1
|
de Almeida MCL, Rocha RGG, Magno MB, Lima RR, Saito MT. Performance of multiple therapeutic approaches for palatal wound healing after soft tissue graft removal - an overview of systematic reviews. Clin Oral Investig 2024; 28:347. [PMID: 38819478 DOI: 10.1007/s00784-024-05733-z] [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: 02/19/2024] [Accepted: 05/20/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To overview the literature to answer the following question: "What is the performance of different therapies on wound healing and postoperative discomfort after palatal ASTG removal?" METHODS SRs that evaluated the wound healing (WH), postoperative pain, bleeding, and analgesic consumption of patients submitted to de-epithelialized/free gingival grafts (FGG) or subepithelial connective tissue grafts (SCTG) removed from the palate were included. The searches were conducted on six white and two gray databases up to December 2023. Methodological quality was evaluated through AMSTAR 2. The synthesis of results was described as a narrative analysis. RESULTS Ten SRs (involving 25 randomized clinical trials) related to low-level laser therapy (LLLT) (3), platelet-rich fibrin (PRF) (4), cyanoacrylate tissue adhesives (CTA) (2), and ozone therapy (OT) (1) were included in this overview. All techniques demonstrated improvements in WH. LLT, PRF, and CTA reduced pain and analgesic consumption. PRF and CTA reduced bleeding. Regarding methodological quality, the SRs were classified as critically low (2), low (5), moderate (2), or high quality (1). CONCLUSIONS In SRs related to LLLT, PRF, CTA, and OT, the use of different therapies after palatal ASTG removal improved WH and postoperative discomfort. Due to the studies' low methodological quality and high heterogeneity, data should be interpreted with caution. CLINICAL RELEVANCE The present overview compiles the evidence of SRs related to different therapies for WH and patients' postoperative experience and reveals that different treatments can significantly improve the clinical outcomes of patients who require ASTG removal for periodontal or peri-implant surgeries. REGISTRATION PROSPERO registration number: CRD42022301257.
Collapse
Affiliation(s)
- Maria Clara Lopes de Almeida
- Graduate Program in Dentistry, Federal University of Pará, Augusto Correa Avenue, n. 1, Belém, PA, 66075-110, Brazil
| | | | - Marcela Baraúna Magno
- School of Dentistry, Veiga Almeida University, Rio de Janeiro-RJ, Brazil
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro-RJ, Brazil
| | - Rafael Rodrigues Lima
- Graduate Program in Dentistry, Federal University of Pará, Augusto Correa Avenue, n. 1, Belém, PA, 66075-110, Brazil
- Laboratory of Structural and Functional Biology, Federal University of Pará, Belém, PA, Brazil
| | - Miki Taketomi Saito
- Graduate Program in Dentistry, Federal University of Pará, Augusto Correa Avenue, n. 1, Belém, PA, 66075-110, Brazil.
- Graduate Program in Epidemiology and Health Vigilance, Evandro Chagas Institute, BR 316, km 7, Ananindeua, PA, 67030000, Brazil.
| |
Collapse
|
2
|
Scribante A, Gallo S, Pascadopoli M, Frani M, Butera A. Ozonized gels vs chlorhexidine in non-surgical periodontal treatment: A randomized clinical trial. Oral Dis 2023. [PMID: 38047757 DOI: 10.1111/odi.14829] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/12/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To evaluate the efficacy of newly introduced ozonated gels compared with conventional chlorhexidine gel in the home management of periodontal patients. MATERIALS AND METHODS 30 patients with bilateral periodontal disease (severity I, complexity II) were enrolled (split-mouth study design). After nonsurgical mechanical periodontal debridement, the teeth were randomly divided into two groups: teeth in the Control group were treated with a chlorhexidine-based gel to aid oral hygiene maneuvers for 2 weeks after the first visit, while teeth in the Test group were treated in the same way with ozone-based gels. After the baseline assessment, the follow-up included assessments at 1, 2, and 6 months. The variables evaluated were clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BoP), plaque control record (PCR), recession (R), and tooth mobility (TM). RESULTS For CAL, PPD, BoP, and PCR, significant intragroup differences were found for both groups (p < 0.05), in contrast to intergroup differences (p > 0.05). No significant differences were found for R and TM. CONCLUSION Nonsurgical mechanical periodontal debridement with adjunctive use of ozone and chlorhexidine was found to be effective in periodontal treatment. Ozone could be suggested as an alternative to chlorhexidine.
