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Wright HN, Mayer ET, Lallier TE, Maney P. Utilization of a periodontal endoscope in nonsurgical periodontal therapy: A randomized, split-mouth clinical trial. J Periodontol 2023; 94:933-943. [PMID: 36861468 DOI: 10.1002/jper.22-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/25/2023] [Accepted: 02/20/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND The removal of subgingival calculus to obtain gingival health is an integral part of nonsurgical periodontal therapy. The periodontal endoscope is used by some clinicians to help enhance access to effectively remove subgingival calculus; however, longer-term studies on this subject are still lacking. The purpose of this randomized, controlled clinical trial was to compare the clinical outcomes of scaling and root planing (SRP) using a periodontal endoscope versus conventional SRP using loupes for up to 12 months, utilizing a split-mouth design. METHODS Twenty-five patients were recruited who exhibited generalized stage II or stage III periodontitis. SRP was rendered by the same experienced hygienist using either a periodontal endoscope or conventional SRP using loupes, following random assignment of the left and right halves of the mouth. All periodontal evaluations were done by the same periodontal resident at baseline, and at 1, 3, 6, and 12 months after therapy. RESULTS Single-rooted teeth interproximal sites displayed a significantly lower percentage of improved sites (P < 0.05) than multirooted teeth for probing depth and clinical attachment level (CAL). Maxillary multirooted interproximal sites favored the use of the periodontal endoscope at the 3- and 6-month time periods (P = 0.017 and 0.019, respectively) in terms of the percentage of sites with improved CAL. Mandibular multirooted interproximal sites showed more sites with improved CAL using conventional SRP than with the periodontal endoscope (P < 0.05). CONCLUSION Overall, the use of a periodontal endoscope was more beneficial in multirooted sites compared to single-rooted sites, specifically in maxillary multirooted sites.
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Affiliation(s)
- Hillary N Wright
- Department of Periodontics, Louisiana State University Health New Orleans School of Dentistry, New Orleans, Louisiana, USA
| | - Elizabeth T Mayer
- Department of Periodontics, Louisiana State University Health New Orleans School of Dentistry, New Orleans, Louisiana, USA
| | - Thomas E Lallier
- Department of Cell Biology and Anatomy, Louisiana State University Health New Orleans School of Medicine, New Orleans, Louisiana, USA
| | - Pooja Maney
- Department of Periodontics and Dental Hygiene, University of Texas Health, Science Center at Houston School of Dentistry, Houston, Texas, USA
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Verma V, Ojha M, Yadav S, Ranjan M, Hassan S, Dhull KS. Effectiveness of Diode Lasers in the Reduction of Bacteremia Associated with Ultrasonic Scaling: A Clinical and Microbiological Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S1308-S1310. [PMID: 37694063 PMCID: PMC10485482 DOI: 10.4103/jpbs.jpbs_108_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction As is known, periodontal pathogens and their products as well as inflammatory mediators produced in periodontal tissues might enter the bloodstream, causing systemic effects and/or contributing to systemic diseases. Aim To evaluate the effect of diode lasers on the incidence of bacteremia associated with ultrasonic scaling and its clinical efficacy as an adjunct to scaling in the treatment of moderate periodontitis. Result The use of diode laser is more effective in killing or detoxifying periodontopathic bacteria such as P. gingivalis associated with chronic periodontitis as compared to ultrasonic alone with ablate bacteria only when it comes in contact with plaque biofilm directly. Conclusion The results of study confirm the previously reported findings that bacteremia is caused by ultrasonic scaling and adjunct use of diode laser with scaling has the potential to reduce the bacteremia associated with ultrasonic scaling alone.
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Affiliation(s)
- Vartika Verma
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Moitri Ojha
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sweta Yadav
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Maitreyi Ranjan
- Department of Microbiology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Sahba Hassan
- Department of Prosthodontics and Crown and Bridge, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Kanika S. Dhull
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
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Adjunctive Nd:YAG laser irradiation in the treatment of stage III/IV periodontitis: a 12-month, randomized, controlled trial. Clin Oral Investig 2023:10.1007/s00784-023-04908-4. [PMID: 36795248 DOI: 10.1007/s00784-023-04908-4] [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: 08/10/2022] [Accepted: 02/03/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical efficacy of the adjunctive use of Nd:YAG laser (1064 nm) to full-mouth scaling and root planning (FMS), in stage III/IV periodontitis patients. MATERIALS AND METHODS Sixty stage III/IV periodontitis patients were randomly assigned to three groups. The control group received FMS, laser 1 group received combined FMS/single Nd:YAG laser irradiation (3 W, 150 mJ, 20 Hz,100 μs), and laser 2 group received combined FMS/double Nd:YAG laser irradiation with 1-week interval (2.0 W, 200 mJ, 10 Hz, 100 μs). PD, CAL, FMPS, GI, FMBS, and GR were evaluated at baseline, 6 weeks, 3, 6, and 12 months after treatment. Patient-reported outcomes were evaluated 1 week after treatment. RESULTS A significant improvement (p < 0.001) for all clinical parameters was observed during the entire study period, with the exception of mean CAL gain for the laser 2 group at 12 months. The percentage of pockets ≤ 4 mm was significantly higher compared to baseline for all groups throughout the study, with no inter-group differences at any time point. Patient-reported analgesic consumption was higher for laser 1 group. CONCLUSIONS The adjunctive use of Nd:YAG laser irradiation was similarly effective to FMS alone, during the entire study period. A slightly higher, though not statistically significant improvement was reported for PD at 6 and 12 months after a single post-FMS application of Nd:YAG laser for pocket epithelium removal and coagulation. CLINICAL RELEVANCE Additional Nd:YAG laser application for sulcular epithelium removal and coagulation may provide minor long-term improvements compared to FMS or laser irradiation for pocket disinfection and detoxification. TRIAL REGISTRATION ISRCTN26692900. Registration date: 09/06/2022.
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Calculus as a Risk Factor for Periodontal Disease: Narrative Review on Treatment Indications When the Response to Scaling and Root Planing Is Inadequate. Dent J (Basel) 2022; 10:dj10100195. [PMID: 36286005 PMCID: PMC9600378 DOI: 10.3390/dj10100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Based on the 2018 classification of periodontal disease, a series of articles have been published describing the decision points of periodontal therapy and how the findings collected at those decision points can be used as guidelines for periodontal therapy. The articles are reviewed with a focus on the finding of inadequate calculus removal at the decision points and how that finding impacts treatment outcomes. Methods: A narrative review of the literature discussing the influence of calculus on inflammation was performed and the effects of inadequate removal of calculus during periodontal therapy were analyzed in light of the 2018 classification of periodontal disease, the decision points of periodontal therapy, and the guidelines of periodontal therapy. Results: The published literature supports that calculus is a major risk factor for periodontal inflammation. Recent studies indicate that the pathologic risk of calculus goes beyond the retention of biofilm and may represent a different pathophysiologic pathway for periodontal disease separate from the direct action of biofilm. The inadequate removal of calculus is a factor in the failure of periodontal therapy. Conclusions: The inadequate removal of calculus plays an important role in the frequent failure of non-surgical periodontal therapy to eliminate inflammation.
