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Isola G, Polizzi A, Santonocito S, Alibrandi A, Pesce P, Kocher T. Effect of quadrantwise versus full-mouth subgingival instrumentation on clinical and microbiological parameters in periodontitis patients: A randomized clinical trial. J Periodontal Res 2024; 59:647-656. [PMID: 38666373 DOI: 10.1111/jre.13279] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 07/16/2024]
Abstract
AIM This study evaluated the efficacy of quadrantwise subgingival instrumentation (Q-SI) versus one-stage full-mouth subgingival instrumentation (FM-SI) on probing depth and periodontal pathogen reduction over a 6-month follow-up period, as well as whether baseline periodontal pathogens influenced the impact of periodontal treatment protocols on outcomes. METHODS Patients with periodontitis were randomized to receive Q-SI (n = 43) or FM-SI (n = 45). Patients were instructed and motivated to maintain optimal oral hygiene during the treatment sessions. Clinical (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) and periodontal pathogens were assessed at baseline and after 30, 90, and 180 days. Total bacterial load and periodontal pathogens were analysed via real-time PCR. RESULTS At the 6-month follow-up, the median PPD decreased from 4.8 mm (interquartile range [IQR]: 4.3-5.2) to 2.6 mm (IQR: 2.3-2.9) in FM-SI patients and from 4.7 mm (IQR: 4.1-5.2) to 3.2 mm (IQR: 2.4-3.5) in Q-SI patients (p < .001). At 6 months, FM-SI was more effective at reducing the median proportions of Porphyromonas gingivalis (Pg), Aggregatibacter actinocomyctemcomitans, and Tannerella forsythia (Tf) (p < .001 for each value). Multilevel linear regression analysis demonstrated that high baseline PPD (p = .029), Pg (p = .014), and Tf (p < .001) levels and the FM-SI protocol (p < .001) were statistically significant predictors of PPD reduction at 6 months. Furthermore, PPD reduction was significantly greater in the FM-SI group when lower baseline Pg levels were detected. CONCLUSION The FM-SI was more effective than the Q-SI in reducing the mean PPD and number of periodontal pathogens in periodontitis patients over a 6-month follow-up period. Higher baseline PPD and Pg levels had a negative impact on PPD reduction at 6 months after FM-SI.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy
| | - Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Paediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Morikawa S, Watanabe K, Otsuka R, Asoda S, Nakagawa T. Periodontal therapy for localized severe periodontitis in a patient receiving fixed orthodontic treatment: a case report. J Med Case Rep 2023; 17:19. [PMID: 36658639 PMCID: PMC9854180 DOI: 10.1186/s13256-023-03751-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/01/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Orthodontic treatment involves movement of teeth by compression and resorption of the alveolar bone using orthodontic forces. These movements are closely linked to the interactions between the teeth and the periodontal tissues that support them. Owing to an increase in adults seeking orthodontic treatment, orthodontists increasingly encounter patients with periodontal diseases, in whom orthodontic treatment is contraindicated. In rare cases, periodontitis may develop after treatment initiation. However, no approach for treating periodontitis after the initiation of orthodontic treatment has been established. Here, we present an approach for managing localized severe periodontitis manifesting after initiating orthodontic treatment. CASE PRESENTATION A 32-year-old Japanese woman was referred to the Department of Dentistry and Oral Surgery by an orthodontist who observed symptoms of acute periodontitis in the maxillary molars that required periodontal examination and treatment. A detailed periodontal examination, including oral bacteriological examination, revealed localized severe periodontitis (stage III, grade B) in the maxillary left first and second molars and in the mandibular right second molar. After consultation with the orthodontist, the orthodontic treatment was suspended based on the results of the bacteriological examination to allow for periodontal treatment. Full-mouth disinfection was performed with adjunctive oral sitafloxacin. Periodontal and bacteriological examinations after treatment revealed regression of the localized periodontitis with bone regeneration. Thereafter, orthodontic treatment was resumed, and good progress was achieved. CONCLUSIONS Orthodontists should recognize the risk of acute severe periodontitis in young adults. Asymptomatic patients with localized severe periodontitis may clear a screening test before orthodontic treatment but develop acute symptoms with bone resorption during orthodontic treatment. Therefore, patients requiring orthodontic treatment should be examined by their family dentist or a periodontist to rule out periodontal issues that may impede orthodontic treatment. The patients should also be informed of age-related risks. Further, periodontists, family dentists, and orthodontists who treat adults should be informed about periodontitis and the need for interdisciplinary collaboration. In patients who develop periodontitis after orthodontic treatment initiation, temporary interruption of orthodontic treatment and aggressive periodontal intervention may facilitate recovery.
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Affiliation(s)
- Satoru Morikawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Kazuya Watanabe
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan ,Watanabe Orthodontic Office, 1-11-26-2F Kichijoji-honcho, Musashino, Tokyo 180-0004 Japan
| | - Ryo Otsuka
- Familia Orthodontics, 1-7-5-12F Sakuragi-cho, Omiya-ku, Saitama, Saitama 330-0854 Japan
| | - Seiji Asoda
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Taneaki Nakagawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
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Mamaklıoğlu D, Karched M, Kuru L, Kuru B, Asikainen S, Doğan B. Different Scaling And Root Planing Strategies In Turkish Patients With Aggressive Periodontitis: A Randomized Controlled Clinical Trial. Int J Dent Hyg 2022; 20:347-363. [PMID: 35143714 DOI: 10.1111/idh.12592] [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: 06/06/2021] [Revised: 01/06/2022] [Accepted: 02/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study is to compare clinical, cytokine and microbiological responses after quadrant-based scaling and root planing (Q-SRP), full-mouth SRP (FM-SRP) and full-mouth disinfection (FMD) in patients with generalized aggressive periodontitis (GAgP), which is currently termed as generalized stage III grade C periodontitis. METHODS Forty-two patients with GAgP were randomly assigned into groups as Q-SRP, FM-SRP or FMD with chlorhexidine. Clinical parameters were recorded and gingival crevicular fluid (GCF) and subgingival plaque samples collected at baseline, 3 and 6 months after treatment. GCF levels of interleukin (IL)-1β and IL-17 were analysed using ELISA. Quantities of six bacterial species were determined using qPCR. RESULTS Clinical parameters improved significantly in all groups at 3 and 6 months (p<0.05). Percentage of sites with probing depth >6 mm was lower in the FMD than Q-SRP group at 3 and 6 months (p<0.05). FMD showed significantly higher percentage of pocket closure compared to Q-SRP and FM-SRP at both 3 and 6 months after treatment (p<0.05). The IL-1β levels decreased only in the FMD group (p<0.05), whereas no changes were found in IL-17 levels in any group. The levels of five out of six bacterial species decreased at 3 and/or 6 months only in the FMD group (p<0.05). CONCLUSIONS The FMD treatment appears to offer superior outcome than Q-SRP and could be the first choice for patients with GAgP.