Collapse
Affiliation(s)
- Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Monica Frani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
3
|
Alsakr A, Gufran K, Alqahtani AS, Alasqah M, Alnufaiy B, Alzahrani HG, Alahmari AA, Alhumaidani FK, Alhumaidani RK, Althobiti MJ. Ozone Therapy as an Adjuvant in the Treatment of Periodontitis. J Clin Med 2023; 12:7078. [PMID: 38002690 PMCID: PMC10672703 DOI: 10.3390/jcm12227078] [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: 10/04/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023] Open
Abstract
The current study aimed to assess the efficacy of ozone therapy in the treatment of stage II and stage III periodontitis. This prospective split-mouth study selected patients who were diagnosed with either stage II or stage III periodontitis. All patients were treated with scaling and root-planing (SRP) on the control side and SRP with ozone therapy on the test side. Probing depth (PD), clinical attachment loss (CAL), O'Leary plaque index (PI), and bleeding on probing (BOP) scores were recorded at baseline and six weeks after the SRP treatment. A total of 46 patients were selected for this study, including 31 males and 15 females. All periodontal variables (PD, CAL, PI, and BOP) showed significant changes (p < 0.0001) from baseline to six weeks. Moreover, significant changes (PD = 0.0001, CAL = 0.0001, PI = 0.042 and BOP = 0.0001) were also observed between the control and test sides. Gender showed no significance on periodontal variables (p > 0.05) except PD on the test side (p = 0.030). In addition, periodontal stages and grades showed no significant changes (p > 0.05) in any periodontal variables on both sides. Ozone therapy significantly improves the periodontal condition compared to SRP treatment alone. However, the stages and grades of periodontitis do not influence the outcome of ozone therapy.
Collapse
Affiliation(s)
- Abdulaziz Alsakr
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Abdullah Saad Alqahtani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Mohammed Alasqah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Banna Alnufaiy
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Hanadi Ghurmallah Alzahrani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (K.G.); (A.S.A.); (M.A.); (B.A.); (H.G.A.)
| | - Ali Ayidh Alahmari
- Dental Intern, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.A.A.); (F.K.A.); (R.K.A.)
| | - Faisal Khaled Alhumaidani
- Dental Intern, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.A.A.); (F.K.A.); (R.K.A.)
| | - Rakan Khaled Alhumaidani
- Dental Intern, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (A.A.A.); (F.K.A.); (R.K.A.)
| | | |
Collapse
|
4
|
D Ambrosio F, Caggiano M, Acerra A, Pisano M, Giordano F. Is Ozone a Valid Adjuvant Therapy for Periodontitis and Peri-Implantitis? A Systematic Review. J Pers Med 2023; 13:jpm13040646. [PMID: 37109032 PMCID: PMC10143404 DOI: 10.3390/jpm13040646] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Ozone is a naturally occurring unstable compound with three oxygen atoms that generally transforms into an oxygen molecule, releasing one oxygen atom. This feature has been exploited in dentistry for numerous applications, including for periodontal diseases and peri-implantitis. METHODS This review was performed in relation to the PRISMA flow chart and was annotated in the PROSPERO register. PICO questions were used as research questions. The risk of bias in the non-randomized clinical trials was appraised using the ROBINS-I tool. RESULTS An electronic search found a total of 1073 records, in particular, 842 from MEDLINE/PubMed, 13 from Bio Med Central, 160 from Scopus, 1 from the Cochrane library databases, and 57 from the PROSPERO register. A total of 17 studies were included in the present systematic review. Information regarding the characteristics of the periodontal clinical and radiographic parameters for gaseous ozone, ozonate water, ozonate oil, and ozone gel, including clinical attachment loss (CAL) probing depth (PPD), bleeding on probing (BoP), plaque index (PI), gingival index (GI), and marginal bone levels (MBL), were obtained. CONCLUSIONS The studies included in this systematic review show different results regarding the ozone in periodontal treatment in association with or without SRP.
