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Elmeligy SMA, Saleh W, Elewa GM, Abu El-Ezz HZ, Mahmoud NM, Elmeadawy S. The efficacy of diode laser and subgingival air polishing with erythritol in treatment of periodontitis (clinical and microbiological study). BMC Oral Health 2024; 24:763. [PMID: 38965550 PMCID: PMC11225135 DOI: 10.1186/s12903-024-04481-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/13/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND There is insufficient clinical and microbiological evidence to support the use of diode laser and air-polishing with erythritol as supplements to scaling and root planning(SRP). The aim of the current study is to evaluate the clinical and microbiologic efficacy of erythritol subgingival air polishing and diode laser in treatment of periodontitis. METHODS The study encompassed twenty-four individuals seeking periodontal therapy and diagnosed with stage I and stage II periodontitis. Eight patients simply underwent SRP. Eight more patients had SRP followed by erythritol subgingival air polishing, and eight patients had SRP followed by diode laser application. At baseline and six weeks, clinical periodontal parameters were measured, including Plaque Index (PI), Gingival Index (GI), periodontal Probing Depth (PPD), and Clinical Attachment Level (CAL). The bacterial count of Aggregatibacter actinomycetemcomitans(A.A), Porphyromonas gingivalis (P.G) was evaluated at different points of time. RESULTS The microbiological assessment revealed significant differences in the count of A.A. between the laser and erythritol groups immediately after treatment, indicating a potential impact on microbial levels. However, the microbial levels showed fluctuations over the subsequent weeks, without statistically significant differences. Plaque indices significantly decreased post-treatment in all groups, with no significant inter-group differences. Gingival indices decreased, and the laser group showed lower values than erythritol and control groups. PPD and CAL decreased significantly across all groups, with the laser group exhibiting the lowest values. CONCLUSION The supplementary use of diode laser and erythritol air polishing, alongside SRP, represents an expedited periodontal treatment modality. This approach leads to a reduction in bacteria and improvement in periodontal health. TRIAL REGISTRATION This clinical trial was registered on Clinical Trials.gov (Registration ID: NCT06209554) and released on 08/01/2024.
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Affiliation(s)
- Sara M A Elmeligy
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Gasser M Elewa
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt
| | - Hani Z Abu El-Ezz
- Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Suez University, Suez, Egypt
| | - Noha Mostafa Mahmoud
- Medical Microbiology and Immunology Department, Faculty of Medicine Mansoura University, Mansoura, Egypt
- Medical Microbiology and Immunology Department, Faculty of Medicine, Horus University, New Damietta, Egypt
| | - Samah Elmeadawy
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Alsuwaidi S, Almatrooshi A, Shah M, Hakam A, Tawse-Smith A, Alsabeeha NHM, Atieh MA. Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial. J Periodontol 2024. [PMID: 38830779 DOI: 10.1002/jper.24-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 06/05/2024]
Abstract
BACKGOUND The aim of this randomized controlled trial was to assess clinical and patient-reported outcomes of subgingival instrumentation (SI) with adjunctive use of erythritol airflowing (EAF) compared to SI alone in the treatment of periodontitis. METHODS Twenty-six participants with Stage III/IV periodontitis requiring nonsurgical periodontal treatment were randomly allocated into two treatment groups: SI with EAF or SI alone. Clinical parameters of percentage of probing pocket depths (PPDs) of ≥5 mm, full mouth bleeding and plaque scores (FMBS and FMPS), and PPD values were recorded at baseline, and at 3 and 6 months posttreatment. A visual analogue scale was used to evaluate postoperative participants' perception of pain, swelling, bleeding, bruising, and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at six months. RESULTS A total of 26 participants with Stage III/IV periodontitis completed the 6-month follow-up. SI with or without EAF resulted in a statistically significant reductions in the FMBS, FMPS, PPDs, and percentage of PPDs of ≥5 mm at the 3- and 6-month follow-up visits. There was no statistically significant difference between the two treatment groups for any time interval. Participants receiving SI/EAF exhibited a higher reduction in FMBS compared to those in SI alone group at 3 (SI/EAF: 19.4 ± 11.9, SI alone: 30.1 ± 20.5; P = 0.12) and 6 months (SI/EAF: 14.3 ± 9.6, SI alone: 24.5 ± 18.2; P = 0.09). A lower percentage of sites with deep PPDs (≥5 mm) was also noted amongst participants in the SI/EAF group compared to SI alone at 3 months (SI/EAF: 14.3 ± 14.1, SI alone: 19.2 ± 20.3; P = 0.48) and 6 months (SI/EAF: 8.3 ± 10.0, SI alone: 15.4 ± 17.4; P = 0.22). Patient-reported outcomes showed no significant differences between the two treatment groups, except in the psychosocial domain of the GOHAI at 6 months favoring the SI/EAF group (P = 0.03). CONCLUSIONS Within the limitations of the study, the adjunctive use of EAF in addition to SI in the treatment of Stage III/IV periodontitis did not result in a significant improvement in clinical parameters. Limited improvement in the QoL with EAF could be achieved.
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Affiliation(s)
- Salem Alsuwaidi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | | | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | - Abeer Hakam
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
| | - Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Health, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- School of Dentistry, University of Jordan, Amman, Jordan
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Stähli A, Ferrari J, Schatzmann AS, Weigel LD, Roccuzzo A, Imber JC, Duong HY, Eick S, Lang NP, Salvi GE, Sculean A. Clinical evaluation of a novel protocol for supportive periodontal care: A randomized controlled clinical trial. J Periodontol 2024. [PMID: 38291892 DOI: 10.1002/jper.23-0527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND The aim of this study was to compare the clinical efficacy and the patient perception of subgingival debridement with either guided biofilm management (GBM) or conventional scaling and root planing (SRP) during supportive periodontal care (SPC). METHODS Forty-one patients in SPC were randomly assigned to either treatment with GBM or SRP every 6 months. The primary outcome was the percentage of bleeding on probing (BoP) at 1 year. Moreover, pocket probing depths (PPD), recession, and furcation involvements were also measured. Full-mouth and specific site analyzes were performed at baseline, 6 and 12 months of SPC. Patient comfort was evaluated using a visual analogue scale (VAS) at 12 months. RESULTS At 1 year, mean BoP percentage decreased from 12.2% to 9.0% (p = 0.191) and from 14.7% to 7.9% (p = 0.004) for the GBM and SRP groups, respectively. Furcation involved multirooted teeth but no through-and-through lesions were significantly fewer in the GBM than in the SRP group after 12 months (p = 0.015). The remaining parameters showed slight improvement in both groups without any statistically significant differences between the two groups after 1 year. Pain evaluation as patient reported outcome measures (pain evaluation) was in favor (p = 0.347) of the SRP group, while overall satisfaction was similar for both groups. Treatment time was not statistically significantly different between the two groups (p = 0.188). CONCLUSION In well-maintained SPC patients, SRP protocols resulted in significant clinical improvements in terms of BoP; however, for the other clinical improvements, similar efficacy for both GBM and SRP was observed.
