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Gong J, Huang X, Yuan S. Comparative study on the effects of different polishing methods on tooth surface microstructure and roughness following initial periodontal treatment. Clin Exp Dent Res 2024; 10:e851. [PMID: 38345489 PMCID: PMC10828915 DOI: 10.1002/cre2.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To investigate the effects of different polishing methods on the surface microstructure and roughness of teeth following initial periodontal treatment. METHODS Teeth were divided into three groups (silica onegloss, polishing disc, and polishing strip) in vitro. Tooth surface microstructure was characterized via scanning electron microscopy. Roughness was measured by profilometry and laser scanning confocal microscopy (LSCM). According to the in vitro results, one group was chosen for further clinical trials. Effects of the chosen polishing method on patient plaque control and satisfaction were assessed via plaque staining and visual analog scale (VAS). RESULTS Electron microscopy results revealed that the polishing disc group had smoother roots and crowns than did the other two groups. Roughness analysis revealed that the crown roughness with the polishing disc and silica onegloss was lower, and the root roughness with the polishing disc was the lowest (p < .05) The LSCM results showed that the pigment deposition depth with the polishing disc and silicon onegloss in the crowns and roots were significantly lower than those with the other two methods (p = .000). The polishing effect of the polishing disc was best among the three groups. Clinical trials were performed to verify the polishing disc effects. Plaque staining results showed that the decrease in plaque in the polishing disc group was greater than that of the rubber cup group (p = .020), which was similar to the results of LSCM. The VAS results showed that the polishing disc made teeth feel smoother, similar to the results of the roughness detection, and the procedure was more comfortable (p < .05). However, there was no significant difference between the two groups regarding foreign body sensation during pronunciation (p = .178). CONCLUSION Combining in vitro and in vivo evaluations, the use of a polishing disc following periodontal treatment yielded superior polishing effects on teeth and was better accepted by patients.
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Affiliation(s)
- Jingjue Gong
- Dental DepartmentShanghai Jing‐an Dental ClinicShanghaiChina
| | - Xin Huang
- Dental DepartmentShanghai Jing‐an Dental ClinicShanghaiChina
| | - Shuang Yuan
- Dental DepartmentShanghai Jing‐an Dental ClinicShanghaiChina
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Kumari N, Johnson L, Yadav H, Das A, Umrao B, Gera R. Effect of Hand and Ultrasonic Scaling-Root Planing Methods on Tooth Surface Topography: An In-Vitro Atomic Force Microscopy Study. Cureus 2023; 15:e46925. [PMID: 38022287 PMCID: PMC10640483 DOI: 10.7759/cureus.46925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Any instrumentation on the tooth surface for plaque or calculus removal will cause some amount of roughness on the tooth surface. Hence, this study was proposed to investigate the effects of hand and ultrasonic scaling and root planing on enamel and cementum, respectively. MATERIALS AND METHODS Forty tooth samples were prepared from extracted maxillary and mandibular first pre-molars and were divided randomly into four groups of 10 samples each. Group l: received ultrasonic scaling on enamel; Group II: received hand scaling on enamel surface; Group III: root planing with an ultrasonic unit on the cementum samples; and Group IV: root planing using hand curettes on cementum surface. The amount of roughness produced on the surface of each sample of all four groups was evaluated using atomic force microscopy (AFM) and statistically analyzed using Chi-square, ANOVA, and Wilcoxon tests. RESULTS The results suggested that the surface roughness produced on both crown and root after scaling and root planing (SRP) using a hand instrument is lower than that of an ultrasonic unit. The roughness of the crown was found to be lower than that of the root after SRP using both a hand instrument and an ultrasonic unit and was also statistically significant (P = 0.034). In contrast, there is not enough evidence to conclude a significant difference (P=0.13) between root planing using hand instruments and ultrasonic scaler groups. The combined p-value using the Chi-square test (P=0.026) suggests a statistically significant overall difference between crown and root groups. CONCLUSION From the present study, the authors concluded that scaling as well as root planing using an ultrasonic unit cause more tooth (enamel and cementum) surface roughness as compared to hand scaling and root planing. While there is no significant difference in the surface roughness of root-cementum produced due to the root planing in both groups, crown-enamel exhibits a significant difference after scaling in both groups. Clinical significance of the study: Rough, uneven tooth surfaces negatively influence the anticipated healing of the periodontium by providing retention areas for microbial dental plaque.
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Affiliation(s)
- Neebha Kumari
- Department of Periodontology, Rama Dental College, Kanpur, IND
| | - Lynn Johnson
- Department of Periodontology, Rama Dental College, Kanpur, IND
| | - Hemlata Yadav
- Department of Periodontology, Rama Dental College, Kanpur, IND
| | - Arindam Das
- Department of Periodontology, Rama Dental College, Kanpur, IND
| | - Brajendra Umrao
- Department of Periodontology, Rama Dental College, Kanpur, IND
| | - Radhika Gera
- Department of Periodontology, Rama Dental College, Kanpur, IND
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Ince Kuka G, Kuru B, Gursoy H. In Vitro Evaluation of the Different Supragingival Prophylaxis Tips on Enamel Surfaces. Photobiomodul Photomed Laser Surg 2023; 41:212-217. [PMID: 37083509 DOI: 10.1089/photob.2022.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Objective: Periodontal instrumentation during supragingival prophylaxis may increase enamel surface roughness, which may lead to increased dental biofilm accumulation and demineralization of the enamel. The aim of this study was to evaluate the changes of the enamel surface profilometrically after the application of different scaler tips used for the professional supragingival prophylaxis. Materials and methods: Forty-eight enamel block samples obtained from extracted human maxillary premolar teeth were prepared and randomly assigned to four different treatment groups. Each treatment group was instrumented by the same clinician with different tools as Group 1: Er:YAG laser chisel tip, Group 2: scaler, Group 3: new generation universal curette; and Group 4: ultrasonic device. Sample surfaces were evaluated with a profilometer before and after instrumentations and after the polishing process. Results: Baseline roughness of the prepared enamel samples was similar between the groups. After instrumentation and polishing, the Er:YAG laser chisel tip revealed the most irregular surface morphology, whereas the new generation curette induced the smoothest surface. Conclusions: New generation universal curette is a promising tool, which can be used safely for supragingival calculus removal without the need for polishing on enamel surfaces.
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Affiliation(s)
- Gizem Ince Kuka
- Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Bahar Kuru
- Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Hare Gursoy
- Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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de Almeida JM, de Araujo NJ, Matheus HR, de Abreu Furquim EM, Piovezan BR, Fiorin LG, Ervolino E. Hand instrumentation provides improved tissue response over ultrasonic scaler and substantiates safe dental practice: An in vivo study in rats. PLoS One 2023; 18:e0284497. [PMID: 37167233 PMCID: PMC10174520 DOI: 10.1371/journal.pone.0284497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/02/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of hand debridement (HD) versus ultrasonic dental scaler (UDS) for the treatment of experimental periodontitis (EP) in rats. MATERIAL AND METHODS Thirty 3-month-old male rats were used. EP was induced around the mandibular first molars (right and left). Seven days after induction, the treatments with either HD (n = 30) or UDS (n = 30) were randomly performed in each molar. Euthanasia were performed at 7, 15, and 30 days after treatment. Histometric (percentage of bone in the furcation [PBF]), histopathological, and immunohistochemical (for detection of tartrate-resistant acid phosphatase [TRAP] and osteocalcin [OCN]). Parametric data (PBF and TRAP) was analyzed by One-way ANOVA followed by Tukey's post-test. OCN was analyzed by Kruskal-Wallis followed by Student-Newman-Keuls post-test. The level of significance was 5%. RESULTS Group HD presented higher PBF and lower TRAP-immunolabeling at 30 days as compared with UDS in the same period (p≤0.05). Group HD presented higher OCN immunolabeling at 30 days as compared with 7 and 15 days (p≤0.05). Persistent and exacerbated inflammatory process was observed in some specimens from group UDS at 30 days, as well as the bone trabeculae presented irregular contour, surrounded by many active osteoclasts. CONCLUSION Nonsurgical periodontal therapy with HD resulted in higher PBF and lower expression of TRAP as compared with UDS. Also, HD increased the expression of OCN over time.