Collapse
Affiliation(s)
- Francesco D Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84100 Salerno, Italy
| | - Mario Caggiano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84100 Salerno, Italy
| | - Alfonso Acerra
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84100 Salerno, Italy
| | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84100 Salerno, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84100 Salerno, Italy
| |
Collapse
|
5
|
Tetè G, D’Amicantonio T, Polizzi E. Efficacy Ozone Therapy in Reducing Periodontal Disease. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2375. [PMID: 36984255 PMCID: PMC10056049 DOI: 10.3390/ma16062375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study is to highlight the properties of ozone as an aid to non-surgical therapy compared to non-surgical therapy alone. This study included thirty Caucasian patients (eighteen women and twelve men) aged between 35 and 65, recruited at the Oral Hygiene and Prevention Center of the Dental Clinic of the Vita-Salute San Raffaele University, at the San Raffaele hospital in Milan. The periodontal probing was recorded with a PC-PUNC 15 manual probe (Hu Friedy) at time 0; the scaling and root planing session was performed at T1 with or without the aid of ozone therapy, and then, the patients were re-evaluated at one month (T2), three months (T3), and six months (T4). The results obtained show that there are not statistically significant differences in terms of reduction in clinical periodontal indices such as plaque, bleeding, and pocket depth between the two groups. Therefore, treatment with ozoral gel would not seem to improve non-surgical periodontal therapy alone. However, clinical periodontal indices significantly improved in patients treated with non-surgical therapy and ozone gel. From this point of view, ozone gel can be used as an aid to non-surgical therapy due to its excellent characteristics, in particular, its powerful virucidal action.
Collapse
Affiliation(s)
- Giulia Tetè
- Vita-Salute San Raffaele University, Dental School Department of Dentistry, IRCCS San Raffaele Hospital, Via Olgettina 48, 20132 Milan, Italy
| | - Teresa D’Amicantonio
- Center for Oral Hygiene and Prevention, Vita-Salute San Raffaele University, Dental School Department of Dentistry, IRCCS San Raffaele Hospital, Via Olgettina 48, 20132 Milan, Italy
| | - Elisabetta Polizzi
- Center for Oral Hygiene and Prevention, Vita-Salute San Raffaele University, Dental School Department of Dentistry, IRCCS San Raffaele Hospital, Via Olgettina 48, 20132 Milan, Italy
| |
Collapse
|
6
|
Butera A, Pascadopoli M, Gallo S, Pérez-Albacete Martínez C, Maté Sánchez de Val JE, Parisi L, Gariboldi A, Scribante A. Ozonized Hydrogels vs. 1% Chlorhexidine Gel for the Clinical and Domiciliary Management of Peri-Implant Mucositis: A Randomized Clinical Trial. J Clin Med 2023; 12:jcm12041464. [PMID: 36835998 PMCID: PMC9962911 DOI: 10.3390/jcm12041464] [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: 12/11/2022] [Revised: 01/13/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Peri-implant mucositis consists of a reversible inflammation of peri-implant tissues characterized by bleeding on gentle probing in the absence of bone loss. Ozone therapy is being extensively studied for its efficacy in treating different dental conditions. To date, few studies have evaluated ozone as an adjunct to the oral hygiene measures of peri-implant mucositis patients. The aim of the present study is to assess the efficacy of an ozonized gel (Trial group) compared to chlorhexidine (Control group) after a domiciliary protocol of oral hygiene in a 6-month study. According to a split-mouth study design, patients were divided into Group 1 for the application of chlorhexidine gel in peri-implant mucositis sites of quadrants Q1 and Q3, whereas in quadrants Q2 and Q4, the ozonized gel was in-office administered. For Group 2, the quadrants were inverted. At baseline (T0), and after 1 (T1), 2 (T2), and 3 (T3) months, Probing Depth (PD), Plaque Index (PI), SI Suppuration Index (SI), Bleeding Score (BS) and Marginal Mucosa Condition (MMC) were measured. A statistically significant decrease was found for all the variables assessed in each group (p < 0.05), whereas significant intergroup differences were found only for PI, BoP, and BS. Accordingly, both agents tested in this study showed an efficacy in treating peri-implant mucositis. The ozonized gel deserves particular attention, considering the better outcome than chlorhexidine on specific clinical periodontal parameters, as well as its lesser shortcomings.
