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Yaneva B, Mutafchieva M, Shentov P, Tomov G. Guided Biofilm Therapy for Management of "Desquamative Gingivitis"-Clinical Cases. Clin Pract 2024; 14:1931-1939. [PMID: 39311303 PMCID: PMC11417827 DOI: 10.3390/clinpract14050153] [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: 08/20/2024] [Revised: 09/09/2024] [Accepted: 09/18/2024] [Indexed: 09/26/2024] Open
Abstract
Background: Desquamative gingivitis is a clinical manifestation often associated with various mucocutaneous disorders, characterized by red, painful, and friable gingiva. It is predominantly seen in middle-aged to elderly females and is typically linked to autoimmune conditions such as lichen planus, pemphigoid, and pemphigus, among others. Due to the chronic pain and difficulty in maintaining personal oral hygiene, professional care becomes crucial. Methods: This article explores the application of guided biofilm therapy as a novel, gentle approach for managing desquamative gingivitis, focusing on three clinical cases. This therapy employs erythritol-based powders for biofilm removal, offering a less abrasive and more comfortable alternative to traditional mechanical plaque removal techniques. Results: The cases demonstrate the effectiveness of guided biofilm therapy in reducing discomfort and improving clinical outcomes in desquamative gingivitis patients, particularly those suffering from mucous membrane pemphigoid, pemphigus vulgaris, and oral lichen planus. Conclusions: The guided biofilm approach underscores the importance of tailored periodontal therapy in managing nonplaque-induced gingival lesions, improving patient compliance and oral health outcomes.
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Affiliation(s)
- Blagovesta Yaneva
- Department of Periodontology and Oral Mucosa Diseases, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (M.M.); (P.S.)
| | - Maria Mutafchieva
- Department of Periodontology and Oral Mucosa Diseases, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (M.M.); (P.S.)
| | - Petar Shentov
- Department of Periodontology and Oral Mucosa Diseases, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (M.M.); (P.S.)
| | - Georgi Tomov
- Department of Health Care and Social Work, New Bulgarian University, 1618 Sofia, Bulgaria;
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Cyris M, Festerling J, Kahl M, Springer C, Dörfer CE, Graetz C. Guided biofilm therapy versus conventional protocol-clinical outcomes in non-surgical periodontal therapy. BMC Oral Health 2024; 24:1105. [PMID: 39294663 PMCID: PMC11409476 DOI: 10.1186/s12903-024-04898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 09/11/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND The aim of the randomized controlled clinical trial study was to evaluate the effectiveness in reducing pathologically increased pocket probing depths (PPD > 3 mm) using the Guided Biofilm Therapy (GBT) protocol (adapted to the clinical conditions in non-surgical periodontal therapy (NSPT): staining, air-polishing, ultrasonic scaler, air-polishing) compared to conventional instrumentation (staining, hand curettes/sonic scaler, polishing with rotary instruments) both by less experienced practitioners (dental students). METHODS All patients were treated according to a split-mouth design under supervision as diseased teeth of quadrants I/III and II/IV randomly assigned to GBT or conventional treatment. In addition to the treatment time, periodontal parameters such as PPD and bleeding on probing (BOP) before NSPT (T0) and after NSPT (T1: 5 ± 2 months after T0) were documented by two calibrated and blinded examiners (Ethics vote/ Trial-register: Kiel-D509-18/ DRKS00026041). RESULTS Data of 60 patients were analyzed (stage III/IV: n = 36/ n = 24; grade A/ B/ C: n = 1/ n = 31/ n = 28). At T1, a PPD reduction of all diseased tooth surfaces was observed in 57.0% of the GBT group and 58.7% of the control group (p = 0.067). The target endpoint (PPD ≤ 4 mm without BOP) was achieved in 11.5% for GBT (conventional treatment: 11.2%; p = 0.714). With the exception for number of sites with BOP, which was at T1 15.9% in the GBT group and 14.3% in the control group (p < 0.05) no significant differences between the outcomes of the study were found. At 30.3(28.3) min, the treatment time was significantly shorter in GBT than in the control group at 34.6(24.5) min (p < 0.001). CONCLUSIONS With both protocols (GBT/ conventional instrumentation) comparably good clinical treatment results can be achieve in NSPT in stage III-IV periodontitis patients. TRIAL REGISTRATION The study was registered before the start of the study and can be found under the number DRKS00026041 in the German Clinical Trials Register. The registration date was 19/08/2021.
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Affiliation(s)
- Miriam Cyris
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Straße 3, Kiel, 24105, Germany.
| | - Julia Festerling
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Straße 3, Kiel, 24105, Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Straße 3, Kiel, 24105, Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Straße 3, Kiel, 24105, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Straße 3, Kiel, 24105, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Straße 3, Kiel, 24105, Germany
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Bussmeyer F, Saminsky M, Eickholz P. Discomfort/pain due to peri-implant probing at titanium and zirconium implants: A cross-sectional study. Clin Oral Implants Res 2024; 35:1081-1090. [PMID: 38801118 DOI: 10.1111/clr.14298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/16/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE This study was designed to compare discomfort/pain after periodontal and peri-implant probing in patients with titanium compared with zirconium implants. METHODS One examiner recruited and examined 70 patients, each of whom had a dental implant with a contralateral tooth; 37 patients had titanium implants of various types and 33 patients had zirconium implants; one implant was analyzed for each patient. Periodontal and peri-implant probing pocket depth (PPD) and clinical attachment level (CAL) were assessed. Immediately after probing, patients rated their discomfort/pain with a visual analog scale (VAS). The emergence profiles of implant crowns were assessed on periapical radiographs of the implants. RESULTS Seventy patients with a median age of 55 years (interquartile range [IQR]: 42-65 years), including 43 females and 16 current smokers, were examined. The mean PPD and bleeding on probing (BOP) were higher around implants than around teeth (p < .001). CAL and suppuration were well-balanced between implants and teeth. Peri-implant probing caused significantly more discomfort/pain than periodontal probing [median VAS score: 12.5 (IQR 4-22) vs. 9 (2-15); p < .001]. Logistic regression revealed that discomfort/pain after peri-implant probing was less intense in patients who had taken analgesic medication (p = .021) and around titanium implants (p = .037). CONCLUSIONS Peri-implant probing caused significantly more discomfort/pain than periodontal probing. Patients who had taken analgesic medication experienced less discomfort and pain with peri-implant probing than those who had not; furthermore, titanium implants were associated with less pain than zirconium implants.
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Affiliation(s)
- Florian Bussmeyer
- Dental Practice De Liefde, Amsterdam, The Netherlands
- ACTA-Academisch Centrum Tandheelkunde Amsterdam, Afdeling voor Parodontologie, Amsterdam, The Netherlands
| | - Michael Saminsky
- Goldschlager School of Dental Medicine, Department of Periodontology and Dental Implants, Tel-Aviv University, Tel Aviv, Israel
| | - Peter Eickholz
- Center for Dentistry and Oral Medicine (Carolinum), Department of Periodontology, Goethe-University Frankfurt, Frankfurt am Main, Germany
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Gunawan V, Carrington SD, Choi YJ, Choi JJE. Air-polishing technology is an effective alternative chairside method for cleaning dentures. Int J Dent Hyg 2024; 22:626-638. [PMID: 37680139 DOI: 10.1111/idh.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 03/31/2023] [Accepted: 07/30/2023] [Indexed: 09/09/2023]
Abstract
AIMS To investigate the efficiency and abrasiveness of air-polishing on different types of denture base acrylic resins and whether air-polishing can be an effective technique to clean dentures chairside. MATERIALS AND METHODS A total of 60 specimens were prepared (n = 20/group); heat-polymerized polymethyl methacrylate (PMMA) (G1), subtractive manufacturing (SM) (G2) and additive manufacturing (AM) denture base resins (G3). Equal number of specimens in each group were stained with permanent marker or nail polish and pumice mixture to mimic calcified biofilm. All specimens were treated using EMS Airflow® Prophylaxis Master with two different powders; erythritol or sodium bicarbonate powder, following manufacturer instructions. Efficacy of the powders and surface roughness of the specimens were measured. Scanning electron microscopy imaging was captured for qualitative observation. RESULTS The highest efficacy for stain removal was found in erythritol powder on G1 (98.06% ± 1.304%). The lowest was found in the erythritol powder on G3 (91.83% ± 3.611%). The highest efficacy for biofilm removal was found in sodium bicarbonate powder on G3 (71.49% ± 8.607%), and the lowest was found in erythritol powder on G2 (11.64% ± 4.68%). Only AM resins had statistically significant increases in surface roughness with the use of erythritol powder (p < 0.001). The use of sodium bicarbonate powder significantly increases surface roughness of heat-polymerized (p < 0.025) and AM resins (p < 0.724). CONCLUSIONS Air-polishing technology has shown to be effective and suitable for cleaning dentures. The sodium bicarbonate powder showed superior efficacy in cleaning dentures compared to the erythritol powder. Both powders show varyingly increase roughness depending on denture resin.
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Affiliation(s)
- Violina Gunawan
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Samuel D Carrington
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Yunsun Jane Choi
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Alsuwaidi S, Almatrooshi A, Shah M, Hakam A, Tawse-Smith A, Alsabeeha NHM, Atieh MA. Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial. J Periodontol 2024. [PMID: 38830779 DOI: 10.1002/jper.24-0099] [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: 02/09/2024] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 06/05/2024]
Abstract
BACKGOUND The aim of this randomized controlled trial was to assess clinical and patient-reported outcomes of subgingival instrumentation (SI) with adjunctive use of erythritol airflowing (EAF) compared to SI alone in the treatment of periodontitis. METHODS Twenty-six participants with Stage III/IV periodontitis requiring nonsurgical periodontal treatment were randomly allocated into two treatment groups: SI with EAF or SI alone. Clinical parameters of percentage of probing pocket depths (PPDs) of ≥5 mm, full mouth bleeding and plaque scores (FMBS and FMPS), and PPD values were recorded at baseline, and at 3 and 6 months posttreatment. A visual analogue scale was used to evaluate postoperative participants' perception of pain, swelling, bleeding, bruising, and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at six months. RESULTS A total of 26 participants with Stage III/IV periodontitis completed the 6-month follow-up. SI with or without EAF resulted in a statistically significant reductions in the FMBS, FMPS, PPDs, and percentage of PPDs of ≥5 mm at the 3- and 6-month follow-up visits. There was no statistically significant difference between the two treatment groups for any time interval. Participants receiving SI/EAF exhibited a higher reduction in FMBS compared to those in SI alone group at 3 (SI/EAF: 19.4 ± 11.9, SI alone: 30.1 ± 20.5; P = 0.12) and 6 months (SI/EAF: 14.3 ± 9.6, SI alone: 24.5 ± 18.2; P = 0.09). A lower percentage of sites with deep PPDs (≥5 mm) was also noted amongst participants in the SI/EAF group compared to SI alone at 3 months (SI/EAF: 14.3 ± 14.1, SI alone: 19.2 ± 20.3; P = 0.48) and 6 months (SI/EAF: 8.3 ± 10.0, SI alone: 15.4 ± 17.4; P = 0.22). Patient-reported outcomes showed no significant differences between the two treatment groups, except in the psychosocial domain of the GOHAI at 6 months favoring the SI/EAF group (P = 0.03). CONCLUSIONS Within the limitations of the study, the adjunctive use of EAF in addition to SI in the treatment of Stage III/IV periodontitis did not result in a significant improvement in clinical parameters. Limited improvement in the QoL with EAF could be achieved.
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Affiliation(s)
- Salem Alsuwaidi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | | | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | - Abeer Hakam
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
| | - Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- School of Dentistry, University of Jordan, Amman, Jordan
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Liu CC, Dixit N, Hatz CR, Janson TM, Bastendorf K, Belibasakis GN, Cosgarea R, Karoussis IK, Mensi M, O'Neill J, Spahr A, Stavropoulos A, Schmidlin PR. Air powder waterjet technology using erythritol or glycine powders in periodontal or peri-implant prophylaxis and therapy: A consensus report of an expert meeting. Clin Exp Dent Res 2024; 10:e855. [PMID: 38345462 PMCID: PMC10860664 DOI: 10.1002/cre2.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/02/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri-implant diseases. MATERIAL AND METHODS In the first step, a modified one-round online Delphi survey including 44 five-point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively. RESULTS An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long-term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept. CONCLUSIONS In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri-implant therapy and prophylaxis is patient compliant and efficient.
