1
|
Barbato L, Noce D, Di Martino M, Castelluzzo W, Spoleti F, Rupe C, Nieri M, Cairo F. Non-surgical retreatment versus papillary preservation flap surgery for residual pockets: A randomized controlled trial with clinical and patient-reported outcomes. J Clin Periodontol 2024. [PMID: 39011585 DOI: 10.1111/jcpe.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/10/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024]
Abstract
AIM To compare the efficacy of non-surgical re-instrumentation (NSR) and papillary preservation flap (PPF) surgery at single-rooted teeth with residual pockets. MATERIALS AND METHODS Patients with at least a residual pocket depth (PD ≥ 5 mm) after Steps I and II were enrolled and randomly assigned to receive NSR or PPF surgery. The primary outcome was PD reduction, and secondary outcomes were clinical attachment level (CAL) change and patient-reported outcome measures (PROMs). Outcome variables were measured at baseline, 3 and 6 months. The examiner was blinded. Statistical analysis, one site for each patient, included descriptive statistics and analysis of covariance. RESULTS Forty-six participants were enrolled, and one patient dropped out in the PPF group. After 6 months, both treatments resulted in significant PD reduction (1.3 ± 1.2 mm, p = .009 NSR; 2.0 ± 0.7 mm, p < .001 PPF) and CAL gain (1.0 ± 2.4 mm, p = .031 NSR; 1.4 ± 0.8 mm, p < .001 PPF). PD reduction between groups was not statistically significant (diff: 0.6 mm; 95% confidence interval [CI] [-0.3 to 1.5]; p = .167). Pocket closure was 61% NSR versus 86% PPF (p = .091). Smoking was associated with less PD reduction of almost 1 mm in both treatments. Treatment time was longer for PPF surgery, but PROMs and post-operative pain were similar between groups. CONCLUSIONS Both NSR and PPF reduced PD without significant difference between treatments at 6 months. PPF surgery may offer faster PD reduction, but smoking habits reduce treatment efficacy.
Collapse
Affiliation(s)
- Luigi Barbato
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| | - Desirée Noce
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| | - Maria Di Martino
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| | - Walter Castelluzzo
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| | - Folco Spoleti
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| | - Cosimo Rupe
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| | - Francesco Cairo
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
- EFP Accredited Master Program in Periodontology and Implant Dentistry, University of Florence, Florence, Italy
| |
Collapse
|
2
|
Werner N, Heck K, Walter E, Ern C, Bumm CV, Folwaczny M. Probing pocket depth reduction after non-surgical periodontal therapy: Tooth-related factors. J Periodontol 2024; 95:29-39. [PMID: 37436696 DOI: 10.1002/jper.23-0285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND To investigate tooth-related factors that influence the reduction of probing pocket depths (PPD) after non-surgical periodontal therapy (NST). METHODS Seven hundred forty-six patients with a total of 16,825 teeth were included and retrospectively analyzed. PPD reduction after NST was correlated with the tooth-related factors; tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration; using logistic multilevel regression for statistical analysis. RESULTS NST was able to reduce probing depth overall stratified probing depths (1.20 ± 1.51 mm, p ≤ 0.001). The reduction was significantly higher at teeth with higher probing depths at baseline. At pockets with PPD ≥ 6 mm, PPD remains high after NST. Tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration are significantly and independently associated with the rate of pocket closure. CONCLUSIONS The tooth-related factors: tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration had a significant and clinically relevant influence on phase I and II therapy. Considering these factors in advance may enhance the prediction of sites not responding adequately and the potential need for additional treatment, such as re-instrumentation or periodontal surgery, to ultimately achieve the therapy end points.
Collapse
Affiliation(s)
- Nils Werner
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
| | - Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
| | - Elias Walter
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
| | | | - Caspar Victor Bumm
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
- Private practice, Munich, Germany
| | - Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, Germany
| |
Collapse
|
3
|
Graziani F, Gennai S, Marruganti C, Peric M, Ghiadoni L, Marhl U, Petrini M. Acute-phase response following one-stage full-mouth versus quadrant non-surgical periodontal treatment in subjects with comorbid type 2 diabetes: A randomized clinical trial. J Clin Periodontol 2023; 50:487-499. [PMID: 36517997 DOI: 10.1111/jcpe.13760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 11/17/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
AIM To compare the level of inflammatory markers and endothelial function 24 h (Day 1) and 90 days (Day 90) after conventional quadrant-wise scaling and root planing (Q-SRP) versus one-stage full-mouth SRP (FM-SRP) in patients affected by type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS Patients affected by periodontitis and T2DM were randomly allocated to receive FM-SRP or Q-SRP and followed up at Day 1 and Day 90. Serum samples, vital signs, and flow-mediated dilation (FMD) parameters were collected at baseline, Day 1, and Day 90. Periodontal variables were collected at baseline and Day 90. The primary outcome was the C-reactive protein (CRP) concentration at Day 1 after periodontal treatment. Student's t-test for independent samples was used for between-group comparisons (Mann-Whitney U test for non-normal data), while analysis of variance with post hoc Tukey tests (Kruskal-Wallis and Dunn tests for non-normal data) were used for intra-group comparisons. RESULTS Forty subjects were included in the study. FM-SRP produced a significant increase in CRP and a significant reduction in FMD at Day 1 compared to Q-SRP (p < .05). The absolute change in HbA1c (mmol/mol) from baseline to Day 90 was significantly improved in the Q-SRP (ΔHbA1c = -1.59 [SD = 1.20]) compared to the FM-SRP group (ΔHbA1c = -0.8 [SD = 0.95]) (p = .04). CONCLUSIONS FM-SRP triggers a robust acute-phase response at 24 h after treatment compared to Q-SRP. Such systemic acute perturbations may offset the beneficial systemic effects of periodontal treatment in terms of HbA1c reduction and improvement in endothelial function in T2DM subjects.
Collapse
Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Crystal Marruganti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
- Unit of Periodontology, Endodontology and Restorative dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marina Peric
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Urska Marhl
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Morena Petrini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Department of Medical, Oral and Biotechnological Science, University of Chieti, Chieti, Italy
| |
Collapse
|
4
|
Jervøe-Storm PM, Eberhard J, Needleman I, Worthington HV, Jepsen S. Full-mouth treatment modalities (within 24 hours) for periodontitis in adults. Cochrane Database Syst Rev 2022; 6:CD004622. [PMID: 35763286 PMCID: PMC9239328 DOI: 10.1002/14651858.cd004622.pub4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Periodontitis is a highly prevalent, chronic inflammation that causes damage to the soft tissues and bones supporting the teeth. Conventional treatment is quadrant scaling and root planing (the second step of periodontal therapy), which comprises scaling and root planing of teeth in one quadrant of the mouth at a time, with the four different sessions separated by at least one week. Alternative protocols for anti-infective periodontal therapy have been introduced to help enhance treatment outcomes: full-mouth scaling (subgingival instrumentation of all quadrants within 24 hours), or full-mouth disinfection (subgingival instrumentation of all quadrants in 24 hours plus adjunctive antiseptic). We use the older term 'scaling and root planing' (SRP) interchangeably with the newer term 'subgingival instrumentation' in this iteration of the review, which updates one originally published in 2008 and first updated in 2015. OBJECTIVES To evaluate the clinical effects of full-mouth scaling or full-mouth disinfection (within 24 hours) for the treatment of periodontitis compared to conventional quadrant subgingival instrumentation (over a series of visits at least one week apart) and to evaluate whether there was a difference in clinical effects between full-mouth disinfection and full-mouth scaling. SEARCH METHODS An information specialist searched five databases up to 17 June 2021 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) lasting at least three months that evaluated full-mouth scaling and root planing within 24 hours, with or without adjunctive use of an antiseptic, compared to conventional quadrant SRP (control). Participants had a clinical diagnosis of (chronic) periodontitis according to the International Classification of Periodontal Diseases from 1999. A new periodontitis classification was launched in 2018; however, we used the 1999 classification for inclusion or exclusion of studies, as most studies used it. We excluded studies of people with systemic disorders, taking antibiotics or with the older diagnosis of 'aggressive periodontitis'. DATA COLLECTION AND ANALYSIS Several review authors independently conducted data extraction and risk of bias assessment (based on randomisation method, allocation concealment, examiner blinding and completeness of follow-up). Our primary outcomes were tooth loss and change in probing pocket depth (PPD); secondary outcomes were change in probing attachment (i.e. clinical attachment level (CAL)), bleeding on probing (BOP), adverse events and pocket closure (the number/proportion of sites with PPD of 4 mm or less after treatment). We followed Cochrane's methodological guidelines for data extraction and analysis. MAIN RESULTS We included 20 RCTs, with 944 participants, in this updated review. No studies assessed the primary outcome tooth loss. Thirteen trials compared full-mouth scaling and root planing within 24 hours without the use of antiseptic (FMS) versus control, 13 trials compared full-mouth scaling and root planing within 24 hours with adjunctive use of an antiseptic (FMD) versus control, and six trials compared FMS with FMD. Of the 13 trials comparing FMS versus control, we assessed three at high risk of bias, six at low risk of bias and four at unclear risk of bias. We assessed our certainty about the evidence as low or very low for the outcomes in this comparison. There was no evidence for a benefit for FMS over control for change in PPD, gain in CAL or reduction in BOP at six to eight months (PPD: mean difference (MD) 0.03 mm, 95% confidence interval (CI) -0.14 to 0.20; 5 trials, 148 participants; CAL: MD 0.10 mm, 95% CI -0.05 to 0.26; 5 trials, 148 participants; BOP: MD 2.64%, 95% CI -8.81 to 14.09; 3 trials, 80 participants). There was evidence of heterogeneity for BOP (I² = 50%), but none for PPD and CAL. Of the 13 trials comparing FMD versus control, we judged four at high risk of bias, one at low risk of bias and eight at unclear risk of bias. At six to eight months, there was no evidence for a benefit for FMD over control for change in PPD or CAL (PPD: MD 0.11 mm, 95% CI -0.04 to 0.27; 6 trials, 224 participants; low-certainty evidence; CAL: 0.07 mm, 95% CI -0.11 to 0.24; 6 trials, 224 participants; low-certainty evidence). The analyses found no evidence of a benefit for FMD over control for BOP (very low-certainty evidence). There was no evidence of heterogeneity for PPD or CAL, but considerable evidence of heterogeneity for BOP, attributed to one study. There were no consistent differences in these outcomes between intervention and control (low- to very low-certainty evidence). Of the six trials comparing FMS and FMD, we judged two trials at high risk of bias, one at low risk of bias and three as unclear. At six to eight months, there was no evidence of a benefit of FMD over FMS for change in PPD or gain in CAL (PPD: MD -0.11 mm, 95% CI -0.30 to 0.07; P = 0.22; 4 trials, 112 participants; low-certainty evidence; CAL: MD -0.05 mm, 95% CI -0.23 to -0.13; P = 0.58; 4 trials, 112 participants; low-certainty evidence). There was no evidence of a difference between FMS and FMD for BOP at any time point (P = 0.98; 2 trials, 22 participants; low- to very low-certainty evidence). There was evidence of heterogeneity for BOP (I² = 52%), but not for PPD or CAL. Thirteen studies predefined adverse events as an outcome; three reported an event after FMD or FMS. The most important harm identified was an increase in body temperature. We assessed the certainty of the evidence for most comparisons and outcomes as low because of design limitations leading to risk of bias, and the small number of trials and participants, leading to imprecision in the effect estimates. AUTHORS' CONCLUSIONS The inclusion of nine new RCTs in this updated review has not changed the conclusions of the previous version of the review. There is still no clear evidence that FMS or FMD approaches provide additional clinical benefit compared to conventional mechanical treatment for adult periodontitis. In practice, the decision to select one approach to non-surgical periodontal therapy over another should include patient preference and the convenience of the treatment schedule.
Collapse
Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Jörg Eberhard
- Faculty of Dentistry, The University of Sydney, Sydney Dental Hospital, Sydney, Australia
| | - Ian Needleman
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| |
Collapse
|
5
|
Wang J, Wu S, Li Z, Liu L, Pang Y, Wei J. Inhibition of nuclear factor kappa B inducing kinase suppresses inflammatory responses and the symptoms of chronic periodontitis in a mouse model. Int J Biochem Cell Biol 2021; 139:106052. [PMID: 34364989 DOI: 10.1016/j.biocel.2021.106052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/24/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
Chronic periodontitis is an inflammatory disease that represents a major public health issue nowadays. Here, we investigated the protective role of nuclear factor kappa B (NF-κB) inducing kinase (NIK)-inhibitor on chronic periodontitis and revealed the underlying molecular mechanism. NIK-inhibitor was synthesized, and its functions were examined in primary osteoclasts and wild-type (WT) and NIK-/- chronic periodontitis mouse model. Lipopolysaccharides (LPS) or activator of NF-κB was applied to stimulate inflammatory response of osteoclasts. The qRT-PCR, ELISA and Western blot were used to measure the expression of pro-inflammatory and osteoclast-related genes, and the activation of NF-κB signaling. Osteoclastogenesis and bone damage were detected by TRAP staining and micro-CT. NIK knockdown mice had lower expression of osteoclast-related genes and improved CEJ-ABC damage. Similarly, NIK-inhibitor administration inhibited inflammatory responses and CEJ-ABC damage in chronic periodontitis models. NIK-inhibitor suppressed osteoclastogenesis and osteoclast-related genes expression through inhibiting the non-canonical NF-κB signaling. NIK plays important role in bone destruction of chronic periodontitis and NIK-inhibitor represents a promising therapeutic strategy for this disease.
Collapse
Affiliation(s)
- Jianqi Wang
- Department of Stomatology Clinic, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, Hebei, 061000, China.
| | - Shuainan Wu
- Department of Stomatology Clinic, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, Hebei, 061000, China
| | - Zhaobao Li
- Department of Stomatology Clinic, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, Hebei, 061000, China
| | - Lu Liu
- Department of Stomatology Clinic, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, Hebei, 061000, China
| | - Ying Pang
- Department of Stomatology Clinic, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, Hebei, 061000, China
| | - Jianming Wei
- Department of Stomatology Clinic, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou, Hebei, 061000, China
| |
Collapse
|
6
|
Rawlinson A, Vettore MV, Baker SR, Robinson PG. Periodontal treatment, psychological factors and oral health-related quality of life. J Clin Periodontol 2020; 48:226-236. [PMID: 33263182 DOI: 10.1111/jcpe.13405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/19/2020] [Accepted: 11/22/2020] [Indexed: 12/26/2022]
Abstract
AIMS To determine changes in OHRQoL and clinical status after periodontal treatment and the factors predicting these changes. METHODS Cohort of 140 patients with chronic periodontitis receiving non-surgical treatment. Participant self-completed questionnaires: Sense of Coherence, Locus of Control, Self-esteem and Task-specific Self-efficacy before treatment, and Oral Health Impact Profile at treatment, oral hygiene review and end of study. Relationships between OHRQoL, clinical data, individual and environmental characteristics were analysed with structural equation modelling guided by the Wilson and Cleary model. RESULTS OHRQoL and the periodontal status improved after treatment. Greater sense of coherence and age, better periodontal status, lower DMFT and being male predicted better OHRQoL after treatment. Better task-specific self-efficacy and self-esteem, but worse plaque score predicted better end periodontal status. CONCLUSIONS OHRQoL and periodontal status improved after periodontal treatment, and this was predicted by individual demographic and psychological factors. These factors may assist with case selection and as possible points for intervention to improve clinical and subjective outcomes of periodontal treatment.
Collapse
Affiliation(s)
- Andrew Rawlinson
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Mario V Vettore
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sarah R Baker
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | | |
Collapse
|
7
|
Li Y, Zheng JN, Wang EH, Lan KF, Gong CJ, Ding X. Application of weighted gene co-expression network analysis to reveal key modules and hub genes in generalized aggressive periodontitis. Arch Oral Biol 2020; 119:104895. [PMID: 32916454 DOI: 10.1016/j.archoralbio.2020.104895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to construct a gene co-expression network to identify key modules and genes in people with generalized aggressive periodontitis. METHODS We used database GSE79705 to construct a co-expression network by weighted gene co-expression network analysis (WGCNA). In addition, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were conducted. RESULTS A total of 51 co-expression modules were conducted, darkseagreen1 and blue1 modules were the most significantly related to generalized aggressive periodontitis. Genes in the darkseagreen1 module enriched in affecting cellular response to tumor necrosis factor and vascular endothelial growth factor production, and the blue1 module enriched in the regulation of ion transport, proteinaceous extracellular matrix and neuropeptide binding. Besides, we found that 4 hub genes (SNRPG, MRPL22, MRPS18C and CEP290) played an important role in the occurrence of generalized aggressive periodontitis. CONCLUSION Through this study, we identified two modules and four hub genes associated with generalized aggressive periodontitis. Besides, 4 hub genes (SNRPG, MRPL22, MRPS18C and CEP290) can be expected to trigger new therapeutic drug development for generalized aggressive periodontitis.
