Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 204
Filtrar
1.
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
2.
Rev. habanera cienc. méd ; 19(5): e3079, sept.-oct. 2020. ilus
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1144687

RESUMO

RESUMEN Introducción: los agrandamientos gingivales suelen tratarse a través de terapias quirúrgicas de gingivectomías; su tratamiento no quirúrgico mecánico también es una opción sobre todo en los casos de gingivitis asociada a la pubertad como consecuencia de los cambios hormonales. Objetivo: describir el tratamiento no quirúrgico de una paciente de 12 años con agrandamiento gingival asociado a la pubertad y lesiones gingivales inducidas por biofilm dental. Presentación del caso: el caso presentó un agrandamiento gingival leve localizado que remitió al cabo de un mes a la primera fase de tratamiento, después de tres sesiones de fisioterapias con la remoción de biofilm calcificado se obtuvo una reducción del porcentaje del índice de higiene oral sin requerir intervención quirúrgica. A los cuatro años de seguimiento se observó reducción completa del agrandamiento gingival y bolsas periodontales. Conclusiones: la terapia periodontal mecánica es una alternativa eficaz en la reducción de la inflamación gingival inducida por hormonas durante la pubertad sin la necesidad de requerir intervenciones quirúrgicas para el tratamiento del agrandamiento gingival. Otras alternativas como las gingivectomías son aplicables; sin embargo requieren procedimientos más complejos, costosos y aumento de la morbilidad del paciente; en ese sentido el tratamiento mecánico no quirúrgico se muestra como una opción viable(AU)


ABSTRACT Introduction: Gingival enlargement is usually treated with gingivectomy as an alternative to surgery; however, non-surgical mechanical treatment is another option especially in cases of gingivitis associated with puberty as a result of hormonal changes. Objective: To describe the non-surgical treatment of a 12-year-old patient with gingival enlargement associated with puberty and gingival lesions induced by dental biofilm. Case presentation: The patient presented a localized mild gingival enlargement that relapsed to the first phase of treatment after one month. Three months after physiotherapy sessions with removal of calcified biofilm, a reduction in the percentage of oral hygiene index to "good" was obtained; therefore, surgical treatment was not required. Four years later, there was a complete reduction in gingival enlargement and periodontal pockets. Conclusions: Mechanical periodontal therapy is an effective alternative to reduce gingival inflammation induced by hormones during puberty not requiring surgical intervention to treat gingival enlargement. Other alternatives such as gingivectomies are performed; however, they require more complex, expensive procedures and they can also increase patient morbidity. In that sense, the uniqueness of the non-surgical mechanical treatment is chosen as a feasible option(AU)


Assuntos
Humanos , Feminino , Criança , Índice de Higiene Oral , Puberdade , Placa Dentária/terapia , Desbridamento Periodontal/métodos , Hipertrofia Gengival/terapia
3.
Trials ; 21(1): 113, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992331

RESUMO

BACKGROUND: Periodontal diseases are regarded as the most common diseases of mankind. The prevalence rate of periodontal disease assumes a clear growth tendency, increasing by 57.3% from 1990 to 2010. Thereby, effective periodontal therapy is still a long-term task and a difficult problem. The goals of periodontal therapy are to eliminate the infectious and inflammatory processes of periodontal diseases. Root planing, in order to eliminate the "infected cementum," has been an important step in the treatment of periodontitis since the 1970s. However, along with the understanding of the effects of endotoxin on the root surface, the necessity of manual root planing has been gradually queried. Ultrasonic instruments, which are more recent innovations, would not remove the cementum excessively, and are also more time-saving and labor-saving compared to using hand instruments. Hence, an increasing number of dentists prefer to do scaling with ultrasonic instruments only. However, the necessity of root planing remains emphasized in the international mainstream views of periodontal mechanical treatment. Therefore, this study is devoted to compare the clinical effect of ultrasonic subgingival debridement and ultrasonic subgingival scaling combined with manual root planing, which takes the implementation of root planing as the only variable and is more in line with the current clinical situation, thus hoping to provide some valuable reference to dentists. METHODS/DESIGN: Forty adult patients who fit the inclusion criteria are being recruited from the Peking University Hospital of Stomatology (Beijing, China). By means of randomization tables, one quadrant of the upper and lower teeth is the test group and the other is the control group. Test group: ultrasonic subgingival scaling combined with manual root planing. CONTROL GROUP: ultrasonic subgingival debridement. In a 24-week follow-up period, plaque index, probing depth, clinical attachment loss, bleeding index, furcation involvement, mobility, and patient-reported outcome (Visual Analog Scale for pain and sensitivity) will be observed and documented. DISCUSSION: This study evaluates the effectiveness of ultrasonic subgingival scaling combined with manual root planing and ultrasonic subgingival debridement alone in the nonsurgical treatment of periodontitis with a split-mouth design after 1, 3 and 6 months. The result of the trial should potentially contribute to an advanced treatment strategy for periodontitis with an ideal clinical outcome. TRIAL REGISTRATION: International Clinical Trials Registry Platform (ICTRP), ID: ChiCTR1800017122. Registered on 12 July 2018.


