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1.
BMC Oral Health ; 20(1): 364, 2020 12 29.
Artigo em Inglês | MEDLINE | ID: mdl-33372602

RESUMO

BACKGROUND: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. METHODS: Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. RESULTS: In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. CONCLUSIONS: Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. CLINICAL RELEVANCE: The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL .


Assuntos
Eritritol , Periodontite , Raspagem Dentária , Humanos , Bolsa Periodontal/tratamento farmacológico , Periodontite/tratamento farmacológico , Pós
2.
Rev. ADM ; 77(5): 267-271, sept.-oct. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1147148

RESUMO

Introducción: El ozono (O3) presenta múltiples acciones biológicas, entre ellas su efecto antimicrobiano, lo que ha sido beneficioso en odontología, siendo la presentación acuosa la más utilizada (20 µg/ mL), la cual presenta efectos similares a la clorhexidina. Reporte de caso: Paciente masculino de 76 años de edad, diagnosticado con periodontitis crónica moderada localizada, el cual fue tratado mediante ozonoterapia acuosa durante la fase inicial periodontal y la fase quirúrgica en colgajo por debridación. 12 semanas posteriores al acto quirúrgico se obtuvo la eliminación de las bolsas periodontales, encontrándose un surco de 3 y 2 mm y un buen control de placa dentobacteriana. Conclusión: No existen reportes acerca del uso de ozonoterapia acuosa durante un colgajo por debridación. El éxito del tratamiento periodontal consiste en la eliminación del factor causal así como en establecer y mantener un control de placa dentobacteriana adecuado (AU)


Introduction: Ozone (O3) has multiple biological actions, including its antimicrobial effect, which has been beneficial in dentistry, the aqueous presentation being the most used (20 µg/mL), which has similar effects to chlorhexidine. Case report: Male patient of 76 years of age, diagnosed with localized moderate chronic periodontitis, which was treated by aqueous ozone therapy during the initial periodontal phase and surgical phase in debridement flap. Twelve weeks after surgery, the periodontal pockets were eliminated, finding a 3 and 2 mm groove and good control of dentobacterial plaque. Conclusion: There are no reports about the use of aqueous ozone therapy during a debridement flap. The success of the periodontal treatment consists in the elimination of the causal factor, as well as establishing and maintaining an adequate control of plaque (AU)


Assuntos
Humanos , Masculino , Idoso , Ozônio/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Bolsa Periodontal/tratamento farmacológico , Retalhos Cirúrgicos , Periodontite Crônica/cirurgia , Desbridamento Periodontal/métodos
3.
J Biol Regul Homeost Agents ; 34(3 Suppl. 1): 91-98, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32618165

RESUMO

Periodontal treatment has the aim to reduce oral infection and prevent the progression of the disease. The potential benefits of new therapy with Ozonline® for periodontal treatment, include improved patient compliance and an easier access to periodontal pocket. The objective of this study was to explore the efficacy of Ozonline® in the treatment of chronic periodontitis in adult patients. A randomized controlled split-mouth study was carried out in ten patients (5 men and 5 women age 42-73 mean 55 ±7) with a diagnosis of chronic periodontitis. None of these patients received any surgical or non-surgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. The mouth has been divided into upper right and left quadrants. The upper and lower right quadrants were treated with ultrasonic scaler, the left quadrants with ultrasonic scaler with ozonated water (Ozonline®). 10 microbiological samples were collected from upper left quadrants and 10 from upper right quadrants from each patient. Microbiological samples were collected from the sites of the patients at baseline and at the 7th day. 20 localized chronic periodontitis sites were selected (10 in left quadrants and 10 in right quadrants). After the treatment with Ozonline®, a remarkable decrease in bacteria amount, both for some species and for the total count was observed in the left quadrants respect to right ones. Specifically, T. forsythia and T. denticola were eradicated whereas Total Bacteria Loading and Fusobacterium nucleatum showed a reduction of 38% and 55%, respect to right quadrants. Our study demonstrated the efficacy of the Ozonline® in the management of moderate to severe chronic periodontitis. .


Assuntos
Periodontite Crônica , Ozônio/uso terapêutico , Adulto , Idoso , Periodontite Crônica/tratamento farmacológico , Raspagem Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Bolsa Periodontal/tratamento farmacológico
4.
Quintessence Int ; 51(8): 612-621, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32507863