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Shin SJ, Moon SH, Kim HJ, Oh SH, Bae JM. Oral Microbiome Using Colocasia antiquorum var. esculenta Extract Varnish in a Mouse Model with Oral Gavage of P. gingivalis ATCC 53978. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58040506. [PMID: 35454345 PMCID: PMC9029942 DOI: 10.3390/medicina58040506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022]
Abstract
Background and Objective: There is increasing interest in preventing periodontitis using natural products. The purpose of this study was to investigate the effect of Colocasia antiquorum var. esculenta (CA) varnish on the oral microbiome and alveolar bone loss in a mouse periodontitis model. Materials and Methods: Antibacterial activity against Porphyromonas gingivalis (P. gingivalis) ATCC 53978 and cell cytotoxicity using CCK-8 on L929 cells were measured. Balb/c mice were assigned into five groups (negative control, positive control, CA in drinking water, varnish, and CA varnish). P. gingivalis was administered to the mice by oral gavage three times. After sacrifice, the oral microbiome and the levels of the inflammatory cytokine IL-1β and matrix metalloproteinase-9 were analyzed. Alveolar bone loss was measured using micro-computed tomography. Results: CA extract showed an antibacterial effect against P. gingivalis (p < 0.05) and showed no cytotoxicity at that concentration (p > 0.05). Although alpha diversity of the oral microbiome did not statistically differ between the groups (p > 0.05), the relative abundance of dominant bacteria tended to be different between the groups. The inflammatory cytokine IL-1β was reduced in the CA varnish group (p < 0.05), and no difference was observed in MMP-9 expression and alveolar bone loss (p > 0.05). Conclusions: CA varnish did not affect the overall microflora and exhibited an anti-inflammatory effect, suggesting that it is possibility a suitable candidate for improving periodontitis.
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Affiliation(s)
- Seong-Jin Shin
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea; (S.-J.S.); (S.-H.O.)
| | - Seong-Hee Moon
- Institute of Biomaterials and Implant, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea; (S.-H.M.); (H.-J.K.)
| | - Hyun-Jin Kim
- Institute of Biomaterials and Implant, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea; (S.-H.M.); (H.-J.K.)
- Department of Oral Anatomy, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea
| | - Seung-Han Oh
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea; (S.-J.S.); (S.-H.O.)
- Institute of Biomaterials and Implant, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea; (S.-H.M.); (H.-J.K.)
| | - Ji-Myung Bae
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea; (S.-J.S.); (S.-H.O.)
- Institute of Biomaterials and Implant, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Jeonbuk, Korea; (S.-H.M.); (H.-J.K.)
- Correspondence: ; Tel.: +82-63-850-6859
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Abstract
Technological innovations in cellular and molecular aspects of tissue engineering --scaffolds, stem cells and 3D printed tissues --have been dramatically increased in the last decade. However, regenerative treatment still has challenges in translation to clinic. This is partly due to failure of addressing an essential element of wound healing, inflammation. It is now well-recognized that inflammation is an active process. This paradigm shift opened up a new avenue of therapeutic approaches called "host-modulation." Host-modulation therapies capable of modulating inflammatory response at multiple levels and mimicking the natural sequence of wound healing offer a new direction and promising clinical translation.
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Citterio F, Gualini G, Chang M, Piccoli GM, Giraudi M, Manavella V, Baima G, Mariani GM, Romano F, Aimetti M. Pocket closure and residual pockets after non-surgical periodontal therapy: A systematic review and meta-analysis. J Clin Periodontol 2021; 49:2-14. [PMID: 34517433 PMCID: PMC9298904 DOI: 10.1111/jcpe.13547] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
Aim To analyse the efficacy of non‐surgical therapy (NST) in terms of pocket closure (PC) and changes in percentage and number of pockets. Materials and Methods Three databases (PubMed, EMBASE, and Scopus) were searched up to January 2020. Prospective studies with a minimum follow‐up of 12 months and presenting data in terms of PC or number or percentage of pocket depths (PDs) before and after NST on systemically healthy patients were included. Random‐effect meta‐analyses were performed. Results After screening 4610 titles and abstracts, 27 studies were included. Of these, 63.9% of PC was reported by one study. The percentage of PDs ≤3 mm changed from 39.06% to 64.11% with a weighted mean difference (WMD) of 26.14% (p < .001). This accounted for a relative increase of healthy sites of 64.13%. The mean percentage of PD ≥5 mm was 28.23% and 11.71% before and after treatment, respectively, with a WMD of 15.50% (p < .001). The WMD in the number of PDs ≥5 mm before and after treatment was 24.42 (p = .036). The mean number of residual PPD ≥5 after NST was 14.13. Conclusions NST is able to eradicate the majority of the pockets. However, residual pockets after NST may remain and should be considered cautiously for further treatment planning.
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Affiliation(s)
- Filippo Citterio
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Giacomo Gualini
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Moontaek Chang
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy.,Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, South Korea.,Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Gian Marco Piccoli
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Marta Giraudi
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Valeria Manavella
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Giacomo Baima
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Giulia Maria Mariani
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Federica Romano
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Mario Aimetti
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
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Xu YJ, Zhao L, Wu YF, Duan DY. Clinical study of periodontal endoscope-assisted subgingival scaling in the treatment of residual pocket. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:441-446. [PMID: 34409800 PMCID: PMC8381116 DOI: 10.7518/hxkq.2021.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/09/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets. METHODS A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared. RESULTS A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (P<0.001). For sites in a single-rooted tooth, sites with PD≥5 mm, and sites without vertical alveolar bone resorption and furcation involvement, the PD in endoscopy group was significantly lower than that in the control group at 6 weeks and 3 months after treatment (P<0.05). CONCLUSIONS Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.