Assuntos
Raspagem Dentária/métodos , Desbridamento Periodontal/métodos , Periodontite/terapia , Aplainamento Radicular/métodos , Terapia por Ultrassom/métodos , Terapia Combinada , Humanos
4.
Med. oral patol. oral cir. bucal (Internet) ; 25(1): e117-e123, ene. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-196203

RESUMO

BACKGROUND: Titanium-prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high con-centration of platelets that also incorporates leukocytes, and growth factors into the dense fibrin matrix and can be used as a healing biomaterial. This study assesses the adjunctive use of T-PRF in intrabony defects (IBDs) with open flap debridement (OFD) in comparison with guided tissue regeneration (GTR) as a gold standard and OFD alone as a control. MATERIAL AND METHODS: A total of 45 patients (15 per group) were randomized as either T-PRF (test group), GTR (test group), or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and IBD were recorded. The radiographic depth of IBD was also measured. Primary outcomes assessed were changes in PD, CAL, and radiographic IBD that were assessed at the beginning and nine months later. RESULTS: The PRF and GTR group showed significant improvement in clinical parameters compared with the OFD alone (control group) at nine months. While there were no significant differences in PD and CAL between test groups (T-PRF and GTR groups), the significant difference was found in radiographic IBD depth. CONCLUSION: T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fibrina Rica em Plaquetas , Titânio/uso terapêutico , Regeneração Tecidual Guiada Periodontal/métodos , Doenças Periodontais/terapia , Desbridamento Periodontal/métodos , Tratamento do Canal Radicular/métodos , Resultado do Tratamento , Índice Periodontal , Materiais Biocompatíveis/uso terapêutico
5.
Clin Exp Dent Res ; 5(3): 250-258, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31249706

RESUMO

The purpose is to examine early wound healing through histological analysis by characterizing connective tissue distribution and organization in the treated periodontium following nonsurgical therapy. Periodontal disease is a multifactorial pathological process that leads to the loss of the surrounding periodontium. Traditional periodontal therapies have proven beneficial in halting the progression of disease. The aim of this study is to investigate early wound healing in periodontal patients following hand/ultrasonic instrumentation alone, erbium-doped yttrium aluminum garnet laser instrumentation alone, or a combination of hand/ultrasonic instrumentation and Er:YAG laser instrumentation for the nonsurgical treatment of periodontitis by histologic evaluation. Twenty-one patients were randomized to receive nonsurgical therapy for the treatment of chronic periodontitis with three modalities prior to surgical therapy. Baseline clinical measurements were obtained prior to treatment. Wound healing was assessed by obtaining an otherwise discarded tissue sample following nonsurgical therapy of the selected study site. Samples were obtained at 2 or 6 weeks following initial therapy with a step-back incision and fixated for histological and immunohistochemical analysis. There were minimal between-group differences in the amount of collagen distribution when analyzing the Mallory-Heidenhain Azan trichrome, Picrosirus Red stain, and proliferating cell nuclear antigen at both time points. Descriptive analysis of baseline measurements showed no differences in probing depth change, bleeding on probing, and clinical attachment level following initial therapy between the three treatment groups at 2 or 6 weeks. Each treatment modality was effective in treating moderate to severe chronic periodontitis; however, the results of this study are inconclusive regarding superiority of any one treatment approach from a histologic and immunohistochemical perspective. Based on this assessment, there was increased fibroblast proliferation and collagen maturation between the 2- and 6-week time point after treatment in all treatment groups, with few apparent differences between treatment groups. This pilot study qualitatively evaluated early wound healing in periodontal patients following non surgical therapy with various treatment modalities. When comparing descriptive outcomes of Er:YAG laser therapy and hand/ultrasonic instrumentation there were minimal differences in collagen distribution and density between groups. The evaluated modalities were each effective treating periodontal patients with non surgical therapy.


Assuntos
Lasers de Estado Sólido/uso terapêutico , Desbridamento Periodontal/métodos , Periodontite/terapia , Cicatrização , Adulto , Idoso , Raspagem Dentária/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/metabolismo , Periodontite/patologia , Periodonto/metabolismo , Periodonto/patologia , Antígeno Nuclear de Célula em Proliferação/metabolismo , Aplainamento Radicular/métodos , Resultado do Tratamento , Terapia por Ultrassom/métodos
6.
Rev. clín. med. fam ; 12(2): 82-86, jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-186260

RESUMO

Las infecciones odontogénicas son muy frecuentes y representan el 10 % de las prescripciones antibióticas en España. Para el médico de familia es importante conocer los distintos cuadros clínicos para elegir adecuadamente el tratamiento, así como hacer hincapié en la prevención de los mismos. Para ello es necesario identificar la microflora oral y cómo se comporta. No debemos preguntarnos qué antibiótico dar. La cuestión es si necesitamos prescribirlos o no cuando nos enfrentamos a las infecciones odontogénicas vistas en nuestra práctica diaria. Además, debemos conocer los más indicados, tanto para el tratamiento como para la profilaxis


Odontogenic infections are very frequent and account for 10% of all antibiotic prescriptions in Spain. It is important for the family doctor to know their different clinical pictures in order to choose the treatment properly, as well as to emphasize prevention. Hence it is necessary to know the oral microflora and how it behaves. Nowadays we should not ask which antibiotic to give. The question has to be if we need to prescribe antibiotics to deal with the most common odontogenic infections seen in our practice. In addition, we must know the most suitable ones, both for the treatment and for the prophylaxis


