1
|
Romano F, Bebars A, Ortu V, Bottone M, Giraudi M, Mariani GM, Baima G, Aimetti M. Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study. Clin Oral Investig 2023:10.1007/s00784-023-04956-w. [PMID: 36961591 DOI: 10.1007/s00784-023-04956-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/17/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVES The aim of this longitudinal intervention study was to assess the impact of psychosocial stress and coping response strategies on the clinical outcomes in periodontitis patients treated with non-surgical periodontal therapy (NSPT). MATERIALS AND METHODS After the administration of psychological questionnaires, patients diagnosed with generalized stage III-IV periodontitis were categorized into different groups depending on their stress levels (10-item perceived stress level (PSS-10)) and coping response strategies (coping responses inventory (CRI)). Clinical data were collected 1 week before and 3 months after the completion of NSPT. RESULTS Of the 90 patients included at baseline, 27 presented major and 63 minor stress levels, while 40 had avoidance and 50 approach coping behavior. All clinical parameters were similar at the baseline across different categories. At re-evaluation, full-mouth bleeding score (FMBS), mean probing pocket depth (PPD), and number of residual pathological pockets were significantly superior in groups with higher stress levels (p <0.001, p =0.001, and p =0.020, respectively), while higher full-mouth plaque scores (FMPS) and FMBS were found in patients with avoidance coping strategies (p =0.009 and p <0.001, respectively). When jointly evaluated, an added detrimental effect of coping styles on allostatic load was observed. Multivariate analysis confirmed a significant effect of stress levels and coping strategies on final FMBS, but not of coping on mean PPD. CONCLUSION Psychosocial stress and avoidance coping strategy seem to negatively influence the clinical outcomes of NSPT at short term (NCT04739475; 9/1/2017). PRACTICAL IMPLICATIONS Based on these findings, patients reflecting these psychological profiles should be considered at greater risk for poor NSPT response and may benefit from complementary stress management strategies.
Collapse
Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Ahmad Bebars
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | | | - Michele Bottone
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Marta Giraudi
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Giulia Maria Mariani
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy.
- Politecnico di Torino, Turin, Italy.
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| |
Collapse
|
2
|
Morikawa S, Watanabe K, Otsuka R, Asoda S, Nakagawa T. Periodontal therapy for localized severe periodontitis in a patient receiving fixed orthodontic treatment: a case report. J Med Case Rep 2023; 17:19. [PMID: 36658639 PMCID: PMC9854180 DOI: 10.1186/s13256-023-03751-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/01/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Orthodontic treatment involves movement of teeth by compression and resorption of the alveolar bone using orthodontic forces. These movements are closely linked to the interactions between the teeth and the periodontal tissues that support them. Owing to an increase in adults seeking orthodontic treatment, orthodontists increasingly encounter patients with periodontal diseases, in whom orthodontic treatment is contraindicated. In rare cases, periodontitis may develop after treatment initiation. However, no approach for treating periodontitis after the initiation of orthodontic treatment has been established. Here, we present an approach for managing localized severe periodontitis manifesting after initiating orthodontic treatment. CASE PRESENTATION A 32-year-old Japanese woman was referred to the Department of Dentistry and Oral Surgery by an orthodontist who observed symptoms of acute periodontitis in the maxillary molars that required periodontal examination and treatment. A detailed periodontal examination, including oral bacteriological examination, revealed localized severe periodontitis (stage III, grade B) in the maxillary left first and second molars and in the mandibular right second molar. After consultation with the orthodontist, the orthodontic treatment was suspended based on the results of the bacteriological examination to allow for periodontal treatment. Full-mouth disinfection was performed with adjunctive oral sitafloxacin. Periodontal and bacteriological examinations after treatment revealed regression of the localized periodontitis with bone regeneration. Thereafter, orthodontic treatment was resumed, and good progress was achieved. CONCLUSIONS Orthodontists should recognize the risk of acute severe periodontitis in young adults. Asymptomatic patients with localized severe periodontitis may clear a screening test before orthodontic treatment but develop acute symptoms with bone resorption during orthodontic treatment. Therefore, patients requiring orthodontic treatment should be examined by their family dentist or a periodontist to rule out periodontal issues that may impede orthodontic treatment. The patients should also be informed of age-related risks. Further, periodontists, family dentists, and orthodontists who treat adults should be informed about periodontitis and the need for interdisciplinary collaboration. In patients who develop periodontitis after orthodontic treatment initiation, temporary interruption of orthodontic treatment and aggressive periodontal intervention may facilitate recovery.
