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1.
Oral Health Prev Dent ; 18(1): 889-910, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33215481

RESUMO

PURPOSE: To evaluate the efficacy of adjunctive aids to scaling and root planing (SRP) on clinical outcomes in treating periodontal patients included in regular periodontal maintenance programs. MATERIALS AND METHODS: The electronic databases MEDLINE (Pubmed), EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for relevant articles published up to 1st January, 2020. Randomised controlled clinical trials of SRP with or without the use of adjuncts and published in English were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. RESULTS: Nineteen studies were included in the systematic review and sixteen in the meta-analysis. The overall effect of adjunctive aids was statistically significant for reduction in probing depth (PD) (0.376 mm, 95% CI [0.144 to 0.609]) and clinical attachment level (CAL) gain (0.207 mm, 95% CI [0.0728 to 0.340]). No statistically significant differences were observed for changes in bleeding on probing (BOP) (p > 0.05). Among the different adjuncts, statistically significant positive effects were demonstrated for adjunctive photodynamic therapy (PD reduction 0.908 mm, 95% CI [0.227 to 1.589] and CAL change (0.457 mm, 95% CI [0.133 to 0.782]) and tetracycline fibers (PD reduction 0.534 mm, 95% CI [0.290 to 0.778] and CAL gain 0.280 mm, 95% CI [0.0391 to 0.521]). CONCLUSIONS: Despite high heterogeneity of the investigated data, based on the findings of a current systematic review, adjunctive aids (in particular, photodynamic therapy and tetracycline fibers) combined with SRP provide statistically significant clinical benefits compared to SRP alone. Due to the large number of included studies with high risk of bias, future studies should be based on adequate methodological procedures to improve the overall quality of reporting and to reduce the risk of bias.


Assuntos
Periodontite Crônica , Raspagem Dentária , Antibacterianos/uso terapêutico , Terapia Combinada , Assistência Odontológica , Humanos , Aplainamento Radicular
2.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(5): 532-536, 2020 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-33085237

RESUMO

OBJECTIVE: To evaluate the efficacy of scaling and root planing (SRP) with a periodontal endoscope in the treatment of residual pockets in patients with periodontitis after initial periodontal therapy. METHODS: Patients with residual pockets [probing depth (PD)≥5 mm] were included and randomly assigned to the endoscope group (SRP with a periodontal endoscope) or SRP group (SRP alone). The PD, attachment loss (AL), and bleeding on probing (BOP) of residual pockets were recorded before treatment and at 3 and 6 months after treatment. Data were analyzed with SPSS 20.0 software. RESULTS: Compared with the baseline values, the percentage of PD≥5 mm sites, PD, AL, and BOP (+)% in the endoscope group and SRP group at 3 and 6 months after treatment decreased (P<0.05). Compared with the values at 3 months after treatment, the percentage of PD≥5 mm sites, PD, AL, and BOP (+)% at 3 and 6 months after treatment decreased in the endoscope group (P<0.05), whereas no statistical difference in these values was observed in the SRP group (P>0.05). Compared with those in the SRP group, the percentage of PD≥5 mm sites and PD at 3 and 6 months after treatment and AL and BOP (+)% at 6 months after treatment in the endoscope group decreased (P<0.05). CONCLUSIONS: SRP with a periodontal endoscope shows a better effect in improving the PD, AL, and BOP of residual pockets (PD≥5 mm) in patients with periodontitis after initial periodontal therapy and has advantages in improving the long-term curative effect of this therapy.


Assuntos
Raspagem Dentária , Periodontite , Assistência Odontológica , Endoscópios , Humanos , Aplainamento Radicular
3.
J Int Acad Periodontol ; 22(4): 187-204, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32980832

