiwanese patients with periodontitis were recruited. Probing pocket depths (PPDs) and clinical attachment levels (CALs) were measured at baseline and 3 months after the nonsurgical treatment. Plasma levels of fatty acids were determined using gas chromatography. Differences and correlations between plasma fatty acid composition and periodontitis severity at baseline and 3 months after treatment were determined. RESULTS Twenty-six patients completed the study. At the baseline, PPDs were negatively correlated with plasma n-3 PUFAs (r=-0.52, p<0.01), but at 3 months post intervention, periodontitis severity had declined and the weight percentages of n-3 PUFAs, DPA, and DHA were significantly (p=0.019, 0.005, and 0.037, respectively) higher. The recovery percentages of CALs were positively and significantly correlated with plasma ΔPUFAs and the percentage of Δn-3 PUFAs in ΔPUFAs (r=0.42 and 0.45, respectively; p<0.05 for both). CONCLUSIONS We conclude that a higher weight percentage of n-3 PUFAs in total PUFAs was related to the recovery of CALs 3 months after the nonsurgical periodontal treatment. However, no such relationship was found for PPDs.
Collapse
Affiliation(s)
- Sheng-Hung Wang
- School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Chia Hung
- Department of Nursing, College of Health and Nursing, Meiho University, Pingtung, Taiwan
| | - Chi-Cheng Tsai
- School of Dentistry, College of Oral Medicine and Department of Dentistry, University Hospital Chung-Shan Medical University, Taichung, Taiwan
| | - Meng-Chuan Huang
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Yen Ho
- School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Min Wu
- School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Yun Wang
- School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Chu Lin
- School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
17
|
Front E, Laster Z, Unis R, Gavish M, Nagler RM. Salivary biomarker analysis complementing regular clinical examination. Biomark Med 2014; 7:701-8. [PMID: 24044562 DOI: 10.2217/bmm.13.76] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
AIM Tools for the diagnosis and evaluation of the severity and prognosis of periodontitis are currently insufficient. The aim of the current study was to find an array of salivary biomarkers that would be both sensitive and specific enough to be used as a complement to regular clinical examination. Furthermore, we investigated salivary markers of successful periodontal treatment to elucidate the underlying mechanism of disease. PATIENTS & METHODS Saliva was collected from periodontitis patients during illness and following successful disease termination. Parameters measured included sodium, potassium, chloride, calcium, phosphate, magnesium, total protein, Alb, LDH, amylase, IL-1α, uric acid and carbonyls. RESULTS Seven of the parameters analyzed were significantly altered when the disease is active and may be considered biomarkers. CONCLUSION Salivary composition reflects disease severity and response to therapy, suggesting the efficacy of saliva monitoring for periodontal disease status and care.
Collapse
Affiliation(s)
- Eran Front
- Unit of Periodontology, Baruch Padeh Medical Center, Poriya, Tiberias, Israel
| | | | | | | | | |
Collapse
|
18
|
Parpaiola A, Cecchinato D, Toia M, Bressan E, Speroni S, Lindhe J. Dimensions of the healthy gingiva and peri-implant mucosa. Clin Oral Implants Res 2014; 26:657-62. [PMID: 24611985 DOI: 10.1111/clr.12359] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the dimensions of the soft tissue cuff present at various aspects of teeth and to compare these dimensions to those of the mucosa surrounding single implants. MATERIAL AND METHODS Fifty volunteers were recruited that were ≥25 years of age and exhibited no signs of (i) untreated caries; (ii) loss of periodontal tissue support in the incisor, canine, and premolar regions; (iii) systemic or local disease. Furthermore, among the 50 patients recruited (iV), 27 had one single implant in the maxilla with teeth present mesial and/or distal to the implant. Probing pocket depth (PPD) and transmucosal sounding depth (TS) were assessed by five experienced, carefully calibrated examiners and with the use of a periodontal probe at the proximal (mesial, distal) and flat (facial, buccal and palatal/lingual) surfaces of all teeth/implants. The width of the keratinized mucosa (KM) was also determined. RESULTS It was demonstrated that (i) PPD and TS were greater at proximal than at flat surfaces at both tooth and implant sites. In addition, both PPD and TS were deeper at implant than at tooth sites. The TS values documented that the cuff of healthy soft tissue that surrounded a tooth varied between 2 mm at flat surfaces and 4 mm at proximal surfaces, while at implant sites, the mucosa at proximal as well as flat surfaces was 1-1.5 mm greater. CONCLUSION The probing pocket depth (PPD) and the transmucosal sounding depth (TS) values were greater at proximal than at flat, that is, facial/palatal (lingual) surfaces at tooth sites and frequently also at implant sites. Furthermore, the PPD and the TS dimensions were greater at implant than at adjacent tooth sites.
Collapse
|
19
|
Finoti LS, Corbi SCT, Anovazzi G, Teixeira SRL, Capela MV, Tanaka MH, Kim YJ, Orrico SRP, Cirelli JA, Mayer MPA, Scarel-Caminaga RM. Pathogen levels and clinical response to periodontal treatment in patients with Interleukin 8 haplotypes. Pathog Dis 2013; 69:21-28. [PMID: 23821559 DOI: 10.1111/2049-632x.12062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 06/14/2013] [Accepted: 06/15/2013] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to investigate the effect of non-surgical treatment of periodontitis on the levels of periodontopathogens and clinical parameters in patients with different genetic backgrounds produced by polymorphisms in the Interleukin ( IL8) gene. Thirty patients grouped according to IL8 ATC/TTC or AGT/TTC haplotypes were submitted to non-surgical periodontal treatment. Levels of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were determined in 240 subgingival plaque samples by qPCR. The association between IL8 haplotypes and the levels of periodontopathogens and clinical parameters was investigated by multilevel analysis accounting for the clustering of diseased sites analyzed within patients. It was observed that neither levels of periodontopathogens nor non-surgical treatment was associated with the IL8 haplotype. The clinical parameters after periodontal treatment were similar in diseased and healthy sites, independently of the IL8 haplotype. Nonetheless, in the same period, diseased sites of AGT/TTC patients harbored higher levels of P. gingivalis, T. denticola, T. forsythia, and red complex than those of ATC/TTC patients. However, the non-surgical periodontal therapy decreased the levels of these periodontopathogens and of the tested clinical parameters of diseased sites in both groups. Non-surgical therapy is equally effective in improving clinical parameters and decreasing the levels of periodontopathogens, independent of the genotype groups produced by the IL8 haplotype.