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Affiliation(s)
- Juliano Milanezi de Almeida
- Department of Diagnosis and Surgery-Periodontics Division, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
- Nucleus of Study and Research in Periodontology and Implantology (NEPPI), School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Nathália Januario de Araujo
- Department of Diagnosis and Surgery-Periodontics Division, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
- Nucleus of Study and Research in Periodontology and Implantology (NEPPI), School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Henrique Rinaldi Matheus
- Department of Diagnosis and Surgery-Periodontics Division, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
- Nucleus of Study and Research in Periodontology and Implantology (NEPPI), School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Elisa Mara de Abreu Furquim
- Department of Diagnosis and Surgery-Periodontics Division, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
- Nucleus of Study and Research in Periodontology and Implantology (NEPPI), School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Bianca Rafaeli Piovezan
- Department of Diagnosis and Surgery-Periodontics Division, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
- Nucleus of Study and Research in Periodontology and Implantology (NEPPI), School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Luiz Guilherme Fiorin
- Department of Diagnosis and Surgery-Periodontics Division, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
- Nucleus of Study and Research in Periodontology and Implantology (NEPPI), School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Edilson Ervolino
- Nucleus of Study and Research in Periodontology and Implantology (NEPPI), School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
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Furcation-involved molar teeth - part 2: management and prognosis. Br Dent J 2022; 233:923-928. [PMID: 36494531 DOI: 10.1038/s41415-022-5254-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/23/2022] [Indexed: 12/13/2022]
Abstract
Furcation-involved molars are a common presentation in general dental practice. Teeth with increasing degrees of furcation involvement are at a higher risk of requiring extraction. This second article reviews management and prognosis of furcation-involved molar teeth. An improved understanding of how to appropriately manage these teeth can result in improved outcomes for patients.
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Kesarwani S, Parihar S, Singh S, Gautam A, Pandey A, Anjum MM. A new era of Nano!!! Comparative evaluation of ganglioside polymeric nanoparticle coated satranidazole gel and 1% metronidazole gel for the treatment of periodontitis. J Indian Soc Periodontol 2022; 26:378-383. [PMID: 35959308 PMCID: PMC9362811 DOI: 10.4103/jisp.jisp_233_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 12/01/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The present study was intended to comparatively assess the efficacy of ganglioside polymeric nanoparticle-coated 0.25% satranidazole-loaded nanoparticles in gel form with that of the commercially available 1% metronidazole gel as a local drug delivery (LDD) agent for the treatment of periodontal pockets. Materials and Methods: A split-mouth randomized clinical trial was carried out in 46 chronic periodontitis patients with probing pocket depth (PPD) ≥4 mm or clinical attachment loss greater than 3 mm on both quadrants of the same arch. Full-mouth scaling and root planing (SRP) was performed for all the patients followed by application of 0.25% satranidazole-loaded nanoparticles in gel form on one site (Group 1) and commercially available 1% metronidazole gel on another site (Group 2). Clinical parameters (gingival index, plaque index, PPD, clinical attachment level gain, and bleeding on probing) and microbiological analysis of the subgingival plaque samples were performed and assessed at baseline, after SRP, 21st day, and 90th day post treatment. Unpaired “t”-test and ANOVA tests were used for intergroup and intragroup comparison of recorded parameters. Results: The results showed that the satranidazole-loaded nanoparticle group as an adjunct to SRP in chronic periodontitis showed a statistically significant improvement in all the clinical parameters and a fewer relapse of microbial flora in comparison with the metronidazole group as an LDD agent. Conclusion: The present study depicted that both the LDD agents showed an effective improvement of clinical as well as microbiological parameters, but the satranidazole group consistently produced better results than the metronidazole group and hence has a promising future as an LDD agent in treating periodontal pockets.
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Affiliation(s)
- Shivam Kesarwani
- Division of Periodontology, Faculty of Dental Science, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sarita Parihar
- Division of Periodontology, Faculty of Dental Science, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sanjay Singh
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Anju Gautam
- Division of Periodontology, Faculty of Dental Science, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Aishwarya Pandey
- Division of Periodontology, Faculty of Dental Science, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Md Meraj Anjum
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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7
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Analysis of the nano and microstructures of the cervical cementum and saliva in periodontitis: A pilot study. J Oral Biosci 2021; 63:370-377. [PMID: 34583024 DOI: 10.1016/j.job.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES During the progression of periodontitis, the structures of the cementum and saliva are altered due to pathological changes in the environment. This study aimed to analyze the nanostructures of the cervical cementum and saliva in patients with periodontitis. METHODS Patients with periodontitis (n = 10) and periodontally healthy controls (n = 8) were included. Single-rooted teeth with indications for extraction were obtained from individuals. The cervical-thirds of the roots were sectioned transversely to obtain 1 mm thick sections. Unstimulated whole saliva samples were collected from each individual. The nanostructures of the cementum and saliva were analyzed using small and wide-angle X-ray scattering methods. RESULTS The mean radius and distance values of the cementum nanoparticles in the periodontitis and control groups were 368 Å and 1152 Å, and 377 Å and 1186 Å, respectively. The mean radius and distance values of the saliva nanoparticles in the periodontitis and control groups were 425 Å and 1359 Å, and 468 Å and 1452 Å, respectively. More wide-angle X-ray scattering profile peaks were observed in the cementum of the controls. Similarities were observed between the 3D profiles of the cementum and the saliva nanoparticles. CONCLUSIONS According to the results of the present study, (i) the cementum and saliva nanoparticles were of similar size in periodontitis and healthy controls, (ii) the cementum was more crystalline according to the (002) crystallographic plane in controls, and (iii) the similarities in the 3D-profile of the cementum and saliva nanoparticles suggest some interactions between them in the sulcus/periodontal pocket at the nanolevel.
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Iorio-Siciliano V, Ramaglia L, Isola G, Blasi A, Salvi GE, Sculean A. Changes in clinical parameters following adjunctive local sodium hypochlorite gel in minimally invasive nonsurgical therapy (MINST) of periodontal pockets: a 6-month randomized controlled clinical trial. Clin Oral Investig 2021; 25:5331-5340. [PMID: 33687555 PMCID: PMC8370947 DOI: 10.1007/s00784-021-03841-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The mechanical disruption and removal of the subgingival biofilm represent the most important step in the treatment of periodontitis. However, in deep periodontal pockets, mechanical removal of the subgingival biofilm is difficult and frequently incomplete. Preliminary findings indicate that the use of amino acid buffered sodium hypochlorite (NaOCl) gel may chemically destroy the bacterial biofilm and facilitate its mechanical removal. OBJECTIVES To clinically evaluate the efficacy of minimally invasive nonsurgical therapy (MINST) of periodontal pockets with or without local application of an amino acid buffered sodium hypochlorite (NaOCl) gel. MATERIALS AND METHODS Forty untreated patients diagnosed with severe/advanced periodontitis (i.e. stage III/IV) with a slow/moderate rate of progression (i.e. grade A/B) were randomly allocated in two treatment groups. In the test group, the periodontal pockets were treated by means of MINST and NaOCl gel application, while in the control group, treatment consisted of MINST alone. Full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), probing depths (PD), clinical attachment levels (CAL) and gingival recessions (GR) were assessed at baseline and at 6 months following therapy. The primary outcome variable was PD reduction at sites with PD ≥ 5 mm at baseline. RESULTS At 6 months, statistically significant differences between the two groups were found (p = 0.001) in terms of PD and CAL change. No statistically significant differences were found in terms of GR (p = 0.81). The number of sites with PD ≥ 5 mm and BOP (+) decreased statistically significantly (p = 0.001), i.e. from 85.3 to 2.2% in the test group and from 81.6 to 7.3% in the control group, respectively. Statistically significant differences between test and control groups were recorded at 6 months (p = 0.001). MINST + NaOCl compared to MINST alone decreased statistically significantly (p = 0.001) the probability of residual PDs ≥ 5 mm with BOP- (14.5% vs 18.3%) and BOP+ (2.2% vs. 7.2%). CONCLUSIONS Within their limits, the present results indicate that (a) the use of MINST may represent a clinically valuable approach for nonsurgical therapy and (b) the application of NaOCl gel in conjunction with MINST may additionally improve the clinical outcomes compared to the use of MINST alone. CLINICAL RELEVANCE In patients with untreated periodontitis, treatment of deep pockets by means of MINST in conjunction with a NaOCl gel may represent a valuable approach to additionally improve the clinical outcomes obtained with MINST alone.
