The effect of long-term aspirin intake on the outcome of non-surgical periodontal therapy in smokers: a double-blind, randomized pilot study.

OBJECTIVE: The objective of this parallel, double-blind, randomized pilot study was to determine the effect of a daily dose of 325 mg of aspirin (ASA) on the clinical outcomes of scaling and root planing in a selected group of adult smokers. BACKGROUND: The response to periodontal therapy is inferior among smokers compared to non-smokers. Long-term intake of ASA has been shown to exert a positive impact on reducing both the prevalence and severity of periodontitis, among high-risk groups of subjects such as heavy smokers and diabetics. It is reasonable to assume that systemic administration of ASA in conjunction with reduction of the bacterial load by scaling and root planing may improve and prolong the benefits of periodontal therapy. To date, only few prospective interventional clinical studies have specifically addressed the periodontal needs of smokers. METHODS: The study includes 24 smokers. The following clinical parameters were measured preoperatively and at 3, 6, 9 and 12 mo postoperatively: (i) gingival index; (ii) plaque index; (iii) probing depth; (iii) probing attachment level; (iv) gingival recession; and (v) bleeding scores. Study subjects received scaling and root planing over several visits and were randomly assigned into two equal groups; a control group (C), which received a placebo and a test group (T), which took a daily dose of 325 mg ASA. No additional therapy was provided over the 1 year observation period. RESULTS: There were more statistically significant differences (p < 0.05; one- tailed) between pretest and posttest scores in the T group than in the C group. Mean percent increase in sites with probing depth 1-3 mm (T: 8.78; C: 7.21); mean percent reduction in sites with probing depth 4-6 mm (T: -7.25; C: -5.09 not statistically significant, NS); mean percent reduction in sites with probing depth ≥ 7 mm (T: -1.42; C: -02.09); mean percent reduction in sites with probing attachment level 3-4 mm (T: -3.63; C: 0.48 NS); mean percent reduction in sites with bleeding on probing (T: -12.37; C: -2.59 NS) (p < 0.05, NS). CONCLUSIONS: Daily intake of 325 mg of ASA following scaling and root planing improved treatment outcomes in smokers, without an increase in gingival bleeding tendency. ASA promoted a higher incidence of shallow pockets and more gain in attachment level.

Comparison of the Hydrabrush powered toothbrush with two commercially-available powered toothbrushes.

INTRODUCTION: An examiner-blinded, randomized, parallel, three-cell, controlled clinical trial was conducted to compare the efficacy of a new powered toothbrush (Hydrabrush) to that of two presently marketed power brushes (Oral-B and Sonicare) in reducing stain, supragingival plaque, gingivitis and the signs of periodontitis while monitoring safety. METHODS: One hundred ten subjects were randomly assigned to three groups (35--Oral-B group, 36--Sonicare group, and 39--Hydrabrush group). Subjects were instructed to use the assigned powered toothbrush according to the manufacturer's instructions for 2-minutes duration twice per day. Clinical examinations conducted at baseline and at weeks 4, 8, and 12 included the following parameters: (1) oral tissues; (2) staining; (3) plaque index; (4) gingivitis; (5) probing depth; (6) clinical attachment loss; and 7) bleeding on probing. RESULTS: The results showed that the body intensity and extent of stain and the gingival intensity and extent of stain at 8 and 12 weeks, respectively, were significantly less in the Hydrabrush group compared with the Sonicare group. The modified gingival index (MGI) in all groups significantly decreased over the 12 weeks. However, the groups did not differ from each other statistically. At 4, 8 and 12 weeks, the Hydrabrush group had statistically significantly less plaque than the Sonicare group. At 4 weeks, the Hydrabrush group had statistically significantly lower mean probing depth than both the Oral-B and Sonicare groups. At 8 and 12 weeks, the Hydrabrush group had statistically significantly lower mean probing depths than the Sonicare group. With regard to mean percentage of sites with probing depth > or =4 mm, the Hydrabrush group had statistically significantly fewer sites > or =4 mm at 4, 8 and 12 weeks. Differences among the groups in clinical attachment loss at 4, 8 and 12 weeks were representative of small imbalances at baseline. No differences were seen among the treatment groups with regard to gingival recession and bleeding on probing. CONCLUSIONS: With the exception of clinical attachment loss, all subject groups were balanced for all measured clinical parameters at baseline. Tooth stain became significantly less in the Hydrabrush group compared with the Sonicare group at 8 and 12 weeks. At all examinations, the Hydrabrush group had statistically significantly less plaque than the Sonicare group. At 4 weeks, the Hydrabrush group had statistically significantly lower mean probing depth than both the Oral-B and Sonicare groups, and at 8 and 12 weeks, the Hydrabrush group had statistically significantly lower mean probing depth than the Sonicare group. With regard to mean percentage of sites with probing depth > or =4 mm, the Hydrabrush group had statistically significantly fewer sites > or =4 mm when compared to the other two tested brushes at all examinations. No differences were seen among the treatment groups with regard to gingival recession and bleeding on probing and none of the tested brushes caused any adverse reactions.