Collapse
Affiliation(s)
- Livia S Finoti
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Sâmia C T Corbi
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Giovana Anovazzi
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Silvia R L Teixeira
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Marisa V Capela
- Department of Physical Chemistry, Institute of Chemistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Márcia H Tanaka
- Department of Morphology, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Yeon J Kim
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Silvana R P Orrico
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Joni A Cirelli
- Department of Oral Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Marcia P A Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Raquel M Scarel-Caminaga
- Department of Morphology, School of Dentistry at Araraquara, UNESP- Universidade Estadual Paulista, Araraquara, SP, Brazil
| |
Collapse
|
20
|
Sahrmann P, Sener B, Ronay V, Attin T, Schmidlin PR. Clearance of topically-applied PVP-iodine as a solution or gel in periodontal pockets in men. Acta Odontol Scand 2012; 70:497-503. [PMID: 22181668 DOI: 10.3109/00016357.2011.640276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of the study was to investigate the clearance of PVP-iodine applied as a gel or solution in periodontal pockets. METHODS Teeth of 12 subjects with at least eight periodontal pockets of ≥5 mm probing depth were isolated with a rubber dam to allow contamination-free access to the pockets. In each subject, three pockets were filled with PVP-iodine gel (10%) and three with PVP-iodine solution (10%). One pocket of each subject without iodine application served as a negative control. The treatment allocation was assigned randomly. Any excess material was removed subsequently. After 1, 5 and 15 min, a paper point was used to collect the sulcus liquid and the concentration of PVP-iodine was chemically determined. In addition, PVP-iodine gel was administered into 12 periodontal pockets immediately after sub-gingival ultrasound debridement and the concentration of PVP-iodine was determined after 1 min. RESULTS Descending concentrations of PVP-iodine were determined at 1, 5 and 15 min after the application. No PVP-iodine was found in the pockets serving as negative controls. The mean concentrations of the gel and solution were 6.14 μg/ml and 4.44 μg/ml (1 min; p ≥ 0.028), 3.20 μg/ml and 1.44 μg/ml (5 min; p ≥ 0.126), 0.69 μg/ml and 0.23 μg/ml (15 min; p ≤ 0.019), respectively. In the pockets with previous debridement the mean concentration was 1.68 ± 1.97 μg/ml. CONCLUSION The application of PVP-iodine gel in periodontal pockets allows a prolonged remnant effect as compared to that of the solution formula.
Collapse
Affiliation(s)
- Philipp Sahrmann
- Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental and Oral Medicine and Maxillofacial Surgery, University of Zurich, Switzerland.
| | | | | | | | | |
Collapse
|
21
|
Kyriazis T, Gkrizioti S, Mikrogeorgis G, Tsalikis L, Sakellari D, Lyroudia K, Konstantinides A. Crestal bone resorption after the application of two periodontal surgical techniques. A randomized, controlled clinical trial. J Clin Periodontol 2012; 39:971-8. [DOI: 10.1111/j.1600-051x.2012.01928.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Kyriazis
- Department of Preventive Dentistry, Periodontology and Implant Biology; Dental School, Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - Sofia Gkrizioti
- Department of Preventive Dentistry, Periodontology and Implant Biology; Dental School, Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - Georgios Mikrogeorgis
- Department of Endodontology; Dental School, Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology; Dental School, Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology; Dental School, Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - Kleoniki Lyroudia
- Department of Endodontology; Dental School, Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - Antonios Konstantinides
- Department of Preventive Dentistry, Periodontology and Implant Biology; Dental School, Aristotle University of Thessaloniki; Thessaloniki; Greece
| |
Collapse
|
22
|
Goodson JM, Haffajee AD, Socransky SS, Kent R, Teles R, Hasturk H, Bogren A, Van Dyke T, Wennstrom J, Lindhe J. Control of periodontal infections: a randomized controlled trial I. The primary outcome attachment gain and pocket depth reduction at treated sites. J Clin Periodontol 2012; 39:526-36. [PMID: 22512461 DOI: 10.1111/j.1600-051x.2012.01870.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare the treatment outcome of scaling and root planing (SRP) in combination with systemic antibiotics, local antibiotic therapy and/or periodontal surgery. MATERIAL AND METHODS One hundred and eighty-seven patients were assigned to eight groups treated by SRP plus none, one, two or three adjunctive treatments and monitored for 24 months in a randomized controlled clinical trial using a 2 × 2 × 2 factorial design. Systemic amoxicillin + metronidazole (SMA), local tetracycline delivery (LTC) and periodontal surgery (SURG) were evaluated as adjuncts. Changes in clinical attachment level (CAL) and probing pocket depth (PPD) were statistically evaluated by ancova of main effects. RESULTS Effects of adjunctive therapy to SRP were minimal at 3 months. Between 3 and 6 months PPD reduction occurred particularly in patients receiving periodontal surgery. After 6 months, both CAL gain and PPD reduction reached a plateau that was maintained at 24 months in all groups. The 24-month CAL gain was improved by SMA (0.50 mm) while PPD was reduced by SMA (0.51 mm) and SURG (0.36 mm). Smoking reduced CAL gain and PPD reduction. CONCLUSION Patients receiving adjunctive therapies generally exhibited improved CAL gain and/or PPD reduction when compared with the outcome of SRP alone. Only additive, not synergistic effects of the various adjunctive therapies were observed.
Collapse
|
23
|
Patel RA, Wilson RF, Palmer RM. The Effect of Smoking on Periodontal Bone Regeneration: A Systematic Review and Meta-Analysis. J Periodontol 2012; 83:143-55. [DOI: 10.1902/jop.2011.110130] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
24
|
Frydman A, Verdugo F, Simonian K, Kar K. Trisomy 21–Associated Aggressive Periodontitis: A Five-Year Follow-Up. Clin Adv Periodontics 2011. [DOI: 10.1902/cap.2011.110013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
25
|
Gupta I, Vandana KL. Alterations of the marginal soft tissue (gingival margin) following periodontal therapy: A clinical study. J Indian Soc Periodontol 2011; 13:85-9. [PMID: 20407656 PMCID: PMC2847130 DOI: 10.4103/0972-124x.55843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 07/01/2009] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives: The evaluation of gingival margin position (GMP) plays a vital role in periodontal therapy and is critical in esthetic/plastic surgical procedures revolving around restorative dentistry. Comparative evaluations of GMP measurements in various periodontal therapies are scarce. Thus, the objectives of this study are to measure the alteration in the gingival margin position following various therapies, and to compare GMP alterations among different treatment modalities from the baseline to six months after therapy. Materials and Methods: The changes in GMP were studied for MB, B, DB, ML, and L sites for SRP, curettage, and flap surgery, and for MB, B, and DB sites for crown lengthening cases at the end of one, three, and six months after therapy. The results were interpreted from baseline to one, three, and six months posttreatment. Statistical Analysis: The results were subjected to statistical analysis. Paired ‘t’-test was used for intra-group comparisons and intergroup comparisons were done by one-way ANOVA. Results: The GMP changed from baseline in all the sites at different time periods following various therapies. The net results after six months were an apical shift of GMP in SRP, curettage, and flap surgery, and a coronal shift of GMP in crown lengthening. Conclusion: GMP shows various patterns of alteration after various periodontal therapies. One should wait for the GMP to become stable before attempting any restorative procedure.
Collapse
Affiliation(s)
- Ira Gupta
- Senior Lecturer, Department of Periodontics, Rama Dental College and Hospital, Kanpur, India
| | | |
Collapse
|
26
|
Leininger M, Tenenbaum H, Davideau JL. Modified periodontal risk assessment score: long-term predictive value of treatment outcomes. A retrospective study. J Clin Periodontol 2010; 37:427-35. [PMID: 20507367 DOI: 10.1111/j.1600-051x.2010.01553.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the long-term clinical predictive value of the periodontal risk assessment diagram surface (PRAS) score and the influence of patient compliance on the treatment outcomes. MATERIALS AND METHODS Thirty subjects suffering from periodontitis were re-examined 6-12 years after the initial diagnosis and periodontal treatments. The baseline PRAS score was calculated from the initial clinical and radiograph records. Patients were then classified into a low-to-moderate (0-20) or a high-risk group (>20). Patients who did not attend any supportive periodontal therapy were classified into a non-compliant group. PRAS and compliance were correlated to the mean tooth loss (TL)/year and the mean variation in the number of periodontal pockets with a probing depth (PPD) >4 mm. RESULTS TL was 0.11 for the low-to-moderate-risk group and 0.26 for the high-risk group (p<0.05); PPD number reduction was 2.57 and 2.17, respectively, and bleeding on probing reduction was 6.7% and 23.3%, respectively. Comparing the compliance groups, the PPD number reduction was 3.39 in the compliant group and 1.40 in the non-compliant group (p<0.05). CONCLUSION This study showed the reliability of PRAS in evaluating long-term TL and patient susceptibility to periodontal disease. Our data confirmed the positive influence of patient compliance on periodontal treatment outcomes.
