RESUMEN
BACKGROUND: There is insufficient clinical and microbiological evidence to support the use of diode laser and air-polishing with erythritol as supplements to scaling and root planning(SRP). The aim of the current study is to evaluate the clinical and microbiologic efficacy of erythritol subgingival air polishing and diode laser in treatment of periodontitis. METHODS: The study encompassed twenty-four individuals seeking periodontal therapy and diagnosed with stage I and stage II periodontitis. Eight patients simply underwent SRP. Eight more patients had SRP followed by erythritol subgingival air polishing, and eight patients had SRP followed by diode laser application. At baseline and six weeks, clinical periodontal parameters were measured, including Plaque Index (PI), Gingival Index (GI), periodontal Probing Depth (PPD), and Clinical Attachment Level (CAL). The bacterial count of Aggregatibacter actinomycetemcomitans(A.A), Porphyromonas gingivalis (P.G) was evaluated at different points of time. RESULTS: The microbiological assessment revealed significant differences in the count of A.A. between the laser and erythritol groups immediately after treatment, indicating a potential impact on microbial levels. However, the microbial levels showed fluctuations over the subsequent weeks, without statistically significant differences. Plaque indices significantly decreased post-treatment in all groups, with no significant inter-group differences. Gingival indices decreased, and the laser group showed lower values than erythritol and control groups. PPD and CAL decreased significantly across all groups, with the laser group exhibiting the lowest values. CONCLUSION: The supplementary use of diode laser and erythritol air polishing, alongside SRP, represents an expedited periodontal treatment modality. This approach leads to a reduction in bacteria and improvement in periodontal health. TRIAL REGISTRATION: This clinical trial was registered on Clinical Trials.gov (Registration ID: NCT06209554) and released on 08/01/2024.
Asunto(s)
Aggregatibacter actinomycetemcomitans , Carga Bacteriana , Índice de Placa Dental , Raspado Dental , Eritritol , Láseres de Semiconductores , Índice Periodontal , Porphyromonas gingivalis , Aplanamiento de la Raíz , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Aggregatibacter actinomycetemcomitans/efectos de los fármacos , Abrasión Dental por Aire/métodos , Carga Bacteriana/efectos de los fármacos , Raspado Dental/métodos , Eritritol/uso terapéutico , Estudios de Seguimiento , Láseres de Semiconductores/uso terapéutico , Pérdida de la Inserción Periodontal/terapia , Pérdida de la Inserción Periodontal/microbiología , Bolsa Periodontal/terapia , Bolsa Periodontal/microbiología , Periodontitis/microbiología , Periodontitis/terapia , Periodontitis/tratamiento farmacológico , Porphyromonas gingivalis/aislamiento & purificación , Porphyromonas gingivalis/efectos de los fármacos , Aplanamiento de la Raíz/métodos , Resultado del TratamientoRESUMEN
OBJECTIVES: This study aimed to systematically review the effect of sugar substitute consumption on caries prevention in permanent teeth among children and adolescents. DATA: Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing the clinical effect of sugar substitutes (both high- and low-intensity sweeteners) in preventing caries in permanent teeth among children and adolescents aged 6-19 were included. SOURCES: A systematic search was conducted in three databases (PubMed, Web of Science and Embase) without any restrictions on publication year. STUDY SELECTION: The initial search found 1,859 items, and finally, 15 studies (11 RCTs and 4 CCTs) with a total of 6325 participants (age: 6-18 years) were included. The Cochrane risk-of-bias assessment tools were used for quality assessment. Most (80%, 12/15) were graded as having a 'moderate' or 'high' risk of bias. All trials investigated sugar alcohol, which is a low-intensity sweetener. Xylitol was the most commonly investigated (73.3%, 11/15), followed by sorbitol (46.7%, 7/15), and erythritol (13.3%, 2/15). Results of the meta-analysis showed that both xylitol (standardized mean difference [SMD]: -0.50, 95% confidence interval [CI] -0.85 to -0.16, P = 0.005) and sorbitol (SMD: -0.10, 95% CI: -0.19 to -0.01, P = 0.03) had a significant effect in preventing dental caries compared to no treatment/placebo. No clinical trials on high-intensity sweeteners such as aspartame and saccharin were found. CONCLUSION: The consumption of xylitol or sorbitol is potentially effective in preventing caries in permanent teeth among children and adolescents. No clinical evidence is available regarding the role of high-intensity sweeteners in caries prevention. CLINICAL SIGNIFICANCE: The use of xylitol or sorbitol as sugar substitutes has a beneficial effect in preventing dental caries among children and adolescents.