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Affiliation(s)
- Yu-Juan Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ya-Fei Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ding-Yu Duan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Wang D, Pan H, Yan Y, Zhang F. Rose bengal-mediated photodynamic inactivation against periodontopathogens in vitro. Photodiagnosis Photodyn Ther 2021; 34:102250. [PMID: 33711535 DOI: 10.1016/j.pdpdt.2021.102250] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/25/2021] [Accepted: 03/05/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The main goal of periodontal therapy is to eliminate the spread of infection in the periodontium. Antimicrobial photodynamic therapy (aPDT) is a bactericidal method that has been recently introduced for controlling periodontal infection. The aim of this in vitro study was to evaluate the effect of aPDT using a combination of medium-power blue light-emitting diodes (LEDs) and rose bengal (RB) on selected key periodontopathogens. METHODS Porphyromonas gingivalis ATCC33277, Aggregatibacter actinomycetemcomitans ATCC29523 and Fusobacterium nucleatum ATCC10953 were used in the experiments. Each bacterial suspension was irradiated with a blue LED (BL) (450-470 nm, output power density of 1.2 W/cm2) for 20-60 s (6-18 J/cm2), treated with RB (1 min), or subjected to a combination of RB treatment and BL irradiation (40 s, 12 J/cm2). All bacterial suspensions were serially diluted, plated and incubated anaerobically or microaerobically, and the numbers of colony-forming units (CFUs) were counted on day 7. One-way analysis of variance (ANOVA) and Tukey's HSD tests were used for statistical analysis. RESULTS Treatment with BL irradiation from 6 to 18 J/cm2 did not significantly reduce the number of CFUs, whereas treatment with RB alone induced a low-to-high reduction in the bacterial CFUs in a dye concentration-dependent manner. Furthermore, the difference in the effects obtained with 16 μg/mL and 160 μg/mL RB was not statistically significant. Treatment with the BL at 12 J/cm2 combined with 160 μg/mL RB yielded maximal log reductions of 3.03, 4.2 and 2.23 in P. gingivalis, A. actinomycetemcomitans and F. nucleatum CFUs, respectively. CONCLUSION Within the limits of this study, the three periodontal pathogens, especially A. actinomycetemcomitans, were susceptible to photodynamic inactivation by the combination of the BL and RB. RB-mediated aPDT may offer a viable alternative tool for periodontal pathogen treatment, especially for A. actinomycetemcomitans eradication. aPDT may be a valuable tool for the treatment of periodontal diseases, particularly those in which A. actinomycetemcomitans is a dominating pathogen.
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Affiliation(s)
- Dongqing Wang
- VIP Clinic and Multi-Disciplinary Treatment Center, Beijing Stomatological Hospital & School of Stomotology, Capital Medical University, Beijing, China.
| | - Hui Pan
- Department of Periodontology, Beijing Stomatological Hospital & School of Stomotology, Capital Medical University, Beijing, China
| | - Yuwei Yan
- Department of Implantology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Fengqiu Zhang
- Department of Periodontology, Beijing Stomatological Hospital & School of Stomotology, Capital Medical University, Beijing, China
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10
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Cobb CM, Sottosanti JS. A re-evaluation of scaling and root planing. J Periodontol 2021; 92:1370-1378. [PMID: 33660307 DOI: 10.1002/jper.20-0839] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/11/2021] [Accepted: 02/25/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Extensive reviews on the role of scaling and root planing (SRP) in the treatment of periodontitis have been previously published. This commentary will address the importance of subgingival calculus in the progression and treatment of periodontitis and addresses factors that make the execution of a "definitive" SRP a critical part of therapy. METHODS A search for articles, using keywords relevant to the subject , (e.g., periodontitis, dental scaling, root planing, dental calculus, biofilm, inflammation) was conducted using PubMed, Ovid Medline, Cochrane Reviews and the ADA Center for Evidence Based Dentistry data bases. Additionally, references cited in relevant articles were also considered. RESULTS Surfaces of subgingival calculus are covered with a biofilm of metabolically active bacteria. Periodontal inflammation is clearly related to the presence of calculus and biofilm. The primary goal of SRP is removal of subgingival calculus and biofilm deposits to create a biologically compatible root surface and reduce the inflammatory burden. Current evidence suggests that inflammation associated with periodontal infections affects both the immediate oral environment and the patient's systemic health. CONCLUSION SRP is still critical to the treatment of periodontitis. SRP involving deep probing depths (≥ 5 mm) and root surfaces with anatomical and surface irregularities, regardless of the type of instrumentation, requires time, exceptional skill and perseverance, and patient compliance with periodontal maintenance. Sites with persistent nonresponding probing depths and signs of inflammation following a definitive SRP, should be considered for surgical intervention.
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Affiliation(s)
- Charles M Cobb
- Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, 64108
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11
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Zafar F, Romano F, Citterio F, Ferrarotti F, Dellavia C, Chang M, Aimetti M. Chemical cleansing as an adjunct to subgingival instrumentation with ultrasonic and hand devices in deep periodontal pockets: a randomized controlled study. J Periodontal Implant Sci 2021; 51:276-284. [PMID: 34387047 PMCID: PMC8367643 DOI: 10.5051/jpis.2007080354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/17/2021] [Accepted: 04/12/2021] [Indexed: 01/25/2023] Open
Abstract
Purpose The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm. Conclusions The additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.
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Affiliation(s)
- Fahad Zafar
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Francesco Ferrarotti
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Moontaek Chang
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy.,Department of Periodontology, Institute of Oral Bioscience, Jeonbuk National University School of Dentistry, Jeonju, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
| | - Mario Aimetti
- Department of Surgical Sciences, University of Turin C.I.R. Dental School, Turin, Italy
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Sanz‐Sánchez I, Montero E, Citterio F, Romano F, Molina A, Aimetti M. Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta‐analysis. J Clin Periodontol 2020; 47 Suppl 22:282-302. [DOI: 10.1111/jcpe.13259] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Ignacio Sanz‐Sánchez
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group University Complutense Madrid Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group University Complutense Madrid Spain
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
| | - Ana Molina
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group University Complutense Madrid Spain
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School University of Turin Turin Italy
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Factors affecting decision making at reassessment of periodontitis. Part 3: interpretation of clinical findings - local factors. Br Dent J 2019; 227:869-874. [PMID: 31758121 DOI: 10.1038/s41415-019-0941-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper is the third in a four-part series outlining treatment planning at periodontal reassessment. The first article focused on the information that should be gathered at the reassessment appointment. The second article discussed systemic factors that can relate to residual periodontal probing depths. This article outlines local factors that need to be assessed when faced with residual periodontal probing depths. Treatment can involve a range of non-surgical and surgical approaches. A variety of general, practical and local site factors can affect the choice of one option over another in choosing the most predictable treatment option.
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Influence of Adjacent Teeth Absence or Extraction on the Outcome of Non-Surgical Periodontal Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224344. [PMID: 31703336 PMCID: PMC6888517 DOI: 10.3390/ijerph16224344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/26/2022]
Abstract
Background: Extraction of periodontally compromised or strategically non-important teeth is often an integral part of non-surgical periodontal treatment (NSPT). This study evaluated the association between the status of adjacent teeth and the outcome of NSPT on molars. Methods: Charting data of patients with generalized chronic periodontitis receiving NSPT in 2012–2014 were included. The association between initial clinical parameters and significant clinical improvement, including the reductions of probing pocket depth (PPD) and clinical attachment loss (CAL), in molar teeth with severe periodontitis after NSPT was assessed by a generalized linear model and logistic regression. Results: ≥7 mm PPD and <2 mm gingival recession (REC) at the tooth level, and ≥7 mm PPD, ≥7 mm CAL and <2 mm REC at the site level, were associated with significant clinical improvement. Absence or extraction of an adjacent tooth achieved an additional 0.22–0.23 mm and 0.60–0.83 mm clinical improvement. Among the interproximal sites, ≥7 mm PPD, <2 mm REC, ≥7 mm CAL, <Degree II furcation involvement, and absence of an adjacent tooth were associated with significant clinical improvement. Conclusion: Absence or extraction of teeth during NSPT significantly improves the PPD and CAL of the adjacent periodontal sites of molars.
