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Blyleven GM, Johnson TM, Inouye KA, Stancoven BW, Lincicum AR. Factors influencing intraoperative and postoperative complication occurrence: A series of 1135 periodontal and implant-related surgeries. Clin Exp Dent Res 2024; 10:e849. [PMID: 38345517 PMCID: PMC10847704 DOI: 10.1002/cre2.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES In periodontology, it is widely recognized that evidence characterizing the incidence and effect of treatment complications is lacking. The objective of this study was to assess the influence of operator-, procedure-, patient-, and site-associated factors on intraoperative and postoperative complication occurrence. MATERIAL AND METHODS A single investigator reviewed records of patients treated by eight periodontics residents from July 2018 through June 2022. For each procedure, the investigator recorded each intraoperative and postoperative complication or indicated that no complication had occurred. These outcomes were analyzed against a panel of explanatory covariates. In addition, the severity of each postoperative complication was assessed using a standardized grading system. RESULTS A total of 1135 procedures were included in the analysis. Intraoperative and postoperative complications were identified in 2.8% and 15.2% of procedures, respectively. The most common intraoperative complications were Schneiderian membrane perforation (1.3%) and gingival flap perforation/tear (1%), and the most common postoperative complications were dentin hypersensitivity (2.6%), excessive pain (2.5%), and infection (2.2%). Subepithelial connective tissue graft (odds ratio [OR]: 3.2, 95% confidence interval [CI]: 1.6, 6.1; p < .001), guided bone regeneration (OR: 3.0, 95% CI: 1.4, 6.5; p = .004), and guided bone regeneration with implant placement (OR: 3.1, 95% CI: 1.3, 7.6; p = .011) were associated with higher odds of postoperative complication, whereas lateral sinus elevation (OR: 102.5, 95% CI: 12.3, 852.9; p < .001), transalveolar sinus elevation (OR: 22.4, 95% CI: 2.2, 224.5; p = .008), open flap debridement (OR: 36.4, 95% CI: 3.0, 440.7; p = .005), and surgically facilitated orthodontic therapy (OR: 20.5, 95% CI: 1.2, 358.4; p = .039) were associated with higher odds of intraoperative complication occurrence. CONCLUSIONS Consistent with previous reports, procedure type appears to be the predominant factor driving complication occurrence. As analyses of treatment complications increase, individualized risk-benefit assessments will become progressively meaningful for patients.
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Affiliation(s)
- Gary M. Blyleven
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Thomas M. Johnson
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Kimberly Ann Inouye
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Brian W. Stancoven
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Adam R. Lincicum
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
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Mounssif I, Bentivogli V, Rendón A, Gissi DB, Maiani F, Mazzotti C, Mele M, Sangiorgi M, Zucchelli G, Stefanini M. Patient-reported outcome measures after periodontal surgery. Clin Oral Investig 2023; 27:7715-7724. [PMID: 37940683 PMCID: PMC10713745 DOI: 10.1007/s00784-023-05362-y] [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: 06/27/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES The present study aimed to explore the impact of different periodontal surgical treatments on the quality of life and postoperative morbidity. MATERIALS AND METHODS The present study is a single-center, prospective, observational cohort trial. One hundred fifty-five patients, referred to the Periodontal Department of Bologna University who needed periodontal surgical treatment, were recruited. The self-reported perception of the postoperative course was assessed using the following anonymous questionnaires: Italian oral health impact profile (I-OHIP-14), visual analog scale (VAS) to evaluate the intensity of the pain, and 5-point Likert scale. RESULTS Patients reported a mean OHIP-14 total score of 9.87±8.5 (range 0-42), significantly influenced by the female sex, flap extension, and periodontal dressing. A mean VAS score of 2.96±2.39 (range 0-9) was calculated, and was found to be influenced by the presence of vertical releasing incisions and palatal flap extension. Of the 155 subjects, 40 (25.8%) patients reported bleeding as a post-surgical complication, 96 (61.9%) swelling, 105 (67.7%) eating discomfort, and 44 (28.4%) reported speech discomfort. CONCLUSIONS Within the limitations of the nature of the present study, periodontal surgical procedures have a low impact on patients' quality of life evaluated through the OHIP-14 and VAS pain questionnaires. CLINICAL RELEVANCE Periodontal surgical procedures are safe procedures, with a limited duration of postoperative discomfort as well as the incidence of complications.
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Affiliation(s)
- Ilham Mounssif
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Valentina Bentivogli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Alexandra Rendón
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Davide B Gissi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Francesco Maiani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Claudio Mazzotti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Monica Mele
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Matteo Sangiorgi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Santos EC, Huller D, Brigola S, Ferreira MD, Pochapski MT, dos Santos FA. Pain management in periodontal therapy using local anesthetics and other drugs: an integrative review. J Dent Anesth Pain Med 2023; 23:245-256. [PMID: 37841520 PMCID: PMC10567545 DOI: 10.17245/jdapm.2023.23.5.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/17/2023] Open
Abstract
Background Surgical and non-surgical periodontal procedures often lead to postoperative pain. Clinicians use pharmacological methods such as anesthetics, anti-inflammatory drugs, and analgesics for relief. However, the multitude of options makes it challenging to select the best approach for routine dental care. Objective This review aimed to describe previous studies regarding the pharmacological management used for pain control during periodontal procedures as well as factors that may interfere with patients' perception of pain. Methods We included studies (period of 2000-2023, whose approach corresponded to the pharmacological protocols used for preoperative, trans-operative, and postoperative pain control in adult patients undergoing surgical and non-surgical periodontal therapy. Results A total of 32 studies were included in the analysis, of which 17 (53%) were related to anesthetic methods and 15 (47%) were related to therapeutic protocols (anti-inflammatory/analgesic agents). These studies predominantly involved nonsurgical periodontal procedures. Studies have reported that factors related to age, type of procedure, and anxiety can influence pain perception; however, only seven of these studies evaluated anxiety. Conclusions Numerous methods for pain control can be applied in periodontal therapy, which are accomplished through anesthetic methods and/or therapeutic protocols. Factors such as anxiety, age, and type of procedure are related to pain perception in patients. Thus, it is the responsibility of dentists to evaluate each clinical situation and define the best protocol to follow based on the literature.
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Affiliation(s)
| | - Daniela Huller
- Department of Dentistry, Universidade Estadual de Ponta Grossa, Paraná, Brazil
| | - Sabrina Brigola
- Department of Dentistry, Universidade Estadual de Ponta Grossa, Paraná, Brazil
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Gufran K, Khan MS, Alqahtani AS, Alnufaiy B. Pain Assessment and Need for Analgesics after Scaling and Root Planing in Patients with Stage II and Stage III Periodontitis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1203. [PMID: 37512015 PMCID: PMC10385337 DOI: 10.3390/medicina59071203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/19/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: The most common treatment procedure for periodontitis and gingivitis is scaling and root planing, which is perceived as a painful dental treatment. The current study aimed to assess pain perception and analgesics consumption after scaling and root planing (SRP) in patients with stage II and stage III periodontitis. Materials and Methods: Before starting the SRP, all the periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL), were measured. The anxiety level of the patients was also assessed using the modified dental anxiety scale (MDAS) questionnaire. Pain perception of the patients was recorded with the visual analog scale (VAS) after performing the SRP. Patients were asked to mark their pain level on the VAS sheet after two hours, four hours, eight hours, 24 h, and 48 h after the periodontal treatment. The following cut-off points were used for the pain intensity in the VAS: 0 = no pain, 1-4 = mild pain, 4-6 = moderate pain, and 7-10 = severe pain. Patients were advised to take analgesics if the pain was intolerable. Multivariate logistic regression was performed to conduct the association of all dependent variables and the pain perception of patients. A nonparametric Friedman test was conducted to assess pain perception at different times. Results: A total of 52 patients including 32 males and 20 females participated in the current study, with a mean age of 43.10 ± 12.33 years. Multivariate analyses showed that MDAS and analgesic consumption is significantly associated with pain perception. Other clinical variables are not associated with pain perception. The Friedman test exhibited that pain perception is significantly associated (p < 0.05) with time. Conclusions: Analgesic consumption and anxiety level are significantly associated with pain perception after SRP treatment.
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Affiliation(s)
- Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Mohammad Shoyab Khan
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Abdullah Saad Alqahtani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Banna Alnufaiy
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
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Graziani F, Tinto M, Orsolini C, Izzetti R, Tomasi C. Complications and treatment errors in nonsurgical periodontal therapy. Periodontol 2000 2023; 92:21-61. [PMID: 36591941 DOI: 10.1111/prd.12478] [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: 05/03/2022] [Revised: 09/14/2022] [Accepted: 10/14/2022] [Indexed: 01/03/2023]
Abstract
Nonsurgical periodontal therapy can be subject to iatrogenesis, which includes all the complications directly or indirectly related to a treatment. These complications include both operator-dependent harms and errors and the consequences and adverse effects of the therapeutic procedures. The complications arising following nonsurgical periodontal treatment can be categorized as intraoperative and postoperative and can affect both soft and hard tissues at an intra-oral and extraoral level. Soft-tissues damage or damage to teeth and restorations can occur while performing the procedure. In the majority of cases, the risk of bleeding associated with nonsurgical therapy is reported to be low and easily controlled by means of local hemostatic measures, even in medicated subjects. Cervicofacial subcutaneous emphysema is not a frequent extraoral intraoperative complication, occurring during the use of air polishing. Moreover, side effects such as pain, fever, and dentine hypersensitivity are frequently reported as a consequence of nonsurgical periodontal therapy and can have a major impact on a patient's perception of the treatment provided. The level of intraoperative pain could be influenced by the types of instruments employed, the characteristics of tips, and the individual level of tolerance of the patient. Unexpected damage to teeth or restorations can also occur as a consequence of procedural errors.