Collapse
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
- Health Sciences PhD Programme, Universidad Catòlica de Murcia UCAM, Campus de Ios Jerònimos N. 135, Guadalupe, 30107 Murcia, Spain
- Correspondence: (A.B.); (M.P.); (S.G.)
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (M.P.); (S.G.)
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (M.P.); (S.G.)
| | - Carlos Pérez-Albacete Martínez
- Tissue Regeneration and Repair Group, Biomaterials and Tissue Engineering, Faculty of Health Sciences, UCAM—Universidad Catòlica San Antonio de Murcia, Guadalupe, 30107 Murcia, Spain
| | - José Eduardo Maté Sánchez de Val
- Tissue Regeneration and Repair Group, Biomaterials and Tissue Engineering, Faculty of Health Sciences, UCAM—Universidad Catòlica San Antonio de Murcia, Guadalupe, 30107 Murcia, Spain
| | - Luca Parisi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Alice Gariboldi
- 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 Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| |
Collapse
|
7
|
Rapone B, Ferrara E, Santacroce L, Topi S, Gnoni A, Dipalma G, Mancini A, Di Domenico M, Tartaglia GM, Scarano A, Inchingolo F. The Gaseous Ozone Therapy as a Promising Antiseptic Adjuvant of Periodontal Treatment: A Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020985. [PMID: 35055807 PMCID: PMC8775443 DOI: 10.3390/ijerph19020985] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/07/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023]
Abstract
Background: the establishment of periodontitis is regulated by the primary etiological factor and several individual conditions including the immune response mechanism of the host and individual genetic factors. It results when the oral homeostasis is interrupted, and biological reactions favor the development and progression of periodontal tissues damage. Different strategies have been explored for reinforcing the therapeutic effect of non-surgical periodontal treatment of periodontal tissue damage. Gaseous ozone therapy has been recognized as a promising antiseptic adjuvant, because of its immunostimulating, antimicrobial, antihypoxic, and biosynthetic effects. Then, we hypothesized that the adjunct of gaseous ozone therapy to standard periodontal treatment may be leveraged to promote the tissue healing response. Methods: to test this hypothesis, we conducted a prospective randomized study comparing non-surgical periodontal treatment plus gaseous ozone therapy to standard therapy. A total of 90 healthy individuals with moderate or severe generalized periodontitis were involved in the study. The trial was conducted from September 2019 to October 2020. Forty-five patients were randomized to receive scaling and root-planning (SRP) used as conventional non-surgical periodontal therapy plus gaseous ozone therapy (GROUP A); forty-five were allocated to standard treatment (GROUP B). The endpoint was defined as the periodontal response rate after the application of the ozone therapy at 3 months and 6 months, defined as no longer meeting the criteria for active periodontitis. Statistical analysis was performed employing SPSS v.18 Chicago: SPSS Inc. Results: periodontal parameters differed significantly between patients treated with the two distinct procedures at 3 months (p ≤ 0.005); a statistically significant difference between groups was observed from baseline in the CAL (p ≤ 0.0001), PPD (p ≤ 0.0001) and BOP (p ≤ 0.0001) scores. Conclusions: The present study suggests that SRP combined with ozone therapy in the treatment of periodontitis revealed an improved outcome than SRP alone.
Collapse
Affiliation(s)
- Biagio Rapone
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (F.I.)
- Correspondence: ; Tel.: +39-347-7619-817
| | - Elisabetta Ferrara
- Complex Operative Unit of Odontostomatology, Hospital S.S. Annunziata, 66100 Chieti, Italy; (E.F.); (L.S.)
| | - Luigi Santacroce
- Complex Operative Unit of Odontostomatology, Hospital S.S. Annunziata, 66100 Chieti, Italy; (E.F.); (L.S.)
| | - Skender Topi
- Department of Clinical Disciplines, School of Technical Medical Sciences, University A. Xhuvani, 3001 Elbasan, Albania;
| | - Antonio Gnoni
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, “Aldo Moro” University of Bari, 70121 Bari, Italy;
| | - Gianna Dipalma
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (F.I.)
| | - Antonio Mancini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (F.I.)
