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1.
Oral Health Prev Dent ; 18(1): 881-887, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33215480

RESUMO

PURPOSE: To evaluate effects of the adjunctive subgingival application of sodium hypochlorite on clinical outcome following nonsurgical periodontal treatment. MATERIALS AND METHODS: A search protocol was developed to answer the following focused question: 'in patients with periodontitis, does adjunctive subgingival application of sodium hypochlorite have additional clinical benefits compared to subgingival debridement alone?' Randomised controlled clinical trials (RCTs) published up to January 30, 2020, with at least 6 months of follow-up, in which sodium hypochlorite was used as an adjunct in nonsurgical periodontitis treatment were included. The search was limited to the English language. RESULTS: Out of 355 studies retrieved, the search resulted in two publications that fulfilled the inclusion criteria. The adjunctive application of sodium hypochlorite did not provide additional beneficial effect in terms of changes in the evaluated clinical outcomes (i.e. probing depth values [PDs], clinical attachment level gain [CAL] and bleeding on probing [BOP]) when compared to mechanical instrumentation alone over the 12-month investigation period (p > 0.05). CONCLUSION: The available data have failed to show any additional clinical benefit following the use of sodium hypochlorite in conjunction with nonsurgical periodontal therapy.


Assuntos
Periodontite , Hipoclorito de Sódio , Raspagem Dentária , Humanos , Periodontite/tratamento farmacológico , Hipoclorito de Sódio/uso terapêutico
2.
Oral Health Prev Dent ; 18(1): 889-910, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33215481

RESUMO

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


Assuntos
Periodontite Crônica , Raspagem Dentária , Antibacterianos/uso terapêutico , Terapia Combinada , Assistência Odontológica , Humanos , Aplainamento Radicular
3.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(5): 532-536, 2020 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-33085237

RESUMO

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


Assuntos
Raspagem Dentária , Periodontite , Assistência Odontológica , Endoscópios , Humanos , Aplainamento Radicular
4.
Shanghai Kou Qiang Yi Xue ; 29(3): 308-311, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33043350

RESUMO

PURPOSE: To evaluate the clinical efficacy of erbium-doped yttrium aluminium garnet (Er: YAG) laser in the treatment of degree II bifurcation periodontitis. METHODS: Thirty patients(60 teeth) with grade II bifurcation lesions of chronic periodontitis were enrolled in this study. One week after supergingival scaling with ultrasound, the patients were randomly divided into experimental group: subgingival scaling with ultrasound and hand instruments + Er: YAG laser irradiation in periodontal pocket; control group: the contralateral homonymous teeth were treated with subgingival scaling with ultrasound and hand instruments alone. The changes of gingival index(GI), pocket depth(PD), horizontal probing depth (HPD) and attachment loss(AL) were compared between the two groups 12 and 20 weeks after treatment. SPSS 20.0 software package was used for statistical analysis. RESULTS: Periodontal clinical indexes(GI, PD, HPD, AL) of the experimental group and control group were significantly reduced compared with baseline at 12 and 20 weeks after treatment(P<0.05). At 12 and 20 weeks after treatment, PD in the experimental group was (4.03±0.48) mm and (3.43±0.45) mm, (4.82±0.55) mm and (4.27±0.36) mm in the control group, respectively. The reduction of PD in the experimental group was significantly greater than that in the control group (P<0.05). There was no significant difference in HPD between the two groups at 12 weeks after treatment. Twenty weeks after operation, HPD in the experimental group was found to be (3.01±0.34) mm and (3.78±0.29) mm in the control group. The decrease of HPD in the experimental group was significantly greater than that in the control group (P<0.05). GI and AL of the experimental group at 12 and 20 weeks were lower than those of the control group, but the difference was not statistically significant. CONCLUSIONS: Er: YAG laser is safe and effective in the treatment of chronic periodontitis patients with grade II root bifurcation lesions with significant clinical value.