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Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Manuel Tinto
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Chiara Orsolini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Leira Y, Cho H, Marletta D, Orlandi M, Diz P, Kumar N, D'Aiuto F. Complications and treatment errors in periodontal therapy in medically compromised patients. Periodontol 2000 2023; 92:197-219. [PMID: 36166645 DOI: 10.1111/prd.12444] [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: 04/26/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Abstract
Patients who are medically compromised may be at an increased risk of complications and treatment errors following periodontal therapy. A review of the evidence on the topic is presented, in relation to the type of complication reported, of periodontal treatment, and of patients' medical status. Further, a framework for risk assessment and appropriate treatment modifications is introduced, with the aim of facilitating the management of patients with existing comorbidities and reducing the incidence of treatment complications.
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Affiliation(s)
- Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Hana Cho
- Special Care Dentistry Unit, ENT & Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
| | | | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
| | - Pedro Diz
- Special Care Dentistry Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Navdeep Kumar
- Special Care Dentistry Unit, ENT & Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
| | - Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
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Can Intra-Oral Qualitative Sensory Testing Foretell Postoperative Dental Pain? A Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138059. [PMID: 35805715 PMCID: PMC9265558 DOI: 10.3390/ijerph19138059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 12/10/2022]
Abstract
Pain prevention and management is one of the primary goals of dental care. Postoperative dental pain (PDP) following caries removal and performance of a restorative dental treatment is a common clinical phenomenon, often causing significant discomfort to dental patients. In the present study, a psychophysical non-invasive method, qualitative sensory testing (QualST), was used in an attempt to foretell PDP following dental restorative procedures. Forty-two dental patients underwent an intra-oral cold QualST four times: immediately prior to a restorative dental procedure and at a follow-up meeting 1−3 weeks later, on the treated and on the contralateral oral sides. The QualST measures included subjects’ evaluation of the magnitude of pain and cold sensations experienced (on visual analogue scales) and the duration of the cold sensation (in seconds). Additional measures included age, gender, level of dental anxiety, jaw treated, and type of dental restoration performed (Class I or Class V). Subjects’ PDP was assessed through the phone using numeric rating scales 24, 48, and 72 h postoperatively. The highest level of PDP experienced by subjects occurred 24 h postoperatively (ANOVA with repeated measures). Of the study variables, the QualST pain sensation (B = 0.645, p < 0.001), duration of the cold sensation (B = 0.042, p < 0.05), and an interaction between gender and dental anxiety (B = 0.136, p < 0.05) emerged as possible predictors of the highest PDP experienced by subjects (stepwise regression). The results suggest that subjects’ reaction to an intra-oral cold stimulation of the oral mucosa can serve as a potential tool to foretell postoperative dental pain following restorative dental procedures.
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Hussain B, Karaca EO, Kuru BE, Gursoy H, Haugen HJ, Wohlfahrt JC. Treatment of residual pockets using an oscillating chitosan device versus regular curettes alone-A randomized, feasibility parallel-arm clinical trial. J Periodontol 2022; 93:780-789. [PMID: 34710240 DOI: 10.1002/jper.21-0496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND A brush made of chitosan has shown to be an effective and harmless device for non-surgical treatment of mild to moderate peri-implantitis. To date, no study has evaluated the use of a chitosan brush in the non-surgical treatment of residual pockets in periodontal treatment. METHODS Seventy-eight patients with periodontitis were included in this multicenter, randomized, examiner-blind clinical trial of 6 months duration. Patients with residual probing pocket depth (PPD) of ≥5 mm and ≤7 mm following previous active periodontal treatment were included. Patients were assigned either subgingival treatment with curettes (control) or an oscillating chitosan brush (test). Changes in bleeding on probing (BoP) and PPD between baseline and terminal evaluation at 6 months were evaluated. RESULTS A significant reduction in both PPD and BoP was seen within both groups. There was no significant difference in BoP between test and control groups after 6 months, but the reduction in PPD was significantly improved in the test group (P ≤ 0.01). The combined outcome of no BOP and PPD ≤4 mm was significantly better in the test group (P ≤ 0.01). No adverse reactions were seen. CONCLUSION Treatment of residual periodontal pockets (PPD = 5 to 7 mm) with a chitosan brush disclosed equal or better clinical results as compared to regular curettes. This study supports that a chitosan brush can be used for subgingival biofilm removal and soft tissue curretage in the treatment of periodontitis.
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Affiliation(s)
- Badra Hussain
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Ebru Ozkan Karaca
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Bahar Eren Kuru
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Hare Gursoy
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Johan Caspar Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.,Bjerke Tannmedisin, Oslo, Norway
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Abstract
Periodontitis is a common disorder affecting >40% of adults in the United States. Globally, the severe form of the disease has a prevalence of 11%. In advanced cases, periodontitis leads to tooth loss and reduced quality of life. The aetiology of periodontitis is multifactorial. Subgingival dental biofilm elicits a host inflammatory and immune response, ultimately leading to irreversible destruction of the periodontium (i.e. alveolar bone and periodontal ligament) in a susceptible host. In order to successfully manage periodontitis, dental professionals must understand the pathogenesis, primary aetiology, risk factors, contributing factors and treatment protocols. Careful diagnosis, elimination of the causes and reduction of modifiable risk factors are paramount for successful prevention and treatment of periodontitis. Initial non-surgical periodontal therapy primarily consists of home care review and scaling and root planing. For residual sites with active periodontitis at periodontal re-evaluation, a contemporary regenerative or traditional resective surgical therapy can be utilised. Thereafter, periodontal maintenance therapy at a regular interval and long-term follow-ups are also crucial to the success of the treatment and long-term retention of teeth. The aim of this review is to provide current concepts of diagnosis, prevention and treatment of periodontitis. Both clinical and biological rationales will be discussed.
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Affiliation(s)
| | - Ira B Lamster
- Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Alwan AM, Mousa HA, Talib HJ, Jassim TK. Impact of Air and Manual Scaling on Dental Anxiety and Blood Glucose Level among Diabetic Patients. J Int Soc Prev Community Dent 2021; 11:510-515. [PMID: 34760794 PMCID: PMC8533038 DOI: 10.4103/jispcd.jispcd_411_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/14/2021] [Accepted: 04/06/2021] [Indexed: 11/05/2022] Open
Abstract
Aims: The current study aimed at describing the short-term effect of nonsurgical periodontal treatment on dental anxiety and blood glucose level change among diabetic patients. Materials and Methods: One hundred and fifty patients with diabetes participated in a cross-sectional study design. All of them were divided into two groups, with 75 patients in each group. The first group was treated with air scaling, whereas the second group was treated with manual scaling. The determination of treatment needs and the evaluation of periodontal health status were achieved by using Community Periodontal Index for Treatment Need (CPITN). The level of dental anxiety was assessed by using Visual Analogue Scale (VAS). The glucose change was calculated by subtracting the glucose level before treatment from the glucose level straight after treatment. Results: No significant difference in glucose level was observed between manual scaling and air scaling after treatment (P = 0.076), and the level of glucose was significantly lower after scaling treatment within the treatment groups (P = 0.000). The level of glucose change between the groups was significantly lower for the manual scaling treatment group (P = 0.013), and it was significantly correlated with VAS (P = 0.000). Multiple regression analysis showed a significant association between the treatment groups (P = 0.007). Conclusions: Scaling reduced blood glucose and dental anxiety levels in patients with diabetes. Manual scaling was associated with reduced glucose level change less than air scaling after treatment.
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Affiliation(s)
- Alyamama M Alwan
- Department of Periodontal Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
| | - Hussein A Mousa
- Department of Periodontal Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
| | - Haider J Talib
- Department of Periodontal Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
| | - Tameem K Jassim
- Department of Prosthetic Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
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TEZCİ N, KARADUMAN B. The Effects of Different Pre-operative Information Timings on Patients’ Anxiety Level and Pain Perception. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.801354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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12
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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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Hu J, Su XJ, Si HL, Song RX, Zhang F, Qiu XJ, Chen XP. Simultaneous Determination of Celecoxib, Dezocine and Dexmedetomidine in Beagle Plasma Using UPLC-MS/MS Method and the Application in Pharmacokinetics. Drug Des Devel Ther 2021; 15:2529-2541. [PMID: 34163139 PMCID: PMC8214532 DOI: 10.2147/dddt.s314562] [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: 04/19/2021] [Accepted: 05/28/2021] [Indexed: 01/31/2023] Open
Abstract
Background An efficient, fast and sensitive ultra high-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) method for simultaneous determination of celecoxib (CEL), dezocine (DEZ) and dexmedetomidine (DEX) in beagle plasma were established. Methods The beagle dogs plasmawas precipitated by acetonitrile. The column was Acquity UPLC BEH C18 column and the mobile phase was acetonitrile-formic acid with gradient mode, and the flow rate was set at 0.4 mL/min. Under the positive ion mode, CEL, DEZ, DEX and Midazolam (internal standard, IS) were monitored by multiple reaction monitoring (MRM) as the following mass transition pairs: m/z 381.10→282.10 for CEL, m/z 246.20→147.00 for DEZ, m/z 201.10→94.90 for DEX, and m/z 326.10→291.10 for IS. Results This UPLC-MS/MS method had good linearity for CEL, DEZ and DEX. The RSDs of inter-day and intra-day precision were the values of 0.31–7.66% and 0.11–9.63%, respectively; the RE values were from −6.05% to 10.98%. The extraction recovery was more than 79%, and the matrix effect was around 100%. The RSDs of stability were less than 8.96%. All of them met the acceptance standard of biological analysis method recommended by FDA. Conclusion This UPLC-MS/MS method is an effective tool for the simultaneous determination of CEL, DEX and DEX, and has been successfully applied to the study of pharmacokinetics in beagle dogs.