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy;
| | - Antonio Scarano
- Department of Oral Science, Nano and Biotechnology and CeSi-Met University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (F.I.)
| |
Collapse
|
8
|
Gheorghe DN, Popescu DM, Salan A, Boldeanu MV, Ionele CM, Pitru A, Turcu-Stiolica A, Camen A, Florescu C, Rogoveanu I, Surlin P. Non-Surgical Periodontal Therapy Could Improve the Periodontal Inflammatory Status in Patients with Periodontitis and Chronic Hepatitis C. J Clin Med 2021; 10:jcm10225275. [PMID: 34830557 PMCID: PMC8619210 DOI: 10.3390/jcm10225275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Non-surgical periodontal therapy (NSPT) is the first essential step for the management of any periodontitis patient. This study aims to evaluate the impact of NSPT on pro-inflammatory mediators’ regulation and on clinical parameters in periodontitis patients who suffer from chronic hepatitis C. At baseline, selected patients were clinically evaluated for their periodontal status. A subsequent quantitative assessment of C-reactive protein and pentraxin-3 in samples of gingival fluid was performed by Enzyme-Linked Immunosorbent Assay (ELISA). Afterwards, NSPT was performed. Three months after NSPT, the clinical and ELISA assessments were repeated. The results show an improvement of the clinical parameters in periodontitis patients at the three-month recall. In chronic hepatitis C patients with periodontitis, the gingival fluid levels of pro-inflammatory markers reduced significantly. The targeted markers also expressed significant correlations with the clinical parameters used for the assessment of periodontitis’ severity. The results suggest that, while chronic hepatitis C patients exhibited a more negative periodontal status at baseline as compared to non-hepatitis ones, NSPT is effective in decreasing the local periodontal inflammatory reaction and in proving the periodontal status of this type of patients. Given the limitation of the study, periodontal screening and NSPT should be included in the integrated therapeutical approach of chronic hepatitis C patients, for its impact on the local inflammatory response.
Collapse
Affiliation(s)
- Dorin Nicolae Gheorghe
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.N.G.); (P.S.)
| | - Dora Maria Popescu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.N.G.); (P.S.)
- Correspondence: (D.M.P.); (M.V.B.)
| | - Alex Salan
- Department of Oral Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.); (A.C.)
| | - Mihail Virgil Boldeanu
- Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (D.M.P.); (M.V.B.)
| | - Claudiu Marinel Ionele
- Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.M.I.); (I.R.)
| | - Allma Pitru
- Department of Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adina Turcu-Stiolica
- Department of Pharmacoeconomics and Statistical Analysis, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adrian Camen
- Department of Oral Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.); (A.C.)
| | - Cristina Florescu
- Department of Internal Medicine and Cardiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Ion Rogoveanu
- Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.M.I.); (I.R.)
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.N.G.); (P.S.)
| |
Collapse
|
9
|
Foratori-Junior GA, Mosquim V, Buzalaf MAR, Sales-Peres SHDC. Salivary cytokines levels, maternal periodontitis and infants' weight at birth: A cohort study in pregnant women with obesity. Placenta 2021; 115:151-157. [PMID: 34628311 DOI: 10.1016/j.placenta.2021.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/05/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Obesity and pregnancy may have synergistic effects on maternal periodontal tissues. In contrast, maternal obesity and periodontitis are antagonistic factors for the babies' weight at birth. This study evaluated, during pregnancy (T1) and after delivery (T2), periodontal parameters and salivary levels of cytokines in women with obesity, and the association of these outcomes with the baby's weight at birth. METHODS After matching by age, socioeconomic status and systemic health, the sample was composed of pregnant women with obesity (GO = 25; BMI ≥30 kg/m2) and normal BMI (GN = 25; BMI between 18.5 and 24.99 kg/m2), who were evaluated regarding: periodontal parameters; salivary levels of TNF-α, IL-1β and leptin (Luminex® assay); and babies' weight at birth. Mann-Whitney, Friedman, ANOVA; chi-square and Cochran's Q tests were applied (p < 0.05). RESULTS GO showed higher prevalence of periodontitis in T1 and T2 (p <0.001), with higher salivary levels of TNF-α (p = 0.003) and IL-1β (p = 0.009) in T1. IL-1β significantly decreased after delivery in GO. No intergroup differences for leptin levels were found, but both groups had a significant reduction of leptin levels between periods (p <0.001). GO had children with lower birth weight (p = 0.022), being classified as low (<2,500 g) or insufficient (2,500-2,999 g) weight. DISCUSSION It is suggestive that the inflammatory pattern caused by obesity and periodontitis, mainly related to high levels of TNF-α, impair the babies' weight at birth, resulting in more frequency of low/insufficient weight at birth.
