Subgingival ultrasonic instrumentation of residual pockets irrigated with essential oils: a randomized controlled trial.

AIM: To evaluate the clinical efficacy of subgingival ultrasonic instrumentation irrigated with essential oils (EOs) of residual periodontal pockets. MATERIAL AND METHODS: Sixty-four individuals with chronic periodontitis were invited to participate in this randomized, double-blind, parallel, and placebo-controlled clinical trial. All subjects received non-surgical periodontal therapy. After re-evaluation (baseline), residual pockets (pocket depth ≥5 mm) received test (ultrasonic instrumentation irrigated with EOs) or control therapy (ultrasonic instrumentation irrigated with negative control). Probing pocket depth (PPD), gingival recession (R), clinical attachment level (CAL), bleeding on probing (BOP), and plaque were assessed at baseline and after 4, 12, and 24 weeks. Differences between groups and changes over the course of time were analysed according to a generalized linear model. RESULTS: There was a significant reduction in PPD and BOP, as well as a significant CAL gain in the two groups (p<0.001). Nevertheless, there were no differences between the groups at any time of the study. When only initially deep pockets (PPD ≥7 mm) were analysed, a significantly greater CAL gain (p=0.03) and PPD reduction (p=0.01) was observed in the test group. CONCLUSION: The adjunctive use of EOs may promote significant CAL gain and PPD reduction in deep residual pockets.

Propolis extract as an adjuvant to periodontal treatment.

PURPOSE: The aim of this study was to evaluate the effect of subgingival irrigation with propolis extract by clinical and microbiological parameters. MATERIALS AND METHODS: Twenty patients diagnosed with chronic periodontitis presenting three non-adjacent teeth with deep pockets were selected. After scaling and root planing, the selected periodontal sites were submitted to one of the following treatments: irrigation with a hydro alcoholic solution of propolis extract twice/week for two weeks (group A); irrigation with a placebo twice/week for two weeks (group B); or no additional treatment (C). Subgingival plaque sampling and scaling and root planing were performed two weeks after clinical data recording. Two weeks later irrigation procedures were started (Baseline). Microbiological and clinical data were collected at baseline, and after 4, 6 and 24 weeks. RESULTS: A decrease in total viable counts of anaerobic bacteria (p=0.007), an increase in the proportion of sites with low levels (< or = 10(3) cfu/mL) of Porphyromonas gingivalis (p=0.005), and a decrease in the number of sites with detectable presence of yeasts (p=0.000) were observed in group A sites when compared to group B and C sites. Propolis treatment did not lead to an increase in organisms such as coagulase positive Staphylococci and Pseudomonas spp. 24 weeks after treatment there was an increased proportion of sites showing probing depth (PD) < or = 3 mm in Group A sites. CONCLUSION: Subgingival irrigation with propolis extract as an adjuvant to periodontal treatment was more effective than conventional treatment both by clinical and microbiological parameters.