Asunto(s)
Caries Dental , Dentición Permanente , Sorbitol , Edulcorantes , Xilitol , Humanos , Caries Dental/prevención & control , Adolescente , Niño , Xilitol/uso terapéutico , Sorbitol/uso terapéutico , Edulcorantes/uso terapéutico , Eritritol/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVES: To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri-implant diseases. MATERIAL AND METHODS: In the first step, a modified one-round online Delphi survey including 44 five-point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively. RESULTS: An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long-term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept. CONCLUSIONS: In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri-implant therapy and prophylaxis is patient compliant and efficient.
Asunto(s)
Implantes Dentales , Glicina , Humanos , Glicina/uso terapéutico , Polvos , Eritritol/uso terapéutico , Resultado del TratamientoRESUMEN
AIM: To assess the efficacy of Er:YAG laser (ERL) and erythritol powder air-polishing (AP) in addition to the submarginal instrumentation in the non-surgical treatment of peri-implant mucositis (PM). MATERIALS AND METHODS: Patients with at least one implant diagnosed with PM were included in the present 6-month randomized clinical trial (RCT). Implants were randomly assigned to one of the three treatment groups after submarginal instrumentation: AP (test 1 group), ERL (test 2 group) or no adjunctive methods (control group). The primary and secondary outcomes were, respectively, bleeding on probing (BoP) reduction and, complete disease resolution (total absence of BoP) and probing pocket depth (PPD) changes. The patient and the implant were considered the statistical unit. A multivariate logistic regression analysis was performed. RESULTS: A total of 75 patients were enrolled in the study. At each time point, significant BoP and PPD reductions were observed within each group. Intergroup analysis did not show statistically significant differences. Complete disease resolution ranged between 29% and 31%. The logistic regression showed that supramucosal restoration margin, PPD < 4 mm and vestibular keratinized mucosa (KM) significantly influenced the probability to obtain treatment success. CONCLUSION: The adjunctive use of AP and ERL in PM non-surgical therapy does not seem to provide any significant or clinically relevant benefit in terms of BoP and PPD reductions and complete disease resolution, over the use of submarginal instrumentation alone. Baseline PPD < 4 mm, presence of buccal KM and supramucosal restoration margin may play a role in the complete resolution of PM.
Asunto(s)
Implantes Dentales , Láseres de Estado Sólido , Mucositis , Periimplantitis , Humanos , Mucositis/complicaciones , Polvos/uso terapéutico , Eritritol/uso terapéutico , Láseres de Estado Sólido/uso terapéutico , Periimplantitis/tratamiento farmacológico , Resultado del TratamientoRESUMEN
BACKGROUND: A variety of interventions have been explored in the non-surgical management of peri-implantitis. In spite of extensive testing of various study protocols, effective treatments largely remain unavailable. The objective of the present 12-month single-centre, examiner-masked, randomized controlled clinical trial was to explore whether a low-abrasive erythritol air-polishing system produces added clinical benefit when used adjunctive to conventional non-surgical management of peri-implantitis and to record any associated patient-centered outcomes. METHODS: Forty-three patients with mild to severe peri-implantitis including at least one implant either received ultrasonic/curette subgingival instrumentation and erythritol air-polishing (test) or ultrasonic/curette instrumentation only (control) at baseline and at 3, 6, 9, and 12 months. Probing depth (PD), bleeding on probing (BoP), dental plaque, suppuration (SUP), crestal bone level (CBL), and peri-implant crevicular fluid (PCF) were recorded at baseline, 6 and 12 months. Visual Analogue Scale (VAS) scores were collected immediately following subgingival interventions at all time-points. RESULTS: A reduction in PD was observed from baseline to 6 months for the test (p = 0.006) and control (p < 0.001) and from baseline to 12 months for the control (p < 0.001). No intergroup differences were observed for primary outcome variables PD or CBL over time (p > 0.05). At 6 months, a intergroup difference in PCF was observed in favor of the test (p = 0.042). Moreover, a reduction in SUP from baseline to 6 and 12 months was observed in the test (p = 0.019). Overall, patients in the control group experienced less pain/discomfort compared with the test (p < 0.05), females reporting more pain/discomfort than males (p = 0.005). CONCLUSIONS: This study confirms that conventional non-surgical management of peri-implantitis produces limited clinical improvement. It is shown that an erythritol air-polishing system may not produce added clinical benefits when used adjunctive to conventional non-surgical management. In other words, neither approach effectively resolved peri-implantitis. Moreover, the erythritol air-polishing system produced added pain/discomfort particularly in female patients. TRIAL REGISTRATION: The clinical trial was prospectively registered in ClinicalTrials.gov with registration NCT04152668 (05/11/2019).