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Affiliation(s)
- Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Neha Dixit
- Department of Clinical Affairs and Medical EducationElectro Medical Systems SANyonSwitzerland
| | - Christian R. Hatz
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Tobias M. Janson
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | | | - Georgios N. Belibasakis
- Department of Dental Medicine, Division of Oral DiseasesKarolinska InstitutetStockholmSweden
| | - Raluca Cosgarea
- Department of Periodontology, Cariology and Preventive DentistryUniversity of BonnBonnGermany
| | - Ioannis K. Karoussis
- Department of Periodontology, Faculty of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Magda Mensi
- Section of Periodontics, Department of Surgical Specialities, Radiological Science and Public Health, School of DentistryUniversity of BresciaBresciaItaly
| | - Jessica O'Neill
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of OdontologyUniversity of MalmöMalmöSweden
- Division of Conservative Dentistry and PeriodontologyUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
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Stähli A, Ferrari J, Schatzmann AS, Weigel LD, Roccuzzo A, Imber JC, Duong HY, Eick S, Lang NP, Salvi GE, Sculean A. Clinical evaluation of a novel protocol for supportive periodontal care: A randomized controlled clinical trial. J Periodontol 2024. [PMID: 38291892 DOI: 10.1002/jper.23-0527] [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: 09/09/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND The aim of this study was to compare the clinical efficacy and the patient perception of subgingival debridement with either guided biofilm management (GBM) or conventional scaling and root planing (SRP) during supportive periodontal care (SPC). METHODS Forty-one patients in SPC were randomly assigned to either treatment with GBM or SRP every 6 months. The primary outcome was the percentage of bleeding on probing (BoP) at 1 year. Moreover, pocket probing depths (PPD), recession, and furcation involvements were also measured. Full-mouth and specific site analyzes were performed at baseline, 6 and 12 months of SPC. Patient comfort was evaluated using a visual analogue scale (VAS) at 12 months. RESULTS At 1 year, mean BoP percentage decreased from 12.2% to 9.0% (p = 0.191) and from 14.7% to 7.9% (p = 0.004) for the GBM and SRP groups, respectively. Furcation involved multirooted teeth but no through-and-through lesions were significantly fewer in the GBM than in the SRP group after 12 months (p = 0.015). The remaining parameters showed slight improvement in both groups without any statistically significant differences between the two groups after 1 year. Pain evaluation as patient reported outcome measures (pain evaluation) was in favor (p = 0.347) of the SRP group, while overall satisfaction was similar for both groups. Treatment time was not statistically significantly different between the two groups (p = 0.188). CONCLUSION In well-maintained SPC patients, SRP protocols resulted in significant clinical improvements in terms of BoP; however, for the other clinical improvements, similar efficacy for both GBM and SRP was observed.
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Affiliation(s)
- Alexandra Stähli
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Jvana Ferrari
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | | | - Andrea Roccuzzo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - Ho-Yan Duong
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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Nong Z, Ya Z, Zheng J, Yong X, Tao R. The efficacy of subgingival air polishing and subgingival debridement in periodontal support therapy: a meta-analysis. Evid Based Dent 2023; 24:142-143. [PMID: 37433921 DOI: 10.1038/s41432-023-00910-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/30/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE To assess whether there is sufficient evidence of a difference in efficacy between subgingival air polishing (SubAP) and subgingival debridement as periodontal support treatment. The systematic review protocol was registered in the PROSPERO database under no. CRD42020213042. METHODS A comprehensive search was conducted using eight online databases to develop straightforward clinical questions and search strategies, from their inception to 27 January 2023. The references of identified reports were also retrieved for inclusion in the analysis. The risk-of-bias of the included studies was evaluated using the Revised Cochrane Risk-of-Bias tool (RoB 2). A meta-analysis was performed on five clinical indicators using the Stata 16 software. RESULTS Twelve randomized controlled trials were ultimately included, and most included studies had varying degrees of risk-of-bias. The results of the meta-analysis indicated that there was no significant difference between SubAP and subgingival scaling in terms of improving probing depth (PD), clinical attachment loss (CAL), plaque index (PLI), and bleeding on probing% (BOP%). The results of the visual analogue scale score analysis indicated that SubAP produced less discomfort than did subgingival scaling. DISCUSSION SubAP can provide better treatment comfort than subgingival debridement. There was no significant difference in the efficacy of the two modalities in improving PD, CAL, and BOP% in supportive periodontal therapy. CONCLUSION Currently, evidence for assessing the difference in the efficacy of SubAP and subgingival debridement in improving the PLI is insufficient, and further high-quality clinical studies are needed.
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Affiliation(s)
- Zuwei Nong
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Zuke Ya
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China.
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China.
| | - Jiali Zheng
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Xiangzhi Yong
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Renchuan Tao
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
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Mensi M, Caselli E, D'Accolti M, Soffritti I, Farina R, Scotti E, Guarnelli ME, Fabbri C, Garzetti G, Marchetti S, Sordillo A, Trombelli L. Efficacy of the additional use of subgingival air-polishing with erythritol powder in the treatment of periodontitis patients: a randomized controlled clinical trial. Part II: effect on sub-gingival microbiome. Clin Oral Investig 2023; 27:2547-2563. [PMID: 36538094 PMCID: PMC10264538 DOI: 10.1007/s00784-022-04811-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To date, scarce evidence exists around the application of subgingival air-polishing during treatment of severe periodontitis. The aim of this study was to evaluate the effect on the health-related and periodontitis-related subgingival microbiome of air-polishing during non-surgical treatment of deep bleeding pockets in stage III-IV periodontitis patients. MATERIALS AND METHODS Forty patients with stage III-IV periodontitis were selected, and pockets with probing depth (PD) 5-9 mm and bleeding on probing were selected as experimental sites. All patients underwent a full-mouth session of erythritol powder supragingival air-polishing and ultrasonic instrumentation. Test group received additional subgingival air-polishing at experimental sites. Subgingival microbial samples were taken from the maxillary experimental site showing the deepest PD at baseline. Primary outcome of the first part of the present study was the 3-month change in the number of experimental sites. Additional analysis of periodontal pathogens and other sub-gingival plaque bacteria sampled at one experimental site at baseline and 3 months following treatment was performed through a real-time quantitative PCR microarray. RESULTS In the test group, a statistical increase of some health-related species was observed (Abiotropha defectiva, Capnocytophaga sputigena, and Lautropia mirabilis), together with the decrease of pathogens such as of Actinomyces israelii, Catonella morbi, Filifactor alocis, Porphyromonas endodontalis, Sele-nomonas sputigena, Tannerella forsythia, Treponema denticola, and Treponema socranskii. In the control group, statistical significance was found only in the decrease of Filifactor alocis, Tannerella forsythia, and Treponema socranskii. CONCLUSIONS The addition of erythritol-chlorhexidine powder seems to cause a shift of the periodontal micro-biome toward a more eubiotic condition compared to a conventional treatment. The study was registered on Clinical Trials.gov (NCT04264624). CLINICAL RELEVANCE Subgingival air-polishing could help re-establishing a eubiotic microbioma in deep bleeding periodontal pockets after initial non-surgical treatment.
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Affiliation(s)
- Magda Mensi
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, P.Le Spedali Civili 1, 25123, Brescia, Italy.
- U.O.C. Odontostomatologia - ASST Degli Spedali Civili Di Brescia, Brescia, Italy.
| | - Elisabetta Caselli
- Section of Microbiology and LTTA, Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Maria D'Accolti
- Section of Microbiology and LTTA, Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Irene Soffritti
- Section of Microbiology and LTTA, Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Eleonora Scotti
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, P.Le Spedali Civili 1, 25123, Brescia, Italy
- U.O.C. Odontostomatologia - ASST Degli Spedali Civili Di Brescia, Brescia, Italy
| | - Maria Elena Guarnelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Chiara Fabbri
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Gianluca Garzetti
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, P.Le Spedali Civili 1, 25123, Brescia, Italy
- U.O.C. Odontostomatologia - ASST Degli Spedali Civili Di Brescia, Brescia, Italy
| | - Silvia Marchetti
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, P.Le Spedali Civili 1, 25123, Brescia, Italy
- U.O.C. Odontostomatologia - ASST Degli Spedali Civili Di Brescia, Brescia, Italy
| | - Annamaria Sordillo
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, P.Le Spedali Civili 1, 25123, Brescia, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
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10
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Selimović A, Bunæs DF, Lie SA, Lobekk MA, Leknes KN. Non-surgical treatment of peri-implantitis with and without erythritol air-polishing a 12-month randomized controlled trial. BMC Oral Health 2023; 23:240. [PMID: 37095488 PMCID: PMC10125257 DOI: 10.1186/s12903-023-02973-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 04/17/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND A variety of interventions have been explored in the non-surgical management of peri-implantitis. In spite of extensive testing of various study protocols, effective treatments largely remain unavailable. The objective of the present 12-month single-centre, examiner-masked, randomized controlled clinical trial was to explore whether a low-abrasive erythritol air-polishing system produces added clinical benefit when used adjunctive to conventional non-surgical management of peri-implantitis and to record any associated patient-centered outcomes. METHODS Forty-three patients with mild to severe peri-implantitis including at least one implant either received ultrasonic/curette subgingival instrumentation and erythritol air-polishing (test) or ultrasonic/curette instrumentation only (control) at baseline and at 3, 6, 9, and 12 months. Probing depth (PD), bleeding on probing (BoP), dental plaque, suppuration (SUP), crestal bone level (CBL), and peri-implant crevicular fluid (PCF) were recorded at baseline, 6 and 12 months. Visual Analogue Scale (VAS) scores were collected immediately following subgingival interventions at all time-points. RESULTS A reduction in PD was observed from baseline to 6 months for the test (p = 0.006) and control (p < 0.001) and from baseline to 12 months for the control (p < 0.001). No intergroup differences were observed for primary outcome variables PD or CBL over time (p > 0.05). At 6 months, a intergroup difference in PCF was observed in favor of the test (p = 0.042). Moreover, a reduction in SUP from baseline to 6 and 12 months was observed in the test (p = 0.019). Overall, patients in the control group experienced less pain/discomfort compared with the test (p < 0.05), females reporting more pain/discomfort than males (p = 0.005). CONCLUSIONS This study confirms that conventional non-surgical management of peri-implantitis produces limited clinical improvement. It is shown that an erythritol air-polishing system may not produce added clinical benefits when used adjunctive to conventional non-surgical management. In other words, neither approach effectively resolved peri-implantitis. Moreover, the erythritol air-polishing system produced added pain/discomfort particularly in female patients. TRIAL REGISTRATION The clinical trial was prospectively registered in ClinicalTrials.gov with registration NCT04152668 (05/11/2019).
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Affiliation(s)
- Armin Selimović
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | - Dagmar F Bunæs
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | | | - Knut N Leknes
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway.
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11
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Martins O, Costa A, Silva D. The efficacy of air polishing devices in supportive periodontal therapy: Clinical, microbiological and patient-centred outcomes. A systematic review. Int J Dent Hyg 2023; 21:41-58. [PMID: 36300683 DOI: 10.1111/idh.12635] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/14/2022] [Accepted: 10/24/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this review was to compare air polishing devices with conventional periodontal therapy (hand instrumentation and/or ultrasonic debridement), in terms of their clinical, microbiological and patient-related outcomes in patients undergoing periodontal maintenance therapy. METHODS An online database search was performed to identify randomized controlled trials (RCTs) published between January 1987 and March 2021. Selection, data extraction and assessment risk of individual bias were conducted by two independent reviewers. The PICO method was employed to formulate the question: "In patients undergoing periodontal maintenance therapy/supportive periodontal therapy, do air polishing systems result in better clinical, microbiological and patient related outcomes than ultrasonic instrumentation or hand instrumentation?" Primary outcomes were bleeding on probing, gingival index and/or bleeding index. Secondary outcomes were probing depth, clinical attachment level, plaque index, microbiological counts and/or patient tolerance. The risk of bias was evaluated and the systematic review protocol was registered in PROSPERO. RESULTS The electronic search yielded 501 references of which 14 were included in this review. A meta-analysis was not performed due to great heterogeneity within the studies. Air polishing devices and conventional periodontal therapy presented identical results in the 14 studies analysed; however, air polishing devices presented better antimicrobial behaviour and better patient-related outcomes. CONCLUSIONS Both air polishing devices and conventional techniques demonstrated no difference in terms of clinical efficacy; however, air polishing devices seem to present improved antimicrobial results. In addition, they are also a safer, faster and more comfortable option for patients undergoing supportive periodontal therapy.