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Affiliation(s)
- Dilek Mamaklıoğlu
- Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Maribasappa Karched
- Oral Microbiology Research Laboratory, Faculty of Dentistry, Kuwait University, Kuwait
| | - Leyla Kuru
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Bahar Kuru
- Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Sirkka Asikainen
- Oral Microbiology Research Laboratory, Faculty of Dentistry, Kuwait University, Kuwait.,Oral Microbiology, Umea University, Umea, Sweden
| | - Başak Doğan
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Stein JM, Yekta-Michael SS, Schittenhelm F, Reichert S, Kupietz D, Dommisch H, Kasaj A, Wied S, Vela OC, Stratul SI. Comparison of three full-mouth concepts for the non-surgical treatment of stage III and IV periodontitis: A randomized controlled trial. J Clin Periodontol 2021; 48:1516-1527. [PMID: 34517434 DOI: 10.1111/jcpe.13548] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 12/29/2022]
Abstract
AIM To evaluate the clinical efficacy of full-mouth scaling (FMS), full-mouth disinfection (FMD), and FMD with adjuvant erythritol air-polishing (FMDAP) compared to quadrant-wise debridement (Q-SRP) in patients with periodontitis stage III/IV. METHODS In this four-arm parallel, prospective, randomized, controlled multi-centre study, changes of pocket probing depths (PPDs), clinical attachment level (CAL), bleeding on probing (BOP), and proportion of closed pockets (PPD ≤4 mm without BOP) were evaluated at baseline and after 3 and 6 months. RESULTS From 190 randomly participating patients, 172 were included in the final analysis. All groups showed significant (p < .05) improvements in all clinical parameters over 3 and 6 months. During the study period, FMDAP showed significantly higher reductions of mean PPD in teeth with moderate (PPD 4-6 mm) and deep (PPD > 6 mm) pockets and significantly increased proportions of pocket closure than Q-SRP. Patients treated with FMD had significantly greater PPD reduction in deep pockets and a higher percentage of pocket closure after 3 months but not after 6 months compared to Q-SRP. CAL and BOP changes did not significantly differ among all groups. Efficiency of treatment (time effort to gain one closed pocket) was significantly higher for FMDAP, FMD, and FMS compared to Q-SRP (6.3, 8.5, 9.5 vs. 17.8 min per closed pocket; p < .05). CONCLUSIONS All treatment modalities were effective, without significant differences between full-mouth approaches. FMDAP showed improved clinical outcomes over Q-SRP for moderate and deep pockets after 6 months. Full-mouth protocols were more time-efficient than conventional Q-SRP. CLINICAL SIGNIFICANCE The trial was registered in a clinical trial database (ClinicalTrials.gov: NCT03509233).
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Affiliation(s)
- Jamal M Stein
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | | | - Florian Schittenhelm
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin Luther University, Mainz, Germany
| | - David Kupietz
- Department of Operative Dentistry and Periodontology, Martin Luther University, Mainz, Germany
| | - Henrik Dommisch
- Department of Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Adrian Kasaj
- Department of Periodontology and Operative Dentistry, University Medical Center, Mainz, Germany
| | - Stephanie Wied
- Department of Medical Statistics, University Hospital (RWTH), Aachen, Germany
| | - Octavia-Carolina Vela
- Department of Periodontology, Anton Sculean Center for Research and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Anton Sculean Center for Research and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, Romania
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Beikler T, Bunte K, Chan Y, Weiher B, Selbach S, Peters U, Klocke A, Watt R, Flemmig T. Oral Microbiota Transplant in Dogs with Naturally Occurring Periodontitis. J Dent Res 2021; 100:764-770. [PMID: 33733913 PMCID: PMC8217902 DOI: 10.1177/0022034521995423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In periodontitis patients, dysbiosis of the oral microbiota is not only found at clinically diseased periodontal sites but also at clinically healthy periodontal sites, buccal mucosae, tongue, and saliva. The present study evaluated the safety and efficacy of an oral microbiota transplant (OMT) for the treatment of periodontitis in dogs. Eighteen systemically healthy beagle dogs with naturally occurring periodontitis were enrolled in the study and randomly assigned to a test or control group. A 4-y-old, periodontally healthy female beagle dog served as a universal OMT donor. To reduce periodontal inflammation, all dogs received full-mouth mechanical debridement of teeth and mucosae 2 wk before baseline. At baseline, full-mouth mechanical debridement was repeated and followed by adjunctive subgingival and oral irrigation with 0.1% NaOCl. Subsequently, test dogs were inoculated with an OMT from the healthy donor. No daily oral hygiene was performed after OMT transplantation. Adverse events were assessed throughout the observation period. Clinical examinations were performed and whole-mouth oral microbiota samples were collected at week 2, baseline, week 2, and week 12. The composition of oral microbiota samples was analyzed using high-throughput 16S ribosomal RNA gene amplicon sequencing followed by taxonomic assignment and downstream bioinformatic and statistical analyses. Results demonstrated that the intergroup difference in the primary outcome measure, probing pocket depth at week 12, was statistically insignificant. However, the single adjunctive OMT had an additional effect on the oral microbiota composition compared to the full-mouth mechanical and antimicrobial debridement alone. The OMT resulted in an "ecological shift" toward the composition of the donor microbiota, but this was transient in nature and was not observed at week 12. No local or systemic adverse events were observed throughout the study period. The results indicate that OMT may modulate the microbiota composition in dogs with naturally occurring periodontitis and can be applied safely.
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Affiliation(s)
- T. Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K. Bunte
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Y. Chan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - S. Selbach
- The School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - U. Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - R.M. Watt
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - T.F. Flemmig
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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6
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Ko Y, Lee EM, Park JC, Gu MB, Bak S, Ji S. Salivary microbiota in periodontal health and disease and their changes following nonsurgical periodontal treatment. J Periodontal Implant Sci 2020; 50:171-182. [PMID: 32617182 PMCID: PMC7321711 DOI: 10.5051/jpis.2020.50.3.171] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 11/08/2022] Open
Abstract
Purpose The aims of this study were to examine the salivary microbiota in conditions of periodontal health and disease and to explore microbial changes following nonsurgical periodontal treatment. Methods Non-stimulated saliva samples were collected from 4 periodontally healthy participants at baseline and from 8 patients with chronic periodontitis at baseline and 3 months following nonsurgical periodontal therapy. The V3 and V4 regions of the 16S rRNA gene from the DNA of saliva samples were amplified and sequenced. The salivary microbial compositions of the healthy participants and patients with periodontitis prior to and following nonsurgical treatment of periodontitis were compared based on the relative abundance of various taxa. Results On average, 299 operational taxonomic units were identified in each sample. The phylogenetic diversity in patients with periodontitis was higher than that in healthy participants and decreased following treatment. The abundance of the phylum Spirochaetes and the genus Treponema in patients with periodontitis was 143- and 134-fold higher than in the healthy control group, respectively, but decreased significantly following treatment. The species that were overabundant in the saliva of patients with periodontitis included the Peptostreptococcus stomatis group, Porphyromonas gingivalis, the Fusobacterium nucleatum group, Parvimonas micra, Porphyromonas endodontalis, Filifactor alocis, and Tannerella forsythia. The phylum Actinobacteria, the genus Streptococcaceae_uc, and the species Streptococcus salivarius group were more abundant in healthy participants than in those with periodontitis. There was a trend toward a decrease in disease-associated taxa and an increase in health-associated taxa following treatment. Conclusions Our results revealed differences in the taxa of salivary microbiota between conditions of periodontal health and disease. The taxa found to be associated with health or disease have potential for use as salivary biomarkers for periodontal health or disease.
