Salivary tumor necrosis factor-alpha to detect the severity of erectile dysfunction: A randomized clinical trial

Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions

OBJECTIVE

To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up.

MATERIALS AND METHODS

A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities.

RESULTS

The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: -0.69; -0.41) after 3 months compared to the control group.

CONCLUSION

Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions.

TRIAL REGISTRATION

This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.

The Efficacy of Minocycline Hydrochloride Combined with Multiple Antibiotic Paste in Elderly Patients with Chronic Periodontitis and Concomitant Pulp Lesions

Objective

To explore the efficacy of Minocycline hydrochloride combined with multiple antibiotic pastes in the treatment of chronic periodontitis with concomitant pulp lesions in elderly patients, as well as to analyze the changes in the levels of inflammatory markers.

Methods

100 patients suffering from chronic periodontitis with concomitant pulp lesions treated in our hospital from July 2018 to January 2020 were selected as the study subjects, and were randomly assigned to either an experimental group (n = 50) or a control group (n = 50). Patients in the experimental group were treated with Minocycline hydrochloride combined with multiple antibiotic pastes, while those in the control group were treated with Minocycline hydrochloride alone. The treatment efficacy in the two groups was then assessed using such factors as periodontal probing depth, dental plaque index, gingival index, periodontal attachment level, and the presence or absence of adverse effects. We also measured and compared the levels of inflammatory markers such as CRP, TNF-α, IL-1β, IL-5, IL-6, and others in both groups, before treatment, as well as after a week of treatment.

Results

There was a statistically significant difference in the treatment efficacy between the two groups (P < 0.05), with a higher treatment efficacy seen in the experimental group as compared to the control group. When compared to the control group, the experimental group had lower depths of periodontal probing, lower dental plaque indices, lower gingival indices, lower periodontal attachment levels, as well a significantly lower incidence of adverse reactions (P < 0.05). Before treatment, the levels of inflammatory markers such as CRP, TNF-α, IL-1β, IL-5, and IL-6 were elevated in both groups. After a week of treatment, there were reductions in the levels of inflammatory markers in both groups, but a more significant reduction was seen in the experimental than in the control group (P < 0.05).

Conclusion

Minocycline hydrochloride combined with various antibiotic pastes is more effective in the treatment of chronic periodontitis with concomitant pulp lesions in elderly patients than monotherapy with Minocycline hydrochloride alone.

PERIODONTAL AND SYSTEMIC DISEASES: ERECTILE DYSFUNCTION

Periodontal hastalıklar toplumda yaygın bir şekilde görülmektedir. Son yıllarda yapılan çalışmalarla periodontal hastalıkların sistemik hastalıklara, benzer şekilde sistemik rahatsızlıklarında periodontal hastalıklara katkıda bulunabileceği bilinmektedir. Periodontal hastalıklar ve sistemik hastalıklar arasındaki bu iki yönlü ilişki son yıllarda dikkat çekici bir şekilde araştırmalara neden olmuştur. Bu konulardan biri de erektil disfonksiyondur. Periodontal hastalıkların erektil disfonksiyon ile ilişkisi ilgi çekicidir. Farklı etyolojiye sahip olan erektil disfonksiyonda periodontal hastalıkların etkisi son dönemde sıkça araştırılmıştır. Bu geleneksel derlemede, tedavi sağlayıcılara periodontal hastalıkların genel özellikleri, erektil disfonksiyonun genel özellikleri ve birbiri ile olan ilişkiler üzerinde durulacaktır.