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Liang H, Wang Z, Wu J, Li X, Semirumi DT. Microstructural and micromechanical modeling of gum-gelatin-based soft tissue engineering scaffolds. Int J Biol Macromol 2023; 241:124544. [PMID: 37086767 DOI: 10.1016/j.ijbiomac.2023.124544] [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: 12/08/2022] [Revised: 03/23/2023] [Accepted: 04/17/2023] [Indexed: 04/24/2023]
Abstract
Oral and dental diseases, including periodontal disease, are among the most common conditions in the field of dentistry. The best treatment for this complication is the use of different polymers and multi-component biological tissue prepared through the freeze-drying technique. In this study, biocompatible and biodegradable polymers, namely polyvinyl alcohol (PVA) and gelatin (GN), were used for this purpose, along with Arabian gum-hydroxyapatite (HA) for its antibacterial properties. Arabian gum, with weight percentages of 0, 2, 4, and 6 wt%, was added to the polyvinyl alcohol-gelatin composition at -55 °C for 28 h in the freezer and 48 h at -45 °C under a pressure of 0.01 mbar. The resulting porous biological tissue, with four different ratios, was tested for mechanical and biological analysis in a physiological solution. Then, the samples were analyzed using a scanning electron microscope (SEM) and X-ray diffraction (XRD) technique to study the morphology and structure of the compounds before and after placement in biological solutions. Additionally, a wettability and antibacterial test were performed on the nanocomposite specimen. The SEM observations revealed that this method can create a porous structure with a porosity of about 30-50 μm with a spherical and circular architecture, which was further improved by the addition of gum, reducing the percentage of porosity and improving the tissue's tensile strength and elastic modulus. The porosity changes showed a decrease from 72 % to 60 %, and the tensile strength increased from 53.5 KPa to 76 KPa, resulting in an elastic modulus of 510 KPa to 800 KPa. The addition of gum also reduced the rate of destruction of the biological tissue, making it more suitable for soft tissue applications. The obtained results of the pH test showed that the concentration changes were neutral. The contact angle of water droplets was measured to determine hydrophilicity, indicating an improvement in hydrophilicity after the addition of gum. The results showed that the use of PVA and gelatin, due to their ductility and suitable mechanical properties, along with Arabian gum-HA, could accelerate the healing process of dental periodontal problems.
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Affiliation(s)
- Huixing Liang
- School of Marine and Bioengineering, Yancheng Institute of Technology, Yancheng 224051, China.
| | - Ziming Wang
- School of Mechanical Engineering, Yancheng Institute of Technology, Yancheng 224051, China
| | - Junsong Wu
- Department of Basic Medical Science, Jiangsu Vocational Collere of Medicine, Yancheng 224000, China
| | - Xiang Li
- School of Marine and Biological Engineering, Yancheng Teachers University, Yancheng 224005, China.
| | - D T Semirumi
- School of Marine and Bioengineering, Yancheng Institute of Technology, Yancheng 224051, China
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Zhao H, Hu J, Zhao L. Adjunctive subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis. BMC Oral Health 2020; 20:34. [PMID: 32005169 PMCID: PMC6995104 DOI: 10.1186/s12903-020-1021-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/23/2020] [Indexed: 01/27/2023] Open
Abstract
Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of systematic review and meta-analysis justifying the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP. Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained. Results Seventeen studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth ≥ 4 mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15 mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP. Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites in NSPT appears to provide slight benefits in PPD reduction compared to NSPT alone for CP. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.
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Affiliation(s)
- Han Zhao
- Multi-disciplinary Treatment Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li Number.4, Beijing, 100050, China.,Department of Periodontology, Witten/Herdecke, University, Alfred-Herrhausen-Str. 45, 58445, Witten, Germany
| | - Jingchao Hu
- Department of Periodontology, Witten/Herdecke, University, Alfred-Herrhausen-Str. 45, 58445, Witten, Germany.,Department of Periodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li Number 4, Beijing, 100050, China
| | - Li Zhao
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 400015, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 400015, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 400015, China.