RESUMO

AIMS: To systemically review the literature on the effect of hand and sonic/ultrasonic instruments used for the non-surgical treatment of periodontitis. MATERIALS AND METHODS: Five databases were searched for randomized clinical trials that compared the results of periodontal treatment using hand and sonic/ultrasonic for nonsurgical periodontal treatment. Four meta-analyses were performed, using the calculated mean differences (MD) between baseline and 3-months or 6-months after periodontal treatment for clinical attachment level (CAL), and probing pocket depth (PPD). RESULTS: Eighteen studies were included. All included studies showed significant improvement, in at least one periodontal parameter, in both tested periodontal therapies. The sonic/ultrasonic instruments spend significantly less time in comparison to manual instrumentation. At both 3- and 6-months after periodontal therapy, no statistically significant differences were detected for CAL gain between therapies (MD; 95%CI: 0.05; -0.21-0.30 and -0.23; -0.59-0.12). Similarly, no statistically significant differences were detected for PPD reduction between therapies at 3-months of follow-up (MD; 95%CI: -0.03; -0.34-0.28). After 6-months, the PPD reduction was 0.21 (95%CI: -0.43-0.00, p=0.05). CONCLUSION: Similar results may be expected for the periodontal treatment performed with hand and sonic/ultrasonic instruments. However, further studies with lower risk of bias are warranted.


Assuntos
Raspagem Dentária , Periodontite , Mãos , Humanos , Aplainamento Radicular , Ultrassom
4.
Int J Periodontics Restorative Dent ; 40(5): e205-e209, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32926006

RESUMO

During a scaling and root planing procedure, a large, actively germinating seed was removed from a deep periodontal pocket. The histologic examination confirmed that it was a germinating tomato seed (Solanum lycopersicum). Since all seeds inside their fruits are in a quiescent stage, this seed was quiescent when the patient ate the tomato. Therefore, the germination occurred inside the periodontal pocket. This case led to a very interesting biologic finding: A periodontal pocket is not only a favorable environment for the development of periodontal microbiota, it is also an ecologic niche that can promote the germination and development of a plant seed.


Assuntos
Germinação , Lycopersicon esculentum , Humanos , Bolsa Periodontal , Aplainamento Radicular , Sementes
5.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 385-392, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865356

RESUMO

OBJECTIVE: To evaluate the effect of scaling and root planing (SRP) on serum C-reactive protein (CRP) levels in patients with moderate to severe chronic periodontitis. METHODS: We searched the PubMed, Web of Science, EMBASE, Cochrane, CNKI, Wanfang, and VIP databases from the inception to July 8th, 2019. Two reviewers independently screened literature, extracted data, and evaluated the bias risk of included studies. Then, a meta-analysis was performed using RevMan 5.3 software. RESULTS: A total of 13 randomized controlled clinical trials and 12 prospective clinical trials were included. Meta-analysis showed that serum CRP levels decreased at 2 and 3 months after SRP (P<0.05), and no significant difference in serum CRP levels was found at 6 months (P=0.49). CONCLUSIONS: SRP can reduce serum CRP levels in systematically healthy patients with moderate to severe chronic periodontitis at 2 and 3 months after SRP.


Assuntos
Periodontite Crônica , Proteína C-Reativa , Raspagem Dentária , Humanos , Estudos Prospectivos , Aplainamento Radicular
6.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 393-397, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865357

RESUMO

OBJECTIVE: To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis. METHODS: Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded. RESULTS: The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P<0.05), but no significant difference in BOP was found between the two groups. The decrease in PD, BOP in group B2 was more obvious than those in group A2 (P<0.000 1), and the GR values in group B2 were more than those in group A2 (P<0.000 1). But the improvement of AL showed no statistical difference between the two groups (P=0.296 8). In group C1, no significant difference in PD, AL, and GR was observed after endoscopy-assisted therapy, but it was more effective for BOP (P<0.000 1). In group C2, the improvement in PD and AL was significantly different from the improvement in SRP alone (P=0.000 5, P=0.000 2) and was accompanied by more GR (P=0.000 5). CONCLUSIONS: In non-surgical treatment of severe and generalized periodontitis, SRP can achieve good therapeutic effect on sites with 46 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.


Assuntos
Raspagem Dentária , Periodontite , Endoscópios , Seguimentos , Hemorragia Gengival , Humanos , Perda da Inserção Periodontal , Índice Periodontal , Bolsa Periodontal , Aplainamento Radicular , Resultado do Tratamento
7.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(5): 723-726, 2020 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-32897208

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of ultrasound subgingival scaling combined with manual root planing for treatment of chronic periodontitis in elderly patients. METHODS: Forty elderly patients with chronic periodontitis were randomly divided into test group for treatment with ultrasound and Gracey subgingival curette for subgingival scaling combined with manual root planing and control group treated with ultrasound subgingival curette scaling (n=20). We compared plaque index (PLI), bleeding index (BI), probing depth (PD), and attachment loss (AL) between the two groups before and at 6 weeks and 12 weeks after the treatment. RESULTS: After periodontal treatment, PLI, BI, PD and AL all decreased significantly in both groups compared with the levels before the treatment (P < 0.05). The patients in the test group showed significantly more obvious decrease of PD and AL than those in the control group (P < 0.05), but the reduction of PLI and BI was comparable between the two groups (P>0.05). CONCLUSIONS: Ultrasound subgingival scaling combined with manual root planing produces better therapeutic effect than ultrasonic subgingival scaling alone for treatment of chronic periodontitis in elderly patients.