Asunto(s)
Implantes Dentales , Periimplantitis , Masculino , Humanos , Femenino , Periimplantitis/terapia , Eritritol/uso terapéutico , Resultado del Tratamiento , DolorRESUMEN
Background and objectives: The purpose of the present systematic review was to analyze the effectiveness of erythritol-based air-polishing in non-surgical periodontal therapy. Materials and methods: The protocol details were registered in the PROSPERO database (CRD42021267261). This review was conducted under the PRISMA guidelines. The electronic search was performed in PubMed, Scopus, and Web of Science databases to find relevant clinical trials published until January 2022. The inclusion criteria consisted of human clinical trials which reported the use of non-surgical periodontal treatment and erythritol air-polishing compared to non-surgical periodontal treatment alone in patients with good systemic health requiring treatment for periodontal disease. Results: 810 studies were imported into the Covidence Platform. Of these, seven clinical trials met the inclusion criteria. In active periodontal therapy, for PD (probing depth), CAL (clinical attachment level), and BOP (bleeding on probing), no statistical significance was achieved at 6 months follow-up. In supportive periodontal therapy for PD, CAL, and BOP, no statistical significance was achieved at 3 months follow-up. Conclusions: The findings suggest that erythritol air-polishing powder did not determine superior improvements of periodontal parameters compared to other non-surgical periodontal therapies. Future randomized clinical trials (RCTs) with calibrated protocols for diagnosis, therapeutic approaches, and longer follow-up are needed to draw a clear conclusion about the efficiency of erythritol air-polishing powder.
Asunto(s)
Eritritol , Enfermedades Periodontales , Eritritol/uso terapéutico , Humanos , Enfermedades Periodontales/terapia , Polvos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
AIM: To assess the efficacy of the adjunct use of a subgingival erythritol powder air-polishing device (EPAP) in comparison to conventional subgingival instrumentation alone during initial non-surgical periodontal therapy. MATERIALS AND METHODS: Twenty-one patients with generalized Stages 2 and 3 grade B periodontitis were included in this single centre, single blinded, split-mouth, randomized clinical trial. Teeth on the control side were treated with conventional hand and ultrasonic instrumentation, while those on the contralateral test side was treated using EPAP as adjunct to conventional subgingival instrumentation with hand and ultrasonic instruments. Three months after initial instrumentation, persisting pockets of ≥4 mm were re-treated, in both control and test sides, again with the respective treatment approach-subgingival instrumentation alone on control, and subgingival instrumentation + EPAP on test side. Clinical parameters such as probing pocket depth (PPD), bleeding on probing, and relative attachment level were recorded at baseline and 3 and 6 months following the initial instrumentation. Subgingival plaque samples were collected at baseline, immediately post surgery, as well as at 1 week, 1 month, 3 months, and 6 months after initial instrumentation. RESULTS: In the test group after 6 months, a significantly larger number of initially deep pockets (PPD ≥ 5.5 mm) were reduced to shallow (PPD ≤ 3.4 mm), and a larger attachment gain was observed. No statistically significant microbiological differences could be found between test and control group. CONCLUSIONS: The results of the present study indicate that the adjunct use of subgingival airflow therapy with EPAP during initial non-surgical periodontal therapy might be beneficial in initially deep pockets (PPD ≥ 5.5 mm).