Collapse
Affiliation(s)
- Matthieu Leininger
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | | | | |
Collapse
|
27
|
Sahrmann P, Puhan MA, Attin T, Schmidlin PR. Systematic review on the effect of rinsing with povidone-iodine during nonsurgical periodontal therapy. J Periodontal Res 2009; 45:153-64. [PMID: 19909406 DOI: 10.1111/j.1600-0765.2009.01232.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE The existing literature is inconsistent regarding whether there is any additional effect of povidone-iodine (PVP-iodine) as an adjunctive to scaling and root planing, and, if there is an effect, what its size is. Therefore, the aim of this study was to assess the additional effect of PVP-iodine as an adjunct to scaling and root planing compared with water, saline or no rinse in the treatment of chronic periodontitis. MATERIAL AND METHODS An electronic literature search of the databases PubMed, EMBASE and the Cochrane Central Library, and a handsearch, were performed (up to November 2008). Two reviewers independently identified and selected screened abstracts for possible inclusion, and assessed randomized, controlled clinical trials comparing the additional benefit of PVP-iodine with water, saline rinsing or no rinsing in the nonsurgical periodontal therapy of patients with chronic periodontitis. A fixed-effects meta-analysis was conducted in the absence of statistically significant heterogeneity. RESULTS A small, but statistically significant additional beneficial effect of the adjunctive use of PVP-iodine with enhanced probing pocket depth reductions of 0.28 mm (95% confidence interval: 0.08 to 0.48, p = 0.007) was found. There was no significant heterogeneity between studies (I(2) = 0%). However, most of the studies included in the meta-analysis were of low quality, and the treatment modalities showed various differences such as the use of PVP-iodine at different concentrations and application modalities. Nevertheless, single-rooted teeth, in particular, showed an additional benefit after scaling and root planing with PVP-iodine, particularly when the treatment was repeated during the healing stage. CONCLUSION The adjunctive use of PVP-iodine during scaling and root planing may increase the clinical pocket depth reduction, although the clinical significance is small to moderate.
Collapse
Affiliation(s)
- P Sahrmann
- Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental and Oral Medicine and Maxillofacial Surgery, University of Zurich, Zurich, Switzerland
| | | | | | | |
Collapse
|
28
|
Beuchat M, Busslinger A, Schmidlin PR, Michel B, Lehmann B, Lutz F. Clinical comparison of the effectiveness of novel sonic instruments and curettes for periodontal debridement after 2 months. J Clin Periodontol 2008. [DOI: 10.1111/j.1600-051x.2001.281209.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
29
|
Beikler T, Peters U, Prior K, Eisenacher M, Flemmig TF. Gene expression in periodontal tissues following treatment. BMC Med Genomics 2008; 1:30. [PMID: 18606014 PMCID: PMC2491649 DOI: 10.1186/1755-8794-1-30] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 07/07/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In periodontitis, treatment aimed at controlling the periodontal biofilm infection results in a resolution of the clinical and histological signs of inflammation. Although the cell types found in periodontal tissues following treatment have been well described, information on gene expression is limited to few candidate genes. Therefore, the aim of the study was to determine the expression profiles of immune and inflammatory genes in periodontal tissues from sites with severe chronic periodontitis following periodontal therapy in order to identify genes involved in tissue homeostasis.Gingival biopsies from 12 patients with severe chronic periodontitis were taken six to eight weeks following non-surgical periodontal therapy, and from 11 healthy controls. As internal standard, RNA of an immortalized human keratinocyte line (HaCaT) was used. Total RNA was subjected to gene expression profiling using a commercially available microarray system focusing on inflammation-related genes. Post-hoc confirmation of selected genes was done by Realtime-PCR. RESULTS Out of the 136 genes analyzed, the 5% most strongly expressed genes compared to healthy controls were Interleukin-12A (IL-12A), Versican (CSPG-2), Matrixmetalloproteinase-1 (MMP-1), Down syndrome critical region protein-1 (DSCR-1), Macrophage inflammatory protein-2beta (Cxcl-3), Inhibitor of apoptosis protein-1 (BIRC-1), Cluster of differentiation antigen 38 (CD38), Regulator of G-protein signalling-1 (RGS-1), and Finkel-Biskis-Jinkins murine osteosarcoma virus oncogene (C-FOS); the 5% least strongly expressed genes were Receptor-interacting Serine/Threonine Kinase-2 (RIP-2), Complement component 3 (C3), Prostaglandin-endoperoxide synthase-2 (COX-2), Interleukin-8 (IL-8), Endothelin-1 (EDN-1), Plasminogen activator inhibitor type-2 (PAI-2), Matrix-metalloproteinase-14 (MMP-14), and Interferon regulating factor-7 (IRF-7). CONCLUSION Gene expression profiles found in periodontal tissues following therapy indicate activation of pathways that regulate tissue damage and repair.
Collapse
Affiliation(s)
- Thomas Beikler
- Department of Periodontics, University of Washington, Seattle, USA.
| | | | | | | | | |
Collapse
|
30
|
Hellström MK, McClain PK, Schallhorn RG, Bellis L, Hanlon AL, Ramberg P. Local minocycline as an adjunct to surgical therapy in moderate to severe, chronic periodontitis. J Clin Periodontol 2008; 35:525-31. [DOI: 10.1111/j.1600-051x.2008.01219.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
31
|
Kahl M, Haase E, Kocher T, Rühling A. Clinical effects after subgingival polishing with a non-aggressive ultrasonic device in initial therapy. J Clin Periodontol 2007; 34:318-24. [PMID: 17378888 DOI: 10.1111/j.1600-051x.2007.01056.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The Vector ultrasonic system provides root debridement supported by different abrasive irrigation fluids. The aim of this study was to investigate the clinical outcome of initial therapy with subgingival low-abrasive debridement. MATERIAL AND METHODS Twenty patients, who had at least two teeth with pocket depths >5 mm in each quadrant, took part in this prospective randomized clinical study. Patients were treated in a split-mouth design as one test quadrant (1) subgingivally with Vector fluid polish (VU-H) and as three control quadrants, (2) with only supragingival polishing (PO-H), (3) with hand instruments (HI-H) performed by a hygienist and (4) with hand instruments (HI-D) performed by a dentist. At baseline, 3 and 6 months after treatment, pocket depths and attachment levels (ALs) were measured and bleeding on probing (BOP) was recorded. RESULTS At 6-month evaluation, all groups showed an improvement in clinical parameters. No statistically significant differences in any of the investigated parameters could be observed between the Vector group and the hand scaling groups, or when comparing the results of the two different operators. CONCLUSION This study demonstrates that Vector treatment with polishing fluid was able to reduce pocket depths and the prevalence of BOP and improve clinical AL in a similar way as scaling with curettes.