Assuntos
Periodontite Crônica , Idoso , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Aplainamento Radicular , Resultado do Tratamento , Ultrassonografia
8.
Arch Oral Biol ; 117: 104825, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32622257

RESUMO

OBJECTIVE: The aim of this study was to evaluate the effects of Lactobacillus reuteri applied locally or systemically with scaling and root planing (SRP) to the treatment of experimental periodontitis (EP) in rats treated with 5-fluorouracil. METHODS: A cotton ligature was installed on the molars of rats. The animals (n = 54) underwent chemotherapy and were divided into groups: SRP (n = 18), scaling and root planing only; LP (n = 18), SRP and 4 sessions of local probiotic (PRO); SP, SRP and 4 sessions of systemic PRO. The molar furcation area was submitted to histopathological, histometric of alveolar bone loss (ABL) and immunolabeling analysis after euthanasia at 7, 15 and 30 days. The data were submitted to statistical analysis (α = 5%). RESULTS: At 15 days ABL was higher in LP compared to SP. At 30 days, ABL was higher in LP compared to SRP and SP. Higher immunolabeling of TGF-ß1 was observed in LP and SP at 7 days compared to SRP (p < 0.05). Lower immunolabeling of OCN and higher immunolabeling of RANKL were observed at all periods in SRP compared to SP (p < 0.05). At 30 days, SRP showed lower immunolabeling of OPG compared to SP and LP (p < 0.05). In SP, lower immunolabeling was observed at 15 days compared at 30 days (p < 0.05). CONCLUSION: The ABL was similar among the groups treated with SRP associated or not to probiotic therapeutic, although the systemic use of Lactobacillus reuteri considerably reduced inflammation and favored periodontal tissues repair.


Assuntos
Raspagem Dentária , Lactobacillus reuteri , Periodontite , Aplainamento Radicular , Animais , Fluoruracila/farmacologia , Periodontite/terapia , Ratos
9.
J Contemp Dent Pract ; 21(5): 494-499, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32690830

RESUMO

AIM: This study aimed to compare the effects of subgingival delivery of 2% curcumin gel and 0.2% chlorhexidine gel as an adjunct to scaling and root planing (SRP) on clinical and microbiological parameters in the management of patients with chronic periodontitis. MATERIALS AND METHODS: In total, 25 systemically healthy individuals with age group ≥30 years diagnosed with chronic periodontitis were included in the study. The study was a double-blind split-mouth randomized control clinical trial. Two sites were selected in each patient and were randomly allocated to experimental and control sites. At baseline, measurements of site-specific periodontal parameters and collection of subgingival plaque sample were done. After full-mouth SRP, subgingival delivery of 2% curcumin gel in experimental sites and 0.2% chlorhexidine gel in control sites was done. At 1 and 3 months, subgingival plaque samples were collected again and site-specific periodontal parameters were measured. RESULTS: The experimental group (2% curcumin gel) showed statistically significant improvements in periodontal [i.e., sulcus bleeding index (SBI), probing pocket depth (PPD), and relative attachment level (RAL)] and microbiologic parameters in the form of colony-forming units (CFUs) in comparison with control group (0.2% chlorhexidine gel). CONCLUSION: Subgingival delivery of curcumin has shown effective anti-inflammatory and antibacterial properties. Since it is biologically accepted by the patients and its delivery in periodontal pockets can be recommended as an adjunct to SRP therapy for the treatment of patients with localized, moderate chronic periodontitis and in patients under the periodontal maintenance phase. CLINICAL SIGNIFICANCE: Curcumin being a herbal agent may be excellent alternative to chlorhexidine. It is biologically accepted by the patients and can be recommended as an adjunct to SRP in the treatment of localized moderate chronic periodontitis and periodontal maintenance patients.


