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1.
Indian J Dent Res ; 32(2): 187-191, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34810387

RESUMO

Background and Aim: Increased oxidative stress has emerged as one of the prime factors in the pathogenesis of periodontitis. Hence, antioxidant therapy may become a promising tool in the treatment of periodontal disease. Uric acid is a major salivary antioxidant, levels of which decrease in periodontitis. The aim of the present study was to investigate the effect of antioxidant therapy on the progression of periodontal disease. Material and Methods: This is a randomized controlled clinical trial conducted among 48 systemically healthy participants having generalized gingivitis with probing depth <3 mm, plaque index (PI) <1, and no bone and attachment loss. Participants were randomly assigned equally (n = 24) into two groups (test and control) using the lottery method. Full mouth scaling and root planing were performed in both the groups and oral hygiene instructions were given. Periodontal assessment at baseline 1 h after scaling and root planing was done with clinical parameters by a single examiner. Test group was prescribed; the commercially available anti-oxidant containing natural lycopene with green tea extract. Sample collection was done for both the groups at baseline and at the 45th day. Results: It was observed that significantly high results were obtained during intra-group comparison for both modified plaque index and sulcus bleeding index from baseline to 45 days. After treatment, a very highly significant increase (P ≤ 0.001) in the test group and significant (P ≤ 0.05) increase in the control group were observed in salivary uric acid levels. Conclusion: Oral lycopene and green tea extract supplementation is positively associated with salivary uric acid levels and plays an important role in the management of gingivitis.


Assuntos
Antioxidantes , Periodontite Crônica , Antioxidantes/uso terapêutico , Índice de Placa Dentária , Raspagem Dentária , Humanos , Perda da Inserção Periodontal , Índice Periodontal , Aplainamento Radicular
2.
Complement Ther Clin Pract ; 45: 101493, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34662850

RESUMO

BACKGROUND: Periodontal disease (PD) is the second most prevalent buccal infectious condition in adults. Owing to its multifactorial etiology, treatment and maintenance are challenging. Scaling and root planing, associated with adequate plaque control, are considered the gold standard treatments for this disease. However, the instrumentation techniques can fail to completely eliminate calculus, particularly in higher grade and progression rated PD cases, and the continuing efficient removal of the biofilm by the patient can limit the long-term response of this treatment. Anti-infective herbal products, such as Curcuma, have been added as adjuvant therapy to prolong periodontal treatment outcomes. OBJECTIVE: This systematic review aimed to summarize and evaluate whether Curcuma can contribute to PD treatment when applied as an adjunct to the standard scaling and root planing therapy. DATA SOURCES: We searched databases using specific keywords and Boolean operators and systematically conducted the extraction and analysis according to the PROSPERO (CRD42019145691) database. The main eligibility criteria were randomized clinical trials in humans published in the English language. RESULTS: Twelve studies were included in the review and 11 in the meta-analysis. Quantitative analysis of different clinical parameters was described. In comparison with the control group, Curcuma was associated with a reduction in pocket depth after 90 days of treatment (mean deviation: 0.48; 95% confidence interval: 0.89-0.08). CONCLUSION: This systematic review and meta-analysis indicated that Curcuma is an effective product when applied as adjunct therapy for PD treatment. This improved the clinical and microbiological parameters.


Assuntos
Periodontite Crônica , Doenças Periodontais , Adulto , Terapia Combinada , Curcuma , Raspagem Dentária , Humanos , Doenças Periodontais/tratamento farmacológico , Aplainamento Radicular
3.
Chin J Dent Res ; 24(3): 191-198, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34491014

RESUMO

OBJECTIVE: To investigate various factors affecting the clinical outcome of nonsurgical periodontal treatment and evaluate the treatment effects of adjunctive amoxicillin and metronidazole (AMX + MET) in patients with generalised aggressive periodontitis (GAgP). METHODS: Forty-two patients with GAgP were recruited and randomly assigned to three groups: scaling and root planing (SRP) only, AMX + MET after SRP, and AMX + MET during SRP. The patients were assessed every 2 months post-therapy. Periodontal clinical and subgingival microbiological parameters were analysed at baseline and 6 months post-therapy. The impacts of different covariates on pocket probing depth (PD) reduction were evaluated. RESULTS: A multilevel analysis revealed that 58% of the variability in PD reduction was attributed to site-level parameters, 27.3% to patient-level parameters and 18.7% to tooth-level parameters. Greater PD reduction can be expected at initially deeper PD sites and sites with intrabony defects, and in patients with adjunctive use of AMX + MET. Persistent Tannerella forsythia infection and tooth mobility after treatment were negatively associated with PD reduction. CONCLUSION: The clinical outcomes of nonsurgical periodontal treatment were mainly influenced by site-level parameters, and adjunctive use of AMX + MET can lead to better clinical results in patients with GAgP in a short time.