RESUMO

OBJECTIVE: Adjunctive antimicrobials improve probing depth and clinical attachment loss compared with subgingival debridement (SD) alone in patients with aggressive periodontitis. The microbiologic and clinical effectiveness of moxifloxacin (MOX) and amoxicillin plus metronidazole (AMOX+ME) as adjunctive therapies for generalized aggressive periodontitis were compared. METHOD AND MATERIALS: This pilot randomized controlled clinical trial included 36 patients who were assigned to one of three therapy groups: SD plus systemic MOX (400 mg QD for 7 days), SD plus systemic AMOX+ME (500 mg TID each for 7 days), or SD plus placebo. Probing depth, clinical attachment loss, bleeding on probing, and plaque were recorded at baseline and 3 and 6 months after treatment. Subgingival plaque samples were analyzed. RESULTS: All treatments resulted in significant probing depth and clinical attachment loss reduction compared with the baseline values (P < .0001 for all), with the effects still present at 6 months posttreatment, but the patients taking antibiotic protocols presented the most significant gains (P < .0001). There was a significant reduction in the occurrence of gingival pockets ≥ 6 mm at 6 months in all treatment groups (P < .0001), favoring the MOX and AMOX+ME groups. Adjunctive MOX diminished subgingival Aggregatibacter actinomycetemcomitans to unnoticeable stages, after the follow-up period. Adverse events were noted only in some patients of the AMOX+ME group. CONCLUSIONS: This pilot clinical trial proposes that using MOX and AMOX+ME as adjuncts to SD improves the clinical and microbiologic parameters in comparison to mechanical therapy alone; however, the MOX protocol did not cause adverse events and decreased subgingival A actinomycetemcomitans to imperceptible levels.


Assuntos
Periodontite Agressiva , Amoxicilina , Antibacterianos/uso terapêutico , Raspagem Dentária , Humanos , Metronidazol , Moxifloxacina , Perda da Inserção Periodontal/tratamento farmacológico , Bolsa Periodontal/tratamento farmacológico , Porphyromonas gingivalis , Resultado do Tratamento
5.
BMC Oral Health ; 20(1): 123, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32321490

RESUMO

BACKGROUND: This pilot study was part of a larger study which compared the effect of subgingival air-polishing using trehalose powder with sonic scaling on clinical parameters during supportive periodontal therapy. Within this microbiological part of the investigation subgingival samples were taken from 10 participants to analyze the survival of different bacterial species after the two different treatments as a proof of principle. METHODS: In 10 participants two non-adjacent, single-root teeth requiring treatment (PD =5 mm with bleeding on probing (BOP) or > 5 mm) were selected following a split-mouth design and were treated either with a sonic scaler or air-polishing device and trehalose powder. For persistent pockets (PD =4 mm and BOP or > 4 mm), treatment was repeated after 3 months. Subgingival biofilm samples were taken at baseline (BL), subsequently and three and six months after treatment. After determination of the bacterial counts (TBL), isolated bacteria were identified by MALDI-TOF-MS. If unsuccessful, PCR and 16S rDNA sequencing were performed. RESULTS: In both treatment groups, TBL decreased immediately after treatment remaining at a lower level. This confirms the findings of the larger study regarding clinical parameters showing a comparable effect on PD, BOP and CAL. Immediately after treatment, the diversity of detected species decreased significantly more than in the sonic group (p = 0.03). After 3 months, the proportion of Gram-positive anaerobic rods was lower in the air-polishing group (powder/ sonic 7%/ 25.9%, p = 0.025). Also, there was a greater reduction of Gram-negative aerobic rods for this group at this time (air-polishing/ sonic - 0.91 / -0.23 Log10 cfu/ ml, p = 0.020). CONCLUSION: Within the limitations of this study air-polishing and sonic treatment seem to have a comparable effect on the subgingival oral biofilm during supportive periodontal treatment. TRIAL REGISTRATION: The study was registered in an international trial register (German Clinical Trial Register number DRKS 00006296) on 10th of June 2015. HTML&TRIAL_ID = DRKS00006296.


Assuntos
Biofilmes/efeitos dos fármacos , Placa Dentária/terapia , Raspagem Dentária/instrumentação , Bolsa Periodontal/tratamento farmacológico , Trealose/farmacologia , Adulto , Idoso , Placa Dentária/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Bolsa Periodontal/prevenção & controle , Projetos Piloto , Pós , Trealose/uso terapêutico
6.
Sci Rep ; 10(1): 1850, 2020 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024893

RESUMO

Platelet-rich fibrin (PRF) provides a scaffold for cell migration and growth factors for promoting wound healing and tissue regeneration. Here, we report using PRF in periodontal healing after open flap debridement (OFD) in canine periodontitis. A split-mouth design was performed in twenty dogs. Forty periodontitis surgical sites were randomly categorized into 2 groups; OFD alone and OFD with PRF treatment. Clinical parameters of periodontal pocket depth, gingival index, and the cemento-enamel junction-alveolar bone levels/root length ratio were improved in the OFD + PRF group. The OFD + PRF group also demonstrated a dramatically decreased inflammatory score compared with the OFD group. Collagen accumulation was improved in the OFD + PRF group at later time points compared with baseline. PRF application also significantly reduced inflammatory cytokine expression (TNFA and IL1B), and promoted the expression of collagen production-related genes (COL1A1, COL3A1, and TIMP1) and growth factors (PDGFB, TGFB1, and VEGFA). These findings suggest that PRF combined with OFD provides a new strategy to enhance the overall improvement of canine periodontitis treatment outcomes, especially in terms of inflammation and soft tissue healing. Therefore, PRF use in treating periodontitis could play an important role as a regenerative material to improve canine periodontitis treatment.


