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Oliveira LM, de Oliveira CA, Angst PDM, Antoniazzi RP, Zanatta FB. Should supragingival scaling be performed separately prior to subgingival scaling and root planning in nonsurgical periodontal therapy? A systematic review of randomized trials. Int J Dent Hyg 2024; 22:35-44. [PMID: 37661290 DOI: 10.1111/idh.12731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 05/10/2023] [Accepted: 08/06/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To systematically evaluate randomized controlled trials (RCTs), with at least 6 months of follow-up, on whether professional mechanical plaque removal (PMPR) including supragingival scaling should be performed prior and separately from subgingival scaling and root planning (SRP) in nonsurgical periodontal therapy (NSPT), in terms of clinical and patient-reported outcomes (PROs) (CRD42020219759). METHODS The MEDLINE, EMBASE, CENTRAL, LILACS and Web of Science electronic databases, as well as grey literature sources, were searched by two independent reviewers up to May 2023. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and GRADE for assessing the certainty of evidence. Random-effects pairwise meta-analyses compared the changes in probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BoP) of a stepwise NSPT approach (PMPR prior and separately from SRP) and conventional one-step NSPT through mean differences (MDs) and associated confidence intervals (95% CI). RESULTS Two RCTs were included, including data of 77 participants with severe periodontitis. One RCT presents high risk of bias and the other has some concerns. No significant differences were found between the stepwise approach and performing both steps simultaneously for any clinical outcomes, with overall very low certainty on evidence. No adverse effects were detected and there was no data on PROs. CONCLUSIONS There is very-low certainty evidence of no significant difference on PPD and BoP reductions and CAL gain between supragingival scaling performed prior and separately from SRP and conventional one-step NSPT.
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Affiliation(s)
- Leandro Machado Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Cícero Anghinoni de Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Raquel Pippi Antoniazzi
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Fabrício Batistin Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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Miller LM, Piccinin FB, van der Velden U, Gomes SC. The Impact of Omega-3 Supplements on Non-Surgical Periodontal Therapy: A Systematic Review. Nutrients 2022; 14:1838. [PMID: 35565809 PMCID: PMC9105356 DOI: 10.3390/nu14091838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022] Open
Abstract
AIM This systematic review examined the additional effect of taking omega-3 supplements on periodontal therapy. METHODS The focused question was "What is the possible effect of omega-3 supplementation concomitant to non-surgical periodontal therapy on clinical periodontal parameters?" Databases Cochrane, Embase, Google Scholar, PubMed, and Web of Science (January-July 2021) were searched to identify appropriate studies. Randomized clinical trials (RCT) about non-surgical therapy with omega-3 supplementation, with at least 3 months of supplementation period were included. Cochrane risk of bias tool version 2 and Grading of Recommendations Assessment, Development, and Evaluation were used. RESULTS A total of 1556 studies were found, of which eight studies met the inclusion criteria. All eight studies evaluated periodontal probing depth and clinical attachment loss; plaque and gingival inflammation were evaluated in seven studies. High variety of omega-3 dosage, different study lengths, questionable results from periodontal therapy (including test and control groups), high risk of bias and moderate quality of evidence prevented a satisfactory conclusion regarding the benefits of omega-3 supplementation. The studies' high heterogeneity avoided meta-analysis. CONCLUSION Notwithstanding all limitations, the promising effects of omega-3 supplementation presented in two six-month studies encourage performing RCT with better-defined treatment protocols and greater methodological rigor.