Assuntos
Periodontite Agressiva , Periodontite Agressiva/terapia , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Raspagem Dentária , Humanos , Análise Multinível , Aplainamento Radicular , Resultado do Tratamento
4.
Oral Health Prev Dent ; 19(1): 489-494, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34585874

RESUMO

PURPOSE: To clinically evaluate and compare the efficacy of indocyanine green mediated photodynamic therapy (PDT) and aloe vera (AV) gel when used as adjunct therapy to scaling and root planing (SRP) for treatment of chronic periodontitis. MATERIALS AND METHODS: One hundred fifty patients were randomly assigned to three treatment groups: group 1 (SRP), group 2 (SRP+PDT) and group 3 (SRP+AV). Four clinical parameters - plaque index (PI), bleeding on probing (BoP), periodontal (PD) pocket depth and clinical attachment level (CAL) - were evaluated at baseline and 3 and 6 months post treatment. Additionally, the amount of three inflammatory - cytokines IL-6, IL-8 and TNF-α - in gingival crevicular fluid (GCF) was identified using an enzyme-linked immune-sorbent assay (ELISA). RESULT: Statistically significant improvement was observed for all clinical parameters in group 3 at follow-up in comparison to groups 1 and 2. Individuals treated with adjunct PDT showed statistically significant reduction in moderate (4-5 mm) and deep (≥6 mm) PD pockets at the 3-month follow-up. Group-2 and -3 patients displayed statistically significant reductions in cytokines IL-6, IL-8 and TNF-α at the 3-month follow-up in comparison to group 1 patients. This reduction in cytokines was maintained at the 6-month follow-up. CONCLUSION: Adjunct treatment regimens PDT and AV gel statistically significantly contributed to decreasing inflammation in periodontal tissue. AV /gel showed potential to decrease BoP, whereas PDT can facilitate increasing the clinical attachment level.


Assuntos
Periodontite Crônica , Verde de Indocianina , Periodontite Crônica/tratamento farmacológico , Raspagem Dentária , Seguimentos , Humanos , Preparações de Plantas , Aplainamento Radicular
5.
Braz Oral Res ; 35(Supp 2): e099, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34586213

RESUMO

There are several studies that evaluate the use of lasers in periodontal treatment in non-surgical or surgical therapy. However, while several studies showed clinically beneficial effects of some lasers in periodontal treatment, there are few clinical reports of additional advantages of lasers as adjunctive treatments in periodontology. The aim of this paper is to demonstrate and critically analyze the level of scientific evidence of effects of low-level lasers and high-power lasers in periodontology. A narrative review of the studies was carried out in each topic and type of laser or periodontal treatment. In nonsurgical periodontal therapy the results showed that there is an additional clinical benefit when using a diode laser (DL) associated with scaling and root planing (SRP) in patients with moderate to severe periodontitis. The Er:YAG laser seems to be the most suitable for nonsurgical periodontal therapy and promotes the same clinical effects as conventional therapy. In periodontal surgery vaporization of the gingival or mucosal tissue can be carried out with DL, CO2, Nd:YAG, Er:YAG and Er,Cr:YSGG lasers. Photobiomodulation (PBM), mediated by low-level lasers associated with non-surgical periodontal therapy, promotes additional benefits in the short term and accelerates the bone and gingival tissue repair process and also reduces postoperative symptoms of periodontal surgery. The effect of antimicrobial Photodynamic Therapy is relevant in the initial reevaluation periods. Studies have shown controversial results of the use of lasers in periodontics, and this fact may be due to the lack of standard parameters of irradiation in each clinical application.


Assuntos
Periodontite Crônica , Terapia a Laser , Lasers de Estado Sólido , Periodontite , Raspagem Dentária , Humanos , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Aplainamento Radicular
6.
J Biol Regul Homeost Agents ; 35(4 Suppl. 1): 51-63, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34425660