Collapse
Affiliation(s)
- Satoru Morikawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Kazuya Watanabe
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan ,Watanabe Orthodontic Office, 1-11-26-2F Kichijoji-honcho, Musashino, Tokyo 180-0004 Japan
| | - Ryo Otsuka
- Familia Orthodontics, 1-7-5-12F Sakuragi-cho, Omiya-ku, Saitama, Saitama 330-0854 Japan
| | - Seiji Asoda
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Taneaki Nakagawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| |
Collapse
|
3
|
Stein JM, Yekta-Michael SS, Schittenhelm F, Reichert S, Kupietz D, Dommisch H, Kasaj A, Wied S, Vela OC, Stratul SI. Comparison of three full-mouth concepts for the non-surgical treatment of stage III and IV periodontitis: A randomized controlled trial. J Clin Periodontol 2021; 48:1516-1527. [PMID: 34517434 DOI: 10.1111/jcpe.13548] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 12/29/2022]
Abstract
AIM To evaluate the clinical efficacy of full-mouth scaling (FMS), full-mouth disinfection (FMD), and FMD with adjuvant erythritol air-polishing (FMDAP) compared to quadrant-wise debridement (Q-SRP) in patients with periodontitis stage III/IV. METHODS In this four-arm parallel, prospective, randomized, controlled multi-centre study, changes of pocket probing depths (PPDs), clinical attachment level (CAL), bleeding on probing (BOP), and proportion of closed pockets (PPD ≤4 mm without BOP) were evaluated at baseline and after 3 and 6 months. RESULTS From 190 randomly participating patients, 172 were included in the final analysis. All groups showed significant (p < .05) improvements in all clinical parameters over 3 and 6 months. During the study period, FMDAP showed significantly higher reductions of mean PPD in teeth with moderate (PPD 4-6 mm) and deep (PPD > 6 mm) pockets and significantly increased proportions of pocket closure than Q-SRP. Patients treated with FMD had significantly greater PPD reduction in deep pockets and a higher percentage of pocket closure after 3 months but not after 6 months compared to Q-SRP. CAL and BOP changes did not significantly differ among all groups. Efficiency of treatment (time effort to gain one closed pocket) was significantly higher for FMDAP, FMD, and FMS compared to Q-SRP (6.3, 8.5, 9.5 vs. 17.8 min per closed pocket; p < .05). CONCLUSIONS All treatment modalities were effective, without significant differences between full-mouth approaches. FMDAP showed improved clinical outcomes over Q-SRP for moderate and deep pockets after 6 months. Full-mouth protocols were more time-efficient than conventional Q-SRP. CLINICAL SIGNIFICANCE The trial was registered in a clinical trial database (ClinicalTrials.gov: NCT03509233).
Collapse
Affiliation(s)
- Jamal M Stein
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | | | - Florian Schittenhelm
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin Luther University, Mainz, Germany
| | - David Kupietz
- Department of Operative Dentistry and Periodontology, Martin Luther University, Mainz, Germany
| | - Henrik Dommisch
- Department of Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Adrian Kasaj
- Department of Periodontology and Operative Dentistry, University Medical Center, Mainz, Germany
| | - Stephanie Wied
- Department of Medical Statistics, University Hospital (RWTH), Aachen, Germany
| | - Octavia-Carolina Vela
- Department of Periodontology, Anton Sculean Center for Research and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Anton Sculean Center for Research and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, Romania
| |
Collapse
|
4
|
Milinkovic I, Mijailovic I, Markovic A, Janjic B, Nikolic N, Milasin J, Milicic B, Aleksic Z, Vasovic D. Adjunctive Application of Systemic Antibiotics in Non-surgical Aggressive Periodontitis Treatment: Clinical and Microbiological Findings. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Aggressive periodontitis (AgP) is associated with an extensive and rapid destruction of periodontal tissues. Unpredictable treatment outcomes of the disease are consequences of various cross-linked factors. Antimicrobial adjunctive treatment is routinely used as a part of non-surgical periodontal treatment (NSPT) of AgP.