Assuntos
Periodontite Crônica/metabolismo , Fibrina/farmacologia , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/metabolismo , Fibrina Rica em Plaquetas/metabolismo , Regeneração/efeitos dos fármacos , Regeneração/fisiologia , Perda do Osso Alveolar/tratamento farmacológico , Perda do Osso Alveolar/metabolismo , Animais , Citocinas/metabolismo , Desbridamento/métodos , Cães , Genes Reguladores/genética , Inflamação/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Índice Periodontal , Retalhos Cirúrgicos/fisiologia , Resultado do Tratamento , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologia
7.
J Periodontol ; 91(10): 1318-1327, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32103495

RESUMO

BACKGROUND: Supplementation with omega-3 polyunsaturated fatty acids (ω-3 PUFA) and low-dose aspirin (ASA) have been proposed as a host modulation regimen to control chronic inflammatory diseases. The aim of this study was to investigate the clinical and immunological impact of orally administered ω-3 PUFA and ASA as adjuncts to periodontal debridement for the treatment of periodontitis in patients type 2 diabetes. METHODS: Seventy-five patients (n = 25/group) were randomly assigned to receive placebo and periodontal debridement (CG), ω-3 PUFA + ASA (3 g of fish oil/d + 100 mg ASA/d for 2 months) after periodontal debridement (test group [TG]1), or ω-3 PUFA + ASA (3 g of fish oil/d + 100 mg ASA/d for 2 months) before periodontal debridement (TG2). Periodontal parameters and GCF were collected at baseline (t0), 3 months after periodontal debridement and ω-3 PUFA + ASA or placebo for TG1 and CG (t1), after ω-3 PUFA + ASA (before periodontal debridement) for TG2 (t1), and 6 months after periodontal debridement (all groups) (t2). GCF was analyzed for cytokine levels by multiplex ELISA. RESULTS: Ten patients (40%) in TG1 and nine patients (36%) in TG2 achieved the clinical endpoint for treatment (less than or equal to four sites with probing depth ≥ 5 mm), as opposed to four (16%) in CG. There was clinical attachment gain in moderate and deep pockets for TG1. IFN-γ and interleukin (IL)-8 levels decreased over time for both test groups. IL-6 levels were lower for TG1. HbA1c levels reduced for TG1. CONCLUSION: Adjunctive ω-3 and ASA after periodontal debridement provides clinical and immunological benefits to the treatment of periodontitis in patients with type 2 diabetes.


Assuntos
Periodontite Crônica , Diabetes Mellitus Tipo 2 , Aspirina/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Periodontite Crônica/cirurgia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/terapia , Método Duplo-Cego , Humanos , Perda da Inserção Periodontal , Desbridamento Periodontal , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/cirurgia
8.
J Biol Regul Homeost Agents ; 34(5 Suppl. 3): 67-78. Technology in Medicine, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33386036

RESUMO

Periodontitis represents a major problem for patients, since it is not possible to eliminate the bacteria that are responsible for this pathology with a pharmacological treatment. The present study included forty-four patients with periodontitis, who had undergone disinfection via photodynamic therapy (PDT) using a laser source having a 635 nm wavelength associated with a photoactivable substance (methylene blue). Clinical assessment of plaque index (PI), bleeding on probing (BOP), probing depth (PD), calculus index (CI), gingival recession (REC) and clinical attachment level (CAL) were recorded at base line, 1 month (4 weeks) after treatment and again 3 months (12 weeks) after treatment, while site radiography (RX) and microbiological test (MT) were recorded at base line and 3 months (12 weeks) after treatment. The outcomes show a good efficacy of the PDT in the elimination of the periodontal pathogenic microflora and in the improvement of the clinical parameters considered: from the base line to the final check after 12 weeks it has been observed a reduction in REC of about 16.9%, a reduction of CAL of about 17.85%, a reduction of the BoP of about 93.3%, a reduction of the PD of about 17%, a reduction of the CI of about 66.3%, a reduction of PI of about 44%, and microbiologically a reduction of the total amount of bacteria with proven parodontopathic properties (red complex bacteria) of about 58.74%. Within the limits of the present study, PDT can be reasonably considered as a good carrier that leads to significant improvements in the parameters (clinical and microbiological) considered.