Collapse
Affiliation(s)
- Yang Li
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, PR China; State key laboratory of molecular engineering of polymers, Fudan University, Shanghai, PR China
| | - Ji-Na Zheng
- Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - En-Hao Wang
- Department of Otolaryngology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Keng-Fu Lan
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Chan-Juan Gong
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - XiaoJun Ding
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, PR China.
| |
Collapse
|
8
|
Campisciano G, Toschetti A, Comar M, Taranto RD, Berton F, Stacchi C. Shifts of subgingival bacterial population after nonsurgical and pharmacological therapy of localized aggressive periodontitis, followed for 1 year by Ion Torrent PGM platform. Eur J Dent 2019; 11:126-129. [PMID: 28435379 PMCID: PMC5379826 DOI: 10.4103/ejd.ejd_309_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The possibility of targeting the hypervariable region V3 of the 16S rRNA gene using Ion Torrent Personal Genome Machine (PGM) could provide a complete analysis of subgingival plaque samples, potentially able to identify microbiological species missed by culture-based methods. A 16-year-old female smoker patient, affected by localized aggressive periodontitis, underwent a full-mouth disinfection protocol and was inserted in a 3-month recall program. Microbiological samples were collected at baseline and at 30, 100, 365 days follow-up and analyzed by Ion Torrent PGM. Capnocytophaga, Fusobacterium, Prevotella, and Treponema were the most represented pathogens at baseline. Nonsurgical treatment and systemic antibiotics drastically lowered the anaerobic species, and their presence remained limited after 100 days, while a consistent recolonization by anaerobic bacteria was detected at 365 days. The patient showed a general improvement of periodontal conditions. Differently from polymerase chain reaction and other microarray techniques, Ion Torrent performs a quantitative analysis of the microbiota, irrespective of the searched species. An accurate definition of the shifts of the bacterial community might help periodontal researchers for a better understanding of the impact of different treatment approaches or in intercepting nonresponsive conditions.
Collapse
Affiliation(s)
- Giuseppina Campisciano
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,Advanced Diagnostics Department, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Manola Comar
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,Advanced Diagnostics Department, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Federico Berton
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| |
Collapse
|
9
|
Hormdee D, Prajaneh S, Kampichai A, Tak R, Chaiyarit P. Prolonged Suppressive Effects of Periodontitis on Salivary TFF3 Production. Eur J Dent 2019; 13:193-198. [PMID: 31466117 PMCID: PMC6777149 DOI: 10.1055/s-0039-1693949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective
As a follow-up to our previous study that demonstrated decreased salivary trefoil factor family 3 (TFF3) peptide levels in chronic periodontitis patients, this current study aimed to observe the effects of nonsurgical periodontal treatment on salivary TFF3 peptides in patients with periodontal diseases.
Materials and Methods
Eighty-seven volunteers that comprised of 30 individuals with healthy periodontium, 31 with gingivitis, and 26 with chronic periodontitis were considered for the study. Prior to periodontal treatment, a general periodontal examination was performed along with collection of saliva samples from each volunteer. Nonsurgical periodontal treatments were provided to patients with gingivitis and periodontitis. Two weeks post-treatment, saliva samples were recollected, and the periodontal status was re-evaluated. Salivary TFF3 concentrations were measured by enzyme-linked immunosorbent assay.
Statistical Analysis
Mann–Whitney U test was used when the investigated data were not normally distributed. Chi-squared test was used when dealing with categorical data. Kruskal–Wallis test with post-hoc corrections was used to compare data among the three investigated groups. Two-tailed
p
< 0.05 was considered as statistically significant.
Results
Prior to the periodontal treatment, salivary TFF3 concentrations in patients with gingivitis and periodontitis were significantly lower than those with healthy periodontium. Two weeks post-treatment, increased levels of salivary TFF3 were observed in patients with gingivitis, whereas the concentrations decreased in patients with chronic periodontitis.
Conclusion
This study demonstrated the effects of periodontal disease on the production of salivary TFF3 peptides. Interestingly, nonsurgical periodontal treatment also affected the recovery of salivary TFF3 peptides but varied in their outcomes between gingivitis and periodontitis patients.
Collapse
Affiliation(s)
- Doosadee Hormdee
- Division of Periodontology, Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.,Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases Associated with Oral Health, Khon Kaen University, Thailand
| | - Saengsome Prajaneh
- Division of Periodontology, Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | | | - Ranuch Tak
- Faculty of Dentistry, International University, Phnom Penh, Cambodia
| | - Ponlatham Chaiyarit
- Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases Associated with Oral Health, Khon Kaen University, Thailand.,Division of Oral Diagnosis, Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
10
|
Yashima A, Morozumi T, Yoshie H, Hokari T, Izumi Y, Akizuki T, Mizutani K, Takamatsu H, Minabe M, Miyauchi S, Yoshino T, Tanaka M, Tanaka Y, Gomi K. Biological responses following one‐stage full‐mouth scaling and root planing with and without azithromycin: Multicenter randomized trial. J Periodontal Res 2019; 54:709-719. [DOI: 10.1111/jre.12680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/22/2019] [Accepted: 06/09/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Akihiro Yashima
- Department of Periodontology, School of Dental Medicine Tsurumi University Yokohama Japan
| | - Toshiya Morozumi
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, School of Dentistry Kanagawa Dental University Yokosuka Japan
- Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Hiromasa Yoshie
- Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Takahiro Hokari
- Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - Tatsuya Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - Hideyuki Takamatsu
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
| | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, School of Dentistry Kanagawa Dental University Yokosuka Japan
- Bunkyo‐Dori Dental Clinic Chiba Japan
| | | | | | - Maki Tanaka
- Seikeikai Group Seikeikai Hospital Yokohama Japan
| | | | - Kazuhiro Gomi
- Department of Periodontology, School of Dental Medicine Tsurumi University Yokohama Japan
| |
Collapse
|
11
|
Klepper KL, Chun YP, Cochran D, Chen S, McGuff HS, Mealey BL. Impact of Er:YAG laser on wound healing following nonsurgical therapy: A pilot study. Clin Exp Dent Res 2019; 5:250-258. [PMID: 31249706 PMCID: PMC6585580 DOI: 10.1002/cre2.179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/18/2019] [Indexed: 12/02/2022] Open
Abstract
The purpose is to examine early wound healing through histological analysis by characterizing connective tissue distribution and organization in the treated periodontium following nonsurgical therapy. Periodontal disease is a multifactorial pathological process that leads to the loss of the surrounding periodontium. Traditional periodontal therapies have proven beneficial in halting the progression of disease. The aim of this study is to investigate early wound healing in periodontal patients following hand/ultrasonic instrumentation alone, erbium-doped yttrium aluminum garnet laser instrumentation alone, or a combination of hand/ultrasonic instrumentation and Er:YAG laser instrumentation for the nonsurgical treatment of periodontitis by histologic evaluation. Twenty-one patients were randomized to receive nonsurgical therapy for the treatment of chronic periodontitis with three modalities prior to surgical therapy. Baseline clinical measurements were obtained prior to treatment. Wound healing was assessed by obtaining an otherwise discarded tissue sample following nonsurgical therapy of the selected study site. Samples were obtained at 2 or 6 weeks following initial therapy with a step-back incision and fixated for histological and immunohistochemical analysis. There were minimal between-group differences in the amount of collagen distribution when analyzing the Mallory-Heidenhain Azan trichrome, Picrosirus Red stain, and proliferating cell nuclear antigen at both time points. Descriptive analysis of baseline measurements showed no differences in probing depth change, bleeding on probing, and clinical attachment level following initial therapy between the three treatment groups at 2 or 6 weeks. Each treatment modality was effective in treating moderate to severe chronic periodontitis; however, the results of this study are inconclusive regarding superiority of any one treatment approach from a histologic and immunohistochemical perspective. Based on this assessment, there was increased fibroblast proliferation and collagen maturation between the 2- and 6-week time point after treatment in all treatment groups, with few apparent differences between treatment groups. This pilot study qualitatively evaluated early wound healing in periodontal patients following non surgical therapy with various treatment modalities. When comparing descriptive outcomes of Er:YAG laser therapy and hand/ultrasonic instrumentation there were minimal differences in collagen distribution and density between groups. The evaluated modalities were each effective treating periodontal patients with non surgical therapy.