Collapse
Affiliation(s)
- Maren Kahl
- Department of Periodontology, School of Dentistry, University of Kiel, Kiel, Germany.
| | | | | | | |
Collapse
|
32
|
Carnevale G, Cairo F, Tonetti MS. Long-term effects of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. I: recurrence of pockets, bleeding on probing and tooth loss. J Clin Periodontol 2007; 34:334-41. [PMID: 17324157 DOI: 10.1111/j.1600-051x.2007.01051.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Periodontal surgery is indicated in the treatment of persistent pockets following cause-related therapy. The aim of this study was to evaluate the long-term effect of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. METHODS Three-hundred and four consecutive patients were identified and retrospectively examined while presenting for a supportive periodontal care (SPC) appointment (T2). All had received non-surgical periodontal treatment and osseous resective surgery as needed, to obtain no sites with probing depth (PD) >3 mm before being enrolled in the SPC programme. The mean SPC duration for the patients was 7.8+/-3.2 years while the mean interval of SPC was 3.4+/-0.8 months. RESULTS During SPC, a total of 67 teeth had been removed (0.9%). At T2, mean full-mouth plaque scores (FMPS) was 13+/-11.3% and full-mouth bleeding scores (FMBS) was 2+/-3%. In 98.5% of the sites, PD was minimal (<or=3 mm). The majority of pockets at T2 showed PDs of 4-5 mm (83.4% of pockets). At the same time, the total number of pockets >or=6 mm was 68 and limited to 41 patients (13.8% of sample). Initial periodontal diagnosis of severe periodontitis, smoking habits, FMBS, number of teeth at completion of active periodontal therapy (T1), number of surgically treated teeth, number of teeth with furcation involvement and number of multi-rooted teeth were associated with the number of pockets at T2. A total of 598 sites (2.1%) displayed bleeding on probing (BOP) at T2. The odds ratio of sites 4 mm or deeper to be BOP positive was 32.9 compared with sites of <3 mm depth. Gender, FMBS, FMPS, furcation involvements and overall number of pockets were associated with the number of bleeding pockets at T2. CONCLUSION Shallow PDs achieved by treatment of the persistent pockets by fibre retention osseous resective surgery can be maintained over time. These patients displayed minimal gingival inflammation and tooth loss during SPC.
Collapse
|
33
|
Radnai M, Gorzó I, Urbán E, Eller J, Novák T, Pál A. Possible association between mother's periodontal status and preterm delivery. J Clin Periodontol 2006; 33:791-6. [PMID: 16970625 DOI: 10.1111/j.1600-051x.2006.00986.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND A case-control study was undertaken to detect whether initial chronic localized periodontitis could be a risk factor for preterm birth (PB) and foetal growth restriction. METHODS A PB case was defined if a patient had a threatening premature event during pregnancy pre-term premature rupture of membranes, or spontaneous pre-term delivery, before the 37th week of pregnancy, and/or the weight of the newborn was <2500 g. Into the PB (case) group, 77 women were allocated, while 84 were included in the control group, all of whom had delivery after the 37th gestational week and with a newborn weighing >or=2500 g. RESULTS A significant association was found between PB and initial chronic localized periodontitis, the criteria being bleeding at >or=50% of the examined teeth and having at least at one site at >or=4 mm probing depth (p=0.0001). The adjusted odds ratio for initial chronic localized periodontitis was 3.32, 95% CI: 1.64-6.69. The average weight of newborns of mothers with periodontitis was significantly less than that of the women without periodontitis (p=0.002). CONCLUSIONS The results support the hypothesis that initial chronic localized periodontitis of pregnant women could lead to PB, and birth-weight reduction.
Collapse
Affiliation(s)
- Márta Radnai
- Department of Dentistry and Oral Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary.
| | | | | | | | | | | |
Collapse
|
34
|
Zitzmann NU, Berglundh T, Lindhe J. Inflammatory lesions in the gingiva following resective/non-resective periodontal therapy. J Clin Periodontol 2005; 32:139-46. [PMID: 15691342 DOI: 10.1111/j.1600-051x.2005.00649.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Findings from previous experiments have revealed that inflammatory cell infiltrates may remain in the gingiva following clinically successful non-surgical periodontal therapy. PURPOSE To investigate the presence of inflammatory lesions in the gingiva following a periodontal treatment procedure that included either soft-tissue resection [gingivectomy (GV)] or non-resective open-flap debridement (OFD). MATERIAL AND METHODS Fifteen patients with advanced generalized chronic periodontitis were recruited. Following oral hygiene instruction and supragingival debridement, one tooth site in each quadrant (non-molar, probing pocket depth>5 mm, bleeding on probing(+) and >50% bone loss) was selected and a soft-tissue biopsy was obtained and prepared for immunohistochemical analysis. Using a split-mouth design, two quadrants were randomly selected for periodontal therapy including GV, while the two remaining quadrants were exposed to non-resective OFD procedure. Six months after completion of surgical treatment, a new set of biopsies was obtained from GV and OFD sites. RESULTS The inflammatory lesions residing in the gingival biopsies obtained prior to surgical therapy were 1.33-1.41 mm(2) large and contained similar proportions of CD19(+)- (B-cells, 15%), CD3(+)- (T-cells, 7%) and elastase(+)- (polymorphonuclear cells, 2%) cells in the two treatment groups. The corresponding lesions identified in the soft-tissue specimens obtained after 6 months of healing were twice as large at OFD as at GV sites (0.19 versus 0.08 mm(2), p=0.002). The densities of CD19(+)- and elastase(+)-cells in these lesions were significantly greater at OFD than at GV sites. CONCLUSION The findings of the present study indicate that surgical therapy including soft-tissue resection results in regenerated gingival units that contain smaller lesions with lower densities of immunocompetent cells when compared with the lesions remaining in sites treated by non-resective means.
Collapse
Affiliation(s)
- N U Zitzmann
- Department of Periodontology, Box 450, Göteborg University, SE-405 30 Göteborg, Sweden.
| | | | | |
Collapse
|
35
|
|
36
|
Büchter A, Meyer U, Kruse-Lösler B, Joos U, Kleinheinz J. Sustained release of doxycycline for the treatment of peri-implantitis: randomised controlled trial. Br J Oral Maxillofac Surg 2004; 42:439-44. [PMID: 15336770 DOI: 10.1016/j.bjoms.2004.06.005] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2004] [Indexed: 11/15/2022]
Abstract
UNLABELLED With the increased use of osseointegrated implants and with many implants functioning for a long time, the treatment of peri-implantitis has become important. Animal studies and clinical case reports have shown that the principle of guided bone regeneration can be applied to the surgical treatment of moderate to profound loss of bone around the implant, but we have found no published clinical studies. PATIENTS AND METHODS Twenty-eight patients whose ages ranged from 25 to 78 years and who had a total of 48 peri-implant defects were examined at baseline (week 0) and after 18 weeks. This included the recording of bleeding on probing, pocket probing depths, and probing attachment levels at six sites for each tooth. For 2-18 weeks before week 0 all patients had been treated for peri-implantitis, including motivation, instruction in oral hygiene, and implant scaling with a hand plastic instrument. They were then randomly allocated to continue with this treatment or to have in addition mechanical debridement and local application of Atridox trade mark which slowly release doxycycline. RESULTS Patients treated with Atridox trade mark showed a significantly greater gain in mean (S.D.) probing attachment levels than those not treated with Atridox. Only subjects treated with Atridox had a significant gain in mean bleeding on probing (P = 0.001). Application of the biodegradable sustained release device after initial periodontal treatment resulted in a significant gain in mean probing attachment levels in the Atridox trade mark group and a significant reduction in pocket probing depths. There was also a significant difference in mean probing attachment levels (0.6mm).