AIM: Therefore, the aim of this study was to compare the effects of active periodontal treatment (APT) combined with systemic antibiotics with mechanical debridement alone, in patients with generalized AgP (GAgP).
METHODS: Two groups, consisting of 10 participants each, were randomly formed. Both groups were clinically and microbiologically tested and monitored for 3 months. Test group received APT with antimicrobial supplementation (amoxicillin and metronidazole [AMX-MET]). Patients from the control group were treated by APT only. Clinical and microbiological parameters were recorded at baseline and 3 months following the NSPT. Clinical measurements involved probing depth, clinical attachment level, bleeding on probing, and plaque index. Samples of subgingival crevicular fluid were analyzed by qualitative polymerase chain reaction.
RESULTS: Significant improvement of all clinical parameters was observed 3 months following the NSPT (p < 0.05), but significant difference between groups was not found (p > 0.05). Periodontal pathogens’ detection between baseline and 3 months follow-up was also not statistically significant in both examined groups (p > 0.05).
CONCLUSION: Similarity of results obtained in both treatment groups underlined the key role of APT in the treatment of AgP. The AMX-MET supplementation did not improve clinical and microbiological outcomes, when compared to APT alone. Longer follow-up period, with larger sample, could provide a more comprehensive insight into this issue.
Collapse
|
5
|
Analysis of geometrical tomographic parameters of furcation lesions in periodontitis patients. Heliyon 2021; 7:e06119. [PMID: 33553764 PMCID: PMC7851341 DOI: 10.1016/j.heliyon.2021.e06119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives This study was aimed to investigate the relationship between geometric parameters of furcation lesions - maximum area of lesion opening (MALO), angle formed between the roots (ABR), lesion volume (LV) and presence and height of infra-osseous defects (IOD) - and the success of therapy with enamel matrix derivative proteins (EMD) in patients with grade C periodontitis, using cone-beam computed tomography (CBCT). Methods The study consisted of two groups of patients with grade C periodontitis: control (surgery) (n = 17) and test (surgery + EMD) (n = 17). Images parameters on CBCT were recorded using OnDemand3D and ITK-SNAP software. Results Pearson's correlation coefficient demonstrated that only IOD was statistically significant in the probing depth PD (P = 0.01), with a moderate positive correlation (R = 0.59). MALO was found to be statistically significant (P = 0.03) in the test group (surgery + EMD), with moderate negative correlation (R = -0.5). Conclusion The presence of infra-osseous defects and height were relevant in relation to the success of the type of treatment addressed in this study.
Collapse
|
6
|
Mendes CL, Assis PD, Annibal H, Oliveira LJRD, Albuquerque MSD, Soares MDL, Lago MC, Braz R. Metronidazole and amoxicillin association in aggressive periodontitis: A systematic review and meta-analysis. Saudi Dent J 2020; 32:269-275. [PMID: 32874066 PMCID: PMC7452018 DOI: 10.1016/j.sdentj.2020.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Cácio Lopes Mendes
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | - Paulo de Assis
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | - Hermínia Annibal
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | | | | | | | - Maria Catarina Lago
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | - Rodivan Braz
- Biomaterials Research Center, University of Pernambuco, Camaragibe, PE, Brazil
| |
Collapse
|
7
|
Trikka D, Vassilopoulos S. Periodontal Regeneration with Enamel Matrix Derivative in the Management of Generalized Aggressive Periodontitis: A Case Report with 11-Year Follow-up and Literature Review. J Int Soc Prev Community Dent 2019; 9:13-20. [PMID: 30923688 PMCID: PMC6402248 DOI: 10.4103/jispcd.jispcd_119_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 11/20/2018] [Indexed: 12/15/2022] Open
Abstract