RESUMO

The aim of this literature review is to assess the effectiveness of diode laser at a wavelength of 800-980 nm in addition to non-surgical periodontal therapy in periodontitis treatment. The authors performed an electronic research on Pubmed inserting as keywords: (laser OR laser therapy OR diode laser) and (periodontitis OR periodontal disease). The field has been narrowed to select only Randomized controlled clinical trials (RCT) performed from 2010 to 2020. The result of this research was 84 articles, of which eight were included in the review because they respect the inclusion criteria. The clinical, immunological, and microbiological parameters studied in the various clinical random trials were analysed. It has been shown that four out of eight studies have achieved greater benefits, in terms of clinical parameters, with the use of diode laser compared to Scaling and Root Planing. However, the greater increase in clinical parameters in diode laser-treated patients compared to the control group was mainly detected in the short term rather than in the long term. In terms of microbiological parameters, no improvement was detected after six months. Only one study reported six-month improvements in immunological parameters in patients treated with DL compared to the Scaling and Root Planing only group. In conclusion, considering the limitations of this review of literature, there is no evidence that the diode laser at 800-980 nm in addition to non-surgical periodontal therapy is more effective than SRP alone in the long term.


Assuntos
Periodontite Crônica , Terapia a Laser , Terapia com Luz de Baixa Intensidade , Periodontite Crônica/cirurgia , Humanos , Lasers Semicondutores/uso terapêutico , Aplainamento Radicular
7.
J Evid Based Dent Pract ; 21(2): 101547, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34391565

RESUMO

OBJECTIVES: To evaluate the efficacy of probiotics as an adjunctive therapy to scaling and root planning treatment (SRP) in the management of periodontitis. METHODS: PubMed, Embase, Web of science, SCOPUS and the Cochrane library were systematically searched to identify eligible studies. Stata 12.0 software was used to calculate the weighted mean differences (WMD) and 95% confidential interval (CI). The primary outcomes were clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing (BOP). RESULTS: Twenty-four randomized controlled trials (RCT) were included in the meta-analysis. The pooled results showed CAL gain (WMD: 0.20, 95% CI 0.09 to 0.31), PPD reduction (WMD: -0.31, 95% CI -0.52 to -0.10) and BOP reduction (WMD: -2.98, 95% CI -4.70 to -1.26) in the SRP+ probiotics group were significantly improved compared to control group at 3 months follow-up, but no significant difference was observed at 6 months. In addition, the probiotics administration could improve Plaque index (WMD: -0.30, 95% CI -0.59 to -0.05) and Gingival index (WMD: -0.46, 95% CI -0.71 to -0.21) at short term. CONCLUSIONS: The results support the clinical efficacy of probiotics as an adjunctive therapy to SRP in the management of periodontitis at least 3 months follow-up. Within the limits of the evidence, the long-term efficacy needs to further confirm.


Assuntos
Periodontite Crônica , Probióticos , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Aplainamento Radicular , Resultado do Tratamento
8.
J Biol Regul Homeost Agents ; 35(2 Suppl. 1): 67-78, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34281303

RESUMO

The objective of this study was to establish the significance of probiotic usage, both as a preventive as well as a therapeutic strategy for the management of periodontal disease. It also substantiates the existing studies of single/combined bacterial strain for exhibiting variable ecological impact on oral bacteria. Data sources included literature searches of PubMed (MEDLINE), Scopus, Embase, CENTRAL and Web of science databases for placebo controlled randomized clinical trials of SRP with orally administered probiotics in any form as an adjunct. Data extraction was conducted and information from the included studies was tabulated according to the study designs, form of drug delivery, main outcomes, and clinical parameters. Data collected were based on the focused question outlined for the present systematic review. The reviewers cross-checked all extracted data. CAL and PD were assessed as the primary outcome to compare the effectiveness of adjunctive probiotic therapy in addition to SRP. Fourteen clinical studies were included and demonstrated efficacy in reducing periodontal probing depth (PPD) and gaining clinical attachment level (CAL), between probiotics and SRP/placebo. Adjunctive probiotic therapy in addition to SRP leads to decrease in probing depth and clinical attachment gain in chronic periodontitis patients. However, further high-quality randomized clinical trials with microbiological outcomes are required to fortify the conclusion.


Assuntos
Periodontite Crônica , Probióticos , Periodontite Crônica/terapia , Terapia Combinada , Raspagem Dentária , Humanos , Probióticos/uso terapêutico , Aplainamento Radicular
9.
J Biol Regul Homeost Agents ; 35(2 Suppl. 1): 89-96, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34281305

RESUMO

Grape seed extract (GSE), a naturally producing polyphenolic compound, is found to be a potent hostmodulatory agent and considered for management of periodontal disease. Its anti-bacterial, antioxidant, and anti-inflammatory property may aid in achieving periodontal health. To assess the clinical efficacy of GSE in adjunct to scaling and root planing (SRP) in healing of periodontal pockets. The present study was a longitudinal, parallel design, randomized clinical trial. Seventy-two patients (mean age 39.2±8.6 years) with periodontal pockets were randomly divided into two groups; Test group received intra-pocket delivery of GSE with SRP and Control group received SRP alone. The clinical parameters like Plaque Index (PI), Gingival Index (GI), Probing Depth (PD) and Relative Attachment Level (RAL) were recorded at baseline and 3 months. 64 patients completed the study. Test group at the end of 3 months had statistically significant reduced PD (p=0.002) and RAL (p=0.01). No significant difference was observed for PI and GI at the end of 3 months. Intra-pocket application of GSE with SRP could be beneficial in management of periodontal pockets.