Assuntos
Periodontite Crônica , Lasers de Estado Sólido , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Lasers de Estado Sólido/uso terapêutico , Índice Periodontal , Bolsa Periodontal
5.
Shanghai Kou Qiang Yi Xue ; 29(3): 321-324, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33043353

RESUMO

PURPOSE: To evaluate the clinical effect of 65 µm glycine powder air-polishing (GPAP) by comparing with sodium hydrogen carbonate after ultrasonic scaling during subgingival polishing. METHODS: Thirty-three patients who were systematically healthy were involved in this study. After ultrasonic scaling,they were randomly assigned to the experimental group or the control group. Patients in the control group were treated with rubber cup + sodium hydrogen carbonate, while patients in the experimental group were treated only with 65 µm GPAP therapy. The clinical parameters including probing depth(PD), bleeding index(BI), plaque index(PI), staining index(SI) were recorded at baseline, 1week, 1 month, 3 months and 6 months after treatment. The results were analyzed by paired sample Wilcoxon signed-rank test with SPSS 23.0 software package. RESULTS: Both methods had good clinical effects. PD, BI, PI and SI of the two groups at 1 month, 3 months and 6 months after treatment were significantly better than those at baseline (P<0.01). SI of the experimental groups was significantly lower than that of the control group at 1 month, 3 months and 6 months after treatment(P<0.01). CONCLUSIONS: The results indicated that 65 µm GPAP may be as effective as sodium hydrogen carbonate after ultrasonic scaling in removal of dental plaque and stain. 65 µm GPAP had the advantage of reducing restaining.


Assuntos
Glicina , Ultrassom , Raspagem Dentária , Humanos , Índice Periodontal , Bolsa Periodontal
6.
J Int Acad Periodontol ; 22(4): 187-204, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32980832

RESUMO

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


Assuntos
Raspagem Dentária , Periodontite , Mãos , Humanos , Aplainamento Radicular , Ultrassom
7.
J Vis Exp ; (163)2020 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-32955504

RESUMO

An experimental and image analysis technique is presented for imaging cavitation bubbles and calculating their area. The high-speed imaging experimental technique and image analysis protocol presented here can also be applied for imaging microscopic bubbles in other fields of research; therefore, it has a wide range of applications. We apply this to image cavitation around dental ultrasonic scalers. It is important to image cavitation to characterize it and to understand how it can be exploited for various applications. Cavitation occurring around dental ultrasonic scalers can be used as a novel method of dental plaque removal, which would be more effective and cause less damage than current periodontal therapy techniques. We present a method for imaging the cavitation bubble clouds occurring around dental ultrasonic scaler tips using a high-speed camera and a zoom lens. We also calculate the area of cavitation using machine learning image analysis. Open source software is used for image analysis. The image analysis presented is easy to replicate, does not require programming experience, and can be modified easily to suit the application of the user.


Assuntos
Processamento de Imagem Assistida por Computador , Microbolhas , Fotografação , Raspagem Dentária/instrumentação , Movimento (Física) , Fotografação/métodos , Sonicação/instrumentação
8.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 385-392, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865356

RESUMO

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


Assuntos
Periodontite Crônica , Proteína C-Reativa , Raspagem Dentária , Humanos , Estudos Prospectivos , Aplainamento Radicular
9.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 393-397, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865357

RESUMO

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


Assuntos
Raspagem Dentária , Periodontite , Endoscópios , Seguimentos , Hemorragia Gengival , Humanos , Perda da Inserção Periodontal , Índice Periodontal , Bolsa Periodontal , Aplainamento Radicular , Resultado do Tratamento
10.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(5): 723-726, 2020 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-32897208

RESUMO

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


Assuntos
Periodontite Crônica , Idoso , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Aplainamento Radicular , Resultado do Tratamento , Ultrassonografia
11.
Arch Oral Biol ; 117: 104825, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32622257

RESUMO

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


Assuntos
Raspagem Dentária , Lactobacillus reuteri , Periodontite , Aplainamento Radicular , Animais , Fluoruracila/farmacologia , Periodontite/terapia , Ratos
12.
J Biol Regul Homeost Agents ; 34(3 Suppl. 1): 45-54, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32618160

RESUMO

The aim of this review was to investigate the additional effects of diode laser irradiation in combination with nonsurgical periodontal therapy. An electronic search of publications was established from three electronic databases: Cochrane, PubMed and Web of Science. The search strategy used a combination of controlled vocabulary and free-text words. Inclusion and exclusion criteria were defined by the authors before the start of the study. The inclusion criteria were all studies published in English language, randomized controlled trials, based on human subjects. All trials were designed to evaluate the efficacy of the diode laser therapy as an adjunct to nonsurgical periodontal therapy in the treatment of chronic periodontitis patients. All studies analyzed are not older than five years. The search resulted in 188 titles. After the analysis of the abstracts, an article was excluded because it was not relevant for the study and two because it treated aggressive periodontitis. At the end only 6 articles were included in the qualitative analysis. The potential role in chronic periodontal disease treatment of diode laser is still not demonstrated. Several studies regard the diode laser therapy, but there is still heterogeneity for what it concerns research and clinical protocols. As a result, several randomized controlled trials are needed to obtain certain data.