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Affiliation(s)
- Alexandra Stähli
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Jvana Ferrari
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | | | - Andrea Roccuzzo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - Ho-Yan Duong
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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Martins O, Costa A, Silva D. The efficacy of air polishing devices in supportive periodontal therapy: Clinical, microbiological and patient-centred outcomes. A systematic review. Int J Dent Hyg 2023; 21:41-58. [PMID: 36300683 DOI: 10.1111/idh.12635] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/14/2022] [Accepted: 10/24/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this review was to compare air polishing devices with conventional periodontal therapy (hand instrumentation and/or ultrasonic debridement), in terms of their clinical, microbiological and patient-related outcomes in patients undergoing periodontal maintenance therapy. METHODS An online database search was performed to identify randomized controlled trials (RCTs) published between January 1987 and March 2021. Selection, data extraction and assessment risk of individual bias were conducted by two independent reviewers. The PICO method was employed to formulate the question: "In patients undergoing periodontal maintenance therapy/supportive periodontal therapy, do air polishing systems result in better clinical, microbiological and patient related outcomes than ultrasonic instrumentation or hand instrumentation?" Primary outcomes were bleeding on probing, gingival index and/or bleeding index. Secondary outcomes were probing depth, clinical attachment level, plaque index, microbiological counts and/or patient tolerance. The risk of bias was evaluated and the systematic review protocol was registered in PROSPERO. RESULTS The electronic search yielded 501 references of which 14 were included in this review. A meta-analysis was not performed due to great heterogeneity within the studies. Air polishing devices and conventional periodontal therapy presented identical results in the 14 studies analysed; however, air polishing devices presented better antimicrobial behaviour and better patient-related outcomes. CONCLUSIONS Both air polishing devices and conventional techniques demonstrated no difference in terms of clinical efficacy; however, air polishing devices seem to present improved antimicrobial results. In addition, they are also a safer, faster and more comfortable option for patients undergoing supportive periodontal therapy.
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Affiliation(s)
- Orlando Martins
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Costa
- DDM, Private Practice, Vila Real, Portugal
| | - Daniela Silva
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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5
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Alkan İİ, Akkaya HÜ, Sağlam M. The effectiveness of scaling and root planing with combined application of air polishing and Nd:YAG laser in periodontal pockets of stage III grade C periodontitis patients: a single-blinded randomized clinical trial. Clin Oral Investig 2022; 26:5459-5469. [PMID: 35505199 DOI: 10.1007/s00784-022-04513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Evaluating the efficiency of combined air polishing and Nd:YAG laser application in addition to scaling and root planning (SRP) in treatment of periodontal pockets of stage III grade C periodontitis patients was the aim of this clinical trial. MATERIALS AND METHODS Twenty-four systemically healthy, stage III grade C periodontitis patients were recruited for this clinical trial. In this split-mouth study, the quadrants were randomly allocated to either SRP with combined air polishing (erythritol/chlorhexidine powder) and Nd:YAG laser (2 W, 200 mJ/pulse, 10 Hz) therapy (test group) or SRP alone (control group). A masked examiner recorded clinical parameters such as plaque index (PI), gingival index (GI), bleeding on probing (%) (BOP %), probing depth (PD), and clinical attachment level (CAL) on periodontal charts at baseline, 1 month and 3 months after treatment. RESULTS The clinical parameters had significantly reduced 1 and 3 months after treatment compared to baseline for both study groups (p < 0.05). Considering PI, GI, and BOP (%) parameters, there were no significant differences between the study groups at any time points (p > 0.05). While PD and CAL reductions were similar in study groups for moderately deep pockets (5 to 6 mm) (p > 0.05), PD and CAL reductions were significantly greater in test group compared to control group for deep pockets (PD ≥ 7 mm) (p < 0.05). CONCLUSIONS The present clinical trial demonstrated that SRP with combined application of air polishing and Nd:YAG laser may be advantageous in sites where mechanical debridement alone cannot access, such as deep pockets in the short term. Long-term, well-designed future studies including clinical, biochemical, and microbiological analyses are needed to determine the effectiveness of this procedure. CLINICAL RELEVANCE SRP with combined application of air polishing and Nd:YAG laser provided more reductions in probing depth and clinical attachment level parameters in deep pockets compared to SRP alone.
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Affiliation(s)
- İsmet İlke Alkan
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey.,Private Practice, Karabağlar, İzmir, Turkey
| | - Hazal Üstünel Akkaya
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mehmet Sağlam
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey.
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6
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Antimicrobial Impact of Different Air-Polishing Powders in a Subgingival Biofilm Model. Antibiotics (Basel) 2021; 10:antibiotics10121464. [PMID: 34943676 PMCID: PMC8698523 DOI: 10.3390/antibiotics10121464] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/18/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
Subgingival air-polishing devices (SAPD) can reduce bacterial biofilms and thus support periodontal healing. The authors of this study evaluated the effectiveness of the glycine-based and trehalose-based air-polishing powders in removing pathogenic bacteria in a subgingival biofilm model. We treated 56 subgingival pockets in porcine jaws with SAPD. Subgingival air polishing was performed in three groups of 13 pockets each: I, glycine-based powder; II, trehalose-based powder; and III, water alone. Another group (IV) served as untreated controls. Prior to air polishing, inoculated titanium bars were inserted into the pockets containing periopathogenic bacteria such as Porphyromonas gingivalis and Tannerella forsythia. Remaining bacteria were evaluated using real-time PCR. The numbers of remaining bacteria depended on the treatment procedure, with the lowest number of total bacteria in group I (median: 1.96 × 106 CFU; min: 1.46 × 105; max: 9.30 × 106). Both polishing powders in groups I and II (median: 1.36 × 107 CFU; min: 5.22 × 105; max: 7.50 × 107) showed a statistically significantly lower total bacterial load in comparison to both group IV (median: 2.02 × 108 CFU; min: 5.14 × 107; max: 4.51 × 108; p < 0.05) and group III (median: 4.58 × 107 CFU; min: 2.00 × 106; max: 3.06 × 108; p < 0.05). Both subgingival air-polishing powders investigated can reduce periopathogenic bacteria and thus support antimicrobial therapy approaches in periodontal treatment regimens.