Objectives: Aggressive periodontitis (AgP) represents an uncommon but rapidly advanced inflammatory process, which involves the destruction of periodontal tissues. This study aimed to report a case of generalized AgP (GAgP), where the treatment approach consists of the utilization of the full-mouth disinfection protocol (FMDP) in conjunction with flap curettage and regenerative appliance of enamel matrix derivatives (EMDs). The associated literature was also reviewed. Materials and Methods: A 19-year-old female patient was diagnosed with GAgP. The treatment was initiated with FMDP and administration of antibiotics. Afterward, open flap debridement was performed, and EMD was selected as the regenerative material for the reconstruction of the periodontal defects. Over an 11-year period and during all the phases of the treatment, the outcomes were regularly evaluated with clinical measurements and radiographic controls. Results: The 11-year results demonstrated no recurrence of disease, and the patient's periodontal health exhibited evident improvement. Overall, the pocket depths presented satisfactory reduction while the clinical attachment loss (CAL) was improved. Both our limited experience and available literature data revealed that the use of EMD in AgP treatment contributes to bone fill of the intrabony defects as well as regeneration of the destructed periodontal apparatus. Conclusions: Although the outcomes of this treatment approach have not been widely evaluated, it seems that the use of EMD may be an effective means of periodontal regeneration in patients with GAgP. Additional prospective studies with adequate number of GAgP patients are essential to thoroughly assess the effectiveness of this approach.
Collapse
Affiliation(s)
- Dimitra Trikka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Spyridon Vassilopoulos
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Greece
| |
Collapse
|
8
|
Aral K, Aral CA, Kapila Y. Six‐month clinical outcomes of non‐surgical periodontal treatment with antibiotics on apoptosis markers in aggressive periodontitis. Oral Dis 2019; 25:839-847. [DOI: 10.1111/odi.13032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/05/2018] [Accepted: 12/31/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Kübra Aral
- Division of Periodontics Malatya Oral and Dental Heath Hospital Malatya Turkey
| | - Cüneyt A. Aral
- Department of PeriodontologyFaculty of Dentistry, Inonu University Malatya Turkey
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of DentistryUniversity of California California
| |
Collapse
|
9
|
Pockpa AD, Soueidan A, Louis P, Coulibaly NT, Badran Z, Struillou X. Twenty Years of Full-Mouth Disinfection: The Past, the Present and the Future. Open Dent J 2018; 12:435-442. [PMID: 29988213 PMCID: PMC5997853 DOI: 10.2174/1874210601812010435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/23/2018] [Accepted: 05/14/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Conventional periodontal treatment, performed quadrant by quadrant in multiple visits, was re-evaluated in the early 1990s when the full-mouth disinfection concept was introduced. Over the years, several modifications to the full-mouth disinfection approach have been suggested. Objective: The purpose of this article is to review the evolution of full-mouth disinfection during the past 20 years, to specify its indications and to consider the prospects for this approach. Materials and Methods: An electronic and manual search of the literature, ending in December 2016, was performed by two independent researchers. Only pivotal studies and randomized controlled clinical trials published in the English language that evaluated a new approach to full-mouth disinfection were selected. Results: According to the studies included in our analysis (21 articles), several modified full-mouth disinfection protocols have been designed including: full-mouth treatment without chlorhexidine, the extension of hygiene methods and an increase in the duration of post-treatment chlorhexidine use, the replacement of chlorhexidine with other antiseptics, supplementation with antibiotics or probiotics, full-mouth antimicrobial photodynamic therapy and one-stage full-mouth disinfection combined with a periodontal dressing. Conclusion: Since 1995, several modifications have been suggested to improve the effectiveness of full-mouth disinfection. The majority of the studies demonstrate that the results obtained with full-mouth disinfection and its variants are equivalent to each other and to those obtained with the conventional quadrant method. Currently, the selection of this technique remains empirical and depends on the preferences of the practitioner and the patient. In the future, a patient-centered approach should be the best indication for the use of this technique.
