A multicenter prospective cohort study on the effect of smoking cessation on periodontal therapies in Japan.

Few prospective studies have reported the effects of periodontal therapy on patients who attempted to quit smoking. This study aimed to assess how smoking cessation affects periodontal therapy. Twenty-five smokers with periodontitis were investigated by dividing them into two groups, a smoking cessation support group and a continued smoking group. Those in the support group received counseling and nicotine replacement therapy, followed by periodontal treatment conducted by dentists who had completed an e-learning course on smoking cessation. Clinical parameters were measured at baseline, 3, and 6 months. Most clinical parameters improved for those in the smoking cessation support group. There were no significant improvements in bleeding on probing (BOP) or the number of severe periodontal disease sites in the continued smoking group. Probing pocket depth (PPD) and clinical attachment levels (CAL) at sites that received scaling and root planing (SRP) significantly improved in all subjects. BOP did not improve at reevaluation in the smoking relapse subgroup. Patients in the smoking cessation support program led by dental professionals showed more improvement in BOP than those in the continued smoking group.

Periodontal Regenerative Therapy of Intrabony Defects Using Deproteinized Bovine Bone Mineral in Combination with Collagen Barrier Membrane: A Multicenter Prospective Case-Series Study.

This multicenter prospective case series study aimed to evaluate the outcome of periodontal regenerative therapy using a deproteinized bovine bone mineral (DBBM) in combination with a collagen barrier (CB) in the treatment of intrabony defects. A total of 36 nonsmoking patients with chronic periodontitis were recruited in five centers in Japan. All patients had at least one intrabony defect of ≥ 3 mm. The surgical procedures included access for debridement using a papilla preservation technique. Defects were filled with DBBM and covered with CB. Clinical evidence after 6 months supported the effectiveness of the combination therapy in the treatment of intrabony defects.

Clinical outcome of periodontal regenerative therapy using collagen membrane and deproteinized bovine bone mineral: a 2.5-year follow-up study.

BACKGROUND: This study aimed to evaluate, longitudinally, the outcome of periodontal regenerative therapy using a deproteinized bovine bone mineral (DBBM) in combination with a collagen barrier (CB) for the treatment of intrabony defects. RESULTS: Patients with chronic periodontitis who have completed initial periodontal therapy participated in this study. They had at least one 2- or 3-wall intrabony periodontal defect of ≥3 mm in depth. During surgery, defects were filled with DBBM and covered with CB. Ten patients completed 2.5-year reevaluation. At baseline, mean clinical attachment level (CAL) of the treated site was 8.0 mm and mean probing depth (PD) was 7.5 mm. Mean depth of intrabony component was 4.6 mm. Mean gains in CAL at 6 months and 2.5 years were 2.8 ± 1.0 and 1.4 ± 1.5 mm, respectively, both showing a significant improvement from baseline. CAL gains at 1 and 2.5 years were significantly reduced from that at 6 months. A significant improvement in PD was also noted: mean reductions in PD at 6 months and 2.5 years were 4.0 ± 0.8 and 3.2 ± 0.8 mm, respectively. CONCLUSIONS: The combination therapy using DBBM and CB yielded statistically significant effects such as CAL gain and PD reduction, up to 2.5 years in the treatment of intrabony defects. However, the trend for decrease in CAL gain over time calls for the need for careful maintenance care.

Clinical outcome of surgical periodontal therapy: a short-term retrospective study.

This study aimed to investigate retrospectively the outcome of surgical periodontal therapy. Periodontal surgeries implemented at General Dentistry, Tokyo Dental College Suidobashi Hospital during the period of April 2010 through March 2012 were subjected to data analysis. After initial periodontal therapy, 17 clinicians performed a total of 138 periodontal surgeries in 80 patients with moderate to advanced periodontitis (31 men and 49 women; mean age 54). Cases (sites) operated were as follows: open flap debridement=102, periodontal regenerative therapy=29 (17 for intrabony defects, 12 for furcation involvements) and periodontal plastic surgery=7. Enamel matrix derivative or bone graft was used for regenerative therapy. Clinical data were analyzed focusing on the comparison between open flap debridement and regenerative therapy. At 5 months after open flap debridement, mean reduction in probing depth (PD) and gain in clinical attachment level (CAL) was 3.9 mm (range -1.0-9.0) and 2.3 mm (range -1.0-9.0), respectively. The corresponding values with regenerative therapy were 4.0 mm (range 0-8.0) and 2.8 mm (-1.0-6.0), respectively. At sites with initial PD≥8 mm, a significantly greater gain in CAL was obtained with the regenerative therapy than with flap surgery (mean CAL gain 4.3 mm vs. 2.9 mm, p<0.05). Periodontal surgery performed in our clinical setting demonstrated a favorable short-term outcome. Our data suggest the efficacy of regenerative therapy, in particular for the treatment of deep pockets.

