1
|
Siva NTD, Silva DNDA, Azevedo MLDS, Silva Júnior FLD, Almeida ML, Longo JPF, Moraes MD, Gurgel BCDV, de Aquino Martins ARL. The effectiveness of photodynamic therapy as a complementary therapy to mechanical instrumentation on residual periodontal pocket clinical parameters: A clinical split-mouth test. Photodiagnosis Photodyn Ther 2019; 29:101565. [PMID: 31586644 DOI: 10.1016/j.pdpdt.2019.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of photodynamic therapy as complementary therapy to mechanical instrumentation on periodontal residual pockets. This longitudinal, prospective, double-blind and controlled split-mouth clinical trial included one hundred and fourteen residual periodontal sites with probing depth ≥ 4 mm and bleeding on probing, which were distributed into two groups: 57 in the test group (SRP + aPDT) - using a low power laser application Therapy XT (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 110 mW for 15s, and 57 in the control group (SRP). Oral hygiene conditions were evaluated, through the Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI), as well as periodontal clinical outcomes, comprising the Bleeding on Probing (BOP), Probing Depth (PD) and Clinical Attachment Level (CAL) at baseline and after 3 months. Decrease of 17.74% was observed for the VPI after 3 months of follow-up, while the GBI was reduced by 19.91%, thus indicating statistically significant decreases for both parameters (p < 0.001). Decreases in VPI per site, BOP and PD and CAL gain between T0 and T3 in both treatment groups (p < 0.001) were observed, but no statistically significant intergroup differences were found (p > 0.05). Within the parameters used in this study, adjuvant aPDT to SRP did not lead additional benefits regarding the assessed clinical parameters after three months.
Collapse
Affiliation(s)
| | | | | | | | | | - João Paulo Figueiró Longo
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília, DF, Brazil.
| | - Maiara de Moraes
- Department of Health Sciences, Center for Biological and Health Sciences, Medicine, Rural Federal University of Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, RN, Brazil.
| | | | | |
Collapse
|
2
|
Graetz C, Plaumann A, Bielfeldt J, Tillner A, Sälzer S, Dörfer CE. Efficacy versus health risks: An in vitro evaluation of power-driven scalers. J Indian Soc Periodontol 2015; 19:18-24. [PMID: 25810588 PMCID: PMC4365149 DOI: 10.4103/0972-124x.145796] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 05/05/2014] [Indexed: 11/26/2022] Open
Abstract
Background: Power-driven instrumentation of root surfaces during supportive periodontal therapy is an alternative to hand instrumentation. The purpose of this pilot in vitro study was to investigate the efficacy of sub- and supragingival plaque removal with a sonic (AIR: Synea, W and H, Bürmoos, Austria) and two ultrasonic devices (TIG: Tigon+, W and H, Bürmoos, Austria; VEC: Vector, Dürr, Bietigheim-Bissingen, Germany) as well as the health-risk for dental professionals during treatment. Materials and Methods: The power-driven devices were utilized to remove plaque from model teeth in dummy heads. The percentage of residual artificial plaque after 2 min of supra- or subgingival instrumentation was calculated by means of image-processing techniques at four sites (n = 576) of each tooth. The Health-Risk-Index (HRI: spatter/residual plaque quotient) with the different power-driven devices was assessed during treatment. Results: The smallest amounts of residual plaque were found for the sonic device AIR (8.89% ± 10.92%) and the ultrasonic scaler TIG (8.72% ± 12.02%) (P = 0.707). Significantly more plaque was remained after the use of the ultrasonic scaler VEC (18.76% ± 18.07%) (P < 0.001). Irrespectively of the scaler, efficacy was similar sub- (10.7% ± 11.6%) and supragingivally (13.5% ± 17.2%) (P = 0.901). AIR/TIG demonstrated equal residual amounts of plaque sub- (P = 0.831) as well as supragingivally (P = 0.510). However, AIR/VEC and TIG/VEC were significantly in favor of AIR and TIG (P < 0.001). In contrast, the lowest HRI was found after using VEC (0.0043) and differed considerably for AIR (0.2812) and TIG (0.0287). Conclusion: Sonic devices are as effective as ultrasonic devices in the removal of biofilm but bear a higher risk to the dental professional's health concerning the formation of spatter.
