Minimally invasive non-surgical periodontal therapy of intrabony defects: A prospective multi-centre cohort study.

AIM: To assess the potential benefits of minimally invasive non-surgical therapy (MINST) in teeth with intrabony defects and to explore factors associated with the outcomes. MATERIALS AND METHODS: A multi-centre trial was conducted in 100 intrabony defects in periodontitis patients in private practice. Steps 1 and 2 periodontal therapy including MINST were provided. Clinical and radiographic data were analysed at baseline and 12 months after treatment, with the primary aim being change in radiographic defect depth at 12 months. RESULTS: Eighty-four patients completed the 12-month follow up. The mean total radiographic defect depth reduced by 1.42 mm and the defect angle increased by 3° (both p < .05). Statistically significant improvements in probing pocket depth (PPD) and clinical attachment level (CAL) were seen at 12 months compared to baseline (p < .001). Fifty-six defects (66.7%) achieved pocket closure (PPD ≤ 4 mm) and 49 defects (58.3%) achieved the composite outcome (PPD ≤ 4 mm and CAL gain ≥3 mm). Deeper and narrower angled defects were positively correlated with radiographic and clinical improvements, respectively. CONCLUSIONS: Improvements in clinical and radiographic outcomes were seen after MINST. This study highlights the generalizability and wide applicability of this approach, further supporting its effectiveness in the treatment of intrabony defects. CLINICAL TRIAL REGISTRATION: NCT03741374. https://clinicaltrials.gov/study/NCT03741374?cond=minimally%20invasive%20non%20surgical%20therapy&locStr=UK&country=United%20Kingdom&distance=50&rank=2.

Periodontal infectogenomics: systematic review of associations between host genetic variants and subgingival microbial detection.

BACKGROUND: Recent research is increasingly showing that host genetic variants can affect the colonization by specific microbes. The aim of this study was to systematically investigate the associations between host genetic variants and subgingival microbial detection and counts. MATERIALS AND METHODS: A systematic search of the literature was conducted in Ovid Medline, Embase, LILACS and Cochrane Library for studies reporting data on host genetic variants and detection of microbes subgingivally. RESULTS: A total of 43 studies were included in the review, from an initial search of 3887 titles. Studies consisted mainly of candidate gene studies and of one genome-wide analysis. Some promising associations were detected between single nucleotide polymorphisms and microbial detection. The only feasible meta-analysis failed to show any association between Interleukin 1 (IL1) genetic variants and detection of periodontopathogenic bacteria subgingivally. CONCLUSIONS: There is no evidence yet that neither IL1 genetic polymorphisms nor other investigated genetic polymorphisms are associated with presence and counts of subgingival bacteria. Further studies on large populations with replication samples should clarify the possible effects of other genetic variants on the subgingival microbiota.

Effect and timing of non-surgical treatment prior to periodontal regeneration: a systematic review.

OBJECTIVES: The aim of this systematic review was to assess the study design and reporting of studies on periodontal regeneration, with respect to the effect of the provision of non-surgical periodontal therapy (NSPT) before surgery. MATERIALS AND METHODS: A systematic search of the literature was conducted for studies on periodontal regeneration on Medline and EMBASE, complemented by a manual search. Initially, 3310 potentially eligible articles were identified. RESULTS: A total of 293 studies were included in the review. Nearly 10% of studies did not include NSPT in the study protocol before regenerative surgery, while 14% of papers did not report this aspect. Seventy-six percent of studies reported that non-surgical subgingival debridement was performed before periodontal surgery (2 weeks to 6 months before surgery according to the different studies). However, no papers reported clinical and radiographic data before and after NSPT prior to periodontal surgery. Only 45% of papers reported timing of reassessment following NSPT, prior to proceeding with regenerative surgery. CONCLUSIONS: This review highlights the lack of reporting information on non-surgical periodontal therapy prior to periodontal regenerative surgery, calling for a revision of the current clinical protocols and of the study designs of periodontal regenerative surgery studies. CLINICAL RELEVANCE: Periodontal regenerative surgery protocols should take into account the possible effects of non-surgical periodontal therapy in the clinical and radiographic healing of intrabony defects.

Periodontal progression based on radiographic records: An observational study in chronic and aggressive periodontitis.

OBJECTIVES: The current classification assumes that aggressive periodontitis (AgP) has a faster rate of progression than chronic periodontitis (CP). However, this has not been clearly proven and difficulties exist in establishing progression. This study aimed to assess the feasibility of retrospectively utilising previous records for clinical diagnosis of periodontal diseases and to assess if two different patterns of disease progression exist between AgP and CP. MATERIALS AND METHODS: Previous radiographic records of a cohort of 235 patients clinically diagnosed with AgP or CP were requested from the referring general dental practitioners (GDPs). Comparable radiographic records were analysed in order to assess progression patterns and associate these with clinical diagnosis, by multilevel analysis. RESULTS: 43 patients out of the initial 235 had comparable radiographs retrieved from the GDPs. 858 sites were followed for an average 6.6 years. Radiographically, AgP showed a faster linear pattern of progression than CP (0.31mm/year vs. 0.20mm/year, p<0.001). CONCLUSION: This study provides evidence for a faster disease progression in untreated AgP compared to CP as assessed by radiographic bone levels. Furthermore, it shows that retrievability of previous radiographs from GDPs is unpredictable and GDPs should be encouraged to send them along with their referral. CLINICAL SIGNIFICANCE: The importance of differentially diagnosing AgP and CP might be useful in establishing a clinically relevant definition for periodontal disease progression and may have an impact on the clinical management of aggressive periodontitis, since our findings show that there is continuous destruction in patients with aggressive periodontitis if left untreated.