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Affiliation(s)
- Jie Hu
- Department of Anesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710049, People's Republic of China.,Department of Anesthesiology, Luoyang Central Hospital, Luoyang, Henan Province, 471003, People's Republic of China
| | - Xin-Juan Su
- Department of Anesthesiology, Luoyang Central Hospital, Luoyang, Henan Province, 471003, People's Republic of China
| | - Hui-Ling Si
- Department of Anesthesiology, Luoyang Central Hospital, Luoyang, Henan Province, 471003, People's Republic of China
| | - Rui-Xiang Song
- School of Basic Medical Sciences, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Fang Zhang
- School of Basic Medical Sciences, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Xiang-Jun Qiu
- School of Basic Medical Sciences, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Xing-Peng Chen
- Department of Anesthesiology, Luoyang Central Hospital, Luoyang, Henan Province, 471003, People's Republic of China
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Santos BFE, Costa FO, Vasconcelos AMA, Cyrino RM, Cota LOM. Preemptive effects of ibuprofen and nimesulide on postoperative pain control after open flap periodontal surgeries: A randomized placebo-controlled split-mouth clinical trial. J Periodontol 2021; 93:298-307. [PMID: 34031888 DOI: 10.1002/jper.20-0887] [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: 12/22/2020] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Data on preemptive analgesia in periodontal surgeries are scarce and still diverse. The aim of this study was to evaluate and compare the analgesic effects of the preemptive administration of ibuprofen and nimesulide in open flap periodontal surgeries. METHODS The present randomized controlled clinical trial comprised 40 individuals, divided into two groups (n = 20), according to the test drug (ibuprofen and nimesulide) to be administered 1 hour preoperatively. Participants underwent bilateral periodontal surgeries at two different times, and were randomly given the test drug or placebo in a split-mouth design. Postoperative pain and rescue medication were evaluated at different times. Comparisons between ibuprofen and nimesulide were performed through a Generalized Estimation Equation model, using test drug and evaluation times, along with an interaction between these two variables as predictors. RESULTS In intergroup comparisons regarding pain control, ibuprofen showed better effects than placebo only at the first postoperative hour, whereas nimesulide showed better effects than placebo at 1, 6, 24, and 48 postoperative hours. In intergroup comparisons, nimesulide showed better effects than ibuprofen at 24, 48, and 72 postoperative hours, demonstrating a higher overall preemptive effect. No differences were observed in relation to the number of rescue medication. CONCLUSION Preemptive administration of nimesulide showed better overall preemptive effects on postoperative pain control when compared with ibuprofen.
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Affiliation(s)
- Bianca F E Santos
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Fernando O Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Andrea M A Vasconcelos
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Renata M Cyrino
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Luís O M Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
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15
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Vieth MP, Deas DE, Archontia Palaiologou A, Diogenes A, Mader MJ, Mealey BL. Effect of intravenous dexamethasone on postoperative pain and swelling following periodontal flap surgery: A randomized controlled trial of patient-centered outcomes. J Periodontol 2021; 93:237-245. [PMID: 34021915 DOI: 10.1002/jper.21-0153] [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: 03/11/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND This randomized, crossover trial sought to determine if a preoperative intravenous (IV) dose of dexamethasone reduces pain, swelling, and analgesic usage following periodontal surgery. METHODS Thirty-seven patients planned for two similar periodontal flap surgeries under IV sedation were enrolled. Patients were randomized to receive either 2 mL (8 mg) dexamethasone sodium phosphate or 2 mL of IV solution (placebo) before the first surgery, and 2 mL of the other solution before the second surgery. Postoperative discomfort was managed with a standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen. A smartphone application was used to record self-assessed pain and swelling scores using 21-point numerical (NRS-21) and 4-point verbal (VRS-4) rating scales as well as the number of analgesic medications taken at 12-, 24-, 48-, 72-, 168-, and 336-hours following each surgery. RESULTS IV dexamethasone was associated with a significant reduction in pain at 12, 24, 48, and 72 hours (P <0.05), and swelling at 12, 24, 48, and 168 hours (P < 0.05) postoperatively when compared with placebo based on NRS-21 responses. VRS-4 data showed significant reductions in pain at 12, 72, and 168 hours and swelling at 12, 24, and 168 hours postoperatively with dexamethasone. No significant differences were found in the number of tablets of ibuprofen or acetaminophen between dexamethasone and placebo surgeries. CONCLUSIONS Preoperative, intravenously administered dexamethasone reduces pain and swelling within the first postoperative week following periodontal flap surgery and should be considered a useful adjunct for perioperative management.
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Affiliation(s)
- Michael P Vieth
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | - David E Deas
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | | | - Anibal Diogenes
- Department of Endodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | - Michael J Mader
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX
| | - Brian L Mealey
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
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16
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Puglisi R, Santos A, Pujol A, Ferrari M, Nart J, Pascual A. Clinical comparison of instrumentation systems for periodontal debridement: A randomized clinical trial. Int J Dent Hyg 2021; 20:328-338. [PMID: 34018671 DOI: 10.1111/idh.12520] [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: 04/01/2020] [Revised: 04/29/2021] [Accepted: 05/14/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare clinical efficacy, chairside time and post-treatment hypersensitivity of four instruments used for subgingival periodontal debridement. MATERIALS & METHODS Seventeen patients with stage II and III periodontitis were enrolled in this randomized clinical trial using a split-mouth design. Quadrants were randomly divided into four treatment groups: Group A: Gracey curettes-Hu-Friedy® ; Group B: piezoelectric ultrasonic (Satelec® ) with No.1S insert; Group C: diamond burs 40 µm (Intensiv Perioset® ); and Group D: piezosurgery ultrasonic (Mectron® ) with PP1 insert. Clinical outcomes, chairside time and hypersensitivity were assessed at 1, 2, 4 and 8 weeks after treatment. The primary outcome variable was improvement in clinical attachment level. RESULTS At 8 weeks post-treatment, Gracey curettes, piezoelectric ultrasonic (Satelec® ) and piezosurgery ultrasonic (Mectron® ) were statistically more effective than diamond burs in increasing attachment level and reducing probing pocket depth. Comparison of piezoelectric ultrasonic (Satelec® ) and piezosurgery ultrasonic (Mectron® ) with the other instruments showed a statistical difference (p < 0.001) in chairside time. Regarding post-treatment hypersensitivity, no statistical differences were observed in any of the groups. CONCLUSIONS Gracey curettes, piezoelectric ultrasonic (Satelec® ) and piezosurgery ultrasonic (Mectron® ) were clinically more effective than diamond burs 40 µm. The ultrasonic instruments showed a significant reduction in chairside time.
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Affiliation(s)
- Rosario Puglisi
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Antonio Santos
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Angels Pujol
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marco Ferrari
- Department of Medical Biotechnology, Universitá degli Studi di Siena, Siena, Italy
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Andrés Pascual
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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17
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Al-Bayati O, Font K, Soldatos N, Carlson E, Parsons J, Powell CA. Evaluation of the need to prescribe opioid medication to control post-surgical pain of different periodontal/oral surgeries. J Periodontol 2020; 92:1030-1035. [PMID: 33155320 DOI: 10.1002/jper.20-0315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/16/2020] [Accepted: 10/20/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND To determine the level of perceived pain after different types of periodontal/oral surgical procedures, and the differences in patients' selection of pain management, over the counter (OTC) versus opioid, based on procedure type. METHODS Patients undergoing surgical procedures were asked to complete a pain questionnaire at four time points: 1) before surgery 2) first dose of analgesic at home, 3) 24 hours postoperatively, and 4) 72 hours postoperatively. The questionnaire consisted of numerical and descriptive scales to describe the perceived pain. RESULTS A total of 198 patients completed the questionnaire. All surgical procedures were grouped into five major categories: bone augmentation procedures (11% BAP), teeth extractions (26% EXT), surgical implant placement (25% IP), mucogingival surgeries (21% MGS), and pocket elimination procedures (17%). IP surgery was associated with significantly less pain compared with MGS and EXT (P <0.05). There was a statistically significant difference for taking any medication based on type of surgical procedure at 24 hours (P <0.05). CONCLUSIONS IP is associated with significantly lower perceived pain compared with EXT and MGS surgery. Analgesic consumption was generally parallel to pain perception. A considerable number of patients elected to control the post-surgical pain using OTC medication up to 72 hours. Periodontal/oral surgery procedures vary in the amount of perceived postoperative pain. Tailoring postoperative medications to the type of periodontal/oral surgery performed will help prevent overprescribing of opioids.