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7
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Hentenaar DFM, De Waal YCM, Stewart RE, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol air polishing in the surgical treatment of peri-implantitis: A randomized controlled trial. Clin Oral Implants Res 2021; 33:184-196. [PMID: 34808006 PMCID: PMC9299917 DOI: 10.1111/clr.13881] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 01/14/2023]
Abstract
Objectives To compare erythritol air polishing with implant surface cleansing using saline during the surgical treatment of peri‐implantitis. Material and Methods During a resective surgical intervention, implant surfaces were randomly treated with either air polishing (test group n = 26 patients/53 implants) or saline‐soaked cotton gauzes (control group n = 31 patients/ 40 implants). Primary outcome was change in mean bleeding on probing (BoP) from baseline to 12 months follow‐up. Secondary outcomes were changes in mean suppuration on probing (SoP), plaque score (Plq), probing pocket depth (PPD), marginal bone loss (MBL), periodontal full‐mouth scores (PFMS), and levels of 8 classical periodontal pathogens. Clinical and radiographical parameters were analyzed using multilevel regression analyses. Microbiological outcomes were analyzed using the Mann–Whitney U test. Results No differences between the test and control group were found for BoP over 12 months of follow‐up, nor for the secondary parameters Plq, PPD, and MBL. Between both groups, a significant difference was found for the levels of SoP (p = 0.035). No significant effect on microbiological levels was found. A total number of 6 implants were lost in the test group and 10 in the control group. At 1‐year follow‐up, a successful treatment outcome (PPD<5 mm, max 1 out of 6 sites BoP, no suppuration and no progressive bone loss >0.5 mm) was achieved for a total of 18 implants (19.2%). Conclusions Erythritol air polishing as implant surface cleansing method was not more effective than saline during resective surgical treatment of peri‐implantitis in terms of clinical, radiographical, and microbiological parameters. Both therapies resulted in low treatment success. Trial registry: https://www.trialregister.nl/ Identifier: NL8621.
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Affiliation(s)
- Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roy E Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Shrivastava D, Natoli V, Srivastava KC, Alzoubi IA, Nagy AI, Hamza MO, Al-Johani K, Alam MK, Khurshid Z. Novel Approach to Dental Biofilm Management through Guided Biofilm Therapy (GBT): A Review. Microorganisms 2021; 9:microorganisms9091966. [PMID: 34576863 PMCID: PMC8468826 DOI: 10.3390/microorganisms9091966] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Dental biofilm plays a very crucial role in the etiopathogenesis of periodontal andperi-implant diseases. Over the past decade, tremendous research has been carried outto know the structure of biofilm and the mechanism by which it causes the destruction of supporting tissues of tooth or implant. Periodontal or peri-implant therapy usually begins with primarily removing thebiofilm and is considered as non-surgical mechanical debridement. Although scaling and root planing (SRP) is regarded as a gold standard for mechanical plaque debridement, various other means of biofilm removal have constantly been evolving. These may vary from different scaling systems such as vector systems to decontamination of pockets with LASER therapy. Nowadays, a new concept has emerged known as “guided biofilm therapy” (GBT). It is beneficial in removing the biofilm around the tooth and implant structures, resulting in better or comparable clinical outcomes than SRP. These results were substantiated with the reduction in the microbial load as well as the reduction in the inflammatory cytokines. This review will highlight the various aspects of GBT used in periodontal and peri-implant disease.
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Affiliation(s)
- Deepti Shrivastava
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
- Correspondence: ; Tel.: +966-500-782-498
| | - Valentino Natoli
- Department of Dentistry, School of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain;
- Private Dental Practice, 72015 Fasano, Italy
| | - Kumar Chandan Srivastava
- Oral Medicine Radiology, Department of Oral Maxillofacial Surgery Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ibrahim A Alzoubi
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Ahmed Ismail Nagy
- Oral Surgery, Department of Oral Maxillofacial Surgery Diagnostic Sciences, Jouf University, Sakaka 72345, Saudi Arabia;
| | - May Othman Hamza
- Department of Prosthodontics, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Khalid Al-Johani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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9
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Amate-Fernández P, Figueiredo R, Blanc V, Àlvarez G, León R, Valmaseda-Castellón E. Erythritol-enriched powder and oral biofilm regrowth on dental implants: an in vitro study. Med Oral Patol Oral Cir Bucal 2021; 26:e602-e610. [PMID: 33772566 PMCID: PMC8412445 DOI: 10.4317/medoral.24622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/01/2021] [Indexed: 12/24/2022] Open
Abstract
Background Peri-implant mucositis and peri-implantitis are the main biological complications associated with dental implants. Since most authors agree that bacteria play a major etiological role, the main aims of this study were to determine if a formulation of erythritol and chlorhexidine applied with an air polishing system inhibits biofilm regrowth over dental implants and to compare the decontamination capacity of this therapy with that of mechanical removal by saline and gauze. Material and Methods A multispecies biofilm (P. gingivalis, A. actinomycetemcomitans, F. nucleatum, A. naeslundii, V. parvula and S. oralis) was grown for 14 days on 52 dental implants in an artificial mouth. These implants were divided into three groups according to the applied treatment: 14 negative control (CON), 19 erythritol-chlorhexidine (ERY) and 19 gauze with saline (GAU) samples. Twelve dental implants from the ERY and GAU groups and 8 implants from the CON group were re-incubated for 7 additional days after treatment. The bacterial count was performed by quantitative polymerase chain reaction (qPCR) using propidium monoazide (PMA). A descriptive and bivariate analysis of the data was performed. Results The erythritol and chlorhexidine formulation significantly inhibited biofilm regrowth in comparison with the mechanical treatment (GAU), since a significant decrease in all the species was observed in the ERY group (except for Aggregatibacter actinomycetemcomitans). The antibiofilm and antibacterial capacity of the two active treatment groups (ERY and GAU) was similar for a 14 days multispecies in vitro biofilm, except for the lower count of A. naeslundii in the GAU group. Conclusions The use of erythritol powder with chlorhexidine applied with an air polishing system reduces biofilm regrowth over dental implants when compared with mechanical removal by saline and gauze. This effect might be beneficial for patients included in peri-implant maintenance programs. Key words:Dental implants, biofilms, peri-implantitis, erythritol, chlorhexidine.
