Supportive periodontal treatment and full-mouth ultrasonic debridement: a randomised controlled clinical trial.

PURPOSE: To evaluate the effect of different maintenance recall intervals in patients with chronic periodontitis treated by full-mouth ultrasonic debridement. MATERIALS AND METHODS: Twenty-eight patients participated in the study and were divided into two groups: group 1 (n = 14) underwent full-mouth ultrasonic debridement followed by monthly supportive periodontal therapy; group 2 (n = 14) underwent full-mouth ultrasonic debridement followed by supportive periodontal therapy delivered at 3-month intervals. Plaque index (PI), bleeding on probing (BOP), pocket probing depth (PD), gingival recession (GR) and clinical attachment level (CAL) were evaluated at baseline and after 3 and 6 months. RESULTS: Subjects in group 1 had statistically significantly lower PI scores than did subjects in group 2 at six months. However, no differences in BOP, PPD, GR and CAL were observed between groups at any of the time points evaluated. Nonetheless, while full-mouth BOP and PPD scores progressively decreased over time in group 1, the same parameters were significantly reduced at 3 months in group 2, but remained stable thereafter. The proportion of moderate and deep pockets decreased progressively over time in the group of monthly recalls, while the proportion of moderate to deep sites decreased significantly in group 2 only at 3 months; no additional reductions were seen at 6 months. CONCLUSION: Supportive periodontal therapy both at one- and three-month intervals promotes short-term stability of clinical improvements obtained after full-mouth ultrasonic debridement in patients with chronic periodontitis.

Double-masked randomized clinical trial evaluating the effect of a triclosan/copolymer dentifrice on periodontal healing after one-stage full-mouth debridement.

BACKGROUND: This study evaluates the effect of triclosan/copolymer dentifrice on the 6-month clinical response of patients with generalized severe chronic periodontitis (GSCP) treated with one-stage, full-mouth ultrasonic debridement (FMUD). METHODS: Thirty patients diagnosed with GSCP (≥8 teeth presenting probing depth [PD] ≥5 mm and bleeding on probing [BOP]) were selected and randomly allocated to a control group (n = 15) subjected to FMUD and daily use of a placebo dentifrice or to a test group (n = 15) subjected to FMUD and daily use of a triclosan/copolymer dentifrice. Patients were analyzed for the following parameters: full-mouth plaque index (FMPI), full-mouth BOP score (FMBS), gingival recession, PD, and clinical attachment level (CAL). Patients were evaluated at 3 and 6 months by a calibrated and masked examiner. RESULTS: Initially, the groups presented similar periodontal conditions, with no significant differences in any of the parameters evaluated (P >0.05). In both groups, improvements in all periodontal parameters (P <0.05) were seen at the completion of the experimental period. Additionally, the test group showed lower FMPI (3 months) and FMBS (3 and 6 months) than the control group (P <0.05). Moreover, the CAL gain was significantly greater in the test group, especially at initially deep pockets (PD ≤7 mm). Whereas in the control group the CAL gain in deep pockets was 2.7 ± 0.6 mm, in the test group the CAL gain was 3.6 ± 1.4 mm (P <0.05). CONCLUSION: Within the limits of the present study, the use of triclosan/copolymer dentifrice promoted additional clinical benefits in the treatment of GSCP treated by one-stage FMUD.

Clinical and metabolic evaluation of one-stage, full-mouth, ultrasonic debridement as a therapeutic approach for uncontrolled type 2 diabetic patients with periodontitis.