Assuntos
Humanos , Antibacterianos/uso terapêutico , Infecção Focal Dentária/tratamento farmacológico , Antibioticoprofilaxia/métodos , Abscesso Periapical/tratamento farmacológico , Doenças Dentárias/tratamento farmacológico , Atenção Primária à Saúde/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Gengivite/tratamento farmacológico , Fatores de Risco , Desbridamento Periodontal/métodos
7.
Oral Health Prev Dent ; 17(2): 167-171, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30968072

RESUMO

PURPOSE: To retrospectively evaluate the clinical outcomes of subgingival debridement (e.g. scaling and root planing, SRP) and application of either a chlorhexidine chip (PerioChip, PC) or Arestin (AR) minocycline microspheres in patients with chronic periodontitis during supportive periodontal treatment (SPT). MATERIALS AND METHODS: Patients diagnosed with moderate to severe chronic periodontitis who were treated with SRP and a slow-release device during SPT were evaluated (total n = 53; n = 37 received PC, n = 16 received AR). Clinical measurements at baseline, 3, 6 and 12 months included changes in probing pocket depth (PD), bleeding on probing (BOP) and clinical attachment level (CAL). RESULTS: Both treatments led to a reduction in PD and gain of CAL. AR showed higher improvements in pockets of ≥7 mm compared with PC. In contrast, PC was more effective in 5-6 mm PD. At one year following treatment, both treatments reduced the need-for-surgery index (95% to 100%) of the sites at baseline to 30% for AR and 42% for PC, with no differences between PC and AR. CONCLUSIONS: In patients enrolled in SPT, the use of both PC and AR in conjunction with subgingival mechanical debridement represents an effective treatment modality for improving the clinical outcomes and reducing the need for surgery.


Assuntos
Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/análogos & derivados , Periodontite Crônica/terapia , Minociclina/uso terapêutico , Desbridamento Periodontal/métodos , Aplainamento Radicular/métodos , Idoso , Clorexidina/uso terapêutico , Raspagem Dentária/métodos , Feminino , Humanos , Masculino , Microesferas , Pessoa de Meia-Idade , Perda da Inserção Periodontal , Índice Periodontal , Bolsa Periodontal , Estudos Retrospectivos
8.
Photodiagnosis Photodyn Ther ; 25: 440-447, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30684674

RESUMO

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) has proved to be an effective adjunctive modality with potential benefits in the management of chronic periodontitis. The combination of photothermal and photodynamic effects of Indocyanine green (ICG) dye, when it is photoactivated with a diode laser of 810 nm wavelength, has been well documented in literature. AIM: This study was conducted to evaluate whether a single session of antimicrobial photodynamic therapy using ICG dye-810 nm diode laser combination can provide a substantial benefit when it is utilised as an adjunct to open flap debridement (OFD) in the management of chronic periodontitis. MATERIALS AND METHOD: Following thorough scaling and root planing, a comparative split mouth randomized controlled clinical trial was carried out on 20 recruited subjects who provided one test (OFD + aPDT) and one control site (OFD alone) each (total 40 treatment sites). The test group was subjected to a single episode of aPDT using ICG photosensitiser dye (1 mg/ml) activated with 810 nm diode laser. The laser was used in a continuous wave, non-contact mode at a power output of 100 mW applied for 30 s/spot (the total of 4 spots per tooth) and delivered by 400 µm fibre, to provide a fluence (energy density) value of 0.0125 J/cm² per spot and generate a total energy of 3 J. The following clinical parameters were assessed at baseline and 3 months: probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), plaque index (PI), gingival index (GI), and gingival bleeding index (GBI). Intragroup and intergroup comparison was performed using paired t-test and independent samples t-test respectively. RESULTS: Intragroup comparison revealed a statistically significant improvement from baseline visit (p < 0.05). Intergroup comparison showed a statistically significant improvement in RAL, RGML and GI in the test group (p < 0.05). CONCLUSION: Utilisation of ICG dye activated with 810 nm diode laser, which mediated aPDT, has demonstrated surplus clinical improvement following OFD in the management of chronic periodontitis.


Assuntos
Periodontite Crônica/tratamento farmacológico , Verde de Indocianina/uso terapêutico , Desbridamento Periodontal/métodos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Adulto , Periodontite Crônica/terapia , Terapia Combinada , Inquéritos de Saúde Bucal , Raspagem Dentária/métodos , Feminino , Humanos , Lasers Semicondutores , Masculino , Pessoa de Meia-Idade
9.
Clin Exp Dent Res ; 5(6): 601-610, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31943916

RESUMO

OBJECTIVES: Periodontal healing is often accompanied by side effects, which may cause an aesthetic deficit. The present investigation was focussed to compare patient's subjective perception of their posttherapy aesthetics with the objective measures of the results. MATERIALS AND METHODS: Survey results from patients (subjective parameters) on oral status and aesthetics were compared against routine clinical parameters and corresponding survey results from treating dentists (objective parameters), both before and after periodontal treatment. Subjective outcome parameters were then suitably transformed and compared with the objective ones to investigate the agreement between patients' perception and actual outcomes. RESULTS: Objective recordings of periodontal status by the dentist and subjective awareness of the patient are quite contradictory to each other for almost all participants. Further, it was found that their aesthetics in the front were better after treatment, but dentist professionals targeted for future treatment needs. CONCLUSIONS: In this study, it was found that patients improved aesthetically on the upper jaw front after the therapy, which was not shared by the dentists. This discrepancy was due to the clinicians' view on more aesthetic corrective procedures than on patients' need.