Assuntos
Retração Gengival , Periodontite , Fotoquimioterapia , Índice de Placa Dentária , Raspagem Dentária , Humanos , Perda da Inserção Periodontal/tratamento farmacológico , Bolsa Periodontal/tratamento farmacológico , Periodontite/tratamento farmacológico , Aplainamento Radicular , Resultado do Tratamento
9.
AAPS PharmSciTech ; 20(8): 325, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31659563

RESUMO

Localized intra-pocket, retentive, biodegradable, prolonged release thiolated membrane can provide an improved therapeutic efficacy of doxycycline at the site of action with evading off target side effects. To this end, thiolated chitosan-hyaluronic acid composite polymeric complex next-generation of the periodontal membrane was manufactured by solvent casting method. FTIR spectroscopic analysis displayed successful immobilization of thiol groups on the manufactured thiolated periodontal membrane. Moreover, XRD, DSC, AFM and TGA of the membrane confirmed the compatibility of ingredients and modifications in surface chemistry. The thiolated periodontal film was also investigated in terms of thickness, weight uniformity, water-uptake capacity, drug content, pH, entrapment efficiency, lysozymal degradation and release patterns. Also, mucoadhesion profile was explored on gingival mucosa. The immobilized thiol groups on thiolated chitosan and thiolated hyaluronate were found to be 168 ± 11 µM/g (mean ± SD, n = 3) and 189 ± 8 µM/g (mean ± SD, n = 3) respectively. Swelling capacity of the thiolated periodontal membrane was significantly ∼2-fold higher (p < 0.05) as compared to unmodified membrane. The obtained thiolated membrane depicted 3 -old higher mucoadhesive features as compared to the un-modified membrane. In vitro release kinetics indicated approximately more than 80% prolonged release within 7 days. Mechanical strength of the Thiolated bandage was also significantly ∼2-fold higher (p < 0.05) as compared to unmodified membrane. Ex-vivo retention study revealed enhanced retention of thiolated membrane as compared to unmodified membrane. In-vitro antimicrobial studies demonstrated that thiolated membrane could efficiently kill Porphyromonas gingivalis cells as compared to the native membrane. Moreover, ex-vivo biodegradation results indicated that 90% of the thiolated membrane was biodegradable in 28 days. Based on these findings, thiolated next-generation of the periodontal membrane seems to be promising for periodontitis therapy.


Assuntos
Antibacterianos/administração & dosagem , Doxiciclina/administração & dosagem , Sistemas de Liberação de Medicamentos/métodos , Bolsa Periodontal/tratamento farmacológico , Compostos de Sulfidrila/administração & dosagem , Adulto , Animais , Antibacterianos/metabolismo , Doxiciclina/química , Doxiciclina/metabolismo , Composição de Medicamentos , Avaliação Pré-Clínica de Medicamentos/métodos , Cabras , Humanos , Bolsa Periodontal/metabolismo , Compostos de Sulfidrila/química , Compostos de Sulfidrila/metabolismo , Adulto Jovem
10.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 83-88, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538453

RESUMO

The aim of this study was to evaluate the adjunctive benefit offers by the administration of a chlorhexidine based local drug deliver (Chlo-SITE) into periodontal socket after a full mouth disinfection session. The study design was a randomized, crossover, clinical trial conducted on 60 non-smokers subjects with chronic periodontitis. Each volunteer was subjected to a one-stage full mouth disinfection session and, immediately after that, test product (Chlo-SITE) was inserted in 1 pocket in 2 quadrant. The 1° and 4° quadrant were used for the study with the application of antiseptic (Test); the 2° and 3° as a control. Periodontal probe (PD), bleeding on probing (BOP) and plaque index (PI) was collected at baseline (T0), after 7 days (T1), after 4 weeks (T2). The results of this study suggest that the application of xanthan-based chlorhexidine gel (Xan-CHX) offers a great benefit in improving of the indices in chronic periodontitis.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Bolsa Periodontal/tratamento farmacológico , Periodontite/tratamento farmacológico , Estudos Cross-Over , Géis , Humanos , Índice Periodontal
11.
BMC Oral Health ; 19(1): 176, 2019 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387569

