1
|
Rajagopal A, Varghese J, Bhat V, Acharya V, Kamath V. Anti-infective Efficacy of Mechanical Debridement with Adjunctive Modalities on Clinical and Cytokine Parameters in Treatment of Chronic Periodontitis: Randomized Controlled Clinical Trial. Eur J Dent 2024; 18:526-533. [PMID: 37848071 PMCID: PMC11132771 DOI: 10.1055/s-0043-1772567] [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: 10/19/2023] Open
Abstract
OBJECTIVES Periodontal debridement involves conventional scaling and root planing (SRP) along with variant forms of adjunctive therapies. In the present clinical trial, we investigated if the adjunctive use of HybenX gel or diode laser along with SRP could provide a favorable outcome for the treatment of chronic periodontitis. MATERIALS AND METHODS The present study involved 60 subjects diagnosed with chronic periodontitis who were randomly assigned as test groups (laser or HybenX) or control group (SRP alone). The primary outcomes of the clinical trial were pocket probing depth (PPD) and clinical attachment level (CAL), which was evaluated at baseline and at third-month time interval. Additionally, secondary outcomes included estimation of reduction in inflammatory mediators interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in gingival crevicular fluid using enzyme-linked immunosorbent assay at baseline and third-month intervals. STATISTICAL ANALYSIS Normality determination was checked using Shapiro-Wilk test. Since the data was not normally distributed, nonparametric tests were applied. The comparison of clinical parameters between the groups was analyzed with Kruskal-Wallis test. Wilcoxon sign rank test was used to compare the pairwise comparison of clinical parameters among the groups from baseline to third-month follow-up. The inflammatory mediators at various time points were compared using a One-way analysis of variance test, and the inflammatory mediators in each study group were compared using a paired t-test. RESULTS Both the test groups demonstrated a decrease in PPD and CAL. However, the HybenX group exhibited statistically significant reduction at the end of the third-month study interval compared to the laser group and SRP alone. Further, the secondary outcome IL-1β and TNF-α analysis exhibited statistically significant reduction in all the groups posttherapy. CONCLUSION The adjunctive application of HybenX gel yielded an advantage compared to laser and SRP for the treatment of chronic periodontitis. CLINICAL RELEVANCE Adjunctive use of the oral tissue desiccant (HybenX gel) combined with SRP improved the periodontal pocket disinfection process and enhanced tissue healing devoid of adverse effects.
Collapse
Affiliation(s)
- Anjale Rajagopal
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Jothi Varghese
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vinutha Bhat
- Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vibha Acharya
- Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vinayak Kamath
- Department of Public Health Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| |
Collapse
|
2
|
Soancă A, Leucuța DC, Roman A, Ciurea A, Negucioiu M, Pascu LC, Picoș A, Delean AG, Micu IC, Popa Wagner A, Rusu D. The Treatment of Severe Periodontitis Using a Local Antiseptic Desiccant and Subgingival Mechanical Instrumentation: A Pilot Study. J Clin Med 2023; 12:4286. [PMID: 37445321 DOI: 10.3390/jcm12134286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
This randomized, split-mouth, controlled clinical study assessed the additional clinical benefits of a local desiccant antimicrobial agent (HY) combined with subgingival mechanical instrumentation (SRP) vs. SRP alone in treating severe periodontitis. Patients with stages III and IV periodontitis received full-mouth periodontal examinations at baseline and after a three-month follow-up. Two randomly selected hemiarches in each periodontitis patient were treated with SRP plus HY and were included in the test group, while the other two hemiarches received only SRP and were included in the control group. In thirty patients, the analyses of the evolution of the periodontal parameters over time showed statistically significant mean differences for the probing depths and clinical attachment level values resulting from all the examined sites, as well as from the interproximal sites (p < 0.001) in both the test and control groups. The intergroup comparisons of the same four parameters showed no significant differences (p = 0.322, p = 0.36, p = 0.516, and p = 0.509, respectively). Based on these study results, no additional benefits were obtained after HY subgingival applications.