Collapse
Affiliation(s)
- Kandice L. Klepper
- Department of PeriodonticsUT Health San AntonioSan AntonioTexasUSA
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| | - Yong‐Hee Patricia Chun
- Department of PeriodonticsUT Health San AntonioSan AntonioTexasUSA
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| | - David Cochran
- Department of PeriodonticsUT Health San AntonioSan AntonioTexasUSA
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| | - Shuo Chen
- Department of Developmental DentistryUT Health San AntonioSan AntonioTexasUSA
| | - Howard S. McGuff
- Department of Biomedical SciencesUT Health San AntonioSan AntonioTexasUSA
| | - Brian L. Mealey
- Department of PeriodonticsUT Health San AntonioSan AntonioTexasUSA
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| |
Collapse
|
12
|
Graziani F, Karapetsa D, Alonso B, Herrera D. Nonsurgical and surgical treatment of periodontitis: how many options for one disease? Periodontol 2000 2018; 75:152-188. [PMID: 28758300 DOI: 10.1111/prd.12201] [Citation(s) in RCA: 230] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression.
Collapse
|
13
|
Madhumathi K, Rubaiya Y, Doble M, Venkateswari R, Sampath Kumar TS. Antibacterial, anti-inflammatory, and bone-regenerative dual-drug-loaded calcium phosphate nanocarriers—in vitro and in vivo studies. Drug Deliv Transl Res 2018; 8:1066-1077. [DOI: 10.1007/s13346-018-0532-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
14
|
Scanning Electron Microscopy Evaluation of Root Surfaces After Instrumentation With Two Piezoelectric Devices. J Craniofac Surg 2018; 29:988-991. [PMID: 29485561 DOI: 10.1097/scs.0000000000004364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Scanning electron microscopy evaluation of root surfaces after ultrasonic instrumentation was performed with 2 different metallic tips on piezoelectric devices. Fresh extracted teeth were collected for experimental observation and randomly divided into 2 groups: Test Group, where the root surfaces were treated using an iron, rough, double nano-structural coated (T-Black), corindone-treated tip, and Control Group where the root surfaces were treated with a conventional iron smooth tip. A scanning electronic microscope analysis was performed and the surface roughness and the amount of residual debris were evaluated. Descriptive and inferential statistics were performed. Twenty specimens were analyzed, 10 per group and a total of 21.4 × 10 μm has been observed. On treated area percentage of debris after ultrasonic scaling in Test Group was 1.9 ± 1.8%, while in Control Group it was 5.7 ± 4.3%. Within the limits of the study, it seems that the efficacy of the novel iron, rough, double nano-structural coated (T-Black), corindone-treated structure tip showed greater performance in terms of root surface debridement than the conventional iron smooth tip. The possibility to use a single tool (ultrasonic device with a specific tip) for the root planing procedure within the nonsurgical mechanical therapy may represent a significant advantage for the clinicians. The tested novel tip seems to be able to show the requested ideal characteristics. However, further clinical studies are needed to demonstrate the in vitro results.
Collapse
|
15
|
McGowan K, McGowan T, Ivanovski S. Optimal dose and duration of amoxicillin-plus-metronidazole as an adjunct to non-surgical periodontal therapy: A systematic review and meta-analysis of randomized, placebo-controlled trials. J Clin Periodontol 2017; 45:56-67. [DOI: 10.1111/jcpe.12830] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Kelly McGowan
- School of Dentistry and Oral Health; Griffith University; Southport Qld Australia
| | - Troy McGowan
- School of Dentistry and Oral Health; Griffith University; Southport Qld Australia
| | - Saso Ivanovski
- School of Dentistry; University of Queensland; Herston Qld Australia
| |
Collapse
|
16
|
Eickholz P, Nickles K, Koch R, Harks I, Hoffmann T, Kim T, Kocher T, Meyle J, Kaner D, Schlagenhauf U, Doering S, Gravemeier M, Ehmke B. Is furcation involvement affected by adjunctive systemic amoxicillin plus metronidazole? A clinical trials exploratory subanalysis. J Clin Periodontol 2016; 43:839-48. [PMID: 27393928 DOI: 10.1111/jcpe.12594] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Peter Eickholz
- Department of Periodontology Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
| | - Katrin Nickles
- Department of Periodontology Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research University of Münster Münster Germany
| | - Inga Harks
- Department of Periodontology University Hospital Münster Münster Germany
| | | | - Ti‐Sun Kim
- Section of Periodontology Department of Conservative Dentistry University Hospital Heidelberg Heidelberg Germany
| | - Thomas Kocher
- Unit of Periodontology University Medicine Greifswald Greifswald Germany
| | - Jörg Meyle
- Department of Periodontology University of Giessen Giessen Germany
| | - Doğan Kaner
- Department of Periodontology Witten/Herdecke University Witten Germany
- Department of Periodontology and Synoptic Dentistry Charité Centrum 3 Charité‐Universitäsmedizin Berlin Berlin Germany
| | | | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy Medical University of Vienna Vienna Austria
| | - Martina Gravemeier
- Department of Periodontology University Hospital Münster Münster Germany
| | - Benjamin Ehmke
- Department of Periodontology University Hospital Münster Münster Germany
| |
Collapse
|
17
|
Lecic J, Cakic S, Janjic Pavlovic O, Cicmil A, Vukotic O, Petrovic V, Cicmil S. Different methods for subgingival application of chlorhexidine in the treatment of patients with chronic periodontitis. Acta Odontol Scand 2016; 74:502-7. [PMID: 27409799 DOI: 10.1080/00016357.2016.1206964] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate (CHX) preparations applied subgingivally as an adjunct to scaling and root planing (SRP). MATERIAL AND METHODS A total of 120 periodontal pockets was included in this randomized, controlled, split mouth designed study. According to protocols used in treatment, periodontal pockets were assigned to experimental and control groups as follows: CHX solution as an addition to SRP versus control SRP group; CHX gel as an addition to SRP versus control SRP; CHX chip as an addition to SRP versus control SRP group. Following clinical parameters were recorded at baseline, one and three months after the baseline: plaque index (PI), probing pocket depth (PPD), bleeding index (BI) and clinical attachment level (CAL). RESULTS The most significant improvements were found concerning PI in CHX solution with SRP and CHX gel with SRP groups over controls at one month recall, as well as concerning BI and PPD in CHX chip with SRP group over SRP alone at three-month recall. CONCLUSION Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.
Collapse
|
18
|
Santuchi CC, Cortelli JR, Cortelli SC, Cota LOM, Fonseca DC, Alencar CO, Costa FO. Scaling and Root Planing per Quadrant Versus One-Stage Full-Mouth Disinfection: Assessment of the Impact of Chronic Periodontitis Treatment on Quality of Life — A Clinical Randomized, Controlled Trial. J Periodontol 2016; 87:114-23. [DOI: 10.1902/jop.2015.150105] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
19
|
Canabarro A, Marcantonio É, De-Deus G. Use of the Strength of Recommendation Taxonomy (SORT) to assess full-mouth treatments of chronic periodontitis. J Oral Sci 2015; 57:345-53. [PMID: 26666858 DOI: 10.2334/josnusd.57.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Previous studies have not resolved whether scaling and root planing with a full-mouth (with or without antiseptics) or quadrant approach is better for treatment of chronic periodontitis. We identified relevant studies and used Strength of Recommendation Taxonomy (SORT) criteria to critically interpret the results of all relevant studies. A literature search was performed using the PubMed, EMBASE, and Cochrane databases up to July 2015. Selected studies were stratified according to their quality, quantity, and consistency. In total, 377 studies were identified, and 36 articles selected for retrieval were stratified according SORT criteria, as follows: no level 1 studies, 15 level 2 studies, and 21 level 3 studies (which were excluded from subsequent analysis). Among the selected level 2 studies, including seven randomized clinical trials and three systematic reviews, 67% showed no significant difference between scaling and root planing with a full-mouth or quadrant approach. In conclusion, on the basis of the best available data, the strength of evidence is grade B (consistent, low-quality evidence) for full-mouth (with or without antiseptics) and quadrant scaling and root planing for treatment of chronic periodontitis.