Collapse
Affiliation(s)
- Christian Graetz
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Anna Plaumann
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Jule Bielfeldt
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Anica Tillner
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Sonja Sälzer
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Christof Edmund Dörfer
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| |
Collapse
|
3
|
Graetz C, Schwendicke F, Plaumann A, Rauschenbach S, Springer C, Kahl M, Sälzer S, Dörfer CE. Subgingival instrumentation to remove simulated plaque in vitro: influence of operators' experience and type of instrument. Clin Oral Investig 2014; 19:987-95. [PMID: 25231069 DOI: 10.1007/s00784-014-1319-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/09/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is uncertainty regarding the benefits and risks of hand versus powered root surface instrumentation. Moreover, the influence of operators' experience on treatment results is unclear. We compared newly developed sonic, ultrasonic and hand instruments, hypothesizing that powered devices allow to remove more simulated plaque in less time than hand instruments, with significant influence of operators' experience. METHODS Sonic scaler (AIR), ultrasonic scaler (TIG) device and double Gracey curettes (GRA) were utilized by seven experienced operators (EOs) and four less experienced operators (LOs) in periodontitis manikin heads. The time required for treatment, the proportion of residual-simulated plaque and the weight loss caused by scaling as a proxy for root surface destruction were measured. RESULTS Using different instruments led to significantly different proportions of removed simulated plaque regardless of operators' experience (AIR, 80.2 ± 21.3 %, TIG, 69.9 ± 22.5 %, GRA, 73.1 ± 20.0 %) (p < 0.001). Treatment times did not significantly differ between EO and LO (p > 0.05). Weight loss was increased when using hand instead of powered instruments (p < 0.001), with significantly higher weight loss induced by LO than EO (p = 0.004). CONCLUSION Within the present study, EO did not remove more simulated plaque in less time but induced less root surface destruction. Using a sonic device was most beneficial for plaque removal. CLINICAL RELEVANCE Successful root surface debridement requires both time and training regardless of the used instrument. Hand instruments might cause more damage to root surfaces, especially in the hands of less experienced operators.
Collapse
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany,
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Luchesi VH, Pimentel SP, Kolbe MF, Ribeiro FV, Casarin RC, Nociti FH, Sallum EA, Casati MZ. Photodynamic therapy in the treatment of class II furcation: a randomized controlled clinical trial. J Clin Periodontol 2013; 40:781-8. [DOI: 10.1111/jcpe.12121] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Vanessa H. Luchesi
- Dental Research Division; School of Dentistry; Paulista University São Paulo; São Paulo Brazil
| | - Suzana P. Pimentel
- Dental Research Division; School of Dentistry; Paulista University São Paulo; São Paulo Brazil
| | - Maria F. Kolbe
- Dental Research Division; School of Dentistry; Paulista University São Paulo; São Paulo Brazil
| | - Fernanda V. Ribeiro
- Dental Research Division; School of Dentistry; Paulista University São Paulo; São Paulo Brazil
| | - Renato C. Casarin
- Dental Research Division; School of Dentistry; Paulista University São Paulo; São Paulo Brazil
| | - Francisco H. Nociti
- Department of Prosthodontics and Periodontics; School of Dentistry at Piracicaba; University of Campinas (UNICAMP) Piracicaba; São Paulo Brazil
| | - Enilson A. Sallum
- Department of Prosthodontics and Periodontics; School of Dentistry at Piracicaba; University of Campinas (UNICAMP) Piracicaba; São Paulo Brazil
| | - Marcio Z. Casati
- Dental Research Division; School of Dentistry; Paulista University São Paulo; São Paulo Brazil
| |
Collapse
|
5
|
Peres MFS, Ribeiro ÉDP, Casarin RCV, Ruiz KGS, Junior FHN, Sallum EA, Casati MZ. Hydroxyapatite/β-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial. J Clin Periodontol 2013; 40:252-9. [DOI: 10.1111/jcpe.12054] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 10/20/2012] [Accepted: 11/30/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Maria F. S. Peres
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Érica D. P. Ribeiro
- Department of Periodontics; Bahian Foundation for Development of Science; Bahia Brazil
| | | | - Karina G. S. Ruiz
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Francisco H. N. Junior
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Enilson A. Sallum
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Márcio Z. Casati
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| |
Collapse
|
6
|