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Macrophage response and surface analysis of dental cementum after treatment with high intensity focused ultrasound. Arch Oral Biol 2019; 98:195-203. [DOI: 10.1016/j.archoralbio.2018.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/16/2018] [Accepted: 10/17/2018] [Indexed: 01/20/2023]
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Chandra S, Shashikumar P. Diode Laser - A Novel Therapeutic Approach in the Treatment of Chronic Periodontitis in Type 2 Diabetes Mellitus Patients: A Prospective Randomized Controlled Clinical Trial. J Lasers Med Sci 2018; 10:56-63. [PMID: 31360370 DOI: 10.15171/jlms.2019.09] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Maturity-onset diabetes mellitus affecting the elderly population is marked by insulin resistance and decreased insulin production. The relationship between periodontitis and diabetes is bidirectional. Type 2 diabetic patients are more prone to chronic periodontitis (CP) and severe periodontitis affects the glycemic control in such patients. Recently, dental diode laser has become an effective tool in controlling CP. To date, very few studies have been conducted to check the efficacy of diode laser in control of periodontal destruction in type 2 diabetes mellitus (DM2) patients. Hence, the need of the study was to evaluate whether diode laser helps improvement of periodontal outcome and reduction in anaerobic bacteria in elderly diabetic patients with CP. Methods: Forty DM2 patients with CP were randomized into group A (control): scaling and root planing (SRP) only and group B (test): SRP followed by soft tissue dental diode laser (808 nm) application. Four patients (2 in each group) were lost during follow up. Clinical parameters, plaque samples and glycated hemoglobin levels were evaluated at both baseline and 90 days post-treatment. Results: Improvement in clinical, microbiological and glycemic parameters were noted in the group that received SRP as well as SRP + LANAP (laser-assisted new attachment procedure). The reductions in clinical parameters were statistically significant after 3 months (P<0.001). The microbial analysis of plaque samples for Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) decreased significantly after 3 months in group B than in group A. Glycated hemoglobin level (HbA1c) decreased significantly after 90 days in both the groups (P<0.001) with more reduction in the SRP+LANAP group (6.49%) in comparison to SRP alone (16.25% vs. 9.76%). However, on the intergroup comparison, the difference in HbA1c reduction was nonsignificant. Conclusion: Laser as an adjunct to SRP is an effective procedure for improving clinical and microbiological parameters in maturity onset diabetes mellitus patients with CP. Also, there was a better improvement in glycemic control in the test group compared to control group after 3 months. Hence, medically compromised patients like DM2 with CP with delayed wound healing can effectively be treated by laser as an adjunct to nonsurgical periodontal therapy for better results.
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Affiliation(s)
- Sourav Chandra
- Department of Periodontology & Implantology, Hazaribag College of Dental Sciences & Hospital, Hazaribag, Jharkhand825301, India
| | - Pratibha Shashikumar
- Department of Periodontology, JSS Dental College & Hospital (Constituent College), Jagadguru Sri Shivarathreeshwara University, Mysuru- 570015, Karnataka, India
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Kozlovsky A, Rapaport A, Artzi Z. Influence of operator skill level on the clinical outcome of non-surgical periodontal treatment: a retrospective study. Clin Oral Investig 2018; 22:2927-2932. [DOI: 10.1007/s00784-018-2380-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 02/06/2018] [Indexed: 12/16/2022]
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Cobb CM. Lasers and the treatment of periodontitis: the essence and the noise. Periodontol 2000 2017; 75:205-295. [DOI: 10.1111/prd.12137] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Goh EX, Tan KS, Chan YH, Lim LP. Effects of root debridement and adjunctive photodynamic therapy in residual pockets of patients on supportive periodontal therapy: A randomized split-mouth trial. Photodiagnosis Photodyn Ther 2017; 18:342-348. [PMID: 28366818 DOI: 10.1016/j.pdpdt.2017.03.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The study aims to compare the effects of adjunctive photodynamic therapy (PDT) with scaling and root debridement alone on periodontal parameters and inflammatory cytokines in residual pockets of patients undergoing maintenance therapy. METHODS 27 subjects, each with at least 2 residual pockets ≥5mm, were recruited for this randomized, split-mouth controlled trial, providing total of 72 sites. Probing pocket depth (PPD), recession, clinical attachment loss (CAL), plaque and bleeding on probing of all sites were examined at baseline, 3 and 6 months. Gingival crevicular fluids (GCFs) were collected to determine levels of IL-1β, IL-6, IL-8, TNF-α and MMP-8 via enzyme-linked immunosorbent assay. At baseline, all sites received subgingival instrumentation and polishing. In addition, test sites received a single application of PDT using Fotosan® with toluidine blue O solution photosensitizer. At 3 and 6 months, site level analysis was performed for changes in clinical parameters and cytokine level. RESULTS Based on mixed model analysis, at 3 months, test sites showed significant reduction in CAL (p=0.016) and PPD (p=0.027) (from 6.14±0.28mm to 5.49±0.20mm and 5.42±0.16mm to 4.65±0.18mm respectively) compared to control sites (from 6.32±0.24mm to 6.08±0.17mm and 5.32±0.13mm to 5.15±0.15mm respectively). At 6 months, these differences were no longer significant (p=0.510). Adjunctive PDT did not offer additional reduction in levels of GCF cytokines. CONCLUSIONS A single application of PDT to residual pockets provided a modest improvement of CAL and PPD over 3 months. Application of adjunctive PDT may lead to faster resolution of residual pockets and may be recommended for periodontal patients with slower healing capacity.
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Affiliation(s)
- Edwin X Goh
- Discipline of Periodontology, Faculty of Dentistry, National University of Singapore, Republic of Singapore.
| | - Kai Soo Tan
- Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, Republic of Singapore.
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore.
| | - Lum Peng Lim
- Discipline of Periodontology, Faculty of Dentistry, National University of Singapore, Republic of Singapore.