Asunto(s)
Raspado Dental , Eritritol , Desbridamiento , Raspado Dental/métodos , Eritritol/uso terapéutico , Humanos , Desbridamiento Periodontal/métodos , Bolsa Periodontal/microbiología , Bolsa Periodontal/terapia , Polvos , Resultado del TratamientoRESUMEN
Non-cariogenic sweet substances, like sugar alcohols, are used to decrease the risk of caries by reducing the growth of dental plaque. The aim of our study was to reveal the impact of xylitol and erythritol on the growth and biofilm formation of cariogenic bacteria including as a novelty, set of clinical mutans streptococci and Scardovia wiggsiae and to assess the possible synergistic influence of these polyols. We found both xylitol and erythritol to express high growth inhibition effect on cariogenic bacteria. In synergistic effect experiments, 10% polyol combination with excess of erythritol was found to be more effective against growth of Streptococcus mutans and the combination with excess of xylitol more effective against growth of Streptococcus sobrinus and S. wiggsiae. In biofilm inhibition experiments, solutions of 10% polyols in different combinations and 15% single polyols were equally effective against mutans streptococci. At the same time, higher biofilm formation of S. wiggsiae compared to experiments without polyols was detected in different polyol concentrations for up to 34%. In conclusion, both erythritol and xylitol as well as their combinations inhibit the growth of different cariogenic bacteria. Biofilm formation of mutans streptococci is also strongly inhibited. When applying polyols in caries prophylaxis, it is relevant to consider that the profile of pathogens in a particular patient may influence the effect of polyols used.
Asunto(s)
Cariostáticos/farmacología , Caries Dental/prevención & control , Eritritol/farmacología , Xilitol/farmacología , Actinobacteria/efectos de los fármacos , Adhesión Bacteriana/efectos de los fármacos , Biopelículas/efectos de los fármacos , Biopelículas/crecimiento & desarrollo , Cariostáticos/uso terapéutico , Caries Dental/microbiología , Sinergismo Farmacológico , Quimioterapia Combinada/métodos , Eritritol/uso terapéutico , Humanos , Pruebas de Sensibilidad Microbiana , Streptococcus mutans/efectos de los fármacos , Streptococcus sobrinus/efectos de los fármacos , Xilitol/uso terapéuticoRESUMEN
Several proteins and peptides in saliva were shown to stimulate gingival wound repair, but the role of salivary metabolites in this process remains unexplored. In vitro gingival re-epithelialization kinetics were determined using unstimulated saliva samples from healthy individuals collected during an experimental gingivitis study. Elastic net regression with stability selection identified a specific metabolite signature in a training dataset that was associated with the observed re-epithelialization kinetics and enabled its prediction for all saliva samples obtained in the clinical study. This signature encompassed ten metabolites, including plasmalogens, diacylglycerol and amino acid derivatives, which reflect enhanced host-microbe interactions. This association is in agreement with the positive correlation of the metabolite signature with the individual's gingival bleeding index. Remarkably, intra-individual signature-variation over time was associated with elevated risk for gingivitis development. Unravelling how these metabolites stimulate wound repair could provide novel avenues towards therapeutic approaches in patients with impaired wound healing capacity.
Asunto(s)
Eritritol/uso terapéutico , Encía/efectos de los fármacos , Gingivitis/metabolismo , Hemorragia/metabolismo , Metaboloma , Saliva/metabolismo , Adolescente , Adulto , Aminoácidos/metabolismo , Aminoácidos/farmacología , Bioensayo , Estudios de Casos y Controles , Línea Celular , Diglicéridos/metabolismo , Diglicéridos/farmacología , Susceptibilidad a Enfermedades , Células Epiteliales/citología , Células Epiteliales/efectos de los fármacos , Femenino , Encía/metabolismo , Encía/microbiología , Encía/patología , Gingivitis/tratamiento farmacológico , Gingivitis/microbiología , Gingivitis/patología , Hemorragia/tratamiento farmacológico , Hemorragia/microbiología , Hemorragia/patología , Interacciones Huésped-Patógeno , Humanos , Masculino , Persona de Mediana Edad , Plasmalógenos/metabolismo , Plasmalógenos/farmacología , Repitelización/efectos de los fármacos , Repitelización/fisiología , Saliva/química , Saliva/microbiología , Índice de Severidad de la Enfermedad , Streptococcus mutans/crecimiento & desarrollo , Streptococcus mutans/patogenicidadRESUMEN