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Ambhore S, Padhye A. Comparative evaluation of the efficacy of Triphala gel and chlorhexidine digluconate gel in management of patients with chronic gingivitis: A randomized clinical trial. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_209_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhang J, Ab Malik N, McGrath C, Lam O. The effect of antiseptic oral sprays on dental plaque and gingival inflammation: A systematic review and meta-analysis. Int J Dent Hyg 2018; 17:16-26. [PMID: 29405627 DOI: 10.1111/idh.12331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To review the effectiveness of antiseptic oral sprays on oral health. METHODS AND MATERIALS Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included. RESULTS Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta-analyses. A meta-analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: -1.03 to -0.45) and 0.22 (95% CI: -0.38 to -0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta-analysis demonstrated an increase of 0.18 (95% CI: -0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta-analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta-analysis, eight studies reported significant improvements in PI and GI scores. CONCLUSIONS Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high-quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health.
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Affiliation(s)
- J Zhang
- Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - N Ab Malik
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - C McGrath
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Olt Lam
- Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Lecic J, Cakic S, Janjic Pavlovic O, Cicmil A, Vukotic O, Petrovic V, Cicmil S. Different methods for subgingival application of chlorhexidine in the treatment of patients with chronic periodontitis. Acta Odontol Scand 2016; 74:502-7. [PMID: 27409799 DOI: 10.1080/00016357.2016.1206964] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate (CHX) preparations applied subgingivally as an adjunct to scaling and root planing (SRP). MATERIAL AND METHODS A total of 120 periodontal pockets was included in this randomized, controlled, split mouth designed study. According to protocols used in treatment, periodontal pockets were assigned to experimental and control groups as follows: CHX solution as an addition to SRP versus control SRP group; CHX gel as an addition to SRP versus control SRP; CHX chip as an addition to SRP versus control SRP group. Following clinical parameters were recorded at baseline, one and three months after the baseline: plaque index (PI), probing pocket depth (PPD), bleeding index (BI) and clinical attachment level (CAL). RESULTS The most significant improvements were found concerning PI in CHX solution with SRP and CHX gel with SRP groups over controls at one month recall, as well as concerning BI and PPD in CHX chip with SRP group over SRP alone at three-month recall. CONCLUSION Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.
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Mishra V, Shettar L, Bajaj M, Math AS. Comparison of a commercially available herbal and 0.2% chlorhexidine mouthrinse for prevention of oral malodor: A clinical trial. J Int Soc Prev Community Dent 2016; 6:S6-S11. [PMID: 27195230 PMCID: PMC4863486 DOI: 10.4103/2231-0762.181160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives: Despite the adverse effects of chlorhexidine (CHX) in the oral cavity, it is still the most commonly prescribed mouthrinse for halitosis control due to its excellent results. The purpose of this study was to compare the efficacy of a mouthrinse with herbal formulation for halitosis control with 0.2% CHX gluconate containing rinse and to simultaneously assess adverse effects caused by the herbal mouthrinse if any. Materials and Methods: Ninety-six systemically healthy subjects with chronic generalized gingivitis were recruited in the study and divided into three groups receiving 0.2% CHX gluconate mouthrinse, herbal mouthrinse, or negative control, respectively as Group A, B, and C. The halimeter scores and organoleptic scores were recorded for each subject at baseline and after scaling. Others parameters recorded were plaque index and gingival index. All scores were reassessed on the 7th and 14th day, respectively. Statistical analysis was performed using Kruskal–Wallis ANOVA, Mann–Whitney U-test, and Wilcoxon matched pairs test. Results: There was an overall reduction in the halimeter scores both in Group A and B subjects which were not statistically significant within the groups; this was in accordance with the decrease in the mean organoleptic scores. Reduction in Group C scores was the least and differed statistically from both Group A and B scores. Conclusions: The results indicate an equivalent reduction in breath odor by both the herbal mouthrinse and CHX. Furthermore, side effects were less, and patient compliance was more with the herbal mouthrinse, which can thus be prescribed more safely and with predictable outcomes for oral malodor.