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Affiliation(s)
- Vincenzo Iorio-Siciliano
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy.
| | - Luca Ramaglia
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Gaetano Isola
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Immages, School of Dentistry, University of Messina, AOU Policlinico "G.Martino", Via C.Valeria 1, 98125, Messina, Italy
- Department of General Surgery and Surgical-Medical Specialities, School of Dentistry University of Catania, Via Sofia 78, 95125, Catania, Italy
| | - Andrea Blasi
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
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Wang T, Ma W, Jiang Z, Bi L. The penetration effect of HMME-mediated low-frequency and low-intensity ultrasound against the Staphylococcus aureus bacterial biofilm. Eur J Med Res 2020; 25:51. [PMID: 33092628 PMCID: PMC7583205 DOI: 10.1186/s40001-020-00452-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 10/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to observe the effect of hematoporphyrin monomethyl ether (HMME)-mediated low-frequency and low-intensity ultrasound on mature and stable Staphylococcus aureus (S. aureus) biofilms under different ultrasound parameters. Methods The biofilm was formed after 48-h culture with stable concentration of bacterial solution. Different types of ultrasound and time were applied to the biofilm, and the ultrasonic type and time of our experiments were determined when the biofilm was not damaged. The penetration effects of low-frequency and low-intensity ultrasound were decided by the amount of HMME that penetrated into the biofilm which was determined by fluorescence spectrometry. Results The destruction of biofilms by pulse waveform was the strongest. Sinusoidal low-frequency and low-intensity ultrasound can enhance the biofilm permeability. For a period of time after the ultrasound was applied, the biofilm permeability increased, however, changes faded away over time. Conclusions Low-frequency and low-intensity sinusoidal ultrasound significantly increased the permeability of the biofilms, which was positively correlated with the time and the intensity of ultrasound. Simultaneous action of ultrasound and HMME was the most effective way to increase the permeability of the biofilms.
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Affiliation(s)
- Tao Wang
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, YinHang Street, Nangan District, P.O. Box 31, Harbin, 150001, China
| | - Wei Ma
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, YinHang Street, Nangan District, P.O. Box 31, Harbin, 150001, China
| | - Zhinan Jiang
- Department of Periodontics, WuHan First Stomatological Hospital, WuHan, 430000, China
| | - Liangjia Bi
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, YinHang Street, Nangan District, P.O. Box 31, Harbin, 150001, China.
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Dassatti L, Manicone PF, Lauricella S, Pastorino R, Filetici P, Nicoletti F, D'Addona A. A comparative scanning electron microscopy study between the effect of an ultrasonic scaler, reciprocating handpiece, and combined approach on the root surface topography in subgingival debridement. Clin Exp Dent Res 2020; 6:470-477. [PMID: 32573120 PMCID: PMC7453770 DOI: 10.1002/cre2.299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/08/2020] [Accepted: 04/16/2020] [Indexed: 01/06/2023] Open
Abstract
Objective This study aimed to analyze the effectiveness of root‐shape inserts mounted on a reciprocating handpiece during the procedure of root surface debridement (RSD) on extracted teeth. Three different approaches were compared: ultrasonic scaling, employment of root‐shape inserts mounted on a reciprocating handpiece, and a combination of both. Materials and Methods A total of 51 extracted teeth were divided into three groups. The first group was instrumented with an ultrasonic scaler, the second group with flexible root‐shape inserts mounted on a reciprocating handpiece (grain size 40, 15, and 4 μm), whereas the final group underwent a combination of both approaches. The time required for the instrumentation was taken. The specimens were subjected to optical and scanning electron microscopy (SEM), and the photographs were evaluated by three examiners who were blinded to the study. The parameters included were: SEM roughness index (SRI) for the roughness calculation, remaining calculus Index (RCI) to evaluate the residual calculus deposits, and loss of tooth substance index (LTSI) to evaluate the loss of tooth substance caused by instrumentation. Result The results revealed that the time taken for the instrumentation was on average longer when the root‐shape inserts were employed alone, meanwhile the combined approach did not show significant difference in comparison with the ultrasonic scaling. The lower average RCI was obtained with a combined approach. The use of root‐shape inserts seems to cause a moderate increase in LTSI, especially in a combined approach, whereas it resulted in a better average SRI. Conclusion The employment of root‐shape inserts seems to be effective in the RSD for its ability to obtain a smooth and calculus‐free instrumented surface, especially when used in combination with an ultrasonic scaler, and their use can so represent a valid approach to be tested in further in vivo studies.
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Affiliation(s)
- Leonardo Dassatti
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Paolo Francesco Manicone
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Selenia Lauricella
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Pierfrancesco Filetici
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Fabrizio Nicoletti
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio D'Addona
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
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11
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Yan Y, Zhan Y, Wang X, Hou J. Clinical evaluation of ultrasonic subgingival debridement versus ultrasonic subgingival scaling combined with manual root planing in the treatment of periodontitis: study protocol for a randomized controlled trial. Trials 2020; 21:113. [PMID: 31992331 PMCID: PMC6988244 DOI: 10.1186/s13063-019-4031-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Periodontal diseases are regarded as the most common diseases of mankind. The prevalence rate of periodontal disease assumes a clear growth tendency, increasing by 57.3% from 1990 to 2010. Thereby, effective periodontal therapy is still a long-term task and a difficult problem. The goals of periodontal therapy are to eliminate the infectious and inflammatory processes of periodontal diseases. Root planing, in order to eliminate the "infected cementum," has been an important step in the treatment of periodontitis since the 1970s. However, along with the understanding of the effects of endotoxin on the root surface, the necessity of manual root planing has been gradually queried. Ultrasonic instruments, which are more recent innovations, would not remove the cementum excessively, and are also more time-saving and labor-saving compared to using hand instruments. Hence, an increasing number of dentists prefer to do scaling with ultrasonic instruments only. However, the necessity of root planing remains emphasized in the international mainstream views of periodontal mechanical treatment. Therefore, this study is devoted to compare the clinical effect of ultrasonic subgingival debridement and ultrasonic subgingival scaling combined with manual root planing, which takes the implementation of root planing as the only variable and is more in line with the current clinical situation, thus hoping to provide some valuable reference to dentists. METHODS/DESIGN Forty adult patients who fit the inclusion criteria are being recruited from the Peking University Hospital of Stomatology (Beijing, China). By means of randomization tables, one quadrant of the upper and lower teeth is the test group and the other is the control group. Test group: ultrasonic subgingival scaling combined with manual root planing. CONTROL GROUP ultrasonic subgingival debridement. In a 24-week follow-up period, plaque index, probing depth, clinical attachment loss, bleeding index, furcation involvement, mobility, and patient-reported outcome (Visual Analog Scale for pain and sensitivity) will be observed and documented. DISCUSSION This study evaluates the effectiveness of ultrasonic subgingival scaling combined with manual root planing and ultrasonic subgingival debridement alone in the nonsurgical treatment of periodontitis with a split-mouth design after 1, 3 and 6 months. The result of the trial should potentially contribute to an advanced treatment strategy for periodontitis with an ideal clinical outcome. TRIAL REGISTRATION International Clinical Trials Registry Platform (ICTRP), ID: ChiCTR1800017122. Registered on 12 July 2018.
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Affiliation(s)
- Yue Yan
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Yalin Zhan
- Department of General Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xian'e Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Jianxia Hou
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
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12
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Shukla S, Chug A, Mahesh L, Singh S, Singh K. Optimal management of intrabony defects: current insights. Clin Cosmet Investig Dent 2019; 11:19-25. [PMID: 30697083 PMCID: PMC6340362 DOI: 10.2147/ccide.s166164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Periodontitis is the most common condition, which causes bony defects. Intrabony defects thought not as common as the horizontal bone loss pose a risk of disease progression and thus should be managed optimally; however, it does not mean all the intrabony defects can be treated and all the mobile teeth saved! But, with the advent of new biomaterials prognosis of teeth can be improved. The objective of this article is to discuss old and new concepts toward the optimal management of intrabony defects.
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Affiliation(s)
- Sagrika Shukla
- Department of Dentistry (Periodontology), All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India,
| | - Ashi Chug
- Department of Dentistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | | | | | - Kuldeep Singh
- Department of Conservative Dentistry & Endodontics, RR Dental College, Udaipur, India
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13
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Ma L, Zhang X, Ma Z, Shi H, Zhang Y, Wu M, Cui W. Clinical Effectiveness of Er: YAG Lasers Adjunct to Scaling and Root Planing in Non-Surgical Treatment of Chronic Periodontitis: A Meta-Analysis of Randomized Controlled Trials. Med Sci Monit 2018; 24:7090-7099. [PMID: 30289123 PMCID: PMC6186153 DOI: 10.12659/msm.911863] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Er: YAG lasers (ERLs) show suitable characteristics for scaling and root planing, but previous studies have drawn conflicting conclusions. This meta-analysis aimed to systematically appraise the available evidence concerning the effectiveness of ERLs as an adjunct to scaling and root planing (SRP) for non-surgical periodontal treatment. MATERIAL AND METHODS Randomized controlled trials (RCTs) comparing ERLs+SRP with SRP alone for the treatment of chronic periodontitis were searched in 9 electronic biomedical databases up to January 2018. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were counted for probing depth (PD) reduction, clinical attachment level (CAL) gain, and visual analog scale (VAS) score. Heterogeneity was evaluated with the I² statistic for interstudy comparisons and the χ²-based Q statistic for intra-study comparisons. Sensitivity analysis was conducted by switching to a random or fixed effect model based on the heterogeneity. Publication bias was measured by Begg's test. RESULTS Ten related RCTs met the inclusion criteria. There were statistically significant differences in the assessed clinical parameters at the three-month follow-up: PD reduction (WMD=0.32, 95%CI range from 0.14 to 0.51, p<0.001; p=0.003, I²=69.7%); CAL gain (WMD=0.31, 95%CI range from 0.22 to 0.40, p<0.001; p=0.209, I²=28.8%); and VAS scores (WMD=-1.38, 95%CI range from -2.45 to -0.31, p<0.001; p=0.182, I²=44%). There were no significant differences at the six- and twelve-month follow-ups. Sensitivity analysis revealed that the results were consistent. No evidence of publication bias was detected. CONCLUSIONS This systematic analysis demonstrated that ERLs+SRP provides additional short-term effectiveness and that patients experience less pain compared to SRP. There were no significant differences at the medium-term and long-term follow-ups. Long-term well-designed RCTs are required.
