ABSTRACT
OBJECTIVES: To systematically evaluate randomised controlled trials (RCTs) on whether adjuvant application of antimicrobial photodynamic therapy (aPDT) through the technique of irradiation in the external region of the periodontal pocket with optic-fibre tip offers benefits to scaling and root planning (SRP). METHODS: Five databases were searched by two independent reviewers according to pre-specified eligibility criteria up to April 2023. No restrictions regarding date of publication, language and minimum follow-up period were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and Grading of Recommendations, Assessment, Development and Evaluation for assessing the certainty of evidence. RESULTS: A total of 1388 publications were identified and reviewed for eligibility. Four of them fulfilled the inclusion criteria. The sample consisted of a total of 83 patients with periodontitis. In these, 330 periodontal sites were evaluated. The clinical findings of the majority of the included studies demonstrated that patients who received the association of aPDT + RAR with the protocol evaluated here, obtained clinical results similar to patients who received only the SRP alone. In none of the evaluated RCTs, clinical advantages were observed that would categorise this aPDT protocol as superior to conventional treatment. CONCLUSION: Applying aPDT after SRP with external irradiation of the periodontal pocket does not seem to result in any clinical benefit compared to the use of SRP alone in patients with periodontitis.
Subject(s)
Anti-Infective Agents , Chronic Periodontitis , Periodontitis , Photochemotherapy , Humans , Periodontal Pocket , Root Planing , Randomized Controlled Trials as Topic , Photochemotherapy/methods , Dental Scaling/methods , Combined Modality Therapy , Chronic Periodontitis/drug therapyABSTRACT
Scaling and root planing is the gold standard procedure in the periodontal disease treatment. Although this therapy has the ability to reduce or eliminate periodontopathogens mthrough periodontal instrumentation, sometimes the response to treatment may not promote the complete eradication of pathogens, affecting the healing process and leading to the presence of residual periodontal pockets. The aim of this study was to analyze the effectiveness of photodinamic therapy with laser photobiomodulation and as an adjunct to scaling and root planing (having as a conductive agent a fiber optic tip radiating inside the periodontal pocket), compared to scaling and root planing alone in patients with periodontitis on randomized trials. This systematic review was carried out complying with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta Analyses. The databases used were Pubmed, Lilacs, Biblioteca Virtual em Saúde - Odontologia and Medline. "Periodontal Disease" OR "Periodontal Treatment" AND m"Photodinamic Theraphy" were the descriptors used. A total of five articles were included. Two studies have shown superior results in relation to the referred association; a study indicated benefits in biochemical and/or microbiological aspects; it suggests, however, that clinical relevance needs to be better evaluated; two studies did not reveal benefits that categorize photodynamic therapy + scaling and root planning as superior to conventional treatment. The association in question, when well standardized and performed, can result in promising responses in the control of periodontal disease; however, the clinical benefits that demonstrate its superiority will certainly be subject to new researches. (AU)
A raspagem e alisamento radicular é o procedimento padrão-ouro no tratamento da doença periodontal. Embora essa terapia seja capaz de reduzir ou eliminar os periodontopatógenos por meio da instrumentação periodontal, algumas vezes a resposta ao tratamento pode não promover completa erradicação dos patógenos, afetando assim, o processo de cicatrização e levando à presença de bolsas periodontais residuais. O objetivo do presente estudo foi analisar a eficácia da terapia fotodinâmica com fotobiomodulação laser adjuvante a raspagem e alisamento radicular (tendo como agente condutor uma ponta de fibra óptica que irradia o interior da bolsa periodontal), em comparação com a raspagem e alisamento radicular isoladamente em pacientes com periodontite, avaliados em estudos clínicos randomizados. Esta revisão sistemática foi realizada de acordo com as recomendações Principais Itens para Relatar Revisões sistemáticas e Meta-análises. As bases de dados utilizadas foram Pubmed, Lilacs, Biblioteca Virtual em Saúde - Odontologia e Medline. "Doença periodontal" OR "Tratamento periodontal" AND "Terapia fotodinâmica" foram os descritores utilizados. Um total de cinco artigos foram incluídos. Dois estudos mostraram resultados superiores em relação à referida associação; um estudo indicou benefícios nos aspectos bioquímicos e/ou microbiológicos; sugere, no entanto, que a relevância clínica precisa ser melhor avaliada; dois estudos não revelaram benefícios que categorizassem a terapia fotodinâmica + raspagem e alisamento radicular como superiores ao tratamento convencional. A associação em questão, quando bem padronizada e realizada, pode resultar em respostas promissoras no controle da doença periodontal; entretanto, os benefícios clínicos que demonstram sua superioridade certamente serão alvo de novas pesquisas. (AU)
ABSTRACT
ABSTRACT Wound healing consists of the coordinated cascade of molecular, cellular and biochemical events that interact for tissue recomposition to occur. The interruption or failure in this process can trigger the delay in closing the lesion and chronic wounds, in addition to infections. Ozonotherapy proves to be a promising alternative, capable of assisting in the tissue healing process, modulating the inflammatory response and preventing the development of infection. To present, analyze and discuss, through a literature review, the use of Ozonated Oils in the repair of the human body and oral cavity systems. SciELO, LILACS, MEDLINE and PubMed databases were consulted, using the following DeCS / MeSH descriptors: "ozonized oil"; "healing"; "ozone therapy". After crossing, counting and analyzing, 13 studies were selected, according to the theme. Due to the complementary theoretical foundation, 44 articles were included, totaling 57 articles used for the present review. Ozonized Oil therapy has beneficial clinical effects, which include antimicrobial, immunostimulating, analgesic, antipoxic, immunoregulatory and antioxidant action. Topical management of ozone has proven effective for the treatment of foot-and-mouth disease, gingivitis, ulcers and dermatitis, contributing to pain relief and healing. Infectious skin diseases, abscesses, allergic skin diseases, scaly erythema, psoriasis and palmoplantar pustulosis are pathological conditions, the treatment of which benefits from the application of Ozonized Oils. Ozonized Oils have been shown to be effective in the treatment of local infections, when in appropriate formulations and in controlled cases, being a promising therapeutic alternative for tissue repair.