Collapse
Affiliation(s)
- André Büchter
- Department of Cranio-Maxillofacial Surgery, University of Münster, Waldeyerstrasse 30, D-48129 Münster, Germany.
| | | | | | | | | |
Collapse
|
37
|
Ramberg P, Sekino S, Uzel NG, Socransky S, Lindhe J. Bacterial colonization during de novo plaque formation. J Clin Periodontol 2003; 30:990-5. [PMID: 14761122 DOI: 10.1034/j.1600-051x.2003.00419.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine microbial changes that occur during plaque formation in a dentition free of gingival inflammation. MATERIAL AND METHODS Ten subjects were recruited. The study included one preparatory period (2 weeks) and a plaque accumulation period (4 days). The volunteers exercised proper tooth cleaning methods, were scaled and received repeated professional mechanical tooth cleaning during the preparatory period. During the plaque accumulation period, the participants abstained from plaque control measures. Plaque was scored on the approximal surfaces of maxillary and mandibular premolars on Days 0, 1, 2 and 4 using a scale from 0 to 5 and according to the criteria of the Quigley and Hein Plaque Index (QHI). Supragingival plaque samples were obtained from the same intervals and surfaces and evaluated using a checkerboard DNA-DNA hybridization technique. RESULTS The mean QHI increased from 0 to 1.6 (Day 4). The total number of organisms on Day 0 averaged 140 x 10(5) and increased to about 210 x 10(5) after 4 days without oral hygiene. The most dominant species on Day 0 were members of the genus Actinomyces. These organisms comprised almost 50% of the microbiota evaluated. None of the Actinomyces species increased significantly during the 4 days. Some Streptococcus species increased significantly over time as well as species of the genera Capnocytophaga, Campylobacter, Fusobacteria and Actinomyces actinomycetemcomitans. CONCLUSION In the present investigation, the preparatory phase established a situation with minimal gingival inflammation and close to zero amounts of dental plaque. The Day 0 plaque samples exhibited high proportions of Actinomyces species. During the 4 days of no oral hygiene, there was a small increase in total numbers of organisms as well as a modest increase in the proportion of "disease-associated" taxa such as species of the "orange complex" species.
Collapse
Affiliation(s)
- Per Ramberg
- Department of Periodontology, Institute of Odontology, Göteborg University, Sweden.
| | | | | | | | | |
Collapse
|
38
|
Heitz-Mayfield LJA, Trombelli L, Heitz F, Needleman I, Moles D. A systematic review of the effect of surgical debridement vs non-surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol 2003; 29 Suppl 3:92-102; discussion 160-2. [PMID: 12787211 DOI: 10.1034/j.1600-051x.29.s3.5.x] [Citation(s) in RCA: 262] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To systematically review the evidence of effectiveness of surgical vs. non-surgical therapy for the treatment of chronic periodontal disease. METHODS A search was conducted for randomized controlled trials of at least 12 months duration comparing surgical with non-surgical treatment of chronic periodontal disease. Data sources included the National Library of Medicine computerised bibliographic database MEDLINE, and the Cochrane Oral Health Group (COHG) Specialist Trials Register. Screening, data abstraction and quality assessment were conducted independently by multiple reviewers (L.H., F.H., L.T.). The primary outcome measures evaluated were gain in clinical attachment level (CAL) and reduction in probing pocket depth (PPD). RESULTS The search provided 589 abstracts of which six randomized controlled trials were included. Meta-analysis evaluation of these studies indicated that 12 months following treatment, surgical therapy resulted in 0.6 mm more PPD reduction (WMD 0.58 mm; 95% CI 0.38, 0.79) and 0.2 mm more CAL gain (WMD 0.19 mm; 95% CI 0.04, 0.35) than non-surgical therapy in deep pockets (>6 mm). In 4-6 mm pockets scaling and root planing resulted in 0.4 mm more attachment gain (WMD -0.37 mm; 95% CI -0.49, -0.26) and 0.4 mm less probing depth reduction (WMD 0.35 mm; 95% CI 0.23, 0.47) than surgical therapy. In shallow pockets (1-3 mm) non-surgical therapy resulted in 0.5 mm less attachment loss (WMD -0.51 mm; 95% CI -0.74, -0.29) than surgical therapy. CONCLUSIONS Both scaling and root planing alone and scaling and root planing combined with flap procedure are effective methods for the treatment of chronic periodontitis in terms of attachment level gain and reduction in gingival inflammation. In the treatment of deep pockets open flap debridement results in greater PPD reduction and clinical attachment gain.
Collapse
Affiliation(s)
- L J A Heitz-Mayfield
- Department of Periodontology and Fixed Prosthodontics, University of Berne, Berne, Switzerland.
| | | | | | | | | |
Collapse
|
39
|
Heasman PA, McCracken GI, Steen N. Supportive periodontal care: the effect of periodic subgingival debridement compared with supragingival prophylaxis with respect to clinical outcomes. J Clin Periodontol 2003; 29 Suppl 3:163-72; discussion 195-6. [PMID: 12787216 DOI: 10.1034/j.1600-051x.29.s3.9.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The programme of supportive periodontal care (SPC) is essential to the long-term stability of patients with chronic periodontitis. The clinical strategy for SPC is often determined according to 'clinical needs' of the patient and is thus determined by clinical observation and individual decision-making rather than being based on the best available clinical evidence. OBJECTIVE To evaluate the effectiveness of supragingival prophylaxis vs. sub-gingival debridement for SPC following the treatment of chronic periodontitis. SEARCH STRATEGY Computerized for Medline and the Cochrane Oral Health Group Specialty Trials Register. Hand searching of the Journals of Clinical Periodontology, Periodontal Research and Periodontology. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted to obtain additional information. SELECTION CRITERIA Studies were selected if they were designed as a prospective clinical trial in which patients with chronic periodontitis had followed a programme of SPC, which included at least one of the regimens of interest in part of the mouth, for a minimum of 12 months. DATA COLLECTION AND ANALYSIS Information regarding methods, patients, interventions (SPC), outcome measures and results were extracted independently, in duplicate, by two reviewers (P.A.H., G.McC.). Absent data were recorded as such and incomplete data were sought from the researchers wherever possible. RESULTS In all, 28 papers were identified by the manual and electronic searches; 11 papers were eligible for inclusion. Only one study reported a direct comparison of the two SPCs of interest. The data were reported as mean changes in probing depth and attachment level between baseline and the 12-month follow-up point. For coronal scaling DeltaPD = 0.59 mm [0.13], DeltaAL = -0.13 mm [0.19]. For subgingival debridement DeltaPD = 0.37 mm [0.15], DeltaAL = -0.14 mm [0.18]. There were no significant differences between the SPC regimens. The weighted mean DeltaPD [95% confidence intervals] for the five additional studies that reported supragingival prophylaxis as the SPC regimen was 1.15 mm [-0.17, 2.38]. The weighted mean DeltaPD [95% confidence intervals] for the four studies that reported subgingival debridement as the SPC regimen was 0.56 mm [0.37, 1.47]. The difference between the SPC treatments for the mean DeltaPD is therefore 0.23 mm. The confidence interval for the combined studies was very wide [0.37, 1.47] and very little additional information is gained unless some strong assumptions are made about the comparability of the populations from which the samples are drawn. Such an assumption was not considered appropriate. The weighted mean DeltaAL [95% confidence intervals] for the six additional studies that reported supragingival prophylaxis as the SPC regimen was 0.18 mm [-0.38, 0.74]. The weighted mean DeltaAL [95% confidence intervals] for the six additional studies that reported supragingival prophylaxis as the SPC regimen was 0.50 mm [0.11, 0.89]. The difference between the SPC treatments for mean DeltaAL is 0.32 mm. The confidence interval [-0.36, 1.00] is very wide and the data from the additional studies provide little extra information than that reported in the one study that compared the treatments directly. CONCLUSION It is not possible to make any firm recommendations regarding clinical practice based on the crude meta-analysis and the review of these 11 studies. The best available evidence indicates that SPC regimens of supragingival prophylaxis and subgingival debridement are comparable with respect to the clinical outcomes of probing depth and attachment levels at 12 months post non-surgical treatment.