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Affiliation(s)
- Lei Ma
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University; Hebei Province Center for Disease Prevention and Control, Shijiazhuang, Hebei, China (mainland)
| | - Zhe Ma
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Hong Shi
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Yanning Zhang
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Mingxuan Wu
- College and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Wei Cui
- Department of Stomatology, No. 2 Hospital of Baoding, Baoding, Hebei, China (mainland)
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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: 220] [Impact Index Per Article: 36.7] [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.
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Isola G, Matarese G, Williams RC, Siciliano VI, Alibrandi A, Cordasco G, Ramaglia L. The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial. Clin Oral Investig 2018. [PMID: 28624914 DOI: 10.1007/s00784-017-2154-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of CP. MATERIALS AND METHODS Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored. RESULTS Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23 ± 0.31 mm vs. desiccant: 3.25 ± 0.57 mm, p < 0.05), CAL (SRP: 3.16 ± 0.29 mm vs. desiccant: 4.21 ± 0.34 mm, p < 0.05 mm) and bleeding on probing (BOP) (SRP: 4.56 ± 1.5% vs. desiccant: 34.23 ± 4.2%, p < 0.001) at 12 months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (p < 0.05); and the level of inflammatory mediators was significantly reduced (p < 0.003) compared to SRP alone. CONCLUSIONS SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone. CLINICAL RELEVANCE Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.
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Affiliation(s)
- Gaetano Isola
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, Unit of Periodontology, School of Dentistry, University of Messina, AOU Policlinico "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II", Via G. Pansini 5, 80131, Naples, Italy
| | - Giovanni Matarese
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, Unit of Periodontology, School of Dentistry, University of Messina, AOU Policlinico "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy.
| | - Ray C Williams
- Department of Periodontology, UNC School of Dentistry, Campus Box #7450, Chapel Hill, NC, 27599-7450, USA
| | | | - Angela Alibrandi
- Department of Economics, Unit of Statistics and Mathematical Sciences, University of Messina, Via Pugliatti 1, 98122, Messina, Italy
| | - Giancarlo Cordasco
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, Unit of Periodontology, School of Dentistry, University of Messina, AOU Policlinico "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
| | - Luca Ramaglia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II", Via G. Pansini 5, 80131, Naples, Italy
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Kozlovsky A, Rapaport A, Artzi Z. Influence of operator skill level on the clinical outcome of non-surgical periodontal treatment: a retrospective study. Clin Oral Investig 2018; 22:2927-2932. [DOI: 10.1007/s00784-018-2380-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 02/06/2018] [Indexed: 12/16/2022]
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Talebi-Ardakani MR, Torshabi M, Karami E, Vajar N, Rezaei Esfahrood Z, Meimandi M, Mojahedi SM. Comparison of Er:YAG Laser and Hand Instrumentation on the Attachment of Cultured Human Gingival Fibroblasts to Periodontally Involved Root Surfaces. J Lasers Med Sci 2017; 8:S51-S55. [PMID: 29071036 DOI: 10.15171/jlms.2017.s10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: The present study compared the effects of erbium-doped yttrium aluminium garnet (Er:YAG) laser and hand instrumentation on the attachment of human gingival fibroblast (HGF) cells to periodontally involved root surfaces. Methods: A total of 40 tooth specimens were collected and treated in four distinct groups: scaled and root planed with hand instruments, scaled with Er:YAG laser, treated with a combination of hand instruments and Er:YAG laser and non-treated control group. The attachment and proliferation rate of HGF were assessed using MTT assay and scanning electron microscope (SEM) examination was used for cell morphological evaluation. Results: The MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyl tetrazolium bromide) assay showed significant decrease in HGF cell viability in both hand instruments only and combination treated teeth specimens compared to control specimens (P<0.05), 24 hours after cell seeding. However, at time 48, the cell viability of attached cells in these 2 treated groups was almost similar to control. In contrast, at 24 and 48 hours after cell seeding, viability of attached cells was higher than control in Er:YAG laser treated only specimens (P<0.05). According to SEM study, the laser treated specimens showed more surface roughness. Conclusion: Er:YAG laser increased attachment and proliferation of HGF cells in comparison to the hand instruments method.
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Affiliation(s)
| | - Maryam Torshabi
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Karami
- Department of Periodontics, School of Dentistry, Yazd University of Medical Sciences, Yazd, Iran
| | - Nazanin Vajar
- School of Dentistry, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Rezaei Esfahrood
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Meimandi
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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18
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Abbaszadeh HA, Peyvandi AA, Sadeghi Y, Safaei A, Zamanian-Azodi M, Khoramgah MS, Rezaei-Tavirani M. Er:YAG Laser and Cyclosporin A Effect on Cell Cycle Regulation of Human Gingival Fibroblast Cells. J Lasers Med Sci 2017; 8:143-149. [PMID: 29123635 DOI: 10.15171/jlms.2017.26] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Periodontitis is a set of inflammatory disorders characterized by periodontal attachment loss and alveolar bone resorption. Because of deficiency in periodontitis mechanical therapy, this study was aimed to explore the molecular influence of the erbiumdoped: yttrium aluminum garnet (Er:YAG) laser and cyclosporin A (CsA) on human gingival fibroblasts (HGFs) for improvement in periodontal diseases therapy. Methods: We focused on articles that studied the proteome profiles of HGFs after treatment with laser irradiation and application of CsA. The topological features of differentially expressed proteins were analyzed using Cytoscape Version 3.4.0 followed by module selection from the protein-protein interaction (PPI) network using Cluster ONE plugin. In addition, we performed gene ontology (GO) enrichment analysis for the densely connected region and key proteins in both PPI networks. Results: Analysis of PPI network of Er:YAG laser irradiation on HGFs lead to introducing YWHAZ, VCP, HNRNPU, YWHAE, UBA52, CLTC, FUS and IGHG1 as key proteins while similar analysis revealed that ACAT1, CTSD, ALDOA, ANXA2, PRDX1, LGALS3, ARHGDI and EEF1A1 are the crucial proteins related to the effect of drug. GO enrichment analysis of hubbottleneck proteins of the 2 networks showed the different significant biological processes and cellular components. The functional enrichments of module of Er:YAG laser network are included as fatty acid transmembrane transport, cytokinesis, regulation of RNA splicing and asymmetric protein localization. There are not any significant clusters in network of HGF treated by CsA. Conclusion: The results indicate that there are 2 separate biomarker panels for the 2 treatment methods.
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Affiliation(s)
- Hojjat-Allah Abbaszadeh
- Hearing Disorders Research Center and Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Peyvandi
- Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yousef Sadeghi
- Hearing Disorders Research Center and Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Safaei
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mona Zamanian-Azodi
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sadat Khoramgah
- Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Arora S, Lamba AK, Faraz F, Tandon S, Ahad A. Evaluation of the Effects of Er,Cr:YSGG Laser, Ultrasonic Scaler and Curette on Root Surface Profile Using Surface Analyser and Scanning Electron Microscope: An In Vitro Study. J Lasers Med Sci 2017; 7:243-249. [PMID: 28491260 DOI: 10.15171/jlms.2016.43] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The periodontal therapy is primarily targeted at removal of dental plaque and plaque retentive factors. Although the thorough removal of adherent plaque, calculus and infected root cementum is desirable, it is not always achieved by conventional modalities. To accomplish more efficient results several alternative devices have been used. Lasers are one of the most promising modalities for nonsurgical periodontal treatment as they can achieve excellent tissue ablation with strong bactericidal and detoxification effects. Methods: Thirty freshly extracted premolars were selected and decoronated. The mesial surface of each root was divided vertically into four approximately equal parts. These were distributed into four group based on the root surface treatment. Part A (n = 30) was taken as control and no instrumentation was performed. Part B (n = 30) was irradiated by Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser. Part C (n = 30) was treated by piezoelectric ultrasonic scaler. Part D (n = 30) was treated by Gracey curette. The surface roughness was quantitatively analyzed by profilometer using roughness average (Ra) value, while presence of smear layer, cracks, craters and melting of surface were analyzed using scanning electron microscope (SEM). The means across the groups were statistically compared with control using Dunnett test. Results: Among the test groups, Er,Cr:YSGG laser group showed maximum surface roughness (mean Ra value of 4.14 μm) as compared to ultrasonic scaler (1.727 μm) and curette group (1.22 μm). However, surface with smear layer were found to be maximum (50%) in curette treated samples and minimum (20%) in laser treated ones. Maximum cracks (83.34%) were produced by ultrasonic scaler, and minimum (43.33%) by curettes. Crater formation was maximum (50%) in laser treated samples and minimum (3.33%) in curette treated ones. 63.33% samples treated by laser demonstrated melting of root surface, followed by ultrasonic scaler and curettes. Conclusion: Er,Cr:YSGG laser produced maximum microstructural changes on root surface that can influence the attachment of soft periodontal tissues as well as plaque and calculus deposition. In vivo studies are needed to validate these results and to evaluate their clinical effects.