Assuntos
Odontólogos/psicologia , Estética Dentária/psicologia , Satisfação do Paciente/estatística & dados numéricos , Desbridamento Periodontal/efeitos adversos , Periodontite/prevenção & controle , Estudos de Coortes , Odontólogos/estatística & dados numéricos , Estética Dentária/estatística & dados numéricos , Feminino , Humanos , Masculino , Maxila , Desbridamento Periodontal/métodos , Inquéritos e Questionários/estatística & dados numéricos
10.
Int J Dent Hyg ; 17(2): 170-176, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30582880

RESUMO

OBJECTIVE: This aim of this study was to evaluate a chitosan brush for the treatment of peri-implant mucositis. MATERIALS AND METHODS: A total of 11 patients with a combined total of 24 dental implants and who were diagnosed with peri-implant mucositis were included in this 6-month, split mouth, pilot clinical trial. Implants were randomly assigned to either treatment with a chitosan brush using an oscillating dental hand piece or treatment with titanium curettes. Supportive treatment was provided at 3 months. Two calibrated periodontists, blinded to treatment group, performed all examinations, including probing pocket depths (PPD) and bleeding on probing (mBoP). The changes in clinical parameters were compared between groups at 2 weeks, 4 weeks and 6 months. A Mann-Whitney U test with an alpha level of 0.05 was used for the statistical analyses. RESULTS: Both groups demonstrated significant reductions in mBoP between baseline and 6 months. The test implants treated with the chitosan brush had a better improvement in mBoP at 2 weeks and 4 weeks compared to the implants treated with the titanium curettes. The reduction in PPD was significantly better in the test group at 4 weeks. All implants had stable bone levels, as seen on radiographs between baseline and 6 months. CONCLUSION: Reduced signs of inflammation were seen in both groups 6 months after the baseline treatment and 3 months after maintenance. A chitosan brush seems to be a safe and efficient device for debridement of dental implants.


Assuntos
Quitosana/administração & dosagem , Peri-Implantite/tratamento farmacológico , Desbridamento Periodontal/métodos , Estomatite/tratamento farmacológico , Escovação Dentária/métodos , Implantes Dentários/efeitos adversos , Humanos , Peri-Implantite/etiologia , Índice Periodontal , Projetos Piloto , Estomatite/etiologia , Fatores de Tempo
11.
Photodiagnosis Photodyn Ther ; 24: 115-120, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30227258

RESUMO

BACKGROUND: This study's aim was to evaluate the local effect of clarithromycin associated with antimicrobial photodynamic therapy (aPDT) in the treatment of generalized aggressive periodontitis. MATERIALS AND METHODS: The study sample comprised 72 periodontal pockets on single-rooted teeth in multiple quadrants, with both probing depth and clinical attachment level ≥5 mm, and with bleeding on probing. The pockets were randomly distributed into four groups (n = 18 each) that received ultrasonic periodontal debridement in addition to placebo (the UPD group), systemic clarithromycin (the UPD + CLM group), aPDT (the UPD + aPDT group), or both systemic clarithromycin and aPDT (the UPD + CLM + aPDT group). The measurements were performed prior to treatment (baseline) and at 3 and 6 months postoperatively. The following parameters were evaluated: plaque index, bleeding on probing, probing depth, gingival recession, and clinical attachment level. A 5% significance level was used in the statistical analysis. RESULTS: At 3 months, UPD + aPDT, UPD + CLM, and UPD + CLM + aPDT groups all exhibited reduced probing depths relative to the UPD group (p < 0.05). However, at 6 months, the reduction in mean probing depth was greater in the antibiotic groups (UPD+CLM and UPD+CLM+aPDT) than in the UPD and UPD+aPDT groups (p < 0.05). Regarding clinical attachment level, only the UPD+CLM+aPDT group presented a significant gain relative to the UPD and UPD + PDT groups (p < 0.05). CONCLUSIONS: Ultrasonic periodontal debridement has greater clinical advantages when associated with clarithromycin than with associated with aPDT. However, the joint application of aPDT and clarithromycin did not present additional benefits.