Assuntos
Periodontite Crônica , Extrato de Sementes de Uva , Periodontite , Adulto , Índice de Placa Dentária , Raspagem Dentária , Seguimentos , Humanos , Pessoa de Meia-Idade , Perda da Inserção Periodontal , Bolsa Periodontal , Periodontite/tratamento farmacológico , Aplainamento Radicular , Resultado do Tratamento
10.
BMC Oral Health ; 21(1): 340, 2021 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246253

RESUMO

BACKGROUNDS: To date, there is still no consensus about the clinical efficacy of non-surgical periodontal therapy in rheumatoid arthritis (RA) patients with periodontitis. Therefore, the aim of this study was to summarize clinical data regarding the efficacy of scaling and root planing (SRP) in patients with RA and periodontitis compared to non-RA periodontitis patients. METHODS: We selected randomized controlled trials (RCTs) that compared periodontal clinical data in RA as compared to non-RA periodontitis patients by searching Embase, PubMed and Cochrane Central Register of Controlled Trials and by manually retrieving from the earliest records to March 8, 2021. The overall effect size of plaque index (PI), gingival index (GI), attachment loss (AL), probing depth (PD) and bleeding on probing (BOP) were calculated by either a fixed or random-effect model, and subgroup analyses were conducted according to the different time points of follow-up. Two investigators extracted the data and assess the accuracy of the obtained results with 95% of Confidence Intervals (CI). Cochrane Collaboration's tool was responsible for the evaluation of the literature quality and the inter-study heterogeneity was evaluated by Q test and I2 statistic. Sensitivity analyses were applied for results with heterogeneity. Publication bias was determined by Begg's test, Egger's test and the trim-and-fill method. RESULTS: Seven RCTs including 212 patients eventually met the inclusion criteria for the study. As the primary results, the change of PD was not statistically significant and in the secondary results changes of PI, GI, AL and BOP were also not statistically significant in RA patients with periodontitis compared to non-RA periodontitis patients. In subgroup analysis, a larger BOP reduction at 3 months, PI and AL reduction at 6 months were observed in patients with RA and periodontitis group. The results of sensitivity analyses had no significant effect. No evidence of potential publication bias was tested. There were some limitations due to the small number of eligible RCTs. CONCLUSIONS: SRP is equally effective in RA as compared to non-RA periodontitis patients. It suggests RA does not affect the clinical efficacy of non-surgical periodontal therapy. These results could serve evidence-based practice.


Assuntos
Artrite Reumatoide , Periodontite Crônica , Periodontite , Artrite Reumatoide/complicações , Artrite Reumatoide/terapia , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Perda da Inserção Periodontal/terapia , Índice Periodontal , Periodontite/complicações , Periodontite/terapia , Aplainamento Radicular
11.
Photodiagnosis Photodyn Ther ; 35: 102451, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34303029

RESUMO

BACKGROUND: The aim of this study was to compare, through clinical and microbiological analysis, the use of multiple applications of aPDT as an adjuvant therapy to non-surgical periodontal treatment of stage III and IV grade C periodontitis in type 2 diabetic (DM2) patients. METHODS: Thirty-four patients with non-compensated DM2 and periodontitis were randomly divided into two groups: SRP Group (n = 17): scaling and root planing (SRP); and SRP+aPDT Group (n = 17): SRP followed by 3 consecutive aPDT applications, immediately, 48 and 96 h after in pockets with probing depth (PD) ≥5 mm. In SRP+aPDT, after 1 min of irrigation with methylene blue (10 mg/ml), the sites were irradiated with a 660 nm diode laser for 50 s (157 J/cm2, 4.7 J, 100 mW). Porphyromonas gingivalis (P. gingivalis) and Prevotella intermedia (P. intermedia) were quantified by real-time qPCR. Periodontal clinical and microbiological data (baseline, 90 and 180 days) were statistically analyzed (α = 5%). RESULTS: There was a significant reduction in PD and bleeding on probing at 90 and 180 days post-treatment in both groups (p<0.05). The SRP+aPDT group presented a significant reduction in the number of residual pockets at 90 and 180 days (p<0.05). The SRP+aPDT group presented reduced PD means in deep pockets 180 days post-treatment (p<0.05). No differences were observed in P. gingivalis and P. intermedia levels (p>0.05). CONCLUSION: The results of present study indicate that the use of multiples aPDT sessions as adjuvant therapy in the periodontal treatment of uncompensated diabetic patients with periodontitis promotes additional clinical benefits.