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Antimicrobial photodynamic therapy vs. local minocycline in addition to non-surgical therapy of deep periodontal pockets: a controlled randomized clinical trial. Clin Oral Investig 2016; 21:2253-2264. [DOI: 10.1007/s00784-016-2018-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/23/2016] [Indexed: 12/23/2022]
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Armitage GC, Xenoudi P. Post-treatment supportive care for the natural dentition and dental implants. Periodontol 2000 2016; 71:164-84. [DOI: 10.1111/prd.12122] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2015] [Indexed: 12/11/2022]
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The in Vitro Antimicrobial Efficacy of PDT against Periodontopathogenic Bacteria. Int J Mol Sci 2015; 16:27327-38. [PMID: 26580607 PMCID: PMC4661885 DOI: 10.3390/ijms161126027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/28/2015] [Accepted: 11/03/2015] [Indexed: 01/08/2023] Open
Abstract
Periodontitis, an inflammatory disease, is caused by biofilms with a mixed microbial etiology and involves the progressive destruction of the tooth-supporting tissues. A rising number of studies investigate the clinical potential of photodynamic therapy (PDT) as an adjunct during active therapy. The aim of the present review was to evaluate the available literature for the in vitro antimicrobial efficacy of photodynamic therapy focusing on the periodontopathogenic bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Fusobacterium nucleatum. The focused question was: “Is it possible to decrease (at least 3 log steps or 99.9%) or even eliminate bacterial growth by photodynamic therapy in vitro when compared to untreated control groups or control groups treated by placebo?” In general, PDT resulted in a substantial reduction of surviving bacteria. However, not all studies showed the desired reduction or elimination. The ranges of log10-reduction were 0.38 (58%) to a complete eradication (100%) for P. gingivalis, 0.21 (39%) to 100% for A. actinomycetemcomitans and 0.3 (50%) to 100% for F. nucleatum. In conclusion, further and particularly more comparable studies are needed to evaluate if PDT can be clinically successful as an adjuvant in periodontal therapy.
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Perumal MPB, Ramegowda AD, Lingaraju AJ, Raja JJ. Comparison of microsurgical and conventional open flap debridement: A randomized controlled trial. J Indian Soc Periodontol 2015; 19:406-10. [PMID: 26392689 PMCID: PMC4555798 DOI: 10.4103/0972-124x.156884] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/26/2015] [Indexed: 11/12/2022] Open
Abstract
Background: Residual calculus exists not only on teeth treated by scaling alone but also on teeth treated by flap surgery. Periodontal microsurgery enables more definite removal of calculus, atraumatic handling of tissues through optical magnification. The purpose of this study was to compare the clinical outcomes of microsurgery with conventional open flap debridement in patients with chronic periodontitis. Materials and Methods: Thirteen chronic periodontitis patients were randomly assigned for test (microsurgical) and control (conventional) open flap debridement in a split mouth design. At baseline, 3, 6 and 9 months the following clinical parameters were recorded: Probing pocket depth, relative attachment level, gingival recession, gingival bleeding index. Postoperative healing at 1-week by early healing index and pain scale for 7 days were assessed. Results: Paired t-test was used to compare means within the groups, and unpaired t-test was applied to compare the means of the two groups. At 3, 6 and 9 months postoperatively there was a significant reduction in gingival bleeding index, probing pocket depth, relative attachment level within both the groups and there was no significant difference between both the groups. Gingival margin level and gingival recession increased in both the groups, but it was not statistically significant. Early healing Index score of 1 was found in 85% of test sites and 28% of control sites. The mean pain scale was 0 in test site and 1.07 ± 0.75 in control site. Conclusions: In open flap debridement procedure, a microsurgical approach can substantially improve the early healing index and induce less postoperative pain compared with applying a conventional macroscopic approach.
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Affiliation(s)
| | | | | | - James Johnson Raja
- Department of Periodontics, Rajas Dental College and Hospital, Vadakankulam, Tirunelveli, Tamil Nadu, India
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Mittal A, Nichani AS, Venugopal R, Rajani V. The effect of various ultrasonic and hand instruments on the root surfaces of human single rooted teeth: A Planimetric and Profilometric study. J Indian Soc Periodontol 2015; 18:710-7. [PMID: 25624626 PMCID: PMC4296454 DOI: 10.4103/0972-124x.147405] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 03/04/2014] [Indexed: 11/16/2022] Open
Abstract
Background: The purpose of this study was to compare the effectiveness of different ultrasonic scalers and a periodontal curette on the root surfaces for calculus removal and root surface roughness. Materials and Methods: 40 single rooted teeth with subgingival calculus destined for extraction were assigned to one of three experimental groups (n = 10, in each group) and one control group (untreated, n = 10). Experimental groups were: Group 1: Piezoelectric ultrasonic group; Group 2: Magnetostrictive ultrasonic group; Group 3: Hand instrumentation group (Curette). After instrumentation, the teeth were extracted and the presence of residual deposits and root surface roughness were analyzed using Planimetric analyzing tool (Tool that measures the area of a plane figure as a mechanically coupled pointer traversing the perimeter of figure) and Surface Profilometer (Instrument used for profiling of an object). Root surface characteristics were evaluated qualitatively using SEM. Standardization of force, angulations and adaptation of instrument couldn’t be achieved in our study due to in vivo study design rather than in vitro design in previous studies where procedure was done on the extracted teeth samples. Results: The results of the study showed that residual deposits were similar in all experimental groups. With respect to roughness parameters, Rq (Root mean square roughness) and Rt (Total roughness) a significant difference was observed (P < 0.001) among hand instrumentation and ultrasonic devices. SEM analysis revealed a similar root surface pattern for the ultrasonic devices, but curette showed many instrument scratches, gouges, and removal of large amount of cementum. Conclusions: Curette produced the rougher root surfaces than two ultrasonic devices used in the study and caused more root surface removal. Piezoelectric devices produced minimum root surface roughness but caused more root substance removal and more cracks than Magnetostrictive ultrasonic devices.
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Affiliation(s)
- Antush Mittal
- Department of Periodontics, Modern Dental College and Research Centre, Devi Ahilya University, Indore, Madhya Pradesh, India
| | - Ashish Sham Nichani
- Department of Periodontology, AECS Maaruti College of Dental Sciences and Research Centre, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Ranganath Venugopal
- Department of Periodontology, AECS Maaruti College of Dental Sciences and Research Centre, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Vuppalapati Rajani
- Department of Periodontology, AECS Maaruti College of Dental Sciences and Research Centre, Rajiv Gandhi University of Health Sciences, Bangalore, India
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Medaiah S, Srinivas M, Melath A, Girish S, Polepalle T, Dasari AB. Chlorhexidine chip in the treatment of chronic periodontitis - a clinical study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH : JCDR 2014; 8:ZC22-5. [PMID: 25121059 DOI: 10.7860/jcdr/2014/8808.4477] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 05/19/2014] [Indexed: 11/24/2022]
Abstract
AIM The aim of this study was to clinically evaluate the use of biodegradable chlorhexidine chip when used as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe periodontitis patients. The study also intended to compare the combined therapy (SRP and Chlorhexidine chip) with chlorhexidine chip alone in individuals with periodontitis. MATERIALS AND METHODS Fifteen patients with three sites having a probing depth of 5-8mm were considered for the study. Sites were numbered 1, 2, 3 randomly. The clinical parameters assessed were the Plaque Index (PI), gingival index (GI), Bleeding on probing (BOP), Clinical attachment level (CAL) and Probing pocket depth (PPD). Following baseline evaluation, on two sites scaling and root planing (SRP) was performed, no treatment was carried out in the third site. Chlorhexidine chips were placed on one site with SRP and another without SRP. A periodontal pack was placed on the site to prevent dislodgement of the CHX chip. Clinical parameters were recorded at baseline, one month and three months. Duration of the study was for three months. STATISTICAL ANALYSIS T-test and Analysis of variance (ANOVA) has been carried out in the present study. RESULTS All three groups presented with an improvement in the clinical parameters compared to baseline. There was no statistically significant difference between the SRP and SRP + CHIP group in all parameters. There was a significant difference when these two groups were compared to the chip alone group. The mean reductions in PPD were 2.8mm (SRP group), 2.6 (SRP+CHIP group), 0.8 (chip alone group) The mean gain in CAL were 2.8mm (SRP group), 2.5 (SRP+CHIP group), 0.7 (chip alone group). Reduction in bleeding on probing were significant for the SRP and SRP +CHIP group but not for the chip alone group. CONCLUSION The CHX chip did not provide any clinical benefit beyond that achieved with conventional scaling and rootplaning after a three month period.