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Affiliation(s)
- Omar Al-Bayati
- Division of Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Kerri Font
- Division of Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Nikolaos Soldatos
- Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, TX
| | - Emanouela Carlson
- Division of Endodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Joseph Parsons
- Division of Endodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
| | - Charles A Powell
- Department of Surgical Dentistry, Division of Periodontics, Director of Postdoctoral Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO.,Department of Periodontics, UT Health San Antonio, San Antonio, TX
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18
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Derman SHM, Lantwin EM, Barbe AG, Noack MJ. Does a pretreatment with a dentine hypersensitivity mouth-rinse compensate the pain caused by professional mechanical plaque removal? A single-blind randomized controlled clinical trial. Clin Oral Investig 2020; 25:3151-3160. [PMID: 33094406 PMCID: PMC8060178 DOI: 10.1007/s00784-020-03643-4] [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: 05/29/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022]
Abstract
Objectives Pain is affecting acceptance of supportive periodontal therapy and primary periodontitis prevention. Our objective was to evaluate the efficacy of a 1-week pre-treatment use of dentinal-hypersensitivity-reducing mouth-rinses (DHM) in periodontal maintenance (SPT) or dental prophylaxis patients. Material and methods One hundred fifty-five participants attending for professional mechanical plaque removal (PMPR) were randomly assigned to use a mouth-rinse twice daily for 1 week prior to their next PMPR. Rinses were containing either potassium oxalate (n = 52), arginine (n = 52), or herbal extracts (n = 51). At baseline and reassessment, procedural pain was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). Self-reported efficacy was documented. Results No inter-group differences were estimated between both test groups and the control for baseline and reassessment means (VAS, VRS). In the SPT group, VAS reduction and self-reported efficacy were found (p < 0.05). Conclusion The 1-week use of DHM failed to show a predictable effect on discomfort during PMPR overall. Around 20% of the patients showed a quantifiable benefit from both test mouth-rinses, whereas more than 50% reported a subjective pain reduction. Focusing patients undergoing supportive periodontal therapy, quantifiable effects were found for both test groups. From a patient’s point of view, DHM might be a suitable adjunct to enhance procedural comfort, especially in patients with a history of periodontitis. Clinical relevance The 1-week use of the dentinal-hypersensitivity-reducing mouth-rinses prior to professional-mechanical-plaque-removal showed to be a suitable adjunct to enhance procedural comfort during instrumentation, especially in patients undergoing supportive periodontal therapy. Registration number: DRKS00010811 Electronic supplementary material The online version of this article (10.1007/s00784-020-03643-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sonja H M Derman
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany.
| | - Eva-Maria Lantwin
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - Michael J Noack
- Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
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19
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Font K, Johnson L, Powell C. Five different solutions to mitigate overprescribing opioid medications. J Dent Educ 2020; 85:31-36. [PMID: 32929746 DOI: 10.1002/jdd.12393] [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: 06/04/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE The University of Colorado School of Dental Medicine took 5 distinct actions to mitigate the amount of opioids prescribed at the dental school between the years 2016-2020. METHODS This retrospective study evaluated a comprehensive 5-step quality improvement strategy which was implemented to decrease opioid prescribing. a) development of a Dental Pain Management Protocol, b) implementation of the protocol with pre-doctoral students, c) incorporating the results of a Master's project that determined the actual postoperative pain after periodontal/oral surgical procedures, d) development of a favorite electronic prescription list, and e) creation of patient instructions to allow for information on nonopioid analgesic use after dental procedures to be disseminated to the patient. RESULTS There was a significant decrease (P = 0.05) in the opioid prescribing trend with the implementation of these 5 actions, resulting in an overall 68.8% decrease for prescription writing of opioids and a 78.6% decrease of opioid pills over this 3 year period. CONCLUSION Simple guidelines and protocols resulted in a drastic decrease in opioid prescribing, with limited negative feedback from faculty and patients.
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Affiliation(s)
- Kerri Font
- Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado, USA
| | - Lonnie Johnson
- Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado, USA
| | - Charles Powell
- Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado, USA
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20
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Esmaeili H, Malekzadeh M, Esmaeili D, Nikeghbal F. Dental anxiety and the effectiveness of local anesthesia. BRAZILIAN JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.20396/bjos.v19i0.8658127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: The successful anesthesia is an essential factor for dental treatment. This study aimed at determining the effectiveness of local anesthesia and it’s relationship with dental Anxiety. Methods: This cross-sectional study was carried out on 256 dental patients, in 2017. Dental Anesthesia was administered after completing the Modified Dental Anxiety Scale by the patients. The level of anesthesia was recorded in one of three states (successful, difficult, and failed). Collected data was analyzed using SPSS version 22 and tests of, Chi-square, independent t-test, analysis of variance, and logistic regression model. Results: About 60.5% subjects had moderate-severe dental anxiety. The mean of dental anxiety significantly was lower in the successful anesthesia group (P<0.01). Patients with elementary education had a significantly higher level of dental anxiety (P<0.01). Dental anxiety was significantly higher in the age group of ≥59 years, compared to the other age groups, except for 49-58 years (P<0.05). Subjects with a significantly higher level of dental anxiety more delayed their visits to the dentist. The logistic regression model showed that the dental anxiety (high anxiety) and literacy level (elementary) were the most important predictors of failed or difficult anesthesia. Conclusion: Informing patients about dental treatment procedures, regular and periodic visits to the dentist, using psychotherapeutic techniques to reduce dental anxiety before anesthesia, could play an important role in the success of anesthesia.
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21
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Caporossi LS, Dos Santos CS, Calcia TBB, Cenci MS, Muniz FWMG, da Silveira Lima G. Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis. Clin Oral Investig 2020; 24:2559-2578. [PMID: 32572640 DOI: 10.1007/s00784-020-03401-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To assess and compare the pharmacological effect of different drugs on pain relief after periodontal surgery. MATERIALS AND METHODS Five databases were searched up to September 2019. The eligible studies comprised randomized clinical trials, involving only adult individuals that received any periodontal surgery and presenting two distinct groups of therapeutic regimens to control postoperative pain. Placebo groups could be included. The risk of bias was assessed with the RoB 2 Cochrane tool and the GRADE system. Meta-analyses were performed using different follow-up and drug comparisons. RESULTS Overall, 2398 studies were identified, of which 35 were included. Low risk of bias was determined for the majority of the studies. The meta-analyses showed that the comparison of dexamethasone or non-steroidal anti-inflammatory drugs (NSAID) versus placebo favored the use of both interventions in a follow-up of 1 to 8 h for open flap procedures (OFP). However, no statistical difference was found for the comparison between NSAID and dexamethasone for OFP. CONCLUSIONS Patients may benefit from several pharmacological schemes for pain relief after periodontal surgeries. However, due to the high heterogeneity among studies, no fixed pharmacological protocol could be proposed. CLINICAL RELEVANCE There is not enough evidence to recommend one therapeutic scheme. However, untreated pain is harmful to the patients and it is not advisable.
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Affiliation(s)
- Leonardo Stephan Caporossi
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil
| | - Cinthia Studzinski Dos Santos
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil
| | | | - Maximiliano Sergio Cenci
- Department of Operative Dentistry, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves, St., Pelotas, Rio Grande do Sul, Brazil
| | - Francisco Wilker Mustafa Gomes Muniz
- Department of Periodontology, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil
| | - Giana da Silveira Lima
- Department of Operative Dentistry, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves, St., Pelotas, Rio Grande do Sul, Brazil.
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22
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Moraes GS, Santos IBD, Pinto SCS, Pochapski MT, Farago PV, Pilatti GL, Santos FA. Liposomal anesthetic gel for pain control during periodontal therapy in adults: a placebo-controlled RCT. J Appl Oral Sci 2019; 28:e20190025. [PMID: 31778442 PMCID: PMC6882661 DOI: 10.1590/1678-7757-2019-0025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/24/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. OBJECTIVE This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. METHODOLOGY Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. RESULTS Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. CONCLUSION Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.
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Affiliation(s)
- Gustavo Simao Moraes
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
| | | | | | - Marcia Thais Pochapski
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
| | - Paulo Vitor Farago
- Universidade Estadual de Ponta Grossa, Departamento de Ciências Farmacêuticas, Ponta Grossa, Paraná, Brasil
| | - Gibson Luiz Pilatti
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
| | - Fabio Andre Santos
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia, Ponta Grossa, Paraná, Brasil
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Norum TÅ, Aass AM, Koldsland OC. Pain and morbidity after non-surgical and surgical treatment of peri-implantitis. Acta Odontol Scand 2019; 77:624-629. [PMID: 31250683 DOI: 10.1080/00016357.2019.1632474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Not much information exists on post-treatment pain related to peri-implantitis. The purpose of this study was to evaluate intensity and quality of pain after non-surgical and surgical treatment of peri-implantitis. Material and methods: A total of 30 patients with a diagnosis of peri-implantitis were included in the study. The patients registered pain using a VAS scale after non-surgical and surgical treatment of peri-implantitis. The data were registered for one week after each treatment. The patients also recorded quality of pain and if analgesics were taken. Factors included in the study were number of implants, severity of peri-implantitis (millimetre bone loss at most severely affected implant), implant localization, smoking and gender. Results: Statistically significant difference in intensity of pain was found between day zero and day one for both non-surgical and surgical treatment of peri-implantitis (p < .05). Number of implants, severity of peri-implantitis, implant localization, smoking and gender were not statistically significant related to intensity of pain post-treatment. The most frequently reported quality of pain was throbbing/soreness and numbness for both non-surgical and surgical treatment. Conclusion: Levels of pain are found to be low to moderate for most patients after treatment of peri-implantitis. The pain was most pronounced on the first two days post-treatment. Throbbing/soreness and numbness were the most frequently reported quality of pain.
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Affiliation(s)
- Thomas Åge Norum
- Department of Periodontology, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Anne Merete Aass
- Department of Periodontology, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Odd Carsten Koldsland
- Department of Periodontology, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Akram Z, Shafqat SS, Niaz MO, Raza A, Naseem M. Clinical efficacy of photodynamic therapy and laser irradiation as an adjunct to open flap debridement in the treatment of chronic periodontitis: A systematic review and meta-analysis. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 36:3-13. [PMID: 31373725 DOI: 10.1111/phpp.12499] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/01/2019] [Accepted: 07/24/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim of this systematic review and meta-analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis. METHODS Electronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. RESULTS Six RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD = -0.61, 95% CI = -1.22 to -0.016, P = .044) and PD reduction (WMD = -1.79, 95% CI = -3.44 to -0.14, P = .034) was significant between aPDT and OFD groups at follow-up. No significant overall mean difference was observed for GR depth (WMD = 0.02, 95% CI = -0.75 to 0.79, P = .95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD = 0.23, 95% CI = -0.09 to 0.55, P = .159, Figure 3A), PD reduction (WMD = 0.31, 95% CI = -0.67 to 1.31, P = .52, Figure 3B) and GR depth (WMD = -0.34, 95% CI = -2.47 to 1.78, P = .74, Figure 3C) were found to be significant between LI and OFD groups at follow-up. CONCLUSION With the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.