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Affiliation(s)
- Shipra Arora
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Arundeep Kaur Lamba
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Farrukh Faraz
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Shruti Tandon
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Abdul Ahad
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India
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20
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Fekrazad R, Lotfi G, Harandi M, Ayremlou S, A M Kalhori K, Gholami GA, Nokhbatolfoghahaei H. Comparing fibroblast attachment in root surface scaling with Er, Cr:YSGG laser versus ultrasonic scaler: A SEM study. Microsc Res Tech 2017; 80:917-922. [PMID: 28467022 DOI: 10.1002/jemt.22882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 03/04/2017] [Accepted: 04/10/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES The regeneration of periodontal support is the main concern in periodontal therapy. The aim of this in vitro study was to investigate the fibroblasts attachment on root surfaces after scaling with Er, Cr:YSGG laser and ultrasonic instruments using scanning electron microscopy (SEM). METHODS 72 root plates of ∼6 × 4 × 1 mm3 in dimension were prepared from 27 single-rooted human mature teeth and were then divided into four groups. One group irradiated with a G6 tip of Er, Cr:YSGG laser (2.78 µm, 0.75 W, pulse duration of 140 µs, repetition rate of 20 Hz) for 5 to 7 s, and the other groups were scaled with ultrasonic alone or laser-ultrasonic. The control group was subjected to neither laser nor ultrasonic scaling. Subsequently, Viability and proliferation rates were done using MTT assay on days 3 and 5. Finally the cell attachment was observed using SEM. RESULTS The data derived from MTT and cell-attachment analysis indicated that laser-ultrasonic scaling tended to increase cell-viability by the lapse of time (within 3-5 days), with significantly better cell-attachment compared with other groups on days 3 and 5 (p < .05). The comparison of the difference in fibroblast cell attachment rate on both the third and the fifth day with independent T-Test indicated a significant rise on the fifth day compared to the third day of study (p < .05). CONCLUSION Indeed, both Er, Cr:YSGG laser and ultrasonic scaling may promote fibroblast attachment on dentinal root surfaces more than laser or ultrasonic scaling alone.
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Affiliation(s)
- Reza Fekrazad
- Periodontist, Periodontology Department, Dental Faculty, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ghogha Lotfi
- Periodontist, Periodontology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Harandi
- Dental student, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Katayoun A M Kalhori
- Oral and maxillofacial pathologist, Iranian Medical Laser Association, Tehran, Iran
| | - Gholam Ali Gholami
- Periodontist, Periodontology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Nokhbatolfoghahaei
- Dental Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Krishna R, De Stefano JA. Ultrasonic vs. hand instrumentation in periodontal therapy: clinical outcomes. Periodontol 2000 2016; 71:113-27. [DOI: 10.1111/prd.12119] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 11/29/2022]
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Gurav AN. Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough? World J Diabetes 2016; 7:50-66. [PMID: 26962409 PMCID: PMC4766246 DOI: 10.4239/wjd.v7.i4.50] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/16/2015] [Accepted: 01/19/2016] [Indexed: 02/05/2023] Open
Abstract
Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the “sixth” major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A “two way” relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.
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Gualberto EC, Theodoro LH, Longo M, Novaes VCN, Nagata MJH, Ervolino E, Garcia VG. Antimicrobial photodynamic therapy minimizes the deleterious effect of nicotine in female rats with induced periodontitis. Lasers Med Sci 2015; 31:83-94. [DOI: 10.1007/s10103-015-1820-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 10/13/2015] [Indexed: 12/26/2022]
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Kumar P, Das SJ, Sonowal ST, Chawla J. Comparison of Root Surface Roughness Produced By Hand Instruments and Ultrasonic Scalers: An Invitro Study. J Clin Diagn Res 2015; 9:ZC56-60. [PMID: 26675445 DOI: 10.7860/jcdr/2015/13744.6828] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 07/03/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND Instrumentation on tooth surface for debridement of hard and soft debris forms the basis of periodontal therapy. This involves periodic removal of accumulated material using different methods of instrumentation. An ideal instrument should eliminate all the deposits from the root surfaces with no or minimal alteration of the natural morphology. AIM To compare the root surface roughness after root planing performed with gracey curette and by ultrasonic scalers (Satelec P-5 Booster) set at different power modes. MATERIALS AND METHODS The root surface roughness and its surface microtopography resulting from the use of Gracey curette, ultrasonic instrument at low, medium and high power setting on 35 healthy premolars extracted for orthodontic treatment purpose were examined using Optical Profilometer and the surface topography was assessed using Field Emission Microscope. STATISTICAL ANALYSIS Analysis of variance (ANOVA) test was used to observe the variance in a particular variable is partitioned into components attributable to different sources of variation. Duncan multiple range tests were used to determine whether three or more means differ significantly. RESULTS AND CONCLUSION The mean roughness was found to be the highest in group where Scaling and Root Planing (SRP) was performed using ultrasonic scaler at low power mode (3.03±1.54 μm) whereas the lowest surface roughness was seen on the samples where SRP was performed using ultrasonic scaler at medium power mode. The surface roughness in group where SRP was performed with ultrasonic scaler at high power mode (2.22±0.74μm) was found to be similar to that of group in which root planing was carried out using curette (2.24±1.71μm).
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Affiliation(s)
- Pawan Kumar
- Senior Resident, Department of Periodontics, Oral Health Science Centre, Post Graduate Institute of Medical Education and Research , Chandigarh, India
| | - Swarga Jyoti Das
- Professor and HOD, Department of Periodontics, Regional Dental College , Bhangagarh, Guwahati, Assam, India
| | - Saindhya Tora Sonowal
- Senior Lecturer, Department of Periodontics, Mansarovar Dental College , Bhopal, Madhya Pradesh, India
| | - Jitendra Chawla
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, Government Dental College , Nagpur, Maharastra, India
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Suda T, Kobayashi H, Akiyama T, Takano T, Gokyu M, Sudo T, Khemwong T, Izumi Y. Desensitizing Agent Reduces Dentin Hypersensitivity During Ultrasonic Scaling: A Pilot Study. J Clin Diagn Res 2015; 9:ZC46-9. [PMID: 26501012 DOI: 10.7860/jcdr/2015/13775.6495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/10/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dentin hypersensitivity can interfere with optimal periodontal care by dentists and patients. The pain associated with dentin hypersensitivity during ultrasonic scaling is intolerable for patient and interferes with the procedure, particularly during supportive periodontal therapy (SPT) for patients with gingival recession. AIM This study proposed to evaluate the desensitizing effect of the oxalic acid agent on pain caused by dentin hypersensitivity during ultrasonic scaling. MATERIALS AND METHODS This study involved 12 patients who were incorporated in SPT program and complained of dentin hypersensitivity during ultrasonic scaling. We examined the availability of the oxalic acid agent to compare the degree of pain during ultrasonic scaling with or without the application of the dentin hypersensitivity agent. Evaluation of effects on dentin hypersensitivity was determined by a questionnaire and visual analog scale (VAS) pain scores after ultrasonic scaling. The statistical analysis was performed using the paired Student t-test and Spearman rank correlation coefficient. RESULTS The desensitizing agent reduced the mean VAS pain score from 69.33 ± 16.02 at baseline to 26.08 ± 27.99 after application. The questionnaire revealed that >80% patients were satisfied and requested the application of the desensitizing agent for future ultrasonic scaling sessions. CONCLUSION This study shows that the application of the oxalic acid agent considerably reduces pain associated with dentin hypersensitivity experienced during ultrasonic scaling. This pain control treatment may improve patient participation and treatment efficiency.