RESUMO

BACKGROUND: Glycemic control is vital in the care of type 2 diabetes mellitus (T2DM) and is significantly associated with the incidence of clinical complications. This Bayesian network analysis was conducted with an aim of evaluating the efficacy of scaling and root planning (SRP) and SRP + adjuvant treatments in improving glycemic control in chronic periodontitis (CP) and T2DM patients, and to guide clinical practice. METHODS: We searched the Pubmed, Embase, Cochrane Library and Web of Science databases up to 4 May 2018 for randomized controlled trials (RCTs). This was at least three months of the duration of study that involved patients with periodontitis and T2DM without other systemic diseases given SRP. Patients in the control group did not receive treatment or SRP combination with adjuvant therapy. Outcomes were given as HbA1c% and levels fasting plasma glucose (FPG). Random-effects meta-analysis and Bayesian network meta-analysis were conducted to pool RCT data. Cochrane's risk of bias tool was used to assess the risk of bias. RESULTS: Fourteen RCTs were included. Most were unclear or with high risk of bias. Compared to patients who did not receive treatment, patients who received periodontal treatments showed improved HbA1c% level, including SRP (the mean difference (MD) -0.399 95% CrI 0.088 to 0.79), SRP + antibiotic (MD 0.62, 95% CrI 0.18 to 1.11), SRP + photodynamic therapy (aPDT) + doxycycline (Doxy) (MD 1.082 95% CrI 0.13 to 2.077) and SRP + laser (MD 0.66 95% CrI 0.1037, 1.33). Among the different treatments, SRP + aPDT + Doxy ranked best. Regarding fasting plasma glucose (FPG), SRP did not show advantage over no treatment (MD 4.91 95% CI - 1.95 to 11.78) and SRP with adjuvant treatments were not better than SRP alone (MD -0.28 95% CI -8.66, 8.11). CONCLUSION: The results of this meta-analysis seem to support that periodontal treatment with aPDT + Doxy possesses the best efficacy in lowering HbA1c% of non-smoking CP without severe T2DM complications. However, longer-term well-executed, multi-center trails are required to corroborate the results.


Assuntos
Antibacterianos/uso terapêutico , Periodontite Crônica/terapia , Raspagem Dentária/métodos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Fotoquimioterapia , Aplainamento Radicular/métodos , Antibacterianos/administração & dosagem , Teorema de Bayes , Glicemia , Periodontite Crônica/sangue , Terapia Combinada , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Feminino , Humanos , Masculino , Metanálise em Rede , Bolsa Periodontal/sangue , Bolsa Periodontal/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
12.
Photodiagnosis Photodyn Ther ; 27: 433-439, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31319164

RESUMO

PURPOSE: The main aim in periodontitis treatment is to remove supragingival and subgingival biofilm. Mechanical treatment to eliminate pathogenic bacteria is limited by morphological conditions on the root surface. This study assessed the antibacterial effectiveness of different laser-based photochemical systems, particularly a novel curcumin-based option. METHODS: Ninety-one titanium bars were inoculated with an artificial biofilm of common pathogenic periodontal bacteria and inserted into an artificial periodontal pocket model. The following groups (n = 13) were tested: 1, curcumin solution plus SLB laser irradiation (C + L; 445 nm, 0.6 W, 25% duty cycle, 100 Hz, 10 s); 2, curcumin solution (Cur); 3, dimethyl sulfoxide solution (DMSO); 4, SiroLaser Blue (SLB) - laser irradiation (445 nm, 0.6 W, 25% duty cycle, 100 Hz, 10 s); 5, antimicrobial photodynamic therapy (aPDT); 6, antimicrobial photothermal therapy (aPTT); 7, control. The samples were stored in Eppendorf tubes and analyzed microbiologically using quantitative real-time polymerase chain reaction (PCR). The main parameter for analyzing group differences was the total bacterial load. Statistical analysis was performed with nonparametric methods. RESULTS: Statistically significant reductions in bacterial count were observed in all experimental groups (p < 0.05). The mean percentage reductions were as follows: SLB, 95.03%; aPDT, 83.91%; DMSO, 95.69%; C + L, 97.15%. No statistically significant differences in bacteria reduction were observed for laser alone (SLB), DMSO, or curcumin with or without additional laser irradiation. CONCLUSIONS: The greatest antibacterial efficacy was observed in samples treated with aPTT. Using curcumin as a photosensitizing agent for 445 nm laser irradiation did not result in improved antibacterial effectiveness in comparison with laser alone.


Assuntos
Biofilmes/efeitos dos fármacos , Curcumina/uso terapêutico , Hipertermia Induzida/métodos , Bolsa Periodontal/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Dimetil Sulfóxido/uso terapêutico , Humanos , Verde de Indocianina/uso terapêutico , Lasers Semicondutores , Azul de Metileno/uso terapêutico , Reação em Cadeia da Polimerase em Tempo Real
13.
Photodiagnosis Photodyn Ther ; 27: 132-136, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31152876