Assuntos
Anti-Infecciosos , Periodontite Crônica , Diabetes Mellitus Tipo 2 , Fotoquimioterapia , Anti-Infecciosos/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Terapia Combinada , Raspagem Dentária , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Aplainamento Radicular
12.
Phytother Res ; 35(11): 5980-5991, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34216058

RESUMO

This study aims to evaluate the clinical efficacy of curcumin versus chlorhexidine as adjuncts to scaling and root planing (SRP) for periodontitis treatment. We searched PubMed, EMbase, Cochrane Library, and ClinicalTrials.gov from inception to February 18, 2021 and identified studies with relevant randomized controlled trials (RCTs) using curcumin or chlorhexidine as an adjunct to SRP. Nine RCTs involving 420 patients/sites were included. A meta-analysis with a random-effects model revealed that curcumin and chlorhexidine, as an adjunct to SRP, reduced probing pocket depth (PPD) at similar levels during a 3-, 4-, 6-, and 12-week follow-up. No significant differences were observed in reducing clinical attachment loss (CAL) between curcumin and chlorhexidine as an adjunct to SRP at 4 weeks and 6 weeks. Furthermore, gingival index (GI) and plaque index (PI) were similar using curcumin versus chlorhexidine as an adjunct to SRP at the 4-week-, 6-week-, and 12-week follow-up. Based on the available evidence in RCTs, compared with chlorhexidine as an adjunct to SRP, curcumin has a similar effect on reducing PPD, CAL, GI, and PI. The quality of evidence is low, limited by the number of studies and their limitations. Further studies are needed to firmly establish the clinical efficacy of curcumin.


Assuntos
Anti-Infecciosos Locais , Periodontite Crônica , Curcumina , Clorexidina , Curcumina/uso terapêutico , Humanos , Aplainamento Radicular , Resultado do Tratamento
13.
Quintessence Int ; 52(8): 676-685, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34076375

RESUMO

OBJECTIVE: The purpose of this randomized, controlled, split-mouth clinical trial was to clarify the clinical efficacy of using injectable platelet-rich fibrin (i-PRF) as an adjunctive subgingival irrigation to scaling and root planing (SRP) in the treatment of periodontitis. METHOD AND MATERIALS: The study was conducted in 15 patients suffering from stage II to III with grade B to C periodontitis with bilateral periodontal pockets (≥ 5 mm) on a minimum of two teeth without degree II or III of furcation involvement or tooth mobility. The evaluated clinical parameters were: Plaque Index (PI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession at baseline and after 3 months. After full-mouth supra- and subgingival SRP, the sites were randomly divided into test sites receiving the subgingival application of i-PRF and controls treated with saline. The Wilcoxon test and Mann-Whitney U test were used for intra- and inter-group comparisons, respectively. RESULTS: In total, 726 sites were treated (388 test group and 338 control group) with no uneventful healing effects. Statistically significant decreases in PI (P = .001), BOP (P = .001 for both groups), PPD (P = .001 and P = .000 for test and control groups, respectively), CAL (P = .015 and P = .001 for test and control groups, respectively) between pretreatment and 3 months posttreatment were noted in both test and control groups. For inter-group comparisons, there was no statistically significant difference in all clinical indices (P > .05). CONCLUSION: In this study, both groups were clinically effective as nonsurgical periodontal treatments, without any clinical benefits of using i-PRF.