Two-year follow-up of treatment of intrabony periodontal defect with enamel matrix derivative.

The aim of this retrospective clinical study was to evaluate 2-year follow-up results following regenerative periodontal surgery for intrabony defects using enamel matrix derivative (EMD). Thirteen patients (mean age: 53 years) with a clinical diagnosis of chronic periodontitis were subjected to data analysis. A total of 25 sites with intrabony defects received regenerative therapy with EMD. Follow-up continued for a minimum of 2 years. Treatment of intrabony defects with EMD yielded a statistically significant improvement in the mean values of probing depth and gains in clinical attachment level (CAL) at 2 years compared with those at baseline (p<0.001). Sites treated with EMD demonstrated a mean CAL gain of 3.4 mm and 3.2 mm at 6 months and 2 years, respectively. No statistically significant difference in gain in CAL was found between the 6-month and 2-year results. A gain in CAL of ≥3 mm from at baseline was found in 17 sites at 2 years. This gain was achieved with minimal recession of gingival margin and was sustained over a given period of time. A trend toward a progressive increase in radiopacity, suggestive of bone-fill, was observed. In summary, treatment of intrabony defects with EMD resulted in clinically favorable outcomes. The clinical improvements obtained with regenerative therapy with EMD were maintained over a period of 2 years.

Surgical periodontal therapy at Tokyo Dental College Suidobashi Hospital: a statistical profile in 2010-2011.

The aim of the present study was to investigate the profile of surgical periodontal therapy performed at the Suidobashi Hospital of Tokyo Dental College, during the period of April 2010 through March 2011. A total of 112 periodontal surgeries in 69 patients (mean age: 51.4 years; 28 men and 41 women) were registered for the data analysis. The surgical interventions performed by 17 dentists comprised 79 cases of open flap debridement, 27 cases of periodontal regenerative therapy with enamel matrix derivative and 6 cases of periodontal plastic surgery. Eighty percent of the surgical sites were in the molar region and 41 cases had furcation involvement. In these patients, an improvement in oral hygiene status was observed prior to surgery: the mean plaque score of 45% at initial visit was significantly reduced to 31% after initial periodontal therapy (p<0.01). At sites that subsequently received open flap debridement or periodontal regenerative therapy, the mean probing depth and clinical attachment level after initial therapy was 6.4 mm and 7.6 mm, respectively. These values were significantly lower than those at initial visit (p<0.01). Lower prevalence of sites with positive bleeding on probing was observed after initial therapy. The initial periodontal therapy performed was considered to be effective in improving the periodontal condition of the sites prior to surgery. More effort, however, is indicated in improvement of patient oral hygiene status.

Treatment of periodontal defects with enamel matrix derivative: clinical evaluation at early healing stages.

The aim of this retrospective clinical study was to evaluate the treatment of intrabony periodontal defects with enamel matrix derivative (EMD) during the early stages of healing. Sixteen patients aged 38-77 years with a clinical diagnosis of chronic periodontitis were subjected to data analysis. A total of 25 teeth with various osseous defects received regenerative therapy with EMD, and were followed for a minimum of 6 months. Post-operative healing was uneventful in the majority of cases. Treatment of the intrabony defects with EMD led to a statistically significant improvement in the mean value of probing depth at 3 months compared with that at baseline (p<0.001). Mean values of attachment gain at 3 and 6 months were of clinical significance: 3.6+/-1.8mm and 3.2+/-1.5mm, respectively. Reduction in probing depth was achieved with minimal recession of gingival margin and was sustained over a time course of 6 months. A progressive increase in radiopacity, suggestive of initial signs of bone-fill, was observed by 6 months. In summary, the results suggest that treatment of intrabony defect with EMD induces favorable periodontal healing with a high level of predictability.