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Affiliation(s)
- Youngkyung Ko
- Department of Periodontics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Eun-Mi Lee
- Department of Periodontics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Joo Cheol Park
- Department of Oral Histology, Seoul National University School of Dentistry, Seoul, Korea
| | - Man Bock Gu
- Department of Biotechnology, Korea University College of Life Sciences and Biotechnology, Seoul, Korea
| | - Seongmin Bak
- Department of Periodontology, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Suk Ji
- Department of Periodontology, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
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7
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Aral K, Aral CA, Kapila Y. Six‐month clinical outcomes of non‐surgical periodontal treatment with antibiotics on apoptosis markers in aggressive periodontitis. Oral Dis 2019; 25:839-847. [DOI: 10.1111/odi.13032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/05/2018] [Accepted: 12/31/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Kübra Aral
- Division of Periodontics Malatya Oral and Dental Heath Hospital Malatya Turkey
| | - Cüneyt A. Aral
- Department of PeriodontologyFaculty of Dentistry, Inonu University Malatya Turkey
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of DentistryUniversity of California California
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8
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Roman-Torres CVG, Bryington MS, Kussaba ST, Pimentel AC, Jimbo R, Cortelli JR, Romito GA. Comparison Of Full-Mouth Scaling and Quadrant-Wise Scaling in the Treatment of Adult Chronic Periodontitis. Braz Dent J 2018; 29:296-300. [DOI: 10.1590/0103-6440201801715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 02/09/2018] [Indexed: 02/26/2023] Open
Abstract
Abstract In the search for the ideal treatment of periodontal disease various non-surgical techniques should be considered. The objective of this study was to evaluate the efficacy of full-mouth scaling (FMS) by clinical and microbiological parameters. 670 individuals were evaluated with 230 subjects meeting the selection criteria and were divided into two groups; 115 subjects treated with FMS and 115 treated with weekly sessions of scaling and root planning (SRP). The patient population had a mean age of 51.67 years, with moderate chronic periodontitis. Subjects were evaluated prior to treatment (T1) and 90 days after execution of therapy (T2), with regards to: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and microbial detection for the presence of Porphyromonas gingivalis (P.g.) and Prevotella intermedia (P.i.) by culture method and confirmed by biochemical tests. Subjects treated in the FMS group also rinsed with 0.12% chlorhexidine mouthwash for seven days following treatment. The results were analyzed using statistical Student’s t-test and chi-square test. No statistically significant differences were observed for PD and CAL between T1 and T2 in both groups. For GI and PI significant difference was observed between the groups. For the evaluated microbial parameters was observed reduction of P.g. and P.i., but only for P.g. with a significant reduction in both groups. The full mouth scaling technique with the methodology used in this study provided improved clinical conditions and reduction of P.g. in subjects with moderate periodontitis, optimizing the time spent in the therapeutic execution.
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Affiliation(s)
| | | | | | | | - Ryo Jimbo
- Malmo Hogskola Odontologiska Fakulteten, Sweden
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9
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Activity of taurolidine gels on ex vivo periodontal biofilm. Clin Oral Investig 2017; 22:2031-2037. [DOI: 10.1007/s00784-017-2297-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/06/2017] [Indexed: 12/27/2022]
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10
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Feres M, Figueiredo LC, Soares GMS, Faveri M. Systemic antibiotics in the treatment of periodontitis. Periodontol 2000 2017; 67:131-86. [PMID: 25494600 DOI: 10.1111/prd.12075] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2014] [Indexed: 12/12/2022]
Abstract
Despite the fact that several clinical studies have shown additional benefits when certain systemic antibiotics are used as adjuncts to periodontal treatment, clear guidelines for the use of these agents in the clinical practice are not yet available. Basic questions concerning the use of systemic antibiotics to treat periodontitis remain unanswered, such as: which drug(s) should be used; which patients would most benefit from treatment; which are the most effective protocols (i.e. doses and durations); and in which phase of the mechanical therapy should the drug(s) be administered? Although not all of those questions have been directly addressed by controlled randomized clinical trials, recent concepts related to the ecology of periodontal diseases, as well as the major advances in laboratory and clinical research methods that have occurred in the past decade, have significantly broadened our knowledge in this field. This article endeavored to provide a 'state of the art' overview on the use of systemic antibiotics in the treatment of periodontitis, based on the most recent literature on the topic as well as on a compilation of data from studies conducted at the Center of Clinical Trials at Guarulhos University (São Paulo, Brazil) from 2002 to 2012.
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11
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Martelli FS. Author's reply to letter from the SIdP, Italian Society of Periodontology and Implantology on: Long-term efficacy of microbiology-driven periodontal laser-assisted therapy. Eur J Clin Microbiol Infect Dis 2016; 36:399-401. [PMID: 27738854 PMCID: PMC5253142 DOI: 10.1007/s10096-016-2786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 07/31/2016] [Indexed: 11/24/2022]
Affiliation(s)
- F S Martelli
- Microdentistry, Via dell'Ariento 4, 50123, Florence, Italy.
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12
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Azad MF, Schwiertz A, Jentsch HFR. Adjunctive use of essential oils following scaling and root planing -a randomized clinical trial. Altern Ther Health Med 2016; 16:171. [PMID: 27266517 PMCID: PMC4897933 DOI: 10.1186/s12906-016-1117-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 05/13/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Hitherto no study has been published on the effect of the adjunctive administration of essential oils following scaling and root planing (SRP). This study describes the effect of a mouthrinse consisting of essential oils (Cymbopogon flexuosus, Thymus zygis and Rosmarinus officinalis) following SRP by clinical and microbiological variables in patients with generalized moderate chronic periodontitis. METHODS Forty-six patients (aged 40-65 years) with moderate chronic periodontitis were randomized in a double-blind study and rinsed their oral cavity following SRP with an essential oil mouthrinse (n = 23) or placebo (n = 23) for 14 days. Probing depth (PD), attachment level (AL), bleeding on probing (BOP) and modified sulcus bleeding index (SBI) were recorded at baseline and after 3 and 6 months. Subgingival plaque was taken for assessment of major bacteria associated with periodontitis. RESULTS AL, PD, BOP and SBI were significantly improved in both groups after three (p < 0.001) and 6 months (p ≤ 0.015). AL improved significantly better in the test than in the control group after 3 and 6 months (p < 0.001), so did PD after three months in the tendency (p = 0.1). BOP improved better in the test group after 3 months (p = 0.065). Numbers of Treponema denticola (p = 0.044) and Fusobacterium nucleatum (p = 0.029) decreased more in the test than in the control group after 3 months, those of Tannerella forsythia after 6 months (p = 0.039). Prevotella micra (p < 0.001, p = 0.035) and Campylobacter rectus (p = 0.002 , p = 0.012) decreased significantly in both groups after 3 months. CONCLUSIONS The adjunctive use of a mouthrinse containing essential oils following SRP has a positive effect on clinical variables and on bacterial levels in the subgingival biofilm. TRIAL REGISTRATION 332-12-24092012, DRKS 00009387, German Clinical Trials Register, Freiburg i. Br., 16.09.2015.