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Affiliation(s)
- Vandita Mishra
- Department of Periodontics, Sri Sai College of Dental Surgery, Hyderabad, Telangana, India
| | - Leena Shettar
- Department of Periodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Mahesh Bajaj
- Department of Periodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Abhishek Savir Math
- Department of Prosthodontics, Sri Sai College of Dental Surgery, Hyderabad, Telangana, India
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Rusu D, Stratul SI, Sarbu C, Roman A, Anghel A, Didilescu A, Jentsch H. Evaluation of a hydrophobic gel adhering to the gingiva in comparison with a standard water-soluble 1% chlorhexidine gel after scaling and root planing in patients with moderate chronic periodontitis. A randomized clinical trial. Int J Dent Hyg 2015; 15:53-64. [PMID: 26053503 DOI: 10.1111/idh.12155] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the clinical, microbiological and enzymatic activity of a hydrophobic chlorhexidine-based gingiva-adhering gel containing herbal ingredients, compared with a commercially available 1% chlorhexidine water-soluble gel, during non-surgical therapy of moderate chronic periodontitis. METHODS A total of 34 subjects participated in this 6-month blinded randomized parallel controlled trial (ISRCTN35210084). After scaling and root planing (SRP), test group received the gel, by rubbing on the gingiva, once every second day, for 14 days. The control group received the control gel twice daily. Clinical parameters considered were the approximal plaque index, simplified oral hygiene index, modified gingival index, bleeding on probing, probing depth and clinical attachment level (primary outcome), assessed at baseline, 3 and 6 months, together with the frequency of detection of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis (P.g.), Prevotella intermedia, Treponema denticola (T.d.), Tannerella forsythia (T.f.), and activity of neutrophil elastase and myeloperoxidase (secondary outcomes). RESULTS At 3 and 6 months, all clinical parameters improved significantly, without significant intergroup differences, except OHI-S, which improved at 3 months (P < 0.05). Microbiological data resulted in no significant intergroup differences at baseline and 6 months. At 3 months, significant differences for P.g., T.f. and T.d. were noted. A significant reduction of neutrophil elastase after 3 and 6 months was observed (P < 0.005), without significant intergroup differences. For myeloperoxidase, significant reductions were noted in both groups (P < 0.005 and P < 0.05), but no significant intergroup differences. The tested product seemed to have an increased efficacy, due to longer persistence on the gingiva, with reduced application frequency. CONCLUSIONS Both products had a relatively similar influence on the clinical, microbiological and enzymatic outcomes at 3 and 6 months after SRP.
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Affiliation(s)
- D Rusu
- Department of Periodontology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - S-I Stratul
- Department of Periodontology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - C Sarbu
- Department of Periodontology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - A Roman
- Department of Periodontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A Anghel
- Department of Biochemistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - A Didilescu
- Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - H Jentsch
- Centre for Periodontology, Department of Conservative Dentistry and Periodontology, University of Leipzig, Leipzig, Germany
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John P, Lazarus F, George JP, Selvam A, Prabhuji MLV. Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study. J Clin Diagn Res 2015; 9:ZC70-4. [PMID: 26155567 DOI: 10.7860/jcdr/2015/11534.5965] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/25/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. AIM The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). SETTINGS AND DESIGN The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. MATERIALS AND METHODS In a split-mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. RESULTS In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. CONCLUSION The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis.