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Affiliation(s)
- P Amate-Fernández
- Faculty of Medicine and Health Sciences, University of Barcelona Campus de Bellvitge UB, Facultat de Medicina i Ciències de la Salut, Odontologia C/ Feixa Llarga, s/n, Pavelló Govern, 2a planta, Despatx 2.9 08907, L'Hospitalet de Llobregat, Barcelona, Spain
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10
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Lisbona-González MJ, Muñoz-Soto E, Lisbona-González C, Vallecillo-Rivas M, Diaz-Castro J, Moreno-Fernandez J. Effect of Propolis Paste and Mouthwash Formulation on Healing after Teeth Extraction in Periodontal Disease. PLANTS 2021; 10:plants10081603. [PMID: 34451647 PMCID: PMC8401982 DOI: 10.3390/plants10081603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 12/14/2022]
Abstract
This study investigated the antimicrobial effects of a mouthwash containing propolis and the effect of a propolis paste formulation on dental healing after teeth extraction in patients with periodontal disease. In the mouthwash experience, the population comprised 40 patients, which were divided as follows: the control mouthwash, 0.2% chlorhexidine (v/v) mouthwash, 2% (w/v) propolis mouthwash, and propolis + chlorhexidine mouthwash. The study of the propolis paste comprised a population of 60 patients with periodontal disease, and a total of 120 symmetric tooth extractions were performed. Propolis showed antimicrobial activity by itself, and especially with the chlorhexidine association. Three days after surgery in the teeth treated with control paste, only 13.4% had completely healed; however, with propolis paste, in 90% of the periodontal sockets, healing was complete. In addition, a reduction in Streptococci mutans and Lactobacilli cfu was observed with propolis, and especially with the association of chlorhexidine + propolis. Propolis mouthwash reduced bacterial proliferation, especially in association with chlorhexidine. Propolis paste is a viable alternative for socket healing after dental extraction. The knowledge gained from these findings will provide a foundation for similar propolis therapies in order to improve the healing process after dental surgery.
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Affiliation(s)
- Maria Jesús Lisbona-González
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.J.L.-G.); (E.M.-S.); (C.L.-G.); (M.V.-R.)
| | - Esther Muñoz-Soto
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.J.L.-G.); (E.M.-S.); (C.L.-G.); (M.V.-R.)
| | - Cristina Lisbona-González
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.J.L.-G.); (E.M.-S.); (C.L.-G.); (M.V.-R.)
| | - Marta Vallecillo-Rivas
- Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain; (M.J.L.-G.); (E.M.-S.); (C.L.-G.); (M.V.-R.)
| | - Javier Diaz-Castro
- Department of Physiology, Faculty of Pharmacy, Campus Universitario de Cartuja, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, 18016 Granada, Spain
- Correspondence: (J.D.-C.); (J.M.-F.)
| | - Jorge Moreno-Fernandez
- Department of Physiology, Faculty of Pharmacy, Campus Universitario de Cartuja, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, 18071 Granada, Spain
- Correspondence: (J.D.-C.); (J.M.-F.)
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11
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Albonni H, Alseirafi W, Tekleh H, Sawaf H. Clinical outcomes of performance of dental students using erythritol powder by means of air polishing with ultrasonic debridement with students' assessment: Part II. Int J Dent Hyg 2021; 20:391-400. [PMID: 34318588 DOI: 10.1111/idh.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Assessment of a dental student's clinical performance is essential for providing feedback for improving education. This study evaluated the ability of undergraduate dental students to treat periodontal patients with two techniques, ultrasonic debridement with polishing (UD+P) and the erythritol powder air polishing with ultrasonic instrumentation (EPAP+UD) in a split-mouth design. METHODS The study was conducted on undergraduate students with patients suffering from gingivitis and stage I periodontitis with grade A. The evaluation consisted of two parts: first, assessment of the student by clinical indices (full mouth plaque index (FMPI), calculus index (CI), remaining calculus index (RCI), modified gingival index (MGI) and papillary bleeding index (PBI)) at baseline, immediately and after 2 weeks. In addition to assessing treatment time for each student; and second, obtaining student feedback about the two methods used. RESULTS Five undergraduate fourth years' students, and thirteen patients participated. Statistically significant decreases in FMPI, CI, MGI and PBI between baseline and 2 weeks post-treatment were noted in both test and control groups. At 2 weeks of inter-group comparisons, there was a statistically significant difference in FMPI and MGI indices, and immediately after the treatment, there was also a significant reduction in FMPI and CI. Treatment time was significantly less for the EPAP+UD method, and it got 10-time method preferring in comparison with the control group (UD+P) by students. CONCLUSION The undergraduate dental student has the capacity to treat the periodontal patient using both approaches with a preference for the EPAP+UI approach over UI+P. In addition, this EPAP+UI is a promising method of education.
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Affiliation(s)
- Hala Albonni
- Periodontology Department, Faculty of Dental Medicine, Damascus University, Damascus, Syria.,Periodontology Department, Faculty of Dentistry - Syrian Private University, Daraa, Syria.,Periodontology Department, Faculty of Dentistry - Al Sham Private University, Damascus, Syria
| | | | | | - Hazem Sawaf
- Periodontology Department, Faculty of Dentistry - Syrian Private University, Daraa, Syria.,Periodontology Department, Faculty of Dentistry - Al Sham Private University, Damascus, Syria
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12
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Ulvik IM, Sæthre T, Bunæs DF, Lie SA, Enersen M, Leknes KN. A 12-month randomized controlled trial evaluating erythritol air-polishing versus curette/ultrasonic debridement of mandibular furcations in supportive periodontal therapy. BMC Oral Health 2021; 21:38. [PMID: 33478480 PMCID: PMC7819243 DOI: 10.1186/s12903-021-01397-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/06/2021] [Indexed: 12/22/2022] Open
Abstract
Background Due to complex morphology and limited access, the cleaning of the furcation area is extremely challenging. Therefore, novel therapeutic approaches need to be tested to potentially overcome debridement limitations. The aim of the present prospective 12-month study was to compare clinical and microbiological effects following erythritol air-polishing versus conventional mechanical debridement of furcation defects in a cohort of periodontal maintenance patients.