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13
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Fonseca DC, Cortelli JR, Cortelli SC, Miranda Cota LO, Machado Costa LC, Moreira Castro MV, Oliveira Azevedo AM, Costa FO. Clinical and Microbiologic Evaluation of Scaling and Root Planing per Quadrant and One-Stage Full-Mouth Disinfection Associated With Azithromycin or Chlorhexidine: A Clinical Randomized Controlled Trial. J Periodontol 2015; 86:1340-51. [DOI: 10.1902/jop.2015.150227] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Fang H, Han M, Li QL, Cao CY, Xia R, Zhang ZH. Comparison of full-mouth disinfection and quadrant-wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta-analysis. J Periodontal Res 2015; 51:417-30. [PMID: 26477533 DOI: 10.1111/jre.12326] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2015] [Indexed: 11/28/2022]
Abstract
Scaling and root planing are widely considered as effective methods for treating chronic periodontitis. A meta-analysis published in 2008 showed no statistically significant differences between full-mouth disinfection (FMD) or full-mouth scaling and root planing (FMS) and quadrant scaling and root planing (Q-SRP). The FMD approach only resulted in modest additional improvements in several indices. Whether differences exist between these two approaches requires further validation. Accordingly, a study was conducted to further validate whether FMD with antiseptics or FMS without the use of antiseptics within 24 h provides greater clinical improvement than Q-SRP in patients with chronic periodontitis. Medline (via OVID), EMBASE (via OVID), PubMed and CENTRAL databases were searched up to 27 January 2015. Randomized controlled trials comparing FMD or FMS with Q-SRP after at least 3 mo were included. Meta-analysis was performed to obtain the weighted mean difference (WMD), together with the corresponding 95% confidence intervals. Thirteen articles were included in the meta-analysis. The WMD of probing pocket depth reduction was 0.25 mm (p < 0.05) for FMD vs. Q-SRP in single-rooted teeth with moderate pockets, and clinical attachment level gain in single- and multirooted teeth with moderate pockets was 0.33 mm (p < 0.05) for FMD vs. Q-SRP. Except for those, no statistically significant differences were found in the other subanalyses of FMD vs. Q-SRP, FMS vs. Q-SRP and FMD vs. FMS. Therefore, the meta-analysis results showed that FMD was better than Q-SRP for achieving probing pocket depth reduction and clinical attachment level gain in moderate pockets. Additionally, regardless of the treatment, no serious complications were observed. FMD, FMS and Q-SRP are all effective for the treatment of adult chronic periodontitis, and they do not lead to any obvious discomfort among patients. Moreover, FMD had modest additional clinical benefits over Q-SRP, so we prefer to recommend FMD as the first choice for the treatment of adult chronic periodontitis.
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Affiliation(s)
- H Fang
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - M Han
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Q-L Li
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - C Y Cao
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - R Xia
- The 2nd Hospital affiliated to Anhui Medical University, Hefei, China
| | - Z-H Zhang
- Hospital of Anhui Province, Hefei, China
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15
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Pozhitkov AE, Leroux BG, Randolph TW, Beikler T, Flemmig TF, Noble PA. Towards microbiome transplant as a therapy for periodontitis: an exploratory study of periodontitis microbial signature contrasted by oral health, caries and edentulism. BMC Oral Health 2015; 15:125. [PMID: 26468081 PMCID: PMC4607249 DOI: 10.1186/s12903-015-0109-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 10/06/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Conventional periodontal therapy aims at controlling supra- and subgingival biofilms. Although periodontal therapy was shown to improve periodontal health, it does not completely arrest the disease. Almost all subjects compliant with periodontal maintenance continue to experience progressive clinical attachment loss and a fraction of them loses teeth. An oral microbial transplant may be a new alternative for treating periodontitis (inspired by fecal transplant). First, it must be established that microbiomes of oral health and periodontitis are distinct. In that case, the health-associated microbiome could be introduced into the oral cavity of periodontitis patients. This relates to the goals of our study: (i) to assess if microbial communities of the entire oral cavity of subjects with periodontitis were different from or oral health contrasted by microbiotas of caries and edentulism patients; (ii) to test in vitro if safe concentration of sodium hypochlorite could be used for initial eradication of the original oral microbiota followed by a safe neutralization of the hypochlorite prior transplantation. METHODS Sixteen systemically healthy white adults with clinical signs of one of the following oral conditions were enrolled: periodontitis, established caries, edentulism, and oral health. Oral biofilm samples were collected from sub- and supra-gingival sites, and oral mucosae. DNA was extracted and 16S rRNA genes were amplified. Amplicons from the same patient were pooled, sequenced and quantified. Volunteer's oral plaque was treated with saline, 16 mM NaOCl and NaOCl neutralized by ascorbate buffer followed by plating on blood agar. RESULTS Ordination plots of rRNA gene abundances revealed distinct groupings for the oral microbiomes of subjects with periodontitis, edentulism, or oral health. The oral microbiome in subjects with periodontitis showed the greatest diversity harboring 29 bacterial species at significantly higher abundance compared to subjects with the other assessed conditions. Healthy subjects had significantly higher abundance in 10 microbial species compared to the other conditions. NaOCl showed strong antimicrobial properties; nontoxic ascorbate was capable of neutralizing the hypochlorite. CONCLUSIONS Distinct oral microbial signatures were found in subjects with periodontitis, edentulism, or oral health. This finding opens up a potential for a new therapy, whereby a health-related entire oral microbial community would be transplanted to the diseased patient.
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Affiliation(s)
- Alex E Pozhitkov
- Department of Oral Health Sciences, University of Washington, Box 3574444, Seattle, WA, 98195-7444, USA.
| | - Brian G Leroux
- Department of Oral Health Sciences, University of Washington, Box 3574444, Seattle, WA, 98195-7444, USA.
| | - Timothy W Randolph
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., PO Box 19024, Seattle, WA, 98109, USA.
| | - Thomas Beikler
- Section of Periodontics, School of Medicine, Heinrich-Heine-University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Thomas F Flemmig
- Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, Peoples' Republic of China.
| | - Peter A Noble
- Department of Oral Health Sciences, University of Washington, Box 3574444, Seattle, WA, 98195-7444, USA.
- PhD Program in Microbiology, Alabama State University, Montgomery, AL, 36101, USA.