Collapse
Affiliation(s)
- Peter A Heasman
- School of Dental Science, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
| | | | | |
Collapse
|
40
|
Cobb CM. Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing. J Clin Periodontol 2002. [PMID: 12010523 DOI: 10.1034/j.1600-051x.29.s2.4.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Analysis of Egyptian hieroglyphics and medical papyri indicate that non-surgical periodontal treatment was common 3000-4000 years ago. Even today, scaling and root planing (SRP) remains an essential part of successful periodontal therapy. The collective evidence from numerous clinical trials reveals a consistency of clinical response in the treatment of chronic periodontitis by SRP using manual, sonic, or ultrasonic instrumentation. Thus, SRP remains the 'gold standard' to which more recently developed therapeutic modalities must be compared. Inherent to the clinical evaluation of SRP are such concerns as manual versus sonic and ultrasonic instrumentation, control of sub-gingival bacterial populations, removal of calculus, root smoothness and changes in various clinical parameters, e.g. probing depth, attachment levels, bleeding on probing and gingival inflammation. Lastly, an abbreviated discussion is presented on a relatively new paradigm of complete mouth 'disinfection' in a compressed time-frame that includes SRP as a significant component of the treatment regimen.
Collapse
Affiliation(s)
- Charles M Cobb
- Department of Periodontics, School of Dentistry, University of Missouri, Kansas City, MO 64108, USA.
| |
Collapse
|
41
|
Salvi GE, Mombelli A, Mayfield L, Rutar A, Suvan J, Garrett S, Lang NP. Local antimicrobial therapy after initial periodontal treatment. J Clin Periodontol 2002; 29:540-50. [PMID: 12296782 DOI: 10.1034/j.1600-051x.2002.290611.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM The aim of this single-blind, randomized, parallel-designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained-release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy. METHODS Forty-seven patients (28 females and 19 males) with a mean age of 51 years (range 29-71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full-mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox trade mark, Elyzol Dental Gel or PerioChip at all residual periodontal pockets with a probing depth >/= 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters. RESULTS Between the baseline and 18-week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm +/- 0.09 (SD) than subjects treated with Elyzol Dental Gel [0.03 mm +/- 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm +/- 0.10 (SD) found after PerioChip application did not differ significantly from that obtained following the application of Atridox(p = 0.27). Of the sites treated with Atridox, 42% gained >/= 1 mm PAL and 9% >/= 2 mm PAL as opposed to the sites treated with Elyzol Dental Gel, in which 34% gained >/= 1 mm PAL and 8% gained >/= 2 mm PAL. Of the sites treated with PerioChip, 36% gained >/= 1 mm and 6% gained >/= 2 mm PAL following a completed initial periodontal therapy. CONCLUSIONS The application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with Atridox were compared with sites treated with Elyzol, a significant difference in mean PAL gain (0.3 mm) was observed.
Collapse
Affiliation(s)
- Giovanni E Salvi
- University of Berne, School of Dental Medicine, Berne, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
42
|
Moser P, Hammerle CHF, Lang NP, Schlegel-Bregenzer B, Persson R. Maintenance of periodontal attachment levels in prosthetically treated patients with gingivitis or moderate chronic periodontitis 5-17 years post therapy. J Clin Periodontol 2002; 29:531-9. [PMID: 12296781 DOI: 10.1034/j.1600-051x.2002.290610.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The present retrospective analysis was performed to evaluate the long-term results of initial periodontal and fixed prosthodontic treatment in patients with gingivitis or moderate chronic periodontitis during post-therapeutic irregular maintenance of 5-17 years. MATERIAL AND METHODS Thirty-four patients participated in the study. Baseline data were taken from the patients' records when the periodontal and the prosthetic treatment was finished. A follow-up examination was performed in conjunction with the radiographic examination including assessment of plaque, bleeding on probing, probing pocket depth, recession and probing attachment loss. Information regarding the oral hygiene habits of the subjects as well as the amount of dental and initial therapy received between the observation time was obtained from the patients' records. RESULTS The results from the clinical trial revealed that during the mean examination period of 11 years only 31 teeth were lost. The remaining restored and non-restored teeth did not show any significant differences in attachment loss (from 2.9 mm to 3.0 mm) in spite of a higher plaque value at the follow-up examination (from 42% to 48%). The BoP remained stable in the same time period and scored 31% to 28%. CONCLUSIONS The periodontal attachment levels were maintained during a prolonged period despite irregular maintenance care. This indicates that in a population of obviously decreased susceptibility to chronic periodontitis, it is possible that fixed reconstructions will not - even under suboptimal supportive care - jeopardize the periodontal status.
Collapse
Affiliation(s)
- Peter Moser
- Department of Periodontology and Fixed Prosthodontics, University of Berne, Switzerland.
| | | | | | | | | |
Collapse
|
43
|
Abstract
The prevention and treatment of the periodontal diseases is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of disease. Prominent and confirmed risk factors or risk predictors for periodontitis in adults include smoking, diabetes, race, P. gingivalis, P. intermedia, low education, infrequent dental attendance and genetic influences. Several other specific periodontal bacteria, herpesviruses, increased age, male, sex, depression, race, traumatic occlusion and female osteoporosis in the presence of heavy dental calculus have been shown to be associated with loss of periodontal support and can be considered to be risk indicators of periodontitis. The presence of furcation involvement, tooth mobility, and a parafunctional habit without the use of a biteguard are associated with a poorer periodontal prognosis following periodontal therapy. An accurate diagnosis can only be made by a thorough evaluation of data that have been systematically collected by: 1) patient interview, 2) medical consultation as indicated, 3) clinical periodontal examination, 4) radiographic examination, and 5) laboratory tests as needed. Clinical signs of periodontal disease such as pocket depth, loss of clinical attachment and bone loss are cumulative measures of past disease. They do not provide the dentist with a current assessment of disease activity. In an attempt to improve the ability to predict future disease progression, several types of diagnostic tests have been studied, including host inflammatory products and mediators, enzymes, tissue breakdown products and subgingival temperature. In general, the usefulness of these tests for predicting future disease activity remains to be established in terms of sensitivity, specificity and predictive value. Although microbiological analysis of subgingival plaque is not necessary to diagnose and treat most patients with periodontitis, it is helpful when treating patients with unusual forms of periodontal disease such as early-onset, refractory and rapidly progressive disease. There appears to be a strong genetic component in some types of periodontal disease and genetic testing for disease susceptibility has potential for future use, but more research is needed to determine its utility for use in clinical practice. Treatment of the periodontal diseases may be divided into four phases: systemic, hygienic, corrective and maintenance or supportive periodontal therapy. Regardless of the type of treatment provided, periodontal therapy will fail or will be less effective in the absence of adequate supportive periodontal therapy.