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Affiliation(s)
- Orlando Martins
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Costa
- DDM, Private Practice, Vila Real, Portugal
| | - Daniela Silva
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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12
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Reinhart D, Singh-Hüsgen P, Zimmer S, Bizhang M. In-vitro influence of the use of an erythritol powder through air polishing on the surface roughness and abrasiveness of various restorative materials. PLoS One 2022; 17:e0270938. [PMID: 35797310 PMCID: PMC9262204 DOI: 10.1371/journal.pone.0270938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of this in-vitro study is to compare the prophylaxis powder Airflow® Plus to a conventional prophylaxis paste with regards to surface abrasion and roughness on four different restorative materials. A total of 80 samples were fabricated, including 20 of each investigated material. Among those were a nanocomposite (Ceram X Spectra™ ST, Dentsply), a glass ionomer cement (Ketac Fill™, 3M™), a cast metal alloy (Bio Maingold SG®, Heraeus Kulzer) and a ceramic (HeraCeram® Saphir, Heraeus Kulzer). Of each material, all samples were equally divided into two groups. Samples in one group were treated with AirFlow® Plus using the AirFlow® Prophylaxis Master (EMS, Switzerland) (Group AF) and the ones in the other group with Prophy Paste (Cleanic™, Kerr, Austria) (Group CL) on a rubber cup. Applied force amounted to 1.5 N at 2000 rpm. Under controlled reproduceable conditions, a 10-year interval with 4 application per year, a total of 200 seconds, was simulated. Size of each sample amounted to 6 mm in diameter and 2 mm in height. Half side of each sample were treated. While comparing the treated and untreated area of each sample, surface abrasion and roughness were measured using an optical 3D system. Roughness was measured based on the arithmetic roughness average of the surface (Ra) and root mean square of the surface roughness (Rq). The statistical evaluation of the data was carried out using the non-parametric Mann-Whitney-U-test, Wilcoxon-test and the Kruskal-Wallis test for group comparisons. In conclusion, the use of the rubber cup with Prophy Paste caused a significantly higher abrasion on composite, ceramic and gold compared to the AirFlow® Plus powder (p < 0.05). In group AF, the significant highest values for Ra were determined on GIC, followed by composite, gold and then ceramic in intragroup comparison. Ra on GIC was significantly higher in group AF (p < 0.05).
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Affiliation(s)
- David Reinhart
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
- * E-mail:
| | - Preeti Singh-Hüsgen
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Mozhgan Bizhang
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
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13
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Effectiveness and Clinical Performance of Erythritol Air-Polishing in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials. Medicina (B Aires) 2022; 58:medicina58070866. [PMID: 35888585 PMCID: PMC9319203 DOI: 10.3390/medicina58070866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background and objectives: The purpose of the present systematic review was to analyze the effectiveness of erythritol-based air-polishing in non-surgical periodontal therapy. Materials and methods: The protocol details were registered in the PROSPERO database (CRD42021267261). This review was conducted under the PRISMA guidelines. The electronic search was performed in PubMed, Scopus, and Web of Science databases to find relevant clinical trials published until January 2022. The inclusion criteria consisted of human clinical trials which reported the use of non-surgical periodontal treatment and erythritol air-polishing compared to non-surgical periodontal treatment alone in patients with good systemic health requiring treatment for periodontal disease. Results: 810 studies were imported into the Covidence Platform. Of these, seven clinical trials met the inclusion criteria. In active periodontal therapy, for PD (probing depth), CAL (clinical attachment level), and BOP (bleeding on probing), no statistical significance was achieved at 6 months follow-up. In supportive periodontal therapy for PD, CAL, and BOP, no statistical significance was achieved at 3 months follow-up. Conclusions: The findings suggest that erythritol air-polishing powder did not determine superior improvements of periodontal parameters compared to other non-surgical periodontal therapies. Future randomized clinical trials (RCTs) with calibrated protocols for diagnosis, therapeutic approaches, and longer follow-up are needed to draw a clear conclusion about the efficiency of erythritol air-polishing powder.
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14
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Divnic-Resnik T, Pradhan H, Spahr A. The efficacy of the adjunct use of subgingival air-polishing therapy with erythritol powder compared to conventional debridement alone during initial non-surgical periodontal therapy. J Clin Periodontol 2022; 49:547-555. [PMID: 35373340 PMCID: PMC9321595 DOI: 10.1111/jcpe.13623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/19/2022] [Accepted: 03/24/2022] [Indexed: 01/12/2023]
Abstract
Aim To assess the efficacy of the adjunct use of a subgingival erythritol powder air‐polishing device (EPAP) in comparison to conventional subgingival instrumentation alone during initial non‐surgical periodontal therapy. Materials and Methods Twenty‐one patients with generalized Stages 2 and 3 grade B periodontitis were included in this single centre, single blinded, split‐mouth, randomized clinical trial. Teeth on the control side were treated with conventional hand and ultrasonic instrumentation, while those on the contralateral test side was treated using EPAP as adjunct to conventional subgingival instrumentation with hand and ultrasonic instruments. Three months after initial instrumentation, persisting pockets of ≥4 mm were re‐treated, in both control and test sides, again with the respective treatment approach—subgingival instrumentation alone on control, and subgingival instrumentation + EPAP on test side. Clinical parameters such as probing pocket depth (PPD), bleeding on probing, and relative attachment level were recorded at baseline and 3 and 6 months following the initial instrumentation. Subgingival plaque samples were collected at baseline, immediately post surgery, as well as at 1 week, 1 month, 3 months, and 6 months after initial instrumentation. Results In the test group after 6 months, a significantly larger number of initially deep pockets (PPD ≥ 5.5 mm) were reduced to shallow (PPD ≤ 3.4 mm), and a larger attachment gain was observed. No statistically significant microbiological differences could be found between test and control group. Conclusions The results of the present study indicate that the adjunct use of subgingival airflow therapy with EPAP during initial non‐surgical periodontal therapy might be beneficial in initially deep pockets (PPD ≥ 5.5 mm).
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Affiliation(s)
- Tihana Divnic-Resnik
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Harold Pradhan
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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15
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Alkan İİ, Akkaya HÜ, Sağlam M. The effectiveness of scaling and root planing with combined application of air polishing and Nd:YAG laser in periodontal pockets of stage III grade C periodontitis patients: a single-blinded randomized clinical trial. Clin Oral Investig 2022; 26:5459-5469. [PMID: 35505199 DOI: 10.1007/s00784-022-04513-x] [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: 02/17/2022] [Accepted: 04/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Evaluating the efficiency of combined air polishing and Nd:YAG laser application in addition to scaling and root planning (SRP) in treatment of periodontal pockets of stage III grade C periodontitis patients was the aim of this clinical trial. MATERIALS AND METHODS Twenty-four systemically healthy, stage III grade C periodontitis patients were recruited for this clinical trial. In this split-mouth study, the quadrants were randomly allocated to either SRP with combined air polishing (erythritol/chlorhexidine powder) and Nd:YAG laser (2 W, 200 mJ/pulse, 10 Hz) therapy (test group) or SRP alone (control group). A masked examiner recorded clinical parameters such as plaque index (PI), gingival index (GI), bleeding on probing (%) (BOP %), probing depth (PD), and clinical attachment level (CAL) on periodontal charts at baseline, 1 month and 3 months after treatment. RESULTS The clinical parameters had significantly reduced 1 and 3 months after treatment compared to baseline for both study groups (p < 0.05). Considering PI, GI, and BOP (%) parameters, there were no significant differences between the study groups at any time points (p > 0.05). While PD and CAL reductions were similar in study groups for moderately deep pockets (5 to 6 mm) (p > 0.05), PD and CAL reductions were significantly greater in test group compared to control group for deep pockets (PD ≥ 7 mm) (p < 0.05). CONCLUSIONS The present clinical trial demonstrated that SRP with combined application of air polishing and Nd:YAG laser may be advantageous in sites where mechanical debridement alone cannot access, such as deep pockets in the short term. Long-term, well-designed future studies including clinical, biochemical, and microbiological analyses are needed to determine the effectiveness of this procedure. CLINICAL RELEVANCE SRP with combined application of air polishing and Nd:YAG laser provided more reductions in probing depth and clinical attachment level parameters in deep pockets compared to SRP alone.
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Affiliation(s)
- İsmet İlke Alkan
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey.,Private Practice, Karabağlar, İzmir, Turkey
| | - Hazal Üstünel Akkaya
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mehmet Sağlam
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey.
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Németh KD, Haluszka D, Seress L, Lovász BV, Szalma J, Lempel E. Effect of Air-Polishing and Different Post-Polishing Methods on Surface Roughness of Nanofill and Microhybrid Resin Composites. Polymers (Basel) 2022; 14:polym14091643. [PMID: 35566812 PMCID: PMC9100913 DOI: 10.3390/polym14091643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/27/2022] Open
Abstract
Air-abrasion is a popular prophylactic procedure to maintain oral hygiene. However, depending on the applied air-abrasive powder, it can damage the surface of the tooth and restorations, making it susceptible to plaque accumulation. The purpose of this study was to investigate the effect of 5 s and 10 s air-abrasion of calcium carbonate on surface roughness (Ra) of enamel, nanofill, and microhybrid resin-composites and the effect of post-polishing with two-step rubber- (RP) or one-step brush polisher (BP) to re-establish the surface smoothness. Surface topography was visualized by scanning-electron-microscopy. The quantitative measurement of the Ra was carried out with atomic-force-microscopy. Air-abrasion for 10 s decreased the Ra of enamel as a result of abrasion of the natural surface texture. Post-polishing with RP after 10 s air-abrasion did not change the Ra or BP; however, Ra was increased significantly by scratching the surface. Air-abrasion increased the Ra of resin composites significantly, irrespective of the application time. While RP provided a similarly smooth surface to the control in the case of microhybrid resin composite, BP increased the Ra significantly. The Ra for the control group of the nanofill-resin composite was initially high, which was further increased by air-abrasion. RP and BP re-established the initial Ra with deeper and shallower scratches after BP. Both the material and treatment type showed a large effect on Ra.
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Affiliation(s)
- Kinga Dorottya Németh
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
| | - Dóra Haluszka
- Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó Street 37–47, 1094 Budapest, Hungary;
| | - László Seress
- Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary;
| | - Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
- Correspondence: ; Tel.: +36-72-535926
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17
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Tan SL, Grewal GK, Mohamed Nazari NS, Mohd-Dom TN, Baharuddin NA. Efficacy of air polishing in comparison with hand instruments and/or power-driven instruments in supportive periodontal therapy and implant maintenance: a systematic review and meta-analysis. BMC Oral Health 2022; 22:85. [PMID: 35321688 PMCID: PMC8944123 DOI: 10.1186/s12903-022-02120-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant placement. This systematic review aimed to assess clinical outcomes, patients' perception, and cost-effectiveness of repeated periodontal therapy with air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments (conventional interventions) in SPT and implant maintenance. METHODS Electronic search for randomised controlled clinical trials with minimum 6 months follow-up for SPT and implant maintenance programme was conducted for data published from 01 January 2000 to 30 April 2020 using multiple databases and hand searching. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). RESULTS A total of 823 articles were screened. 4 SPT and 2 implant maintenance studies were eligible for inclusion. For SPT, repeated APDs interventions revealed no statistically significant difference when compared to the conventional interventions (weighted mean difference [WMD] 0.11 mm, p = 0.08). Likewise, no statistical difference was noted in terms of percentage of bleeding on probing (BOP) and clinical attachment level (CAL) gain. APDs were associated with lower pain score (based on Visual Analogue Scale) and higher patient acceptance in SPT studies. For implant maintenance, APDs resulted in reduction in PPD and percentage of BOP. However, CAL gain was comparable between the two groups. In terms of patient reported outcomes, no implant maintenance studies recorded any forms of patient reported outcomes. In addition, no studies reported on economic evaluation of APDs in both SPT and implant maintenance. CONCLUSION Within the limitations of this systematic review and meta-analysis, repeated subgingival debridement using APDs in SPT resulted in similar clinical outcomes but better patients' comfort when compared to the conventional interventions. For implant maintenance, there is limited evidence to show that repeated application of APDs leads to improved clinical outcomes when compared to conventional treatments.