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Affiliation(s)
- Luísa Martins Miller
- Post-Graduate Program, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil;
| | - Flávia Benetti Piccinin
- Department of Periodontology, School of Dentistry, Institute of Higher Education of Santo Ângelo (IESA), Santo Ângelo 98801-015, Brazil;
| | - Ubele van der Velden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam, 1081 LA Amsterdam, The Netherlands;
| | - Sabrina Carvalho Gomes
- Conservative Dentistry Department, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
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Antiplaque and antigingivitis efficacy of medicated and non-medicated sugar-free chewing gum as adjuncts to toothbrushing: systematic review and network meta-analysis. Clin Oral Investig 2022; 26:1155-1172. [DOI: 10.1007/s00784-021-04264-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/26/2021] [Indexed: 12/28/2022]
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Rossi V, Romagna R, Angst PDM, Gomes SC. Gingival crevicular fluid response to protocols of non-surgical periodontal therapy: A longitudinal evaluation. Indian J Dent Res 2019; 30:736-741. [PMID: 31854365 DOI: 10.4103/ijdr.ijdr_148_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context and Aim Gingival crevicular fluid (GCF) volume reflects the level of periodontal inflammation. This secondary analysis aimed to evaluate the GCF volume in patients submitted to non-surgical periodontal therapies under a split-mouth design. Materials and Methods GCF volume of 25 participants (47.24 ± 6.47 years) with moderate-to-severe chronic periodontitis was collected at Days 0, 30, 60, 90, 120, 270, and 450. The participants were submitted to three different non-surgical therapies randomly assigned per quadrant [GI: supragingival control (Supra) as only intervention (one quadrant); GII: Supra plus scaling and root planing (SRP) on Day 0 (two quadrants); GIII: Supra on Day 0 and SRP 30 days later (one quadrant)]. During treatment (0-60 days) and maintenance (90-450 days) participants were submitted to supragingival plaque control reinforcements. GCF volumes were analyzed after logarithmic transformation (log10) and linear models were used for intra- and inter-group comparisons, considering the data dependence. Results Baseline GCF volumes were similar between groups (GI: 0.39 ± 0.22 μl; GII: 0.42 ± 0.26 μl; GIII: 0.41 ± 0.14 μl;P > 0.05). At Day 60, GCF volumes were significantly reduced (GI: 0.20 ± 0.13 μl; GII: 0.18 ± 0.11 μl; GIII: 0.22 ± 0.13 μl; P < 0.001), without inter-groups differences. These results were maintained along maintenance period (P > 0.05). Even in sites bleeding on probing (BOP) + the means of GCF volume did not differ between groups (P > 0.05). Conclusions All therapies determined reductions on the GCF volume along time. Supragingival plaque control modulated the subgingival area during the study, reinforcing the importance of this control over the subgingival inflammatory response.
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Affiliation(s)
- Vanessa Rossi
- Private Practice, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rachel Romagna
- Department of Periodontics, School of Dentistry, Lutheran University of Brazil, Canoas, RS, Brazil
| | | | - Sabrina Carvalho Gomes
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Angst PDM, Finger Stadler A, Mendez M, Oppermann RV, van der Velden U, Gomes SC. Supportive periodontal therapy in moderate‐to‐severe periodontitis patients: A two‐year randomized clinical trial. J Clin Periodontol 2019; 46:1083-1093. [DOI: 10.1111/jcpe.13178] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/26/2019] [Accepted: 07/30/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Amanda Finger Stadler
- Division of Comprehensive Oral Health ‐ Periodontology Adams School of Dentistry The University of North Carolina at Chapel Hill Chapel Hill NC USA
| | | | - Rui Vicente Oppermann
- Conservative Dentistry Department School of Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Ubele van der Velden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam VU University Amsterdam Amsterdam The Netherlands
| | - Sabrina Carvalho Gomes
- Conservative Dentistry Department School of Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
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Abreu MGL, Kawamoto D, Mayer MPA, Pascoal VDB, Caiaffa KS, Zuza EP, Duque C, Camargo GADCG. Frequency of Porphyromonas gingivalis fimA in smokers and nonsmokers after periodontal therapy. J Appl Oral Sci 2019; 27:e20180205. [PMID: 30994772 PMCID: PMC6459229 DOI: 10.1590/1678-7757-2018-0205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/29/2018] [Indexed: 12/25/2022] Open
Abstract
Porphyromonas gingivalis is one of the most important Gram-negative anaerobe bacteria involved in the pathogenesis of periodontitis. P. gingivalis has an arsenal of specialized virulence factors that contribute to its pathogenicity. Among them, fimbriae play a role in the initial attachment and organization of biofilms. Different genotypes of fimA have been related to length of fimbriae and pathogenicity of the bacterium.