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Affiliation(s)
- Tomonari Suda
- Reseach Associate, Peirodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Hiroaki Kobayashi
- Lecturer, Peirodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Toshiharu Akiyama
- Registered Dentist, Periodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Takuya Takano
- Research Student, Periodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Misa Gokyu
- Graduate Student, Periodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Takeaki Sudo
- Graduate Student, Periodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Thatawee Khemwong
- Graduate Student, Periodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Yuichi Izumi
- Professor, Periodontology, Department of Bio-Matrix, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
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Priyanka N, Kalra N, Saquib S, Kudyar N, Malgaonkar N, Jain H, Pradeep AR. Clinical and microbiological efficacy of 3% satranidazole gel as a local drug delivery system in the treatment of chronic periodontitis: A randomized, controlled clinical trial. Contemp Clin Dent 2015; 6:364-70. [PMID: 26321836 PMCID: PMC4549988 DOI: 10.4103/0976-237x.161891] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The present clinical trial was designed to investigate the effectiveness of subgingivally delivered satranidazole (SZ) gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. MATERIALS AND METHODS Seventy subjects with probing depth (PD) ≥5 mm were selected. Thirty-five subjects each were randomly assigned to SRP + placebo (Group 1) and SRP + SZ (Group 2). The clinical outcomes evaluated were plaque index, gingival index, clinical attachment level (CAL), and PD at baseline; 1 month, 3 months, and 6 months interval. Furthermore, microbial analysis using polymerase chain reaction was done to estimate the number of sites harboring periodontopathogens. RESULTS Sixty four subjects were evaluated up to 6 months. At 6 months, the Group 2 resulted in greater mean reduction (4.10 mm) in PD as compared to Group 1 (1.49 mm), and also a greater mean CAL gain (4.20 mm) in Group 2 as compared to Group 1 (1.13 mm). These subjects also showed a significant reduction in the number of sites harboring periodontopathogens. CONCLUSION The use of 3% SZ gel, when used as an adjunct to nonsurgical periodontal therapy in subjects with periodontitis, achieved better results than initial periodontal treatment alone.
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Affiliation(s)
- N Priyanka
- Department of Periodontics, Government Dental College and Research Institute, Bengaluru, India
| | - Nitish Kalra
- Department of Periodontics, Government Dental College and Research Institute, Bengaluru, India
| | - Shahab Saquib
- Department of Periodontics, Yogita Dental College and Hospital, Khed, Ratnagiri, Maharashtra, India
| | - Nitin Kudyar
- Department of Periodontics, Himachal Dental College, Sundernagar, Himachal Pradesh, India
| | - Nikhil Malgaonkar
- Department of Oral Pathology, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Hunny Jain
- Department of Oral Surgery, Yogita Dental College and Hospital, Khed, Ratnagiri, Maharashtra, India
| | - A. R. Pradeep
- Department of Periodontics, Government Dental College and Research Institute, Bengaluru, India
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Fekrazad R, Lotfi G, Harandi M, Ayremlou S, Kalhori KA. Evaluation of fibroblast attachment in root conditioning with Er, Cr:YSGG laser versus EDTA: A SEM study. Microsc Res Tech 2015; 78:317-22. [DOI: 10.1002/jemt.22477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 01/29/2015] [Indexed: 12/23/2022]
Affiliation(s)
- Reza Fekrazad
- Laser Research Center of Dentistry; Dental Faculty; Tehran University of Medical Sciences, Periodontal Department, Dental Faculty, AJA University of Medical Sciences; Tehran Iran
| | - Ghogha Lotfi
- Dental Research Center; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | | | - Sara Ayremlou
- Postgraduate Student of Prosthodontics, Dental Branch, Islamic Azad University; Tehran Iran
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Dilsiz A, Sevinc S. Trauma from instrumentation after non-surgical periodontal treatment with ultrasonic scalers and Nd:YAG laser. Acta Odontol Scand 2015; 73:144-9. [PMID: 25252593 DOI: 10.3109/00016357.2014.961955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Periodontal therapies aimed at altering the progression of periodontal diseases must include meticulous mechanical debridement during both the non-surgical and the surgical phases of periodontal treatment. The aim of this study was to evaluate and compare the immediate effect of trauma from instrumentation on clinical attachment level after non-surgical periodontal treatment with ultrasonic scalers and a Nd:YAG laser. MATERIALS AND METHODS Twenty-four patients with untreated chronic periodontitis, presenting probing depths of 4-6 mm on anterior teeth, upper and lower, were entered into the study. The selected teeth were probed with a pressure-controlled probe, guided by stents. Each quadrant was randomly allocated in a split-mouth design either to treatment with Nd:YAG laser using an energy of 1W, 100mj, 1064nm (test group) or to periodontal treatment using ultrasonic scalers (control group). Clinical parameters, including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were acquired prior to and immediately after treatment. RESULTS Statistical analysis demonstrated no differences between groups at baseline for all parameters (p > 0.05). Immediately after treatment, the control group showed a greater PAL loss than the test group (p < 0.05). For the control group, there were statistically significant differences between PAL immediately before and after treatment (p < 0.05), but not test group (p > 0.05). CONCLUSIONS Within the limits of the present study, it may be concluded that non-surgical periodontal treatment with ultrasonic scalers causes a mean immediate attachment loss of 0.68 mm and that a Nd:YAG laser seems to reduce significantly the trauma the instrumentation produced.
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Affiliation(s)
- Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University , Erzurum , Turkey
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Ogita M, Tsuchida S, Aoki A, Satoh M, Kado S, Sawabe M, Nanbara H, Kobayashi H, Takeuchi Y, Mizutani K, Sasaki Y, Nomura F, Izumi Y. Increased cell proliferation and differential protein expression induced by low-level Er:YAG laser irradiation in human gingival fibroblasts: proteomic analysis. Lasers Med Sci 2014; 30:1855-66. [PMID: 25429773 DOI: 10.1007/s10103-014-1691-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 11/05/2014] [Indexed: 11/28/2022]
Abstract
Erbium-doped yttrium aluminum garnet (Er:YAG) laser treatment has demonstrated favorable wound healing effect after periodontal therapy. One of the reasons may be the positive biological effect of the low-level laser on the irradiated tissues, although the mechanism remains unclear. The aim of this study was to investigate the effect of low-level Er:YAG laser irradiation on cell proliferation and laser-induced differential expression of proteins in human gingival fibroblasts (HGFs) by proteomic analysis. In the first experiment, HGFs were exposed to low-level Er:YAG laser irradiation and the laser-induced cell proliferation and damage were evaluated on day 3. In the second experiment, proteomic analysis was performed on day 1 after irradiation. The peptides prepared from HGFs were analyzed by a hybrid ion trap-Fourier transform mass spectrometer, Mascot search engine, and UniProtKB database. A significant increase in cell proliferation without cell damage after irradiation was observed. Among the total identified 377 proteins, 59 proteins, including galectin-7, which was associated with the process of wound healing, were upregulated and 15 proteins were downregulated in laser-treated HGFs. In the third experiment, the increase in messenger RNA (mRNA) and protein expression of galectin-7 in the irradiated HGFs was validated by various analytical techniques. In addition, the effect of recombinant human galectin-7 on the modulation of HGFs proliferation was confirmed. The results indicate that low-level Er:YAG laser irradiation can promote HGF proliferation and induce a significant change in protein expression and the upregulation of galectin-7 expression may partly contribute to the increase in cell proliferation.
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Affiliation(s)
- Mayumi Ogita
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Dilsiz A, Sevinc S. KTP laser therapy as an adjunctive to scaling and root planing in treatment of chronic periodontitis. Acta Odontol Scand 2014; 72:681-6. [PMID: 24646100 DOI: 10.3109/00016357.2014.898088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The main goal of periodontal treatment is to control infection and, thereby, curb disease progression. Recent studies have suggested that the use of a laser as an adjunct to scaling and root planing (SRP) might improve the effectiveness of conventional periodontal treatment. The aim of this study was to evaluate and compare the clinical effects of potassium-titanyl-phosphate (KTP) laser therapy in the treatment of chronic periodontitis in combination with traditional SRP. MATERIALS AND METHODS Twenty-four patients with untreated chronic periodontitis were treated using a split-mouth study design in which each side was randomly treated by SRP alone (control group) or KTP laser (0.8W, time on 50 ms, time off 50 ms, 30 s, 532 nm) followed by SRP (test group). In the distribution of the teeth (total = 124 teeth) in the patients, 106 (86%) were molars and 18 (14%) were premolars. The selected teeth were probed with a pressure-controlled probe, guided by stents. Clinical periodontal parameters including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were recorded at baseline and at 2 and 12 months following therapy. RESULTS Statistical analysis demonstrated no differences between groups at baseline for all parameters (p > 0.05). BOP and PPD reductions and PAL gains were statistically significant both between baseline and 2 months and between baseline and 12 months in both groups (p < 0.05). The test group showed a greater reduction in PPD compared to the control group (p < 0.05). In addition, the test group showed a greater probing attachment gain compared to the control group (p < 0.05). CONCLUSIONS In patients with chronic periodontitis, clinical outcomes of conventional periodontal treatment can be improved by using an adjunctive KTP laser.