Collapse
Affiliation(s)
- Ange Désiré Pockpa
- Clinical Investigation Unit 11 Odontology, CHU Nantes, Nantes, France.,Department of Periodontology, Faculty of Dental Surgery, University of Felix Houphouët Boigny, Abidjan, Ivory Coast
| | - Assem Soueidan
- Clinical Investigation Unit 11 Odontology, CHU Nantes, Nantes, France.,Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Pauline Louis
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Nadin Thérèse Coulibaly
- Department of Periodontology, Faculty of Dental Surgery, University of Felix Houphouët Boigny, Abidjan, Ivory Coast
| | - Zahi Badran
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes, Nantes, France.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Xavier Struillou
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes, Nantes, France
| |
Collapse
|
10
|
Ramesh A, Ravi S, Kaarthikeyan G. Comprehensive rehabilitation using dental implants in generalized aggressive periodontitis. J Indian Soc Periodontol 2018; 21:160-163. [PMID: 29398863 PMCID: PMC5771115 DOI: 10.4103/jisp.jisp_213_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Generalized aggressive periodontitis (GAP) is a debilitating form of the disease and it results in deteriorating effects on the esthetic and functional aspects of the oral cavity. This case report describes the comprehensive rehabilitation of GAP patient using dental implants. The treatment planning involved thorough scaling and root planning (SRP) with oral hygiene instructions. The patient was motivated to adhere to a strict oral hygiene regimen following which periodontal flap surgery employing guided tissue regeneration and bone grafts was performed. Bacterial culture for anaerobic microorganisms was done using a gas pack pre- and postperiodontal treatment to confirm the effectiveness of the periodontal treatment regimen and also to proceed with dental implant placement. The rigorous maintenance program ensured the stability of the periodontium following which immediate placement of dental implants in the maxillary and mandibular anterior region was done. The fixed metal-ceramic prosthesis was fabricated in a step-by-step process and the patient was recalled on a periodic basis over a 3-year follow-up duration. This case is a testimonial to the postperiodontal treatment long-term stability with excellent patient cooperation and strict maintenance protocol.
Collapse
Affiliation(s)
- Asha Ramesh
- Department of Periodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Sheethalan Ravi
- Department of Periodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India
| | | |
Collapse
|
11
|
Andere NMRB, Castro Dos Santos NC, Araujo CF, Mathias IF, Taiete T, Casarin RCV, Jardini MAN, Shaddox LM, Santamaria MP. Clarithromycin as an Adjunct to One-Stage Full-Mouth Ultrasonic Periodontal Debridement in Generalized Aggressive Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol 2017; 88:1244-1252. [PMID: 28671507 DOI: 10.1902/jop.2017.170165] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The aim of the present study is to evaluate the periodontal clinical and microbiologic responses and possible adverse effects of clarithromycin (CLM) combined with periodontal mechanical therapy in the treatment of patients with generalized aggressive periodontitis. METHODS Forty patients were selected and randomly assigned into one of two groups: 1) CLM (n = 20): one-stage full-mouth ultrasonic debridement (FMUD) associated with CLM (500 mg, every 12 hours for 3 days); and 2) placebo (n = 20): FMUD associated with placebo pills. Clinical and microbiologic parameters were evaluated at baseline and 3 and 6 months postoperatively. RESULTS Both treatments presented statistically significant clinical and microbiologic improvements. However, the CLM group presented lower means of probing depth for pockets ≥7 mm at 6 months (4.0 ± 1.7 mm) compared with the placebo group (4.7 ± 1.3 mm) (P = 0.04). In addition, the CLM group also presented greater reduction of Porphyromonas gingivalis (Pg) DNA counts at 6 months (P = 0.0001). CONCLUSION Results from this study suggest both treatments are effective; however, adjunct use of CLM to FMUD leads to better reduction of deep pockets and Pg at 6 months compared with FMUD alone.