Methods Twenty patients with grade II mandibular molar furcation defects volunteered to enroll in this single-centre, examiner masked, randomized controlled trial. In a split-mouth study design, two furcation sites in each patient were randomly assigned to either receive subgingival debridement using erythritol air-polishing (test) or conventional ultrasonic/curette debridement (control) at baseline, and at 3, 6, 9 and 12 months. Probing depth, clinical attachment level and bleeding on probing were recorded at 3-month intervals. Subgingival microbiological samples obtained at baseline, 6 and 12 months were analyzed using checkerboard DNA–DNA hybridization. Discomfort from treatment was scored at 12 months using a visual analogue scale. The differences between treatments, and time-points, were tested using multilevel analysis (mixed effect models and robust variance estimates). Results A significant reduction in probing depth took place following both treatments (p < 0.001). Control sites experienced a significant mean gain in clinical attachment level of 0.5 mm (± 0.2) (p = 0.004), whereas a non-significant gain of 0.4 mm (± 0.3) was observed at test sites (p = 0.119). At 6 months, a significant between-treatment difference of 0.8 mm (± 0.4) was observed in favor of the control (p = 0.032). No significant between-treatment differences were observed in microbial load or composition. Notably, at 12 months patients experienced significantly less discomfort following air-polishing compared with control (p = 0.001). Conclusions The 12-month observations indicate that erythritol air-polishing and conventional mechanical debridement both support clinical improvements. A significant between-treatment difference in clinical attachment level was, however, detected in favour of control debridement at 6 months. In terms of patient comfort, erythritol air-polishing is superior. Trial Registration: The clinical trial was retrospectively registered in ClinicalTrial.gov with registration NCT04493398 (07/28/2020).
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Affiliation(s)
- Ingvild M Ulvik
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Terje Sæthre
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Dagmar F Bunæs
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Stein Atle Lie
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Morten Enersen
- Faculty of Dentistry, Institute for Oral Biology, University of Oslo, Oslo, Norway
| | - Knut N Leknes
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway.
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13
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Use of air polishing for supra- and subgingival biofilm removal for treatment of residual periodontal pockets and supportive periodontal care: a systematic review. Clin Oral Investig 2021; 25:779-795. [PMID: 33464417 DOI: 10.1007/s00784-020-03762-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
AIM To systematically review the literature to compare the efficacy of air polishing to hand or ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care. METHODS Electronic searches were performed in five different databases, and two databases were used to capture the "grey literature partially." Clinical trials that compared the use of an air-polishing device to either conventional scaling and root planing (hand and/or ultrasonic instrumentation) or no treatment during periodontal therapy were included without restriction of year and publication status. The Joanna Briggs Institute instrument for clinical trials was used to appraise the studies critically. The results were submitted to qualitative descriptive analysis. The systematic review protocol was registered in PROSPERO (CRD420220156176). RESULTS Electronic searches found 1100 hits published between 2008 and 2019. Thirteen studies were included in the review, out of which four had a follow-up longer than 180 days. Results indicated no differences between the efficacy of air polishing and hand or ultrasonic instruments to reduce periodontal inflammation. CONCLUSIONS Our findings suggest that there is no difference in the efficacy of air polishing and hand or ultrasonic instrumentation to control biofilm and reduce periodontal inflammation. However, these findings must be carefully interpreted owing to methodological issues, including a short follow-up, and a potential conflict of interest related to industry funding. CLINICAL RELEVANCE Air polishing for biofilm control may be used as an alternative to hand and ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care.
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14
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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial. BMC Oral Health 2020; 20:364. [PMID: 33372602 PMCID: PMC7771063 DOI: 10.1186/s12903-020-01363-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. METHODS Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. RESULTS In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. CONCLUSIONS Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. CLINICAL RELEVANCE The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL .