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16
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Clinical and microbiological effects of quadrant versus full-mouth root planing—A randomized study. J Dent Sci 2014. [DOI: 10.1016/j.jds.2013.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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One-stage full-mouth disinfection and basic periodontal treatment in patients with diabetes mellitus. J Public Health (Oxf) 2013. [DOI: 10.1007/s10389-013-0596-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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18
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Lauenstein M, Kaufmann M, Persson GR. Clinical and microbiological results following nonsurgical periodontal therapy with or without local administration of piperacillin/tazobactam. Clin Oral Investig 2013; 17:1645-60. [DOI: 10.1007/s00784-012-0856-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 09/27/2012] [Indexed: 10/27/2022]
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19
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Silva-Senem MXE, Heller D, Varela VM, Torres MCB, Feres-Filho EJ, Colombo APV. Clinical and microbiological effects of systemic antimicrobials combined to an anti-infective mechanical debridement for the management of aggressive periodontitis: a 12-month randomized controlled trial. J Clin Periodontol 2013; 40:242-51. [DOI: 10.1111/jcpe.12052] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 11/06/2012] [Accepted: 11/30/2012] [Indexed: 01/15/2023]
Affiliation(s)
- Mayra Xavier e Silva-Senem
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Débora Heller
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- Periodontology and Oral Biology Department; Boston University; Boston MA USA
| | - Victor Macedo Varela
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Maria Cynesia Barros Torres
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Eduardo Jorge Feres-Filho
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Ana Paula Vieira Colombo
- Department of Medical Microbiology, Institute of Microbiology; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
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Flemmig TF, Arushanov D, Daubert D, Rothen M, Mueller G, Leroux BG. Randomized Controlled Trial Assessing Efficacy and Safety of Glycine Powder Air Polishing in Moderate-to-Deep Periodontal Pockets. J Periodontol 2012; 83:444-52. [DOI: 10.1902/jop.2011.110367] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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21
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Aimetti M, Romano F, Guzzi N, Carnevale G. Full-mouth disinfection and systemic antimicrobial therapy in generalized aggressive periodontitis: a randomized, placebo-controlled trial. J Clin Periodontol 2012; 39:284-94. [DOI: 10.1111/j.1600-051x.2011.01795.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2011] [Indexed: 01/21/2023]
Affiliation(s)
- Mario Aimetti
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Federica Romano
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Nicoletta Guzzi
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Gianfranco Carnevale
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
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22
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Eick S, Radakovic S, Pfister W, Nietzsche S, Sculean A. Efficacy of taurolidine against periodontopathic species—an in vitro study. Clin Oral Investig 2011; 16:735-44. [DOI: 10.1007/s00784-011-0567-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 05/11/2011] [Indexed: 12/25/2022]
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23
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Paola RDI, Oteri G, Mazzon E, Crisafulli C, Galuppo M, Toso RDAL, Pressi G, Cordasco G, Cuzzocrea S. Effects of verbascoside, biotechnologically purified by Syringa vulgaris plant cell cultures, in a rodent model of periodontitis. J Pharm Pharmacol 2011; 63:707-17. [DOI: 10.1111/j.2042-7158.2011.01262.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Objectives
Verbascoside has previously been characterized as an effective scavenger of active free radicals and an inhibitor of lipid peroxidation. In the present study, we have investigated the effects of verbascoside from Syringa vulgaris in a rat model of ligature-induced periodontitis.
Methods
Male Sprague–Dawley rats were lightly anaesthetized with pentobarbitone (35 mg/kg). Sterile, 2-0 black braided silk thread was placed around the cervix of the lower left first molar and knotted medially. Animals received vebascoside 2 mg/kg orally, daily for 8 days.
Key findings
On the eighth day after placement of the ligature, we evaluated several markers of inflammation: (i) myeloperoxidase activity, (ii) thiobarbituric acid-reactant substance measurements, (iii) NF-κB expression, (iv) iNOS expression, (v) the nitration of tyrosine residues, (vi) activation of the nuclear enzyme poly(ADP-ribose) polymerase, (vii) Bax and Bcl-2 expression and (viii) a degree of gingivomucosal tissue injury. Oral administration of verbascoside (2 mg/kg daily for 8 days) significantly decreased all of the parameters of inflammation as described above.
Conclusions
These results demonstrate that verbascoside exerts an anti-inflammatory role during experimental periodontitis and is able to ameliorate the tissue damage associated with ligature-induced periodontitis.
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Affiliation(s)
| | - Giacomo Oteri
- Istituto Policattedra di Odontostomatologia Universita degli Studi di Messina, Messina, Italy
| | | | - Concetta Crisafulli
- Department of Clinical and Experimental Medicine and Pharmacology, School of Medicine, University of Messina, Messina, Italy
| | - Maria Galuppo
- Department of Clinical and Experimental Medicine and Pharmacology, School of Medicine, University of Messina, Messina, Italy
| | | | | | - Giancarlo Cordasco
- Istituto Policattedra di Odontostomatologia Universita degli Studi di Messina, Messina, Italy
| | - Salvatore Cuzzocrea
- IRCCS Centro Neurolesi ‘Bonino-Pulejo’, Messina, Italy
- Department of Clinical and Experimental Medicine and Pharmacology, School of Medicine, University of Messina, Messina, Italy
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24
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Liu D, Zhou Y, Li C, Li Y, Jiang Y, Huang Z, Liang J, Shu R. Denaturing gradient gel electrophoresis analysis with different primers of subgingival bacterial communities under mechanical debridement. Microbiol Immunol 2011; 54:702-6. [PMID: 21155359 DOI: 10.1111/j.1348-0421.2010.00261.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
DGGE of 16S rDNA is one of the most frequently used methods to study microbial communities. In this study, the DGGE profiles of different 16S rDNA regions of the periodontal pathogens Porphyromonas gingivalis, Fusobacterium nucleatum, and Prevotella nigrescens were investigated. The results suggested that V3-V5 and V6-V8 fragments may be suitable for community analysis of subgingival bacteria. Further analysis of subgingival samples with V3-V5 and V6-V8 regions as target fragments suggested that, in chronic periodontitis, re-colonization by periodontal bacteria with a population very similar to the baseline may occur by 6 weeks after mechanical debridement.
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Affiliation(s)
- Dali Liu
- Department of Periodontology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
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25
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Aimetti M, Romano F, Guzzi N, Carnevale G. One-stage full-mouth disinfection as a therapeutic approach for generalized aggressive periodontitis. J Periodontol 2010; 82:845-53. [PMID: 21091345 DOI: 10.1902/jop.2010.100468] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Data concerning treatment outcomes in patients with generalized aggressive periodontitis (GAgP) are limited. The aim of this study is to investigate 6-month clinical and microbiologic outcomes of the one-stage full-mouth disinfection (OSFMD) in the management of patients with GAgP. METHODS Twenty-seven patients with advanced GAgP were included in this prospective follow-up intervention study. Clinical and microbiologic parameters were collected at baseline and 3 and 6 months after the OSFMD. Patient-, tooth-, and site-level analyses were carried out. Subgingival samples from moderate (4 to 5 mm) and deep (≥6 mm) pocket sites were analyzed using a polymerase chain reaction for Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), and Treponema denticola. RESULTS The OSFMD resulted in significant improvements in all parameters. After 6 months, the whole-mouth probing depth (PD) decreased from 4.2 ± 1.1 mm to 2.8 ± 0.6 mm, and the clinical attachment level was reduced from 4.5 ± 1.2 mm to 3.4 ± 1.1 mm (P <0.001). When data were analyzed based on the frequency distribution of PD, the number of sites with PD ≥5 mm decreased by 61% from baseline values, and mean PD reductions of 1.5 and 2.5 mm were noted in moderate and deep pockets, respectively. At 6 months, percentages of moderate and deep sites free of pathogens were 40% and 27%, respectively. CONCLUSION The OSFMD may be a viable approach to deal with severe GAgP.
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Affiliation(s)
- Mario Aimetti
- Department of Periodontology, Dental School, University of Turin, Turin, Italy.
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26
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Abstract
Periodontal diseases are multifactorial infections elicited by a complex of primarily gram-negative bacteria that interact with host tissues and lead to the destruction of the periodontal structures. Bdellovibrio bacteriovorus is a gram-negative bacterium that preys upon other gram-negative bacteria. It was previously shown that B. bacteriovorus has an ability to attack and remove surface-attached bacteria or biofilms. In this study, we examined the host specificity of B. bacteriovorus strain 109J and its ability to prey on oral pathogens associated with periodontitis, including; Aggregatibacter actinomycetemcomitans, Eikenella corrodens, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis and Tannerella forsythia. We further demonstrated that B. bacteriovorus 109J has an ability to remove biofilms of Ei. corrodens as well as biofilms composed of A. actinomycetemcomitans. Bdellovibrio bacteriovorus was able to remove A. actinomycetemcomitans biofilms developed on hydroxyapatite surfaces and in the presence of saliva, as well as to detach metabolically inactive biofilms. Experiments aimed at enhancing the biofilm removal aptitude of B. bacteriovorus with the aid of extracellular-polymeric-substance-degrading enzymes demonstrated that proteinase-K inhibits predation. However, treating A. actinomycetemcomitans biofilms with DspB, a poly-N-acetylglucosamine (PGA) -hydrolysing enzyme, increased biofilm removal. Increased biofilm removal was also recorded when A. actinomycetemcomitans PGA-defective mutants were used as host cells, suggesting that PGA degradation could enhance the removal of A. actinomycetemcomitans biofilm by B. bacteriovorus.