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Affiliation(s)
- Zohaib Akram
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | | | - Muhammad Omar Niaz
- Department of Community Dentistry, Foundation University College of Dentistry, Islamabad, Pakistan
| | - Anam Raza
- Department of Health Care Management, University College, University of Denver, Denver, CO, USA
| | - Mustafa Naseem
- College of Dentistry Research Center, King Saud University, Riyadh, Saudi Arabia
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Choi AN, Jang IS, Son SA, Jung KH, Park JK. Effect of erosive and abrasive stress on sealing ability of different desensitizers: In-vitro study. PLoS One 2019; 14:e0220823. [PMID: 31369650 PMCID: PMC6675100 DOI: 10.1371/journal.pone.0220823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/23/2019] [Indexed: 11/30/2022] Open
Abstract
This in vitro study examined the sealing ability of different desensitizing agents under a chemo-mechanical stress condition. For the study, a total of 144 extracted, caries-free human third molars were used to produce 1 mm-thick dentin discs. The specimens were divided randomly into four groups: Superseal (SS), Gluma (GL), Gluma Self-etch (GS), and Tooth Coat (TC). For each group, the permeability was measured before and after applying the desensitizer, after being exposed to Coca Cola for 5 minutes, and after 3150 strokes of a brushing abrasion. The decrease in permeability after the erosive and abrasive stress was analyzed by ANOVA and Tukey post hoc test. As a result, the dentin permeability decreased significantly for all desensitizers immediately after application (p < 0.05). SS and GS showed a significant difference in permeability reduction observed immediately after application and after acid action with Coca Cola (p < 0.05). After brushing abrasion, the permeability reduction decreased significantly for all desensitizers tested in this study (p < 0.05). TC showed the largest decrease in dentinal permeability compared to that of the other desensitizers and the differences were significant after brushing abrasion (p < 0.05). All tested desensitizers were effective in reducing dentin permeability. The behavioral characteristics under erosive and abrasive stress varied according to the products used. TC exhibited excellent sealing ability among the other desensitizers.
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Affiliation(s)
- An-Na Choi
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Il-Seok Jang
- Department of Microbiology, School of Natural Sciences, Pusan National University, Busan, Korea
| | - Sung-Ae Son
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Kyoung-Hwa Jung
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Jeong-Kil Park
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
- * E-mail:
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Calik Koseler B, Yilanci H, Ramoglu SI. Does audiovisual information affect anxiety and perceived pain levels in miniscrew application? - a within-person randomized controlled trial. Prog Orthod 2019; 20:29. [PMID: 31367995 PMCID: PMC6669226 DOI: 10.1186/s40510-019-0281-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety can cause difficulties during surgical procedures. The main objective of this study was to evaluate changes in patients' anxiety and perceived pain levels after receiving audiovisual and verbal information about miniscrew application. MATERIALS AND METHODS Eighty-eight patients (30 males and 58 females) with a mean age of 18.18 ± 5.39 years who had fixed orthodontic treatment and required miniscrew anchorage took part in this questionnaire-based randomized controlled trial. The participants were randomly allocated to two groups and either watched a video depicting miniscrew application (study group, 44 patients) or were informed verbally about the procedure (control group, 44 patients) before miniscrew placement. The audiovisual information was given via a video containing footage of local anesthesia injection, topical antiseptic application, and miniscrew insertion. The Spielberger State-Trait Anxiety Inventory (STAI) was used to measure anxiety immediately before miniscrew application. Self-drilling miniscrews (8 mm length, 1.5 mm diameter; Aarhus System Miniscrews, American Orthodontics, Washington, USA) were placed in posterior buccal interdental region. Each patient received only one miniscrew. Postoperative pain (PP) was determined using a 100-mm horizontal visual analog scale (VAS). RESULTS State and total anxiety scores were significantly higher in the study group than in the control group (p = 0.009 and p = 0.011 respectively). The mean PP scores (SD) for control and study groups were 12.86 (14.22) and 12.8 (16.22), respectively. The results of Mann-Whitney U test showed no significant difference (p > 0.05). Participants' PP scores did not have a significant effect on state, trait, or total anxiety scores. There was a weak but significant positive correlation between trait anxiety and state anxiety scores in both groups. CONCLUSION Using an audiovisual method to inform patients about miniscrew placement increased anxiety levels but did not affect pain perception.
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Affiliation(s)
| | - Hilal Yilanci
- Department of Orthodontics, Faculty of Dentistry, Medipol University, Bağcılar, 34214, Istanbul, Turkey.
| | - Sabri Ilhan Ramoglu
- Department of Orthodontics, Faculty of Dentistry, Altınbaş University, Istanbul, Turkey
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Askar H, Di Gianfilippo R, Ravida A, Tattan M, Majzoub J, Wang HL. Incidence and severity of postoperative complications following oral, periodontal, and implant surgeries: A retrospective study. J Periodontol 2019; 90:1270-1278. [PMID: 31177525 DOI: 10.1002/jper.18-0658] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/22/2019] [Accepted: 01/27/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Incidence and severity of postoperative complications are key elements in determining the risk-benefit relationship of any surgical procedure. The aim of this retrospective study was to assess and categorize the postoperative complications that occur following, and are associated with, oral, periodontal, and implant surgeries. METHODS A total of 3,900 patients who underwent surgical procedures including, but not limited to, sinus floor elevation, guided tissue regeneration, crown lengthening, implant placement, soft tissue graft, open flap debridement or surgical removal of impacted teeth were included. Postoperative complications were recorded and graded based on impedance to routine daily activity and favorable surgical outcomes. Regression models were generated to evaluate correlations between complication types, as well as between patient/surgical characteristics and the incidence of complications. RESULTS Surgical removal of impacted teeth and lateral sinus floor elevation had the highest incidence and severity of complications. Postoperative dentinal hypersensitivity (5.7%) was the most frequent complication, followed by excessive pain (4.1%), and moderate postoperative bleeding (3.5%). Based on the devised grading system described in this paper, the complications were 11.1% of Grade I, 3.3% of Grade II, 8.3% of Grade III, 0.1% of Grade IV, and no complications recorded under Grades V or VI. CONCLUSIONS Surgical removal of impacted teeth and lateral sinus floor elevation are more prone to more severe complications compared with other procedures. Additionally, complications that do not impede favorable surgical outcomes and/or routine daily activity are the most likely to occur. Smoking and diabetes are generally associated with postoperative complications.
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Affiliation(s)
- Houssam Askar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Andrea Ravida
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Mustafa Tattan
- Department of Periodontics and Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA
| | - Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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Lee JH, Park YS, Kim YT, Kim DH, Jeong SN. Assessment of early discomfort and wound healing outcomes after periodontal surgery with and without enamel matrix derivative: an observational retrospective case-control study. Clin Oral Investig 2019; 24:229-237. [DOI: 10.1007/s00784-019-02941-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/02/2019] [Indexed: 02/06/2023]
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Tocarruncho O, Espitia Robayo XA, Ibáñez Pinilla E, Ríos-Osorio NR. Comparison between 940 nm Laser Diode and Topical 5 % Potassium Nitrate for Tooth Desensitization. Randomized Controlled Clinical trial. ACTA ACUST UNITED AC 2018. [DOI: 10.11144/javeriana.uo37-79.cldt] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To compare the effectiveness of two dental desensitization therapies, 940 nm laser diode and potassium nitrate, in patients with dental hypersensitivity (DH) symptoms. Methods: This randomized clinical trial included 30 patients who initially underwent basic periodontal therapy and presented gingival recessions Class I and II (Miller 1985) with symptoms of DH. Subjects were randomly assigned into two groups. The first group (n = 15) received laser 940 nm application for 90 seconds on the surface of the recession and were given a tube of glycerin to be applied daily in order to avoid generating bias. Patients in the second group (n = 15) were exposed to inactive laser simulating the actual application of the laser, and they were given a desensitizing gel containing 0.5 g of potassium nitrate to be applied twice daily during 14 days. Controls were carried out at 15 minutes, 8 days, 15 days, and 4 weeks. Data obtained were filled out in an Excel table. For comparison between groups the Mann Whitney U and t student tests were used (p=0.05). Results: All patients involve in the study experienced reduction in DH (p<0.01) and differences between the two interventions performed. Conclusions: Laser and nitrate therapies were effective to manage DH after basic periodontal therapy. However, a statistically significant higher sensitivity reduction was observed in laser therapy group.