Assuntos
Fibrina Rica em Plaquetas , Raspagem Dentária , Fibrina , Humanos , Boca , Aplainamento Radicular , Resultado do Tratamento
14.
J Periodontal Res ; 56(5): 837-847, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34173676

RESUMO

Curcumin is the main active ingredient of turmeric, which has a wide range of pharmacological effects, including antitumor, antibacterial, anti-inflammatory, anti-oxidation, immune regulation, and so on. Periodontitis is a prevalent oral inflammatory disease caused by a variety of factors. In recent years, many studies have shown that curcumin has a potential role on the treatment of periodontitis. Curcumin has been used in research related to the treatment of periodontitis in the form of solution, chip, gel, and capsule. Combined with other periodontitis treatment methods, such as scaling and root planing (SRP) and photodynamic therapy (PDT), can enhance curcumin's efficacy in treating periodontitis. In addition to natural curcumin, chemically modified curcumin, such as 4-phenylaminocarbonyl bis-demethoxy curcumin (CMC 2.24) and 4-methoxycarbonyl curcumin (CMC 2.5), have also been used in animal models of periodontitis. Here, this paper reviews the research progress of curcumin on the treatment of periodontitis and its related mechanisms.


Assuntos
Curcumina , Periodontite , Animais , Anti-Inflamatórios/uso terapêutico , Curcumina/uso terapêutico , Raspagem Dentária , Periodontite/tratamento farmacológico , Aplainamento Radicular
15.
Photodiagnosis Photodyn Ther ; 35: 102379, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34087466

RESUMO

BACKGROUND: The aim of this randomized controlled clinical trial was to evaluate the efficacy of indocyanine-green mediated antimicrobial photodynamic therapy (ICG-aPDT) in the treatment of stage III grade C periodontitis in terms of clinical, microbiological, and immune-inflammatory parameters in patients with well-controlled and poorly-controlled form of type-2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Subjects with a diagnosis of chronic periodontitis according to the new classification and case definition of periodontitis [probing depth (PD): ≥6 mm, interdental clinical attachment loss (CAL): ≥5 mm and bone loss extending to mid-third of root and beyond (≥3 mm)] were recruited. Subjects were grouped on the basis of well-controlled and poorly-controlled diabetic status. Two subgroups were made according to the treatment modality (RSD versus ICG-aPDT/RSD) in each group. A split-mouth design was used in which one site was designated for control (RSD alone treatment) while the other contralateral site was chosen for test treatment (ICG-aPDT/RSD) in all the patients. Periodontal parameters included the measurement of plaque score (PS), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) and alveolar bone levels (ABL). Identification of Porphyromonas gingivalis and Tannarella forsythia through PCR was executed using species specific primers. Gingival crevicular fluid samples were then analyzed using enzyme-linked immunosorbent assay for the quantification of interleukin (IL)-17 and interferon (IFN)-γ. All the clinical, microbiological, and immunological parameters were assessed using repeated measure ANOVA for intra and inter-group comparisons. The p-value significance was set at 0.05. RESULTS: The mean age of the 50 patients was 44.7 ± 7.4 years. Systemic parameters suggest no significant change between the times in either HbA1c or serum CRP levels in any of the groups. A statistically significant reduction for BOP was noted for ICG-aPDT group for non-diabetic subjects at 3 months follow up only, while a significant reduction was seen at both 3 months and 6 months among well-controlled and poorly-controlled T2DM subjects (p<0.05). For PD and CAL, a significant improvement was seen for ICG-aPDT group among non-diabetic and well-controlled T2DM subjects at both 3- and 6-months follow up, while a significant reduction was seen at only 3 months among poorly-controlled T2DM subjects. A significant reduction was seen for ICG-aPDT group compared to RSD group for both bacteria in all the three groups at 6 months follow up (p<0.05). CONCLUSION: ICG-aPDT significantly improved clinical and antimicrobial parameters in well-controlled and poorly-controlled T2DM having stage III and grade C periodontitis. Glycemic status did not have negative impact in the reduction of periodontal parameters in either types of T2DM. TRIAL REGISTRATION: The present RCT was registered in the clinicaltrials.gov under the identifier: NCT04857346.


Assuntos
Anti-Infecciosos , Periodontite Crônica , Diabetes Mellitus Tipo 2 , Fotoquimioterapia , Adulto , Anti-Infecciosos/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Raspagem Dentária , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Aplainamento Radicular
16.
Photodiagnosis Photodyn Ther ; 34: 102314, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33932563

RESUMO

BACKGROUND: Limitations of scaling and root planing (SRP) have directed research to utilize additional therapies to enhance conventional techniques. The present systematic review was conducted to evaluate and present a comprehensive overview on effectiveness of antimicrobial photodynamic therapy (aPDT) in the management of aggressive periodontitis (AgP). METHODOLOGY: The PRISMA statement guidelines and Cochrane Collaboration recommendations were followed to conduct this systematic review. The review protocol is registered in PROSPERO (CRD 42019143316). A structured electronic and manual search strategy was implied to gather the relevant published data on in vivo human RCTs from their earliest records until 31st October 2019. Relevant data was extracted from the eligible studies, analysed and impartially appraised for its quality. RESULTS: Eleven papers met the eligibility criteria and included in this review. The data on standardized study protocol, ideal photosensitizer (PS) dye-wavelength combination, optimal parameters was inconclusive and a high risk of bias in majority of the studies noted, which are fundamental in establishing a standardized and replicable protocol. CONCLUSION: Ultimately researchers should conduct well-designed and robust RCTs performed by trained clinicians in order to determine the effectiveness of aPDT, if any, after acknowledging the drawbacks highlighted in this systematic review.