Assuntos
Anti-Infecciosos Locais , Periodontite Crônica , Curcumina , Clorexidina , Raspagem Dentária , Humanos , Aplainamento Radicular
10.
J Contemp Dent Pract ; 21(4): 410-415, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584278

RESUMO

AIM: The aim of this article was to determine the effect of nonsurgical periodontal therapy on clinical parameters and also to evaluate serum level of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in chronic periodontitis patients with and without hypothyroidism. MATERIALS AND METHODS: Subjects were 40 female patients (20 systemically healthy subjects with chronic periodontitis and 20 subjects with hypothyroidism and chronic periodontitis). Clinical parameters like plaque score, gingival score, gingival recession, probing pocket depth, and clinical attachment level were recorded at baseline and 4 weeks after nonsurgical periodontal therapy. Nonsurgical periodontal therapy included oral hygiene instructions and full-mouth scaling and root planing. A total of 5 mL of venous blood sample was collected from each subject at baseline and 4 weeks after nonsurgical periodontal therapy. RESULTS: The clinical parameters and biochemical parameters like IL-6 and TNF-α in both groups showed pronounced reduction at the end of 4 weeks following nonsurgical periodontal therapy. However, simultaneous comparison of clinical and biochemical parameters between the two groups was not statistically significant. CONCLUSION: This study provides evidence that nonsurgical periodontal therapy contributes to reduction in serum level of IL-6 and TNF-α in systemically healthy subjects with chronic periodontitis and subjects with hypothyroidism and chronic periodontitis. CLINICAL SIGNIFICANCE: The prevalence of periodontitis as well as hypothyroidism is increasing nowadays. Interleukin-6 and TNF-α are found to play a significant role in pathobiology of both periodontitis and hypothyroidism. With the treatment of periodontitis, it is found that there is improvement in periodontal and thyroid status of the patients. So, it is an alert to health professionals about the relation of hypothyroidism and periodontitis so that they consider a multidisciplinary approach.


Assuntos
Periodontite Crônica , Hipotireoidismo , Índice de Placa Dentária , Raspagem Dentária , Feminino , Líquido do Sulco Gengival/química , Humanos , Interleucina-6 , Perda da Inserção Periodontal , Bolsa Periodontal , Aplainamento Radicular , Fator de Necrose Tumoral alfa
11.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(3): 290-296, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32573137

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use. METHODS: Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies. RESULTS: Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group. CONCLUSIONS: CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.


Assuntos
Periodontite Crônica/tratamento farmacológico , Claritromicina , Antibacterianos/uso terapêutico , Raspagem Dentária , Humanos , Índice Periodontal , Aplainamento Radicular , Resultado do Tratamento
12.
Swiss Dent J ; 130(7-8): 572-583, 2020 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-32515568

RESUMO

The aim of this systematic review was to compare the combination of amoxicillin and metronidazole or azithromycin when used as adjunct systemic antibiotics during the non-surgical periodontal therapy of chronic periodontitis. The databases Medline, Embase, Cochrane and Biosis were electronically searched. Additionally, a hand search was conducted up to24 October 2019. From 76 papers, only two papers could be included in the analysis. The calculated mean probability of having probing depth (PD) ≤ 3 mm after non-surgical periodontal therapy in moderate (4-6 mm) and deep (> 6 mm) pockets accounted for 7% and 6% for the combination of amoxicillin and metronidazole. For azithromycin it was 3% and 1%, respectively. The mean probability of persisting pockets ≥ 5 mm was 0 for moderate pockets with both antibiotic therapies whereas for deep pockets therapy with amoxicillin and metronidazole seems slightly lower. On the basis of two studies included in this systematic review, azithromycin as an adjunct to scaling and root planing in the non-surgical adjunctive treatment of chronic periodontitis seems to provide clinical results similar to the combination of amoxicillin and metronidazole. On behalf of patients' compliance and well-being, the use of azithromycin as an adjunct to non-surgical periodontal therapy of chronic periodontitis may be a substitute to amoxicillin and metronidazole. However, interpretation should be taken with caution, since the results are based on two studies only; thus, further clinical trials are necessary to underline or refute this trend.