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15
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Butera A, Maiorani C, Natoli V, Bruni A, Coscione C, Magliano G, Giacobbo G, Morelli A, Moressa S, Scribante A. Bio-Inspired Systems in Nonsurgical Periodontal Therapy to Reduce Contaminated Aerosol during COVID-19: A Comprehensive and Bibliometric Review. J Clin Med 2020; 9:jcm9123914. [PMID: 33276626 PMCID: PMC7761598 DOI: 10.3390/jcm9123914] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/25/2020] [Accepted: 11/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background: On 30 January 2020, a public health emergency of international concern was declared as a result of the new COVID-19 disease, caused by the SARS-CoV-2 virus. This virus is transmitted by air and, therefore, clinical practices with the production of contaminant aerosols are highly at risk. The purpose of this review was to assess the effectiveness of bio-inspired systems, as adjuvants to nonsurgical periodontal therapy, in order to formulate bio-inspired protocols aimed at restoring optimal condition, reducing bacteremia and aerosols generation. Methods: A comprehensive and bibliometric review of articles published in English. Research of clinical trials (RCTs) were included with participants with chronic or aggressive periodontal disease, that have compared benefits for nonsurgical periodontal therapy (NSPT). Results: Seventy-four articles have been included. For probing depth (PPD) there was a statically significant improvement in laser, probiotic, chlorhexidine groups, such as gain in clinical attachment level (CAL). Bleeding on probing (BOP) reduction was statistically significant only for probiotic and chlorhexidine groups. There were changes in microbiological and immunological parameters. Conclusions: The use of bio-inspired systems in nonsurgical periodontal treatment may be useful in reducing risk of bacteremia and aerosol generation, improving clinical, microbiological and immunological parameters, of fundamental importance in a context of global pandemic, where the reduction of bacterial load in aerosols becomes a pivotal point of clinical practice, but other clinical trials are necessary to achieve statistical validity.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
- Correspondence:
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | | | | | | | | | | | | | | | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
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16
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Kröger JC, Haribyan M, Nergiz I, Schmage P. Air polishing with erythritol powder - In vitro effects on dentin loss. J Indian Soc Periodontol 2020; 24:433-440. [PMID: 33144771 PMCID: PMC7592611 DOI: 10.4103/jisp.jisp_414_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/06/2020] [Accepted: 04/06/2020] [Indexed: 01/03/2023] Open
Abstract
Context: Low-abrasive polishing powders such as glycine (GLY) or erythritol (ERY) are used for subgingival air polishing. GLY was reported to possibly affect the dentin surface, while this is unclear for ERY. Aims: This in vitro study aimed to evaluate the substance loss from the dentin surface by air polishing with ERY at different settings for pressure (PR), distance (DI), and angulation of the spray jet to the surface (AJ). Materials and Methods: The in vitro testing was performed on smooth human root dentin surfaces. In 18 groups with 10 specimens each, ERY was applied with constant water supply for 5 s without moving the handpiece at the following settings: PR minimum (min), medium (med), and maximum (max); DI at 1, 3, and 5 mm; and 45° or 90° AJ. The substance loss was measured as defect depth (DD) using three-dimensional (3D)-laser profilometry. ANOVA with Bonferroni correction and α = 0.05 were used for statistical analysis. Results: The DD was statistically significantly higher at a DI of 1 mm compared to a DI of 5 mm for the respective groups of the same PR and AJ (P < 0.05). For DI 1 mm, max PR, and AJ 90°, the maximum loss of substance amounted DD of 117 ± 43 μm. The minimal loss of substance occurred at minimal PR, 45° AJ, and a DI of 5 mm (15 μm × 20 μm). DD related directly with the parameters PR and AJ and inversely with DI. The highest influence on DD was proven for DI. Conclusions: Slight loss of dentin might occur during air polishing with ERY depending on DI, PR and AJ. The setting influences the amount of dentin loss.
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Affiliation(s)
- Jella C Kröger
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mikael Haribyan
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ibrahim Nergiz
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra Schmage
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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17
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Cosgarea R, Jepsen S, Fimmers R, Bodea A, Eick S, Sculean A. Clinical outcomes following periodontal surgery and root surface decontamination by erythritol-based air polishing. A randomized, controlled, clinical pilot study. Clin Oral Investig 2020; 25:627-635. [PMID: 32839833 PMCID: PMC7820077 DOI: 10.1007/s00784-020-03533-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/14/2020] [Indexed: 12/11/2022]
Abstract
Aim To evaluate the outcomes following surgical periodontal treatment and root surface decontamination by means of air polishing using an erythritol powder or conventional mechanical root debridement. Material and methods Thirty systemically healthy patients (44.38 ± 8.2 years old, 11 smokers, 19 women) diagnosed with periodontitis stages III–IV were included. Each patient, with one single-rooted tooth, with one probing pocket depth (PD) ≥ 6 mm associated with horizontal bone loss, was treated by means of simplified papilla preservation flap (SPPF) and randomized to either test treatment (careful removal of the calculus with the tip of a blade, air polishing of the root surfaces with erythritol) or to the control group (scaling and root planing with hand curettes, ultrasonic instruments). PD, clinical attachment (CAL), bone sounding (BS), and radiographic bone level (BL) were evaluated at baseline and 12 months postsurgically. Results Twenty-seven patients completed the 12-month follow-up (test: n = 14, control: n = 13). In both groups, statistically significant improvements were obtained (p < 0.05, mean CAL gain/PD reduction: test, 2.50 ± 1.60 mm/3.00 ± 0.96 mm; control, 2.85 ± 1.21 mm/3.38 ± 1.12 mm). No statistically significant differences were observed between the groups for any of the investigated parameters (p < 0.05). Conclusion Within their limits, the present results indicate that the use of air polishing with an erythritol powder during periodontal surgery may represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus. Clinical relevance The use of air polishing with an erythritol powder during periodontal surgery appears to represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus.
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Affiliation(s)
- Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany. .,Department of Prosthetic Dentistry, University Iuliu-Hatieganu, Str. Clinicilor nr 32, 400006, Cluj-Napoca, Romania. .,Department of Periodontology and Peri-implant Diseases, Philipps University of Marburg, Georg-Voigt Str. 3, 35033, Marburg, Germany.
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Rolf Fimmers
- Institute for Medical Biometry, Informatics and Epidemiology, University Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Aura Bodea
- Periodontal Private Practice for Periodontology, Gheorghe Doja Str. 9, 400068, Cluj-Napoca, Romania
| | - Sigrun Eick
- Department of Periodontology, University Bern, Bern, Switzerland, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, University Bern, Bern, Switzerland, Freiburgstrasse 7, CH-3010, Bern, Switzerland
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18
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Janiszewska-Olszowska J, Drozdzik A, Tandecka K, Grocholewicz K. Effect of air-polishing on surface roughness of composite dental restorative material - comparison of three different air-polishing powders. BMC Oral Health 2020; 20:30. [PMID: 32000753 PMCID: PMC6993449 DOI: 10.1186/s12903-020-1007-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background Increased composite roughness enhances bacterial adhesion and discoloration, thus increasing the risk of gingival inflammation and secondary caries. Concerns about detrimental effects of sodium bicarbonate on surface roughness influenced the development of less abrasive powders: a glycine-based powder and an erythritol-based powder, additionally - sodium bicarbonate-based powder of reduced grain size. However, there is limited evidence on effects of these materials on the surface of dental fillings. The aim of the present study was to compare the effects of three air-polishing powders (of a reduced abrasiveness) on surface roughness of microhybrid restorative composite material. Material and methods Microhybrid light-cure resin composite samples were placed on 64 plaster cubes and light-cured through polyester strips. Surface roughness was measured using laser confocal microscope (magnification 2160x). The specimens were randomly divided into three groups (n = 20, 20 and 24) and air-polished with: sodium bicarbonate (40 μm), glycine (25 μm) and erythritol (14 μm), respectively. Then surface roughness was remeasured, keeping the same field of observation. Specialized 3D analysis software was used for data processing. Parameters according to ISO 25178: Sa, Sq, Sku, Sp, Sv, Sz, Ssk were used to describe surface roughness. Results Sa, Sq, Sp, Sv, Sz increased significantly following air polishing. Ssk was significantly higher, whereas Sku was significantly lower in sodium bicarbonate and erythritol groups than before air polishing. Comparison between the three powders revealed that Sa was significantly higher in sodium bicarbonate group than in glycine group. Sku was significantly higher in glycine and erythritol groups than in sodium bicarbonate group. Conclusions Sodium bicarbonate has a stronger detrimental effect on composite surface than glycine or erythritol. No advantage of erythritol comparing to glycine could be found.