Collapse
Affiliation(s)
- Antonio Canabarro
- Department of Periodontology, School of Dentistry, Veiga de Almeida University
| | | | | |
Collapse
|
20
|
Fonseca DC, Cortelli JR, Cortelli SC, Miranda Cota LO, Machado Costa LC, Moreira Castro MV, Oliveira Azevedo AM, Costa FO. Clinical and Microbiologic Evaluation of Scaling and Root Planing per Quadrant and One-Stage Full-Mouth Disinfection Associated With Azithromycin or Chlorhexidine: A Clinical Randomized Controlled Trial. J Periodontol 2015; 86:1340-51. [DOI: 10.1902/jop.2015.150227] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
21
|
Santuchi CC, Cortelli SC, Cortelli JR, Cota LOM, Alencar CO, Costa FO. Pre- and post-treatment experiences of fear, anxiety, and pain among chronic periodontitis patients treated by scaling and root planing per quadrant versus
one-stage full-mouth disinfection: a 6-month randomized controlled clinical trial. J Clin Periodontol 2015; 42:1024-31. [DOI: 10.1111/jcpe.12472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Camila Carvalho Santuchi
- Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Sheila Cavalca Cortelli
- Periodontics Research Division; Department of Dentistry; University of Taubaté; Taubaté São Paulo Brazil
| | - José Roberto Cortelli
- Periodontics Research Division; Department of Dentistry; University of Taubaté; Taubaté São Paulo Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Camila Oliveira Alencar
- Periodontics Research Division; Department of Dentistry; University of Taubaté; Taubaté São Paulo Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte Brazil
| |
Collapse
|
22
|
Proksch S, Strobel SL, Vach K, Abouassi T, Tomakidi P, Ratka-Krüger P, Hellwig E. Melatonin as a candidate therapeutic drug for protecting bone cells from chlorhexidine-induced damage. J Periodontol 2015; 85:e379-89. [PMID: 25153702 DOI: 10.1902/jop.2014.140279] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Melatonin was proposed for use in periodontitis and peri-implantitis therapy due to its bone-supportive effects. This issue is of interest because standard adjuvant antiseptics, namely chlorhexidine (CHX), prove damaging for osteoblasts. Thus, the aim of this study is to investigate if melatonin is suitable as an auxiliary agent for protecting osteoblasts from CHX damage. METHODS MC3T3 osteoblast response was determined following administration of various CHX concentrations in the absence or presence of melatonin. Osteoblast morphology was evaluated, total reactive oxygen species (ROS) and superoxide levels were quantified, ratios of apoptotic and necrotic cells were identified by flow cytometry, metabolic activity of remaining cells was assessed, and effects were calculated with repeated measures analysis and post hoc P value adjustment. RESULTS CHX led to poor morphology, increased total ROS and superoxide levels, and rigorously diminished the number of vital and metabolic active osteoblasts in a concentration-dependent manner. However, simultaneous melatonin supply supported cell morphogenesis and growth, reduced ROS and superoxide generation, shifted the percentage of CHX-damaged cells from necrotic/late to early apoptotic events, and modulated metabolic activity in osteoblasts. CONCLUSION These data reveal that melatonin protects osteoblasts in the CHX context, thereby implicating melatonin as a promising drug in periodontitis and peri-implantitis treatment.
Collapse
Affiliation(s)
- Susanne Proksch
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, University Medical Center Freiburg, Freiburg, Germany
| | | | | | | | | | | | | |
Collapse
|
23
|
Fang H, Han M, Li QL, Cao CY, Xia R, Zhang ZH. Comparison of full-mouth disinfection and quadrant-wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta-analysis. J Periodontal Res 2015; 51:417-30. [PMID: 26477533 DOI: 10.1111/jre.12326] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2015] [Indexed: 11/28/2022]
Abstract
Scaling and root planing are widely considered as effective methods for treating chronic periodontitis. A meta-analysis published in 2008 showed no statistically significant differences between full-mouth disinfection (FMD) or full-mouth scaling and root planing (FMS) and quadrant scaling and root planing (Q-SRP). The FMD approach only resulted in modest additional improvements in several indices. Whether differences exist between these two approaches requires further validation. Accordingly, a study was conducted to further validate whether FMD with antiseptics or FMS without the use of antiseptics within 24 h provides greater clinical improvement than Q-SRP in patients with chronic periodontitis. Medline (via OVID), EMBASE (via OVID), PubMed and CENTRAL databases were searched up to 27 January 2015. Randomized controlled trials comparing FMD or FMS with Q-SRP after at least 3 mo were included. Meta-analysis was performed to obtain the weighted mean difference (WMD), together with the corresponding 95% confidence intervals. Thirteen articles were included in the meta-analysis. The WMD of probing pocket depth reduction was 0.25 mm (p < 0.05) for FMD vs. Q-SRP in single-rooted teeth with moderate pockets, and clinical attachment level gain in single- and multirooted teeth with moderate pockets was 0.33 mm (p < 0.05) for FMD vs. Q-SRP. Except for those, no statistically significant differences were found in the other subanalyses of FMD vs. Q-SRP, FMS vs. Q-SRP and FMD vs. FMS. Therefore, the meta-analysis results showed that FMD was better than Q-SRP for achieving probing pocket depth reduction and clinical attachment level gain in moderate pockets. Additionally, regardless of the treatment, no serious complications were observed. FMD, FMS and Q-SRP are all effective for the treatment of adult chronic periodontitis, and they do not lead to any obvious discomfort among patients. Moreover, FMD had modest additional clinical benefits over Q-SRP, so we prefer to recommend FMD as the first choice for the treatment of adult chronic periodontitis.
Collapse
Affiliation(s)
- H Fang
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - M Han
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Q-L Li
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - C Y Cao
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - R Xia
- The 2nd Hospital affiliated to Anhui Medical University, Hefei, China
| | - Z-H Zhang
- Hospital of Anhui Province, Hefei, China
| |
Collapse
|
24
|
Graziani F, Cei S, Orlandi M, Gennai S, Gabriele M, Filice N, Nisi M, D'Aiuto F. Acute-phase response following full-mouth versus
quadrant non-surgical periodontal treatment: A randomized clinical trial. J Clin Periodontol 2015; 42:843-852. [DOI: 10.1111/jcpe.12451] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Silvia Cei
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Marco Orlandi
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Stefano Gennai
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Mario Gabriele
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Natalia Filice
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Marco Nisi
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | | |
Collapse
|
25
|
The Quality of the Evidence According to GRADE Is Predominantly Low or Very Low in Oral Health Systematic Reviews. PLoS One 2015; 10:e0131644. [PMID: 26162076 PMCID: PMC4498810 DOI: 10.1371/journal.pone.0131644] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 06/05/2015] [Indexed: 11/20/2022] Open
Abstract
Objectives The main objective was to assess the credibility of the evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) in oral health systematic reviews on the Cochrane Database of Systematic Reviews (CDSR) and elsewhere. Study Design and Setting Systematic Reviews or meta-analyses (January 2008-December 2013) from 14 high impact general dental and specialty dental journals and the Cochrane Database of Systematic Reviews were screened for meta-analyses. Data was collected at the systematic review, meta-analysis and trial level. Two reviewers applied and agreed on the GRADE rating for the selected meta-analyses. Results From the 510 systematic reviews initially identified 91 reviews (41 Cochrane and 50 non-Cochrane) were eligible for inclusion. The quality of evidence was high in 2% and moderate in 18% of the included meta-analyses with no difference between Cochrane and non-Cochrane reviews, journal impact factor or year of publication. The most common domains prompting downgrading of the evidence were study limitations (risk of bias) and imprecision (risk of play of chance). Conclusion The quality of the evidence in oral health assessed using GRADE is predominantly low or very low suggesting a pressing need for more randomised clinical trials and other studies of higher quality in order to inform clinical decisions thereby reducing the risk of instituting potentially ineffective and/or harmful therapies.
Collapse
|
26
|
Moura LA, Ribeiro FV, Aiello TB, Duek EADR, Sallum EA, Nociti Junior FH, Casati MZ, Sallum AW. Characterization of the release profile of doxycycline by PLGA microspheres adjunct to non-surgical periodontal therapy. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2015; 26:573-84. [PMID: 25917501 DOI: 10.1080/09205063.2015.1045249] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this pilot study was to assess the release of locally delivered doxycycline by poly (l-lactide-co-glycolide) (PLGA) microspheres in the periodontal pocket of patients with chronic periodontitis, treated by non-surgical periodontal therapy. Nineteen sites of non-adjacent teeth of four different patients were evaluated. Five milligram of PLGA microspheres loaded with 16 doxycycline hyclate (DOX) was administered per periodontal site. To quantify DOX released into the periodontal pocket, gingival crevicular fluid (GCF) was collected from the sites on days 2, 5, 7, 10, 15, and 20 after DOX application, and high-performance liquid chromatography was performed. Data were statistically assessed by ANOVA/Tukey test. At days 2, 5, and 7, the DOX concentration was stably sustained (23.33 ± 1.38, 23.4 ± 1.82, and 22.75 ± 1.33 μg/mL, respectively), with no significant differences over these assessment times (p > 0.05). At days 10 and 15, a tendency was observed toward a decrease in DOX concentration (21.74 ± 0.91 and 20.53 ± 4.88 μg/mL, respectively), but a significant decrease in GCF drug concentration (19.69 ± 4.70 μg/mL) was observed only on day 20. The DOX delivery system developed demonstrated a successful sustained release after local administration, as an adjunct to non-surgical periodontal therapy.