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Affiliation(s)
- Shiuan Lee Tan
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Galvinderjeet Kaur Grewal
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Nor Shafina Mohamed Nazari
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Tuti Ningseh Mohd-Dom
- Department of Family Oral Health Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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18
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Kruse AB, Wölki BJ, Woelber JP, Frisch E, Vach K, Ratka-Krüger P. Subgingival air polishing with trehalose powder during supportive periodontal therapy: use of a conical shaped tip during a randomized clinical trial. BMC Oral Health 2022; 22:70. [PMID: 35282825 PMCID: PMC8918077 DOI: 10.1186/s12903-022-02109-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/07/2022] [Indexed: 10/01/2024] Open
Abstract
Background This study investigated clinical parameters using a new air-polishing device compared to sonic scaling for subgingival biofilm removal during supportive periodontal therapy. The aim was to evaluate noninferiority of air-polishing compared to sonic scaling in deeper periodontal pockets with respect to pocket depth (PD).
Methods In 44 participants, 2 single-rooted teeth [(PD) ≥ 5 mm] were treated using a split-mouth design. While a new air polishing device with a conical shaped tip was used for the experimental group, sonic scaling was performed in the control group. PD, clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at baseline, (T0) after 3 months (T1) and 6 months (T2). Pain perception was rated using a visual analog scale (VAS; 0 = no pain, 100 = maximum pain). Results PD and CAL decreased significantly for both groups, while no intergroup differences were found (PD [mean, mm] control T0 5.96, T2 4.75; experimental T0 5.96, T2 4.8; intergroup p = 0.998; CAL [mean, mm] control T0 7.38, T2 5.84; experimental T0 7.28, T2 6.34; intergroup p = 0.368). For BOP, no intergroup differences were found from T0 to T2 (reduction control 42.5%; experimental 46.5% p = 0.398). Pain perception was significantly lower for air polishing (VAS [mean, mm] control 28.8, experimental 12.56; p = 0.006). Conclusion None of the two treatment procedures showed inferior clinical effects with regard to PD, CAL and BOP with air polishing being more comfortable to patients. Trial registration The study was registered in an international trial register on August 14/08/2019, before the start of recruitment (German Clinical Trial Register number DRKS00017844).
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Vinel A, Al Halabi A, Roumi S, Le Neindre H, Millavet P, Simon M, Cuny C, Barthet JS, Barthet P, Laurencin-Dalicieux S. Non-surgical Periodontal Treatment: SRP and Innovative Therapeutic Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:303-327. [DOI: 10.1007/978-3-030-96881-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Schlagenhauf U, Hess JV, Stölzel P, Haubitz I, Jockel-Schneider Y. Impact of a two-stage subgingival instrumentation schemeinvolvingair-polishingon attachment gain after activeperiodontal therapy. J Periodontol 2021; 93:1500-1509. [PMID: 34870331 DOI: 10.1002/jper.21-0351] [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: 06/07/2021] [Revised: 11/13/2021] [Accepted: 11/17/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND To evaluate whether clinical attachment levelgain (ΔCAL) in deepuntreated periodontal lesionsmay be improved by a two-stage, subgingival instrumentation schemeinvolving air-polishing. METHODS This 6-month, randomized, controlled, examiner-blinded clinical trial was performed in 44 periodontitis patients with untreated periodontal lesions ≥ 6 mm. At baseline, day 28, 84, and 168 clinical attachment level (CAL), probing pocket depth (PPD), bleeding on probing (BoP) and plaque control record (PlaCR) were recorded. After baseline examination control grouppatients received full-mouth sub- and supragingival instrumentation using scalers and curettes. In the test group initial subgingival cleaningwas limited to the removal of soft bacterial deposits by air-polishing. Subgingival scaling and root planing was performed only after the first reevaluation at day 28. RESULTS In deep lesions ≥ 6 mm a significant reduction of mean CAL scores was observed at day 28 and at day 168 for both experimental groups. Differences between the groupshowever did not reach the level of significance. Mean PPD was also significantly reduced at day 28 and at 168 in both experimental groups, with no significant differences between the groups. Mean BoP scores did not change significantly in both groups during the 168-day observation period. Only in the test group mean PlaCR scores were significantly reduced at day 168 compared to baseline. CONCLUSIONS Subgingival instrumentation of untreated periodontal pockets ≥ 6 mm by air-polishing alone resultsin a significant short-term gain of CAL comparable to conventional scaling and root planing. Its sequential two-step combination with scaling and root planinghowever does not additionally enhancelong-termgain of CAL. (ClinicalTrials.gov: NCT03098498). ONE-SENTENCE SUMMARY A two-step combination of air-polishing and scaling and root planing does not improve attachment gain in untreated deep periodontal lesions. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ulrich Schlagenhauf
- Department of Periodontology, University Hospital Wuerzburg, Pleicherwall 2, Wuerzburg, D-97070, Germany
| | - Jeanine V Hess
- Department of Periodontology, University Hospital Wuerzburg, Pleicherwall 2, Wuerzburg, D-97070, Germany
| | - Peggy Stölzel
- Department of Periodontology, University Hospital Wuerzburg, Pleicherwall 2, Wuerzburg, D-97070, Germany
| | - Imme Haubitz
- Department of Periodontology, University Hospital Wuerzburg, Pleicherwall 2, Wuerzburg, D-97070, Germany
| | - Yvonne Jockel-Schneider
- Department of Periodontology, University Hospital Wuerzburg, Pleicherwall 2, Wuerzburg, D-97070, Germany
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21
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Hentenaar DFM, De Waal YCM, Stewart RE, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol air polishing in the surgical treatment of peri-implantitis: A randomized controlled trial. Clin Oral Implants Res 2021; 33:184-196. [PMID: 34808006 PMCID: PMC9299917 DOI: 10.1111/clr.13881] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 01/14/2023]
Abstract
Objectives To compare erythritol air polishing with implant surface cleansing using saline during the surgical treatment of peri‐implantitis. Material and Methods During a resective surgical intervention, implant surfaces were randomly treated with either air polishing (test group n = 26 patients/53 implants) or saline‐soaked cotton gauzes (control group n = 31 patients/ 40 implants). Primary outcome was change in mean bleeding on probing (BoP) from baseline to 12 months follow‐up. Secondary outcomes were changes in mean suppuration on probing (SoP), plaque score (Plq), probing pocket depth (PPD), marginal bone loss (MBL), periodontal full‐mouth scores (PFMS), and levels of 8 classical periodontal pathogens. Clinical and radiographical parameters were analyzed using multilevel regression analyses. Microbiological outcomes were analyzed using the Mann–Whitney U test. Results No differences between the test and control group were found for BoP over 12 months of follow‐up, nor for the secondary parameters Plq, PPD, and MBL. Between both groups, a significant difference was found for the levels of SoP (p = 0.035). No significant effect on microbiological levels was found. A total number of 6 implants were lost in the test group and 10 in the control group. At 1‐year follow‐up, a successful treatment outcome (PPD<5 mm, max 1 out of 6 sites BoP, no suppuration and no progressive bone loss >0.5 mm) was achieved for a total of 18 implants (19.2%). Conclusions Erythritol air polishing as implant surface cleansing method was not more effective than saline during resective surgical treatment of peri‐implantitis in terms of clinical, radiographical, and microbiological parameters. Both therapies resulted in low treatment success. Trial registry: https://www.trialregister.nl/ Identifier: NL8621.
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Affiliation(s)
- Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roy E Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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22
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Shrivastava D, Natoli V, Srivastava KC, Alzoubi IA, Nagy AI, Hamza MO, Al-Johani K, Alam MK, Khurshid Z. Novel Approach to Dental Biofilm Management through Guided Biofilm Therapy (GBT): A Review. Microorganisms 2021; 9:microorganisms9091966. [PMID: 34576863 PMCID: PMC8468826 DOI: 10.3390/microorganisms9091966] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Dental biofilm plays a very crucial role in the etiopathogenesis of periodontal andperi-implant diseases. Over the past decade, tremendous research has been carried outto know the structure of biofilm and the mechanism by which it causes the destruction of supporting tissues of tooth or implant. Periodontal or peri-implant therapy usually begins with primarily removing thebiofilm and is considered as non-surgical mechanical debridement. Although scaling and root planing (SRP) is regarded as a gold standard for mechanical plaque debridement, various other means of biofilm removal have constantly been evolving. These may vary from different scaling systems such as vector systems to decontamination of pockets with LASER therapy. Nowadays, a new concept has emerged known as “guided biofilm therapy” (GBT). It is beneficial in removing the biofilm around the tooth and implant structures, resulting in better or comparable clinical outcomes than SRP. These results were substantiated with the reduction in the microbial load as well as the reduction in the inflammatory cytokines. This review will highlight the various aspects of GBT used in periodontal and peri-implant disease.
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Affiliation(s)
- Deepti Shrivastava
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
- Correspondence: ; Tel.: +966-500-782-498
| | - Valentino Natoli
- Department of Dentistry, School of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain;
- Private Dental Practice, 72015 Fasano, Italy
| | - Kumar Chandan Srivastava
- Oral Medicine Radiology, Department of Oral Maxillofacial Surgery Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ibrahim A Alzoubi
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ahmed Ismail Nagy
- Oral Surgery, Department of Oral Maxillofacial Surgery Diagnostic Sciences, Jouf University, Sakaka 72345, Saudi Arabia;
| | - May Othman Hamza
- Department of Prosthodontics, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Khalid Al-Johani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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23
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Albonni H, Alseirafi W, Tekleh H, Sawaf H. Clinical outcomes of performance of dental students using erythritol powder by means of air polishing with ultrasonic debridement with students' assessment: Part II. Int J Dent Hyg 2021; 20:391-400. [PMID: 34318588 DOI: 10.1111/idh.12540] [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: 01/13/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Assessment of a dental student's clinical performance is essential for providing feedback for improving education. This study evaluated the ability of undergraduate dental students to treat periodontal patients with two techniques, ultrasonic debridement with polishing (UD+P) and the erythritol powder air polishing with ultrasonic instrumentation (EPAP+UD) in a split-mouth design. METHODS The study was conducted on undergraduate students with patients suffering from gingivitis and stage I periodontitis with grade A. The evaluation consisted of two parts: first, assessment of the student by clinical indices (full mouth plaque index (FMPI), calculus index (CI), remaining calculus index (RCI), modified gingival index (MGI) and papillary bleeding index (PBI)) at baseline, immediately and after 2 weeks. In addition to assessing treatment time for each student; and second, obtaining student feedback about the two methods used. RESULTS Five undergraduate fourth years' students, and thirteen patients participated. Statistically significant decreases in FMPI, CI, MGI and PBI between baseline and 2 weeks post-treatment were noted in both test and control groups. At 2 weeks of inter-group comparisons, there was a statistically significant difference in FMPI and MGI indices, and immediately after the treatment, there was also a significant reduction in FMPI and CI. Treatment time was significantly less for the EPAP+UD method, and it got 10-time method preferring in comparison with the control group (UD+P) by students. CONCLUSION The undergraduate dental student has the capacity to treat the periodontal patient using both approaches with a preference for the EPAP+UI approach over UI+P. In addition, this EPAP+UI is a promising method of education.
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Affiliation(s)
- Hala Albonni
- Periodontology Department, Faculty of Dental Medicine, Damascus University, Damascus, Syria.,Periodontology Department, Faculty of Dentistry - Syrian Private University, Daraa, Syria.,Periodontology Department, Faculty of Dentistry - Al Sham Private University, Damascus, Syria
| | | | | | - Hazem Sawaf
- Periodontology Department, Faculty of Dentistry - Syrian Private University, Daraa, Syria.,Periodontology Department, Faculty of Dentistry - Al Sham Private University, Damascus, Syria
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Abdulbaqi HR, Shaikh MS, Abdulkareem AA, Zafar MS, Gul SS, Sha AM. Efficacy of erythritol powder air-polishing in active and supportive periodontal therapy: A systematic review and meta-analysis. Int J Dent Hyg 2021; 20:62-74. [PMID: 34318577 DOI: 10.1111/idh.12539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This systematic review aimed to analyse available evidence to answer two focused questions about the efficacy of erythritol powder air-polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes. METHODS PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three independent reviewers, and the agreement was measured by Cohen's kappa score. Out of 1043 articles, eight randomized clinical trials were selected for systematic review and quantitative synthesis. Only periodontal parameters, such as clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing (BoP), showed homogeneity and, thus, were selected for meta-analysis. RESULTS The improvement in PPD and BoP scores after using EPAP was comparable with hand/ultrasonic instrumentation during both APT and SPT. Significant CAL gain was achieved with EPAP during APT (0.16 mm, p < 0.02) compared with hand/ultrasonic instrumentation at the end point, whereas non-significant CAL gain was achieved during SPT. No differences were observed regarding microbiological outcomes between the two treatment modalities. However, EPAP inflicted less pain and was better perceived by the patients. CONCLUSION Erythritol powder air-polishing can substitute hand/ultrasonic instrumentation for SPT, and CAL gain is significantly improved when EPAP is used as an adjunct during APT. For microbiological outcomes, no significant differences were observed between the two approaches; however, EPAP was better tolerated by the patients than hand/ultrasonic instrumentation. CLINICAL RELEVANCE Erythritol powder air-polishing can be used as an adjunct during APT and as an alternative to conventional mechanical debridement during SPT.