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Affiliation(s)
- A Dashiff
- Department of Oral Biology, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
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27
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Duss C, Lang NP, Cosyn J, Persson GR. A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery. J Clin Periodontol 2010; 37:988-97. [DOI: 10.1111/j.1600-051x.2010.01609.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
The comparison of the efficacy of surgical and nonsurgical procedures revealed that scaling and root planing alone or in combination with flap procedures are effective methods for the treatment of chronic periodontitis. Also, the consistent message is that in treating deep pockets, open-flap debridement results in greater probing pocket depth reduction and clinical attachment gain than nonsurgical modalities. Nonsurgical modalities in shallower pockets consistently involve less post-therapy recession and are clearly recognized as being more conservative. Research is still needed on the clinical benefit of the granulation tissue removal that is a feature of periodontal surgical therapy and, to a lesser extent, occurs through indirect trauma in nonsurgical therapy.
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Affiliation(s)
- Danae A Apatzidou
- Dental School, Department of Preventive Dentistry, Periodontology and Biology of Implants, Aristotle University of Thessaloniki, University Campus, 54124 Greece.
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30
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Tomasi C, Wennström JL. Full-mouth treatment vs. the conventional staged approach for periodontal infection control. Periodontol 2000 2009; 51:45-62. [DOI: 10.1111/j.1600-0757.2009.00306.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Feres M, Gursky LC, Faveri M, Tsuzuki CO, Figueiredo LC. Clinical and microbiological benefits of strict supragingival plaque control as part of the active phase of periodontal therapy. J Clin Periodontol 2009; 36:857-67. [PMID: 19703236 DOI: 10.1111/j.1600-051x.2009.01471.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To compare the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with mechanical [professional plaque control (PPC)] or chemical [chlorhexidine rinsing (CHX)] control of supragingival plaque in the treatment of chronic periodontitis. MATERIAL AND METHODS Sixty subjects were randomly assigned to receive SRP alone or combined with PPC (twice a week) or with CHX rinsing (twice a day). The adjunctive treatments began with SRP and were continued for 42 days. Clinical and microbiological examinations were performed at baseline, 2 and 6 months post-therapy. Subgingival plaque samples were analysed for 38 bacterial species by checkerboard DNA-DNA hybridization. RESULTS The two test treatments were more effective in improving probing depth and clinical attachment level (CAL) than SRP alone, even in intermediate and deep sites. CAL gain was better maintained in the CHX group. The most beneficial microbiological changes were observed in CHX-treated subjects, who showed a significant reduction in the proportions of red and orange complexes, as well as an increase in the proportions of the host-compatible bacterial species. CONCLUSION Strict plaque control performed during and after SRP improves periodontal treatment outcomes. The greatest microbiological and clinical benefits were observed with the use of CHX rinsing.
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Affiliation(s)
- Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.
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32
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Teughels W, Dekeyser C, Van Essche M, Quirynen M. One-stage, full-mouth disinfection: fiction or reality? Periodontol 2000 2009; 50:39-51. [PMID: 19388952 DOI: 10.1111/j.1600-0757.2008.00292.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Cortelli SC, Cortelli JR, Holzhausen M, Franco GCN, Rebelo RZ, Sonagere AS, Queiroz CDS, Costa FO. Essential oils in one-stage full-mouth disinfection: double-blind, randomized clinical trial of long-term clinical, microbial and salivary effects. J Clin Periodontol 2009; 36:333-42. [DOI: 10.1111/j.1600-051x.2009.01376.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lang NP, Tan WC, Krähenmann MA, Zwahlen M. A systematic review of the effects of full-mouth debridement with and without antiseptics in patients with chronic periodontitis. J Clin Periodontol 2009; 35:8-21. [PMID: 18724838 DOI: 10.1111/j.1600-051x.2008.01257.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To assess the clinical and microbiological effects of full-mouth debridement with (FMD) and without the use of antiseptics [full-mouth scaling and root planing (FMSRP)] in comparison with conventional staged debridement (CSD) in patients with chronic periodontitis after at least 6 months. MATERIAL AND METHODS The search in MEDLINE (PubMed), covering a period of 1975 to October 2007, and hand searching yielded 207 titles. Forty-two abstracts and 17 full-text articles were screened for inclusion. RESULTS Twelve articles allowed a direct comparison of FMD with CSD, FMSRP with CSD and FMD with FMSRP. Probing pocket depth reductions were significantly greater (0.2 mm) with FMD and FMSRP compared with CSD. Moreover, a modest reduction in BOP (9%) favoured FMD. Likewise, clinical attachment levels were improved by 0.2-0.4 mm in favour of FMD and FMSRP, respectively. In all comparisons, single-rooted teeth and deep pockets benefitted slightly from FMD and FMSRP. Limited differences in the changes of the subgingival microbiota were noted between the treatment modalities. CONCLUSIONS Despite the significant differences of modest magnitude, FMD or FMSRP do not provide clinically relevant advantages over CSD. Hence, all three treatment modalities may be recommended for debridement in the initial treatment of patients with chronic periodontitis.
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Affiliation(s)
- Niklaus P Lang
- School of Dental Medicine, University of Berne, Berne, Switzerland.