Collapse
Affiliation(s)
| | - Nídia Cristina Castro Dos Santos
- Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry, São Paulo State University, São José dos Campos, Brazil
| | - Cássia Fernandes Araujo
- Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry, São Paulo State University, São José dos Campos, Brazil
| | - Ingrid Fernandes Mathias
- Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry, São Paulo State University, São José dos Campos, Brazil
| | - Tiago Taiete
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, Campinas State University, Piracicaba, Brazil
| | - Renato Corrêa Viana Casarin
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, Campinas State University, Piracicaba, Brazil
| | - Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry, São Paulo State University, São José dos Campos, Brazil
| | - Luciana Machion Shaddox
- Department of Periodontology and Oral Biology, College of Dentistry, University of Florida, Gainesville, FL
| | - Mauro Pedrine Santamaria
- Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry, São Paulo State University, São José dos Campos, Brazil
| |
Collapse
|
12
|
De Genaro Modanese D, Tiosso-Tamburi R, Furletti de Goes VF, de Cássia Bergamaschi C, Martinez EF, Napimoga MH, Peruzzo DC. Clinical and Immunoinflammatory Evaluation of One-Stage Full-Mouth Ultrasonic Debridement as a Therapeutic Approach for Smokers With Generalized Aggressive Periodontitis: A Short-Term Follow-Up Study. J Periodontol 2016; 87:1012-21. [DOI: 10.1902/jop.2016.150632] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
13
|
Neering SH, Adyani-Fard S, Klocke A, Rüttermann S, Flemmig TF, Beikler T. Periodontitis associated with plasminogen deficiency: a case report. BMC Oral Health 2015; 15:59. [PMID: 25971786 PMCID: PMC4438564 DOI: 10.1186/s12903-015-0045-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 04/29/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Plasminogen deficiency is a rare autosomal recessive disease, which is associated with aggressive periodontitis and gingival enlargement. Previously described treatments of plasminogen deficiency associated periodontitis have shown limited success. This is the first case report indicating a successful therapy approach consisting of a non-surgical supra- and subgingival debridement in combination with an adjunctive systemic antibiotic therapy and a strict supportive periodontal regimen over an observation period of 4 years. CASE PRESENTATION The intraoral examination of a 17-year-old Turkish female with severe plasminogen deficiency revealed generalized increased pocket probing depths ranging from 6 to 9 mm, bleeding on probing over 30%, generalized tooth mobility, and gingival hyperplasia. Alveolar bone loss ranged from 30% to 50%. Clinical attachment loss corresponded to pocket probing depths. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia, Prevotella nigrescens and Eikenella corrodens have been detected by realtime polymerase chain reaction. Periodontal treatment consisted of full mouth disinfection and adjunctive systemic administration of amoxicillin (500 mg tid) and metronidazole (400 mg tid). A strict supportive periodontal therapy regimen every three month in terms of supra- and subgingival debridement was rendered. The reported therapy has significantly improved periodontal health and arrested disease progression. Intraoral examination at the end of the observation period 3.5 years after non-surgical periodontal therapy showed generalized decreased pocket probing depths ranging from 1 to 6 mm, bleeding on probing lower 30%, and tooth mobility class I and II. Furthermore, microbiological analysis shows the absence of Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola after therapy. CONCLUSION Adjunctive antibiotic treatment may alter the oral microbiome and thus, the inflammatory response of periodontal disease associated to plasminogen deficiency and diminishes the risk of pseudomembrane formation and progressive attachment loss. This case report indicates that patients with plasminogen deficiency may benefit from non-surgical periodontal treatment in combination with an adjunctive antibiotic therapy and a strict supportive periodontal therapy regimen.
Collapse
Affiliation(s)
- Sarah H Neering
- Section of Periodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Sabine Adyani-Fard
- Section of Periodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Astrid Klocke
- Section of Periodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Stefan Rüttermann
- Department of Operative Dentistry Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, D-60598, Frankfurt, Germany.
| | - Thomas F Flemmig
- Dean Faculty of Dentistry, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong.
| | - Thomas Beikler
- Section of Periodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany. .,Department of Periodontics, University of Washington, 1959 NE Pacific St B307, Seattle, WA, 98195, USA.