Collapse
Affiliation(s)
- Lucas Alves Moura
- a Division of Periodontics, Department of Prosthodontics and Periodontics, Piracicaba Dental School , State University of Campinas (UNICAMP) , Av. Limeira 901, Caixa Postal: 052, CEP: 13414-903 Piracicaba , São Paulo , Brazil
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Eberhard J, Jepsen S, Jervøe‐Storm P, Needleman I, Worthington HV. Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database Syst Rev 2015; 2015:CD004622. [PMID: 25884249 PMCID: PMC8687876 DOI: 10.1002/14651858.cd004622.pub3] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Periodontitis is chronic inflammation that causes damage to the soft tissues and bones supporting the teeth. Mild to moderate periodontitis affects up to 50% of adults. Conventional treatment is quadrant scaling and root planing. In an attempt to enhance treatment outcomes, alternative protocols for anti-infective periodontal therapy have been introduced: full-mouth scaling (FMS) and full-mouth disinfection (FMD), which is scaling plus use of an antiseptic. This review updates our previous review of full-mouth treatment modalities, which was published in 2008. OBJECTIVES To evaluate the clinical effects of 1) full-mouth scaling (over 24 hours) or 2) full-mouth disinfection (over 24 hours) for the treatment of chronic periodontitis compared to conventional quadrant scaling and root planing (over a series of visits at least one week apart). A secondary objective was to evaluate whether there was a difference in clinical effect between full-mouth disinfection and full-mouth scaling. SEARCH METHODS The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 26 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2015, Issue 2), MEDLINE via OVID (1946 to 26 March 2015), EMBASE via OVID (1980 to 26 March 2015) and CINAHL via EBSCO (1937 to 26 March 2015). We searched the US National Institutes of Health Trials Register (ClinicalTrials.gov) and the WHO International Clinical Trials Registry Platform for ongoing studies. There were no restrictions regarding language or date of publication in the searches of the electronic databases. We scanned reference lists from relevant articles and contacted the authors of eligible studies to identify trials and obtain additional information. SELECTION CRITERIA We included randomised controlled trials (RCTs) with at least three months of follow-up that evaluated full-mouth scaling and root planing within 24 hours with adjunctive use of an antiseptic such as chlorhexidine (FMD) or without the use of antiseptic (FMS), compared to conventional quadrant scaling and root planing (control). Participants had a clinical diagnosis of chronic periodontitis according to the International Classification of Periodontal Diseases. We excluded studies of people with aggressive periodontitis, systemic disorders or who were taking antibiotics. DATA COLLECTION AND ANALYSIS Several review authors independently conducted data extraction and risk of bias assessment (which focused on method of randomisation, allocation concealment, blinding of examiners and completeness of follow-up). Our primary outcome was tooth loss and secondary outcomes were change in probing pocket depth (PPD), bleeding on probing (BOP) and probing attachment (i.e. clinical attachment level; CAL), and adverse events. We followed the methodological guidelines of The Cochrane Collaboration. MAIN RESULTS We included 12 trials, which recruited 389 participants. No studies assessed the primary outcome tooth loss.Ten trials compared FMS and control; three of these were assessed as being at high risk of bias, three as unclear risk and four as low risk. There was no evidence for a benefit for FMS over the control for change in probing pocket depth (PPD), gain in probing attachment (i.e. clinical attachment level; CAL) or bleeding on probing (BOP). The difference in changes between FMS and control for whole mouth PPD at three to four months was 0.01 mm higher (95% CI -0.17 to 0.19, three trials, 82 participants). There was no evidence of heterogeneity. The difference in changes for CAL was 0.02 mm lower (95% CI -0.26 to 0.22, three trials, 82 participants), and the difference in change in BOP was 2.86 per cent of sites lower (95% CI -7.65 to 1.93, four trials, 120 participants).We included six trials in the meta-analyses comparing FMD and control, with two trials assessed as being at high risk of bias, one as low and three as unclear. The analyses did not indicate a benefit for FMD over the control for PPD, CAL or BOP. The difference in changes for whole-mouth PPD between FMD and control at three to four months was 0.13 mm higher (95% CI -0.09 to 0.34, two trials, 44 participants). There was no evidence of heterogeneity. The difference in changes for CAL was 0.04mm higher (95% CI -0.25 to 0.33, two trials, 44 participants) and the difference in change in BOP being 12.59 higher for FMD (95% CI -8.58 to 33.77, three trials, 68 participants).Three trials were included in the analyses comparing FMS and FMD. The mean difference in PPD change at three to four months was 0.11 mm lower (-0.34 to 0.12, two trials, 45 participants) indicating no evidence of a difference between the two interventions. There was a difference in the gain in CAL at three to four months (-0.25 mm, 95% CI -0.42 to -0.07, two trials, 45 participants), favouring FMD but this was not found at six to eight months. There was no evidence for a difference between FMS and FMD for BOP (-1.59, 95% CI -9.97 to 6.80, two trials, 45 participants).Analyses were conducted for different teeth types (single- or multi-rooted) and for teeth with different levels of probing depth at baseline, for PPD, CAL and BOP. There was insufficient evidence of a benefit for either FMS or FMD.Harms and adverse events were reported in eight studies. The most important harm identified was an increased body temperature after FMS or FMD treatments.We assessed the quality of the evidence for each comparison and outcome as 'low' because of design limitations leading to risk of bias and because of the small number of trials and participants, which led to imprecision in the effect estimates. AUTHORS' CONCLUSIONS The inclusion of five additional RCTs in this updated review comparing the clinical effects of conventional mechanical treatment with FMS and FMD approaches for the treatment of chronic periodontitis has not changed the conclusions of the original review. From the twelve included trials there is no clear evidence that FMS or FMD provide additional benefit compared to conventional scaling and root planing. In practice, the decision to select one approach to non-surgical periodontal therapy over another should include patient preference and the convenience of the treatment schedule.
Collapse
Affiliation(s)
- Joerg Eberhard
- Hannover Medical SchoolProsthetic Dentistry and Biomaterials ScienceCarl‐Neuberg‐Straße 1HannoverGermany30625
| | - Sören Jepsen
- University Hospital BonnDepartment of Periodontology, Operative and Preventive DentistryWelschnonnenstr. 16BonnGermany53113
| | - Pia‐Merete Jervøe‐Storm
- University Hospital BonnDepartment of Periodontology, Operative and Preventive DentistryWelschnonnenstr. 16BonnGermany53113
| | - Ian Needleman
- UCL Eastman Dental InstituteUnit of Periodontology and International Centre for Evidence‐Based Oral Healthcare256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupCoupland III Building, Oxford RoadManchesterUKM13 9PL
| | | |
Collapse
|
28
|
Sanz-Sánchez I, Ortiz-Vigón A, Matos R, Herrera D, Sanz M. Clinical Efficacy of Subgingival Debridement With Adjunctive Erbium:Yttrium-Aluminum-Garnet Laser Treatment in Patients With Chronic Periodontitis: A Randomized Clinical Trial. J Periodontol 2015; 86:527-35. [DOI: 10.1902/jop.2014.140258] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
29
|
Kamath DG, Nayak SU, Pai KK, Shenoy R. Knowledge and awareness of oral health among diabetic patients—a cross-sectional study from Mangalore City. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0334-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
30
|
Clinical and microbiological effects of quadrant versus full-mouth root planing—A randomized study. J Dent Sci 2014. [DOI: 10.1016/j.jds.2013.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
31
|
Bhansali RS. Non-surgical periodontal therapy: An update on current evidence. World J Stomatol 2014; 3:38-51. [DOI: 10.5321/wjs.v3.i4.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/06/2014] [Accepted: 11/19/2014] [Indexed: 02/06/2023] Open
Abstract
Periodontal disease is an inflammatory condition that involves a complex interaction between pathogenic bacteria, environmental and acquired factors and host related factors. Till recently periodontal treatment was directed primarily towards reduction of bacterial load by subgingival debridement of root surfaces and modification of environmental risk factors. The current paradigm of periodontal disease stresses greater role of host-mediated inflammatory response in tissue destruction characteristic of periodontal disease. Various therapeutic modalities have been developed adjuvant to mechanical periodontal therapy. The use of laser and photodynamic therapy show great promise but their effectiveness has still not been conclusively proven. Chemotherapeutic agents, either systemic and local antimicrobials or host modulating drugs, played pivotal role in better and more predictable management of periodontal disease. The present review focuses on the best available evidence, for the current management of the chronic periodontal patients, gathered from systematic reviews and meta-analysis of mechanical non surgical periodontal therapy (NSPT) (subgingival debridement, laser therapy and photodynamic therapy) and the adjunctive chemotherapeutic approaches such as systematic and local antibiotics and antiseptics, subgingival pocket irrigation and host modulation therapies. The review also attempts to briefly introduce future developments in some of these modalities. At the end, the review summarizes the analysis of the current evidence that suggests that thorough subgingival debridement remains the mainstay of NSPT and that adjunct use of chemotherapeutic agents may offer better management of clinical parameters in periodontitis patients.