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Affiliation(s)
- Sangeetha Medaiah
- Senior Lecturer, Department of Periodontology, Farooquia Dental College , Mysore, India
| | - M Srinivas
- Professor, Department of Periodontology, SIBAR Institute of Dental Sciences , Guntur, India
| | - Anil Melath
- Professor, Department of Periodontology, Coorg Institute of Dental Sciences , Virajpet, India
| | - Suragimath Girish
- Professor, Department of Periodontology, Coorg Institute of Dental Sciences , Virajpet, India
| | - Tejaswin Polepalle
- Senior Lecturer, Department of Periodontology, SIBAR Institute of Dental Sciences , Guntur, India
| | - Ankineedu Babu Dasari
- Lecturer, Department of Periodontology, SIBAR Institute of Dental Sciences , Guntur, India
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Minimal intervention dentistry II: part 6. Microscope and microsurgical techniques in periodontics. Br Dent J 2014; 216:503-9. [DOI: 10.1038/sj.bdj.2014.356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Resolution of Localized Chronic Periodontitis Associated with Longstanding Calculus Deposits. Case Rep Dent 2014; 2014:391503. [PMID: 24876977 PMCID: PMC4026880 DOI: 10.1155/2014/391503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/28/2014] [Accepted: 04/11/2014] [Indexed: 11/22/2022] Open
Abstract
This report, which is based on nonstandardized serial radiographs obtained over a period of 15 years, documents a case of localized chronic periodontitis associated with progressive deposition of calculus on the distal aspect of a mandibular second molar. The site was treated by scaling and root planing, followed by a course of adjunctive systemic azithromycin. Treatment yielded favorable reductions in probing depth and clinical inflammation, leaving only few isolated sites with pockets no deeper than 4 mm. Two years after completion of active treatment, there was radiographic evidence of increased bone density distal to the second molar.
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Jagadish Pai BS, Rajan SA, Srinivas M, Padma R, Suragimath G, Walvekar A, Goel S, Kamath V. Comparison of the efficacy of chlorhexidine varnish and chip in the treatment of chronic periodontitis. Contemp Clin Dent 2013; 4:156-61. [PMID: 24015002 PMCID: PMC3757875 DOI: 10.4103/0976-237x.114848] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The purpose of this study was to clinically evaluate the benefits of sub gingival chlorhexidine (CHX) varnish and biodegradable CHX chip application used as an adjunct to scaling and root planning (SRP) as combined therapy and also to compare the effect of combined therapy with SRP alone. MATERIALS AND METHODS Fifteen patients with at least three sites with a probing pocket depth (PPD) of 5-8 mm were considered. Following baseline evaluation, all three sites were subjected for SRP. After completing SRP, each site was randomly subjected for CHX varnish, CHX chip application and the 3(rd) site was left without any medication as a control. Clinical parameters such as sulcus bleeding index, plaque index, bleeding on probing (BOP), PPD, and clinical attachment level (CAL) were recorded at baseline, 1 month and 3 months post-operatively. RESULTS All three groups presented with an improvement in clinical parameters compared to baseline. The mean reduction in PPD was 2.4 mm in SRP sites, 2.5 mm in SRP + CHX varnish sites and 2.8 mm in SRP + CHX chip sites. The mean gain in CAL was 2.4 mm in SRP sites, 2.3 mm in SRP + CHX varnish sites and 2.8 mm SRP + CHX chip sites. INTERPRETATION AND CONCLUSION The present study indicated that application of CHX varnish and placement of CHX chip as an adjunct to SRP produced a clinically significant reduction in the PPD, BOP and a gain in CAL at 30(th) day and 90(th) day from baseline when compared to SRP alone. The results though were not statistically significant.
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Affiliation(s)
- B S Jagadish Pai
- Department of Periodontics, Coorg Institute of Dental Sciences, K. K. Campus, Maggula, Virajpet, South Coorg, Karnataka, India
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Abstract
UNLABELLED Periodontitis is a complex disease that has both oral and systemic consequences. The treatment of periodontitis may be both surgical and non-surgical but, in recent years, there has been a shift towards managing disease non-surgically in preference to surgery. Fundamental to all types of therapy is the patient's role in disease control, in the form of self-performed plaque control, and it is important that the patient understands this. Non-surgical periodontal therapy has a long history and has traditionally been carried out using a variety of hand and powered instruments, the objective being root surface disinfection by the removal of plaque, calculus and contaminated root cementum. However, over the last 30 years or so, it has become apparent that calculus does not cause disease, cementum does not become significantly infected and bacteria and their toxins are only loosely adherent to the diseased root surface. This has led to the development of less invasive instrumentation principles which may be better for patients, more cost-effective and more easily applied in different clinical settings. CLINICAL RELEVANCE This paper aims to describe and justify a minimally-invasive approach to the management of the diseased root surface in periodontitis, to clarify the terminology used and to suggest how these principles may be applied in general practice.
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Affiliation(s)
- Philip Ower
- Briars Dental Centre, Newbury and www.periocourses. co.uk
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Chen TH, Tu YK, Yen CC, Lu HK. A systematic review and meta-analysis of guided tissue regeneration/osseous grafting for the treatment of Class II furcation defects. J Dent Sci 2013. [DOI: 10.1016/j.jds.2013.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Preus HR, Gunleiksrud TM, Sandvik L, Gjermo P, Baelum V. A Randomized, Double-Masked Clinical Trial Comparing Four Periodontitis Treatment Strategies: 1-Year Clinical Results. J Periodontol 2013; 84:1075-86. [DOI: 10.1902/jop.2012.120400] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Singh S, Uppoor A, Nayak D. A comparative evaluation of the efficacy of manual, magnetostrictive and piezoelectric ultrasonic instruments--an in vitro profilometric and SEM study. J Appl Oral Sci 2012; 20:21-6. [PMID: 22437673 PMCID: PMC3928767 DOI: 10.1590/s1678-77572012000100005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 03/18/2010] [Indexed: 11/22/2022] Open
Abstract
Objectives The debridement of diseased root surface is usually performed by mechanical
scaling and root planing using manual and power driven instruments. Many new
designs in ultrasonic powered scaling tips have been developed. However, their
effectiveness as compared to manual curettes has always been debatable. Thus, the
objective of this in vitro study was to comparatively evaluate
the efficacy of manual, magnetostrictive and piezoelectric ultrasonic
instrumentation on periodontally involved extracted teeth using profilometer and
scanning electron microscope (SEM). Material and Methods 30 periodontally involved extracted human teeth were divided into 3 groups. The
teeth were instrumented with hand and ultrasonic instruments resembling clinical
application. In Group A all teeth were scaled with a new universal hand curette
(Hu Friedy Gracey After Five Vision curette; Hu Friedy, Chicago, USA). In Group B
CavitronTM FSI - SLITM ultrasonic device with focused
spray slimline inserts (Dentsply International Inc., York, PA, USA) were used. In
Group C teeth were scaled with an EMS piezoelectric ultrasonic device with
prototype modified PS inserts. The surfaces were analyzed by a Precision
profilometer to measure the surface roughness (Ra value in µm) consecutively
before and after the instrumentation. The samples were examined under SEM at
magnifications ranging from 17x to 300x and 600x. Results The mean Ra values (µm) before and after instrumentation in all the three groups
A, B and C were tabulated. After statistically analyzing the data, no significant
difference was observed in the three experimental groups. Though there was a
decrease in the percentage reduction of Ra values consecutively from group A to C.