Assuntos
Antibacterianos/uso terapêutico , Claritromicina/uso terapêutico , Desbridamento Periodontal/métodos , Periodontite/tratamento farmacológico , Fotoquimioterapia/métodos , Adulto , Antibacterianos/administração & dosagem , Claritromicina/administração & dosagem , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Masculino , Azul de Metileno/uso terapêutico , Índice Periodontal , Fármacos Fotossensibilizantes/uso terapêutico
12.
Int J Dent Hyg ; 16(4): 559-568, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29708654

RESUMO

OBJECTIVES: To evaluate in patients with untreated adult periodontitis, the effect of treatment with a novel pocket irrigator/evacuator device (IED) compared to conventional subgingival debridement (CPT), both provided during the initial phase of active periodontal therapy. METHODS: This study was an examiner-blind, randomized controlled clinical trial using a split-mouth design. Systemically healthy patients with adult periodontitis were selected. Full-mouth probing pocket depth (PPD), gingival bleeding on pocket probing scores (BOPP), gingival recession (REC) and dental plaque (PI) were assessed at baseline. All participants received oral hygiene instructions and supragingival prophylaxis including polishing. In 2 randomly assigned contra-lateral quadrants, approximal sites were irrigated with the IED, whereas in the other quadrants, CPT was provided. The CPT consisted of subgingival debridement using ultrasonic devices followed by the use of hand instruments. At 3 months post-treatment, the clinical parameters were re-assessed. RESULTS: Twenty-five patients met the inclusion criteria and were willing to participate. At 3 months post-treatment, the PPD and BOPP had significantly improved for both treatment modalities. Pockets of ≥5 mm reduced by 0.64 mm in the IED group (P < .001), compared to a reduction of 0.82 mm for the CPT group (P < .001). With respect to the primary outcome parameter (PPD) and BI, the results with the IED were less pronounced. Between the test and control groups, no significant differences were observed for REC and PI. CONCLUSIONS: Oral hygiene instructions, supragingival prophylaxis and subgingival lavage with the IED resulted in a significant reduction in PPD and BOPP. However, the effect does not reach the results of CPT which included the subgingival use of ultrasonic and hand instruments.


Assuntos
Periodontite Crônica/terapia , Bolsa Periodontal/terapia , Irrigação Terapêutica/instrumentação , Adulto , Idoso , Placa Dentária , Feminino , Retração Gengival , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Educação de Pacientes como Assunto , Desbridamento Periodontal/métodos , Índice Periodontal , Irrigação Terapêutica/métodos , Resultado do Tratamento
13.
J Periodontal Res ; 53(3): 440-445, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29574763

RESUMO

BACKGROUND AND OBJECTIVE: Glycine powder air-polishing (GPAP) is an alternative approach to removing subgingival plaque biofilms for effective periodontal therapy. This study aimed to investigate the effect of subgingival GPAP as an additional approach to nonsurgical periodontal treatment in subjects with chronic periodontitis. MATERIAL AND METHODS: Twenty-seven nonsmoking subjects were recruited. Two quadrants in each subject were randomly assigned, according to a split-mouth design, to receive scaling and root planing (SRP) and GPAP (Test group) or SRP and air flushing with water (Control group) at sites with probing depth ≥5 mm. Clinical parameters, gingival crevicular fluid volumes and the concentrations of interleukin-1ß and interleukin-1ra in gingival crevicular fluid were measured at baseline and 1, 3 and 6 months after the treatments. RESULTS: At baseline, no statistically significant difference in periodontal and gingival crevicular fluid parameters was found between the Test and Control groups. Overall, the periodontal conditions of all subjects showed significant improvement after the treatments. Notably, the Test group showed greater reduction in gingival crevicular fluid volume (0.37 ± 0.26 µL) than the Control group (0.23 ± 0.30 µL) at 3 months (P < .05). The gingival crevicular fluid levels of interleukin-1ß and interleukin-1ra showed a significant decrease in both groups at 6 months, and no significant difference was found between the groups. CONCLUSION: These preliminary results suggest that GPAP, as an additional approach to nonsurgical periodontal treatment, may be beneficial for the short-term improvement of subclinical inflammation when measured by gingival crevicular fluid volume. Further longitudinal studies with larger sample sizes are required to clarify the exact benefits of GPAP treatment for controlling inflammation and maintaining long-term periodontal health.


Assuntos
Periodontite Crônica/terapia , Placa Dentária/terapia , Glicina/uso terapêutico , Desbridamento Periodontal/métodos , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Citocinas/análise , Índice de Placa Dentária , Polimento Dentário/métodos , Raspagem Dentária/métodos , Líquido do Sulco Gengival/química , Hong Kong , Humanos , Inflamação/terapia , Interleucina-1beta/análise , Pessoa de Meia-Idade , Perda da Inserção Periodontal , Desbridamento Periodontal/instrumentação , Índice Periodontal , Bolsa Periodontal , Aplainamento Radicular/métodos , Método Simples-Cego , Inquéritos e Questionários , Terapia por Ultrassom/métodos , Adulto Jovem
14.
Cochrane Database Syst Rev ; 1: CD009376, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29291254