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Affiliation(s)
- Hayder R Abdulbaqi
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ali A Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Muhammad S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Medina, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Sarhang S Gul
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Aram M Sha
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq.,Smart Health Tower, Sulaimani, Iraq
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25
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Mensi M, Scotti E, Sordillo A, Dalè M, Calza S. Clinical evaluation of air polishing with erythritol powder followed by ultrasonic calculus removal versus conventional ultrasonic debridement and rubber cup polishing for the treatment of gingivitis: A split-mouth randomized controlled clinical trial. Int J Dent Hyg 2021; 20:371-380. [PMID: 34275193 PMCID: PMC9292536 DOI: 10.1111/idh.12537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 05/24/2021] [Accepted: 06/26/2021] [Indexed: 01/03/2023]
Abstract
Objectives To evaluate the clinical efficacy in the short‐term resolution of gingivitis of a novel protocol involving full‐mouth erythritol powder air polishing followed by ultrasonic calculus removal. Methods Forty‐one healthy patients completed the study. Following a split‐mouth design, quadrants 1–4 and 2–3 were randomly allocated to receive air polishing followed by ultrasonic calculus removal (A+US) or traditional full‐mouth ultrasonic debridement followed by polishing with a rubber cup and prophylactic paste (US+P). Bleeding on probing (BoP) and plaque index (PI) were collected at baseline and 2 and 4 weeks. Moreover, the residual plaque area (RPA), treatment time and patient comfort/satisfaction were evaluated at the end of the treatment. Results Both treatments showed a significant reduction in BoP and PI. At 4 weeks, A+US seems to reach a statistically significant lower BoP (8.7% [6.9; 10.9] vs. 11.6%[9.3; 14.4], p < 0.0001) and PI (10.7% [8.9; 13.0] vs. 12.3% [10.2; 14.9], p = 0.033). Moreover, A+US treatment time lasted on average 9.2% less than US+P (p < 0.0001) and was the preferred treatment for a significantly higher number of patients (73.2% vs. 17.1%, p = 0.0001). Conclusion The A+US protocol is suitable for the short‐term resolution of plaque‐induced gingivitis.
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Affiliation(s)
- Magda Mensi
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.,U.O.C. Odontostomatologia - ASST degli Spedali Civili di Brescia, Brescia, Italy
| | - Eleonora Scotti
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.,U.O.C. Odontostomatologia - ASST degli Spedali Civili di Brescia, Brescia, Italy
| | - Annamaria Sordillo
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Matteo Dalè
- Section of Periodontics, School of Dentistry, Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
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26
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Albonni H, Alseirafi W, Tekleh H, Abo Orabi F, Alhaj M, Almasri D, Hamadh H, Sawaf H. Clinical outcomes of using erythritol powder by means of air polishing with ultrasonic debridement in the treatment of initial periodontal pockets in hand of dental students: A split-mouth, randomized, comparative, controlled study. Part I. Int J Dent Hyg 2021; 19:262-272. [PMID: 34013650 DOI: 10.1111/idh.12519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/07/2021] [Accepted: 05/16/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The purpose of this trial was to evaluate the clinical efficacy and patient acceptance of using the erythritol powder air polishing with mechanical debridement in non-surgical periodontal therapy. METHODS The trial was conducted as a split-mouth design study of 6 weeks' duration including 13 patients with gingivitis and stage I periodontitis with grade A. Each patient received ultrasonic debridement and polishing (UD+P) on one side, whereas the contralateral side was treated by erythritol powder air polishing and ultrasonic instrumentation (EPAP+UI) when required. Clinical variables were as follows: papillary bleeding index (PBI), bleeding on probing (BOP), full mouth plaque index (FMPI), calculus index (CI), modified gingival index (MGI), probing pocket depth (PPD), the time needed and rate the pain for each group. RESULTS The FMPI, MGI, CI, PBL and BOP parameters improved significantly for both treatment procedures; however, there were no statistically significant differences between the two groups at any of the examinations intervals, except for MGI and CI which showed a significant reduction at 2 weeks compared with baseline. PPD was significantly decreased in EPAP+UI group. Perceived pain intensity was lower for EPAP+UI group than UD+P group without any significant difference during follow-up periods between the two groups. Seven patients favoured air polishing. The treatment's time was (24.92 ± 9.260 and 34.08 ± 9.106) minutes for the test and control side, respectively. CONCLUSION This study generally revealed no significant differences in clinical outcomes between two groups for gingivitis and stage I periodontitis treatment. However, EPAP+UI had higher patient's preference and less time-consuming compared with UD+P.
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Affiliation(s)
- Hala Albonni
- Periodontology Department, Faculty of Dental Medicine, Damascus University, Damascus, Syria.,Periodontology Department, Faculty of Dentistry-Syrian Private University, Daraa, Syria
| | - Walaa Alseirafi
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hiba Tekleh
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Feras Abo Orabi
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Mouaaid Alhaj
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Dima Almasri
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hussen Hamadh
- Faculty of Dentistry- Syrian Private University, Daraa, Syria
| | - Hazem Sawaf
- Periodontology Department, Faculty of Dentistry-Syrian Private University, Daraa, Syria
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27
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Hentenaar DFM, De Waal YCM, Stewart RE, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol airpolishing in the non-surgical treatment of peri-implantitis: A randomized controlled trial. Clin Oral Implants Res 2021; 32:840-852. [PMID: 33844373 PMCID: PMC8360148 DOI: 10.1111/clr.13757] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/13/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022]
Abstract
Objectives To compare erythritol air polishing with piezoelectric ultrasonic scaling in the non‐surgical treatment of peri‐implantitis. Material and methods Eighty patients (n = 139 implants) with peri‐implantitis (probing pocket depth (PPD) ≥5 mm, marginal bone loss (MBL) ≥2 mm as compared to bone level at implant placement, bleeding, and/or suppuration on probing (BoP/SoP)) were randomly allocated to air polishing or ultrasonic treatment. The primary outcome was mean BoP (%) at 3 months after therapy (T3). Secondary outcomes were mean SoP (%), plaque score (Plq) (%), PPD (mm), MBL (mm), full mouth periodontal scores (FMPS) (%), levels of 8 classical periodontal pathogens, and treatment pain/discomfort (Visual Analog Scale, VAS). Patients who were considered successful at T3 were additionally assessed at 6, 9, and 12 months. Differences between both groups were analyzed using multilevel statistics. Results Three months after therapy, no significant difference in mean BoP (%) between the air polishing and ultrasonic therapy was found (crude analysis β (95% CI) −0.037 (−0.147; 0.073), p = .380). Neither secondary outcomes SoP (%), Plq (%), PPD (mm), MBL (mm), FMPS (%), and periodontal pathogens showed significant differences. Treatment pain/discomfort was low in both groups (VAS score airpolishing group 2.1 (±1.9), ultrasonic 2.6 (±1.9); p = .222). All successfully treated patients at T3 (18.4%) were still considered successful at 12‐month follow‐up. Conclusions Erythritol air polishing seems as effective as piezoelectric ultrasonic scaling in the non‐surgical treatment of peri‐implantitis, in terms of clinical, radiographical, and microbiological parameters. However, neither of the proposed therapies effectively resolved peri‐implantitis. Hence, the majority of patients required further surgical treatment.
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Affiliation(s)
- Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roy E Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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28
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Ulvik IM, Sæthre T, Bunæs DF, Lie SA, Enersen M, Leknes KN. A 12-month randomized controlled trial evaluating erythritol air-polishing versus curette/ultrasonic debridement of mandibular furcations in supportive periodontal therapy. BMC Oral Health 2021; 21:38. [PMID: 33478480 PMCID: PMC7819243 DOI: 10.1186/s12903-021-01397-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/06/2021] [Indexed: 12/22/2022] Open
Abstract
Background Due to complex morphology and limited access, the cleaning of the furcation area is extremely challenging. Therefore, novel therapeutic approaches need to be tested to potentially overcome debridement limitations. The aim of the present prospective 12-month study was to compare clinical and microbiological effects following erythritol air-polishing versus conventional mechanical debridement of furcation defects in a cohort of periodontal maintenance patients.
Methods Twenty patients with grade II mandibular molar furcation defects volunteered to enroll in this single-centre, examiner masked, randomized controlled trial. In a split-mouth study design, two furcation sites in each patient were randomly assigned to either receive subgingival debridement using erythritol air-polishing (test) or conventional ultrasonic/curette debridement (control) at baseline, and at 3, 6, 9 and 12 months. Probing depth, clinical attachment level and bleeding on probing were recorded at 3-month intervals. Subgingival microbiological samples obtained at baseline, 6 and 12 months were analyzed using checkerboard DNA–DNA hybridization. Discomfort from treatment was scored at 12 months using a visual analogue scale. The differences between treatments, and time-points, were tested using multilevel analysis (mixed effect models and robust variance estimates). Results A significant reduction in probing depth took place following both treatments (p < 0.001). Control sites experienced a significant mean gain in clinical attachment level of 0.5 mm (± 0.2) (p = 0.004), whereas a non-significant gain of 0.4 mm (± 0.3) was observed at test sites (p = 0.119). At 6 months, a significant between-treatment difference of 0.8 mm (± 0.4) was observed in favor of the control (p = 0.032). No significant between-treatment differences were observed in microbial load or composition. Notably, at 12 months patients experienced significantly less discomfort following air-polishing compared with control (p = 0.001). Conclusions The 12-month observations indicate that erythritol air-polishing and conventional mechanical debridement both support clinical improvements. A significant between-treatment difference in clinical attachment level was, however, detected in favour of control debridement at 6 months. In terms of patient comfort, erythritol air-polishing is superior. Trial Registration: The clinical trial was retrospectively registered in ClinicalTrial.gov with registration NCT04493398 (07/28/2020).
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Affiliation(s)
- Ingvild M Ulvik
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Terje Sæthre
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Dagmar F Bunæs
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Stein Atle Lie
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Morten Enersen
- Faculty of Dentistry, Institute for Oral Biology, University of Oslo, Oslo, Norway
| | - Knut N Leknes
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway.
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29
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Use of air polishing for supra- and subgingival biofilm removal for treatment of residual periodontal pockets and supportive periodontal care: a systematic review. Clin Oral Investig 2021; 25:779-795. [PMID: 33464417 DOI: 10.1007/s00784-020-03762-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
AIM To systematically review the literature to compare the efficacy of air polishing to hand or ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care. METHODS Electronic searches were performed in five different databases, and two databases were used to capture the "grey literature partially." Clinical trials that compared the use of an air-polishing device to either conventional scaling and root planing (hand and/or ultrasonic instrumentation) or no treatment during periodontal therapy were included without restriction of year and publication status. The Joanna Briggs Institute instrument for clinical trials was used to appraise the studies critically. The results were submitted to qualitative descriptive analysis. The systematic review protocol was registered in PROSPERO (CRD420220156176). RESULTS Electronic searches found 1100 hits published between 2008 and 2019. Thirteen studies were included in the review, out of which four had a follow-up longer than 180 days. Results indicated no differences between the efficacy of air polishing and hand or ultrasonic instruments to reduce periodontal inflammation. CONCLUSIONS Our findings suggest that there is no difference in the efficacy of air polishing and hand or ultrasonic instrumentation to control biofilm and reduce periodontal inflammation. However, these findings must be carefully interpreted owing to methodological issues, including a short follow-up, and a potential conflict of interest related to industry funding. CLINICAL RELEVANCE Air polishing for biofilm control may be used as an alternative to hand and ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care.