Conclusion Within the limits of the present study, given that the manual, magnetostrictive
and piezoelectric ultrasonic instruments produce the same surface roughness, it
can be concluded that their efficacy for creating a biologically compatible
surface of periodontally diseased teeth is similar.
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Affiliation(s)
- Sumita Singh
- Department of Periodontics, Manipal College of Dental Sciences, Manipal University, Karnataka, India
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A randomized clinical trial on the clinical and microbiological efficacy of a xanthan gel with chlorhexidine for subgingival use. Clin Oral Investig 2012; 17:55-66. [DOI: 10.1007/s00784-012-0685-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
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Jepsen S, Deschner J, Braun A, Schwarz F, Eberhard J. Calculus removal and the prevention of its formation. Periodontol 2000 2010; 55:167-88. [DOI: 10.1111/j.1600-0757.2010.00382.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mombelli A, Cionca N, Almaghlouth A. Does adjunctive antimicrobial therapy reduce the perceived need for periodontal surgery? Periodontol 2000 2010; 55:205-16. [DOI: 10.1111/j.1600-0757.2010.00356.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Müller P, Guggenheim B, Attin T, Marlinghaus E, Schmidlin PR. Potential of shock waves to remove calculus and biofilm. Clin Oral Investig 2010; 15:959-65. [DOI: 10.1007/s00784-010-0462-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Accepted: 08/25/2010] [Indexed: 11/24/2022]
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Leib AM. Re: clinical and histologic evaluation of non-surgical periodontal therapy with enamel matrix derivative: a report of four cases. Mellonig JT, Valderrama P, Gregory HJ, Cochran DL. (J Periodontol 2009;80:1534-1540.). J Periodontol 2010; 81:340-1; author reply 341-2. [PMID: 20192857 DOI: 10.1902/jop.2010.090560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mellonig JT, Valderrama P, Gregory HJ, Cochran DL. Letter to the Editor: Authors' Response. J Periodontol 2010. [DOI: 10.1902/jop.2010.090593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Moëne R, Décaillet F, Andersen E, Mombelli A. Subgingival Plaque Removal Using a New Air-Polishing Device. J Periodontol 2010; 81:79-88. [PMID: 20059420 DOI: 10.1902/jop.2009.090394] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Raphaël Moëne
- Department of Periodontology, School of Dental Medicine, University of Geneva, Rue Barthélemy-Menn 19, CH-1205 Geneva, Switzerland.
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Checchi L, Montevecchi M, Checchi V, Zappulla F. The relationship between bleeding on probing and subgingival deposits. An endoscopical evaluation. Open Dent J 2009; 3:154-60. [PMID: 19672332 PMCID: PMC2724644 DOI: 10.2174/1874210600903010154] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 04/02/2009] [Accepted: 05/08/2009] [Indexed: 11/23/2022] Open
Abstract
Background: Bleeding on probing (BOP) is an indicator of tissue inflammatory response to bacterial pathogens. Due to anatomical limitations, the entity and physical state of microbial aggregations located under the gingival margin and their relations to BOP have been hardly investigated till now. The recent introduction of the endoscopy has allowed clinicians to observe the subgingival environment in a non-traumatic way. The aim of this study is to evaluate the correlation between BOP and subgingival deposits by using this new technology. Methods: 107 teeth (642 individual sites) from 16 periodontal patients, treated with scaling and root planing, were evaluated for plaque index (PI), gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), endoscopic biofilm index (EBI), and endoscopic calculus index (ECI) at one-month revaluation. Results: A linear association between BOP and PD, EBI, and ECI was detected. The BOP provided a high level of specificity but quite low sensitivity values both for ECI (sensitivity 40%, specificity 86%) and EBI (sensitivity 37%, specificity 89%). The BOP sensitivity was directly linked to the amount of subgingival deposits. Conclusions: This study demonstrates a direct relationship between BOP and presence/amount of subgingival deposits. More investigations on larger samples are, however, needed.
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Affiliation(s)
- Luigi Checchi
- Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum - University of Bologna. Bologna, Italy.
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El Yazami H, Zeinoun T, Bou Saba S, Lamard L, Peremans A, Limme M, Geerts S, Lamy M, Nammour S. Pulp temperature increase during photo-activated disinfection (PAD) of periodontal pockets: an in vitro study. Lasers Med Sci 2009; 25:655-9. [PMID: 19529881 DOI: 10.1007/s10103-009-0686-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2008] [Accepted: 05/12/2009] [Indexed: 11/29/2022]
Abstract
The capacity of photo-sensitizers, used in combination with laser light to kill micro-organisms has been demonstrated in different studies. Photo-activated disinfection (PAD) has been introduced in periodontology as an aid for disinfection of periodontal pockets. The aim of this study is to verify the harm for dental vitality of the use of PAD in periodontal pockets. Root canals of 24 freshly extracted human teeth where prepared using profiles up to a size of ISO #50 and filled with thermo-conductor paste. A silicon-based false gum was made in which a periodontal pocket was created and filled with photo-sensitizer phenothiazine chloride (phenothiazine-5-ium, 3.7-bis (dimethylamino)-, chloride). The external root surface was irradiated during 60 s with a 660-nm diode laser (output power: 20 mW; power density: 0.090 W/cm(2); Energy density: 5.46 J/cm(2)) using a periodontal tip with a diameter of 1 mm and a length of 7 mm. Temperatures were recorded inside the root canal using a thermocouple. Measurements were recorded every second, starting at 10 s before lasering, during the irradiation and were continued for 150 s after the end of irradiation, and six measurements were done per tooth. An average temperature increase of 0.48 +/- 0.11 degrees C was recorded. Our results demonstrated that pulp temperature increase was lower than 3 degrees C, which is considered to be harmless for pulp injury. Regarding pulp temperature increase, the use of PAD for disinfection of periodontal pockets can be considered as a safe procedure for dental vitality.
