A Novel Piezoelectric-Assisted Non-Surgical Periodontal Treatment: A Prospective Case Series.

The purpose of this study was to evaluate the clinical efficacy of a non-surgical periodontal treatment using a piezoelectric power-driven device with a novel insert. Plaque index (PlI), bleeding on probing (BoP), probing depth (PD), recession depth (Rec) and clinical attachment level (CAL) were assessed at 6 weeks, 3 months and 6 months. Furthermore, tooth mobility and furcation involvement were recorded and chewing discomfort and dental hypersensitivity were evaluated. Eighteen stage I to IV periodontitis patients providing 437 teeth and 2622 sites in total were analyzed. At six weeks, CAL gain (0.4; p < 0.0001), PD reduction (0.4; p < 0.0001) and Rec increase (0.1; p = 0.0029) were statistically significant. Similarly, the mean number of sites with PD > 4 mm and absence of BoP significantly decreased between baseline and 6 weeks (-12.7; p < 0.0001). At this time point, the patient's chewing discomfort was also significantly diminished (1.4; p = 0.0172). Conversely, no statistically significant changes were observed between 6 weeks and 3 months and between 3 months and 6 months for any of the clinical variables evaluated. In conclusion, within the limitation of this study, mechanical piezo-assisted non-surgical periodontal treatment in conjunction with an innovative tip resulted significantly efficacious to reduce pathological periodontal pockets, to gain clinical attachment and to reduce gingival inflammation.

Clinical effects of the adjunctive use of polynucleotide and hyaluronic acid-based gel in the subgingival re-instrumentation of residual periodontal pockets: A randomized, split-mouth clinical trial.

BACKGROUND: Polynucleotides (PN) and hyaluronic acid (HA) have been effective in stimulating the growth of primary gingival fibroblasts and promoting wound healing. The aim of this study was to investigate the clinical efficacy of a gel containing PN and HA used in association with subgingival re-instrumentation in the treatment of residual periodontal pockets. METHODS: Fifty patients were enrolled in a randomized, split-mouth, single-blind, clinical trial. For each patient, two teeth with similar residual pockets with probing depth (PD) ≥5 mm were selected to receive re-instrumentation with (test group) or without (control group) the adjunctive use of a PN and HA-based gel. Differences in changes of PD, gingival recession, clinical attachment level (CAL), modified sulcular bleeding index (mSBI), plaque index (PI) from baseline to 6, 8, 24, 36, and 48 weeks were analyzed and the frequencies of sites with PD ≤4 mm at 48 weeks were compared. RESULTS: At 48 weeks, the test group showed better results in terms of PD reduction (2.08 ± 1.24 vs. 1.94 ± 1.19, p = 0.533) and sites with PD ≤4 mm (38/50 vs. 35/50, p = 0.499), although not statistically significant. Similarly, CAL gain was comparable between groups (test: 0.50 ± 1.85 vs. CONTROL: 0.36 ± 1.80, p = 0.700). Significantly higher reduction in mSBI was recorded in the test group only in sites with baseline PD ≥6 mm (p = 0.004). CONCLUSIONS: The adjunctive use of a PN and HA-based gel could help to ensure a greater reduction of clinical parameters of inflammation in deep residual pockets.

Experimental gingivitis in patients with and without altered passive eruption.

BACKGROUND: Individuals with altered passive eruption (APE) are assumed to be more susceptible to periodontal diseases. To date, this hypothesis has not been sufficiently supported by scientific evidence. The aim of this study, using an experimental gingivitis model, was to examine the development and resolution of gingival inflammation in patients with APE when compared to patients with normal gingival anatomy. METHODS: A localized experimental gingivitis was induced in 9 patients with APE (test group) and 9 patients without APE (control group) in the maxillary right quadrant. After 21 days, patients were instructed to resume proper home oral hygiene procedures. At baseline (day 0) and at days 7, 14, 21, 28, 35, and 42, plaque index (PlI), gingival index (GI), and gingival crevicular fluid volume (GCF) were evaluated for teeth 6 (canine), 7 (lateral incisor) and 8 (central incisor) of test and control groups. RESULTS: During the experimental gingivitis phase (days 0 to 21), the rate of change in gingival inflammation (GI) was dramatically different between the APE test group and the control group. On day 21, at the time of maximum plaque accumulation, the GI of the APE test group was a 109% greater than the GI of the test group (P ≤ 0.001) despite similar plaque levels (P = 0.436). During the resolution of inflammation phase (days 22 to 42), the APE test group continued to exhibit statistically higher GI scores than the control group (P = 0.029). CONCLUSION: In the presence of similar amounts of plaque deposits and plaque accumulation rates, APE patients exhibited differences in the development and resolution of plaque-induced gingival inflammation when compared to controls.

Adjunctive use of an ethyl lauroyl arginate-(LAE-)-containing mouthwash in the nonsurgical therapy of periodontitis: a randomized clinical trial.

BACKGROUND: This randomized clinical trial evaluated the clinical and microbiological effects of 0.147% ethyl lauroyl arginate (LAE)-containing mouthwash compared to 0.12% chlorhexidine (CHX) mouthwash in the treatment of periodontitis. METHODS: Subjects were randomized to use 0.147% LAE and 0.12% CHX mouthwash after professional mechanical plaque removal (PMPR) twice daily 1 hour after brushing for 4 weeks. Periodontal pocket depth (PPD), bleeding on probing (FMBS) and dental plaque (FMPS) were measured at baseline, 4 weeks and 3 months. Microbiological samples were taken at baseline, at 4 weeks and 3 months after plaque recording and prior to PPD and BoP measurements. RESULTS: Forty subjects were randomized to treatment. Both therapies resulted in reduced FMPS, FMBS and residual pockets at 4 weeks and 3 months. The differences were not statistically significant. There were no treatment-related adverse events. Total bacterial count and the specific pathogens were reduced at 4 weeks and 3 months by both mouthwashes with no statistical differences between them at neither period of time. CONCLUSIONS: A mouthwash containing 0.147% LAE could be an alternative to the use of 0.12% CHX in the non-surgical therapy of periodontitis considering the similar clinical effects, more stable microbiological improvement and absence of adverse effects.