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30
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Efficacy of the additional use of subgingival air polishing with erythritol powder in the treatment of periodontitis patients: a randomized controlled clinical trial. Clin Oral Investig 2021; 25:729-736. [PMID: 33404760 DOI: 10.1007/s00784-020-03648-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/15/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To date, scarce evidence exists around the application of subgingival air polishing during treatment of severe periodontitis. The aim of this study was to evaluate the benefits of subgingival air polishing during non-surgical treatment of deep bleeding pockets in stages III-IV periodontitis patients MATERIALS AND METHODS: Forty patients with stages III-IV periodontitis were selected, and pockets with probing depth (PD) 5-9 mm and bleeding on probing (BoP) were selected as experimental sites. All patients underwent a full-mouth session of erythritol powder supragingival air polishing and ultrasonic instrumentation. Test group received additional subgingival air polishing at experimental sites. The proportion of experimental sites shifting to PD ≤ 4 mm and no BoP at 3 months (i.e., non-bleeding closed pockets, NBCPs) was regarded as the primary outcome variable. RESULTS The proportion of NBCP was comparable between test and control group (47.9 and 44.7%, respectively). Baseline PD of 7-9 mm, multi-rooted teeth and the presence of plaque negatively influenced the probability of obtaining NBCP. CONCLUSIONS The additional application of subgingival air polishing does not seem to provide any significant clinical advantage in achieving closure at moderate to deep bleeding pockets in treatment of stages III-IV periodontitis patients. The study was registered on Clinical Trials.gov (NCT04264624). CLINICAL RELEVANCE While air polishing can play a role in biofilm removal at supragingival and shallow sites, ultrasonic root surface debridement alone is still the choice for initial treatment of deep bleeding periodontal pockets.
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31
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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial. BMC Oral Health 2020; 20:364. [PMID: 33372602 PMCID: PMC7771063 DOI: 10.1186/s12903-020-01363-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. METHODS Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. RESULTS In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. CONCLUSIONS Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. CLINICAL RELEVANCE The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL .
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Park BY, Kim M, Park J, Jeong JH, Noh H. Research on dental plaque removal methods for efficient oral prophylaxis: With a focus on air polishing and rubber cup polishing. Int J Dent Hyg 2020; 19:255-261. [PMID: 33217770 DOI: 10.1111/idh.12481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 07/06/2020] [Accepted: 10/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study was conducted to compare the plaque control effectiveness of rubber cup polishing with that of air polishing during oral prophylaxis procedures and to investigate the effect of the order of air-polishing application on the efficiency of oral prophylaxis. METHODS The study included adult patients (≥20 years of age) who had visited the dental clinic for oral prophylaxis. A total of 173 subjects were divided into three groups (scaling followed by rubber cup polishing, SR; scaling followed by air polishing, SA; and air polishing followed by scaling, AS) based on sex, age, oral health status, oral hygiene status, and indications and contraindications according to the oral prophylaxis method. The analysis of variance (ANOVA) was used to determine the difference in oral prophylaxis time, residual deposits rate, subjects and dental hygienist satisfaction. RESULTS The total scaling time was shorter in the AS group (15.4 ± 6.9 minutes) than in the SA (18.7 ± 5.5 minutes) and SR groups (19.9 ± 6.2 minutes) (p < 0.05). The rate of residual deposits was significantly higher in the SR group than in the AS or SA groups (p < 0.05). The satisfaction level of dental hygienists was higher in the AS group (8.8 ± 1.0 points) and the SA group (8.4 ± 1.0 points) than in the SR group (6.2 ± 1.3 points). CONCLUSION During oral prophylaxis, dental plaque removal using air polishing requires a relatively longer time when compared to rubber cup polishing, but it can better eliminate dental plaque. In addition, we found that dental plaque removal using air polishing prior to scaling reduced the total scaling time.
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Affiliation(s)
- Bo-Young Park
- Department of Dental Hygiene, The Graduate School, Yonsei University, Wonju, Republic of Korea
| | | | | | - Ju-Hui Jeong
- Department of Dental Hygiene, The Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Hiejin Noh
- Department of Dental Hygiene, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
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Butera A, Maiorani C, Natoli V, Bruni A, Coscione C, Magliano G, Giacobbo G, Morelli A, Moressa S, Scribante A. Bio-Inspired Systems in Nonsurgical Periodontal Therapy to Reduce Contaminated Aerosol during COVID-19: A Comprehensive and Bibliometric Review. J Clin Med 2020; 9:jcm9123914. [PMID: 33276626 PMCID: PMC7761598 DOI: 10.3390/jcm9123914] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/25/2020] [Accepted: 11/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background: On 30 January 2020, a public health emergency of international concern was declared as a result of the new COVID-19 disease, caused by the SARS-CoV-2 virus. This virus is transmitted by air and, therefore, clinical practices with the production of contaminant aerosols are highly at risk. The purpose of this review was to assess the effectiveness of bio-inspired systems, as adjuvants to nonsurgical periodontal therapy, in order to formulate bio-inspired protocols aimed at restoring optimal condition, reducing bacteremia and aerosols generation. Methods: A comprehensive and bibliometric review of articles published in English. Research of clinical trials (RCTs) were included with participants with chronic or aggressive periodontal disease, that have compared benefits for nonsurgical periodontal therapy (NSPT). Results: Seventy-four articles have been included. For probing depth (PPD) there was a statically significant improvement in laser, probiotic, chlorhexidine groups, such as gain in clinical attachment level (CAL). Bleeding on probing (BOP) reduction was statistically significant only for probiotic and chlorhexidine groups. There were changes in microbiological and immunological parameters. Conclusions: The use of bio-inspired systems in nonsurgical periodontal treatment may be useful in reducing risk of bacteremia and aerosol generation, improving clinical, microbiological and immunological parameters, of fundamental importance in a context of global pandemic, where the reduction of bacterial load in aerosols becomes a pivotal point of clinical practice, but other clinical trials are necessary to achieve statistical validity.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
- Correspondence:
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | | | | | | | | | | | | | | | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
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Petersilka G, Koch R, Vomhof A, Joda T, Harks I, Arweiler N, Ehmke B. Retrospective analysis of the long-term effect of subgingival air polishing in supportive periodontal therapy. J Clin Periodontol 2020; 48:263-271. [PMID: 33098121 DOI: 10.1111/jcpe.13392] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/16/2022]
Abstract
AIM Glycine powder air polishing (GPAP) procedure has become popular. Aim of the analysis was to compare the clinical outcomes during supportive periodontal therapy (SPT) of subgingival application of GPAP with those using sole conventional mechanical debridement (SC). MATERIAL AND METHODS Over a median SPT period of 5.3 years (re-evaluation through last observation), the GPAP cohort (n = 263) received supra- and subgingival biofilm removal with GPAP. Supragingival calculus was removed using curets and sonic scalers here. Patients in the SC cohort (n = 264) were treated with sonic scalers, curets and rubber cup polishing only. Changes in, that is pocket probing depth (PPD) and furcation involvement were assessed retrospectively. A bootstrapping equivalence testing method in line with the principle of the two one-sided tests (TOST) procedure was used to compare clinical outcomes. RESULTS The GPAP procedure was statistically equivalent to SC regarding the number of sites with stable PPDs (83.3%; IQR 68.8%, 91.0% vs. 84.0%; IQR 77.8%, 90.0%). However, in the GPAP cohort, a trend towards deterioration in furcation status (no equivalence) was noted. CONCLUSIONS In periodontal maintenance, the use of GPAP instead of mechanical plaque removal does not improve the clinical outcome. It seems to be contraindicated to treat furcation defects with GPAP only.
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Affiliation(s)
- Gregor Petersilka
- Private Practice, Würzburg, Germany.,Department of Periodontology, Philipps University of Marburg, Marburg, Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Muenster, Münster, Germany
| | - Anna Vomhof
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
| | - Tim Joda
- Department of Reconstructive Dentistry, University of Basel, Basel, Switzerland
| | - Inga Harks
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
| | - Nicole Arweiler
- Department of Periodontology, Philipps University of Marburg, Marburg, Germany
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Muenster, Münster, Germany
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Kröger JC, Haribyan M, Nergiz I, Schmage P. Air polishing with erythritol powder - In vitro effects on dentin loss. J Indian Soc Periodontol 2020; 24:433-440. [PMID: 33144771 PMCID: PMC7592611 DOI: 10.4103/jisp.jisp_414_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/06/2020] [Accepted: 04/06/2020] [Indexed: 01/03/2023] Open
Abstract
Context: Low-abrasive polishing powders such as glycine (GLY) or erythritol (ERY) are used for subgingival air polishing. GLY was reported to possibly affect the dentin surface, while this is unclear for ERY. Aims: This in vitro study aimed to evaluate the substance loss from the dentin surface by air polishing with ERY at different settings for pressure (PR), distance (DI), and angulation of the spray jet to the surface (AJ). Materials and Methods: The in vitro testing was performed on smooth human root dentin surfaces. In 18 groups with 10 specimens each, ERY was applied with constant water supply for 5 s without moving the handpiece at the following settings: PR minimum (min), medium (med), and maximum (max); DI at 1, 3, and 5 mm; and 45° or 90° AJ. The substance loss was measured as defect depth (DD) using three-dimensional (3D)-laser profilometry. ANOVA with Bonferroni correction and α = 0.05 were used for statistical analysis. Results: The DD was statistically significantly higher at a DI of 1 mm compared to a DI of 5 mm for the respective groups of the same PR and AJ (P < 0.05). For DI 1 mm, max PR, and AJ 90°, the maximum loss of substance amounted DD of 117 ± 43 μm. The minimal loss of substance occurred at minimal PR, 45° AJ, and a DI of 5 mm (15 μm × 20 μm). DD related directly with the parameters PR and AJ and inversely with DI. The highest influence on DD was proven for DI. Conclusions: Slight loss of dentin might occur during air polishing with ERY depending on DI, PR and AJ. The setting influences the amount of dentin loss.
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Affiliation(s)
- Jella C Kröger
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mikael Haribyan
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ibrahim Nergiz
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra Schmage
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Effects of subgingival air-polishing with trehalose powder on oral biofilm during periodontal maintenance therapy: a randomized-controlled pilot study. BMC Oral Health 2020; 20:123. [PMID: 32321490 PMCID: PMC7178568 DOI: 10.1186/s12903-020-01111-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background This pilot study was part of a larger study which compared the effect of subgingival air-polishing using trehalose powder with sonic scaling on clinical parameters during supportive periodontal therapy. Within this microbiological part of the investigation subgingival samples were taken from 10 participants to analyze the survival of different bacterial species after the two different treatments as a proof of principle. Methods In 10 participants two non-adjacent, single-root teeth requiring treatment (PD =5 mm with bleeding on probing (BOP) or > 5 mm) were selected following a split-mouth design and were treated either with a sonic scaler or air-polishing device and trehalose powder. For persistent pockets (PD =4 mm and BOP or > 4 mm), treatment was repeated after 3 months. Subgingival biofilm samples were taken at baseline (BL), subsequently and three and six months after treatment. After determination of the bacterial counts (TBL), isolated bacteria were identified by MALDI-TOF-MS. If unsuccessful, PCR and 16S rDNA sequencing were performed. Results In both treatment groups, TBL decreased immediately after treatment remaining at a lower level. This confirms the findings of the larger study regarding clinical parameters showing a comparable effect on PD, BOP and CAL. Immediately after treatment, the diversity of detected species decreased significantly more than in the sonic group (p = 0.03). After 3 months, the proportion of Gram-positive anaerobic rods was lower in the air-polishing group (powder/ sonic 7%/ 25.9%, p = 0.025). Also, there was a greater reduction of Gram-negative aerobic rods for this group at this time (air-polishing/ sonic − 0.91 / -0.23 Log10 cfu/ ml, p = 0.020). Conclusion Within the limitations of this study air-polishing and sonic treatment seem to have a comparable effect on the subgingival oral biofilm during supportive periodontal treatment. Trial registration The study was registered in an international trial register (German Clinical Trial Register number DRKS 00006296) on 10th of June 2015. HTML&TRIAL_ID = DRKS00006296.