RESUMO

BACKGROUND: Periodontitis is a bacterially-induced, chronic inflammatory disease that destroys the connective tissues and bone that support teeth. Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. Following completion of treatment and arrest of inflammation, supportive periodontal therapy (SPT) is employed to reduce the probability of re-infection and progression of the disease; to maintain teeth without pain, excessive mobility or persistent infection in the long term, and to prevent related oral diseases.According to the American Academy of Periodontology, SPT should include all components of a typical dental recall examination, and importantly should also include periodontal re-evaluation and risk assessment, supragingival and subgingival removal of bacterial plaque and calculus, and re-treatment of any sites showing recurrent or persistent disease. While the first four points might be expected to form part of the routine examination appointment for periodontally healthy patients, the inclusion of thorough periodontal evaluation, risk assessment and subsequent treatment - normally including mechanical debridement of any plaque or calculus deposits - differentiates SPT from routine care.Success of SPT has been reported in a number of long-term, retrospective studies. This review aimed to assess the evidence available from randomised controlled trials (RCTs). OBJECTIVES: To determine the effects of supportive periodontal therapy (SPT) in the maintenance of the dentition of adults treated for periodontitis. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 5), MEDLINE Ovid (1946 to 8 May 2017), and Embase Ovid (1980 to 8 May 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials (RCTs) evaluating SPT versus monitoring only or alternative approaches to mechanical debridement; SPT alone versus SPT with adjunctive interventions; different approaches to or providers of SPT; and different time intervals for SPT delivery.We excluded split-mouth studies where we considered there could be a risk of contamination.Participants must have completed active periodontal therapy at least six months prior to randomisation and be enrolled in an SPT programme. Trials must have had a minimum follow-up period of 12 months. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results to identify studies for inclusion, assessed the risk of bias in included studies and extracted study data. When possible, we calculated mean differences (MDs) and 95% confidence intervals (CIs) for continuous variables. Two review authors assessed the quality of evidence for each comparison and outcome using GRADE criteria. MAIN RESULTS: We included four trials involving 307 participants aged 31 to 85 years, who had been previously treated for moderate to severe chronic periodontitis. Three studies compared adjuncts to mechanical debridement in SPT versus debridement only. The adjuncts were local antibiotics in two studies (one at high risk of bias and one at low risk) and photodynamic therapy in one study (at unclear risk of bias). One study at high risk of bias compared provision of SPT by a specialist versus general practitioner. We did not identify any RCTs evaluating the effects of SPT versus monitoring only, or of providing SPT at different time intervals, or that compared the effects of mechanical debridement using different approaches or technologies.No included trials measured our primary outcome 'tooth loss'; however, studies evaluated signs of inflammation and potential periodontal disease progression, including bleeding on probing (BoP), clinical attachment level (CAL) and probing pocket depth (PPD).There was no evidence of a difference between SPT delivered by a specialist versus a general practitioner for BoP or PPD at 12 months (very low-quality evidence). This study did not measure CAL or adverse events.Due to heterogeneous outcome reporting, it was not possible to combine data from the two studies comparing mechanical debridement with or without the use of adjunctive local antibiotics. Both studies found no evidence of a difference between groups at 12 months (low to very low-quality evidence). There were no adverse events in either study.The use of adjunctive photodynamic therapy did not demonstrate evidence of benefit compared to mechanical debridement only (very low-quality evidence). Adverse events were not measured.The quality of the evidence is low to very low for these comparisons. Future research is likely to change the findings, therefore the results should be interpreted with caution. AUTHORS' CONCLUSIONS: Overall, there is insufficient evidence to determine the superiority of different protocols or adjunctive strategies to improve tooth maintenance during SPT. No trials evaluated SPT versus monitoring only. The evidence available for the comparisons evaluated is of low to very low quality, and hampered by dissimilarities in outcome reporting. More trials using uniform definitions and outcomes are required to address the objectives of this review.


Assuntos
Antibacterianos/uso terapêutico , Periodontite Crônica/terapia , Desbridamento Periodontal/métodos , Periodontia/métodos , Fotoquimioterapia/métodos , Perda de Dente/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Periodontite Crônica/complicações , Placa Dentária/terapia , Humanos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
J Periodontal Res ; 53(3): 378-390, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29352461

RESUMO

BACKGROUND AND OBJECTIVE: Oral probiotics appear to improve the treatment of periodontal diseases but there is limited evidence on their efficacy in the treatment of peri-implant diseases. The objective of the present study was to evaluate, clinically and microbiologically, the effect of the oral probiotic, Lactobacillus reuteri Prodentis, as adjuvant to non-surgical mechanical therapy in implants with mucositis or peri-implantitis, placed in patients with a history of periodontal disease. MATERIAL AND METHODS: A randomized, controlled, parallel-design, triple-blind prospective clinical study was designed. Patients included in the study were partially edentulous and had implants with mucositis or peri-implantitis. Implants with radiographic bone loss of ≥5 mm and/or ≥50% of the implant length were excluded, and only one implant per patient was included. After non-surgical mechanical therapy, subjects were randomly assigned to take either 1 probiotic lozenge or 1 placebo lozenge every day for 30 days. Clinical measurements were taken in the whole mouth (general plaque index and general bleeding on probing) and at the implant site (probing pocket depth, plaque index and bleeding on probing) at baseline and 30 and 90 days Microbiological examination (to identify Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum, Campylobacter rectus and Eikenella corrodens) was performed at the same study time points that clinical measurements were made. RESULTS: A total of 44 patients - 22 with mucositis and 22 with peri-implantitis - randomly received treatment with either probiotic or placebo. The probiotic L. reuteri, together with mechanical therapy, produced an additional improvement over treatment with mechanical therapy alone, both in the general clinical parameters of patients with mucositis (bleeding on probing) and at the level of implants with mucositis (probing pocket depth) or peri-implantitis (bleeding on probing and probing pocket depth). However, L. reuteri had a very limited effect on the peri-implant microbiota because the only parameter in which a significant decrease was found was the bacterial load of P. gingivalis in implants with mucositis (P = .031). CONCLUSION: The administration of a daily lozenge of L. reuteri for 30 days, together with mechanical debridement of the whole mouth, improved the clinical parameters of implants with mucositis or peri-implantitis over a period of at least 90 days, but the microbiological effect was much more limited. Probiotics provide an alternative therapeutic approach to consider in the prevention and treatment of peri-implant diseases, but further long-term prospective studies with standardized variables are needed.