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Affiliation(s)
- Mariana Gouvêa Latini Abreu
- Universidade Federal Fluminense, Departamento de Odontologia, Área de Periodontia, Nova Friburgo, Rio de Janeiro, Brasil
| | - Dione Kawamoto
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, São Paulo, Brasil
| | - Marcia Pinto Alves Mayer
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, São Paulo, Brasil
| | | | - Karina Sampaio Caiaffa
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Endodontia, Araçatuba, São Paulo, Brasil
| | - Elizangela P Zuza
- Universidade Federal Fluminense, Departamento de Odontologia, Área de Periodontia, Nova Friburgo, Rio de Janeiro, Brasil
| | - Cristiane Duque
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontopediatria e Saúde Pública, Araçatuba, São Paulo, Brasil
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Antoniazzi RP, Cargnelutti B, Freitas DN, Guimarães MB, Zanatta FB, Feldens CA. Topical intrapocket anesthesia during scaling and root planing: a randomized clinical trial. Braz Dent J 2016; 26:26-32. [PMID: 25672380 DOI: 10.1590/0103-6440201300131] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 11/24/2014] [Indexed: 12/18/2022] Open
Abstract
Although the use of injectable anesthesia prior to subgingival scaling and root planing (SRP) reduces pain, many patients report fear and prolonged numbness of adjacent tissues. The aim of the present study was to compare the effects of a eutectic mixture containing 25 mg/g of lidocaine and 25 mg/g of prilocaine, injectable 2% lidocaine, topical 2% benzocaine and a placebo substance on reducing pain during SRP. In this randomized, split-mouth, masked clinical trial, thirty-two patients presenting more than two teeth with probing depth and clinical attachment level ≥ 5 mm in at least 4 sextants were randomly allocated to four groups: EMLA(r); injectable 2% lidocaine; topical 2% benzocaine and placebo. Pain and discomfort were measured using a visual analogue scale (VAS) and verbal scale (VS). Repeated-measures analysis of variance and Poisson regression were used for analysis. Patient satisfaction with the anesthesia was determined at the end of each treatment session. VAS and VS scores did not differ between injectable 2% lidocaine and EMLA (p > 0.05) and both substances showed significantly better pain control compared to 2% benzocaine and placebo (p < 0.05). 93.7% and 81.2% of the individuals were satisfied with the injectable anesthetic and EMLA, respectively (p = 0.158). Dissatisfaction with benzocaine and placebo was approximately 10 times greater than injectable anesthesia (p = 0.001). In conclusion, EMLA showed an equivalent effect on pain control when compared to the injectable anesthesia and performed better than 2% benzocaine in SRP. Thus, EMLA is a viable anesthetic option during scaling and root planning, despite the frequent need for second application.
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Affiliation(s)
| | - Bruna Cargnelutti
- Dental School, Franciscan University Center, Santa Maria, RS, Brazil
| | - Daniela Napoleão Freitas
- Postgraduate Program in Dentistry, UFSM - Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Fabricio Batistin Zanatta
- Postgraduate Program in Dentistry, UFSM - Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Carlos Alberto Feldens
- Postgraduate Program in Dentistry, ULBRA - Lutheran University of Brazil, Canoas, RS, Brazil
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Mendez M, Melchiors Angst PD, Stadler AF, Oppermann RV, Gomes S. Impacts of supragingival and subgingival periodontal treatments on oral health-related quality of life. Int J Dent Hyg 2016; 15:135-141. [DOI: 10.1111/idh.12193] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 11/27/2022]
Affiliation(s)
- M Mendez
- Department of Periodontology, Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - PD Melchiors Angst
- Department of Periodontology, Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - AF Stadler
- Department of Periodontology, Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - RV Oppermann
- Department of Periodontology, Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - S Gomes
- Department of Periodontology, Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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López NJ. Letter to the editor: re: intrapregnancy non-surgical periodontal treatment and pregnancy outcome: a randomized controlled trial. J Periodontol 2015; 85:880-1. [PMID: 24988126 DOI: 10.1902/jop.2014.130626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Nestor J López