RESUMO A cicatrização de feridas consiste na coordenada cascata de eventos moleculares, celulares e bioquímicos que interagem para que ocorra a recomposição tecidual. A interrupção ou falha nesse processo, pode desencadear o atraso no fechamento da lesão e feridas crônicas, além de infecções. A Ozonioterapia revela-se uma alternativa promissora, capaz de auxiliar no processo de cicatrização tecidual, modular a resposta inflamatória e prevenir o desenvolvimento de infecção. Apresentar, analisar e discutir, através de uma revisão da literatura, o emprego de Óleos Ozonizados no reparo dos sistemas do corpo humano e cavidade oral. Bases de dados SciELO, LILACS, MedLine e PubMed foram consultadas, utilizando os seguintes descritores DeCS/MeSH: "ozonized oil"; "healing"; "ozone therapy". Após cruzamento, apuração e análise, foram selecionados 13 estudos, de acordo com a temática. Devido à fundamentação teórica complementar, 44 artigos foram incluídos, totalizando 57 artigos utilizados para a presente revisão. A terapia com Óleo Ozonizado possui efeitos clínicos benéficos, que incluem ação antimicrobiana, imunoestimulante, analgésica, antipóxica, imunorreguladora e antioxidante. O manejo tópico de ozônio revelou-se eficaz para o tratamento de estomatite aftosa, gengivite, úlceras e dermatite, contribuindo para o alívio da dor e cicatrização. Doenças infecciosas da pele, abscessos, doenças alérgicas da pele, eritema escamoso, psoríase e pustulose palmoplantar são condições patológicas, cujo tratamento é beneficiado pela aplicação de Óleos Ozonizados. Os Óleos Ozonizados têm demonstrado eficácia no tratamento de infecções locais, quando em formulações apropriadas e em casos controlados, sendo uma alternativa terapêutica promissora para o reparo de tecidos.
ABSTRACT
BACKGROUND: The present study aims to compare different diagnostic criteria for periodontal disease that were used to study the association between periodontal disease and osteoporosis. METHODS: A database from a case-control study was used. The present study included sociodemographic, lifestyle, and health-condition data; panoramic radiographs; and clinical measurements on periodontal conditions from 139 postmenopausal women. Each participant was classified with regard to the diagnosis of periodontal disease using five different criteria for the outcome measurement (OM) found in the literature in studies on the association between osteoporosis and periodontal disease (OM1 through OM5). The frequency of periodontal disease and diagnostic values were calculated taking OM5 as the gold standard and the main association measurement for all criteria using odds ratios. RESULTS: The frequency of periodontal disease varied from 24.5% to 98.6% depending on the OM used. OM4 and OM3 presented the highest specificity (98.9% and 94.5%, respectively), whereas OM2 and OM1 presented the highest sensitivity (100% and 77.1%, respectively). The association measurements with adjustments for age and smoking varied significantly according to the OM over a range from 1.87 to 3.75, and there were also variations in the statistical significance of the associations found. CONCLUSIONS: The results of this study emphasize that the frequency of periodontal disease may be influenced by different OMs and indicated variations outside of the association between osteoporosis and periodontal disease. Therefore, there is a need for prior selection of a precise measurement of periodontal disease in investigations on this topic.
Subject(s)
Osteoporosis, Postmenopausal/complications , Periodontal Diseases/complications , Absorptiometry, Photon , Age Factors , Alcohol Drinking , Body Mass Index , Case-Control Studies , Dental Care , Educational Status , Exercise , False Negative Reactions , Female , Gingival Hyperplasia/complications , Gingival Recession/complications , Health Status , Humans , Income , Life Style , Middle Aged , Periodontal Attachment Loss/complications , Periodontal Diseases/classification , Periodontal Pocket/complications , Predictive Value of Tests , Radiography, Panoramic , Sensitivity and Specificity , Smoking , Treatment OutcomeABSTRACT
Uma das principais dificuldades enfrentadas pelos dentistas é a mudança de hábitos de higienização bucal. A maior parte das sessões de instrução e motivação certamente ainda não traz os resultados almejados pelos profissionais. Essa situação se agrava quando se trata de crianças. O aprendizado ativo ou pelo descobrimento baseia-se na utilização de métodos participativos, tais como os jogos educativos, que trazem como primordial característica uma meta de aprendizado. As sensações e o fator divertimento asseguram a motivação do paciente e funcionam como reforço de aprendizagem. O presente artigo propõe-se a avaliar a mudança de hábitos de higienização bucal em alunos de escola pública totalizando 60 crianças com 08 anos de idade, frente a uma metodologia com uso de jogos educativos