| |
Collapse
|
14
|
Bouziane A, Benrachadi L, Abouqal R, Ennibi O. Outcomes of nonsurgical periodontal therapy in severe generalized aggressive periodontitis. J Periodontal Implant Sci 2014; 44:201-6. [PMID: 25177522 PMCID: PMC4148633 DOI: 10.5051/jpis.2014.44.4.201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 08/10/2014] [Indexed: 11/25/2022] Open
Abstract
Purpose Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis. Methods Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ≥7 mm and clinical attachment level (CAL) of sites with attachment loss ≥5 mm were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values. Results Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases. Conclusions These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis. Graphical Abstract ![]()
Collapse
Affiliation(s)
- Amal Bouziane
- Department of Periodontology, Faculty of Dental Medicine, Biostatistical, Clinical, and Epidemiological Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed V Souissi University, Rabat, Morocco
| | - Latifa Benrachadi
- Department of Periodontology, Faculty of Dental Medicine, Mohammed V Souissi University, Rabat, Morocco
| | - Redouane Abouqal
- Biostatistical, Clinical, and Epidemiological Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed V Souissi University, Rabat, Morocco
| | - Oumkeltoum Ennibi
- Department of Periodontology, Faculty of Dental Medicine, Mohammed V Souissi University, Rabat, Morocco
| |
Collapse
|
15
|
Meyer-Bäumer A, Eick S, Mertens C, Uhlmann L, Hagenfeld D, Eickholz P, Kim TS, Cosgarea R. Periodontal pathogens and associated factors in aggressive periodontitis: results 5-17 years after active periodontal therapy. J Clin Periodontol 2014; 41:662-72. [PMID: 24708362 DOI: 10.1111/jcpe.12255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To assess the association between presence of periodontal pathogens and recurrence of disease in patients with aggressive periodontitis (AgP) after active periodontal therapy (APT) and further influencing factors. MATERIAL & METHODS Microbiological samples were taken from 73 patients with AgP 5-17 years after APT at 292 sites (deepest site per quadrant). Real-time polymerase chain reactions were used to detect the periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Uni- and multivariate analyses evaluated the associations between pathogens and recurrence of disease, smoking and adjunctive antibiotic therapy. RESULTS At re-examination A. actinomycetemcomitans could be detected in six patients (8.2%), P. gingivalis in 24 (32.9%), T. forsythia in 31 (42.5%) and T. denticola in 35 (48.0%). Increased levels of T. forsythia and T. denticola at re-examination were significantly associated with recurrence of disease in multivariate analyses (OR: 12.72, p < 0.001; OR 5.55, p = 0.002 respectively). Furthermore, high counts of T. denticola were found in patients with increased percentage of sites with clinical attachment levels (CAL) ≥ 6 mm compared to those with low counts (13.8% versus 3.2%, p = 0.005). CONCLUSION In patients with recurrence of disease T. forsythia and T. denticola were detected more frequently and in higher counts. Furthermore, T. denticola was found more frequently in patients with increased CAL.
Collapse
Affiliation(s)
- Amelie Meyer-Bäumer
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Longoni S, Sartori M, Proserpio N, Marino S, Dusi L, Carini F, Baldoni M. Posizionamento di impianti immediati o differiti in siti postestrattivi o in aree edentule in pazienti trattati con bifosfonati orali. DENTAL CADMOS 2014. [DOI: 10.1016/s0011-8524(14)70162-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
17
|
Socransky SS, Haffajee AD, Teles R, Wennstrom JL, Lindhe J, Bogren A, Hasturk H, van Dyke T, Wang X, Goodson JM. Effect of periodontal therapy on the subgingival microbiota over a 2-year monitoring period. I. Overall effect and kinetics of change. J Clin Periodontol 2013; 40:771-80. [PMID: 23710672 DOI: 10.1111/jcpe.12117] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2013] [Indexed: 11/30/2022]
Abstract
AIM To examine the 2-year post-therapy kinetics of change in the composition of subgingival biofilms. MATERIAL AND METHODS In this study, 178 chronic periodontitis subjects were recruited and clinically monitored at baseline, 3, 6, 12, 18 and 24 months after therapy. All subjects received scaling and root planing and 156 one or more of periodontal surgery, systemically administered amoxicillin + metronidazole or local tetracycline at pockets ≥5 mm. Subgingival biofilm samples taken from each subject at each time point were analysed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization. The significance of changes in median species counts over time was sought using the Wilcoxon or Friedman tests and adjusted for multiple comparisons. RESULTS Mean counts were significantly reduced from baseline to 2 years for 30 of the 40 taxa. Marked reductions were observed for periodontal pathogens including Tannerella forsythia, Treponema denticola and Eubacterium nodatum. The kinetics of change differed from species to species. When data were subset according to baseline PD, patterns of change in the microbial profiles were generally similar. CONCLUSION Periodontal therapy leads to a rapid reduction in periodontal pathogens, followed by a slower reduction in other taxa that can be sustained for at least 2 years.