BACKGROUND: Peri-implantitis is a frequent disease that may lead to implant loss. The aim of this case series was to evaluate the clinical results of a new non-surgical treatment protocol. METHODS: Fifteen patients with dental implants affected by peri-implantitis were treated with a multiple anti-infective non-surgical treatment (MAINST) which included two steps: 1) supra-gingival decontamination of the lesion and sub-gingival treatment with a controlled-release topical doxycycline; 2) after one week, a session of supra and sub gingival air polishing with Erythritol powder and ultrasonic debridement (where calculus was present) of the whole oral cavity was performed along with a second application of topical doxycycline around the infected implant. Primary outcome measures were: implant failure; complications and adverse events; recurrence of peri-implantitis; secondary outcome measure were presence of Plaque (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD). Recession (REC), Relative Attachment level (RAL). RESULTS: Neither implant failure nor complications nor adverse events were reported. Statistically (P<0.01) and clinically significant reductions between baseline and 1 year of PI (100% vs. 13.9%, 95% CI: 72.4% to 93.7%); BOP (98.5% vs. 4.5%, 95% CI: 85.4% to 98.5%) and PPD (7.89 vs. 3.16 mm, 95% CI: -5.67 to -3.77), were detected. At baseline, all 15 patients had a PPD>5 mm at the affected implant(s), whereas only 3.7% at 3-month follow-up a PPD>5 mm, and none at 6 and 12 months. CONCLUSIONS: Within the limits of this study, the MAINST protocol showed improvement of clinical parameters for the treatment of peri-implantitis, which were maintained for up to 12 months.
Asunto(s)
Antiinfecciosos/uso terapéutico , Doxiciclina/uso terapéutico , Eritritol/uso terapéutico , Periimplantitis/terapia , Administración Tópica , Adulto , Antiinfecciosos/administración & dosificación , Clorhexidina/uso terapéutico , Protocolos Clínicos , Terapia Combinada , Implantación Dental Endoósea , Índice de Placa Dental , Pulido Dental/métodos , Fracaso de la Restauración Dental , Raspado Dental , Doxiciclina/administración & dosificación , Eritritol/administración & dosificación , Femenino , Encía/efectos de los fármacos , Encía/patología , Bolsa Gingival/tratamiento farmacológico , Bolsa Gingival/terapia , Recesión Gingival/etiología , Recesión Gingival/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Antisépticos Bucales , Periimplantitis/tratamiento farmacológico , Desbridamiento Periodontal , Índice Periodontal , PolvosRESUMEN
BACKGROUND: The Stevia rebaudiana plant is likely to become a major source of high-potency sweetener for the growing natural-food market. S. rebaudiana is the source of a number of sweet diterpenoid glycosides, but the major sweet constituents are rebaudioside A and stevioside. These two constituents have similar pharmacokinetic and metabolic profiles in rats and humans, and thus, studies carried out with either steviol glycoside are relevant to both. Other studies illustrate the diversity of voluntary sweet intake in mammals. METHOD: This study was done using a series of two-bottle tests that compared a wide range of sweetener concentrations versus saccharin concentrations and versus water. RESULTS: Wistar rats displayed preferences for stevia extract and pure rebaudioside A solutions over water at a range of concentrations (0.001% to 0.3%), and their intake peak occurred at 0.1% concentration. They also preferred solutions prepared with a commercial rebaudioside A plus erythritol mixture to water, and their peak was at 2% concentration. CONCLUSIONS: The present study provides new information about the responses of Wistar rats to stevia compounds and commercial stevia products such as Truvia. These results could help with the appropriate dosage selection for focused behavioral and physiological studies on stevia
ANTECEDENTES: la planta Stevia rebaudiana se convertirá en una de las principales fuentes de edulcorantes debido al crecimiento del consumo de productos naturales en el mercado. S. rebaudiana contiene distintos glucósidos diterpenoides, pero los que proporcionan dulzor son el rebaudiosido A y el esteviosido. Estos dos compuestos tienen perfiles farmacocinéticos y metabólicos similares en ratas y humanos. Por otro lado, hay estudios que muestran la existencia de distintos patrones de ingesta voluntaria de edulcorantes en los mamíferos. MÉTODO: se realizaron series de la prueba de libre elección entre dos botellas. Comparamos la ingesta de un rango de concentraciones de edulcorantes frente al agua y frente a sacarina. RESULTADOS: las ratas Wistar prefieren el extracto de estevia y el rebaudiosido A (concentraciones desde 0,001% hasta 0,3%) frente al agua, la ingesta máxima fue a la concentración de 0,1%. También prefieren las soluciones preparadas con el producto comercial Truvia (rebaudiósido A y eritritol) frente al agua, la ingesta máxima fue a la concentración de 2%. CONCLUSIONES: nuestro trabajo proporciona nueva información sobre la preferencia gustativa de las ratas Wistar por distintos compuestos de estevia. Estos resultados ayudarán al diseño de estudios centrados en los efectos comportamentales y fisiológicos del consumo de estevia