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Affiliation(s)
- Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University , Erzurum , Turkey
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Singh G, Hameister R, Feuerstein B, Awiszus F, Meyer H, Lohmann CH. Low-frequency sonication may alter surface topography of endoprosthetic components and damage articular cartilage without eradicating biofilms completely. J Biomed Mater Res B Appl Biomater 2014; 102:1835-46. [DOI: 10.1002/jbm.b.33163] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/03/2014] [Accepted: 03/19/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Gurpal Singh
- Department of Orthopaedic Surgery; Otto-von-Guericke University; Magdeburg Germany
- University Orthopaedics, Hand and Reconstructive Microsurgery Cluster; National University Health System; Singapore Singapore
| | - Rita Hameister
- Department of Orthopaedic Surgery; Otto-von-Guericke University; Magdeburg Germany
| | - Bernd Feuerstein
- Department of Mechanical Engineering; Magdeburg-Stendal University of Applied Sciences; Magdeburg Germany
| | - Friedemann Awiszus
- Department of Orthopaedic Surgery; Otto-von-Guericke University; Magdeburg Germany
| | - Heiko Meyer
- Department of Orthopaedic Surgery; Otto-von-Guericke University; Magdeburg Germany
| | - Christoph H. Lohmann
- Department of Orthopaedic Surgery; Otto-von-Guericke University; Magdeburg Germany
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Erriu M, Blus C, Szmukler-Moncler S, Buogo S, Levi R, Barbato G, Madonnaripa D, Denotti G, Piras V, Orrù G. Microbial biofilm modulation by ultrasound: current concepts and controversies. ULTRASONICS SONOCHEMISTRY 2014; 21:15-22. [PMID: 23751458 DOI: 10.1016/j.ultsonch.2013.05.011] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 05/08/2013] [Accepted: 05/18/2013] [Indexed: 05/05/2023]
Abstract
Biofilm elimination is often necessary during antimicrobial therapy or industrial medical manufacturing decontamination. In this context, ultrasound treatment has been frequently described in the literature for its antibiofilm effectiveness, but at the same time, various authors have described ultrasound as a formidable enhancer of bacterial viability. This discrepancy has found no solution in the current literature for around 9 years; some works have shown that every time bacteria are exposed to an ultrasonic field, both destruction and stimulation phenomena co-exist. This co-existence proves to have different final effects based on various factors such as: ultrasound frequency and intensity, the bacterial species involved, the material used for ultrasound diffusion, the presence of cavitation effects and the forms of bacterial planktonic or biofilm. The aim of this work is to analyze current concepts regarding ultrasound effect on prokaryotic cells, and in particular ultrasound activity on bacterial biofilm.
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Affiliation(s)
- Matteo Erriu
- Oral Biotechnology Laboratory (OBL), Università degli Studi di Cagliari, Cagliari, Italy.
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Detection, removal and prevention of calculus: Literature Review. Saudi Dent J 2013; 26:7-13. [PMID: 24526823 DOI: 10.1016/j.sdentj.2013.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 09/23/2013] [Accepted: 12/03/2013] [Indexed: 10/25/2022] Open
Abstract
Dental plaque is considered to be a major etiological factor in the development of periodontal disease. Accordingly, the elimination of supra- and sub-gingival plaque and calculus is the cornerstone of periodontal therapy. Dental calculus is mineralized plaque; because it is porous, it can absorb various toxic products that can damage the periodontal tissues. Hence, calculus should be accurately detected and thoroughly removed for adequate periodontal therapy. Many techniques have been used to identify and remove calculus deposits present on the root surface. The purpose of this review was to compile the various methods and their advantages for the detection and removal of calculus.
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Dukić W, Bago I, Aurer A, Roguljić M. Clinical Effectiveness of Diode Laser Therapy as an Adjunct to Non-Surgical Periodontal Treatment: A Randomized Clinical Study. J Periodontol 2013; 84:1111-7. [DOI: 10.1902/jop.2012.110708] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Amid R, Kadkhodazadeh M, Fekrazad R, Hajizadeh F, Ghafoori A. Comparison of the effect of hand instruments, an ultrasonic scaler, and an erbium-doped yttrium aluminium garnet laser on root surface roughness of teeth with periodontitis: a profilometer study. J Periodontal Implant Sci 2013; 43:101-5. [PMID: 23678394 PMCID: PMC3651935 DOI: 10.5051/jpis.2013.43.2.101] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 03/22/2013] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The present study aimed to measure root surface roughness in teeth with periodontitis by a profilometer following root planning with ultrasonic and hand instruments with and without erbium-doped yttrium aluminium garnet (Er:YAG) laser irradiation. METHODS Sixty single-rooted maxillary and mandibular teeth, extracted because of periodontal disease, were collected. The crowns and apices of the roots were cut off using a diamond bur and water coolant. The specimens were mounted in an acrylic resin block such that a plain root surface was accessible. After primary evaluation and setting a baseline, the samples were divided into 4 groups. In group 1, the samples were root planned using a manual curette. The group 2 samples were prepared with an ultrasonic scaler. In group 3, after scaling with hand instrumentation, the roots were treated with a Smart 1240D plus Er:YAG laser and in group 4, the roots were prepared with ultrasonic scaler and subsequently treated with an Er:YAG laser. Root surface roughness was then measured by a profilometer (MahrSurf M300+RD18C system) under controlled laboratory conditions at a temperature of 25℃ and 41% humidity. The data were analyzed statistically using analysis of variance and a t-test (P<0.05). RESULTS Significant differences were detected in terms of surface roughness and surface distortion before and after treatment. The average reduction of the surface roughness after treatment in groups 1, 2, 3, and 4 was 1.89, 1.88, 1.40, and 1.52, respectively. These findings revealed no significant differences among the four groups. CONCLUSIONS An Er:YAG laser as an adjunct to traditional scaling and root planning reduces root surface roughness. However, the surface ultrastructure is more irregular than when using conventional methods.
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Affiliation(s)
- Reza Amid
- Department of Periodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Garcia VG, Gualberto Júnior EC, Fernandes LA, Bosco AF, Hitomi Nagata MJ, Casatti CA, Ervolino E, Theodoro LH. Adjunctive Antimicrobial Photodynamic Treatment of Experimentally Induced Periodontitis in Rats With Ovariectomy. J Periodontol 2013; 84:556-65. [DOI: 10.1902/jop.2012.120163] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Dilsiz A, Canakci V, Aydin T. Clinical Effects of Potassium–Titanyl–Phosphate Laser and Photodynamic Therapy on Outcomes of Treatment of Chronic Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol 2013; 84:278-86. [DOI: 10.1902/jop.2012.120096] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Oliveira AVGD, Silveira VRSD, Nogueira NAP, Moreira MMSM. Debridamento ultrassônico de boca toda no tratamento da periodontite crônica: uma revisão sistematizada. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000100011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: O debridamento ultrassônico de boca toda visa a uma instrumentação mais leve e conservadora da superfície radicular, evitando a recolonização da bolsa periodontal. OBJETIVO: Este trabalho verificou os efeitos do debridamento subgengival com o uso de ultrassom sobre os parâmetros clínicos periodontais no tratamento da periodontite crônica por meio de uma revisão na literatura. MATERIAL E MÉTODO: A revisão foi realizada nas bases de busca bibliográfica PubMed, Lilacs, Scielo, Medline e Centro de Registro de Ensaios Clínicos Controlados (Biblioteca Cochrane). Foram incluídas publicações na língua inglesa que abordaram estudos clínicos de intervenção em humanos, randomizados e controlados, e que utilizaram o debridamento ultrassônico para o tratamento não cirúrgico da periodontite crônica. RESULTADO: Inicialmente, foram encontradas 167 referências e, a partir da análise dos títulos e resumos, dez estudos perfizeram as características exigidas e foram considerados válidos para a realização desta revisão. Os estudos mostraram que a abordagem pelo debridamento ultrassônico pode ser terapia favorável ao tratamento da periodontite crônica. CONCLUSÃO: O tratamento da periodontite crônica por meio do debridamento ultrassônico periodontal de boca toda produz resultados clínicos semelhantes aos conseguidos na raspagem e no alisamento radicular convencionais.