- Department of Research and Postgraduate Studies, Faculty of Dentistry, University Andrés Bello, Santiago, Chile
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GOMES SC, ABASCAL CC, HAAS AN, ANGST PDM, OPPERMANN RV, MARCANTONIO RAC. Influence of supragingival biofilm control and smoking habit on Interleukin-1β concentration. Braz Oral Res 2015; 29:S1806-83242015000100302. [DOI: 10.1590/1807-3107bor-2015.vol29.0115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 06/12/2015] [Indexed: 11/22/2022] Open
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Gomes SC, Romagna R, Rossi V, Corvello PC, Angst PDM. Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation. Braz Oral Res 2014; 28. [PMID: 25000595 DOI: 10.1590/s1806-83242014.50000004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study investigated the clinical effects of using a supragingival biofilm control regimen (SUPRA) as a step prior to scaling and root planing (SRP). A split-mouth clinical trial was performed in which 25 subjects with periodontitis (47.2 ± 6.5 years) underwent treatment (days 0–60) and monitoring (days 90–450) phases. At Day 0 (baseline) treatments were randomly assigned per quadrant: SUPRA, SRP and S30SRP (SUPRA 30 days before SRP). The full-mouth visible plaque index (VPI), gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were examined on days 0, 30, 60, 90, 120, 270, and 450. Baseline data were similar among all groups. From days 0 to 60, the groups showed similar significant decreases in VPI and GBI. Reductions in PPD for the SRP (3.39 ± 0.17 to2.42 ± 0.16 mm) and S30SRP (3.31 ± 0.11 to 2.40 ± 0.07 mm) groups were greater (p < 0.05) than those for the SUPRA group. This pattern was also observed for BOP. Attachment gain was similar and greater for the SRP (3.34 ± 0.28 to 2.58 ± 0.26 mm) and S30SRP (3.25 ± 0.21 to 2.54 ± 0.19 mm) groups compared to the SUPRA group. Results were maintained from day 90 forward. Overall, the S30SRP treatment reduced the subgingival treatment needs in 48.16%. Performance of a SUPRA step before SRP decreased subgingival treatment needs and maintained the periodontal stability over time.
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López NJ, Quintero A, Casanova PA, Martínez B. Routine prophylaxes every 3 months improves chronic periodontitis status in type 2 diabetes. J Periodontol 2013; 85:e232-40. [PMID: 24354651 DOI: 10.1902/jop.2013.130400] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Periodontitis and type 2 diabetes mellitus (T2DM) are major health problems, especially in low-income populations with little access to dental care. Low-cost models for treatment of periodontal disease have not been tested in controlled studies in low-income populations. Dental prophylaxis, which includes removal of supragingival calculus and plaque, has been shown to arrest the progression of periodontitis. A controlled clinical trial was conducted to determine the effect of dental prophylaxis on periodontitis in T2DM. METHODS Twenty-six patients with T2DM and chronic periodontitis (CP) and 26 without T2DM with CP were selected. Periodontal probing depth (PD), gingival bleeding on probing (BOP), clinical attachment level (CAL), and surfaces with plaque were recorded at baseline and 3, 6, and 9 months after initial treatment. All the participants received instructions on oral hygiene and one session of dental prophylaxis at baseline and every 3 months. Glycated hemoglobin (HbA1c) levels were measured at baseline and every 3 months in patients with T2DM. RESULTS A significant improvement of PD, BOP, and sites with plaque was observed 3 months after treatment in patients with T2DM (P = 0.001). In controls, mean PD significantly improved after 6 months compared with baseline (P = 0.001). No significant improvement of CAL occurred in either group. No significant differences in periodontal parameters between the groups were detected, and no participant showed progression of CP during the 9-month study period. Dental prophylaxis did not influence HbA1c levels, and no association among HbA1c concentration, pretreatment metabolic status, and severity of CP was found. CONCLUSION Routine prophylaxes every 3 months significantly improve periodontal health and prevent progression of CP in both poorly controlled and well-controlled patients with T2DM.
