Periodontal dressing may influence the clinical outcome of non-surgical periodontal treatment: a split-mouth study

Comparison of the effects of Diplen LX membrane and Coe-Pak on pain, wound healing, and patient preference after the periodontal flap surgery in patients with moderate to severe chronic periodontitis

Background. After periodontal surgery, in most cases, the surgical area is covered with a surgical pack. It has been suggested that these packs might minimize complications. This study aimed to compare the effects of Diplen LX membrane and Coe-Pak on pain, wound healing, and patient preference after a periodontal flap surgery in patients with moderate to severe chronic periodontitis. Methods. In this randomized clinical trial, 26 patients were evaluated. Pain scores were assessed using visual analog scale (VAS) on the 3rd and 7th days postoperatively and compared between the two dressings. On the 7th and 14th days after both flap surgeries, surgical site healing was evaluated using the wound healing index (WHI). Results. The mean age of the patients was 31. It was observed that the severity of pain in the studied patients on the 3rd and 7th days postoperatively was significantly lower in the intervention group than in the control group. It was also observed that the value of WHI in the studied patients on the 7th and 14th days postoperatively was significantly higher in the intervention group than in the control group. Conclusion. The pain was less severe in both groups using periodontal dressing and also lower in the Diplen LX membrane group. In addition, based on WHI, wound healing score in patients was also higher and more favorable in the Diplex LX membrane group. Due to the above factors, the majority of patients preferred the use of the Diplen LX membrane.

To Pack or Not to Pack: The Current Status of Periodontal Dressings

Surgical wound dressings have been employed over several centuries for the purpose of protection of surgical sites, to prevent postoperative infection and to accelerate healing. Periodontal dressings, also known as periodontal packs, provide similar benefits when applied after periodontal surgical procedures. They can broadly be categorized as eugenol-based dressings and noneugenol dressings. Over the years, many modifications have been made to the composition of such dressings to improve their physical and therapeutic properties. Controversies surrounding the rationale for their use, advantages and disadvantages of the most commonly employed periodontal dressings and their current status in clinical practice are described in this comprehensive review. From the evidence-based literature presented here, we have also attempted to answer the question of whether there is a universal need for the application of periodontal dressings.

Effect of periodontal dressing on non-surgical periodontal treatment outcomes: a systematic review

BACKGROUND

Periodontal dressing has been advocated and showed some positive outcomes for placing over the surgical site after periodontal surgery. However, little is known about its effect on non-surgical therapy.

PURPOSE

The aim of this review was to assess the clinical effect of periodontal dressing when used after non-surgical therapy.

MATERIAL AND METHODS

Two examiners performed an electronic search in several databases for relevant articles published in English up to November 2013. Selected studies were randomized human clinical trials (prospective or retrospective trials) with the clear aim of investigating the effect of periodontal dressing placement upon periodontal non-surgical mechanical therapy. Data were extracted from the included articles for analysis.

RESULTS

Three randomized clinical trials fulfilled the inclusion criteria and thus were included in the data analysis. Statistical analysis could not be carried out due to the lack of clear data of the included studies. However, descriptive analysis showed its effectiveness in improving clinical parameters such as gain of clinical attachment level and reduction of probing pocket depth.

CONCLUSION

Placement of periodontal dressing right after non-surgical mechanical therapy can be beneficial in improving overall short-term clinical outcomes, although more controlled studies are still needed to validate this finding.

One-stage full-mouth disinfection combined with a periodontal dressing: a randomized controlled clinical trial

AIM

To compare the clinical benefit of a periodontal dressing applied after a one-stage full-mouth disinfection (OSFMD) in patients with chronic periodontitis up to 3 months after therapy.

MATERIAL AND METHODS

This randomized, controlled split-mouth study included 24 patients. After OSFMD, a test and a control side were selected by means of a computer-generated randomization list. Test sides received a periodontal dressing (Coepak(®) ) for 7 days and the control sides received no periodontal dressing. After 7 days the periodontal dressing was removed and the pain experience was recorded. After 3 months, the clinical periodontal parameters were recorded.

RESULTS

The periodontal dressing group showed a significant (p < 0.05) additional pocket depth reduction and additional clinical attachment gain for the moderate pockets of single- and multi-rooted teeth compared with the control group. A significant (p < 0.05) lower percentage of sites with probing pocket depth ≥5 mm were shown for the periodontal dressing group compared with the control group (2.7 ± 16.3% versus 4.8 ± 21.4%). The pain intensity was significantly reduced when using a periodontal dressing (5.13 ± 0.89 versus 3.42 ± 1.27).

CONCLUSION

The use of a periodontal dressing for 7 days after a OSFMD offers an additional short-term clinical improvement and lowers the pain intensity.