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Isler SC, Eraydin N, Akkale H, Ozdemir B. Oral flurbiprofen spray for mucosal graft harvesting at the palatal area: A randomized placebo-controlled study. J Periodontol 2018; 89:1174-1183. [DOI: 10.1002/jper.17-0381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 01/06/2018] [Accepted: 01/30/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Sila Cagri Isler
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Nihal Eraydin
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Habibe Akkale
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Burcu Ozdemir
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
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Evaluating the effect of photobiomodulation with a 940-nm diode laser on post-operative pain in periodontal flap surgery. Lasers Med Sci 2018; 33:1639-1645. [DOI: 10.1007/s10103-018-2492-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 03/21/2018] [Indexed: 12/15/2022]
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Beaudette JR, Fritz PC, Sullivan PJ, Piccini A, Ward WE. Investigation of factors that influence pain experienced and the use of pain medication following periodontal surgery. J Clin Periodontol 2018; 45:578-585. [PMID: 29500837 PMCID: PMC5969096 DOI: 10.1111/jcpe.12885] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 11/28/2022]
Abstract
Aims To determine the relationship between anticipated pain and actual pain experienced following soft tissue grafting or implant surgery; to identify the factors that predict actual pain experienced and the use of pain medication following soft tissue grafting or implant surgery. Materials and Methods Prior to dental implant placement (n = 98) or soft tissue grafting (n = 115) and for seven days following the procedure, patients completed a visual analog scale indicating anticipated or experienced pain, respectively. The use of pain medication and alcohol, and smoking were measured. Results Actual pain experienced on day 1 was lower (p < .01) than anticipated pain and continued to decrease (p ≤ .01) for each of the 7 consecutive days. Anticipated and actual pain were positively correlated. Increasing age (p < .05), having sedation during the surgery (p < .05), and lower use of pain pills (p < .01) predicted lower pain experienced. Actual pain experienced was a predictor of pain pill use (p < .01). Greater nervousness (p < .01) prior to surgery was a predictor of greater anticipated pain. Conclusions Patients anticipated more pain than they actually experienced. Sedation, age and number of pain pills used predicted pain experienced. This trial was registered with clinicaltrials.gov as NCT03064178.
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Affiliation(s)
| | - Peter C Fritz
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada.,Periodontal Wellness and Implant Surgery, Fonthill, ON, Canada
| | - Philip J Sullivan
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Assunta Piccini
- Periodontal Wellness and Implant Surgery, Fonthill, ON, Canada
| | - Wendy E Ward
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
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Tabibzadeh Z, Fekrazad R, Esmaeelnejad A, Shadkar MM, Khalili Sadrabad Z, Ghojazadeh M. Effect of combined application of high- and low-intensity lasers on dentin hypersensitivity: A randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2018; 12:49-55. [PMID: 29732021 PMCID: PMC5928474 DOI: 10.15171/joddd.2018.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 01/06/2018] [Indexed: 12/02/2022] Open
Abstract
Background. Diode lasers (DLs) have demonstrated equal or better desensitizing effects than fluoride varnish, 10% potas-sium nitrate (NK) gel and Gluma. The current study evaluated the desensitizing effect of combined application of DLs with two different output powers and compared it with single DL therapy. Methods. Sixty-two hypersensitive teeth were allocated randomly into two groups: the single group was treated with 3-W DL beam once and in the combined group, the teeth were irradiated three times (the first time with 0.2-W and then with 3-W and the second and third times, 48 and 96 hours after the baseline visit, with 0.2-W DL beams). The amount of dentin hyper-sensitivity (DH) was evaluated, immediately before and after each visit, and 1 week and 1 and 3 months after the first visit. Data analysis was performed using chi-squared test, repeated measurement of ANOVA and Mann-Whitney U test. P<0.05 was considered statistically significant. Results. Statistically significant changes were observed in the means of VAS indices between all the measurement intervals and pretreatment measures, in both experimental groups (P<0.001). The difference in VAS reduction among the groups was not significant when the hypersensitive teeth were stimulated by a periodontal probe and a jet of air (P=0.63 and P=0.12). Conclusion. The results of the present study showed that using both high-intensity and combined DL beams gives rise to significant reductions in DH. There was no significant difference between combined and single laser therapies in the treatment of tooth hypersensitivity.
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Affiliation(s)
- Zohreh Tabibzadeh
- Department of Periodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Department of periodontology, Dental Faculty-Laser research center in medical sciences, AJA university of medical sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Azadeh Esmaeelnejad
- Department of Periodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Khalili Sadrabad
- Department of Pedodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran
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Ahmadi M, Kiakojori A, Moudi S. Association of Anxiety with Pain Perception following Periodontal Flap Surgery. J Int Soc Prev Community Dent 2018; 8:28-33. [PMID: 29629326 PMCID: PMC5853039 DOI: 10.4103/jispcd.jispcd_385_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/18/2017] [Indexed: 01/22/2023] Open
Abstract
Aims and Objectives: Dental pain and anxiety are important factors that prevent patients from seeking dental care. The aim of this study was to assess the relationship between trait anxiety and state anxiety and also to determine the effects of age and sex on pain perception after periodontal flap surgery. Materials and Methods: In this descriptive-analytical study, 50 patients who need periodontal flap surgery were assessed in a private periodontal specialty clinic in Babol city. The amount of anxiety was measured by the Spielberger State-Trait Anxiety Inventory test, and visual analog scale scores were used for postsurgical pain perceptions in 7 times (immediately after surgery and days 1–6 after surgery). Data were analyzed and evaluated by SPSS V22.0 software (IBM, United States). Results: In the trait anxiety study, there was a significant difference in pain perception between different anxiety classes at times immediately after surgery, 1st day, and 2nd day after surgery (P < 0.05), and in the state anxiety study, there was a significant difference in pain perception between different anxiety classes at times immediately after surgery until the 5th day after surgery (P < 0.05). Furthermore, the results indicate that the pain perception in female was significantly higher than male, at times immediately after surgery, 3rd day, and 5th day after surgery (P < 0.05). However, there was no association between age and pain perception in different times (P > 0.05). Conclusions: Anxiety is associated with pain perception following periodontal flap surgery, and female experience more pain after surgery, whereas the amount of pain perception is not related to age.
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Affiliation(s)
- Maryam Ahmadi
- Student Research Committee, Babol university of Medical Sciences, Babol, I.R.Iran
| | - Amir Kiakojori
- Oral Health Research Center, Health Research Institute, Babol, I.R.Iran.,Department of Periodontics, School of Dentistry, Babol university of Medical Sciences, Babol, I.R.Iran
| | - Sussan Moudi
- Social Determinants of Health Research Center, Health Research Institute, Babol, I.R.Iran.,Department of Psychiatry, Babol university of Medical Sciences, Babol, I.R.Iran
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Fekrazad R, Chiniforush N, Kalhori K. All done procedure by laser in free gingival graft treatment: A case series study. J COSMET LASER THER 2018; 21:4-10. [PMID: 29451989 DOI: 10.1080/14764172.2017.1418518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
AIM This case series study evaluated the application of Er;Cr:YSGG laser for a free gingival graft procedure and the effect of low level laser therapy on post surgical pain and wound healing. CASES 6 cases with mucogingival problems needing free gingival grafts were selected. First, the recipient site was anesthetized and de-epithelialization was done with a Er;Cr:YSGG laser. After tracing the palatal donor site with the laser, the graft was harvested. For root modification of the recipient tooth, conditioning of the dentin was done by the same laser. The inner side of graft was trimmed by the laser before suturing at the recipient site. After final adaptation of the grafts and suturing process, the recipient and donor sites were irradiated by therapeutic laser for reduction of post surgical complications. RESULTS All patients reported the reduction in pain level after day 2 on donor and recipient site. Also, the wound healing was achieved after 14 days in all cases in donor site. CONCLUSION According to high surface absorbance, better incision, coagulation and application on both soft and hard tissues, Er;Cr:YSGG laser can be safe, minimally invasive manner and useful for all steps of the free gingival graft procedure.
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Affiliation(s)
- Reza Fekrazad
- a Department of Periodontology, Dental Faculty - Laser research center in medical Sciences, AJA University of Medical Sciences , International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN) , Tehran , Iran
| | - Nasim Chiniforush
- b Laser Research Center of Dentistry , Dentistry Research Institute, Tehran University of Medial Sciences , Tehran , Iran
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Raut CP, Sethi KS, Kohale B, Mamajiwala A, Warang A. Evaluation of diode laser and stannous fluoride in the treatment of root sensitivity after access flap surgery: Randomized controlled clinical trial. J Indian Soc Periodontol 2018; 22:158-163. [PMID: 29769771 PMCID: PMC5939024 DOI: 10.4103/jisp.jisp_2_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Postsurgical root sensitivity has always been an enigma to the periodontists. There is a plethora of evidence suggesting the presence of root sensitivity following periodontal flap surgical procedures. Thus, the aim of the present study was to compare and evaluate the effect of low-power diode lasers with and without topical application of stannous fluoride (SnF2) gel in the treatment of root sensitivity and also evaluate whether laser creates any placebo effect in the control group or not. Materials and Methods: Thirty patients participated in this study and 99 teeth were included. Root sensitivity was assessed for all groups with a Verbal Rating Scale (VRS). For each patient, the teeth were randomized into three groups. In the test Group I, sensitive teeth were treated with SnF2 and diode laser. In the test Group II, sensitive teeth were irradiated with laser only. In the control group, no treatment was performed. Results: The mean ± standard deviation (SD) score for VRS and Visual Analog Scale at baseline was not statistically significant (P > 0.05) between the three groups. After 15 min, statistical significant difference was seen in test Group I and test Group II, although no difference was found in the control group. At 15th day and 30th day, the mean ± SD scores were statistically significant (P < 0.05). Conclusion: Within the limitations of the study, it can be concluded that diode lasers alone and in combination with 0.4% SnF2 was effective in the treatment of root sensitivity after access flap surgery.