RESUMO

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) has been investigated as an adjunctive to periodontal treatment but the dosimetry parameters adopted have discrepancies and represent a challenge to measure efficacy. There is a need to understand the clinical parameters required to obtain antimicrobial effects by using aPDT in periodontal pockets. The aim of this study was to investigate parameters relating to the antimicrobial effects of photodynamic therapy in periodontal pockets. MATERIAL AND METHODS: This randomized controlled clinical trial included 30 patients with chronic periodontitis. Three incisors from each patient were selected and randomized for the experimental procedures. Microbiological evaluations were performed to quantify microorganisms before and after treatments and spectroscopy was used to identify methylene blue in the pocket. A laser source with emission of radiation at wavelength of ʎ = 660 nm and output radiant power of 100 mW was used for 1, 3 and 5 min. One hundred µM methylene blue was used in aqueous solution and on surfactant vehicle. RESULTS: The results demonstrated the absence of any antimicrobial effect with aqueous methylene blue-mediated PDT. On the other hand, methylene blue in the surfactant vehicle produced microbial reduction in the group irradiated for 5 min (p < 0.05). Spectroscopy showed that surfactant vehicle decreased the dimer peak signal at 610 nm. CONCLUSION: Within the parameters used in this study, PDT mediated by methylene blue in a surfactant vehicle reached significant microbial reduction levels with 5 min of irradiation. The clinical use of PDT may be limited by factors that reduce the antimicrobial effect. Forms of irradiation and stability of the photosensitizers play an important role in clinical aPDT.


Assuntos
Azul de Metileno/uso terapêutico , Bolsa Periodontal/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Tensoativos/química , Terapia Combinada , Composição de Medicamentos , Feminino , Humanos , Masculino , Azul de Metileno/administração & dosagem , Índice Periodontal , Fármacos Fotossensibilizantes/administração & dosagem , Fatores de Tempo
14.
Photodiagnosis Photodyn Ther ; 27: 167-172, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31116996

RESUMO

BACKGROUND: The persistence of periodontal pockets > 5 mm after periodontal treatments increases the risk of periodontitis recurrence and the need of periodontal surgery. This study evaluated the impact of tooth-related factors on the effectiveness of adjunctive photodynamic treatment (PDT) in the reduction of pockets > 5 mm during active periodontal treatment. METHODS: Thirty-six patients suffering from severe chronic periodontitis were evaluated in a 6-months split-mouth randomized clinical trial. Each quadrant was assigned to test (scaling and root planing (SRP) + PDT) or control (SRP alone) group. PDT was conducted using the toluidine blue O and a light-emitting diode (LED) with a red spectrum. PDT applications were performed immediately after SRP, 7 days later and at 3 months. Plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 3 and 6 months. RESULTS: Multilevel analysis showed a significant reduction of pockets > 5 mm in test group in comparison with control group at 3 (OR = 0.69) and 6 months (OR = 0.77). This effect was mainly observed at 6 months in initially deep sites (PPD > 6 mm) with BOP (OR = 0.57). At sites exhibiting PI > 1 no PDT effect was observed. A more moderate PDT effect was observed on mean PPD and BOP reductions at 3 months only. CONCLUSIONS: Repeated applications of PDT significantly improved SRP outcomes, reducing by more than 40% residual pockets > 5 mm in initially deep and bleeding on probing periodontal sites. PDT effect was negatively influenced by dental plaque accumulation.


Assuntos
Periodontite Crônica/tratamento farmacológico , Raspagem Dentária/métodos , Bolsa Periodontal/tratamento farmacológico , Fotoquimioterapia/métodos , Adulto , Idoso , Periodontite Crônica/terapia , Terapia Combinada , Índice de Placa Dentária , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Fármacos Fotossensibilizantes/uso terapêutico , Aplainamento Radicular , Cloreto de Tolônio/uso terapêutico
15.
AAPS J ; 21(3): 51, 2019 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-30972562

RESUMO

Existing dissolution chambers have relatively large volume compared to the size of the periodontal pocket. A small volume dissolution method that simulates the physiological release environment for periodontal drug delivery is needed. The objectives were to construct a small, more physiologically relevant, dissolution chamber and investigate the properties of the new dissolution chamber for the assessment of sustained drug release systems in periodontal delivery. Flow-through dissolution chambers were constructed using three-dimensional (3D) printing. Drug release experiments were performed using the dissolution chamber and a commercially available long-acting periodontal insert product, PerioChip®. Similar experiments were performed under more traditional larger volume bulk solution conditions for comparison. Computer simulations and experimental results showed that drug clearance from the dissolution chamber was fast compared to drug release from the periodontal product. Drug clearance from the flow-through dissolution chamber and drug release from the sustained release product in the chamber were related to the dissolution medium flow rate and chamber volume. Drug release in the flow-through chamber was slower than that observed in bulk solution, but approached it when the medium flow rate increased. The presence of trypsin in the dissolution medium enhanced drug release from the product. A flow-through dissolution system was constructed that could evaluate drug release from a sustained release product in a small dimension environment by modifying the flow rate and composition of the dissolution medium.