Asunto(s)
Animales , Masculino , Femenino , Ratas , Stevia/fisiología , Ratas Wistar/psicología , Glucósidos/uso terapéutico , Conducta Animal/fisiología , Eritritol/metabolismo , Eritritol/farmacología , Eritritol/uso terapéutico , Edulcorantes/uso terapéutico , Stevia/metabolismo , Psicología Experimental/instrumentación , Psicología Experimental/métodos , Psicología Comparada/métodos , Análisis de VarianzaRESUMEN
Owing to the special characteristics and abilities polymeric networks have received special interest for a range of biomedical applications especially for drug delivery systems. This study was devoted to preparation of new polymeric compounds based on maleic anhydride and 3,9-divinyl-2,4,8,10-tetraoxaspiro (5.5) undecane copolymer (poly maleic anhydride-co-3,9-divinyl-2,4,8,10-tetraoxaspiro (5.5) undecane) (PMAU) patterned as a network for bioconjugation and tested as drug carrier systems. The PMAU copolymer was improved in its functionality by opening the maleic anhydride ring with different amounts of erythritol, which is free of side effects in regular use and a multifunctional compound, and also confers antioxidant character for the new compounds. The new polymeric matrices were loaded with acetaminophen, codeine and their fixed dose combinations. The investigation demonstrated the capability of the new structures to be used as polymer networks for linking bioactive compounds and to perform controlled delivery. The physico-chemical investigations--Fourier transform infrared spectroscopy (FTIR) spectra, contact angle, zeta potential (ZP - z, PMAU and its derivatives samples loaded with medicines present decreased values of zeta potential attesting the bioconjugate formation and as well their stability), and hydrodynamic radius, near infrared chemical imaging evaluation (new specific bands being registered for bio-conjugate with acetaminophen around of 1150-1200 nm and 1700 nm, and also between 1150 and 1200 nm in case of the codeine bio-conjugate), scanning electron microscopy (SEM) studies, X-ray diffraction analysis--evidenced the formation of the bioconjugates in relation to the chemical composition of the polymer matrices, while in vitro release study and in vivo tests confirm the capacity for drug delivery of the prepared bioactive systems.
Asunto(s)
Portadores de Fármacos/administración & dosificación , Poliésteres/administración & dosificación , Polivinilos/administración & dosificación , Acetaminofén/administración & dosificación , Acetaminofén/química , Acetaminofén/uso terapéutico , Analgésicos/administración & dosificación , Analgésicos/química , Analgésicos/uso terapéutico , Animales , Codeína/administración & dosificación , Codeína/química , Codeína/uso terapéutico , Preparaciones de Acción Retardada/administración & dosificación , Preparaciones de Acción Retardada/química , Preparaciones de Acción Retardada/uso terapéutico , Portadores de Fármacos/química , Portadores de Fármacos/uso terapéutico , Liberación de Fármacos , Eritritol/administración & dosificación , Eritritol/química , Eritritol/uso terapéutico , Masculino , Ratones , Dolor/tratamiento farmacológico , Poliésteres/química , Poliésteres/uso terapéutico , Polivinilos/química , Polivinilos/uso terapéuticoRESUMEN
Peri-implantitis represents a major complication that can compromise the success and survival of implant-supported rehabilitations. Both surgical and nonsurgical treatment protocols were proposed to improve clinical parameters and to treat implants affected by peri-implantitis. A systematic review of the literature was performed on electronic databases. The use of air-polishing powder in surgical treatment of peri-implantitis was investigated. A total of five articles, of different study designs, were included in the review. A meta-analysis could not be performed. The data from included studies reported a substantial benefit of the use of air-polishing powders for the decontamination of implant surface in surgical protocols. A case report of guided bone regeneration in sites with implants affected by peri-implantitis was presented. Surgical treatment of peri-implantitis, though demanding and not supported by a wide scientific literature, could be considered a viable treatment option if an adequate decontamination of infected surfaces could be obtained.