The adjunctive effect of photodynamic therapy for residual pockets in single-rooted teeth: a randomized controlled clinical trial. Lasers Med Sci 2012; 28:317-24. [DOI: 10.1007/s10103-012-1159-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 07/05/2012] [Indexed: 11/26/2022]
|
7
|
Yilmaz H, Bayindir H. Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instrumentation of furcation involvements: a randomized controlled clinical trial. Int J Dent Hyg 2011; 10:113-7. [DOI: 10.1111/j.1601-5037.2011.00538.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
8
|
Behal R, Mali AM, Gilda SS, Paradkar AR. Evaluation of local drug-delivery system containing 2% whole turmeric gel used as an adjunct to scaling and root planing in chronic periodontitis: A clinical and microbiological study. J Indian Soc Periodontol 2011; 15:35-8. [PMID: 21772719 PMCID: PMC3134044 DOI: 10.4103/0972-124x.82264] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 03/02/2010] [Indexed: 11/21/2022] Open
Abstract
Aim: To compare the effect of experimental local-drug delivery system containing 2% whole turmeric (gel form) as an adjunct to scaling and root planing (SRP) with the effect achieved using SRP alone by assessing their respective effects on plaque, gingival inflammation, bleeding on probing pocket depth, relative attachment levels and trypsin-like enzyme activity of “red complex” microorganisms, namely, Bacteroides forsythus, Porphvromonas gingivalis and Treponema denticola. Material and Methods: Thirty subjects with chronic localized or generalized periodontitis with pocket depth of 5 to 7 mm were selected in a split-mouth study design. Control sites received SRP alone, while experimental sites received SRP plus experimental material (2% whole turmeric gel). Plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), probing pocket depth (PPD), relative attachment loss (RAL), microbiological study of collected plaque sample for trypsin-like activity of “red complex” by BAPNA assay were the parameters recorded on day 0, 30 days and 45 days. Results: Both groups demonstrated statistically significant reduction in PI, GI, SBI, PPD; and gain in RAL. Significant reduction in the trypsin-like enzyme activity of “red complex” (BAPNA values) was observed for both the groups when compared to the baseline activity. Greater reduction was seen in all the parameters in the experimental group in comparison to the control group. Conclusion: The experimental local drug-delivery system containing 2% whole turmeric gel can be effectively used as an adjunct to scaling and root planing and is more effective than scaling and root planing alone in the treatment of periodontal pockets.
Collapse
Affiliation(s)
- Roobal Behal
- Department of Periodontology, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | | | | | | |
Collapse
|
9
|
Ribeiro EDP, Bittencourt S, Sallum EA, Sallum AW, Nociti FH, Casati MZ. Non-surgical instrumentation associated with povidone-iodine in the treatment of interproximal furcation involvements. J Appl Oral Sci 2011; 18:599-606. [PMID: 21308291 PMCID: PMC3881751 DOI: 10.1590/s1678-77572010000600011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Accepted: 02/16/2010] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this controlled clinical trial was to evaluate the effect of topically
applied povidone-iodine (PVP-I) used as an adjunct to non-surgical treatment of
interproximal class II furcation involvements. Material and methods Thirty-two patients presenting at least one interproximal class II furcation
involvement that bled on probing with probing pocket depth (PPD) ≥5 mm were
recruited. Patients were randomly chosen to receive either subgingival
instrumentation with an ultrasonic device using PVP-I (10%) as the cooling liquid
(test group) or identical treatment using distilled water as the cooling liquid
(control group). The following clinical outcomes were evaluated: visible plaque
index, bleeding on probing (BOP), position of the gingival margin, relative
attachment level (RAL), PPD and relative horizontal attachment level (RHAL). BAPNA
(N-benzoyl-Larginine-p-nitroanilide) testing was used to analyze trypsin-like
activity in dental biofilm. All parameters were evaluated at baseline and 1, 3 and
6 months after non-surgical subgingival instrumentation. Results Six months after treatment, both groups had similar means of PPD reduction, RAL
and RHAL gain (p>0.05). These variables were, respectively, 2.20±1.10 mm,
1.27±1.02 mm and 1.33±0.85 mm in the control group and 2.67±1.21 mm, 1.50±1.09 mm
and 1.56±0.93 mm in the test group. No difference was observed between groups at
none of the posttreatment periods, regarding the number of sites showing clinical
attachment gain ≥2 mm. However, at 6 months posttreatment, the test group
presented fewer sites with PPD ≥5 mm than the control group. Also at 6 months
the test group had lower BAPNA values than control group. Conclusion The use of PVP-I as an adjunct in the non-surgical treatment of interproximal
class II furcation involvements provided limited additional clinical benefits.