Collapse
Affiliation(s)
- Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur St., No. 6, 400349 Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania
| | - Laurențiu Cătălin Pascu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania
| | - Andrei Picoș
- Department of Prevention in Dental Medicine, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu St., No. 31, 400347 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Cariology, Endodontics and Oral Pathology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Motilor St., No. 33, 400001 Cluj-Napoca, Romania
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Aurel Popa Wagner
- Vascular Neurology and Dementia Center, University of Medicine, Essen, Hufeland St., No. 55, 45122 Essen, Germany
- Experimental Research Center in Normal and Pathological Aging (ARES), University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Darian Rusu
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-Implant Diseases, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, Bulevardul Revolutiei din 1989, No. 9, 300230 Timisoara, Romania
| |
Collapse
|
3
|
Micu IC, Muntean A, Roman A, Stratul ȘI, Pall E, Ciurea A, Soancă A, Negucioiu M, Barbu Tudoran L, Delean AG. A Local Desiccant Antimicrobial Agent as an Alternative to Adjunctive Antibiotics in the Treatment of Periodontitis: A Narrative Review. Antibiotics (Basel) 2023; 12:antibiotics12030456. [PMID: 36978324 PMCID: PMC10044681 DOI: 10.3390/antibiotics12030456] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Periodontitis is one of the most common oral polymicrobial infectious diseases induced by the complex interplay between the altered subgingival microbiota and the host’s dysregulated immune-inflammatory response, leading to the initiation of progressive and irreversible destruction of the periodontal tissues and eventually to tooth loss. The main goal of cause-related periodontal therapy is to eliminate the dysbiotic subgingival biofilm in order to arrest local inflammation and further periodontal tissue breakdown. Because, in some cases, subgingival mechanical instrumentation has limited efficiency in achieving those goals, various adjunctive therapies, mainly systemic and locally delivered antimicrobials, have been proposed to augment its effectiveness. However, most adjunctive antimicrobials carry side effects; therefore, their administration should be precociously considered. HybenX® (HY) is a commercial therapeutical agent with decontamination properties, which has been studied for its effects in treating various oral pathological conditions, including periodontitis. This review covers the current evidence regarding the treatment outcomes and limitations of conventional periodontal therapies and provides information based on the available experimental and clinical studies related to the HY mechanism of action and effects following its use associated with subgingival instrumentation and other types of dental treatments.
Collapse
Affiliation(s)
- Iulia C. Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Alexandrina Muntean
- Department of Pedodontics, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu St., No. 31, 400117 Cluj-Napoca, Romania
- Correspondence: (A.M.); (A.S.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Ștefan I. Stratul
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-Implant Diseases, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy Timișoara, Bulevardul Revoluției din 1989, No.9, 300230 Timișoara, Romania
| | - Emöke Pall
- Department of Infectious Disease, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Mănăștur St., No. 3-5, 400372 Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
- Correspondence: (A.M.); (A.S.)
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania
| | - Lucian Barbu Tudoran
- Electron Microscopy Center, Department of Molecular Biology and Biotechnologies, Faculty of Biology and Geology, Babeş-Bolyai University, Clinicilor St., No. 5-7, 400006 Cluj-Napoca, Romania
- Electron Microscopy Integrated Laboratory (LIME), National Institute for Research and Development of Isotopic and Molecular Technologies, Institutul Național de Cercetare-Dezvoltare pentru Tehnologii Izotopice și Moleculare, 67-103 Donath St., 400293 Cluj-Napoca, Romania
| | - Ada G. Delean
- Department of Cariology, Endodontics and Oral Pathology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Moților St., No. 33, 400001 Cluj-Napoca, Romania
| |
Collapse
|
4
|
Fiorino A, Staderini E, Diana R, Rengo C, Gallenzi P. New Conservative Approach for the Management of Recurrent Sublingual Ranula-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2398. [PMID: 36767764 PMCID: PMC9915898 DOI: 10.3390/ijerph20032398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Ranula is a rare and benign extravasation mucocele that is clinically characterized by asymptomatic sublingual or submandibular masses. Surgical excision is considered the most effective treatment approach, but it has been associated with high invasiveness and several complications (hemorrhage, damage to Wharton's duct, and lingual nerve injury). Over the past decade, more conservative therapies have been rapidly disseminated into clinical practice to seek a more effective and less traumatic approach for young patients. In this report, an 8-year-old female with an asymptomatic, recurrent sublingual ranula was treated using a conservative approach with marsupialization and an intracystic injection of a plaque remover (Hybenx® gel). After incision of the cystic dome, Hybenx® gel was applied into the cystic lumen for 20 seconds and then aspirated; next, the area was rinsed thoroughly with sterile saline solution before suturing. Ultrasound re-evaluation at 10 months and intraoral clinical examination at 24 months confirmed the absence of relapse. Our results support the hypothesis that marsupialization combined with intracystic injection of Hybenx® gel could be an encouraging conservative treatment alternative for recurrent sublingual ranula in children. Further randomized controlled trials are needed to test this hypothesis.