Assuntos
Periodontite Crônica , Terapia a Laser , Periodontite Crônica/radioterapia , Raspagem Dentária , Humanos , Lasers Semicondutores/uso terapêutico
13.
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
14.
J Int Acad Periodontol ; 22(3): 129-136, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32655038

RESUMO

AIMS: This case series study aimed to assess the clinical outcomes of a novel protocol for the treatment of patients with severe periodontitis. MATERIALS AND METHODS: Twenty (20) patients with severe periodontitis underwent a single session of One-Stage Full-Mouth Instrumentation (OSFMI) involving supra- and sub-gingival air-polishing with erythritol and chlorhexidine powder and ultrasonic root surface debridement and calculus removal, in association with systemic amoxicillin and metronidazole. Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Recession (REC), Bleeding on Probing (BOP) and Plaque Index (PI) were collected at baseline (T0), 6 weeks (T1), 3 months (T2) and 6 months (T3). RESULTS: At 6 months, 30% of subjects reached the primary clinical endpoint (less than or equal to4 sites with PD greater than or equal to 5 mm). The percentage of BOP decreased from 49.08 (CI95% 36.06; 62.1) at T0 to 12.97 (CI95% 7.57; 18.37) at T3. The mean number pockets with PPD≥ 5 mm and PPD greater than or equal to 7 mm decreased significantly, from 46.0 and 20.6 at T0 to 11.5 and 2.8 at T3 respectively (p less than 0.001). CONCLUSION: The OSFMI protocol led to clinical results comparable to those obtained with traditional SRP. Researchers are encouraged to test this protocol in randomized clinical trials with longer periods of observation.


Assuntos
Raspagem Dentária , Periodontite , Índice de Placa Dentária , Humanos , Metronidazol/uso terapêutico , Bolsa Periodontal/terapia , Periodontite/terapia , Resultado do Tratamento
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(7): 475-481, 2020 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-32634886

RESUMO

Objective: To explore the effect of systemic use of amoxicillin and metronidazole during mechanical therapy on the clinical parameters of the first molars and periodontal microorganisms in subgingival plaque and saliva in patients with generalized aggressive periodontitis (GAgP). Methods: A total of 23 GAgP patients were recruited from Peking University School and Hospital of Stomatology from January 2006 to December 2009 and then randomly divided into two groups according to random number table: 12 patients received scaling and root planning (SRP) only and 11 patients received SRP combined with systemic administration of antibiotics (amoxicillin and metronidazole for a week after supragingival scaling). Clinical examination of periodontal parameters and collection of saliva and pooled subgingival plaque samples from mesial-buccal sites of 4 first molars were performed before initial therapy and 2, 4 and 6 months respectively after mechanical therapy, and saliva samples were also collected 2 weeks after therapy. Eight different periodontal microorganisms were detected in these samples by PCR. In addition, semiquantitative analysis of red complex microorganisms [Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td)] was performed. Results: Both therapies led to significant decrease of the plaque index (PLI), probing depth (PD) and bleeding index (BI) from mesial-buccal sites of first molars. Meanwhile the PD of antibiotics group [(4.21±1.50), (4.00±1.54), (3.84±1.89) mm of 2, 4 and 6 months respectively after therapy] was significantly lower than the SRP group [(5.29±1.27), (5.30±1.34), (4.98±1.36) mm of 2, 4 and 6 months respectively after therapy] at 3 different time points after mechanical therapy (P<0.05). In the antibiotics group, the quantities of Pg, Tf and Td in subgingival plaque samples (the median quantity decreased to 0.0 ng at 2, 4 and 6 months after therapy) and saliva samples (the median quantity of Tf and Td decreased to 0.0 ng at 2, 4 and 6 months after therapy (P<0.05), and the median quantity of Pg decreased to 16.3, 59.6 and 22.4 ng at 2, 4 and 6 months respectively after therapy) significantly decreased at 3 different time points after mechanical therapy compared with before therapy (P<0.05). While in the SRP group, there were no significant changes in the quantities of Tf and Td in saliva at 2, 4 and 6 months after mechanical therapy (P>0.05) , and the quantities of Tf and Td in subgingival plaque significantly decreased only at 2 months after therapy (P<0.05). Conclusions: SRP combined with systemic administration of amoxicillin and metronidazole could achieve greater improvement in PD of first molars and better control of the amounts of red complex microorganisms in the saliva and subgingival plaque of GAgP patients over a 6-month period.