Assuntos
Amoxicilina , Metronidazol , Antibacterianos/uso terapêutico , Azitromicina , Raspagem Dentária , Humanos , Aplainamento Radicular
13.
Clin Oral Investig ; 24(6): 1877-1888, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32399735

RESUMO

OBJECTIVE: This systematic review (SR) aimed at assessing the adjunctive clinical effect of ozone therapy (OT) on nonsurgical periodontal treatment. MATERIALS AND METHODS: Articles published prior to September 2019 were electronically searched in four databases without any other date or language restrictions and manually searched in regular journals and in gray literature. This review was performed according to the PICO format. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the adjunctive effect of OT on nonsurgical periodontal treatment. RESULTS: Twelve studies published between 2010 and 2019 were included in this SR. A metaanalysis of ten reports showed that there was no statistically significant difference in the periodontal parameters analyzed when scaling and root planing (SRP) plus sulcus irrigation with ozonated water or sulcus insertion of ozonated gas were used when compared to SRP alone. Additionally, there was no significant difference when the effect of SRP plus ozonated water was compared with SRP plus 2% chlorhexidine gluconate (CLX). No studies reported significant microbiological differences when the use of ozone was compared with SRP alone. CONCLUSIONS: The results of this SR do not support the use of OT for nonsurgical periodontal treatment. However, due to the potential heterogeneity across the studies, the presence of confounding factors, and the short follow-up of some included RCTs, these results should not be considered definitive. CLINICAL RELEVANCE: The current evidence indicates that ozone has antimicrobial activity and good biocompatibility with periodontal cells and gingival fibroblasts. However, no evidence was found for a positive effect of OT as an adjunct to scaling and root planing.


Assuntos
Periodontite Crônica , Ozônio , Aplainamento Radicular , Periodontite Crônica/terapia , Terapia Combinada , Raspagem Dentária , Ozônio/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
BMC Oral Health ; 20(1): 143, 2020 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32418540

RESUMO

BACKGROUND: Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planning (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. METHODS: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. RESULTS: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. CONCLUSIONS: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Raspagem Dentária , Periodontite/tratamento farmacológico , Aplainamento Radicular , Adulto , Antibacterianos/uso terapêutico , Humanos , Resultado do Tratamento , Adulto Jovem
15.
J Contemp Dent Pract ; 21(2): 156-160, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381820

RESUMO

AIM: The aim of this study was to observe the effects of coenzyme Q10 (CoQ10) in patients with localized periodontitis and place Sticky Bone™ in defects not resolved in the test or control group. MATERIALS AND METHODS: A total of 30 patients with periodontitis of pocket depth ≥5 mm were randomly divided into test and control groups, each comprising 25 sites, where CoQ10 was placed in the test group and methyl cellulose in the control group; all the parameters were recorded, and patients were followed up for 12 months. At the end of 12 months, patients who did not respond to subgingival placement of CoQ10 were treated surgically where Sticky Bone™ was placed and further followed up for 6 months. RESULTS: There was significant difference between plaque index (PI), gingival index (GI), and probing pocket depth (PPD) at baseline and 1 month, and there was an increase in values of PI and PPD seen at 6 months and significant increase in values of GI, PI, and PPD seen at 12 months, and no significant difference in values was seen at 12 months and baseline. CONCLUSION: Coenzyme Q10 does not aid in the treatment of periodontitis. CLINICAL SIGNIFICANCE: Clinically, it shows that CoQ10 has no role to play in the cases of periodontitis. In such cases, without delay patients should be taken up for periodontal flap surgery after complete scaling and root planning (SRP), if the pocket does not resolve.


Assuntos
Periodontite Crônica , Índice de Placa Dentária , Raspagem Dentária , Humanos , Aplainamento Radicular , Ubiquinona/análogos & derivados
16.
J Contemp Dent Pract ; 21(3): 280-284, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32434975