Collapse
Affiliation(s)
- Antonino Fiorino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, “Federico II” University of Naples, 80131 Naples, Italy
| | - Edoardo Staderini
- Postgraduate School of Orthodontics, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Rosalba Diana
- Postgraduate School of Orthodontics, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Carlo Rengo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Patrizia Gallenzi
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, “Federico II” University of Naples, 80131 Naples, Italy
- UOC Odontoiatria Generale e Ortodonzia, Dipartimento di Testa-Collo e Organi di Senso, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| |
Collapse
|
5
|
Oral Lesions in Children and Adolescents. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
6
|
Abstract
Causes of the progression of periodontitis such as an imbalance between the immune response by the host by the release of inflammatory mediators in the response of the oral pathogenic dysbiotic biofilm have been identified. New insights on specific cell signaling pathways that appear during periodontitis have attracted the attention of researchers in the study of new personalised approaches for the treatment of periodontitis. The gold standard of non-surgical therapy of periodontitis involves the removal of supra and subgingival biofilm through professional scaling and root planing (SRP) and oral hygiene instructions. In order to improve periodontal clinical outcomes and overcome the limitations of traditional SRP, additional adjuvants have been developed in recent decades, including local or systemic antibiotics, antiseptics, probiotics, anti-inflammatory and anti-resorptive drugs and host modulation therapies. This review is aimed to update the current and recent evolution of therapies of management of periodontitis based on the adjunctive and target therapies. Moreover, we discuss the advances in host modulation of periodontitis and the impact of targeting epigenetic mechanisms approaches for a personalised therapeutic success in the management of periodontitis. In conclusion, the future goal in periodontology will be to combine and personalise the periodontal treatments to the colonising microbial profile and to the specific response of the individual patient.
Collapse
|
7
|
Cytotoxic Effects on Gingival Mesenchymal Stromal Cells and Root Surface Modifications Induced by Some Local Antimicrobial Products Used in Periodontitis Treatment. MATERIALS 2021; 14:ma14175049. [PMID: 34501140 PMCID: PMC8434495 DOI: 10.3390/ma14175049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
(1) Background: this study aims to test the cytotoxicity of three antimicrobial products used in periodontitis treatment on gingival mesenchymal stem cells (gMSCs) and their influence on root surfaces and gMSC adhesion. We tested the null hypothesis that the effects of the antimicrobials did not differ. (2) Methods: the commercial products based on sulphonic/sulphuric acids, sodium hypochlorite and silver nanoparticles, in five different concentrations, were added to culture medium for growing gMSCs. Cell proliferation capacity was tested using the Cell Counting Kit-8 (CCK8) and their viability was determined by succinate dehydrogenase activity (MTT) assay. Scanning electron microscopy evaluated the adhesion of gMSCs on root samples treated mechanically and with commercial products. (3) Results: the products induced a dose-dependent cytotoxicity in terms of reduced proliferation and viability of gMSCs, as well as cell shape modifications. Significant differences in CCK8 values between the different commercial products were observed. Based on proliferation tests, the null hypothesis was rejected. When MTT values of the three products were compared with each other, no significant differences were observed for any of the five concentrations (p = 0.065, p = 0.067, p = 0.172, p = 0.256, p = 0.060). (4) Conclusions: the three antimicrobials had a certain degree of cytotoxicity on gMSCs. gMSCs repopulated treated root surfaces.
Collapse
|
8
|
Pace R, Giuliani V, Di Nasso L, Pagavino G, Franceschi D, Franchi L. Regenerative Endodontic Therapy using a New Antibacterial Root Canal Cleanser in necrotic immature permanent teeth: Report of two cases treated in a single appointment. Clin Case Rep 2021; 9:1870-1875. [PMID: 33936606 PMCID: PMC8077429 DOI: 10.1002/ccr3.3696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022] Open
Abstract
A case of regenerative endodontics: (a) before treatment; (b) post-treatment Xray; (c) follow-up at 6 months; (d) follow-up at 12 months.
Collapse
Affiliation(s)
- R Pace
- Department of Experimental and Clinical Medicine University of Florence Italy
| | - V Giuliani
- Department of Experimental and Clinical Medicine University of Florence Italy
| | - L Di Nasso
- Department of Experimental and Clinical Medicine University of Florence Italy
| | - G Pagavino
- Department of Experimental and Clinical Medicine University of Florence Italy
| | - D Franceschi
- Department of Experimental and Clinical Medicine University of Florence Italy
| | - L Franchi
- Department of Experimental and Clinical Medicine University of Florence Italy
| |
Collapse
|
9
|
Zafar F, Romano F, Citterio F, Ferrarotti F, Dellavia C, Chang M, Aimetti M. Chemical cleansing as an adjunct to subgingival instrumentation with ultrasonic and hand devices in deep periodontal pockets: a randomized controlled study. J Periodontal Implant Sci 2021; 51:276-284. [PMID: 34387047 PMCID: PMC8367643 DOI: 10.5051/jpis.2007080354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/17/2021] [Accepted: 04/12/2021] [Indexed: 01/25/2023] Open
Abstract
Purpose The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm. Conclusions The additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.