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Affiliation(s)
- Chetan Purushottam Raut
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Kunal Sunder Sethi
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Bhagyashree Kohale
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Alefiya Mamajiwala
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Ayushya Warang
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
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Schirmer C, Dos Santos GO, Rost JF, Ferreira MBC, Weidlich P. Factors associated with pain and analgesic consumption following non-surgical periodontal therapy under local anaesthesia and carried out by dental students. J Clin Periodontol 2017; 45:68-77. [PMID: 29078012 DOI: 10.1111/jcpe.12833] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2017] [Indexed: 11/26/2022]
Abstract
AIM Evaluate factors associated with pain and analgesic consumption following non-surgical periodontal therapy. MATERIALS AND METHODS The sample consisted of 218 patients with chronic periodontitis, submitted to non-surgical scaling and root planing under local anaesthesia at a public dental service in southern Brazil. The data collection instruments included a demographic questionnaire, as well as State-Trait Anxiety Inventory, Corah's Dental Anxiety Scale, Visual Analogue Scale, Numerical Rating Scale and Verbal Rating Scale. The presence and intensity of pain were evaluated at 2, 6, 12, 24 and 48 hr after scaling and root planing. RESULTS A total of 52.3% of the patients reported mild intensity pain at some point during the 48 hr after scaling and root planing with local anaesthesia. Smoking (PR = 1.47; 95% CI = 1.16-1.65), severe periodontal inflammation (PR = 1.31; 95% CI = 1.09-1.58) and dental anxiety (PR = 1.24; 95% CI = 1.03-1.49) were associated with postoperative pain after adjusting for age, gender and state and trait anxiety scores. Moreover, 46.8% of the subjects used analgesics at some time during the 48-hr follow-up period and dental anxiety was the only factor associated with postoperative analgesic use. CONCLUSIONS Smoking, severe periodontal inflammation and dental anxiety were identified as factors associated with pain after non-surgical scaling and root planing with local anaesthesia. Dental anxiety was also a factor associated with postoperative analgesic use.
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Affiliation(s)
- Caroline Schirmer
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Otero Dos Santos
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Júlia Franciele Rost
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Beatriz Cardoso Ferreira
- Department of Pharmacology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patrícia Weidlich
- Section of Periodontology, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Antoniazzi RP, Cargnelutti B, Freitas DN, Guimarães MB, Zanatta FB, Feldens CA. Topical intrapocket anesthesia during scaling and root planing: a randomized clinical trial. Braz Dent J 2016; 26:26-32. [PMID: 25672380 DOI: 10.1590/0103-6440201300131] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 11/24/2014] [Indexed: 12/18/2022] Open
Abstract
Although the use of injectable anesthesia prior to subgingival scaling and root planing (SRP) reduces pain, many patients report fear and prolonged numbness of adjacent tissues. The aim of the present study was to compare the effects of a eutectic mixture containing 25 mg/g of lidocaine and 25 mg/g of prilocaine, injectable 2% lidocaine, topical 2% benzocaine and a placebo substance on reducing pain during SRP. In this randomized, split-mouth, masked clinical trial, thirty-two patients presenting more than two teeth with probing depth and clinical attachment level ≥ 5 mm in at least 4 sextants were randomly allocated to four groups: EMLA(r); injectable 2% lidocaine; topical 2% benzocaine and placebo. Pain and discomfort were measured using a visual analogue scale (VAS) and verbal scale (VS). Repeated-measures analysis of variance and Poisson regression were used for analysis. Patient satisfaction with the anesthesia was determined at the end of each treatment session. VAS and VS scores did not differ between injectable 2% lidocaine and EMLA (p > 0.05) and both substances showed significantly better pain control compared to 2% benzocaine and placebo (p < 0.05). 93.7% and 81.2% of the individuals were satisfied with the injectable anesthetic and EMLA, respectively (p = 0.158). Dissatisfaction with benzocaine and placebo was approximately 10 times greater than injectable anesthesia (p = 0.001). In conclusion, EMLA showed an equivalent effect on pain control when compared to the injectable anesthesia and performed better than 2% benzocaine in SRP. Thus, EMLA is a viable anesthetic option during scaling and root planning, despite the frequent need for second application.
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Affiliation(s)
| | - Bruna Cargnelutti
- Dental School, Franciscan University Center, Santa Maria, RS, Brazil
| | - Daniela Napoleão Freitas
- Postgraduate Program in Dentistry, UFSM - Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Fabricio Batistin Zanatta
- Postgraduate Program in Dentistry, UFSM - Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Carlos Alberto Feldens
- Postgraduate Program in Dentistry, ULBRA - Lutheran University of Brazil, Canoas, RS, Brazil
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Mei CC, Lee FY, Yeh HC. Assessment of pain perception following periodontal and implant surgeries. J Clin Periodontol 2016; 43:1151-1159. [DOI: 10.1111/jcpe.12618] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Chih-Chun Mei
- Department of Periodontics; Section of Dentistry; LinKou Medical Center; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Fu-Ying Lee
- Department of Periodontics; Section of Dentistry; LinKou Medical Center; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Hwey-Chin Yeh
- Department of Periodontics; Section of Dentistry; LinKou Medical Center; Chang Gung Memorial Hospital; Taoyuan Taiwan
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40
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Bahammam MA, Kayal RA, Alasmari DS, Attia MS, Bahammam LA, Hassan MH, Alzoman HA, Almas K, Steffens JP. Comparison Between Dexamethasone and Ibuprofen for Postoperative Pain Prevention and Control After Surgical Implant Placement: A Double-Masked, Parallel-Group, Placebo-Controlled Randomized Clinical Trial. J Periodontol 2016; 88:69-77. [PMID: 27562219 DOI: 10.1902/jop.2016.160353] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Postoperative pain is a potential adverse side effect of oral surgeries, and attempts should be made to prevent or minimize it. This study compares efficacy of preemptive ibuprofen and dexamethasone protocols for pain prevention or control after surgical implant placement. METHODS This prospective, double-masked, parallel-group, placebo-controlled, randomized clinical trial included 117 patients with planned dental implant placement. Patients were assigned to receive one of three different protocols: 1) 600 mg ibuprofen 1 hour before surgery and another 600 mg 6 hours after the first dose; 2) 4 mg dexamethasone 1 hour before surgery and another 4 mg 6 hours after the first dose; or 3) placebo. Rescue medication (1,000 mg acetaminophen) was made available to each patient, and they were instructed to take it as necessary. Pain intensity was evaluated via a 101-point numeric rating scale and a visual analog scale, and discomfort was evaluated using a four-point verbal rating scale hourly for the first 8 hours after surgery and three times daily for the following 3 days. RESULTS Ibuprofen and dexamethasone significantly reduced pain (Kruskal-Wallis; P <0.05) up to 3 days after surgery and discomfort (P <0.05) up to 2 days after surgery compared with placebo treatment. Both treatments reduced the number of painkillers taken and increased time before the first painkiller was taken (P <0.01). CONCLUSION Steroidal dexamethasone is as effective as non-steroidal ibuprofen for preventing or controlling postoperative pain and discomfort after surgical implant placement.
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Affiliation(s)
- Maha A Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Rayyan A Kayal
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Dhafer S Alasmari
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Periodontology, Faculty of Dentistry, Qassim University, Qassim, Kingdom of Saudi Arabia
| | - Mai S Attia
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Periodontology, Faculty of Dentistry, Qassim University, Qassim, Kingdom of Saudi Arabia.,Radiology Department, Al Azhar University
| | - Laila A Bahammam
- Endodontics Department, Faculty of Dentistry, King Abdulaziz University
| | - Mona H Hassan
- Dental Public Health Department, Faculty of Dentistry, King Abdulaziz University.,Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Hamad A Alzoman
- Department of Periodontics and Community Dentistry, King Saud University College of Dentistry, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Almas
- Preventive Dental Science Department, University of Dammam College of Dentistry, Dammam, Kingdom of Saudi Arabia
| | - Joao Paulo Steffens
- Department of Stomatology, Federal University of Paraná, Curitiba, Paraná, Brazil
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41
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Wambier LM, de Geus JL, Chibinski ACR, Wambier DS, Rego RO, Loguercio AD, Reis A. Intra-pocket anaesthesia and pain during probing, scaling and root planing: a systematic review and meta-analysis. J Clin Periodontol 2016; 43:754-66. [PMID: 27097588 DOI: 10.1111/jcpe.12565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2016] [Indexed: 12/17/2022]
Abstract
AIM A systematic review/meta-analysis was performed to evaluate pain during probing, scaling and root planing using intra-pocket anaesthesia versus placebo in adult patients. METHODS A search was performed in PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library and Grey literature. IADR abstracts, unpublished trials registries, dissertations and theses were also searched for randomized clinical trials comparing the clinical effectiveness of intra-pocket anaesthesia and placebo. Risk/intensity of pain was the primary outcome. The risk of bias tool from the Cochrane Collaboration was used for quality assessment. Meta-analysis was performed on studies considered at low risk of bias. RESULTS A total of 1740 articles were identified. Eleven remained in the qualitative synthesis, and nine studies were considered at "low" risk of bias for meta-analysis. Standardized Hedge's g mean difference for pain intensity using visual analogue scale and Heft-Parker pain scales was -0.576 (95% confidence interval [CI] -0.94 to -0.22; p = 0.002) and for verbal rating scale pain scale it was -1.814 (95% CI -3.38 to -0.245; p = 0.023). The odds ratio for the risk of pain was 0.025 (95% CI 0.003 to 0.25; p = 0.002) and the odds ratio for the need for rescue anaesthesia it was 0.358 (95% CI 0.174 to 0.736; p = 0.005). CONCLUSIONS The anaesthetic gel decreases the risk and intensity of pain during probing/SRP.