Collapse
Affiliation(s)
- Sigmund S Socransky
- Department of Applied Oral Sciences, Center for Periodontology, The Forsyth Institute, Cambridge, MA, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Silva-Senem MXE, Heller D, Varela VM, Torres MCB, Feres-Filho EJ, Colombo APV. Clinical and microbiological effects of systemic antimicrobials combined to an anti-infective mechanical debridement for the management of aggressive periodontitis: a 12-month randomized controlled trial. J Clin Periodontol 2013; 40:242-51. [DOI: 10.1111/jcpe.12052] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 11/06/2012] [Accepted: 11/30/2012] [Indexed: 01/15/2023]
Affiliation(s)
- Mayra Xavier e Silva-Senem
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Débora Heller
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- Periodontology and Oral Biology Department; Boston University; Boston MA USA
| | - Victor Macedo Varela
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Maria Cynesia Barros Torres
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Eduardo Jorge Feres-Filho
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Ana Paula Vieira Colombo
- Department of Medical Microbiology, Institute of Microbiology; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| |
Collapse
|
19
|
Casarin RC, Peloso Ribeiro ÉD, Sallum EA, Nociti FH, Gonçalves RB, Casati MZ. The Combination of Amoxicillin and Metronidazole Improves Clinical and Microbiologic Results of One-Stage, Full-Mouth, Ultrasonic Debridement in Aggressive Periodontitis Treatment. J Periodontol 2012; 83:988-98. [DOI: 10.1902/jop.2012.110513] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
20
|
Roshna T, Nandakumar K. Generalized aggressive periodontitis and its treatment options: case reports and review of the literature. Case Rep Med 2012; 2012:535321. [PMID: 22291715 PMCID: PMC3265097 DOI: 10.1155/2012/535321] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 10/04/2011] [Accepted: 10/07/2011] [Indexed: 01/19/2023] Open
Abstract
Generalized aggressive periodontitis results in rapid destruction of the periodontium and can lead to early tooth loss in the affected individuals if not diagnosed early and treated appropriately. The diagnostic features of the disease are characteristic, but the clinical presentation and patterns of destructions may vary between patients. Successful management of the disease is challenging especially if diagnosed at advanced stages of the disease, but not impossible with the current therapeutic choices for the disease. A vast array of treatment modalities is available which can be employed in the treatment of generalized aggressive periodontitis with varying success rates, but a definite guideline for the management is yet to be formulated. However, with the exponential rate of developments in periodontal research, regenerative therapy, tissue engineering, and genetic technologies, the future seems promising in regard to options at managing the disease. This paper attempts to describe the clinical and radiographic diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of generalized aggressive periodontitis patients with case reports and a brief review.
Collapse
Affiliation(s)
- T. Roshna
- Department of Periodontics, People's Dental Academy, Bhopal 462010, India
| | - K. Nandakumar
- Department of Periodontics, Azeezia Dental College, Kollam 691537, India
| |
Collapse
|
21
|
Aimetti M, Romano F, Guzzi N, Carnevale G. Full-mouth disinfection and systemic antimicrobial therapy in generalized aggressive periodontitis: a randomized, placebo-controlled trial. J Clin Periodontol 2012; 39:284-94. [DOI: 10.1111/j.1600-051x.2011.01795.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2011] [Indexed: 01/21/2023]
Affiliation(s)
- Mario Aimetti
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Federica Romano
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Nicoletta Guzzi
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| | - Gianfranco Carnevale
- Department of Biomedical Sciences and Human Oncology; Division of Periodontology; University of Torino; Torino; Italy
| |
Collapse
|