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Janiszewska-Olszowska J, Drozdzik A, Tandecka K, Grocholewicz K. Effect of air-polishing on surface roughness of composite dental restorative material - comparison of three different air-polishing powders. BMC Oral Health 2020; 20:30. [PMID: 32000753 PMCID: PMC6993449 DOI: 10.1186/s12903-020-1007-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background Increased composite roughness enhances bacterial adhesion and discoloration, thus increasing the risk of gingival inflammation and secondary caries. Concerns about detrimental effects of sodium bicarbonate on surface roughness influenced the development of less abrasive powders: a glycine-based powder and an erythritol-based powder, additionally - sodium bicarbonate-based powder of reduced grain size. However, there is limited evidence on effects of these materials on the surface of dental fillings. The aim of the present study was to compare the effects of three air-polishing powders (of a reduced abrasiveness) on surface roughness of microhybrid restorative composite material. Material and methods Microhybrid light-cure resin composite samples were placed on 64 plaster cubes and light-cured through polyester strips. Surface roughness was measured using laser confocal microscope (magnification 2160x). The specimens were randomly divided into three groups (n = 20, 20 and 24) and air-polished with: sodium bicarbonate (40 μm), glycine (25 μm) and erythritol (14 μm), respectively. Then surface roughness was remeasured, keeping the same field of observation. Specialized 3D analysis software was used for data processing. Parameters according to ISO 25178: Sa, Sq, Sku, Sp, Sv, Sz, Ssk were used to describe surface roughness. Results Sa, Sq, Sp, Sv, Sz increased significantly following air polishing. Ssk was significantly higher, whereas Sku was significantly lower in sodium bicarbonate and erythritol groups than before air polishing. Comparison between the three powders revealed that Sa was significantly higher in sodium bicarbonate group than in glycine group. Sku was significantly higher in glycine and erythritol groups than in sodium bicarbonate group. Conclusions Sodium bicarbonate has a stronger detrimental effect on composite surface than glycine or erythritol. No advantage of erythritol comparing to glycine could be found.
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Affiliation(s)
- Joanna Janiszewska-Olszowska
- Department of Interdisciplinary Dentistry Pomeranian Medical, University in Szczecin, al. Powstancow Wlkp, 72, 70-111, Szczecin, Poland.
| | - Agnieszka Drozdzik
- Department of Interdisciplinary Dentistry Pomeranian Medical, University in Szczecin, al. Powstancow Wlkp, 72, 70-111, Szczecin, Poland
| | - Katarzyna Tandecka
- Faculty of Mechanical Engineering Koszalin, University of Technology, ul, Raclawicka 15-17, 75-620, Koszalin, Poland
| | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry Pomeranian Medical, University in Szczecin, al. Powstancow Wlkp, 72, 70-111, Szczecin, Poland
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Müller Campanile V, Megally A, Campanile G, Gayet-Ageron A, Giannopoulou C, Mombelli A. Risk factors for recurrence of periodontal disease in patients in maintenance care in a private practice. J Clin Periodontol 2019; 46:918-926. [PMID: 31271667 DOI: 10.1111/jcpe.13165] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/03/2019] [Accepted: 06/30/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess periodontal and dental conditions in individuals in maintenance care after periodontal therapy in private practice, and to identify risk factors for recurrence of disease and tooth loss. MATERIALS AND METHODS One hundred patients attending a routine recall visit were included. All had been treated for periodontal disease and were in maintenance since ≥ 2 years. RESULTS Examinations took place 18.0 (±8.71) years after the start of periodontal therapy. A total of 40.1 ± 22.5 recall visits were registered during this time. 91% of the participants had an initial diagnosis of chronic, 9% of aggressive periodontitis. The average participant was 46 years old and had 26 teeth. 283 of 2,549 initially present teeth were lost, half of them being molars. Periodontal and endo-periodontal complications accounted for only 16 lost teeth. The prevalence of all probing depth (PD) categories decreased significantly. The longer the time, the more frequent the recall visits, and the more was spent during the maintenance phase, the greater was the reduction. Multivariate analysis rendered BMI and smoking as factors influencing number of sites with PD ≥ 4 mm and bleeding on probing. CONCLUSION Tooth loss and periodontal tissue damage can be contained over prolonged periods if periodontal disease is treated and patients attend regular maintenance care.
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Affiliation(s)
| | - Andrew Megally
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Angèle Gayet-Ageron
- CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University Hospitals Geneva, Geneva, Switzerland
| | - Catherine Giannopoulou
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrea Mombelli
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
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The Clinical Efficacy of Subgingival Debridement by Ultrasonic Instrumentation Compared With Subgingival Air Polishing During Periodontal Maintenance: A Systematic Review. J Evid Based Dent Pract 2019; 19:101314. [DOI: 10.1016/j.jebdp.2019.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/18/2019] [Accepted: 02/04/2019] [Indexed: 01/03/2023]
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Angst PDM, Finger Stadler A, Mendez M, Oppermann RV, van der Velden U, Gomes SC. Supportive periodontal therapy in moderate‐to‐severe periodontitis patients: A two‐year randomized clinical trial. J Clin Periodontol 2019; 46:1083-1093. [DOI: 10.1111/jcpe.13178] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/26/2019] [Accepted: 07/30/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Amanda Finger Stadler
- Division of Comprehensive Oral Health ‐ Periodontology Adams School of Dentistry The University of North Carolina at Chapel Hill Chapel Hill NC USA
| | | | - Rui Vicente Oppermann
- Conservative Dentistry Department School of Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Ubele van der Velden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam VU University Amsterdam Amsterdam The Netherlands
| | - Sabrina Carvalho Gomes
- Conservative Dentistry Department School of Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
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SEM Analysis of Enamel Abrasion after Air Polishing Treatment with Erythritol, Glycine and Sodium Bicarbonate. COATINGS 2019. [DOI: 10.3390/coatings9090549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this in vitro study was to evaluate the enamel surface topography after treatment with three air polishing powders: Glycine (A), erythritol (B), and sodium bicarbonate (C) (Air Flow Soft, Plus and Classic powders, EMS Electro Medical Systems S.A., Nyon, Switzerland). Fifteen extracted incisors were randomly divided into three groups of five teeth each, A, B and C, respectively. The teeth were blocked in plaster bases, washed, dried and half-covered with polytetrafluoroethylene strips before treatment. In this way, each half-treated dental element became test and control of itself. Comparative statistical analysis of Rq (geometric average of the deviations occurring in roughness profile) was performed. The scanning electron microscope (SEM) analysis showed different degrees of surface roughness between the groups, decreasing after treatment. In addition, a statistically significant reduction p < 0.05 was present in group C (Rq mean non-treated 108.17 µm, 95% CI: 97.29–124.01 and Rq mean treated 86.78 µm, 95% CI: 80.63–93.70). A decrease in surface roughness post-treatment was not observed in group A and B. Therefore, it may be concluded that the air flow powders tested herein can be used on dental enamel to reduce the surface roughness due to function and the action of dental therapies.
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Methylene Blue-Mediated Photodynamic Therapy Induces Macrophage Apoptosis via ROS and Reduces Bone Resorption in Periodontitis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1529520. [PMID: 31485288 PMCID: PMC6710739 DOI: 10.1155/2019/1529520] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/01/2019] [Accepted: 05/06/2019] [Indexed: 12/13/2022]
Abstract
Aim To investigate whether methylene blue-mediated photodynamic therapy (MB-PDT) can affect the "fate" of macrophages in vitro or in periodontitis tissues and to explore the potential mechanism. Methods For in vitro treatments, THP-1 macrophages were divided into three experimental groups: C/control, no treatment; MB, methylene blue treatment; and MB-PDT, MB and laser irradiation treatment. Then, apoptosis and apoptosis-related proteins were detected in each group. For in vivo treatments, periodontitis was ligature-induced in the first molars of the bilateral maxilla in 12 Sprague Dawley (SD) rats. After six weeks, the ligatures were removed and all the induced molars underwent scaling and root planning (SRP). Then, the rats were divided into three groups according to the following treatments: SRP, saline solution; MB, phenothiazinium dye; and MB-PDT, MB and laser irradiation. Apoptotic macrophages, inflammation levels, and alveolar bone resorption in the periodontal tissues of rats were analyzed in each group. Results In vitro, flow cytometry analysis demonstrated that 10 μM MB and 40 J/cm2 laser irradiation maximized the apoptosis rate (34.74%) in macrophages. Fluorescence probe and Western blot analyses showed that MB-PDT induced macrophage apoptosis via reactive oxygen species (ROS) and the mitochondrial-dependent apoptotic pathway. Conversely, the addition of exogenous antioxidant glutathione (GSH) and the pan-caspase inhibitor Z-VAD-FMK markedly reduced the apoptotic response in macrophages. In vivo, immunohistochemistry, histology, radiographic, and molecular biology experiments revealed fewer infiltrated macrophages, less bone loss, and lower IL-1β and TNF-α levels in the MB-PDT group than in the SRP and MB groups (P < 0.05). Immunohistochemistry analysis also detected apoptotic macrophages in the MB-PDT group. Conclusion MB-PDT could induce macrophage apoptosis in vitro and in rats with periodontitis. This may be another way for MB-PDT to relieve periodontitis in addition to its antimicrobial effect. Meanwhile, MB-PDT induced apoptosis in THP-1 macrophages via the mitochondrial caspase pathway.
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Parvini P, Saminsky M, Stanner J, Klum M, Nickles K, Eickholz P. Discomfort/pain due to periodontal and peri-implant probing with/without platform switching. Clin Oral Implants Res 2019; 30:997-1004. [PMID: 31325382 DOI: 10.1111/clr.13513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare discomfort/pain following periodontal probing around teeth and peri-implant probing around implants with or without platform switching. METHODS Two dentists recruited and examined 65 patients, each of them exhibiting a dental implant with a contralateral tooth. Only two types of implants were included: one with and one without platform switching. Periodontal and peri-implant probing depths (PPD) and probing attachment level (PAL) were assessed. Whether implant or tooth was measured first was randomly assigned. Immediately after probing, patients scored discomfort/pain using a visual analogue scale (VAS). The emergence profiles of implant crowns were assessed as angles between interproximal surfaces on radiographs. RESULTS Sixty-five patients (age 69; 63/76 years [median; lower/upper quartile]; 38 females, 11 smokers) were examined. With the exception of mean PPD and PAL (p < .05) clinical parameters (PPD, PAL, bleeding on probing, suppuration) were well balanced between implants and teeth. Peri-implant probing (VAS: 10; 0.75/16.25) caused significantly (p < .001) more discomfort/pain than periodontal probing (4; 0/10). Logistic regression analysis identified a larger difference between discomfort/pain for peri-implant and periodontal probing in the maxilla than the mandible (p = .003). Comparing discomfort/pain between implants maxilla (p = .006) and emergence profile (p = .015) were associated with discomfort/pain. Type of implant (with/without platform switching) had no significant effect on discomfort/pain. CONCLUSIONS Peri-implant probing caused significantly more discomfort/pain than periodontal probing. Implant design with/without platform switching failed to have a significant effect on discomfort/pain.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Michael Saminsky
- Department of Periodontology and Osseointegration, Goldschlager School of Dental Medicine, Tel-Aviv University, Tel Aviv, Israel
| | | | | | - Katrin Nickles
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt, Frankfurt am Main, Germany
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Megally A, Zekeridou A, Cancela J, Giannopoulou C, Mombelli A. Short ultrasonic debridement with adjunctive low-concentrated hypochlorite/amino acid gel during periodontal maintenance: randomized clinical trial of 12 months. Clin Oral Investig 2019; 24:201-209. [PMID: 31079243 DOI: 10.1007/s00784-019-02949-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/03/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the benefit of repeated subgingival cleaning with a low-concentrated hypochlorite/amino acid gel in subjects in maintenance care with residual pockets ≥ 5 mm. MATERIAL AND METHODS Examiner masked, randomized two-arm parallel design. Thirty-two adult periodontal patients in maintenance phase, > 3 months after periodontal therapy, with at least one residual periodontal pocket ≥ 5 mm, were randomly assigned to treatment by subgingival ultrasonic debridement with the gel or ultrasonic debridement only. At months 0, 4, and 8, all sites presenting with a probing depth (PD) ≥ 5 mm were treated. Six sites were monitored on each tooth. The primary end point was the presence or absence of PD ≥ 5 mm after 12 months. Secondary clinical outcomes were oral tissue safety; patient acceptance; changes in PD; bleeding on probing; recession after 4, 8, and 12 months; and the presence or absence of six target microorganisms in treated pockets at baseline, after 7 days and 4 months. RESULTS A total of 365 sites in 32 patients with PD ≥ 5 mm were treated at baseline. At the final evaluation at month 12, 47% of these sites in the test and 49% in the control group were still in this PD category. The difference between baseline and month 12 was significant in both groups (p < 0.01), whereas the difference between groups was not. Repeated short ultrasonic instrumentation with adjunctive administration of the test product resulted in a clinical attachment level (CAL) gain of 1.02 mm (p < 0.01) and led to - 0.97 mm of pocket reduction (p < 0.01) without inducing further recession. However, repeated short ultrasonic debridement without the gel led to a similar clinical outcome (p < 0.01). No adverse events were recorded. CONCLUSIONS Short ultrasonic instrumentation of residual pockets with PD ≥ 5 mm during maintenance visits resulted in a clinically relevant CAL gain and PD reduction in the order of 1 mm in 1 year, without inducing further recession. CLINICAL RELEVANCE This study corroborates the benefit of regular maintenance care after periodontal therapy, including short debridement of the residual pockets.