Collapse
Affiliation(s)
- Fahad Zafar
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Francesco Ferrarotti
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Moontaek Chang
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy.,Department of Periodontology, Institute of Oral Bioscience, Jeonbuk National University School of Dentistry, Jeonju, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
| | - Mario Aimetti
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| |
Collapse
|
10
|
Tan OL, Safii SH, Razali M. Clinical Efficacy of Single Application Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review and Network Meta-Analysis. Pharmaceutics 2020; 12:E1086. [PMID: 33198248 PMCID: PMC7698182 DOI: 10.3390/pharmaceutics12111086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022] Open
Abstract
This review aimed to rank the clinical efficacy of commercially available single-application local drug delivery and adjunctive agents (LDAs) compared with subgingival mechanical debridement (SMD) in nonsurgical periodontal therapy (NSPT). Randomized controlled clinical trials that compared LDAs against SMD alone or with placebo in adults (aged at least 18 years) diagnosed with periodontitis with a minimum of 6 months follow-up were included. A frequentist approach to random-effects network meta-analysis was implemented. The efficacies of the LDAs measured by probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were reported as mean difference (MD) with 95% confidence intervals (CIs). The treatments were ranked according to their P-score. Four network meta-analyses suggested that sulfonic/sulfuric acid gel (PPD MD -1.13 mm, 95% CI -1.74 to -0.53, P-score 0.91; CAL MD -1.09 mm, 95% CI -1.58 to -0.61, P-score 0.95) and doxycycline hyclate gel (PPD MD -0.90 mm, 95% CI -1.50 to -0.30, P-score 0.93; CAL MD -0.84 mm, 95% CI -1.40 to -0.28, P-score 0.92) were the most effective in reducing PPD and gaining CAL in split-mouth and parallel studies, respectively (moderate certainty of evidence). LDAs have differing efficacies, but they present with possible clinical significance over SMD alone in NSPT.
Collapse
Affiliation(s)
- Oi Leng Tan
- Centre for Restorative Dentistry, Unit of Periodontology, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Centre for Restorative Dentistry, Unit of Periodontology, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| |
Collapse
|
11
|
In Vitro Alteration by Dentine and Protein of the Antimicrobial Activity of Two Endodontic Irrigants: HybenX ® and Sodium Hypochlorite. Antibiotics (Basel) 2020; 9:antibiotics9110792. [PMID: 33182584 PMCID: PMC7696392 DOI: 10.3390/antibiotics9110792] [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: 07/29/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022] Open
Abstract
Irrigant solutions commonly used for the treatment of endodontic infections can be inhibited by both organic and inorganic substances. The aim of this study was to evaluate the in vitro antimicrobial activity of the novel irrigant HybenX® and 2.5% and 5% sodium hypochlorite against Enterococcus faecalis, in presence of dentine powder (DP) or bovine serum albumin 20% (BSA) as inhibitory agents. An E. faecalis American Type Culture Collection (ATCC) 29212 suspension was added to the irrigants (Hybenx® or NaOCl) and one or two different inhibitors (BSA and DP) either after one-hour pre-incubation at 35 ± 1 °C or not. The antimicrobial activity of HybenX® against E. faecalis was already proved at 15 min and was neither affected by BSA nor by DP or combinations thereof. NaOCl 2.5% showed an effective antimicrobial activity starting from 15 min and this activity was partially inhibited by BSA and BSA plus DP combination within one hour when pre-incubation occurred. NaOCl 5% showed antimicrobial activity within 15 min, which was inhibited within one hour only in the presence of both BSA and DP regardless of the pre-incubation period. HybenX® could represent a good alternative to common irrigants for the treatment of E. faecalis endodontic infections, showing a rapid antimicrobial activity not inhibited by organic and inorganic inhibitors.
Collapse
|
12
|
Successful Management of Peri-Implantitis around Short and Ultrashort Single-Crown Implants: A Case Series with a 3-Year Follow-Up. Int J Dent 2019; 2019:5302752. [PMID: 31636671 PMCID: PMC6766094 DOI: 10.1155/2019/5302752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 07/22/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction and Aim In case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. This retrospective case series presents the clinical and radiographic outcomes of a surgical regenerative procedure to treat peri-implantitis around short and ultrashort implants. Materials and Methods The study is a retrospective evaluation of patients suffering from peri-implantitis and those who underwent access flap surgery, concomitant chemical and mechanical decontamination of implant surface, and bone grafting using a self-hardening mixture of bone substitutes and biphasic calcium sulfate. No membranes were applied to cover the grafting material, and primary tension-free closure was achieved. The retrospective protocol was reviewed and approved by the Ethics Committee for Clinical Sperimentation (CESC) of Verona and Rovigo, Italy (based in the University of Verona) (Prog. 1863CESC. Date of approval: 2018-07-04). Results 15 patients (17 implants) have been diagnosed with peri-implantitis after a mean follow-up of 24 months after loading. Implant length was between 5 and 8 mm. 8 patients (10 implants) had a history of periodontitis. At baseline, the mean PD (probing pocket dept) at the deepest site was 8.12 mm, with an average mBI (modified bleeding index) of 2.35 and a mean BD (bone defect depth) of 3.04 mm. At the 3-year follow-up, the CSR was 100%, the mean mBI was 0.88 (average reduction: −1.47), the mean PD was 3.35 mm (mean PD reduction: 4.77 mm), and the mean bone defect was reduced by 1.74 mm, with a mean bone fill of 55%. Conclusions The results of the present case series suggest that if accurate surface decontamination is achieved, high survival rate and good clinical and radiographic results can be obtained after 3 years. However, only the histological examination could confirm the growth of new bone in direct contact with the implant surface or if the grafted material only fills the space left by the peri-implant defect.