Assuntos
Lactobacillus reuteri/fisiologia , Mucosite/microbiologia , Mucosite/terapia , Peri-Implantite/microbiologia , Peri-Implantite/terapia , Probióticos/uso terapêutico , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/patologia , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Bactérias/patogenicidade , Carga Bacteriana , Implantes Dentários/microbiologia , Índice de Placa Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peri-Implantite/patologia , Desbridamento Periodontal/métodos , Índice Periodontal , Bolsa Periodontal/patologia , Estudos Prospectivos , Espanha , Resultado do Tratamento
16.
Int Endod J ; 51(7): 800-807, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29363136

RESUMO

AIM: To examine the efficacy of a novel supplementary irrigant agitating brush (Finisher GF Brush, MedicNRG, Kibbutz Afikim, Israel) on the debridement of root canals prepared with a novel stainless steel rotary instrumentation system (Gentlefile; MedicNRG), or nickel titanium rotary instruments in oval root canals. METHODOLOGY: Mandibular premolars (n = 72) were selected and divided randomly into three experimental groups (n = 24) after microCT scanning: group 1, canal preparation to rotary NiTi size 20, .04 taper (R20); group 2, rotary NiTi to size 25, .04 taper (R25) and group 3, Gentlefile size 23, .04 taper (GF). Specimens were subdivided into two subgroups: subgroup A, syringe-and-needle irrigation (SNI); subgroup B, Finisher GF Brush (GB). Ten untreated canals served as controls. Specimens were processed for histological evaluation, and the remaining pulp tissue (RPT) was measured. Data were analysed using Mann-Whitney and Kruskal-Wallis tests (P = 0.05). RESULTS: All experimental groups had significantly less RPT than the control (P < 0.05). Group 3B (GF-GB) had significantly less RPT than groups 1B (R20-GB) and 2B (R25-GF; P < 0.05). When irrigated with SNI, there was no significant difference in the RPT between the three groups (P > 0.05). When instrumented with R20, there was no significant difference between SNI and GF (P < 0.05) whilst GB had significantly less RPT than SNI for R25 (P < 0.05). CONCLUSIONS: Supplementary irrigant agitation with the Finisher GF Brush improved the debridement of canals prepared with Gentlefile and size 25, .04 taper rotary NiTi. Root canal debridement did not significantly differ between the instruments when syringe irrigation was used.


Assuntos
Desbridamento Periodontal/métodos , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Ligas , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/cirurgia , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/cirurgia , Humanos , Desbridamento Periodontal/instrumentação , Radiografia Dentária , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Microtomografia por Raio-X
17.
Photodiagnosis Photodyn Ther ; 21: 1-9, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29079351

RESUMO

BACKGROUND: Photodynamic therapy in peri-implantitis has been tested in randomized clinical trials. Though systematic review and meta-analysis on human and animal studies, identifies the utility of photodynamic therapy, a comparison of other interventions with photodynamic therapy for peri-implantitis does not exist. Hence the aim of this network meta-analysis is to identify the role of photodynamic therapy for peri-implantitis compared with other interventions tested in randomized human clinical trials. METHOD: Randomized controlled trials comparing photodynamic therapy and other interventions in patients with peri- implantitis was searched for in electronic databases. The risk of bias was calculated using Cochrane risk of Bias tool. The heterogeneity between the studies in direct comparison was assessed using Chi-square and I2 tests. GRADE working group approach was used to assess the quality of evidence. Publication bias was assessed using Funnel plot and Trim and Fill method was used to identify the number of missing studies. RESULTS: We observed a significant reduction in the level of attachment scores with the use of combined photodynamic therapy with mechanical debridement when compared with other interventions tested. For bleeding on probing, pocket depth and plaque scores no statistically significant results were obtained. CONCLUSION: The use of photodynamic therapy with mechanical debridement will definitely bring about significant improvement in patients with peri-implantitis. Further trials on the use of photodynamic therapy with other treatment modalities need to be tested to arrive at the best possible treatment option for peri-implantitis.


Assuntos
Peri-Implantite/tratamento farmacológico , Desbridamento Periodontal/métodos , Fotoquimioterapia/métodos , Implantes Dentários , Índice de Placa Dentária , Hemorragia , Humanos , Metanálise em Rede , Índice Periodontal , Fármacos Fotossensibilizantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
J Clin Periodontol ; 45(2): 213-224, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29106749