Collapse
|
32
|
Figueiredo LC, Souza DC, Santos VR, Miranda TS, Feres M, Faveri M, Duarte PM. Full-mouth scaling and root planing in type 2 diabetic subjects: one-year microbiological outcomes. Aust Dent J 2014; 59:490-6. [DOI: 10.1111/adj.12221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/27/2022]
Affiliation(s)
- LC Figueiredo
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - DC Souza
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - VR Santos
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - TS Miranda
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - M Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - M Faveri
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - PM Duarte
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| |
Collapse
|
33
|
Abstract
AIM The aim of this review is to discuss the evidence for the management of chronic periodontitis, including methods of non-surgical therapy such as full mouth disinfection, full mouth debridement and conventional quadrant-by-quadrant therapy. METHODS Manual searches of Medline and Embase databases provided the relevant studies. RESULTS Multiple randomised controlled trials (RCTs) selected for the paper failed to show any significant differences between the quadrant-wise treatment and full mouth debridement and modalities. PRACTICAL IMPLICATIONS This review demonstrates that there is no known difference in treatment outcomes between full mouth debridement and traditional quadrant therapy. Further RCTs are necessary to assess clinical effectiveness of chemical adjunct use.
Collapse
|
34
|
Heitz-Mayfield LJA, Lang NP. Surgical and nonsurgical periodontal therapy. Learned and unlearned concepts. Periodontol 2000 2014; 62:218-31. [PMID: 23574468 DOI: 10.1111/prd.12008] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This review aims to highlight concepts relating to nonsurgical and surgical periodontal therapy, which have been learned and unlearned over the past few decades. A number of treatment procedures, such as gingival curettage and aggressive removal of contaminated root cementum, have been unlearned. Advances in technology have resulted in the introduction of a range of new methods for use in nonsurgical periodontal therapy, including machine-driven instruments, lasers, antimicrobial photodynamic therapy and local antimicrobial-delivery devices. However, these methods have not been shown to offer significant benefits over and above nonsurgical debridement using hand instruments. The method of debridement is therefore largely dependent on the preferences of the operator and the patient. Recent evidence indicates that specific systemic antimicrobials may be indicated for use as adjuncts to nonsurgical debridement in patients with advanced disease. Full-mouth disinfection protocols have been proven to be a relevant treatment option. We have learned that while nonsurgical and surgical methods result in similar long-term treatment outcomes, surgical therapy results in greater probing-depth reduction and clinical attachment gain in initially deep pockets. The surgical technique chosen seems to have limited influence upon changes in clinical attachment gain. What has not changed is the importance of thorough mechanical debridement and optimal plaque control for successful nonsurgical and surgical periodontal therapy.
Collapse
|
35
|
Apatzidou DA, Zygogianni P, Sakellari D, Konstantinidis A. Oral hygiene reinforcement in the simplified periodontal treatment of 1 hour. J Clin Periodontol 2013; 41:149-56. [DOI: 10.1111/jcpe.12200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Danae A. Apatzidou
- Department of Preventive Dentistry; Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Penelope Zygogianni
- Department of Preventive Dentistry; Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry; Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Antonis Konstantinidis
- Department of Preventive Dentistry; Periodontology and Implant Biology; School of Dentistry; Aristotle University of Thessaloniki; Thessaloniki Greece
| |
Collapse
|
36
|
Abstract
UNLABELLED Periodontitis is a complex disease that has both oral and systemic consequences. The treatment of periodontitis may be both surgical and non-surgical but, in recent years, there has been a shift towards managing disease non-surgically in preference to surgery. Fundamental to all types of therapy is the patient's role in disease control, in the form of self-performed plaque control, and it is important that the patient understands this. Non-surgical periodontal therapy has a long history and has traditionally been carried out using a variety of hand and powered instruments, the objective being root surface disinfection by the removal of plaque, calculus and contaminated root cementum. However, over the last 30 years or so, it has become apparent that calculus does not cause disease, cementum does not become significantly infected and bacteria and their toxins are only loosely adherent to the diseased root surface. This has led to the development of less invasive instrumentation principles which may be better for patients, more cost-effective and more easily applied in different clinical settings. CLINICAL RELEVANCE This paper aims to describe and justify a minimally-invasive approach to the management of the diseased root surface in periodontitis, to clarify the terminology used and to suggest how these principles may be applied in general practice.
Collapse
Affiliation(s)
- Philip Ower
- Briars Dental Centre, Newbury and www.periocourses. co.uk
| |
Collapse
|
37
|
Clinical results after nonsurgical therapy in aggressive and chronic periodontitis. Clin Oral Investig 2013; 18:453-60. [PMID: 23749245 DOI: 10.1007/s00784-013-1013-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 05/28/2013] [Indexed: 12/12/2022]
Abstract
AIM This study aims to analyze factors influencing treatment results in aggressive (AgP) and chronic (ChP) periodontitis. METHODS ChP [probing pocket depth (PPD) ≥ 3.5 mm, attachment loss ≥ 5 mm at >30 % of sites; age > 35 years] and AgP (clinically healthy; PPD ≥ 3.5 mm at >30 % of sites, radiographic bone loss ≥ 50 % at 2 teeth; age ≤ 35 years) were examined prior and 3 months after nonsurgical therapy according to the full-mouth disinfection concept. Adjunctive systemic antibiotics were used if Aggregatibacter actinomycetemcomitans had been detected at baseline. RESULTS In 31 ChP (12 female, 10 smokers; 4,808 sites) and 28 AgP (16 female, 9 smokers; 4,769 sites), overall mean PPD reductions were less favorable in AgP (0.9 ± 0.5 mm) than in ChP (1.3 ± 0.4 mm; p = 0.033). PPD reductions and relative vertical probing attachment level gain were more favorable at sites with initial PPD ≥ 6 mm, bleeding on probing, and for adjunctive systemic antibiotics. Furthermore, PPD reductions were more favorable for increased baseline tooth mobility and maxillary teeth, whereas AgP, female sex, and multirooted teeth were associated with less favorable PPD reduction. CONCLUSION Regarding PPD reduction, AgP responded less favorably to nonsurgical treatment than ChP.
Collapse
|
38
|
Santos VR, Lima JA, Miranda TS, Gonçalves TED, Figueiredo LC, Faveri M, Duarte PM. Full-mouth disinfection as a therapeutic protocol for type-2 diabetic subjects with chronic periodontitis: twelve-month clinical outcomes: a randomized controlled clinical trial. J Clin Periodontol 2013; 40:155-62. [PMID: 23305133 DOI: 10.1111/jcpe.12040] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 10/08/2012] [Accepted: 10/13/2012] [Indexed: 02/07/2023]
Abstract
AIM The aim of this randomized controlled clinical trial was to evaluate the clinical effects of chlorhexidine (CHX) application in a full-mouth disinfection (FMD) protocol in poorly controlled type-2 diabetic subjects with generalized chronic periodontitis. MATERIAL AND METHODS Thirty-eight subjects were randomly assigned into FMD group (n=19): full-mouth scaling and root planing (FMSRP) within 24 h + local application of CHX gel + CHX rinses for 60 days or Control group (n = 19): FMSRP within 24 h + local application of placebo gel + placebo rinses for 60 days. Clinical parameters, glycated haemoglobin and fasting plasma glucose were assessed at baseline, 3, 6 and 12 months post-therapies. RESULTS All clinical parameters improved significantly at 3, 6 and 12 months post-therapies for both groups (p < 0.05). There were no significant differences between groups for any clinical parameters, and glycemic condition at any time-point (p > 0.05). CONCLUSIONS The treatments did not differ with respect to clinical parameters, including the primary outcome variable (i.e. changes in clinical attachment level in deep pockets), for up to 12 months post-treatments.