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Affiliation(s)
- Priya John
- Senior Lecturer, Mar Baselious Dental College , Kothamangalam, Kerala, India
| | - Flemingson Lazarus
- Former Professor and HOD, Department of Periodontology, Best Dental College , Madurai, India
| | - Joann Pauline George
- Professor, Department of Periodontics, Krishnadevaraya College of Dental Sciences , Bangalore, India
| | - Arul Selvam
- Professor and HOD, Department of Microbiology, Krishnadevaraya College of Dental Sciences , Bangalore, India
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Eastham JE, Seymour RA. Local drug delivery in the management of periodontal diseases part 2: specific agents. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/denu.2014.41.9.796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jane E Eastham
- Research Assistant, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
| | - Robin A Seymour
- Emeritus Professor of Restorative Dentistry, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
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Abstract
AIM The aim of this review is to discuss the evidence for the management of chronic periodontitis, including methods of non-surgical therapy such as full mouth disinfection, full mouth debridement and conventional quadrant-by-quadrant therapy. METHODS Manual searches of Medline and Embase databases provided the relevant studies. RESULTS Multiple randomised controlled trials (RCTs) selected for the paper failed to show any significant differences between the quadrant-wise treatment and full mouth debridement and modalities. PRACTICAL IMPLICATIONS This review demonstrates that there is no known difference in treatment outcomes between full mouth debridement and traditional quadrant therapy. Further RCTs are necessary to assess clinical effectiveness of chemical adjunct use.
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Abstract
Periodontal diseases (gingivitis and periodontitis) are chronic bacterial infections with a remarkably high prevalence and morbidity. Periodontitis, in contrast to gingivitis, is not reversible, is associated with certain bacterial species and affects all of the soft tissue and bone that support teeth. Among the periodontal pathogens, species, such as Aggregatibacter (Actinobacillus) actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and several forms of uncultivable spirochetes play the major role in the pathogenesis. In severe chronic, recurrent and especially aggressive forms of periodontitis, diagnosis of the species involved and, whenever possible, an optimized evidence-based antimicrobial treatment is indicated. In order to monitor alarming bacterial changes in the periodontal pocket, several techniques, namely microscopy, culture, immunoassays, enzyme tests and DNA-based techniques, have been established and the methods are described in the first part of this review. In the second part, the selection and use of locally delivered (topical) and systemic antibiotics used adjunctively in periodontal therapy are discussed.
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Affiliation(s)
- Hans-Peter Horz
- Division of Oral Microbiology and Immunology, Department of Operative and Preventive Dentistry and Periodontology, University Hospital RWTH Aachen, Aachen, Germany.
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Farrer S, Baitson ES, Gedah L, Norman C, Darby P, Mathie RT. Homeopathic prescribing for chronic and acute periodontal conditions in 3 dental practices in the UK. HOMEOPATHY 2013; 102:242-7. [PMID: 24050769 DOI: 10.1016/j.homp.2013.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 01/27/2013] [Accepted: 06/26/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION This investigation extends our previous dental data collection pilot study with the following main aims: to gain insight into the periodontal complaints that dentists in the UK treat using individualised homeopathic prescription; to record patient-assessed change in severity of treated complaint (acute or chronic); to determine periodontal pocket depth (PPD). MATERIALS AND METHODS Three dentists recorded data systematically at 249 homeopathic appointments in 51 patients over a period of 18 months. A spreadsheet enabled the data collection of the following records: date of appointment; anonymised patient identity; main periodontal problem treated; whether the condition was acute or chronic; patient-assessed clinical outcome on a 7-point Likert scale, ranging from -3 to +3, to compare the first and any subsequent appointments; whether any interventional dental surgery (IDS) had been carried out; clinician-assessed PPD measurements. RESULTS At least one follow-up (FU) appointment was reported for each of 46 patients (22 chronic [6 with IDS, 16 without IDS]; 24 acute [10 with IDS, 14 without IDS]). In chronic cases, strongly positive outcomes (score of +2 or +3) were reported by 2 (33.3%) of 6 IDS patients and by 1 (6.3%) of 16 non-IDS patients. In acute cases, strongly positive outcomes were reported by 7 (70%) of 10 IDS patients and by 8 (57.2%) of 14 non-IDS patients (no statistically significant difference between sub-groups). The FU conditions most frequently treated with homeopathy were chronic periodontitis (19 patients) and acute periodontal abscess (11 patients). Analysis of PPD data was not feasible due to the small numbers of patients involved. CONCLUSION Limited insight has been gained into the periodontal complaints treated by homeopathy in the UK. Due to small sample size and equivocal results, the interpretation of the patient-reported outcomes data is unclear. Positive findings obtained in the acute treatment setting suggest that this may be a promising area for research in periodontal homeopathy.