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Affiliation(s)
- Néstor J López
- Currently, Department of Research and Postgraduate Studies, Faculty of Dentistry, University Andrés Bello, Santiago, Chile; previously, Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
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Angst PDM, Piccinin FB, Oppermann RV, Marcantonio RAC, Gomes SC. Response of molars and non-molars to a strict supragingival control in periodontal patients. Braz Oral Res 2013; 27:55-60. [PMID: 23306627 DOI: 10.1590/s1806-83242013000100010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 11/30/2012] [Indexed: 11/21/2022] Open
Abstract
The posterior position in the arches is one of the factors that underlies the poor prognosis of molar teeth (M). It is speculated that M do not benefit from the oral hygiene routine as well as non-molars (NM) do. This study evaluated the response of M and NM to supragingival control during a 6-month period in 25 smokers (S) and 25 never-smokers (NS) with moderate-to-severe periodontitis. One calibrated examiner assessed visible plaque (VPI) and gingival bleeding (GBI) indexes, periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) at days 0 (baseline), 30 and 180. At baseline, M showed significantly higher mean values of VPI (p = 0.017) and PPD (p < 0.001) compared with NM; CAL was also greater in M (p < 0.001) and was affected by smoking (p = 0.007). The reductions obtained for periodontal indicators at day 180 showed similar responses between M and NM. For CAL, M (NS 0.57 ± 0.50; S 0.67 ± 0.64) and NM (NS 0.38 ± 0.23; S 0.50 ± 0.33) reached an almost significant difference (p = 0.05). Smoking did not influence the response to treatment. Multilevel analysis revealed that, only for PDD reductions, the interaction between sites, teeth and patient was significant (p < 0.001). It was concluded that M benefit from an adequate regimen of supragingival biofilm control; therefore, supragingival condition should be considered in the prognosis of molar teeth.
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Froud R, Eldridge S, Diaz Ordaz K, Marinho VCC, Donner A. Quality of cluster randomized controlled trials in oral health: a systematic review of reports published between 2005 and 2009. Community Dent Oral Epidemiol 2012; 40 Suppl 1:3-14. [PMID: 22369703 DOI: 10.1111/j.1600-0528.2011.00660.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To assess the quality of methods and reporting of recently published cluster randomized trials (CRTs) in oral health. METHODS We searched PubMed for CRTs that included at least one oral health-related outcome and were published from 2005 to 2009 inclusive. We developed a list of criteria for assessing trial quality and reporting. This was influenced largely by the extended CONSORT statement for CRTs but also included criteria suggested by other authors. We examined the extent to which trials were consistent with these criteria. RESULTS Twenty-three trials were included in the review. In 15 (65%) trials, clustering had been accounted for in sample size calculations, and in 18 (78%) authors had accounted for clustering in analysis. Intraclass correlation coefficients (ICCs) were reported for eight (35%) trials; the outcome assessor was reported as having been blinded to allocation in 12 (52%) trials; 17 (74%) described eligibility criteria at individual level, but only nine (39%) described such criteria at cluster level. Sixteen of 20 trials (80%), in which individuals were recruited, reported that individual informed consent was obtained. CONCLUSIONS These results suggest that the quality of recent CRTs in oral health is relatively high and appears to compare favourably with other fields. However, there remains room for improvement. Authors of future trials should endeavour to ensure sample size calculations and analyses properly account for clustering (and are reported as such), consider the potential for recruitment/identification bias at the design stage, describe the steps taken to avoid this in the final report and report observed ICCs and cluster-level eligibility criteria.
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Affiliation(s)
- Robert Froud
- Centre for Health Sciences, Queen Mary University of London, Whitechapel, London, UK.
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Meulman T, Casarin RCV, Peruzzo DC, Giorgetti AP, Barbagallo A, Casati MZ, Sallum EA, Gonçalves RB, Nociti FH. Impact of supragingival therapy on subgingival microbial profile in smokers versus non-smokers with severe chronic periodontitis. J Oral Microbiol 2012; 4:JOM-4-8640. [PMID: 22232720 PMCID: PMC3253304 DOI: 10.3402/jom.v4i0.8640] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Revised: 11/29/2011] [Accepted: 11/30/2011] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this study was to assess subgingival microbiological changes in smokers versus non-smokers presenting severe chronic periodontitis after supragingival periodontal therapy (ST). METHODS Non-smokers (n=10) and smokers (n=10) presenting at least nine teeth with probing pocket depth (PPD) (≥5 mm), bleeding on probing (BoP), and no history of periodontal treatment in the last 6 months were selected. Clinical parameters assessed were plaque index (PI), BoP, PPD, relative gingival margin position (rGMP) and relative clinical attachment level (rCAL). Subgingival biofilm was collected before and 21 days after ST. DNA was extracted and the 16S rRNA gene was amplified with the universal primer pair, 27F and 1492R. Amplified genes were cloned, sequenced, and identified by comparison with known 16S rRNA sequences. Statistical analysis was performed by Student's t and Chi-Square tests (α=5%). RESULTS Clinically, ST promoted a significant reduction in PI and PPD, and gain of rCAL for both groups, with no significant intergroup difference. Microbiologically, at baseline, data analysis demonstrated that smokers harbored a higher proportion of Porphyromonas endodontalis, Bacteroidetes sp., Fusobacterium sp. and Tannerella forsythia and a lower number of cultivated phylotypes (p<0.05). Furthermore, non-smokers featured significant reductions in key phylotypes associated with periodontitis, whereas smokers presented more modest changes. CONCLUSION Within the limits of the present study, ST promoted comparable clinical improvements in smokers and non-smokers with severe chronic periodontitis. However, in smokers, ST only slightly affected the subgingival biofilm biodiversity, as compared with non-smokers.