Assuntos
Periodontite Agressiva , Anti-Infecciosos , Periodontite Crônica , Fotoquimioterapia , Periodontite Agressiva/tratamento farmacológico , Anti-Infecciosos/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Terapia Combinada , Raspagem Dentária , Humanos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Aplainamento Radicular
17.
Photodiagnosis Photodyn Ther ; 35: 102349, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34033939

RESUMO

BACKGROUND: Indocyanine green-mediated photodynamic therapy is effective against chronic periodontitis. Here, we evaluated the efficiency of indocyanine green-based adjunctive antimicrobial photodynamic therapy in non-surgical treatment of chronic periodontitis patients. METHODS: Fifty-six periodontally involved teeth of 20 patients were treated with "scaling and root planing" (control group) or "scaling and root planing with indocyanine green-based (perio-green, 0.1 mg/ml) antimicrobial photodynamic therapy" (test group) using a split-mouth design. We performed clinical assessment of probing depth, gingival recession, clinical attachment loss, and other indices, while plaque samples were collected for microbiome analysis. RESULTS: At baseline, periodontal depth and clinical attachment loss were significantly higher in the test group (p < 0.05), and at 1-month post-treatment, we observed a significant favorable reduction of both periodontal depth and clinical attachment loss in test and control sites, with lower means maintained at 3 months (p = 0.01 and p = 0.000, respectively). Additionally, analysis of variance showed significant improvements in periodontal depth and clinical attachment loss in the indocyanine green-antimicrobial photodynamic therapy group (p = 0.001), although not for clinical attachment loss in controls (p = 0.102). Moreover, a significant reduction was observed in test sites for bleeding on probing and residual pocket post-therapy (p = 0.04 and p = 0.0001 respectively). Furthermore, microbiome analysis identified Porphyromonons gingivalis, Treponema, and Tannerella in all samples with favorable changes in test sites (p = 0.07). CONCLUSION: We observed a significant reduction in periodontal clinical parameters (periodontal depth and clinical attachment loss) in chronic periodontitis patients treated with antimicrobial photodynamic therapy as an adjunctive procedure to conventional scaling and root planing. This improvement was associated with periodontal pathogen reduction and increase in the healthy subgingival microbiome.


Assuntos
Anti-Infecciosos , Periodontite Crônica , Fotoquimioterapia , Anti-Infecciosos/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Raspagem Dentária , Humanos , Verde de Indocianina/uso terapêutico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Aplainamento Radicular , Método Simples-Cego
18.
BMC Oral Health ; 21(1): 240, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957902

RESUMO

BACKGROUND: The purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors. One of the drugs that has been tested in many areas and shown good anti-inflammatory properties is erythropoietin (EPO). We evaluated the effect of this drug on the improvement of periodontitis after the phase I treatment. METHODS: This study was conducted on 30 patients with stage III periodontitis who had at least two bilateral teeth with CAL of ≥ 5 mm and PPD ≥ 6 mm at ≥ 2 non-adjacent teeth and bleeding on probing. After oral hygiene instruction and scaling and root planning (SRP), EPO gel containing a solution of 4000 units was applied deeply in the test group and placebo gel was deeply administered in the control pockets (5 times, every other day). The clinical parameters of the plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing depth (PD) and bleeding index (BI) were measured at baseline and after three months of follow up. The P-value was set at 0.05. RESULTS: All clinical variables improved after treatment in both groups. The BI and GI scores (which reflects the degree of gingival inflammation) showed statistically more reduction in test group. The CAL decreased from 5.1 ± 4.1 to 3.40 ± 2.71 mm; and 5.67 ± 4.32 to 4.33 ± 3.19 mm in test and control group, respectively (P < 0.00). After the treatment, there was a significant greater reduction in CAL and also PD values in test group (P < 0.01). CONCLUSION: Local application of EPO gel in adjunct to SRP can improve clinical inflammation and CAL gain in periodontitis. TRIAL REGISTRATION: This study was registered at 2017-11-06 in IRCT. All procedures performed in this study were approved with ID number of IR.TUMS.DENTISTRY.REC.1396.3139 in Tehran University of medical science.