RESUMO

AIM: The present study aimed to assess the use of various local drug delivery systems in the management of chronic periodontitis. MATERIALS AND METHODS: A total of 60 patients aged around 30-55 years were included. The subjects who were enrolled under took a phase I therapy that included scaling and root planing (SRP). Patients who satisfied the conditions for selection to enter the trial were assigned randomly to three groups, with each group consisting of 20 participants as follows: group I: controlled-release drugs-chlorhexidine gel, group II: metronidazole gel, group III: tetracycline fibers. The plaque index (PI), gingival index (GI), and periodontal pocket depth (PPD) were recorded after 1st week as the baseline data and were recorded again after 15 days and 30 days post-baseline. RESULTS: The mean GI scores were 1.32 ± 0.10, 0.88 ± 0.16, and 0.76 ± 0.12, at baseline, 15 days, and 30 days, respectively, in group I. In group II, the mean GI score reduced to 1.09 ± 0.83 at 30 days from 1.48 ± 0.27 at baseline. Likewise, in group III the mean GI score reduced to 0.90 ± 0.62 at 30 days from 1.38 ± 0.06 at baseline. All the groups demonstrated a statistically significant difference at various intervals. The mean PI score decreased to 0.90 ± 0.78 at 15 days from 1.46 ± 0.22 at baseline in group III. A statistically significant difference at different intervals was seen in group III only. In all groups, the intergroup comparison of PPD was found to be statistically significant. CONCLUSION: This study demonstrated that although thorough SRP is an effective treatment method for elimination of chronic periodontal pockets, improved results can be obtained by adjunctive use of locally administered chlorhexidine gel, metronidazole gel, and tetracycline fibers. CLINICAL SIGNIFICANCE: The use of the adjunctive local drug delivery system along with mechanical cleansing in the treatment of periodontal pockets in chronic periodontitis is therapeutically beneficial.


Assuntos
Periodontite Crônica , Adulto , Raspagem Dentária , Sistemas de Liberação de Medicamentos , Humanos , Pessoa de Meia-Idade , Bolsa Periodontal , Aplainamento Radicular
17.
Indian J Dent Res ; 31(2): 229-235, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32436902

RESUMO

Background: : Periodontitis is conventionally treated with both surgical and nonsurgical methods. Various adjuncts have been used previously with compromised efficacy. Recently omega-3(ώ-3) polyunsaturated fatty acids (PUFA) including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) were shown to have therapeutic anti-inflammatory and protective actions in inflammatory diseases including periodontitis. The purpose of the present study was to evaluate and compare the clinical efficacy of ώ-3 fatty acids as an adjunct to scaling and root planing in the treatment of periodontitis. Methods: 110 Patients were selected for the study out of which 20 were excluded (12 not meeting the inclusion criteria and 8 refused to participate). 90 patients (48 in test and 42 in the control group) after randomisation through a coin toss method were enrolled in a single-blind randomised controlled trial conducted in the Periodontics department of a dental college. Full mouth subgingival scaling and root planing and ώ-3 fatty acid 500 mg (EPA/DHA 180/120 mg), BD daily for 1 month was given to the test group and subgingival scaling and root planing only was given to the control group. Clinical parameters like probing pocket depth, clinical attachment level, plaque index and gingival index were recorded at baseline, 1 and 3 months and were compared. Results: Statistical analyses demonstrated a significant reduction in probing pocket depth (t = 65.56, P = 0.000) and (t = 51.69, P = 0.000) at 1 and 3 months, respectively, in test group compared to baseline and control group. There was a significant gain in clinical attachment level (t = 63.29, P = 0.000) and (t = 31.03, P = 0.000) at 1 and 3 months, respectively, in test group compared to baseline and control group. The gingival index shows an appreciable reduction in both groups, and in test group, it is statistically significant at 3 months (t = 2.15, P = 0.03). There was no statistical significant reduction in plaque index at 3 months (t = 0, P = 0.997). Conclusion: The present study showed that adjunctive use of ώ-3 fatty acids proved to be beneficial over scaling and root planing alone in the treatment of chronic moderate periodontitis. The beneficial effects were in terms of significant improvements in clinical parameters, probing pocket depth, and clinical attachment level and gingival index. Dietary modulation is now emerging as an adjunct to periodontal therapy. Hence, omega-3 fatty acid may be used routinely in the management of chronic periodontitis.


Assuntos
Periodontite Crônica , Ácidos Graxos Ômega-3 , Índice de Placa Dentária , Raspagem Dentária , Humanos , Perda da Inserção Periodontal , Bolsa Periodontal , Aplainamento Radicular , Método Simples-Cego , Resultado do Tratamento
18.
Lasers Med Sci ; 35(6): 1403-1410, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32193820