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Affiliation(s)
- Joanna Janiszewska-Olszowska
- Department of Interdisciplinary Dentistry Pomeranian Medical, University in Szczecin, al. Powstancow Wlkp, 72, 70-111, Szczecin, Poland.
| | - Agnieszka Drozdzik
- Department of Interdisciplinary Dentistry Pomeranian Medical, University in Szczecin, al. Powstancow Wlkp, 72, 70-111, Szczecin, Poland
| | - Katarzyna Tandecka
- Faculty of Mechanical Engineering Koszalin, University of Technology, ul, Raclawicka 15-17, 75-620, Koszalin, Poland
| | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry Pomeranian Medical, University in Szczecin, al. Powstancow Wlkp, 72, 70-111, Szczecin, Poland
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19
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Park EJ, Kwon EY, Kim HJ, Lee JY, Choi J, Joo JY. Clinical and microbiological effects of the supplementary use of an erythritol powder air-polishing device in non-surgical periodontal therapy: a randomized clinical trial. J Periodontal Implant Sci 2018; 48:295-304. [PMID: 30405937 PMCID: PMC6207796 DOI: 10.5051/jpis.2018.48.5.295] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 12/16/2022] Open
Abstract
Purpose This study was undertaken to evaluate the clinical and microbiological effects of an erythritol powder air-polishing device (EPAP) as a supplement to scaling and root planing (SRP) therapy in patients with moderate chronic periodontitis. Methods Clinical and microbiological evaluations were performed at 21 sites treated with SRP (control) and 21 sites treated with SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Results There were no significant clinical differences between the test group and the control group. Microbiological analysis revealed that the relative expression level of Porphyromonas gingivalis was significantly lower in the test group than in the control group at 1 month after treatment. Clinical and microbiological results showed improvements at 1 month compared to baseline; in contrast, the results at 3 months after treatment were worse than those at 1 month after treatment. Conclusions In this study, both SRP and SRP+EPAP were clinically and microbiologically effective as non-surgical periodontal treatments. In particular, the SRP+EPAP group showed an antimicrobial effect on P. gingivalis, a keystone bacterium associated with the onset of chronic periodontitis, in a short-term period. Periodic periodontal therapy, at intervals of at least every 3 months, is important for sustaining the microbiological effects of this treatment.
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Affiliation(s)
- Eon-Jeong Park
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Eun-Young Kwon
- Dental Clinic Center, Pusan National University Hospital, Busan, Korea
| | - Hyun-Joo Kim
- Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Ju-Youn Lee
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Jeomil Choi
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Ji-Young Joo
- Department of Periodontology and Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
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20
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Fawzy El-Sayed K, Graetz C, Köhnlein T, Mekhemar M, Dörfer C. Effect of total sonicated Aggregatibacter actinomycetemcomitans fragments on gingival stem/progenitor cells. Med Oral Patol Oral Cir Bucal 2018; 23:e569-e578. [PMID: 30148477 PMCID: PMC6167108 DOI: 10.4317/medoral.22661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/16/2018] [Indexed: 01/24/2023] Open
Abstract
Background Aggregatibacter-actinomycetemcomitans (A.actinomycetemcomitans) are strongly associated with localized-aggressive-periodontitis (LAgP). The study’s aim was to test for the first time the effect of total sonicated A.actinomycetemcomitans-bacterial-fragments on gingival mesenchymal stem/progenitor cells’ (G-MSCs) proliferation and regenerative gene expression in-vitro. Material and Methods G-MSCs were isolated, characterized, expanded and stimulated by total sonicated A.actinomycetemcomitans-bacterial-fragments (0 (negative-control), 15, 60, 120 and 240µg/ml; serovar-b; n=6/group). Cellular proliferation and NF-κβ (NFKB1), Alkaline Phosphatase (ALPL), Collagen-I (COL1A1), Collagen-III (COL3A1), Osteonectin (SPARC) and Osteopontin (SPP1) m-RNA expression were assessed via reverse-transcription-polymerase-chain-reaction (RT-PCR) at 24, 48 and 72 hours and CFUs-ability evaluated at twelve days. Results G-MSCs demonstrated stem/progenitor cells’ characteristics. A.actinomycetemcomitans-bacterial-fragments (up to 72 hours) resulted in marked G-MSCs’ proliferation over-time (p<0.001) and elevated NFKB1 (p=0.017), COL1A1 (p=0.025), SPARC (p=0.025), decreased ALPL (p=0.017), with no significant differences for COL3A1 and SPP1 expression or stimulation times (p>0.05; Friedman-test). Longer-term stimulation for twelve days reduced G-MSCs’ CFUs. Conclusions Sonicated A.actinomycetemcomitans-bacterial-fragments’ exert beneficial short-term effects on G-MSCs’ proliferative and non-mineralized tissue forming aptitude. Results shed new light on the importance of periodontal treatment for LAgP patients, using power driven sonic/ultrasonic devices, which, in addition to reducing the subgingival microbial load, produces cell-stimulatory A.actinomycetemcomitans-bacterial-fragments, with positive attributes on tissue reparative/regenerative responses of tissue resident stem/progenitor cells in their niche. Key words:Ultrasonic, Aggregatibacter actinomycetemcomitans, stem cells, gingiva, Aggressive periodontitis.