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Affiliation(s)
- S Farrer
- Faculty of Homeopathy, 29 Park Street West, Luton LU1 3BE, UK.
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Chauhan AS, Bains VK, Gupta V, Singh GP, Patil SS. Comparative analysis of hyaluronan gel and xanthan-based chlorhexidine gel, as adjunct to scaling and root planing with scaling and root planing alone in the treatment of chronic periodontitis: A preliminary study. Contemp Clin Dent 2013; 4:54-61. [PMID: 23853453 PMCID: PMC3703695 DOI: 10.4103/0976-237x.111619] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study was to evaluate the effects of hyaluronan (HA) and chlorhexidine (CHX) gels as adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. MATERIALS AND METHODS Sixty patients within the age group of 30-65 years recruited to participate in the study were randomly equally divided into three groups. Complete SRP and subgingival debridement were performed within 6 h in all the patients. For control (Group I) patients, SRP was the only treatment modality given; for Group II and III patients, at least 8 teeth with 4-8 mm probing pocket depth (PPD) were selected for subgingival application of HA gel and CHX gel, respectively. Clinical periodontal parameters such as gingival index, PPD, and clinical attachment level (CAL) were recorded at baseline and 3 months, whereas plaque index was recorded at baseline, 1 month, and 3 months. For measuring systemic/hematological parameters, blood samples for laboratory tests for total leucocyte count (TLC), differential leucocyte count (DLC), and C-reactive protein (CRP) were obtained using standard 2-mL syringe from each subject in all the three groups at baseline, 24 h, and on the 1 month and 3 months post-baseline. RESULTS In all the three groups, a significant reduction in PPD and gain in CAL were observed between baseline and 3 months follow-up (P< 0.05); however, at 3 months, change in PPD and CAL was more in Group II than Group III, but the difference was non-significant, and Group I (control) showed less changes in PPD and CAL than both experimental groups. Only one patient revealed positive value for CRP at baseline only, and hence could not be statistically analyzed. In all the three groups, the peak values for TLC count were observed at 24 h. At 1-month and 3-month intervals, a significant improvement in TLC and DLC counts was observed among the experimental (HA gel/SRP and Xan-CHX gel) groups as compared to control group (SRP alone).
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Affiliation(s)
- Avinash Singh Chauhan
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
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14
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Chitsazi MT, Kashefimehr A, Pourabbas R, Shirmohammadi A, Ghasemi Barghi V, Daghigh Azar B. Efficacy of Subgingival Application of Xanthan-based Chlorhexidine Gel Adjunctive to Full-mouth Root Planing Assessed by Real-time PCR: A Microbiologic and Clinical Study. J Dent Res Dent Clin Dent Prospects 2013; 7:95-101. [PMID: 23875088 PMCID: PMC3713868 DOI: 10.5681/joddd.2013.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 10/21/2012] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND AIMS The aim of this clinical investigation was to compare clinical and microbiological effectiveness of adjunctive CHX gel in the treatment of periodontitis. MATERIALS AND METHODS Twenty-four subjects with localized or generalized moderate-to-severe chronic periodontitis underwent scaling and root planing. One tooth in each quadrant with a probing depth of >4 mm was chosen for combined gel and SRP, with contralateral tooth as control (SRP treated site). Clinical assessment was carried out at baseline and 1 and 3 months later; microbial assessment was performed by real-time PCR. Periodontal probing depth (PPD) was considered as primary outcome. RESULTS Twenty patients completed the study. Baseline PPDs were 4.90±0.78 and 5.05±0.79 in the SRP and gel groups, respectively (P>0.05), which decreased to 3.67±0.59 and 3.7±0.83 one month after treatment and 3.25±0.65 and 3.38±0.79 three months after treatment. Although values decreased significantly in both groups after one and three months (P=0.001 in the SRP and P=0.001 in the gel group), the inter-group difference was not significant neither at one-month (P=0.47) nor at three-month (P=0.77) intervals. The only clinical parameters exhibiting statistically significant inter-group differences was BOP in both one-month (P=0.004) and three-month (P=0.0001) intervals. All the other clinical measurements showed significant decreases after one and three months in both sites but without inter-group differences. CONCLUSION Subgingival application of xanthan chlorhexidine gel combined with scaling and root planing reduced bleed-ing of periodontal pockets. Clinical trials to evaluate effectiveness of this gel in aggressive and severe periodontitis modified by systemic factors are suggested.