OBJECTIVE: To evaluate the therapeutic potential of one-stage, full-mouth, ultrasonic debridement (FMUD) as a treatment for type 2 diabetic patients with generalized severe chronic periodontitis. METHOD AND MATERIALS: Sixteen patients diagnosed with generalized severe chronic periodontitis and type 2 diabetes mellitus were allocated to the diabetic group; another 15 subjects with periodontitis but without metabolic disorders were placed in the nondiabetic group. Both groups were treated using the FMUD protocol, a unique 45-minute session of ultrasonic debridement of all sites presenting periodontal disease. Patients were analyzed for the following parameters: plaque and bleeding indices, gingival recession, probing depth, and clinical attachment level. Further, diabetic subjects were assessed using fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) tests. Patients were evaluated at 3 and 6 months for all parameters. ANOVA and the Tukey test were used for data analysis (P < .05). RESULTS: Both groups showed improved periodontal health after treatment. There were no significant differences between the groups for any of the parameters assessed (P > .05). Diabetic subjects treated with FMUD had a clinical response similar to that of nondiabetic subjects at all pocket depths. No adverse effects or medical disturbances were observed in either group during treatment. FPG and HbA1c levels remained unaltered after treatment. CONCLUSION: Within the limitations of this study, FMUD promoted clinical improvements in patients with type 2 uncontrolled diabetes and generalized severe chronic periodontitis.

A comparative study of lingual bracket bond strength.

AIM: To compare the adhesive potential, the mechanics implicated in adhesive failure, and the effect on the enamel of four brands of lingual brackets. METHODS: One hundred sixty premolars and four types of commercially available lingual brackets (STB, ORG, Magic, and Stealth) were selected. Forty brackets per manufacturer were used, half bonded directly and half indirectly. Each of these bonding groups was further subdivided: 10 brackets were bonded without treatment, while the other 10 were sandblasted. Thus, a total of four groups were created for each type of bracket: (a) sandblasted and directly bonded, (b) sandblasted and indirectly bonded, (c) not sandblasted and directly bonded, and (d) not sandblasted and indirectly bonded. Immediately after bonding, each bracket was tested for adhesion strength, and each appliance was then examined via electron microscopy to calculate the ARI. RESULTS: Statistical analysis showed a significant difference among the four bracket types; a general improvement in lingual appliance mechanical features provoked by sandblasting, albeit with some exceptions; and no significant effect of bonding method on the degree of bond strength. The ARI revealed that the most common area of adhesion crisis was at the adhesive-bracket interface. CONCLUSION: Overall, STB brackets performed better, and sandblasting proved to be an efficient way of improving the mechanical features of lingual brackets. Bonding technique, on the other hand, did not seem to exert a great influence on bonding success, and the bracket-adhesive interface was identified as the area most prone to failure.

Clinical effects of supragingival plaque control on uncontrolled type 2 diabetes mellitus subjects with chronic periodontitis

Aim: To determine the clinical changes occurred in chronic periodontitis patients presentinguncontrolled type 2 diabetes mellitus after a supragingival plaque control period. Methods:Subjects presenting generalized chronic periodontitis were divided into two groups: Non-diabetics(n=20) – healthy subjects presenting chronic periodontitis; and Diabetics (n=14) – subjects withuncontrolled type 2 diabetes mellitus presenting chronic periodontitis. All subjects went through 28days of supragingival plaque control - ST - (including prophylaxis, calculus removal, extractionof hopeless teeth and oral hygiene instructions) and were evaluated at baseline and after 28 daysby the following parameters: Full-Mouth Plaque Score (FMPS) and Full-Mouth Bleeding Scores(FMBS), Periodontal Probing Depth (PPD), Gingival Recession (GR) and Clinical AttachmentLevel (CAL). ANOVA/Tukey’s test and Student’s t test were used for data analysis. Results: Nostatistically significant differences (p>0.05) between groups were observed at baseline for anyparameter. Both groups presented a significant reduction in FMPS and FMBS after 28 days(p<0.05), but no statistically significant difference was found (p>0.05) between groups. Clinically,only the Non-diabetic group showed a significant improvement after ST, in PPD of initially deeppockets (p<0.05). However, no change in the clinical parameters was observed in the diabeticsubjects (p>0.05). Conclusions: It may be concluded that uncontrolled diabetes mellitus reducesperiodontal changes in the supragingival plaque control regimen of subjects presenting withchronic periodontitis.