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Affiliation(s)
- K Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, Haus 26, 24105 Kiel, Germany,
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Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints. Int J Dent 2016; 2016:9868421. [PMID: 27635141 PMCID: PMC5011233 DOI: 10.1155/2016/9868421] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/13/2016] [Indexed: 11/21/2022] Open
Abstract
Objective. To provide a comprehensive overview of published evidence on the impact of erythritol, a noncaloric polyol bulk sweetener, on oral health. Methods. A literature review was conducted regarding the potential effects of erythritol on dental plaque (biofilm), dental caries, and periodontal therapy. The efficacy of erythritol on oral health was compared with xylitol and sorbitol. Results. Erythritol effectively decreased weight of dental plaque and adherence of common streptococcal oral bacteria to tooth surfaces, inhibited growth and activity of associated bacteria like S. mutans, decreased expression of bacterial genes involved in sucrose metabolism, reduced the overall number of dental caries, and served as a suitable matrix for subgingival air-polishing to replace traditional root scaling. Conclusions. Important differences were reported in the effect of individual polyols on oral health. The current review provides evidence demonstrating better efficacy of erythritol compared to sorbitol and xylitol to maintain and improve oral health.
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Graetz C, Plaumann A, Wittich R, Springer C, Kahl M, Dörfer CE, El-Sayed KF. Removal of simulated biofilm: an evaluation of the effect on root surfaces roughness after scaling. Clin Oral Investig 2016; 21:1021-1028. [PMID: 27233902 DOI: 10.1007/s00784-016-1861-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/23/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite the development of less invasive devices, a debate exists about the benefits and risks of hand versus powered root surface instrumentation used in supportive periodontal therapy (SPT). The aim of the in vitro study was to differentially compare plaque removal efficacy and root surface roughening of newly developed sonic, ultrasonic scaler, and curettes in the hands of experienced versus less experienced operators. MATERIALS AND METHODS Sonic (AIR), ultrasonic devices (TIG), and double-gracey curettes (GRA) were utilized by seven experienced (EO) and four less experienced operators (LO) for root surface instrumentation of standardized plastic teeth on manikins' heads in a randomized sequence. The proportion of residual simulated plaque (RSP area in %) was planimetrically assessed, and the average root surface roughness produced (Ra and ∆Ra in μm) was measured by a precision profilometer. RESULTS The uninstrumented root surfaces showed a Ra of (median (Q25/Q75)) 1.00 μm (0.83/1.16). Following instrumentation, EO left significantly less RSP than LO regardless of the used instruments (20.00 % (10.00/34.00) vs. 26.00 % (12.00/44.00) p < 0.001), whereas the ∆Ra values (0.29 μm (-0.04/0.96) vs. 0.35 μm (-0.04/1.01), p = 0.237) failed to show significant differences. The surface roughness was higher with GRA followed by AIR then TIG regardless of operators' experience (p < 0.001). CONCLUSION Within the limits of the present study, the sonic device was most efficient in plaque removal, while the ultrasonic device produced the least surface roughness. CLINICAL RELEVANCE All three tested instruments seem effective in the mechanical root debridement during SPT, whereat the ultrasonic device show the smoothest root surface of all.
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Affiliation(s)
- Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany.
| | - Anna Plaumann
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Robert Wittich
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Claudia Springer
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Maren Kahl
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Karim Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany.,Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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Hägi TT, Klemensberger S, Bereiter R, Nietzsche S, Cosgarea R, Flury S, Lussi A, Sculean A, Eick S. A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts. PLoS One 2015; 10:e0131056. [PMID: 26121365 PMCID: PMC4486723 DOI: 10.1371/journal.pone.0131056] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/28/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIM There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a) to establish a pocket model enabling mechanical removal of biofilm and b) to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL) fibroblasts. MATERIAL AND METHODS Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a) hand-instrumentation with curettes (CUR), b) ultrasonication (US), c) subgingival air-polishing using erythritol (EAP) and d) subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX). The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz), the caused tooth substance-loss (thickness) as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD. RESULTS After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10). The lowest reduction was found after CUR (2 log10). Additionally, substance-loss was the highest when using CUR (128±40 µm) in comparison with US (14±12 µm), EAP (6±7 µm) and EAP-CHX (11±10) µm). Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts. CONCLUSION The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air-polishing with erythritol prevents from substance-loss and results in a smooth surface with nearly no residual biofilm that promotes the reattachment of PDL fibroblasts.
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Affiliation(s)
- Tobias T. Hägi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sabrina Klemensberger
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Riccarda Bereiter
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sandor Nietzsche
- Centre of Electron Microscopy, University Hospital of Jena, Jena, Germany
| | - Raluca Cosgarea
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prosthetic Dentistry, University of Cluj-Napoca, Cluj-Napoca, Romania
- Department of Periodontology, Philips University, Marburg, Germany
| | - Simon Flury
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- * E-mail:
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Müller N, Moëne R, Cancela JA, Mombelli A. Subgingival air-polishing with erythritol during periodontal maintenance: randomized clinical trial of twelve months. J Clin Periodontol 2014; 41:883-9. [PMID: 25041441 PMCID: PMC4287198 DOI: 10.1111/jcpe.12289] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2014] [Indexed: 11/30/2022]
Abstract
Objectives To evaluate repeated subgingival air-polishing in residual pockets with a new erythritol powder
containing 0.3% chlorhexidine. Material and Methods Single-centre, examiner masked, randomized clinical trial of 12 months with a two-arm,
within-subject parallel design. Fifty patients in periodontal maintenance were monitored in 3-month
intervals. At months 0, 3, 6 and 9, all sites presenting with a probing depth (PD)
>4 mm were subject to subgingival air-polishing (test side) or ultrasonic debridement
(control side). The primary endpoint was presence/absence of PD >4 mm after
12 months. Results Totally 6918 sites were monitored at baseline, 457 of them had a PD >4 mm
(range 5–9 mm). The number of pockets >4 mm per subject, PD and bleeding
on probing were significantly lower at month 12. Differences between test and control were not
significant. There was a significant difference in favour of air-polishing for the perception of
pain/discomfort. Differences of frequencies at >1000 and >100,000 cells/ml of
six microorganisms between baseline and month 12 were not significant. At month 12, test sites were
less frequently positive for Aggregatibacter actinomycetemcomitans at
>1000 cells/ml than controls, and counts never exceeded 100,000 cells/ml. Conclusions Repeated subgingival air-polishing reduced the number of pockets >4 mm similar to
ultrasonic debridement. It was safe and induced less pain.
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Affiliation(s)
- Nada Müller
- Division of Periodontology and Oral Pathophysiology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
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