Collapse
Affiliation(s)
- Vanessa R Santos
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | | | | | | | | | | |
Collapse
|
39
|
Chambrone L, Preshaw PM, Rosa EF, Heasman PA, Romito GA, Pannuti CM, Tu YK. Effects of smoking cessation on the outcomes of non-surgical periodontal therapy: a systematic review and individual patient data meta-analysis. J Clin Periodontol 2013; 40:607-15. [PMID: 23590649 DOI: 10.1111/jcpe.12106] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 02/15/2013] [Accepted: 03/12/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Leandro Chambrone
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo SP Brazil
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos SP Brazil
| | - Philip M. Preshaw
- School of Dental Sciences and Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - Ecinele Francisca Rosa
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo SP Brazil
| | - Peter A. Heasman
- School of Dental Sciences and Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - Giuseppe A. Romito
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo SP Brazil
| | - Claudio Mendes Pannuti
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo SP Brazil
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine; National Taiwan University; Taipei Taiwan
| |
Collapse
|
40
|
Altay U, Gürgan CA, Ağbaht K. Changes in Inflammatory and Metabolic Parameters After Periodontal Treatment in Patients With and Without Obesity. J Periodontol 2013; 84:13-23. [DOI: 10.1902/jop.2012.110646] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
41
|
Sanz I, Alonso B, Carasol M, Herrera D, Sanz M. Nonsurgical Treatment of Periodontitis. J Evid Based Dent Pract 2012; 12:76-86. [DOI: 10.1016/s1532-3382(12)70019-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
42
|
Reichert C, Hagner M, Jepsen S, Jäger A. Interfaces between orthodontic and periodontal treatment: their current status. J Orofac Orthop 2012; 72:165-86. [PMID: 21744196 DOI: 10.1007/s00056-011-0023-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The contextual relationships between orthodontics and periodontology are diverse and complex. While the consequences of orthodontic tooth movements are discussed in terms of possible damage and improvements in the long-term health of periodontal tissues orthodontic treatment of adults is a routine clinical procedure nowadays, even in patients presenting already-damaged periodontal tissues. As developments in both fields have been so rapid, there is a constant need for evidence-based concepts in this interdisciplinary field. The goal of this review was to discuss the latest aspects of interdisciplinary treatment and to reflect on the latest developments in research. A treatment scheme is also presented which aims to facilitate coordination of the orthodontic treatment of patients with periodontal diseases.
Collapse
|
43
|
Aimetti M, Romano F, Guzzi N, Carnevale G. Full-mouth disinfection and systemic antimicrobial therapy in generalized aggressive periodontitis: a randomized, placebo-controlled trial. J Clin Periodontol 2012; 39:284-94. [DOI: 10.1111/j.1600-051x.2011.01795.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2011] [Indexed: 01/21/2023]
Affiliation(s)
- Mario Aimetti
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Federica Romano
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Nicoletta Guzzi
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Gianfranco Carnevale
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| |
Collapse
|
44
|
Krück C, Eick S, Knöfler GU, Purschwitz RE, Jentsch HFR. Clinical and microbiologic results 12 months after scaling and root planing with different irrigation solutions in patients with moderate chronic periodontitis: a pilot randomized trial. J Periodontol 2011; 83:312-20. [PMID: 21749169 DOI: 10.1902/jop.2011.110044] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study is to determine in a randomized trial the impact on treatment outcome after 12 months of different subgingival irrigation solutions during scaling and root planing (SRP). METHODS Fifty-one adult volunteers with generalized chronic periodontitis were treated by full-mouth SRP using 0.9% sodium chloride, 0.12% chlorhexidine digluconate, or 7.5% povidone-iodine for subgingival irrigation during SRP. Before SRP and after 3 and 12 months, probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded. Subgingival plaque samples were analyzed for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. RESULTS PD, CAL, and BOP were significantly improved in all groups after 12 months (P <0.001 to P = 0.044). No significant differences were seen among the groups for all sites and sites with 4 to 6 mm PD at baseline. The povidone-iodine group had the highest clinical improvements. The counts of A. actinomycetemcomitans and P. gingivalis were significantly reduced after 12 months (P = 0.045 and P = 0.002) using povidone-iodine. Significant differences between the groups were seen after 3 months for A. actinomycetemcomitans and P. gingivalis, and after 12 months for T. forsythia. CONCLUSIONS No differences were seen among the groups in the clinical results after 12 months. Regarding the microbiologic results, a slight benefit seemed to derive from the use of povidone-iodine.
Collapse
Affiliation(s)
- Carlos Krück
- Department of Conservative Dentistry and Periodontology, University of Leipzig, Leipzig, Germany
| | | | | | | | | |
Collapse
|
45
|
Chambrone L, Pannuti CM, Guglielmetti MR, Chambrone LA. Evidence grade associating periodontitis with preterm birth and/or low birth weight: II: a systematic review of randomized trials evaluating the effects of periodontal treatment. J Clin Periodontol 2011; 38:902-14. [PMID: 21736600 DOI: 10.1111/j.1600-051x.2011.01761.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aim of this systematic review was to evaluate whether maternal periodontal disease treatment (MPDT) can reduce the incidence of preterm birth (PB) and/or low birth weight (LBW). METHODS The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched for entries up to October 2010 without restrictions regarding the language of publication. Only randomized-controlled clinical trials (RCTs) that evaluated the effect of MPDT on birth term and birth weight were included. The search was conducted by two independent reviewers and random-effects meta-analyses were conducted methodically. RESULTS Thirteen RCTs provided data, but only five trials were considered to be at a low risk of bias. The results of eight studies (61.5%) showed that MPDT may reduce the incidence of PB and/or LBW. However, the results of all meta-analyses showed contrasting results for PB [RR: 0.88 (95% CI: 0.72, 1.09)], LBW [RR: 0.78 (95% CI: 0.53, 1.17)] and PB/LBW [RR: 0.52 (95% CI: 0.08, 3.31)]. CONCLUSION The results of this review show that MPDT did not decrease the risk of PB and/or LBW; however, the influence of specific aspects that were not investigated (disease diagnosis, extension and severity and the success of MPDT) should be evaluated by future RCTs.
Collapse
Affiliation(s)
- Leandro Chambrone
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of Sao Paulo, Brazil.
| | | | | | | |
Collapse
|
46
|
Nickles K, Ratka-Krüger P, Neukranz E, Raetzke P, Eickholz P. Ten-Year Results After Connective Tissue Grafts and Guided Tissue Regeneration for Root Coverage. J Periodontol 2010; 81:827-36. [DOI: 10.1902/jop.2010.090632] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
47
|
Zijnge V, Meijer HF, Lie MA, Tromp JAH, Degener JE, Harmsen HJM, Abbas F. The recolonization hypothesis in a full-mouth or multiple-session treatment protocol: a blinded, randomized clinical trial. J Clin Periodontol 2010; 37:518-25. [DOI: 10.1111/j.1600-051x.2010.01562.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
48
|
Trombelli L, Rizzi A, Simonelli A, Scapoli C, Carrieri A, Farina R. Age-related treatment response following non-surgical periodontal therapy. J Clin Periodontol 2010; 37:346-52. [DOI: 10.1111/j.1600-051x.2010.01541.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
49
|
Successful collaboration scoops prize. Br Dent J 2010; 208:6. [DOI: 10.1038/sj.bdj.2010.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
50
|
Santos VR, Lima JA, De Mendonça AC, Braz Maximo MB, Faveri M, Duarte PM. Effectiveness of full-mouth and partial-mouth scaling and root planing in treating chronic periodontitis in subjects with type 2 diabetes. J Periodontol 2009; 80:1237-45. [PMID: 19656023 DOI: 10.1902/jop.2009.090030] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND This study evaluated the clinical and metabolic effects of full-mouth scaling and root planing (FMSRP) compared to partial-mouth scaling and root planing (PMSRP) in patients with type 2 diabetes and chronic periodontitis, and it assessed the impact of the glycemic status on the clinical and metabolic response to periodontal therapy. METHODS In this clinical trial, 18 subjects with diabetes received FMSRP in a maximum of 24 hours, and 18 subjects received PMSRP in a maximum of 21 days. Visible plaque accumulation, bleeding on probing, suppuration, probing depth, clinical attachment level (CAL), and glycosylated hemoglobin (HbA1c) levels were obtained at baseline and at 3 and 6 months post-therapy. Baseline HbA1c values > or =9% and <9% defined subjects with poorly and better-controlled diabetes, respectively. RESULTS All clinical parameters improved after therapy (P <0.05). No significant differences were observed between treatment groups for clinical and metabolic parameters at any time (P >0.05). There were no changes in the HbA1c levels after therapy (P >0.05). No subject reported any adverse effects during the study. Individuals with better-controlled diabetes achieved a lower mean CAL at 6 months post-therapy, when FMSRP and PMSRP were evaluated together (P <0.05). CONCLUSIONS FMSRP and PMSRP were equally effective in treating chronic periodontitis in subjects with type 2 diabetes, without significant improvements in the glycemic control at 3 and 6 months. Considering the periodontal therapy as a whole (FMSRP plus PMSRP), subjects with better-controlled diabetes exhibited a benefit in CAL at 6 months compared to subjects with poorly controlled disease.
Collapse
Affiliation(s)
- Vanessa Renata Santos
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | | | | | | | | | | |
Collapse
|