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Affiliation(s)
- Tatiana Meulman
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
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Sapna N, Vandana KL. Evaluation of hyaluronan gel (Gengigel®) as a topical applicant in the treatment of gingivitis. ACTA ACUST UNITED AC 2011; 2:162-70. [DOI: 10.1111/j.2041-1626.2011.00064.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lopes BMV, Theodoro LH, Melo RF, Thompson GMDA, Marcantonio RAC. Clinical and microbiologic follow-up evaluations after non-surgical periodontal treatment with erbium:YAG laser and scaling and root planing. J Periodontol 2010; 81:682-91. [PMID: 20429647 DOI: 10.1902/jop.2010.090300] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study compared erbium-doped: yttrium, aluminum, and garnet (Er:YAG) laser irradiation (100 mJ/pulse; 10 Hz; 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for treatment of periodontal pockets. METHODS Nineteen patients with pockets from 5 to 9 mm were included. In a split-mouth design, each site was allocated to a treatment group: 1) SRPL, SRP and laser; 2) L, laser; 3) SRP, SRP only; and 4) C, no treatment. Clinical parameters of probing depth (PD), gingival recession, and clinical attachment level (CAL) were evaluated at baseline and 1, 3, 6, and 12 months after treatment. Visible plaque index, gingival bleeding index (GI), bleeding on probing (BOP), and subgingival plaque samples were also measured 12 days postoperatively, in addition to the above mentioned months. Intergroup and intragroup statistical analyses were performed (P <0.05). RESULTS GI decreased for SRPL and increased for L, SRP, and C (P <0.05) 12 days postoperatively and decreased for SRPL and SRP (P <0.05) 3, 6, and 12 months after baseline; BOP and PD decreased for all treated groups (P <0.01) 3, 6, and 12 months after treatment. CAL gain was significant for SRPL, L, and SRP (P <0.05) 3, 6, and 12 months postoperatively. SRPL and L presented a significant reduction in the percentage of sites with bacteria 6 and 12 months after treatment (P <0.05). CONCLUSION Non-surgical periodontal treatment with Er:YAG laser may be an alternative treatment for reduction and control of the proliferation of microorganisms in persistent periodontitis.
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Affiliation(s)
- Beatriz Maria Valério Lopes
- Department of Periodontology, Araraquara Dental School, UNESP-São Paulo State University, Araraquara, São Paulo, Brazil
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Jamieson LM, Gunthorpe W, Cairney SJ, Sayers SM, Roberts-Thomson KF, Slade GD. Substance use and periodontal disease among Australian Aboriginal young adults. Addiction 2010; 105:719-26. [PMID: 20148786 DOI: 10.1111/j.1360-0443.2009.02851.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. DESIGN Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. PARTICIPANTS Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. MEASUREMENTS Clinical dental examination and self-report questionnaire. FINDINGS Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06-2.40], marijuana (PR = 1.44, 95% CI = 1.05-1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08-3.11), but not alcohol (PR = 0.92, 95% CI = 0.67-1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03-2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. CONCLUSIONS This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation.
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Affiliation(s)
- Lisa M Jamieson
- Australian Research Center for Population Oral Health, The University of Adelaide, South Australia, Australia.
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Gomes SC, Nonnenmacher C, Susin C, Oppermann RV, Mutters R, Marcantonio RA. The Effect of a Supragingival Plaque-Control Regimen on the Subgingival Microbiota in Smokers and Never-Smokers: Evaluation by Real-Time Polymerase Chain Reaction. J Periodontol 2008; 79:2297-304. [DOI: 10.1902/jop.2008.070558] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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