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Affiliation(s)
- Letícia M Wambier
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Juliana L de Geus
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Ana C R Chibinski
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Denise S Wambier
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Rodrigo O Rego
- Department of Dentistry, Federal University of Ceará, Sobral, CE, Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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42
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Chang H, Noh J, Lee J, Kim S, Koo KT, Kim TI, Seol YJ, Lee YM, Ku Y, Rhyu IC. Relief of Injection Pain During Delivery of Local Anesthesia by Computer-Controlled Anesthetic Delivery System for Periodontal Surgery: Randomized Clinical Controlled Trial. J Periodontol 2016; 87:783-9. [PMID: 26991489 DOI: 10.1902/jop.2016.150448] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Pain from local anesthetic injection makes patients anxious when visiting a dental clinic. This study aims to determine differences in pain according to types of local anesthetizing methods and to identify the possible contributing factors (e.g., dental anxiety, stress, and sex). METHODS Thirty-one patients who underwent open-flap debridement in maxillary premolar and molar areas during treatment for chronic periodontitis were evaluated for this study. A randomized, split-mouth, single-masked clinical trial was implemented. The dental anxiety scale (DAS) and perceived stress scale (PSS) were administered before surgery. Two lidocaine ampules for each patient were used for local infiltration anesthesia (supraperiosteal injection). Injection pain was measured immediately after local infiltration anesthesia using the visual analog pain scale (VAS) questionnaire. Results from the questionnaire were used to assess degree of pain patients feel when a conventional local anesthetic technique (CNV) is used compared with a computer-controlled anesthetic delivery system (CNR). RESULTS DAS and PSS did not correlate to injection pain. VAS scores were lower for CNR than for CNV regardless of the order in which anesthetic procedures were applied. VAS score did not differ significantly with sex. Pearson coefficient for correlation between VAS scores for the two procedures was 0.80, also indicating a strong correlation. CONCLUSION Within the limitations of the present study, relief from injection pain is observed using CNR.
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Affiliation(s)
- Hyeyoon Chang
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Jiyoung Noh
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Jungwon Lee
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Young Ku
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - In-Chul Rhyu
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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43
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Franceschetti G, Rizzi A, Minenna L, Pramstraller M, Trombelli L, Farina R. Patient-reported outcomes of implant placement performed concomitantly with transcrestal sinus floor elevation or entirely in native bone. Clin Oral Implants Res 2016; 28:156-162. [PMID: 26749535 DOI: 10.1111/clr.12774] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/29/2022]
Abstract
AIM Based on the hypothesis that maxillary sinus floor elevation with a transcrestal approach (tSFE) does not increase the morbidity of implant surgery, the study evaluated the patient-reported outcomes as well as the type and incidence of complications when implants are placed either concomitantly with tSFE (performed according to Trombelli et al. 2008, 2010a,b) or entirely in native bone. METHODS Data from the record charts of patients undergone implant placement for single-tooth rehabilitation in the posterior maxilla were retrospectively obtained from four clinical centers. Cases for tSFE group were included if they showed an extent of sinus lift ≥4 mm concomitantly to implant placement. Cases for N group were included when implant placement was performed entirely in native bone. Patient-reported outcomes had been assessed using 100-mm visual analog scales (postoperative pain, VASpain ) and visual rating scales (level of discomfort, VRSdiscomfort ; willingness to undergo the same surgery, VRSwillingness ). The dose of analgesics had been self-recorded. RESULTS A convenience sample of 14 patients and 17 patients (contributing with one implant site each) treated with tSFE and N, respectively, was obtained for this study. Membrane perforation occurred in 1 tSFE case, without compromising the completion of the procedure. VASpain remained low (<12) in both groups. A tendency of VASpain to decrease with time was observed in both groups. The area under the curve for VASpain (AUCpain ), indicating the level of pain experience through the first week following surgery, was 18.0 (IR: 8.5-85.0) and 11.5 (IR: 4.5-18.5) in tSFE and N groups, respectively, with no significant inter-group differences (P = 0.084). The dose of analgesics was similarly low between groups. No significant inter-group difference in VRSdiscomfort and VRSwillingness was observed. CONCLUSIONS Implant placement performed either concomitantly with tSFE (according to Trombelli et al. 2008, 2010a,b) or entirely in native bone is associated with limited incidence of complications, low postoperative pain and medication and are both well tolerated.
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Affiliation(s)
- Giovanni Franceschetti
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Alessandro Rizzi
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Luigi Minenna
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Mattia Pramstraller
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital 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, University-Hospital of Ferrara, Ferrara, Italy
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44
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Patient perceived burden of implant placement compared to surgical tooth removal and apicectomy. J Dent 2015; 43:1456-61. [DOI: 10.1016/j.jdent.2015.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 09/29/2015] [Accepted: 10/15/2015] [Indexed: 11/23/2022] Open
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45
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Ali S, Farooq I, Khan SQ, Moheet IA, Al-Jandan BA, Al-Khalifa KS. Self-reported anxiety of dental procedures among dental students and its relation to gender and level of education. J Taibah Univ Med Sci 2015. [DOI: 10.1016/j.jtumed.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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46
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47
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Konuganti K, Rangaraj M, Elizabeth A. Pre-emptive 8 mg dexamethasone and 120 mg etoricoxib for pain prevention after periodontal surgery: A randomised controlled clinical trial. J Indian Soc Periodontol 2015; 19:474-6. [PMID: 26392703 PMCID: PMC4555812 DOI: 10.4103/0972-124x.153475] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 02/02/2015] [Indexed: 11/24/2022] Open
Abstract
Several anti-inflammatory drugs have been used to reduce pain and discomfort after periodontal surgeries. This study evaluates the efficacy of using etoricoxib and dexamethasone for pain prevention after open-flap debridement surgery. In this study, 60 patients who were undergoing open flap debridment surgery were randomly assigned to receive a single dose preoperative medication 1 hour prior to surgery. The patients were divided into three groups. In Group 1, 20 patients were given placebo drug orally. In Group 2, 20 patients were given 8 mg Dexamethasone orally and in Group 3, 20 patients were given 120 mg Etoricoxib orally. Patients were instructed to complete a pain diary hourly for the first 8 hours after each surgery and three times a day on the following 3 days. The four point verbal rating scale (VRS 4) and Numerical rate scale were used to assess discomfort. Post-operative Assessment of Pain and Discomfort showed that persistent discomfort and pain were found to be more in the placebo group compared to dexamethasone and etoricoxib group. The adoption of a preemptive medication protocol using either etoricoxib or dexamethasone may be considered effective for pain and discomfort prevention after open-flap debridement surgeries.
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Affiliation(s)
- Kranti Konuganti
- Department of Periodontics, M. S. Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - Mani Rangaraj
- Department of Periodontics, M. S. Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - Anjana Elizabeth
- Department of Periodontics, M. S. Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
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48
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Chandna S, Kedige SD. Evaluation of pain on use of electrosurgery and diode lasers in the management of gingival hyperpigmentation: A comparative study. J Indian Soc Periodontol 2015; 19:49-55. [PMID: 25810593 PMCID: PMC4365157 DOI: 10.4103/0972-124x.145823] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 02/13/2014] [Indexed: 11/30/2022] Open
Abstract
Background: Gingival depigmentation is a periodontal plastic surgical procedure whereby the gingival hyperpigmentation is removed by various techniques such as electrosurgery, cryosurgery, abrasion with diamond bur and lasers. The aim of this study was to determine the pain levels during the gingival depigmentation procedure using electrosurgery and lasers. Materials and Methods: Twenty patients, both male and female, between the ages of 20 and 40 years were randomly allocated into two groups of 10 patients each: Those undergoing depigmentation with electrosurgery (Group I) and those by diode lasers (Group II). Patients of both groups were asked to define the level of pain and discomfort by using the Visual Analog Scale (VAS) intraoperatively, 24 h post-operatively and 1 week post-operatively. Results: Both the groups showed a decrease in the pain levels, which was statistically highly significant 1 week post-operatively when compared 24 h post-operatively. There was a statistically highly significant difference in the pain levels between the electrosurgery and the lasers groups after 24 h (P < 0.001), with the lasers group demonstrating lesser pain and discomfort. Although there was no significant difference between the two groups intraoperatively and 1 week post-operatively on comparison, lesser mean scores were observed for the lasers group. Conclusion: The growing concern for esthetic requires the removal of hyperpigmentated gingival areas to create a confident and pleasant smile, which could be easily attained by using either electrosurgery or lasers. This study concluded that lasers produce lesser pain and discomfort compared with electrosurgery during gingival depigmentation.
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Affiliation(s)
- Shalu Chandna
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Haryana, India
| | - Suresh Dyamappa Kedige
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Haryana, India
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49
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Bühler J, Amato M, Weiger R, Walter C. A systematic review on the patient perception of periodontal treatment using air polishing devices. Int J Dent Hyg 2015; 14:4-14. [DOI: 10.1111/idh.12119] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J Bühler
- Department of Periodontology, Endodontology and Cariology; School of Dental Medicine; University of Basel; Basel Switzerland
| | - M Amato
- Department of Periodontology, Endodontology and Cariology; School of Dental Medicine; University of Basel; Basel Switzerland
| | - R Weiger
- Department of Periodontology, Endodontology and Cariology; School of Dental Medicine; University of Basel; Basel Switzerland
| | - C Walter
- Department of Periodontology, Endodontology and Cariology; School of Dental Medicine; University of Basel; Basel Switzerland
- Department of Oral Surgery; School of Dentistry; University of Birmingham; Birmingham UK
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50
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Doshi S, Jain S, Hegde R. Effect of Low-Level Laser Therapy in Reducing Dentinal Hypersensitivity and Pain Following Periodontal Flap Surgery. Photomed Laser Surg 2014; 32:700-6. [DOI: 10.1089/pho.2014.3802] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Shreya Doshi
- Department of Periodontics, M. A. Rangoonwala Dental College and Research Centre, Pune, India
| | - Sanjay Jain
- Department of Periodontics, M. A. Rangoonwala Dental College and Research Centre, Pune, India
| | - Rashmi Hegde
- Department of Periodontics, M. A. Rangoonwala Dental College and Research Centre, Pune, India
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