Collapse
|
13
|
Antonelli A, Giovannini L, Baccani I, Giuliani V, Pace R, Rossolini GM. In Vitro Antimicrobial Activity of the Decontaminant HybenX ® Compared to Chlorhexidine and Sodium Hypochlorite against Common Bacterial and Yeast Pathogens. Antibiotics (Basel) 2019; 8:antibiotics8040188. [PMID: 31627304 PMCID: PMC6963449 DOI: 10.3390/antibiotics8040188] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/12/2019] [Accepted: 10/14/2019] [Indexed: 11/16/2022] Open
Abstract
The recent increase in infections mediated by drug-resistant bacterial and fungal pathogens underlines the urgent need for novel antimicrobial compounds. In this study, the antimicrobial activity (inhibitory and cidal) of HybenX®, a novel dessicating agent, in comparison with commonly used sodium hypochlorite and chlorhexidine, against a collection of bacterial and yeast strains representative of the most common human pathogenic species was evaluated. The minimal inhibitory, bactericidal, and fungicidal concentrations (MIC, MBC, and MFC, respectively) of the three different antimicrobial agents were evaluated by broth microdilution assays, followed by subculturing of suitable dilutions. HybenX® was active against 26 reference strains representative of staphylococci, enterococci, Enterobacterales, Gram-negative nonfermenters, and yeasts, although at higher concentrations than sodium hypochlorite and chlorhexidine. HybenX® MICs were 0.39% for bacteria (with MBCs ranging between 0.39% and 0.78%), and 0.1-0.78% for yeasts (with MFCs ranging between 0.78% and 1.6%). HybenX® exhibited potent inhibitory and cidal activity at low concentrations against several bacterial and yeast pathogens. These findings suggest that HybenX® could be of interest for the treatment of parodontal and endodontic infections and also for bacterial and fungal infections of other mucous membranes and skin as an alternative to sodium hypochlorite and chlorhexidine.
Collapse
Affiliation(s)
- Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
| | - Luca Giovannini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
| | - Ilaria Baccani
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
| | - Valentina Giuliani
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
- Odontostomatology-Endodontic Unit, Careggi University Hospital, 50134 Florence, Italy.
| | - Riccardo Pace
- Odontostomatology-Endodontic Unit, Careggi University Hospital, 50134 Florence, Italy.
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy.
| |
Collapse
|
14
|
Lombardo G, Signoriello A, Corrocher G, Signoretto C, Burlacchini G, Pardo A, Nocini PF. A Topical Desiccant Agent in Association with Manual Debridement in the Initial Treatment of Peri-Implant Mucositis: A Clinical and Microbiological Pilot Study. Antibiotics (Basel) 2019; 8:antibiotics8020082. [PMID: 31216662 PMCID: PMC6628282 DOI: 10.3390/antibiotics8020082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/16/2019] [Accepted: 06/16/2019] [Indexed: 11/23/2022] Open
Abstract
In patients presenting mucositis, effective sub-gingival debridement is crucial to prevent peri-implantitis. The aim of this randomized study was to assess the three-month (T1) effects of a locally delivered liquid desiccant agent with molecular hygroscopic properties, in association with manual debridement, at sites with peri-implant mucositis. Twenty-three patients presenting at least one implant with no radiographically detectable bone loss, a pocket probing depth (PPD) ≥ 4 mm, and bleeding on probing (BOP), were included. At baseline (T0), patients were randomly assigned to receive the aforementioned desiccant agent before debridement (Test-Group), or a Chlorhexidine 1% disinfectant gel after debridement (Control-Group). Treatments were repeated after seven and 14 days. Peri-implant soft tissue assessment [PPD, BOP, Modified Bleeding Index (mBI), Visible Plaque Index (VPI), and Modified Plaque Index (mPLI)] and microbial sampling were performed at T0 and T1. At T1 the Test-Group presented significantly greater reductions for BOP, mBI, VPI, and mPLI. Concerning the deepest sites of the treated implants, both groups showed statistically significant reductions for BOP and mBI between T0 and T1. Furthermore, the Test-Group exhibited a significant decrease in anaerobic bacteria. Despite these valid outcomes, a complete resolution of the inflammatory conditions was not achieved by any of the groups.