RESUMO

Bactericidal and detoxification effects of diode laser (DL) have been reported in periodontal treatment. The objective of this study was investigating the additional effect of DL with nonsurgical periodontal treatment on the red complex bacteria in type 2 diabetes mellitus (DM) patients with chronic periodontitis (CP). Sixty type 2 DM patients with chronic periodontitis (CP) were randomly assigned in two parallel groups to receive scaling root planning (SRP, n = 30) or SRP followed by DL periodontal pocket irradiation (SRP + DL, n = 30). Recording of clinical parameters and subgingival plaque sampling were performed at baseline, and post therapy (1 and 3 months after treatment). Amounts of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia were evaluated with quantitative RT-PCR. Significant reductions for numbers of all three bacterial species were observed at 1 and 3 months compared with baseline for both treatments (p < 0.001), but no significant differences were found between two groups regarding bacterial reductions at these follow-up time points. No additional benefit of DL as an adjunct to nonsurgical periodontal therapy was recognized in the reduction of P. gingivalis, T. denticola, and T. forsythia for type 2 DM patients with CP. Further studies are required to clarify the effects of diode laser on the other periodontopathogens.


Assuntos
Periodontite Crônica/microbiologia , Periodontite Crônica/cirurgia , Diabetes Mellitus Tipo 2/complicações , Lasers Semicondutores/uso terapêutico , Adulto , Periodontite Crônica/tratamento farmacológico , Contagem de Colônia Microbiana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Porphyromonas gingivalis/crescimento & desenvolvimento , Porphyromonas gingivalis/efeitos da radiação , Aplainamento Radicular
19.
J Periodontol ; 91(10): 1307-1317, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32146720

RESUMO

BACKGROUND: The purpose of this prospective study was to compare the changes in periodontal somatosensory function and microcirculation in patients with periodontitis following initial treatment with scaling and root planing (SRP) with or without adjuvant laser therapy. METHODS: Twenty-four patients suffering from periodontitis were recruited and randomly allocated into a split-mouth design to either SRP combined laser therapy side (test side) or SRP only side (control side). All treatments were performed by the same investigator at a single visit. Laser Doppler Flowmetry (LDF) and Quantitative Sensory Testing (QST) were performed at baseline (W0), 1 week (1W), 2 weeks (2W), and 4 weeks (4W) after treatment on both sides of the attached gingiva of the maxillary lateral incisor. Clinical examination including probing depth (PD) and bleeding on probing (BOP) was performed at W0, 2W, and 4W on both sides. Data were analyzed with two-way analysis of variance. RESULTS: PD and BOP significantly improved after treatment (P <0.001). LDF values were significantly decreased on both sides at all follow-up time points (P <0.001), temperature was increased only on the test side (P = 0.017) whereas there was no significant change on the control side (P = 0.792). Significantly less sensitivity was observed for all QST parameters (P <0.030) except for warmth detection after treatment. CONCLUSION: Adjunctive use of laser therapy did not provide any significant clinical advantage or additional effects on the recovery of periodontal somatosensory function or gingival microcirculation in the present study.


Assuntos
Periodontite Crônica , Terapia a Laser , Lasers de Estado Sólido , Periodontite , Periodontite Crônica/radioterapia , Raspagem Dentária , Seguimentos , Humanos , Índice Periodontal , Bolsa Periodontal , Periodontite/terapia , Estudos Prospectivos , Aplainamento Radicular , Resultado do Tratamento
20.
J Oral Sci ; 62(2): 189-196, 2020 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-32132326

RESUMO

Studies suggest that analysis of gingival crevicular fluid (GCF) is useful for evaluating periodontal status. In this study, clinical variables related to tooth mobility, and multiple cytokine levels in proximate GCF, were measured at four time points during initial periodontal treatment: before treatment (baseline), after supragingival scaling, after occlusal adjustment, and after scaling and root planing (SRP); 20 teeth from 13 patients with periodontitis were included. Baseline interleukin (IL)-10 level in GCF was significantly higher around teeth that showed substantial improvement in periodontal epithelial surface area (PESA) after SRP than around teeth without PESA improvement. IL-3 and IL-16 levels in GCF at baseline were significantly higher around teeth with a periodontal inflamed surface area (PISA) of 0 mm2 after SRP than around teeth without PISA improvement. In addition, baseline IL-7, IL-11, and IL-12p40 levels in GCF were significantly lower around teeth with decreased mobility after occlusal adjustment than around teeth without decreased mobility. These results suggest that pre-treatment cytokine levels in GCF are useful in predicting the effects of initial periodontal treatment.


Assuntos
Líquido do Sulco Gengival , Periodontite , Raspagem Dentária , Humanos , Aplainamento Radicular
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