Assuntos
Química Farmacêutica/instrumentação , Clorexidina/análogos & derivados , Sistemas de Liberação de Medicamentos/métodos , Liberação Controlada de Fármacos , Bolsa Periodontal/tratamento farmacológico , Clorexidina/administração & dosagem , Clorexidina/farmacocinética , Simulação por Computador , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/farmacocinética , Desenho de Equipamento , Humanos
16.
Pak J Pharm Sci ; 32(6): 2673-2677, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31969301

RESUMO

Simvastatin is an anti-hyperlipidemic drug which reduces the cholesterol synthesis and also has anti-inflammatory, immunomodulatory and anti-microbial action against the bacteria. This develops the interest of periodontologist to use it in combination with conventional treatment to treat periodontal diseases. The objective of the study was to develop the gel and mouthwash of simvastatin and use it locally to treat gingivitis and periodontitis as an adjunct to scaling and root planning. The patients were randomly allocated into three groups that were standard treatment group, gel treatment group and mouthwash treatment group. Results indicated that simvastatin gel and mouthwash in 1% preparation showed favorable results by significantly reducing periodontal parameters and inflammatory biomarkers (p<0.001) as compared to standard treatment. Thus, we strongly suggest the use of simvastatin by local drug delivery system as an adjunct treatment of scaling and root planning.


Assuntos
Raspagem Dentária/métodos , Doenças Periodontais/terapia , Aplainamento Radicular/métodos , Sinvastatina/uso terapêutico , Adulto , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Terapia Combinada , Feminino , Géis , Gengivite/terapia , Humanos , Masculino , Antissépticos Bucais , Perda da Inserção Periodontal/tratamento farmacológico , Bolsa Periodontal/tratamento farmacológico , Periodontite/terapia , Sinvastatina/administração & dosagem , Mobilidade Dentária/tratamento farmacológico
17.
Lasers Med Sci ; 34(5): 855-863, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30539404

RESUMO

The aim of this study was to assess the effects of repeated applications of antimicrobial photodynamic therapy (aPDT) on the non-surgical periodontal treatment of residual pockets. This work was performed and reported according to the Cochrane and PRISMA recommendations, respectively, and registered at the PROSPERO registry (number CRD42017058403). An extensive search of the biomedical literature was conducted on four databases from January 1960 to August 2018, followed by hand searching. Analysis of the quality of the selected studies was based on the risk of bias. Only two randomised controlled clinical trials (RCTs) met the inclusion criteria although they had unclear risk of bias. One study showed that repeated applications of aPDT in association with conventional non-surgical treatment during periodontal maintenance improved all clinical outcomes after 6 months. The other study, which assessed the effects of repeated applications of aPDT in association with ultrasound debridement on periodontal pathogens, showed no significant reduction of the main pathogens after 3-6 months but reported reductions of probing pocket depth and C-reactive protein after 3 and 6 months, respectively, compared to mechanical therapy alone. Concluding, it was not possible to state that repeated applications of aPDT, in association with non-surgical treatment of residual pockets, have effective clinical effects in the periodontal maintenance therapy. Although one can consider that aPDT is a promising adjuvant therapy, it is still necessary to carry out more RCTs with low risk of bias in order to confirm or refute the benefits of multiple applications for residual periodontal pockets.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Bolsa Periodontal/tratamento farmacológico , Fotoquimioterapia , Adulto , Idoso , Antibacterianos/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Viés de Publicação , Fatores de Risco , Resultado do Tratamento
18.
J Dent Hyg ; 92(4): 51-58, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30143550

RESUMO

Purpose: The purpose of this study was to evaluate the effects of repeated scaling and root planing (SRP), with or without locally-delivered minocycline microspheres (MM) on residual pockets in patients undergoing periodontal maintenance (PMT).Methods: Patients on PMT were randomized into two groups for treatment of one posterior interproximal inflamed pocket (≥5 mm) with a history of bleeding on probing every 6 months: SRP plus MM (n=30) or exclusively SRP (n=30). Baseline and 24-month measurements included radiographic interproximal alveolar bone height, probing depths (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival crevicular fluid (GCF), and salivary interleukin (IL) - 1ß, (24 month only). Results were analyzed for baseline data or change in measurements after 24 months of treatment between different treatment groups, as well as whether significant changes occurred after 24 months of treatment for each treatment group individually.Results: Alveolar bone height and GCF IL-1ß remained stable over the 24 months. The SRP + MM and SRP groups each demonstrated reduced PD (0.8 ± 0.9 mm and 1.1 ±0.6 mm, respectively, p < 0.001 each), CAL (0.8 ± 0.9 mm and 1.0 ± 0.6 mm, respectively, p < 0.001 each) and BOP (55% and 48%, respectively, p = 0.001 each). However, there were no differences between groups over the 24-month study period.Conclusion: Scaling and root planning alone, of moderately inflamed periodontal pockets at 6-month intervals, produced stable interproximal alveolar bone height as well as sustained improvements in probing depths, clinical attachment level, bleeding on probing over 24 months; minocycline microspheres were not shown to enhance these results.