Assuntos
Periodontite Agressiva/terapia , Placa Dentária , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Raspagem Dentária , Humanos , Metronidazol/uso terapêutico , Saliva
16.
J Contemp Dent Pract ; 21(5): 494-499, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32690830

RESUMO

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


Assuntos
Anti-Infecciosos Locais , Periodontite Crônica , Curcumina , Clorexidina , Raspagem Dentária , Humanos , Aplainamento Radicular
17.
BMC Oral Health ; 20(1): 176, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32586315

RESUMO

BACKGROUND: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. METHODS: English-language databases (PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Medline, and ClinicalTrials.gov, by January, 2019) were searched. Weighted mean differences in primary outcomes, PPD and clinical attachment loss (CAL) reduction, were estimated by random effects model. Secondary outcomes, bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus, were analyzed by comparing the results of each study. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The GRADE approach was used to assess quality of evidence. RESULTS: Ten randomized controlled trials were included out of 1434 identified. Initial PPD and follow-up periods formed subgroups. For 3-months follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-months follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. CONCLUSION: When initial PPD was 4-6 mm, PPD reduction proved manual subgingival scaling was superior, but CAL results showed no statistical differences between the two means. When initial PPD was ≥6 mm, PPD and CAL reductions suggested that manual subgingival scaling was superior.


Assuntos
Raspagem Dentária , Periodontite/terapia , Ultrassom , Humanos , Bolsa Periodontal , Projetos Piloto , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
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
19.
J Contemp Dent Pract ; 21(4): 431-437, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584282

RESUMO

AIMS: Periodontitis is one of the most widespread diseases worldwide. Many efforts have been made to increase the efficacy of periodontitis therapy as much as possible. Recently, minimally invasive nonsurgical techniques (MINST) were introduced in the periodontal field as an alternative to minimally invasive surgical techniques (MIST). This clinical audit aims to evaluate the results of MINST in the initial phase of treatment for periodontitis. MATERIALS AND METHODS: One hundred seven patients with periodontitis who were treated with MINST between 2013 and 2017 and reevaluated after 2 months were included in this clinical audit. The primary outcome analyzed was the proportion of pocket closure. The secondary outcomes were tooth extraction before active periodontal therapy, full-mouth plaque score (FMPS) change, full-mouth bleeding score (FMBS) change, average probing pocket depth (PPD) reduction, and average clinical attachment level (CAL) gain between the baseline and reevaluation values. RESULTS: A total of 2,407 teeth were included in the analysis. At the patient level, the treatment resulted in a mean pocket closure rate of 71.6 ± 15.7% for sites with an initial PPD ≥5 mm. The treatment was statistically significantly (p < 0.001) more effective with respect to the primary outcome compared with expected values reported in a recent meta-analysis (57%). The subgroup analysis revealed statistically significant differences between single and multirooted teeth and between shallow (5-6 mm) and deep pockets (≥7 mm) at the baseline. CONCLUSION: Nonsurgical periodontal therapy with MINST achieved satisfactory results that were better than expected based on the scientific literature. Single-rooted and shallow pockets showed the best proportion of pocket closure at the reevaluation after treatment. CLINICAL SIGNIFICANCE: Minimally invasive nonsurgical techniques can be the treatment of choice when approaching periodontally diseased patients with nonsurgical periodontal therapy.


Assuntos
Periodontite , Auditoria Clínica , Raspagem Dentária , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Perda da Inserção Periodontal , Índice Periodontal , Resultado do Tratamento
20.
J Contemp Dent Pract ; 21(4): 410-415, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584278

RESUMO

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


Assuntos
Periodontite Crônica , Hipotireoidismo , Índice de Placa Dentária , Raspagem Dentária , Feminino , Líquido do Sulco Gengival/química , Humanos , Interleucina-6 , Perda da Inserção Periodontal , Bolsa Periodontal , Aplainamento Radicular , Fator de Necrose Tumoral alfa
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