Assuntos
Periodontite Crônica , Eritropoetina , Periodontite , Raspagem Dentária , Eritropoetina/uso terapêutico , Seguimentos , Humanos , Irã (Geográfico) , Perda da Inserção Periodontal , Periodontite/tratamento farmacológico , Aplainamento Radicular , Resultado do Tratamento
19.
J Dent Educ ; 85(10): 1627-1639, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33955000

RESUMO

PURPOSE/OBJECTIVES: Using the periodontal diseases classification published in 2018, this study evaluated the level of agreement among predoctoral and postgraduate students of different education levels and specialties in the diagnosis and treatment planning of periodontal conditions. METHODS: Second-year (D2) and fourth-year (D4) dental students, postgraduate orthodontic students (OS), and periodontology students (PS) were presented with an anonymous survey of 10 cases, each with five choices of diagnosis and seven therapeutic approaches. The cases included a patient summary, photographs, radiographs, periodontal charting, and ranged from health to periodontitis. Consensus diagnosis, used as a gold standard, was established between two experienced periodontists. Diagnosis and treatment choices for each case were compared across educational groups using Fisher's exact test. The level of agreement among educational groups was assessed using a multirater kappa coefficient. RESULTS: The survey was completed in 2020 with a 72.4% overall response rate (57-D2, 45-D4, 17-OS, and 12-PS). The overall level of agreement on diagnosis was fair (κ = 0.24, p <.0001) with PS showing the most agreement (κ = 0.55, p <.0001). There were tendencies to prioritize stage over grade and extent in assigning diagnoses and to overdiagnose disease severity and underdiagnose localized periodontitis. Nonsurgical periodontal therapies had the highest overall agreement (κ = 0.63 for scaling/root planing and κ = 0.44 for maintenance, p <.0001). Response distribution per case and per level of education indicated that PS more consistently agreed with the gold standard than any other group. CONCLUSIONS: OS, D2, and D4 students demonstrated inferior agreement levels compared to PS, successfully recognized health from disease, suggested appropriate treatment plans, and tended to overdiagnose milder periodontal conditions.


Assuntos
Doenças Periodontais , Raspagem Dentária , Educação em Odontologia , Humanos , Doenças Periodontais/diagnóstico , Doenças Periodontais/terapia , Periodontia , Aplainamento Radicular
20.
BMC Oral Health ; 21(1): 239, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952216

RESUMO

BACKGROUND: The gold standard in treatment of periodontitis is mechanical removing of dental biofilm but using local delivery drugs as adjunctive to SRP is widely used to modulate inflammatory host and eradicate microbes. Tea tree oil (TTO) has a broad-spectrum antimicrobial, anti-inflammatory, antifungal, antiviral, antioxidant effect. This study aimed to assess clinically and biochemically the effect of intrapocket application of TTO (Melaleuca alternifolia) gel adjunctive to scaling and root planing (SRP) in the treatment of stage 2 (moderate) periodontitis and to correlate the biochemical levels with clinical response. METHODS: A randomized, controlled clinical trial was conducted on thirty patients with stage 2 periodontitis. Patients were equally divided into two groups: Control Group treated with (SRP) alone and Test Group treated with SRP and locally delivered 5% TTO gel. Clinical assessment included pocket probing depth (PPD), clinical attachment loss (CAL), gingival index (GI) and bleeding on probing (BOP) measured at baseline and after 3 and 6 months. The level of matrix metalloproteinase-8 (MMP-8), in the gingival crevicular fluid (GCF) was also assessed at baseline and after1, 3 and 6 months by Enzyme-linked immunosorbent assay (ELISA) kit. Chi-square, Student t- tests, Mann-Whitney U test and Spearman correlation were the statistical tests used in the study. RESULTS: An improvement of all clinical and biochemical parameters was observed (at p < 0.001) in both groups. A significant difference between the two groups was found in both clinical and biochemical parameters. CONCLUSION: The local delivery of TTO gel adjunctive to SRP proved to be effective in the treatment of stage II periodontitis. Trial registration The study was retrospectively registered at clinicaltrials.gov NCT04769271, on 24/2/2021.


Assuntos
Periodontite Crônica , Periodontite , Óleo de Melaleuca , Periodontite Crônica/tratamento farmacológico , Raspagem Dentária , Líquido do Sulco Gengival , Humanos , Periodontite/tratamento farmacológico , Aplainamento Radicular , Óleo de Melaleuca/uso terapêutico
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