Collapse
Affiliation(s)
- Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health. Bauru School of Dentistry, University of São Paulo, Al Octávio Pinheiro Brisolla 9-75, Zip Code 17012-901, Bauru, São Paulo, Brazil.
| | - Victor Mosquim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Al Octávio Pinheiro Brisolla 9-75, Zip Code 17012-901, Bauru, São Paulo, Brazil.
| | - Marília Afonso Rabelo Buzalaf
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al Octávio Pinheiro Brisolla 9-75, Zip Code 17012-901, Bauru, São Paulo, Brazil.
| | - Silvia Helena de Carvalho Sales-Peres
- Department of Pediatric Dentistry, Orthodontics and Public Health. Bauru School of Dentistry, University of São Paulo, Al Octávio Pinheiro Brisolla 9-75, Zip Code 17012-901, Bauru, São Paulo, Brazil.
| |
Collapse
|
10
|
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: 14] [Impact Index Per Article: 3.5] [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.
Collapse
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;
| |
Collapse
|
11
|
Influence of Laser and Ozone Pretreatment on the Shear Bond Strength of Fissure Sealants: An In Vitro Comparative Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820944285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To evaluate the shear bond strength (SBS) of 3 fissure sealants used alone and with ozone and laser pretreatment. Materials and Methods: For the SBS test, the flattened enamel surfaces of 90 healthy third molars were randomly divided into nine groups ( n = 10 for each groups), based on different sealants (BeautiSealant, Fuji Triage, and Grandio Seal) and pretreatment conditions (no pretreatment, pretreatment with ozone, and pretreatment with neodymium-doped yttrium aluminum garnet [Nd:YAG laser]). Ozone was applied for 30 s in caries superficial mode, and Nd:YAG laser was applied for 60 s. After the pretreatment procedures, sealants were placed inside a mold on the enamel surface. SBS was measured with a universal testing machine. Data were analyzed using analysis of variance. Tukey’s multiple comparison tests were applied to determine the difference between the groups (α = 0.05). Results: The lowest SBS was observed in the Fuji triage group. Nd:YAG laser and ozone did not affect the SBS of BeautiSealant. However, significant differences were determined in the Fuji triage and Grandio Seal groups after pretreatment procedures ( P < .05). Conclusion: Ozone and laser can be employed to disinfect fissures before BeautiSealant application.
Collapse
|
12
|
Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials. Clin Oral Investig 2020; 24:1877-1888. [PMID: 32399735 DOI: 10.1007/s00784-020-03289-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 04/14/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This systematic review (SR) aimed at assessing the adjunctive clinical effect of ozone therapy (OT) on nonsurgical periodontal treatment. MATERIALS AND METHODS Articles published prior to September 2019 were electronically searched in four databases without any other date or language restrictions and manually searched in regular journals and in gray literature. This review was performed according to the PICO format. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the adjunctive effect of OT on nonsurgical periodontal treatment. RESULTS Twelve studies published between 2010 and 2019 were included in this SR. A metaanalysis of ten reports showed that there was no statistically significant difference in the periodontal parameters analyzed when scaling and root planing (SRP) plus sulcus irrigation with ozonated water or sulcus insertion of ozonated gas were used when compared to SRP alone. Additionally, there was no significant difference when the effect of SRP plus ozonated water was compared with SRP plus 2% chlorhexidine gluconate (CLX). No studies reported significant microbiological differences when the use of ozone was compared with SRP alone. CONCLUSIONS The results of this SR do not support the use of OT for nonsurgical periodontal treatment. However, due to the potential heterogeneity across the studies, the presence of confounding factors, and the short follow-up of some included RCTs, these results should not be considered definitive. CLINICAL RELEVANCE The current evidence indicates that ozone has antimicrobial activity and good biocompatibility with periodontal cells and gingival fibroblasts. However, no evidence was found for a positive effect of OT as an adjunct to scaling and root planing.