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35
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Persson GR, Weibel M, Hirschi R, Katsoulis J. Similarities in the Subgingival Microbiota Assessed by a Curet Sampling Method at Sites With Chronic Periodontitis. J Periodontol 2008; 79:2290-6. [DOI: 10.1902/jop.2008.080142] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Guarnelli ME, Franceschetti G, Manfrini R, Trombelli L. Adjunctive effect of chlorhexidine in ultrasonic instrumentation of aggressive periodontitis patients: a pilot study. J Clin Periodontol 2008; 35:333-41. [DOI: 10.1111/j.1600-051x.2008.01199.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Persson GR, Hitti J, Paul K, Hirschi R, Weibel M, Rothen M, Persson RE. Tannerella forsythiaandPseudomonas aeruginosain Subgingival Bacterial Samples From Parous Women. J Periodontol 2008; 79:508-16. [PMID: 18315434 DOI: 10.1902/jop.2008.070350] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- G Rutger Persson
- Department of Periodontology and Fixed Prosthodontics, Division of Oral Microbiology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, Switzerland
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Knöfler GU, Purschwitz RE, Jentsch HF. Clinical Evaluation of Partial- and Full-Mouth Scaling in the Treatment of Chronic Periodontitis. J Periodontol 2007; 78:2135-42. [DOI: 10.1902/jop.2007.070010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Persson GR, Yeates J, Persson RE, Hirschi-Imfeld R, Weibel M, Kiyak HA. The Impact of a Low-Frequency Chlorhexidine Rinsing Schedule on the Subgingival Microbiota (the TEETH clinical trial). J Periodontol 2007; 78:1751-8. [PMID: 17760545 DOI: 10.1902/jop.2007.070138] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Information on the efficacy of chlorhexidine (CHX) rinsing on the subgingival microbiota is limited. This study tested if intermittent CHX rinsing over 5 years had an impact on the subgingival microbiota. METHODS Subgingival plaque samples were analyzed by the checkerboard DNA-DNA hybridization method in a double-blind randomized CHX rinse study. RESULTS A total of 210 subjects were included. The mean age of the subjects was 71.7 (+/- 4.1) years, and 56.2% were women. Evidence of alveolar bone loss was found in 39% of subjects. Bacterial loads were not correlated significantly with probing depth. At year 5, subjects in the CHX rinse group with no evidence of bone loss presented with lower total bacterial counts than control subjects with no bone loss. The levels of the following bacteria were significantly lower in the CHX group: Lactobacillus acidophilus (P <0.05), Eikenella corrodens (P <0.05), Fusobacterium nucleatum sp. nucleatum (P <0.01), Treponema denticola (P <0.05), Leptotrichia buccalis (P <0.05), and Eubacterium saburreum (P <0.05). No differences in bacterial loads were found between CHX and control rinse subjects with alveolar bone loss. CONCLUSIONS Older subjects with or without periodontitis carry a large variety of bacteria associated with periodontitis. Intermittent rinsing with CHX may provide a preventive benefit in reducing levels of bacteria but only in subjects without alveolar bone loss.
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Affiliation(s)
- G Rutger Persson
- Department of Periodontology and Fixed Prosthodontics, Division of Oral Microbiology, School of Dental Medicine, University of Berne, Berne, Switzerland. rutger.persson@zmk
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Casas A, Herrera D, Martín-Carnes J, González I, O'Connor A, Sanz M. Influence of Sampling Strategy on Microbiologic Results Before and After Periodontal Treatment. J Periodontol 2007; 78:1103-12. [PMID: 17539725 DOI: 10.1902/jop.2007.060232] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to test whether different sampling strategies would influence the microbiologic outcomes by assessing the bacterial load and composition of the subgingival microbiota by means of anaerobic culturing before and after periodontal treatment. METHODS The first study (1 versus 4 [1vs4]) included 33 patients with generalized chronic periodontitis. Two sampling strategies were compared, sampling one site from the deepest pocket in the mouth (M1) versus a pooled sample of four sites from the deepest pockets in each quadrant (M4). The second study (2 versus 4 [2vs4]) included 20 patients with generalized chronic periodontitis. The strategy M4 was compared to a pooled sample of two non-adjacent sites in the same quadrant (M2). All samples were processed identically by means of anaerobic culturing. In both studies, a pretreatment sampling was taken. However, in the second study (2vs4), subgingival samples were also taken at 1, 3, and 6 months after periodontal therapy. Quantitative data were compared between strategies by means of t test and signed-rank test; qualitative data were compared by means of 2 x 2 contingency tables. RESULTS Pretreatment samples showed that total anaerobic counts were significantly higher for M4 compared to M1 (P <0.001) and M2 (P = 0.025). However, there were no significant differences in regard to percentage of microbiota and counts for each pathogen. Most of the qualitative differences between strategies were caused by false negatives in M1 and M2. Post-treatment samples showed a reduction in total counts and a limited impact in the frequency of detection of periodontal pathogens. M2 detected a significant decrease in the frequency of detection of Porphyromonas gingivalis, which was not confirmed by the M4 strategy. CONCLUSION The criteria of selection and the number of sites selected when sampling the subgingival biofilm in patients with generalized chronic periodontitis may influence the detection and quantitation of periodontal pathogens when evaluated by culture especially after treatment.
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Affiliation(s)
- Agustín Casas
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
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Cosyn J, Sabzevar MM. Subgingival chlorhexidine varnish administration as an adjunct to same-day full-mouth root planing. II. Microbiological observations. J Periodontol 2007; 78:438-45. [PMID: 17335366 DOI: 10.1902/jop.2007.060222] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Recently, the clinical additive value of a highly concentrated chlorhexidine (CHX) varnish, when applied subgingivally as an adjunct to scaling and root planing, was described. The objective of the present study was to investigate the microbiological impact of a treatment strategy for chronic periodontitis based on a combination of same-day full-mouth root planing and subgingival CHX varnish administration. METHODS A randomized, controlled, single-blind, parallel trial was conducted on 33 non-smoking chronic periodontitis patients. The control group received oral hygiene instructions and same-day full-mouth root planing. The test group received the same instructions and treatment; however, all pockets also were disinfected using a supersaturated CHX varnish. Subgingival plaque samples were collected from the deepest site per quadrant in each patient at baseline and after 1, 3, and 6 months. Pooled sample analysis was performed using a multiplex polymerase chain reaction-based method for the identification of Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), Treponema denticola (Td), and Prevotella intermedia (Pi). RESULTS In terms of detection frequency and bacterial levels, significant, mainly temporary, reductions from baseline were found in both groups. When a comparison was made between the control and the test group, significant differences in the detection frequency of Tf (P = 0.024) and Td (P = 0.024), which favored the test group, were found at 1 month. A similar phenomenon was seen for Td (P = 0.031) based on bacterial levels. An important trend toward lower Tf levels in the test group also was found at 1 month (P = 0.052). Compared to baseline levels, microbiological benefits in the test group seemed to be maintained, at least in part, over a 6-month period. In contrast, all microbial levels had relapsed in the control group at study termination. CONCLUSION The microbiological results of the present study promote the subgingival administration of a highly concentrated CHX varnish as an adjunct to same-day full-mouth root planing.
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Affiliation(s)
- Jan Cosyn
- Department of Periodontology, School of Dental Medicine, Free University of Brussels, Brussels, Belgium.
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Haffajee AD, Teles RP, Socransky SS. Association of Eubacterium nodatum and Treponema denticola with human periodontitis lesions. ACTA ACUST UNITED AC 2006; 21:269-82. [PMID: 16922925 DOI: 10.1111/j.1399-302x.2006.00287.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of the present investigation was to compare the levels, proportions and percentage of sites colonized by 40 bacterial species in subgingival plaque samples from periodontally healthy subjects and patients with chronic periodontitis to seek possible pathogens other than the consensus pathogens Porphyromonas gingivalis and Tannerella forsythia. METHOD Subgingival plaque samples were taken from the mesial aspect of each tooth in 635 subjects with chronic periodontitis and 189 periodontally healthy subjects. The samples were individually analyzed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization (total samples = 21,832). Mean counts, % DNA probe counts and percentage of sites colonized at >10(5) were determined for each species in each subject and then averaged in each clinical group. Significance of difference between groups was determined using the Mann-Whitney test. Association between combinations of species and periodontal status was examined by stepwise logistic regression analysis. Analyses were repeated using a subset of subjects from both clinical groups who had proportions of P. gingivalis plus T. forsythia less than the median (4.42%) found in periodontally healthy subjects. All analyses were adjusted for multiple comparisons. RESULTS For the 824 subjects the consensus pathogens P. gingivalis and T. forsythia as well as Eubacterium nodatum and Treponema denticola had significantly higher mean counts, proportions and percentage of sites colonized in samples from subjects with periodontitis than from periodontally healthy subjects. There were significantly more Capnocytophaga gingivalis, Streptococcus gordonii and Veillonella parvula in periodontally healthy subjects. E. nodatum, T. denticola, Streptococcus oralis, Streptococcus intermedius, Fusobacterium nucleatum ssp. vincentii all had higher counts and proportions in diseased than healthy subjects who had low proportions of P. gingivalis and T. forsythia. Logistic regression analysis indicated that the same species groups were associated with disease status after adjusting for the proportions of the other species. CONCLUSIONS This investigation confirmed the strong association of P. gingivalis and T. forsythia with chronic periodontitis and emphasized a strong association of E. nodatum and T. denticola with periodontitis whether in the presence or absence of high levels of the consensus pathogens. Other species, including S. oralis, Eikenella corrodens, S. intermedius and F. nucleatum ssp. vincentii, were associated with disease when P. gingivalis and T. forsythia were present in low proportions.