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Affiliation(s)
- Mohammad Taghi Chitsazi
- Associate Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atabak Kashefimehr
- Assistant Professor, Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Pourabbas
- Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adileh Shirmohammadi
- Associate Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vadood Ghasemi Barghi
- Post-graduate Student, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Cosyn J, Miremadi SR, Sabzevar MM, De Bruyn H. Clinical effects of an essential oil solution used as a coolant during ultrasonic root debridement. Int J Dent Hyg 2012; 11:62-8. [PMID: 22520627 DOI: 10.1111/j.1601-5037.2012.00554.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The use of chlorhexidine and povidone iodine solutions applied as a coolant during ultrasonic root debridement for the treatment of chronic periodontitis has been described. Hitherto, this application has not yet been extensively investigated for essential oil solutions. The goal was to clinically explore this and to compare to water irrigation. MATERIALS AND METHODS Thirty-five chronic periodontitis patients participated in a single-blind randomized controlled clinical study. Patients were randomly allocated to the control group (n=18) or test group (n=17) receiving oral hygiene instructions and ultrasonic root debridement using water as a coolant, respectively, a pure essential oil solution. Oral hygiene was reinforced if necessary at each occasion, and clinical parameters were collected at baseline and after 1 and 3 months. RESULTS Significant pocket reduction (control, 1.02 mm; test, 0.89 mm) and clinical attachment gain (control and test, 0.48 mm) were shown in both groups. However, there were no significant differences between the groups at any point in time for any of the parameters. CONCLUSION Essential oil solutions do not offer a clinical benefit over water when used as a coolant during ultrasonic root debridement for the treatment of chronic periodontitis.
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Affiliation(s)
- J Cosyn
- Department of Periodontology and Oral Implantology, Faculty of Health Sciences, School of Dental Medicine, University of Ghent, Ghent, Belgium.
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Tenenbaum H, Luc J, Schaaf JF, Federlin-Ducani M, Cotton C, Elkaim R, Cuisinier FJG, Roques C. An 8-week, randomized, controlled, clinical study of the use of a 0.1% chlorhexidine mouthwash by chronic periodontitis patients. ACTA ACUST UNITED AC 2010; 2:29-37. [PMID: 25427325 DOI: 10.1111/j.2041-1626.2010.00031.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
AIM To evaluate the efficacy of a 2-week administration of a 0.1% chlorhexidine mouthwash in the short-term treatment of chronic periodontitis patients and the impact of this product when administered twice by pocket irrigation. METHODS Sixty patients were enrolled in a single-centre, placebo-controlled, randomized study with the blind allocation of product to two parallel groups. Clinical assessments were performed, and samples from six selected subgingival sites were collected for microbial analysis by culture at baseline, D15 and D56. Three of the six sites were randomly selected and were treated by subgingival irrigation with the same 0.1% chlorhexidine product at D0 and D7. A subsequent statistical analysis was performed using the paired Student's t-test and Wilcoxon rank sum test for within-group analyses; analysis of variance and the Kruskall-Wallis test were used for between-group analyses. RESULTS Two-week treatment with a 0.1% chlorhexidine mouthwash slightly reduced the gingival inflammation associated with periodontitis. We observed a significant decrease in Gram-negative, facultative anaerobes and micro-aerophiles, and a significant increase in Gram-positive cocci. No increase in the treatment effect was demonstrated by irrigation of the periodontal pockets. CONCLUSION The 0.1% chlorhexidine mouthwash showed limited beneficial effects in the treatment of periodontitis patients.