Collapse
Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
| | - Annarita Signoriello
- Dentistry and Maxillo-facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
| | - Giovanni Corrocher
- Dentistry and Maxillo-facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
| | - Caterina Signoretto
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
| | - Gloria Burlacchini
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
| | - Alessia Pardo
- Dentistry and Maxillo-facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
| | - Pier Francesco Nocini
- Dentistry and Maxillo-facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
| |
Collapse
|
15
|
Asai D, Nakashima H. Pathogenic Viruses Commonly Present in the Oral Cavity and Relevant Antiviral Compounds Derived from Natural Products. MEDICINES 2018; 5:medicines5040120. [PMID: 30424484 PMCID: PMC6313515 DOI: 10.3390/medicines5040120] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 12/18/2022]
Abstract
Many viruses, such as human herpesviruses, may be present in the human oral cavity, but most are usually asymptomatic. However, if individuals become immunocompromised by age, illness, or as a side effect of therapy, these dormant viruses can be activated and produce a variety of pathological changes in the oral mucosa. Unfortunately, available treatments for viral infectious diseases are limited, because (1) there are diseases for which no treatment is available; (2) drug-resistant strains of virus may appear; (3) incomplete eradication of virus may lead to recurrence. Rational design strategies are widely used to optimize the potency and selectivity of drug candidates, but discovery of leads for new antiviral agents, especially leads with novel structures, still relies mostly on large-scale screening programs, and many hits are found among natural products, such as extracts of marine sponges, sea algae, plants, and arthropods. Here, we review representative viruses found in the human oral cavity and their effects, together with relevant antiviral compounds derived from natural products. We also highlight some recent emerging pharmaceutical technologies with potential to deliver antivirals more effectively for disease prevention and therapy.
Collapse
Affiliation(s)
- Daisuke Asai
- Department of Microbiology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Hideki Nakashima
- Department of Microbiology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan.
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Rodríguez-Archilla A, Raissouni T. Randomized clinical trial of the effectiveness of complementary therapies for recurrent aphthous stomatitis. Med Clin (Barc) 2017; 149:55-60. [PMID: 28238332 DOI: 10.1016/j.medcli.2016.12.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/19/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Despite the high prevalence of recurrent aphthous stomatitis (RAS), its etiology is not yet completely clear and there is no completely remedial treatment available at present. The objective of this study was to evaluate the clinical efficacy and safety of 4 treatments (silver nitrate, propolis, rhubarb and walnut) for RAS. PATIENTS AND METHOD A randomized clinical trial was conducted with 125 patients with minor aphthae, including 25 patients per group: cauterization with silver nitrate, propolis, rhubarb extract, walnut extract and placebo. RESULTS AND CONCLUSIONS No patient reported adverse effects related to the treatment received. There were significant (P<.001) differences in the time elapsed until symptom resolution. The fastest treatment was silver nitrate (1.16 days), followed by the 3 alternative treatments (1.60 days with propolis, 1.84 with rhubarb and 2.00 with walnut; with no differences between them), and finally the placebo (4.64 days). The mean healing time of the lesions was statistically higher (8.96 days) for the placebo than for the 4 treatments: silver nitrate (7.32 days), propolis (6.80), rhubarb (7.72) and walnut (8.00).
Collapse
Affiliation(s)
| | - Tarik Raissouni
- Centro Odontológico M'fedal Afailal Bab Okla, Tetuán, Marruecos
| |
Collapse
|
18
|
Sakly A, De Wever B, Jutla B, Satia M, Bogaert JP. The safety and efficacy of AphtoFix® mouth ulcer cream in the management of recurrent aphthous stomatitis. BMC Oral Health 2016; 16:17. [PMID: 26868504 PMCID: PMC4750241 DOI: 10.1186/s12903-016-0177-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/05/2016] [Indexed: 11/25/2022] Open
Abstract
Background Recurrent Aphthous stomatitis (RAS) is a prevalent ulcerative and painful disorder of the oral cavity with unknown etiology and for which no efficient treatment is currently available. The present study aimed to evaluate the safety and the efficacy of AphtoFix®, a new mouth ulcer cream that was developed to help treat RAS. Prior to launching the product on the market, two initial safety assessment studies were performed. Subjects and methods In a first study, the in vitro biocompatibility of AphtoFix® was evaluated on reconstructed human gingival tissue models according to ISO guidelines 10993. In a second study, the tolerability of AphtoFix® was evaluated in 20 subjects during a 4-weeks daily application in the mouth. The third study investigated both the safety and efficacy of AphtoFix® treatment on 19 patients suffering from RAS. This study was done in compliance with the Helsinki Declaration. Results The results of in vitro biocompatibility study showed that AphtoFix® mouth ulcer cream did not induce any detectable cytotoxicity and irritation. These observations were confirmed in the 4 weeks tolerability study where no undesired of adverse reactions were noticed. The results of the post-market clinical efficacy study demonstrated a clear reduction in ulcer size from baseline after 3 days treatment (p < 0.05). Pain intensity reduction was also observed in all subjects. Conclusion The application of AphtoFix® did not induce any undesired skin or mucosa reactions. These initial findings demonstrate that AphtoFix® is safe and efficient in reducing ulcer size and decreasing the pain intensity induced by ulcers. Trial registration Clinical trial Registry India Nr. CTRI201408004918, Date of registration: 22/08/2014 Electronic supplementary material The online version of this article (doi:10.1186/s12903-016-0177-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Amina Sakly
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein. .,Bonyf AG, Heiligkreuz 16, FL-9490, Vaduz, Liechtenstein.