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Affiliation(s)
- A D Haffajee
- Department of Periodontology, The Forsyth Institute, 140 The Fenway, Boston, MA 02115, USA.
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Affiliation(s)
- Ricardo P Teles
- Department of Periodontology, The Forsyth Institute, Boston, Massachusetts, USA
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Haffajee AD, Teles RP, Socransky SS. The effect of periodontal therapy on the composition of the subgingival microbiota. Periodontol 2000 2006; 42:219-58. [PMID: 16930312 DOI: 10.1111/j.1600-0757.2006.00191.x] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anne D Haffajee
- Department of Periodontology, The Forsyth Institute, Boston, Massachusetts, USA
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Affiliation(s)
- Anne C R Tanner
- Department of Molecular Genetics, The Forsyth Institute, Boston, Massachusetts, USA
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Quirynen M, De Soete M, Boschmans G, Pauwels M, Coucke W, Teughels W, van Steenberghe D. Benefit of “one-stage full-mouth disinfection” is explained by disinfection and root planing within 24 hours: a randomized controlled trial. J Clin Periodontol 2006; 33:639-47. [PMID: 16856902 DOI: 10.1111/j.1600-051x.2006.00959.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The beneficial effects of the one-stage, full-mouth disinfection remain controversial in the scientific literature. This might be due to the fact that an entire mouth disinfection with the use of antiseptics has been confused with a full-mouth scaling and root planing. This parallel, single blind RCT study aimed to compare several full-mouth treatment strategies with each other. MATERIAL AND METHODS Seventy-one patients with moderate periodontitis were randomly allocated to one of the following treatment strategies: scaling and root planing, quadrant by quadrant, at two-week intervals (negative control, NC), full-mouth scaling and root planing within 2 consecutive days (FRP), or three one-stage, full-mouth disinfection (FM) protocols within 2 consecutive days applying antiseptics to all intra-oral niches for periopathogens using as antiseptics: chlorhexidine (FMCHX) for 2 months, amine fluoride/stannous fluoride for 2 months (FMF), or chlorhexidine for 2 months followed by amine fluoride/stannous fluoride for another 6 months (FMCHX+F). At baseline and after 2, 4, and 8 a series of periodontal parameters were recorded. RESULTS All treatment strategies resulted in significant (p<0.05) improvements of all clinical parameters over the entire duration of the study. Inter-treatment differences were often encountered. The NC group nearly always showed significant smaller improvements than the two CHX groups. The differences between the FRP or FM groups, and the two CHX groups only sporadically reached a statistical significance. CONCLUSION These observations indicate that the benefits of the "OSFMD" protocol are partially due to the use of the antiseptics and partially to the completion of the therapy in a short time.
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Affiliation(s)
- Marc Quirynen
- Department of Periodontology, Faculty of Medicine, Catholic University of leuven, Leuven, Belgium.
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Boutaga K, van Winkelhoff AJ, Vandenbroucke-Grauls CMJE, Savelkoul PHM. The additional value of real-time PCR in the quantitative detection of periodontal pathogens. J Clin Periodontol 2006; 33:427-33. [PMID: 16677332 DOI: 10.1111/j.1600-051x.2006.00925.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM For the analysis of subgingival plaque, anaerobic bacterial culture has been the gold standard for many years. Currently, molecular microbial techniques have become available to identify and quantify target organisms with high specificity and sensitivity. The technique of real-time polymerase chain reaction(RT-PCR) provides a new tool to detect oral pathogens both in oral and non-oral human infections. The aim of this study was to compare the RT-PCR and anaerobic culture for detection and quantification of six periodontal pathogens in periodontal health and disease. MATERIAL AND METHODS Subgingival plaque samples from 259 adult patients with periodontitis and 111 healthy controls were analysed with quantitative anaerobic culture and quantitative RT-PCR for Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Micromonas micros and Fusobacterium spp. RESULTS All species were more frequently isolated from patients than controls with both culture and RT-PCR. P. gingivalis, T. forsythia and M. micros appeared significant markers for disease with both techniques. P. intermedia was significantly associated with periodontitis by RT-PCR only (OR 9.7), whereas A. actinomycetemcomitans showed a significant relationship by culture only. The critical differences between culture and RT-PCR were culture-negative/PCR-positive samples which amounted to 7% for A. actinomycetemcomitans, 3% for P. gingivalis, 7% for T. forsythia, 20% for P. intermedia, 6% for M. micros, and 0.8% for Fusobacterium spp. in periodontitis patients and 12%, 3%, 2%, 35%, 14% and 0%, respectively, in the periodontally healthy group. Furthermore, periodontitis individuals had significantly higher amount of all of the test species in the subgingival plaque samples compared with healthy subjects. CONCLUSION RT-PCR provides a new rapid diagnostic tool and opens the opportunity to detect small numbers of oral pathogens in clinical specimens, which are under the detection limit by culture technique.
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Affiliation(s)
- Khalil Boutaga
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam, and Vrije Universiteit, The Netherlands
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Quirynen M, Teughels W, van Steenberghe D. Impact of antiseptics on one-stage, full-mouth disinfection. J Clin Periodontol 2006; 33:49-52. [PMID: 16367856 DOI: 10.1111/j.1600-051x.2005.00868.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tenenbaum HC, Tenenbaum H, Zohar R. Future treatment and diagnostic strategies for periodontal diseases. Dent Clin North Am 2005; 49:677-94, viii. [PMID: 15978247 DOI: 10.1016/j.cden.2005.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Many new technologies have been developed or are being developed that could enhance the ability to diagnose, predict, and treat periodontitis. Newer treatment strategies may allow clinicians to achieve limited or more robust regeneration of the periodontium. New or refreshed approaches to disease control are being pursued that will benefit those suffering from chronic periodontal disease. In addition to novel therapeutics, there has been increasing focus on the development of more sensitive and specific diagnostic tests for periodontal diseases. Such tests will allow the clinician to determine whether a patient has active disease and what sort of attachment loss might be expected if the patient is not treated. By developing newer diagnostic tests, it also may be possible to detect and monitor active disease during therapy.
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Affiliation(s)
- Howard C Tenenbaum
- Discipline of Periodontology, Faculty of Dentistry, University of Toronto, 124 Edward Street, Suite 349C, Toronto, Ontario, Canada M5G 1G6
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Affiliation(s)
- Noel Claffey
- Dublin Dental School and Hospital, Trinity College, Ireland
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