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Affiliation(s)
- Henri Tenenbaum
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France INSERM 977, Strasbourg, France Laboratory of Bacteriology, Virology and Industrial Microbiology, Faculty of Pharmaceutical Sciences, University of Toulouse, Toulouse, France Pierre Fabre Oral Care, Castres, France Parogene, Strasbourg, France
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Paolantonio M, D'Ercole S, Pilloni A, D'Archivio D, Lisanti L, Graziani F, Femminella B, Sammartino G, Perillo L, Tetè S, Perfetti G, Spoto G, Piccolomini R, Perinetti G. Clinical, Microbiologic, and Biochemical Effects of Subgingival Administration of a Xanthan-Based Chlorhexidine Gel in the Treatment of Periodontitis: A Randomized Multicenter Trial. J Periodontol 2009; 80:1479-92. [DOI: 10.1902/jop.2009.090050] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zaman MA, Martin GP, Rees GD. Mucoadhesion, hydration and rheological properties of non-aqueous delivery systems (NADS) for the oral cavity. J Dent 2008; 36:351-9. [DOI: 10.1016/j.jdent.2008.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 01/16/2008] [Accepted: 01/17/2008] [Indexed: 11/29/2022] Open
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Paolantonio M, D'Angelo M, Grassi RF, Perinetti G, Piccolomini R, Pizzo G, Annunziata M, D'Archivio D, D'Ercole S, Nardi G, Guida L. Clinical and Microbiologic Effects of Subgingival Controlled-Release Delivery of Chlorhexidine Chip in the Treatment of Periodontitis: A Multicenter Study. J Periodontol 2008; 79:271-82. [DOI: 10.1902/jop.2008.070308] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Kozlovsky A, Artzi Z, Hirshberg A, Israeli-Tobias C, Reich L. Effect of local antimicrobial agents on excisional palatal wound healing: a clinical and histomorphometric study in rats. J Clin Periodontol 2007; 34:164-71. [PMID: 17309591 DOI: 10.1111/j.1600-051x.2006.01033.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To assess the effect of topically applied antimicrobial agents on palatal excisional wound in rats. MATERIALS AND METHODS Excisional wounds, 5 mm in diameter, were made in the centre of the palate of 125 Wistar male rats. In four experimental groups, chlorhexidine digluconate (CHX) 0.12% solution, 1% CHX gel, phenolic compounds solution (Listerine), amine/stannous fluoride solution (Meridol) and saline solution as a control group were applied daily for 1 min. The wound area was measured photographically and the epithelialization rate was determined histologically at 3, 7, 14 and 21 days post-surgery. RESULTS The mean wound area and mean distance between the epithelial margins decreased significantly with time (p<0.001) in experimental and control groups, with the greatest wound area reduction and rate of epithelialization on day 14. A significantly superior rate of wound epithelialization (p=0.03) was presented following use of 1% CHX gel and Listerine and a comparatively inferior one when the Meridol solution was applied. CONCLUSIONS Each tested antimicrobial agent when applied on an excisional wound with epithelial and connective tissue deficiency did not have a negative effect on the rate of wound closure. The best results were achieved with 1%CHX gel and Listerine.
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Affiliation(s)
- Avital Kozlovsky
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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Cosyn J, Wyn I, De Rouck T, Sabzevar MM. Subgingival Chlorhexidine Varnish Administration as an Adjunct to Same-Day Full-Mouth Root Planing. I. Clinical Observations. J Periodontol 2007; 78:430-7. [PMID: 17335365 DOI: 10.1902/jop.2007.060221] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Chemo-mechanical treatment concepts have been developed to improve the outcome of non-surgical periodontal therapy. Recently, the clinical additive value of a supersaturated chlorhexidine varnish was shown when used as an adjunct to staged scaling and root planing. The aim of this study was to investigate the clinical effects of a treatment strategy for chronic periodontitis based on a combination of same-day full-mouth root planing and subgingival chlorhexidine 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 were disinfected using a chlorhexidine varnish. Clinical response parameters were recorded at baseline and after 1, 3, and 6 months. RESULTS Both groups showed significant reductions in probing depth following therapy (P <0.001). There was no significant difference in full-mouth probing depth between the groups at any examination point. However, when a site-specific comparison was made, additive effects were found in the test group; an extra pocket reduction of 0.93 mm (P = 0.044) for initially deep pockets (>or=7 mm) was found at study termination. Additive clinical attachment gains seemed to be temporary. Impermanent extra pocket reductions and clinical attachment gains were found for initially medium-deep pockets (4 to 6 mm). CONCLUSION The outcome of same-day full-mouth root planing may benefit from the subgingival administration of a highly concentrated chlorhexidine varnish, at least in terms of pocket reduction in initially deep sites (>or=7 mm).