Collapse
Affiliation(s)
- B L Pihlstrom
- Oral Health Clinical Research Center, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
44
|
Doungudomdacha S, Rawlinson A, Walsh TF, Douglas CW. Effect of non-surgical periodontal treatment on clinical parameters and the numbers of Porphyromonas gingivalis, Prevotella intermedia
and Actinobacillus actinomycetemcomitans
at adult periodontitis sites. J Clin Periodontol 2002; 28:437-45. [PMID: 11350507 DOI: 10.1034/j.1600-051x.2001.028005437.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND, AIMS The purpose of this study was to relate the numbers of Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans cells to clinical parameters at diseased and healthy periodontal sites before and after non-surgical periodontal therapy using a sensitive quantitative PCR method (Q-PCR). METHOD The sensitivity of the Q-PCR was less than 10 cells for all three species. Subgingival plaque samples were collected from 541 sites in 50 adult periodontitis subjects pre-treatment, post-treatment and at a follow-up visit (3-6 months post-treatment). Pocket probing depth, attachment loss and bleeding on probing were recorded at each visit and both healthy and diseased sites in each subject were sampled. RESULTS Quantification revealed that P. gingivalis counts were associated with pocket depth (p=0.006) and attachment loss (p=0.010); however, neither P. intermedia nor A. actinomycetemcomitans was associated with the clinical signs examined. Post-treatment, there was a significant decrease in the numbers of all three species in both the diseased and healthy sites (86-99%) but none were eradicated. Positive associations were found between any two of the three species studied both pre- and post-therapy. By the follow-up visit, there was a significant improvement in the probing depth of deep sites (p=0.001) but in no other clinical parameters. CONCLUSION This study demonstrates the usefulness of Q-PCR for enumerating putative pathogens in clinical periodontal specimens and that the numbers of the three organisms in all sites decrease with non-surgical periodontal therapy.
Collapse
Affiliation(s)
- S Doungudomdacha
- Department of Oral Pathology, School of Clinical Dentistry, University of Sheffield, UK
| | | | | | | |
Collapse
|
45
|
Ramberg P, Rosling B, Serino G, Hellström MK, Socransky SS, Lindhe J. The long-term effect of systemic tetracycline used as an adjunct to non-surgical treatment of advanced periodontitis. J Clin Periodontol 2002; 28:446-52. [PMID: 11350508 DOI: 10.1034/j.1600-051x.2001.028005446.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM In the present study both the short- and the long-term effects were evaluated of a treatment that, during the phase of basic therapy, included administration of systemic tetracycline and non-surgical intervention. MATERIAL AND METHODS 35 adult human subjects with advanced periodontitis, 19 females and 16 males, aged between 24 and 60 years, were included in a test group. 80 age- and sex-matched adult periodontitis subjects were recruited for a control group (42 females and 38 males). A baseline examination included assessment of the following parameters: number of teeth, plaque, bleeding on probing, probing attachment level, probing pocket depth. In radiographs, the distance between the cemento-enamel junction and the alveolar bone crest was determined at all interproximal sites. The subjects were given oral hygiene instruction. The members of the test group were provided with tablets with 250 mg of tetracycline hydrochloride and were instructed to take 1 tablet 4x per day for a period of 3 weeks. No antibiotic was given to the subjects in the control group. During the 3-week interval, all participants received 4-6 sessions of non-surgical periodontal therapy. All subjects were subsequently enrolled in a maintenance care program and were provided with supportive periodontal therapy (SPT) 3-4x per year. Clinical re-examinations were performed after 1, 3, 5 and 13 years. RESULTS The present investigation demonstrated that tetracycline administered during a 3-week period concomitant with non-surgical treatment enhanced the outcome of mechanical therapy. At the re-examination 1 year after active therapy, there was in the test group an average gain in probing attachment that was almost 3x higher than the gain that occurred in an age and sex matched Control group. Re-examinations after 3, 5, and 13 years of SPT disclosed that this short-term benefit was not maintained in the longer perspective. CONCLUSION The beneficial effect of systemically administered tetracycline on probing attachment level occurred in the first year post-therapy. Annual rates of probing attachment level change from 1 to 13 years did not differ between groups.
Collapse
Affiliation(s)
- P Ramberg
- Department of Periodontology, Faculty of Odontology, Göteborg University, Sweden
| | | | | | | | | | | |
Collapse
|
46
|
Beuchat M, Busslinger A, Schmidlin PR, Michel B, Lehmann B, Lutz F. Clinical comparison of the effectiveness of novel sonic instruments and curettes for periodontal debridement after 2 months. J Clin Periodontol 2001; 28:1145-50. [PMID: 11737512 DOI: 10.1034/j.1600-051x.2001.281209.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study was to evaluate in vivo the effectiveness of scaling and root planing of new oscillating instruments (Periosonic) using a sonic handpiece compared to hand curettes with a split mouth design after 2 months. METHODS 11 patients with adult periodontitis participated in this study. Plaque index (PII) (O'Leary), bleeding on probing (BOP), probing pocket depth (PPD), recession (REC) and clinical attachment level (CAL) were recorded at baseline and 2 months after treatment. After oral hygiene instruction, 2 randomly assigned quadrants per patient were scaled and root planed with curettes (control side) and the remaining 2 quadrants with the Periosonic instruments 1 and 2 (test side). The student t-test for paired data was used to test the significance of difference between test and control sides. RESULTS There was no statistical difference (p>0.05) between the 2 sides for the improvement of the clinical parameters excepted for the group with initial PPD of 4-6 mm (test: 1.3+/-0.4 mm PPD reduction, control: 1.6+/-0.4 mm). For PPD > or =7 mm, the test side had better clinical improvement in attachment levels (2.2+/-0.9 mm), less recession (-0.4+/-0.5 mm) with lower PPD reduction (2.4+/-0.6 mm) than the control side (AL: 1.6+/-1.8 mm; REC: -1.3+/-0.7 mm, PPD reduction: 3.0+/-1.4 mm). CONCLUSION This clinical study demonstrated that Periosonic(R) instruments are clinically at least as effective as curettes in PPD reduction when initial PPD is < or =6 mm and show better clinical attachment level improvement with less recession for initial PPD of > or =7 mm.
Collapse
Affiliation(s)
- M Beuchat
- Department of Preventive Dentistry, Periodontology and Cariology, Division of Periodontology, University of Zurich, Switzerland.
| | | | | | | | | | | |
Collapse
|
47
|
Serino G, Rosling B, Ramberg P, Socransky SS, Lindhe J. Initial outcome and long-term effect of surgical and non-surgical treatment of advanced periodontal disease. J Clin Periodontol 2001; 28:910-6. [PMID: 11686808 DOI: 10.1034/j.1600-051x.2001.028010910.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM A clinical trial was performed to determine (i) the initial outcome of non-surgical and surgical access treatment in subjects with advanced periodontal disease and (ii) the incidence of recurrent disease during 12 years of maintenance following active therapy. MATERIAL AND METHODS Each of the 64 subjects included in the trial showed signs of (i) generalized gingival inflammation, (ii) had a minimum of 12 non-molar teeth with deep pockets (> or =6 mm) and with > or =6 mm alveolar bone loss. They were randomly assigned to 2 treatment groups; one surgical (SU) and one non-surgical (SRP). Following a baseline examination, all patients were given a detailed case presentation which included oral hygiene instruction. The subjects in SU received surgical access therapy, while in SRP non-surgical treatment was provided. After this basic therapy, all subjects were enrolled in a maintenance care program and were provided with meticulous supportive periodontal therapy (SPT) 3-4 times per year. Sites that at a recall appointment bled on gentle probing and had a PPD value of > or =5 mm were exposed to renewed subgingival instrumentation. Comprehensive re-examinations were performed after 1, 3, 5 and 13 years of SPT. If a subject between annual examinations exhibited marked disease progression (i.e., additional PAL loss of > or =2 mm at > or =4 teeth), he/she was exited from the study and given additional treatment. RESULTS It was observed that (i) surgical therapy (SU) was more effective than non-surgical scaling and root planing (SRP) in reducing the overall mean probing pocket depth and in eliminating deep pockets, (ii) more SRP-treated subjects exhibited signs of advanced disease progression in the 1-3 year period following active therapy than SU-treated subjects. CONCLUSION In subjects with advanced periodontal disease, surgical therapy provides better short and long-term periodontal pocket reduction and may lead to fewer subjects requiring additional adjunctive therapy.