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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]
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Histological and SEM analysis of root cementum following irradiation with Er:YAG and CO2 lasers. Lasers Med Sci 2012; 28:203-13. [PMID: 22580557 DOI: 10.1007/s10103-012-1110-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 04/17/2012] [Indexed: 12/15/2022]
Abstract
Recently, the Er:YAG and CO(2) lasers have been applied in periodontal therapy. However, the characteristics of laser-irradiated root cementum have not been fully analyzed. The aim of this study was to precisely analyze the alterations of root cementum treated with the Er:YAG and the CO(2) lasers, using non-decalcified thin histological sections. Eleven cementum plates were prepared from extracted human teeth. Pulsed Er:YAG laser contact irradiation was performed in a line at 40 mJ/pulse (14.2 J/cm(2)/pulse) and 25 Hz (1.0 W) under water spray. Continuous CO(2) laser irradiation was performed in non-contact mode at 1.0 W, and ultrasonic instrumentation was performed as a control. The treated samples were subjected to stereomicroscopy, scanning electron microscopy (SEM), light microscopy and SEM energy dispersive X-ray spectroscopy (SEM-EDS). The Er:YAG laser-treated cementum showed minimal alteration with a whitish, slightly ablated surface, whereas CO(2) laser treatment resulted in distinct carbonization. SEM analysis revealed characteristic micro-irregularities of the Er:YAG-lased surface and the melted, resolidified appearance surrounded by major and microcracks of the CO(2)-lased surface. Histological analysis revealed minimal thermal alteration and structural degradation of the Er:YAG laser-irradiated cementum with an affected layer of approximately 20-μm thickness, which partially consisted of two distinct affected layers. The CO(2)-lased cementum revealed multiple affected layers showing different structures/staining with approximately 140 μm thickness. Er:YAG laser irradiation used with water cooling resulted in minimal cementum ablation and thermal changes with a characteristic microstructure of the superficial layer. In contrast, CO(2) laser irradiation produced severely affected distinct multiple layers accompanied by melting and carbonization.
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Soo L, Leichter JW, Windle J, Monteith B, Williams SM, Seymour GJ, Cullinan MP. A comparison of Er:YAG laser and mechanical debridement for the non-surgical treatment of chronic periodontitis: A randomized, prospective clinical study. J Clin Periodontol 2012; 39:537-45. [DOI: 10.1111/j.1600-051x.2012.01873.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2012] [Indexed: 01/01/2023]
Affiliation(s)
- Lingfeng Soo
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Jonathan W. Leichter
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Judith Windle
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Brian Monteith
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Sheila M. Williams
- Preventive and Social Medicine, Dunedin School of Medicine; University of Otago; Dunedin; New Zealand
| | - Gregory J. Seymour
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - Mary P. Cullinan
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin; New Zealand
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Berakdar M, Callaway A, Eddin MF, Ross A, Willershausen B. Comparison between scaling-root-planing (SRP) and SRP/photodynamic therapy: six-month study. Head Face Med 2012; 8:12. [PMID: 22480188 PMCID: PMC3353176 DOI: 10.1186/1746-160x-8-12] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 04/05/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The purpose of this long-term clinical study was to examine the additional efficacy of photodynamic therapy (PDT) to scaling and root planing (SRP) in patients with chronic periodontal disease. METHODS A total of 22 patients (mean age: 59.3 ± 11.7 years) with chronic periodontal disease and four teeth with probing depth ≥ 5 mm were enrolled in the study. Inclusion criteria were: no systemic disease, no smoking, no pregnancy and no long-term medication. Beside the anamnesis, the following clinical parameters were assessed at baseline (one week before therapy), and one, three and six months after the therapy: bleeding on probing (BOP), plaque index (PI) probing depth (PD), and clinical attachment loss. All measurements were done by the same examiner with a fixed periodontal probe (PCP 12, Hu-Friedy) at six measurements/tooth. In each patient, two teeth were treated with SRP alone and two teeth with SRP and PDT (Periowave, Ondine Biopharma, Vancouver, Canada). The nonparametric Wilcoxon test for paired samples was used for comparison of the effect of the two treatments (p ≤ 0.05). RESULTS After both types of treatment, the number of teeth positive for BOP declined. At baseline, the CAL measured 7.2 ± 1.2 mm (SRP) or 8.1 ± 1.3 mm (SRP/PDT); one, three and six months after both types of treatment an improvement was observed. At baseline, the probing depth was 5.9 ± 0.8 mm (SRP) or 6.4 ± 0.8 mm (SRP/PDT); after six months, an improvement of 2.4 ± 0.6 mm (SRP) or 2.9 ± 0.8 mm (SRP/PDT) was found. The greater reduction of the PD, achieved by a combination of SRP/PDT, was statistically significant after six months (p = 0.007). CONCLUSION This clinical study demonstrates that SRP in combination with PDT seems to be effective and is therefore suitable as an adjuvant therapy to the mechanical conditioning of the periodontal pockets in patients with chronic periodontal diseases.
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Affiliation(s)
- Mohammad Berakdar
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Germany
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Ge L, Shu R, Li Y, Li C, Luo L, Song Z, Xie Y, Liu D. Adjunctive Effect of Photodynamic Therapy to Scaling and Root Planing in the Treatment of Chronic Periodontitis. Photomed Laser Surg 2011; 29:33-7. [DOI: 10.1089/pho.2009.2727] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Linhua Ge
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Rong Shu
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Yiming Li
- School of Dentistry, Loma Linda University, Loma Linda, California
| | - Chaolun Li
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Lijun Luo
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Zhongchen Song
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Yufeng Xie
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
| | - Dali Liu
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology
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Lea S, Landini G. Reconstruction of dental ultrasonic scaler 3D vibration patterns from phase-related data. Med Eng Phys 2010; 32:673-7. [DOI: 10.1016/j.medengphy.2010.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 02/11/2010] [Accepted: 02/13/2010] [Indexed: 10/19/2022]
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Abstract
Non-surgical removal of plaque and calculus has been part of the initial phase of the management of patients with gingivitis and periodontitis for decades. It consists of patient motivation and oral hygiene instruction as well as mechanical removal of supra and subgingival plaque deposits. The purpose of this review was to assess recent changes. The article reports on changes in our understanding of plaque as a biofilm, developments in patient plaque control, chemical plaque control and scaling instruments. It also comments on full-mouth disinfection, the use of lasers and host modulation. Modern technology has made removal of microbial deposits by the patient and dental professionals more efficient. However, other advancements need to be used in conjunction with mechanical debridement at this time.
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Affiliation(s)
- I Darby
- Melbourne Dental School, The University of Melbourne, Victoria, Australia.
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Lea SC, Walmsley AD. Mechano-physical and biophysical properties of power-driven scalers: driving the future of powered instrument design and evaluation. Periodontol 2000 2009; 51:63-78. [DOI: 10.1111/j.1600-0757.2009.00300.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zucchelli G, Mounssif I, Stefanini M, Mele M, Montebugnoli L, Sforza N. Hand and Ultrasonic Instrumentation in Combination With Root-Coverage Surgery: A Comparative Controlled Randomized Clinical Trial. J Periodontol 2009; 80:577-85. [DOI: 10.1902/jop.2009.080485] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Casarin RCV, Ribeiro FV, Sallum AW, Sallum EA, Nociti-Jr FH, Casati MZ. Root surface defect produced by hand instruments and ultrasonic scaler with different power settings: an in vitro study. Braz Dent J 2009; 20:58-63. [DOI: 10.1590/s0103-64402009000100010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the root surface defect produced by hand curettes and ultrasonic tips with different power settings. Forty root surfaces were divided into 4 groups according the treatment: Gracey curettes, ultrasonic scaler at 10% power, ultrasonic scaler at 50% power and ultrasonic scaler at 100% power. Each specimen was instrumented with 15 strokes and the and divided in the middle to evaluate: (1) the defect depth produced by the instrumentation and (2) contact area of the instrument tips, which was analyzed by scanning electron microscopy. ANOVA and Tukey's test were used for statistical analysis (a=0.05). The results (mean ± SD) of the contact area showed significantly greater defects (p<0.05) for the hand instrumented groups (2092.9 ± 482) compared to the ultrasonic groups (606.8 ± 283.0; 858.6 ± 422.5; 1212.0 ± 366.7, respectively), independently of the power setting. The values for the defect depth on root surface showed no statistically significant difference (p<0.05) between hand instrumentation (66.1 ± 34.0) and ultrasonic scaling at 10%, 50% or 100% power settings (52.4 ± 22.1; 72.0 ± 29.9; 77.7 ± 37.7, respectively). The findings of this study demonstrate that ultrasonic instrumentation produced a similar defect depth to that of hand instrumentation, with a smaller tip contact area, independently of the power setting used for scaling.
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