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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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Cosyn J, Wyn I, De Rouck T, Sabzevar MM. Long-Term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis. J Periodontol 2006; 77:406-15. [PMID: 16512755 DOI: 10.1902/jop.2006.050144] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Scaling and root planing in combination with oral hygiene monitoring are still considered the therapeutic standards for periodontitis. Although this treatment concept customarily results in satisfactory clinical improvements, treatment outcome may become less favorable predominantly when full access to periodontal defects is compromised, thereby leaving accretions behind. The purpose of this study was to investigate, over a 9-month period, the clinical benefits of a treatment strategy for chronic periodontitis based on a combination of sequential scaling and root planing and subgingival chlorhexidine varnish administration. METHODS This randomized controlled, single blind, parallel trial included 26 volunteers with chronic periodontitis. The control group received oral hygiene instructions and was scaled and root planed in two sessions. The test group received the same instructions and treatment; however, all pockets were additionally disinfected using a highly concentrated chlorhexidine varnish. Clinical response parameters were recorded at baseline and at 1, 3, 6, and 9 months. The impact of the initial strategy on the decision-making process for supplementary therapy at 9 months was investigated based on treatment decisions made by five independent clinicians. RESULTS Both treatment strategies showed significant reductions in probing depth and gains in clinical attachment at study termination in comparison with baseline (P<0.001). However, combination therapy resulted in a significant additional pocket reduction of 0.62 mm (P<0.001). Initially deep pockets (>or=7 mm) around multirooted teeth seemed to benefit most from the combination strategy, resulting in an additive pocket reduction of 1.06 mm (P=0.009) and a clinical attachment gain of 0.54 mm (P=0.048) in comparison to scaling and root planing alone. A trend toward a reduction of surgical treatment needs following the varnish-implemented strategy was found (P=0.076). CONCLUSION These findings suggest that the outcome of initial periodontal therapy may benefit from the adjunctive subgingival administration of a highly concentrated chlorhexidine varnish.
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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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Cosyn J, Wyn I. A Systematic Review on the Effects of the Chlorhexidine Chip When Used as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis. J Periodontol 2006; 77:257-64. [PMID: 16460252 DOI: 10.1902/jop.2006.050216] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Several local antimicrobial agents, such as a bioabsorbable chlorhexidine chip, have been developed to enhance the outcome of non-surgical periodontal therapy. METHODS Electronic (MEDLINE and Cochrane Oral Health Group Specialized Trials Register) and manual searches were performed to detect studies concerning the use of the chlorhexidine chip as an adjunct to scaling and root planing in the treatment of chronic periodontitis. Only full-text randomized controlled trials published in English up to June 2005 were included. RESULTS Five studies were finally selected following independent screening by two reviewers. Due to considerable heterogeneity in study design, a qualitative data analysis was performed. Multicenter studies have indicated significantly higher pocket reductions and clinical attachment gains following a combination of mechanical debridement and repeated chlorhexidine chip administration in comparison to scaling and root planing alone. However, some recent studies failed to confirm the additional value of the chlorhexidine chip. A number of interstudy disparities with respect to methodological quality and study design may account for this lack of accordance. CONCLUSIONS The clinical and microbiological data currently available on the chlorhexidine chip are limited and conflicting. More research is needed to elucidate the additional value of the chlorhexidine chip when used as an adjunct to scaling and root planing.
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Affiliation(s)
- Jan Cosyn
- Department of Periodontology, School of Dental Medicine, Free University of Brussels (VUB), Brussels, Belgium.
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