Asunto(s)
Implantes Dentales , Eritritol/uso terapéutico , Periimplantitis/cirugía , Femenino , Humanos , Persona de Mediana Edad , Periimplantitis/diagnóstico por imagen , Radiografía , Resultado del TratamientoRESUMEN
OBJECTIVES: To evaluate repeated subgingival air-polishing in residual pockets with a new erythritol powder containing 0.3% chlorhexidine. MATERIAL AND METHODS: Single-centre, examiner masked, randomized clinical trial of 12 months with a two-arm, within-subject parallel design. Fifty patients in periodontal maintenance were monitored in 3-month intervals. At months 0, 3, 6 and 9, all sites presenting with a probing depth (PD) >4 mm were subject to subgingival air-polishing (test side) or ultrasonic debridement (control side). The primary endpoint was presence/absence of PD >4 mm after 12 months. RESULTS: Totally 6918 sites were monitored at baseline, 457 of them had a PD >4 mm (range 5-9 mm). The number of pockets >4 mm per subject, PD and bleeding on probing were significantly lower at month 12. Differences between test and control were not significant. There was a significant difference in favour of air-polishing for the perception of pain/discomfort. Differences of frequencies at >1000 and >100,000 cells/ml of six microorganisms between baseline and month 12 were not significant. At month 12, test sites were less frequently positive for Aggregatibacter actinomycetemcomitans at >1000 cells/ml than controls, and counts never exceeded 100,000 cells/ml. CONCLUSIONS: Repeated subgingival air-polishing reduced the number of pockets >4 mm similar to ultrasonic debridement. It was safe and induced less pain.
Asunto(s)
Antiinfecciosos Locales/uso terapéutico , Clorhexidina/uso terapéutico , Raspado Dental/métodos , Eritritol/uso terapéutico , Enfermedades Periodontales/prevención & control , Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Antiinfecciosos Locales/administración & dosificación , Carga Bacteriana , Clorhexidina/administración & dosificación , Índice de Placa Dental , Raspado Dental/instrumentación , Sensibilidad de la Dentina/clasificación , Eritritol/administración & dosificación , Femenino , Estudios de Seguimiento , Hemorragia Gingival/prevención & control , Recesión Gingival/clasificación , Humanos , Masculino , Persona de Mediana Edad , Percepción del Dolor/fisiología , Desbridamiento Periodontal/métodos , Enfermedades Periodontales/microbiología , Índice Periodontal , Bolsa Periodontal/microbiología , Bolsa Periodontal/prevención & control , Método Simple Ciego , Ultrasonido/instrumentaciónRESUMEN
OBJECTIVE: The aim of this study was to test the efficacy of long-term, daily intake of erythritol and xylitol candy, compared with sorbitol candy, on the development of enamel and dentin caries lesions. METHODS: The study was a double-blind randomized controlled prospective clinical trial. Altogether 485 primary school children, first- and second-graders at baseline, from southeastern Estonia participated in this 3-year intervention. Each child consumed four erythritol, xylitol or sorbitol (control) candies three times per school day. The daily intake of polyol was about 7.5 g. The International Caries Detection and Assessment System (ICDAS) was used in the clinical examinations by four calibrated examiners at baseline and at 12, 24 and 36 months. RESULTS: The annual examination analyses and the follow-up analyses confirmed that the number of dentin caries teeth and surfaces at 24 months follow-up and surfaces at 36 months follow-up was significantly lower in the mixed dentition in the erythritol group than in the xylitol or control group. Time of enamel/dentin caries lesions to develop and of dentin caries lesions to progress was significantly longer in the erythritol group compared to the sorbitol and xylitol groups. Also the increase in caries score was lower in the erythritol group than in the other groups. CONCLUSIONS: In the follow-up examinations, a lower number of dentin caries teeth and surfaces was found in the erythritol group than in the xylitol or control groups. Time to the development of caries lesions was longest in the erythritol group. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01062633.