| | - Bart De Wever
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein.
| | - Balraj Jutla
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein. .,Bonyf AG, Heiligkreuz 16, FL-9490, Vaduz, Liechtenstein.
| | - Milan Satia
- Ethicare Clinical Trial Services; Satellite, Ahmedabad, 380015, Gujarat, India.
| | - Jean Pierre Bogaert
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein. .,Bonyf AG, Heiligkreuz 16, FL-9490, Vaduz, Liechtenstein.
| |
Collapse
|
19
|
Decontamination using a desiccant with air powder abrasion followed by biphasic calcium sulfate grafting: a new treatment for peri-implantitis. Case Rep Dent 2015; 2015:474839. [PMID: 26000178 PMCID: PMC4427007 DOI: 10.1155/2015/474839] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/31/2015] [Accepted: 04/15/2015] [Indexed: 11/17/2022] Open
Abstract
Peri-implantitis is characterized by inflammation and crestal bone loss in the tissues surrounding implants. Contamination by deleterious bacteria in the peri-implant microenvironment is believed to be a major factor in the etiology of peri-implantitis. Prior to any therapeutic regenerative treatment, adequate decontamination of the peri-implant microenvironment must occur. Herein we present a novel approach to the treatment of peri-implantitis that incorporates the use of a topical desiccant (HYBENX), along with air powder abrasives as a means of decontamination, followed by the application of biphasic calcium sulfate combined with inorganic bovine bone material to augment the intrabony defect. We highlight the case of a 62-year-old man presenting peri-implantitis at two neighboring implants in positions 12 and 13, who underwent access flap surgery, followed by our procedure. After an uneventful 2-year healing period, both implants showed an absence of bleeding on probing, near complete regeneration of the missing bone, probing pocket depth reduction, and clinical attachment gain. While we observed a slight mucosal recession, there was no reduction in keratinized tissue. Based on the results described within, we conclude that the use of HYBENX and air powder abrasives, followed by bone defect grafting, represents a viable option in the treatment of peri-implantitis.
Collapse
|
20
|
Veale B. Alveolar osteitis: a critical review of the aetiology and management. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/ors.12130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- B. Veale
- Oral and Maxillofacial Surgery; Charles Clifford Dental Hospital; Sheffield Teaching Hospitals; South Yorkshire UK
| |
Collapse
|
21
|
Jiang XW, Zhang Y, Zhang H, Lu K, Yang SK, Sun GL. Double-blind, randomized, controlled clinical trial of the effects of diosmectite and basic fibroblast growth factor paste on the treatment of minor recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:570-5. [DOI: 10.1016/j.oooo.2013.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/03/2013] [Accepted: 07/07/2013] [Indexed: 11/24/2022]
|
22
|
Influence of dentin and enamel pretreatment with acidic sulfur compounds on adhesive performance. Clin Oral Investig 2012; 17:1885-92. [PMID: 23138454 DOI: 10.1007/s00784-012-0877-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 10/24/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study tested the potential hampering effects of acidic sulfur compounds (ASC) containing hydroxybenzene sulfonic acid, hydroxymethoxybenzene sulfonic acid, and sulfuric acid, prior to self-etch and etch-and-rinse bonding procedures on enamel and dentin. According to the manufacturer, ASC should be applied after cavity preparation and prior to application of a primer in order to reduce the remaining biofilm in the preparation cavity. Despite promoted marketing, data on the investigated liquid are almost completely lacking. MATERIAL AND METHODS One hundred and fifty-two extracted mandibular bovine incisors were embedded and polished to expose either enamel (E) or dentin (D). Then, specimens were randomly divided and conditioned as follows (n = 12/group): ASC and consecutive phosphoric acid application (E1/D1), ASC (E2/D2; E5/D5), phosphoric acid (E3/D3), and no conditioning (E4/D4; E6/D6). Groups were then treated with either Optibond FL(®) (etch-and-rinse; 1-4) or Clearfil SE Bond(®) (self-etch; 5-6). Hollow acrylic cylinders were bonded with a hybrid composite resin (Filtek Supreme XTE®) to the specimens, and the shear bond strength was measured (1 mm/min). In addition, failure types were assessed. Descriptive statistics and statistical analyses were performed with one-way ANOVA followed by the Scheffé post hoc test. RESULTS For enamel, the highest shear bond strength values were obtained applying routine bonding procedures (23.5 ± 5.6 MPa for etch-and-rinse and 26.0 ± 6.0 MPa for self-etch, respectively). In contrast, dentin pretreatment with a combination of ASC and phosphoric acid led to the highest shear bond values (22.8 ± 4.1 MPa). CONCLUSION This study shows that ASC prior to dental restoration placement cannot be recommended for etch-and-rinse procedures on enamel but is appropriate for dentin without interfering with routine bonding procedures. CLINICAL RELEVANCE The application of acidic sulfur compounds prior to adhesive restoration placement should be restricted to dentin only as it may negatively influence shear bond strength on sound enamel.