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Affiliation(s)
- Andrew Megally
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - Alkisti Zekeridou
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - José Cancela
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - Catherine Giannopoulou
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - Andrea Mombelli
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, 1 rue Michel-Servet, 1211, Geneva 4, Switzerland.
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Affiliation(s)
- Andrea Mombelli
- Division of Periodontology School of Dental Medicine University of Geneva Geneva Switzerland
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Kruse AB, Akakpo DL, Maamar R, Woelber JP, Al-Ahmad A, Vach K, Ratka-Krueger P. Trehalose powder for subgingival air-polishing during periodontal maintenance therapy: A randomized controlled trial. J Periodontol 2018; 90:263-270. [PMID: 30311948 DOI: 10.1002/jper.17-0403] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Air-polishing appears to be a promising procedure for subgingival biofilm removal in periodontal treatment. The aim of this study was to compare trehalose powder for subgingival air-polishing with sonic debridement in residual periodontal pockets during maintenance therapy. METHODS In this blinded, randomized, controlled clinical trial conducted over 6 months with a split-mouth design, single-rooted teeth in 44 participants with residual pocket depths of 5 mm and bleeding or >5 mm with and without bleeding were included in this study. Subgingival debridement was carried out using either trehalose powder with an air-polishing device (test) or a sonic device (control). The reduction in the probing depths after 3 and 6 months was defined as the primary endpoint. A visual analog scale was used to evaluate the discomfort of both procedures. RESULTS Both procedures showed statistically significant intragroup reductions in probing depths (test baseline [BL] 5.52 ± 0.93, 6 months 3.66 ± 0.81, control BL 5.55 ± 0.9, 6 months 3.68 ± 0.86, P < 0.001), clinical attachment level (test BL 6.93 ± 1.5, 6 months 5.3 ± 1.52, control BL 7.27 ± 1.8, 6 months 5.84 ± 1.71, P < 0.001), and bleeding on probing (test BL 86%, 6 months 41%, control BL 89%, 6 months 34%, P < 0.001) after 6 months with no significant intergroup differences (P > 0.05, respectively). The visual analog scale showed a significantly lower incidence of discomfort for air-polishing compared with sonic scaling (test 2.33 ± 2.14, control 4.91 ± 2.65, P < 0.001). CONCLUSIONS Subgingival air-polishing with trehalose powder showed comparable clinical outcomes to sonic scaling. Sonic scaling evoked more discomfort compared with air-polishing.
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Affiliation(s)
- Anne B Kruse
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Dodji L Akakpo
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Rabie Maamar
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Johan P Woelber
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Ali Al-Ahmad
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
| | - Kirstin Vach
- Department of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Freiburg, Germany
| | - Petra Ratka-Krueger
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, University Medical Center Freiburg, Freiburg, Germany
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Biofilm Removal and Bacterial Re-Colonization Inhibition of a Novel Erythritol/Chlorhexidine Air-Polishing Powder on Titanium Disks. MATERIALS 2018; 11:ma11091510. [PMID: 30142888 PMCID: PMC6164901 DOI: 10.3390/ma11091510] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/15/2018] [Accepted: 08/18/2018] [Indexed: 01/10/2023]
Abstract
Air-polishing with low abrasiveness powders is fast arising as a valid and mini-invasive instrument for the management of biofilm colonizing dental implants. In general, the reported advantage is the efficient removal of plaque with respect to the titanium integrity. In the present study, we evaluated the in situ plaque removal and the preventive efficacy in forestalling further infection of an innovative erythritol/chlorhexidine air-polishing powder and compared it with sodium bicarbonate. Accordingly, two peri-implantitis-linked biofilm formers, strains Staphylococcus aureus and Aggregatibacter actinomycetemcomitans, were selected and used to infect titanium disks before and after the air-polishing treatment to test its ability in biofilm removal and re-colonization inhibition, respectively. Biofilm cell numbers and viability were assayed by colony-forming unit (CFU) count and metabolic-colorimetric (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) (XTT) assay. Results demonstrated that air-polishing performed with either sodium bicarbonate or erythritol/chlorhexidine was effective in reducing bacteria biofilm viability and number on pre-infected specimens, thus showing a similar ability in counteracting existing infection in situ; on the other hand, when air-polished pre-treated disks were infected, only erythritol/chlorhexidine powder showed higher post-treatment biofilm re-growth inhibition. Finally, surface analysis via mechanical profilometry failed to show an increase in titanium roughness, regardless of the powder selected, thus excluding any possible surface damage due to the use of either sodium bicarbonate or erythritol/chlorhexidine.
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Lu H, He L, Zhao Y, Meng H. The effect of supragingival glycine air polishing on periodontitis during maintenance therapy: a randomized controlled trial. PeerJ 2018; 6:e4371. [PMID: 29456893 PMCID: PMC5813589 DOI: 10.7717/peerj.4371] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/25/2018] [Indexed: 12/22/2022] Open
Abstract
Background Glycine air polishing has been proved to be safe, comfortable and time-saving. Whether it could substitute ultrasonic scaling to remove dental plaque biofilm during periodontal maintenance remains unclear. The purposes of this study were to evaluate the effect of supragingival glycine air polishing (SGAP) on the subgingival periodontal pathogens during maintenance therapy and to check the association of periodontal pathogens and clinical parameters. Methods Twenty-three chronic periodontitis patients during their maintenance therapy were enrolled in the 12-week study. According to randomized split-mouth design, the test side was treated with SGAP (65 μm), while the control side was treated with supragingival ultrasonic scaling and polishing (SUSP) with rubber cup. Clinical examination including plaque index (PLI), probing depth (PD), bleeding index (BI) were performed at baseline and 12 weeks post-treatment. Sampling of the subgingival plaque at each investigational site (mesiobuccal site of the mandibular first molar) was performed at baseline and 2, 4, 8, 12 weeks after maintenance treatment. Four periodontal pathogens including Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Fusobacterium nucleatum were detected by 16S rDNA polymerase chain reaction. Results Clinical status generally improved after treatment in both groups. PLI in both groups, PD in SGAP group and bleeding on probing (%) in SUSP group significantly decreased after treatment (p < 0.05). There was no significant difference of clinical parameters between two groups before and after treatment. The detection rates of P. gingivalis, T. denticola in both groups, T. forsythia in SUSP group and F. nucleatum in SGAP group decreased after maintenance treatment in both groups, although no significant difference was found, and it rebound to baseline level at 12 weeks after maintenance treatment. There was no significant difference between SGAP group and SUSP group at any time point. T. denticola-positive sites had significantly greater BI than T. denticola-negative sites (p < 0.05). Discussion Supragingival glycine air polishing had a reliable effect in removing subgingival dental plaque biofilm during maintenance period, and three months may be a proper maintenance interval for pockets not more than 5 mm.
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Affiliation(s)
- Hongye Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Lu He
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yibing Zhao
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Manresa C, Sanz‐Miralles EC, Twigg J, Bravo M. Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis. Cochrane Database Syst Rev 2018; 1:CD009376. [PMID: 29291254 PMCID: PMC6491071 DOI: 10.1002/14651858.cd009376.pub2] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Periodontitis is a bacterially-induced, chronic inflammatory disease that destroys the connective tissues and bone that support teeth. Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. Following completion of treatment and arrest of inflammation, supportive periodontal therapy (SPT) is employed to reduce the probability of re-infection and progression of the disease; to maintain teeth without pain, excessive mobility or persistent infection in the long term, and to prevent related oral diseases.According to the American Academy of Periodontology, SPT should include all components of a typical dental recall examination, and importantly should also include periodontal re-evaluation and risk assessment, supragingival and subgingival removal of bacterial plaque and calculus, and re-treatment of any sites showing recurrent or persistent disease. While the first four points might be expected to form part of the routine examination appointment for periodontally healthy patients, the inclusion of thorough periodontal evaluation, risk assessment and subsequent treatment - normally including mechanical debridement of any plaque or calculus deposits - differentiates SPT from routine care.Success of SPT has been reported in a number of long-term, retrospective studies. This review aimed to assess the evidence available from randomised controlled trials (RCTs). OBJECTIVES To determine the effects of supportive periodontal therapy (SPT) in the maintenance of the dentition of adults treated for periodontitis. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 5), MEDLINE Ovid (1946 to 8 May 2017), and Embase Ovid (1980 to 8 May 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised controlled trials (RCTs) evaluating SPT versus monitoring only or alternative approaches to mechanical debridement; SPT alone versus SPT with adjunctive interventions; different approaches to or providers of SPT; and different time intervals for SPT delivery.We excluded split-mouth studies where we considered there could be a risk of contamination.Participants must have completed active periodontal therapy at least six months prior to randomisation and be enrolled in an SPT programme. Trials must have had a minimum follow-up period of 12 months. DATA COLLECTION AND ANALYSIS Two review authors independently screened search results to identify studies for inclusion, assessed the risk of bias in included studies and extracted study data. When possible, we calculated mean differences (MDs) and 95% confidence intervals (CIs) for continuous variables. Two review authors assessed the quality of evidence for each comparison and outcome using GRADE criteria. MAIN RESULTS We included four trials involving 307 participants aged 31 to 85 years, who had been previously treated for moderate to severe chronic periodontitis. Three studies compared adjuncts to mechanical debridement in SPT versus debridement only. The adjuncts were local antibiotics in two studies (one at high risk of bias and one at low risk) and photodynamic therapy in one study (at unclear risk of bias). One study at high risk of bias compared provision of SPT by a specialist versus general practitioner. We did not identify any RCTs evaluating the effects of SPT versus monitoring only, or of providing SPT at different time intervals, or that compared the effects of mechanical debridement using different approaches or technologies.No included trials measured our primary outcome 'tooth loss'; however, studies evaluated signs of inflammation and potential periodontal disease progression, including bleeding on probing (BoP), clinical attachment level (CAL) and probing pocket depth (PPD).There was no evidence of a difference between SPT delivered by a specialist versus a general practitioner for BoP or PPD at 12 months (very low-quality evidence). This study did not measure CAL or adverse events.Due to heterogeneous outcome reporting, it was not possible to combine data from the two studies comparing mechanical debridement with or without the use of adjunctive local antibiotics. Both studies found no evidence of a difference between groups at 12 months (low to very low-quality evidence). There were no adverse events in either study.The use of adjunctive photodynamic therapy did not demonstrate evidence of benefit compared to mechanical debridement only (very low-quality evidence). Adverse events were not measured.The quality of the evidence is low to very low for these comparisons. Future research is likely to change the findings, therefore the results should be interpreted with caution. AUTHORS' CONCLUSIONS Overall, there is insufficient evidence to determine the superiority of different protocols or adjunctive strategies to improve tooth maintenance during SPT. No trials evaluated SPT versus monitoring only. The evidence available for the comparisons evaluated is of low to very low quality, and hampered by dissimilarities in outcome reporting. More trials using uniform definitions and outcomes are required to address the objectives of this review.
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Affiliation(s)
- Carolina Manresa
- Dental School, University of BarcelonaAdult Comprehensive DentistryFeixa LLarga s/nHospitalet de LlobregatBarcelonaSpain08907
| | - Elena C Sanz‐Miralles
- Dental School, University of BarcelonaAdult Comprehensive DentistryFeixa LLarga s/nHospitalet de LlobregatBarcelonaSpain08907
- Columbia UniversityDivision of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental MedicineNew YorkNYUSA
| | - Joshua Twigg
- Cardiff UniversitySchool of DentistryDepartment of Oral and Biomedical SciencesHeath ParkCardiffUKCF14 4XY
| | - Manuel Bravo
- Dental School, University of GranadaPreventive DentistryCampus de la Cartuja s/nGranadaSpain08071
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