Asunto(s)
Dulces , Cariostáticos/uso terapéutico , Caries Dental/prevención & control , Eritritol/uso terapéutico , Xilitol/uso terapéutico , Niño , Índice CPO , Esmalte Dental/efectos de los fármacos , Dentina/efectos de los fármacos , Dentición Mixta , Progresión de la Enfermedad , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Prospectivos , Sorbitol/uso terapéutico , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: Xylitol studies suggest caries reductions in the order of 50%. Based on animal/microbial studies, erythritol potentially has caries-preventive properties. However, clinical studies are required to confirm this. The aim of the study was to investigate the additional caries-preventive effect of xylitol/maltitol and erythritol/maltitol lozenges delivered at school, relative to controls receiving comprehensive prevention, in a low-caries prevalence population. METHODS: A 4-year, cluster-randomized, double-blinded clinical trial. Five hundred and seventy-nine 10-year-old consenting subjects from 21 schools were randomly assigned to one of five groups. Four groups used the lozenges on school days, in three teacher-supervised sessions daily, over 1 or 2 years. The daily amount was 4.7 g/4.6 g for xylitol/maltitol and 4.5 g/4.2 g for erythritol/maltitol. The groups received free examinations and care in the public health centre. Four hundred and ninety-six children were analysed. The main outcome measure was dentin caries increment based on a clinical examination at 4 years since the start. The groups were compared in relation to the increment using hierarchical logistic regression to adjust for potential clustering. RESULTS: Use of xylitol/maltitol or erythritol/maltitol lozenges did not result in caries reduction. A strong relationship between baseline caries prevalence and the 4-year increment was observed (OR = 7.38; 95% CI: 3.78-14.41). CONCLUSIONS: The results suggest that in relatively low-caries conditions the school-based use of xylitol/maltitol or erythritol/maltitol lozenges would not have additional caries-preventive effect when compared with comprehensive prevention.
Asunto(s)
Cariostáticos/uso terapéutico , Caries Dental/prevención & control , Eritritol/uso terapéutico , Fluoruros/análisis , Maltosa/análogos & derivados , Alcoholes del Azúcar/uso terapéutico , Edulcorantes/uso terapéutico , Abastecimiento de Agua/análisis , Xilitol/uso terapéutico , Cariostáticos/administración & dosificación , Cariostáticos/análisis , Niño , Índice CPO , Atención Odontológica , Dentina/patología , Método Doble Ciego , Eritritol/administración & dosificación , Femenino , Finlandia , Estudios de Seguimiento , Humanos , Masculino , Maltosa/administración & dosificación , Maltosa/uso terapéutico , Radiografía de Mordida Lateral , Medición de Riesgo , Alcoholes del Azúcar/administración & dosificación , Edulcorantes/administración & dosificación , Comprimidos , Resultado del Tratamiento , Xilitol/administración & dosificaciónRESUMEN
OBJECTIVE: Hyperglycemia, oxidative stress, and the onset and progression of diabetic complications are strongly linked. Reduction of oxidative stress could be of utmost importance in the long-term treatment of diabetic patients. The chronic nature of the disease calls for a mode of antioxidant intake that can be sustained easily, e.g., by the diet. Erythritol, a simple polyol, could be such a compound. It is orally available, well tolerated, and its chemical structure resembles that of mannitol, a well-known hydroxyl radical (HO*) scavenger. METHODS: We studied the antioxidant properties of erythritol in vitro and subsequently determined its antioxidant activity and its vasoprotective effect in the streptozotocin diabetic rat. RESULTS: Erythritol was shown to be an excellent HO* radical scavenger and an inhibitor of 2,2'-azobis-2-amidinopropane dihydrochloride-induced hemolysis but inert toward superoxide radicals. High-performance liquid chromatographic and electron spin resonance spectroscopy studies showed that the reaction of erythritol with hydroxyl radicals resulted in the formation of erythrose and erythrulose by abstraction of a carbon-bound hydrogen atom. In the streptozotocin diabetic rat, erythritol displayed an endothelium-protective effect and, in accordance with the in vitro experiments, erythrose was found in the urine of erythritol-consuming rats. CONCLUSION: Erythritol acts as an antioxidant in vivo and may help protect against hyperglycemia-induced vascular damage.