Collapse
|
13
|
Zeng J, Lei L, Zeng Q, Yao Y, Wu Y, Li Q, Gao L, Du H, Xie Y, Huang J, Tan W, Lu J. Ozone Therapy Attenuates NF-κB-Mediated Local Inflammatory Response and Activation of Th17 Cells in Treatment for Psoriasis. Int J Biol Sci 2020; 16:1833-1845. [PMID: 32398953 PMCID: PMC7211165 DOI: 10.7150/ijbs.41940] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 03/21/2020] [Indexed: 12/12/2022] Open
Abstract
Ozone therapy has been widely used to treat many skin diseases, including infections, allergic dermatosis, and skin ulcers. However, its efficacy as a treatment for psoriasis is unclear. In this study, we explored the clinical efficacy and the underlying molecular mechanisms of ozone therapy on psoriasis. We found that topical ozone treatment significantly decreased patients' psoriasis area and severity index (PASI) scores and the expression of psoriasis-associated cytokines in their peripheral blood CD4+ T cells. In the IMQ-induced psoriasis mouse model, topical ozone treatment significantly inhibited the formation of IMQ-induced psoriasis-like lesions and the expression of psoriasis-associated inflammatory factors. High-throughput sequencing confirmed that IMQ-induced activation of toll-like receptor 2 (TLR2)/ nuclear factor-κB (NF-κB) signaling pathway was significantly suppressed in psoriasis-like lesions after topical ozone treatment. Furthermore, the activation of spleen T helper (Th) 17 cells was blocked in the mouse model; this was associated with the downregulation of cytokines and NF-κB pathways upon topical ozone treatment. Ozone therapy can attenuate local inflammatory reactions and the activation of Th17 cells in psoriasis by inhibiting the NF-κB pathway. Our results show that ozone therapy is effective in treating psoriasis. We recommend further evaluations for its clinical applications.
Collapse
Affiliation(s)
- Jinrong Zeng
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Lei
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qinghai Zeng
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuying Yao
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Yuqing Wu
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Qinxuan Li
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Lihua Gao
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hongjiao Du
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yajie Xie
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jinhua Huang
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenbin Tan
- Department of Cell Biology and Anatomy, School of Medicine, and.,Department of Biomedical Engineering, College of Engineering and Computing, University of South Carolina, Columbia, South Carolina
| | - Jianyun Lu
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| |
Collapse
|
14
|
Saglam E, Alinca SB, Celik TZ, Hacisalihoglu UP, Dogan MA. Evaluation of the effect of topical and systemic ozone application in periodontitis: an experimental study in rats. J Appl Oral Sci 2019; 28:e20190140. [PMID: 31800874 PMCID: PMC6886394 DOI: 10.1590/1678-7757-2019-0140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/14/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: The goal of the present study was to determine the effect of systemic and topical ozone application on alveolar bone loss (ABL) by evaluating the effect of Hypoxia-inducible factor −1 alpha (HIF-1-α) and receptor activator of NF-kB ligand (RANKL)-positive cells on histopathological and immunohistochemical changes in a rat periodontitis model. Methodology: Thirty male Wistar rats were divided into three groups: 1) Group C (control group); 2) Group SO (systemic ozone group) and 3) Group TO (topical ozone group). Experimental periodontitis was induced with a 3/0 silk suture placed at the mandibular left first molars of rats, and the suture was removed 14 days later. Ozone gas was injected intraperitoneally (0.7 mg/kg) in SO group. Topical ozone application protocol was performed using an ozone generator at 80% concentration (4th grade) 90- degree probe for the duration of 30 s. Both ozone applications were carried out for two weeks at intervals of two days. Histomorphometric and immunohistochemical analysis were performed. Results: ABL was significantly lower in Group SO compared to Group C (p: 0.0052). HIF-1α- positive cells were significantly lower in Group TO than in Group C (p: 0.0043). RANKL-positive cells were significantly lower in Group SO and in Group TO compared to the control group (p: 0.0033, p: 0.0075, respectively). Conclusion: Both ozone applications decreased RANKL-positive cell counts, TO application decreased HIF-1-α positive cells counts, and SO application was found to be more effective in reducing ABL compared to control group.
Collapse
Affiliation(s)
- Ebru Saglam
- Health Sciences University, Faculty of Dentistry, Department of Periodontology, Istanbul, Turkey
| | | | - Tugba Zengin Celik
- Bezmialem Vakıf University, Faculty of Dentistry, Department of Periodontology, Istanbul, Turkey
| | | | | |
Collapse
|