Comparative evaluation of two subgingival irrigating solutions in the management of periodontal disease: A clinicomicrobial study

Effectiveness of Ultrasonic and Manual Instrumentation in Nonsurgical Periodontal Therapy: Are Additional Therapies More Effective? A Systematic Review

Nonsurgical periodontal therapy aims to remove supragingival and subgingival biofilm to restore periodontal health. This systematic review aims to assess the clinical effectiveness of manual and/or ultrasonic instruments and to determine whether other therapies can improve periodontal clinical outcomes. Case-control, cross-sectional and cohort studies and clinical trials of patients undergoing nonsurgical periodontal therapy with ultrasonic and/or manual instruments (and any adjunctive therapies, such as glycine, erythritol, ozone, laser and glycine) from 2013 to 2023 were analyzed using Pub-med/MEDLINE, Scopus and Google Scholar. To assess the risk of bias in this review, blinding, randomization, allocation concealment, outcome data and outcome recording were assessed. No differences between treatments were found; all methods, including manual and ultrasound, were helpful in improving clinical parameters (primary outcome). Although the results were mixed, adjunctive therapies seemed to be helpful in the treatment of periodontal disease. The results of this systematic review are consistent with the previous scientific literature and have shown that both manual and ultrasonic instruments are effective in nonsurgical periodontal therapy. This review could not show how complementary therapies could further improve nonsurgical periodontal therapy. For future research, it would be good to standardize the sample with regard to the degree and stage of periodontal disease and to evaluate the risks and benefits of the instruments (manual and ultrasonic scalers).

Simultaneous determination of chlorite, chlorate, perchlorate and bromate in ozonated saline by using IC-MS

A simple, accurate and reliable analytical method for simultaneous determination of chlorite, chlorate, perchlorate and bromate in ozonated saline by using ion chromatography coupled with triple quadrupole mass spectrometry (IC-MS) has been developed. The use of silver (Ag) and hydrogen (H) OnGuard cartridges and 100-fold dilution were found to be simple and effective for sample pretreatment. Under optimized MS parameters, method validation was convincingly confirmed. A good linearity was obtained with regression correlation coefficients (R2) larger than 0.999. The mean relative recoveries of chlorite (ClO2-), chlorate (ClO3-), perchlorate (ClO4-), and bromate (BrO3-) ranged from 79.96 to 97.63%. The obtained limit of detection (LOD) was 1.00 μg L-1 for ClO2-, 0.10 μg L-1 for ClO3-, 0.04 μg L-1 for ClO4-, and 0.50 μg L-1 for BrO3-. Chlorate and bromate were only detected in ozonated samples. In addition, the concentration of chlorate and bromate was in direct proportion to the amount of ozone in saline.

Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials

OBJECTIVE

This systematic review (SR) aimed at assessing the adjunctive clinical effect of ozone therapy (OT) on nonsurgical periodontal treatment.

MATERIALS AND METHODS

Articles published prior to September 2019 were electronically searched in four databases without any other date or language restrictions and manually searched in regular journals and in gray literature. This review was performed according to the PICO format. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the adjunctive effect of OT on nonsurgical periodontal treatment.

RESULTS

Twelve studies published between 2010 and 2019 were included in this SR. A metaanalysis of ten reports showed that there was no statistically significant difference in the periodontal parameters analyzed when scaling and root planing (SRP) plus sulcus irrigation with ozonated water or sulcus insertion of ozonated gas were used when compared to SRP alone. Additionally, there was no significant difference when the effect of SRP plus ozonated water was compared with SRP plus 2% chlorhexidine gluconate (CLX). No studies reported significant microbiological differences when the use of ozone was compared with SRP alone.

CONCLUSIONS

The results of this SR do not support the use of OT for nonsurgical periodontal treatment. However, due to the potential heterogeneity across the studies, the presence of confounding factors, and the short follow-up of some included RCTs, these results should not be considered definitive.

CLINICAL RELEVANCE

The current evidence indicates that ozone has antimicrobial activity and good biocompatibility with periodontal cells and gingival fibroblasts. However, no evidence was found for a positive effect of OT as an adjunct to scaling and root planing.

Evaluation of ozone as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A randomized clinico-microbial study

Background and Objectives

Mechanical plaque control is an essential part of periodontal therapy. In the present study, the efficacy of ozone water irrigation as an adjunct to scaling and root planing was evaluated in the treatment of generalized chronic periodontitis.

Materials and Methods

Twenty-four patients with chronic periodontitis selected for the study were randomly divided into Group A and Group B, receiving ozone water irrigation and distilled water irrigation, respectively, after scaling and root planing. Subgingival plaque was collected from the selected investigational teeth and was analyzed using BANA-Zyme™ Processor to evaluate the "red complex" periodontal pathogens. The clinical and microbiological parameters were recorded at baseline, 14 days, 21 days, and 2 months.

Results

The mean probing pocket depth scores for Group A and Group B at the baseline were 6.833 ± 1.193 and 7.833 ± 1.276; on day 14^th, they were 6.616 ± 1.403 and 7.083 ± 1.378; on day 21^st, they were 5.166 ± 0.937 and 6.083 ± 1.443;and on the 2^nd month, they were 4.500 ± 0.797 and 5.166 ± 1.029, respectively. At the 2^nd month, in Group A, 9 samples showed BANA negative and 3 samples showed BANA positive, and in Group B, 12 samples showed BANA negative and 0 sample showed BANA positive. The microbiological analysis showed a reduction in periodontal pathogens in both the groups.

Conclusion

Significant improvement in both clinical and microbiological parameters suggests that subgingival ozonated water irrigation could be an efficient adjunct to scaling and root planing in the treatment of chronic periodontitis.