Collapse
|
23
|
Baccaglini L, Lalla RV, Bruce AJ, Sartori-Valinotti JC, Latortue MC, Carrozzo M, Rogers RS. Urban legends: recurrent aphthous stomatitis. Oral Dis 2011; 17:755-70. [PMID: 21812866 DOI: 10.1111/j.1601-0825.2011.01840.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Recurrent aphthous stomatitis (RAS) is the most common idiopathic intraoral ulcerative disease in the USA. Aphthae typically occur in apparently healthy individuals, although an association with certain systemic diseases has been reported. Despite the unclear etiopathogenesis, new drug trials are continuously conducted in an attempt to reduce pain and dysfunction. We investigated four controversial topics: (1) Is complex aphthosis a mild form of Behçet's disease (BD)? (2) Is periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome a distinct medical entity? (3) Is RAS associated with other systemic diseases [e.g., celiac disease (CD) and B12 deficiency]? (4) Are there any new RAS treatments? Results from extensive literature searches, including a systematic review of RAS trials, suggested the following: (1) Complex aphthosis is not a mild form of BD in North America or Western Europe; (2) Diagnostic criteria for PFAPA have low specificity and the characteristics of the oral ulcers warrant further studies; (3) Oral ulcers may be associated with CD; however, these ulcers may not be RAS; RAS is rarely associated with B12 deficiency; nevertheless, B12 treatment may be beneficial, via mechanisms that warrant further study; (4) Thirty-three controlled trials published in the past 6 years reported some effectiveness, although potential for bias was high.
Collapse
Affiliation(s)
- L Baccaglini
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL 32610-3628, USA.
| | | | | | | | | | | | | |
Collapse
|
24
|
Baccaglini L, Lalla RV, Bruce AJ, Sartori-Valinotti JC, Latortue MC, Carrozzo M, Rogers RS. Urban legends: recurrent aphthous stomatitis. Oral Dis 2011. [PMID: 21812866 DOI: 10.1111/j.601-0825.2011.01840.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Recurrent aphthous stomatitis (RAS) is the most common idiopathic intraoral ulcerative disease in the USA. Aphthae typically occur in apparently healthy individuals, although an association with certain systemic diseases has been reported. Despite the unclear etiopathogenesis, new drug trials are continuously conducted in an attempt to reduce pain and dysfunction. We investigated four controversial topics: (1) Is complex aphthosis a mild form of Behçet's disease (BD)? (2) Is periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome a distinct medical entity? (3) Is RAS associated with other systemic diseases [e.g., celiac disease (CD) and B12 deficiency]? (4) Are there any new RAS treatments? Results from extensive literature searches, including a systematic review of RAS trials, suggested the following: (1) Complex aphthosis is not a mild form of BD in North America or Western Europe; (2) Diagnostic criteria for PFAPA have low specificity and the characteristics of the oral ulcers warrant further studies; (3) Oral ulcers may be associated with CD; however, these ulcers may not be RAS; RAS is rarely associated with B12 deficiency; nevertheless, B12 treatment may be beneficial, via mechanisms that warrant further study; (4) Thirty-three controlled trials published in the past 6 years reported some effectiveness, although potential for bias was high.
Collapse
Affiliation(s)
- L Baccaglini
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL 32610-3628, USA.
| | | | | | | | | | | | | |
Collapse
|
25
|
Mousavi F, Mojaver YN, Asadzadeh M, Mirzazadeh M. Homeopathic treatment of minor aphthous ulcer: a randomized, placebo-controlled clinical trial. HOMEOPATHY 2009; 98:137-41. [PMID: 19647206 DOI: 10.1016/j.homp.2009.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Revised: 05/17/2009] [Accepted: 05/27/2009] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The objectives of this study were to clinically determine the efficacy of individualised homeopathy in the treatment of minor recurrent aphthous ulceration (MiRAU). DESIGN & INTERVENTION A randomized, single blind, placebo-controlled clinical trial of individualised homeopathy. One hundred patients with minor aphthous ulcer were treated with individualised homeopathic medicines or placebo and followed up for 6 days. Patients received two doses of individualised homeopathic medicines in the 6C potency as oral liquid at baseline and 12 h later. Pain intensity and ulcer size were recorded at baseline during and at the end of the trial (mornings of days 4 and 6). RESULT All 100 patients completed treatment. Between group differences for pain intensity and ulcer size were statistically significant at day 4 and at day 6 (P<0.05). No adverse effects were reported. CONCLUSION The results suggest that homeopathic treatment is an effective and safe method in the treatment of MiRAU.
Collapse
Affiliation(s)
- Fahimeh Mousavi
- Department of Oral Medicine, Tehran University of Medical Sciences, Dental School, Tehran, Iran
| | | | | | | |
Collapse
|