Collapse
|
10
|
Casarin RCV, Del Peloso Ribeiro É, Nociti FH, Sallum AW, Ambrosano GMB, Sallum EA, Casati MZ. Enamel matrix derivative proteins for the treatment of proximal class II furcation involvements: a prospective 24-month randomized clinical trial. J Clin Periodontol 2010; 37:1100-9. [DOI: 10.1111/j.1600-051x.2010.01614.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
11
|
Donovan TE, Becker W, Brodine AH, Burgess JO, Cagna DR, Summitt JB. Annual review of selected dental literature: report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2008; 100:110-41. [PMID: 18672128 DOI: 10.1016/s0022-3913(08)60159-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Terence E Donovan
- Department of Operative Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA. Terry_Donovan @dentistry.unc.edu
| | | | | | | | | | | |
Collapse
|
12
|
Walmsley AD, Lea SC, Landini G, Moses AJ. Advances in power driven pocket/root instrumentation. J Clin Periodontol 2008; 35:22-8. [DOI: 10.1111/j.1600-051x.2008.01258.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
13
|
Casarin RCV, Del Peloso Ribeiro E, Nociti FH, Sallum AW, Sallum EA, Ambrosano GMB, Casati MZ. A double-blind randomized clinical evaluation of enamel matrix derivative proteins for the treatment of proximal class-II furcation involvements. J Clin Periodontol 2008; 35:429-37. [PMID: 18341602 DOI: 10.1111/j.1600-051x.2008.01202.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of the present randomized, double-blind study was to evaluate the clinical response of proximal furcations treated with enamel matrix derivative proteins (EMD). MATERIAL AND METHODS Fifteen patients, each with a pair of contralateral class-II proximal furcation involvements, presenting probing depths (PDs) >/=5 mm and bleeding on probing (BOP) were selected. The patients were randomly assigned to: control group (n=15) - open flap debridement (OFD)+24% ethylenediaminetetraacetic acid (EDTA) conditioning; test group (n=15) - OFD+24% EDTA conditioning+EMD application. Plaque index (PI), BOP, PD, gingival margin position (GMP), relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated immediately before and 2, 4 and 6 months after the surgeries. RESULTS At 6 months, the RVCAL gains of the control and test group were 0.39 +/- 1.00 and 0.54 +/- 0.95 mm, while the RHCAL gains were 1.21 +/- 2.28 and 1.36 +/- 1.26 mm (p>0.05). The VBL and HBL gains of the control group were 1.04 +/- 1.12 and 1.00 +/- 1.79 mm, and 0.82 +/- 1.82 and 1.17 +/- 1.38 mm for the test group (p>0.05). In addition, a statistical difference was observed in the number of the remaining class-II furcations between the test and control groups (p<0.05) in this period. CONCLUSION It may be concluded that the use of EMD in proximal furcations did not promote a superior reduction in PD or a gain in clinical and osseous attachment levels, but resulted in a higher rate of class-II to class-I furcation conversion.
Collapse
Affiliation(s)
- Renato Corrêa Viana Casarin
- Department of Prosthodontics and Periodontics, Division of Periodontics, Campinas State University, São Paulo, Brazil
| | | | | | | | | | | | | |
Collapse
|