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Affiliation(s)
- H El Yazami
- Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium
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Abstract
Single-tooth replacement may be effected through various methods, including the use of a resin-bonded fixed partial denture, a conventional fixed partial denture, and a single implant-supported crown. Although the introduction of newer therapeutic modalities, surgical and restorative techniques, and restorative materials has significantly expanded available treatment options, a greater demand is now placed on the diagnostic and treatment planning acumen of the clinician. The questions confronting each clinician are when to apply each treatment modality and how to use these therapeutic approaches to their maximum benefit for the patient. This article focuses on the factors that should be considered when making such clinical decisions and offers a framework within which to formulate appropriate treatment algorithms.
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Wilson TG, Carnio J, Schenk R, Myers G. Absence of Histologic Signs of Chronic Inflammation Following Closed Subgingival Scaling and Root Planing Using the Dental Endoscope: Human Biopsies – A Pilot Study. J Periodontol 2008; 79:2036-41. [DOI: 10.1902/jop.2008.080190] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rosling B, Hellström MK, Ramberg P, Socransky SS, Lindhe J. The use of PVP-iodine as an adjunct to non-surgical treatment of chronic periodontitis. J Clin Periodontol 2008. [DOI: 10.1111/j.1600-051x.2001.281106.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kasaj A, Moschos I, Röhrig B, Willershausen B. The effectiveness of a novel optical probe in subgingival calculus detection. Int J Dent Hyg 2008; 6:143-7. [DOI: 10.1111/j.1601-5037.2007.00277.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Comparative study on the effect of ultrasonic instruments on the root surface in vivo. Clin Oral Investig 2007; 12:143-50. [DOI: 10.1007/s00784-007-0167-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Accepted: 11/12/2007] [Indexed: 10/22/2022]
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Schwarz F, Jepsen S, Herten M, Aoki A, Sculean A, Becker J. Immunohistochemical characterization of periodontal wound healing following nonsurgical treatment with fluorescence controlled Er:YAG laser radiation in dogs. Lasers Surg Med 2007; 39:428-40. [PMID: 17523168 DOI: 10.1002/lsm.20509] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of the present study was to immunohistochemically characterize periodontal wound healing following nonsurgical treatment with fluorescence controlled Er:YAG laser radiation in dogs. STUDY DESIGN/MATERIALS AND METHODS Five beagle dogs suffering from naturally occurring chronic periodontitis were randomly allocated in a split-mouth design to nonsurgical periodontal treatment using either (a) an Er:YAG laser at 10.2, 12.8, 15.4, 18, and 20.4 J/cm2 (ERL1-5), or (b) an ultrasonic device (VUS) serving as control. The animals were sacrificed after 3 months. Histomorphometrical (e.g. inflammatory cell infiltrate, surface changes, cementum formation), and immunohistochemical parameters (collagen type I, CD68, matrix metalloproteinase (MMP)-8) were assessed. RESULTS Inflammatory cell infiltrates of different extent were commonly observed in all treatment groups. However, histomorphometrical analysis revealed new cementum formation with inserting collagen type I fibers along the instrumented root surfaces in most specimens of both ERL (ERL2: 31+/-81 to ERL5: 595+/-575 microm) and VUS (50+/- 215 microm) groups. This was associated with pronounced CD68 and weak MMP-8 antigen reactivity. CONCLUSION Within the limits of the present study, it was concluded that both treatment procedures (i) were effective in controlling inflammatory cell infiltrates, and (ii) may support the formation of a new connective tissue attachment.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, D-40225 Düsseldorf, Germany.
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Flemmig TF, Hetzel M, Topoll H, Gerss J, Haeberlein I, Petersilka G. Subgingival debridement efficacy of glycine powder air polishing. J Periodontol 2007; 78:1002-10. [PMID: 17539712 DOI: 10.1902/jop.2007.060420] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Glycine powder air polishing (GPAP) has been shown to be significantly more effective in reducing the subgingival cultivable microflora in shallow periodontal pockets compared to curets and is safe when applied directly to root surfaces. The purpose of this study was to assess the subgingival debridement efficacy of GPAP in periodontal pockets with various depths. METHODS In each of 60 patients with severe periodontitis, one tooth with a probing depth (PD) > or =6 mm was randomly assigned to one of the following interventions: GPAP performed in teeth instrumented 3 months earlier (I); GPAP performed in previously non-instrumented teeth (NI); or no treatment (control). GPAP was performed for 5 seconds per surface. After extraction, teeth were stained with 0.5% toluidine blue, and subgingival debridement efficacy was assessed. RESULTS Overall, median debridement depth was 2.00 mm in I teeth and 1.86 mm in NI teeth, and the median debrided root surface was 49.24% and 45.64%, respectively. In anatomic PDs (APDs) of 2 to 3 mm, relative debridement depth (debridement depth/APD) ranged from 65% to 80% and 60% to 75% in I and NI teeth, respectively; the corresponding values for debrided root surface were 60% to 70% and 50% to 60%. In control teeth, virtually all subgingival root surfaces were stained. Clinical PD measurements were a median of 1.05 mm deeper than APD. CONCLUSION GPAP for 5 seconds per surface is effective in removing most of the subgingival biofilm in periodontal pockets with an APD < or =3 mm.
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Affiliation(s)
- Thomas F Flemmig
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195-7444, USA.
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Schwarz F, Olivier W, Herten M, Sager M, Chaker A, Becker J. Influence of implant bed preparation using an Er:YAG laser on the osseointegration of titanium implants: a histomorphometrical study in dogs. J Oral Rehabil 2007; 34:273-81. [PMID: 17371565 DOI: 10.1111/j.1365-2842.2006.01704.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of the present study was to evaluate the influence of implant bed preparation using an Er:YAG laser on the osseointegration of titanium implants. A total of 24 implant channels were prepared in the lower jaws of four beagle dogs using (i) an Er:YAG laser device (ERL), or (ii) conventional drills (CD) according to a split-mouth design (n=6 implant channels per animal). Three screw-type titanium implants of different manufacturers were randomly inserted in both groups to evaluate submerged healing at 2 and 12 weeks. Width of the peri-implant gap (WPG) and bone-to-implant contact (BIC) were assessed histomorphometrically. There were no identifiable signs of any thermal side effects in both groups. ERL osteotomy frequently resulted in wide peri-implant gaps particularly in the apical area of the implant supporting bone. The following mean scores were assessed (+/-s.d.): WPG (2 weeks): ERL: 0.89+/-0.48 mm; CD: 0.27+/-0.09 mm (P<0.001 respectively); BIC (2 weeks): ERL: 34.5+/-7.76%; CD: 48.5+/-11.08% (P<0.001 respectively); BIC (12 weeks): ERL: 64.1+/-8.97%; CD: 68.94+/-11.23% (P>0.05 respectively). Within the limits of the present study, it was concluded that ERL may represent a promising tool for implant bed preparation.
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Affiliation(s)
- F Schwarz
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany.
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