Collapse
Affiliation(s)
- G Serino
- Department of Periodontology, Faculty of Odontology, Göteborg University, Sweden
| | | | | | | | | |
Collapse
|
48
|
Haffajee AD, Thompson M, Torresyap G, Guerrero D, Socransky SS. Efficacy of manual and powered toothbrushes (I). Effect on clinical parameters. J Clin Periodontol 2001; 28:937-46. [PMID: 11686812 DOI: 10.1034/j.1600-051x.2001.028010937.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIM The purpose of the present investigation was to compare manual (Crest Complete) and powered toothbrushing (Braun Oral-B 3D Plaque Remover) for their ability to affect clinical parameters of periodontal diseases. METHODS 48 periodontal maintenance subjects completed this single-blind 6-month longitudinal study. Subjects had a minimum of 20 natural teeth excluding third molars and >10% of sites (approximately 17 sites) with pocket depth > or =4 mm and/or >10% sites with attachment level >4 mm. At baseline, subjects received full mouth clinical measurements (168 sites) to determine mean Plaque Index, Gingival Index, pocket depth and attachment level and % of sites exhibiting BOP. Subjects were then randomly assigned to one of two groups. The control group (N=26) used a manual toothbrush while the test group (N=22) used a powered toothbrush. Subjects received instruction in oral hygiene and used their assigned toothbrush twice daily according to instruction. Follow-up clinical assessments were performed at 3 and 6 months. Significance of differences in clinical measures over time was determined using the Quade test and between brushing groups at each time point using the Mann-Whitney test. RESULTS Mean pocket depth, mean plaque index and % of sites exhibiting BOP showed significant reductions from baseline to 3 and 6 months in both groups. Mean probing attachment level and mean Gingival Index were significantly reduced in the powered brushing group only. There was a significant positive correlation between plaque reduction and reduction in other clinical parameters in both brushing groups. The majority of subjects showed improvements in clinical parameters at 6 months, although a greater proportion of subjects in the powered group showed a reduction in Plaque Index (77% versus 65%) and in % sites exhibiting BOP (82% versus 69%). Mean pocket depth and mean attachment level showed significantly greater reductions between baseline and 6 months in lingual and mandibular areas in the powered group. CONCLUSIONS Both manual and powered toothbrushes reduced pocket depth, plaque index and BOP. The powered toothbrush significantly reduced mean gingival index and probing attachment level. The greatest benefit of the powered brush was at mandibular and lingual surfaces.
Collapse
Affiliation(s)
- A D Haffajee
- Department of Periodontology,The Forsyth Institute, 140 The Fenway, Boston, MA 02115-3799, USA
| | | | | | | | | |
Collapse
|
49
|
Park JS, Suh JJ, Choi SH, Moon IS, Cho KS, Kim CK, Chai JK. Effects of pretreatment clinical parameters on bioactive glass implantation in intrabony periodontal defects. J Periodontol 2001; 72:730-40. [PMID: 11453234 DOI: 10.1902/jop.2001.72.6.730] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The various methods for regeneration of periodontal tissue that have been developed can be classified into guided tissue regeneration and bone implantation. Since the implantation materials have shown both deficiencies and merits, dentists have begun exploring the bioactive glass first used in plastic surgery. This paper examines the effectiveness of this new material on periodontal intrabony defects. METHODS Clinical effects of bioactive glass implantation in intrabony periodontal defects were evaluated 6 months after surgery in 38 intrabony defects from 38 patients with chronic periodontitis. Twenty-one experimental defects received bioactive glass implantation (test group), while 17 control defects were treated with a flap procedure only (control group). The criteria for comparative observation were preoperative and postoperative probing depth (PD), clinical attachment level (CAL), bone probing depth (BPD), and gingival recession. RESULTS Reductions in PD were observed in both groups (P<0.01). The reduction in PD was significantly greater in the test group when preoperative PD exceeded 7 mm (P<0.01). Improvements in CAL were also observed in both groups (P<0.01), with the test group showing significantly greater gains (P<0.05). In those cases where preoperative CAL was less than 7 mm, there was no statistically significant difference between the two groups. Reduction in BPD was observed in both groups, with the test group showing significantly greater reduction (P <0.01). There was no significant difference in BPD change, however, when preoperative BPD was < or =7 mm. Significantly greater reduction of BPD in the test group was observed when intrabony defect depth was >4 mm (P <0.05). Significant improvements in PD, CAL, and BPD were noted in the test group when the crestal involvement exceeded 100 degrees. Correlation test between various clinical parameters indicated that greater changes in PD and CAL in the test group were observed when preoperative CAL was large (P<0.001), and greater changes in PD (P<0.05), CAL (P<0.01), and BPD (P<0.05) were noted when preoperative BPD was large. Correlation between crestal involvement and CAL change was noted only in the control group (P<0.01). High correlations were observed between PD changes and CAL changes and between CAL changes and BPD changes in both groups. CONCLUSIONS Use of a bone substitute in a flap operation resulted in significantly greater improvements in CAL and BPD over flap operation alone and seemed to have positive effects in postoperative PD, CAL, and BPD in those cases with more severe preoperative CAL and BPD.
Collapse
Affiliation(s)
- J S Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seodaemun-gu, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
50
|
Rosling B, Serino G, Hellström MK, Socransky SS, Lindhe J. Longitudinal periodontal tissue alterations during supportive therapy. Findings from subjects with normal and high susceptibility to periodontal disease. J Clin Periodontol 2001; 28:241-9. [PMID: 11284537 DOI: 10.1034/j.1600-051x.2001.028003241.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of the study was to evaluate disease progression during supportive periodontal therapy in (i) a group of 225 subjects with "normal" (NG) and (ii) a group with high susceptibility (HSG; n= 109) to periodontal disease (based on their baseline disease status). MATERIAL AND METHODS The following variables were recorded at the baseline examination (1 year after they received non-surgical periodontal therapy) and at the re-examination after 12 years of maintenance: number of teeth, plaque, probing pocket depth, probing attachment level, bone level in full mouth radiographs. All assessments were performed in a standardized manner and by well-trained and calibrated examiners. Supportive periodontal therapy was delivered 3-4 x per year and included repeated oral hygiene instruction and debridement. In addition, sites that bled on probing and had a PPD value of > or = 5 mm received subgingival instrumentation. RESULTS A comparison between the findings at baseline and after 12 years revealed that in the NG, most subjects maintained their periodontal condition unchanged during the maintenance period; only a few subjects experienced tooth loss and the figures describing the mean amount of bone and attachment loss were small (0.5 mm and 0.3 mm respectively). The HSG patients experienced some tooth loss and also lost significant amounts of bone and attachment during the 12 years of SPT. Thus, in this group of subjects, the mean overall PAL loss amounted to 0.8 mm, i.e., 0.06 mm/tooth surface/year. In the NG, the overall attachment loss was significantly smaller: 0.5 mm, i.e. 0.04 mm/tooth surface/year. CONCLUSION In subjects with a high susceptibility for periodontal disease who had been treated for this condition by non-surgical means, an SPT program including regularly repeated oral hygiene instruction and subgingival debridement, made it possible to maintain bone and attachment levels at a reasonably stable level over a 12-year period. A similar SPT provided to a group of subjects with normal susceptibility to periodontal disease, on the other hand, prevented almost entirely major tooth, bone and attachment loss.
Collapse
Affiliation(s)
- B Rosling
- Department of Periodontology, Faculty of Odontology, Gothenburg University, Sweden
| | | | | | | | | |
Collapse
|