RESUMO

AIM: To compare two treatment strategies regarding the effect of orthodontic treatment on periodontal status in patients with plaque-induced periodontitis. SUBJECTS AND METHODS: This was a randomized clinical trial. Fifty periodontal patients were randomly assigned to the test or control groups according to periodontal treatment timing. All patients received supra- and subgingival debridement following baseline examination. Control group patients received cause-related periodontal treatment before the start of orthodontic treatment and which was performed simultaneous to orthodontic treatment for the test group patients. RESULTS: No difference between the test and control groups was found regarding change of clinical attachment level (CAL) after periodontal-orthodontic treatment. Fewer sites with initial pocket depth (PD) of 4-6 mm healed after periodontal-orthodontic treatment in the test group (20.5%, IQR = 11.9%) in comparison with controls (30.4%, IQR = 27.1%) (p = .03). Anterior teeth [OR 2.5] and teeth in male patients [OR 1.6] had a greater chance for PD improvement ≥2 mm. Total periodontal-orthodontic treatment duration was significantly longer for the control group (p < .01). CONCLUSIONS: Both groups showed a gain of CAL and a reduction in sites with PD ≥ 4 mm. Orthodontic treatment, simultaneously to the periodontal treatment, could be used in the routine treatment of patients with plaque-induced periodontitis.


Assuntos
Má Oclusão/complicações , Ortodontia Corretiva , Periodontite/complicações , Técnicas de Movimentação Dentária , Adulto , Feminino , Humanos , Masculino , Má Oclusão/terapia , Pessoa de Meia-Idade , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/métodos , Perda da Inserção Periodontal/complicações , Perda da Inserção Periodontal/terapia , Desbridamento Periodontal/métodos , Periodontite/terapia , Técnicas de Movimentação Dentária/métodos
19.
Periodontol 2000 ; 76(1): 180-190, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29239086

RESUMO

Peri-implant and periodontal pockets share a number of anatomical features but also have distinct differences. These differences make peri-implant pockets more susceptible to trauma and infection than periodontal pockets. Inadequate maintenance can lead to infections (defined as peri-implant mucositis and peri-implantitis) within peri-implant pockets. These infections are recognized as inflammatory diseases, which ultimately lead to the loss of supporting bone. Diagnostic and treatment methods conventionally used in periodontics have been adopted to assess and treat these diseases. Controlling infection includes elimination of the biofilm from the implant surface and efficient mechanical debridement. However, the prosthetic supra-structure and implant surface characteristics can complicate treatment. Evidence shows that when appropriately managed, peri-implant mucositis is reversible. Nonsurgical therapy, with or without the use of antimicrobials, will occasionally resolve peri-implantitis, but for the majority of advanced lesions this approach is insufficient and surgery is indicated. The major objective of the surgical approach is to provide access and visualize the clinical situation. Hence, a more informed decision can be made regarding whether to use a resective or a regenerative surgical technique. Evidence shows that following successful decontamination, surgical treatment to regenerate the bone can be performed, and a number of regenerative techniques have been proposed. After treatment, regular maintenance and good oral hygiene are essential for a predictable outcome and long-term stability.


Assuntos
Peri-Implantite/terapia , Bolsa Periodontal/terapia , Perda do Osso Alveolar , Anti-Infecciosos/uso terapêutico , Biofilmes/efeitos dos fármacos , Implantes Dentários , Placa Dentária , Profilaxia Dentária , Humanos , Higiene Bucal , Índice de Higiene Oral , Procedimentos Cirúrgicos Bucais/métodos , Peri-Implantite/diagnóstico , Peri-Implantite/prevenção & controle , Peri-Implantite/cirurgia , Desbridamento Periodontal/métodos , Índice Periodontal , Bolsa Periodontal/diagnóstico , Bolsa Periodontal/prevenção & controle , Bolsa Periodontal/cirurgia , Estomatite/diagnóstico , Estomatite/prevenção & controle , Estomatite/terapia , Resultado do Tratamento
20.
J Endod ; 44(2): 274-279, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29273493

RESUMO

INTRODUCTION: Despite the increasing reports on mechanical aspects of contracted endodontic access cavities (CECs), we believe that the biological aspects (debridement) have not been adequately investigated. This study examined if 1 type of CEC (orifice-directed dentin conservation [DDC] access) was able to debride the pulp chamber, root canals, and isthmus of mesial roots of mandibular molars similar to a traditional endodontic access cavity (TEC). METHODS: Mandibular molars (N = 32) were selected and divided randomly into 2 experimental groups (n = 12) after micro-computed tomographic scanning (group 1: TEC and group 2: DDC) and histologic controls (n = 8). After instrumentation to a size 30/0.06 taper using 3% sodium hypochlorite as irrigant, specimens were processed for histologic evaluation, and the remaining pulp tissue (RPT) was measured from the pulp chamber, root canal, and isthmus at all root thirds. Data were analyzed using 1-way analysis of variance, Kruskal-Wallis, and appropriate post hoc tests (P = .05). RESULTS: The RPT in the pulp chamber was significantly higher in DDC compared with TEC (P < .05). Comparing the root thirds in each group, there was no significant difference in the RPT within the root canals or the isthmus (P > .05). The RPT within the root canals and isthmus was not significantly different between the 2 access cavity designs at any root third (P > .05). CONCLUSIONS: Debridement of the pulp chamber was significantly compromised in DDC. The type of access cavity did not influence the amount of RPT in the root canals and isthmus.


Assuntos
Cavidade Pulpar/metabolismo , Dentina/metabolismo , Dente Molar/metabolismo , Desbridamento Periodontal/métodos , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/métodos , Humanos , Mandíbula
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...