Assuntos
Antibacterianos/uso terapêutico , Microesferas , Minociclina/uso terapêutico , Bolsa Periodontal/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Raspagem Dentária/métodos , Feminino , Seguimentos , Líquido do Sulco Gengival , Hemorragia Gengival/tratamento farmacológico , Hemorragia Gengival/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/tratamento farmacológico , Perda da Inserção Periodontal/terapia , Índice Periodontal , Bolsa Periodontal/tratamento farmacológico , Aplainamento Radicular/métodos
19.
J Investig Clin Dent ; 9(4): e12345, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29863310

RESUMO

The aim of the present systematic review was to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) that is used as an adjunctive therapy with scaling and root planing (SRP) in deep periodontal pockets (≥5 mm). The addressed Patients, Intervention, Comparators, Outcomes, and Study design question was: In patients with advanced periodontitis (population), what is the effect of aPDT as adjunct to SRP (intervention) in comparison to SRP alone (comparison) on deep probing depths (outcome)? Electronic and manual literature searches were conducted using the following databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, up to and including February 2018. Six randomized trials were included. All studies used the combined approach aPDT+SRP and SRP in the test and control groups, respectively. The follow-up period ranged from 12 to 48 weeks. Wavelengths, power density, and duration of irradiation used were 670 nm, 500 mW cm-2 , and 60 seconds, respectively. All studies showed significant reduction of probing depth (PD) ≥5 mm with aPDT at follow up. Considering the effects of adjunctive aPDT compared to SRP, only two studies showed additional benefit of adjunctive aPDT in reducing PD ≥5 mm compared to SRP alone at follow up. The overall mean difference for PD reduction (weighted mean difference = 0.31, 95% confidence interval [CI] = -0.03 to -0.66, P = .08) was also not significant between the aPDT and SRP groups at follow up. Whether aPDT as an adjunct to SRP is efficacious in the reduction of PD ≥5 mm compared to SRP alone in periodontal disease remains debatable, given that the available scientific evidence is weak.


Assuntos
Anti-Infecciosos/uso terapêutico , Doenças Periodontais/tratamento farmacológico , Bolsa Periodontal/tratamento farmacológico , Fotoquimioterapia , Humanos
20.
Biomed Res Int ; 2018: 1805793, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29736391

RESUMO

Periodontal disease consists of chronic gingival inflammation characterized by both degradation of the periodontal connective tissue and alveolar bone loss. Drug therapy is used as an auxiliary treatment method in severe chronic periodontitis, aggressive periodontitis, and periodontitis-associated systemic disease. Nal-P-113, a modified antimicrobial peptide, specifically replaces the histidine residues of P-113 with the bulky amino acid ß-naphthylalanine, and our previous studies have verified that this novel peptide is not toxic to the human body within a certain concentration range. The objective of the present study was to evaluate the effect of Nal-P-113 on periodontal pathogens and periodontal status in clinical studies. In a split-mouth clinical trial, the pocket depth and bleeding index values tended to decrease in the experimental group compared with those in the control group. SEM results verified that Nal-P-113 restrained the maturation of plaque. Based on real-time polymerase chain reaction, the levels of Fusobacterium nucleatum, Streptococcus gordonii, Treponema denticola, and Porphyromonas gingivalis in subgingival plaque were decreased when the subjects were given Nal-P-113. Bacterial growth curve analysis and a biofilm susceptibility assay verified that Nal-P-113 at a concentration of 20 µg/mL restrained the growth of S. gordonii, F. nucleatum, and P. gingivalis and biofilm formation. Therefore, Nal-P-113 effectively reduces periodontal pathogens and ameliorates periodontal status.


Assuntos
Antibacterianos/administração & dosagem , Inflamação/tratamento farmacológico , Peptídeos/administração & dosagem , Doenças Periodontais/tratamento farmacológico , Adulto , Antibacterianos/química , Biofilmes/efeitos dos fármacos , Feminino , Fusobacterium nucleatum/efeitos dos fármacos , Fusobacterium nucleatum/patogenicidade , Gengiva/efeitos dos fármacos , Gengiva/microbiologia , Humanos , Inflamação/microbiologia , Inflamação/patologia , Masculino , Pessoa de Meia-Idade , Peptídeos/química , Doenças Periodontais/microbiologia , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/microbiologia , Porphyromonas gingivalis/efeitos dos fármacos , Porphyromonas gingivalis/patogenicidade , Streptococcus gordonii/efeitos dos fármacos , Streptococcus gordonii/patogenicidade , Treponema denticola/efeitos dos fármacos , Treponema denticola/patogenicidade , beta-Alanina/análogos & derivados , beta-Alanina/química
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