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Herz MM, Braun S, Hoffmann N, Lachmann S, Bartha V, Petsos H. Treating Periodontitis Strictly Non-Surgically-A Retrospective Long-Term Analysis of Tooth Loss During Supportive Periodontal Care. Dent J (Basel) 2025; 13:146. [PMID: 40277476 PMCID: PMC12025359 DOI: 10.3390/dj13040146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 03/06/2025] [Accepted: 03/21/2025] [Indexed: 04/26/2025] Open
Abstract
Background/Objectives: Retrospective analysis of long-term periodontal tooth loss (PTL) during supportive periodontal care (SPC) in patients with Stage III/IV periodontitis who received strictly non-surgical periodontal treatment. Methods: Fully documented medical documentation of SPC > 5 years was analyzed at T0 (baseline), T1 (after Steps 1/2), and during SPC (T2). PTL, periodontal pocket depth (PD), bleeding on probing (BOP), tooth mobility (TM), furcation involvement (FI), and frequency of SPC were recorded. Each parameter was tested for significance in a bivariate analysis, before a multilevel logistic regression analysis was performed to identify possible factors with an impact on PTL during SPC. Results: A total of 51 women/64 men (T1 mean age 55.4 ± 10.3 yrs) were surveilled after 9.0 ± 2.4 yrs; 2647 teeth were included. On average, patients attended 10.6 ± 3.8 SPC sessions between T1 and T2; 77 patients (67%) attended at least 1/year. At T1, 68 teeth were lost; 6.1% of the remaining teeth showed FI, and 13.8% showed TM. During SPC, the PTL range was 118 (1.03 ± 1.21/patient). TM, FI, mean PD, and Stage IV periodontitis proved to be statistically significantly associated with increased PTL. Conclusions: PTL was low in this cohort. Nevertheless, at T1, it may be beneficial to focus on stopping TM by splinting the mobile teeth and reducing the PD or treating FI appropriately, understanding that these precise applications of surgical procedures could positively affect long-term tooth retention.
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Affiliation(s)
- Marco Michael Herz
- Department for Conservative Dentistry and Periodontology, Tuebingen University, 72076 Tuebingen, Germany
| | | | | | | | - Valentin Bartha
- Department for Conservative Dentistry, Heidelberg University, 69120 Heidelberg, Germany;
| | - Hari Petsos
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, 60596 Frankfurt am Main, Germany;
- Private Practice, 59494 Soest, Germany
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Akram HM, Zaidoon R, Alaa R. Prevalence and characteristics of periodontal surgery procedures in postgraduate periodontic clinics: an epidemiological analysis. Folia Med (Plovdiv) 2025; 67. [PMID: 40270144 DOI: 10.3897/folmed.67.e143232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Accepted: 02/14/2025] [Indexed: 04/25/2025] Open
Abstract
BACKGROUND Periodontal diseases include gingivitis, periodontitis, and peri-implant disease. There are different ways to treat these diseases, such as surgical and non-surgical periodontal treatments like gingivectomy, open flap debridement, and crown lengthening.
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Al Asmari D, Alenezi A. Laser Technology in Periodontal Treatment: Benefits, Risks, and Future Directions-A Mini Review. J Clin Med 2025; 14:1962. [PMID: 40142770 PMCID: PMC11943112 DOI: 10.3390/jcm14061962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2025] [Revised: 03/08/2025] [Accepted: 03/13/2025] [Indexed: 03/28/2025] Open
Abstract
Background/Objectives: The efficacy and safety of laser therapy in periodontal treatment are comprehensively reviewed in this study, focusing on efficacy, safety, patient experiences, and cost-effectiveness. Methods: This review encompasses a literature survey, analyzing studies from 2010 to 2024, and a search was conducted in January 2024 across various electronic databases, including PubMed, SCOPUS, EMBASE, COCHRANE library, and Science Direct. The search utilized Mesh terms/keywords such as "Laser therapy", "Periodontal disease", "Efficacy", and "Safety." Results: Out of the initial 884 articles identified, 98 were selected based on their titles and abstracts. After evaluating the full texts and applying the inclusion and exclusion criteria, 16 articles were chosen for the review, meeting the study's criteria. Conclusions: This review identifies gaps in current research and points to emerging trends and potential future advancements in laser therapy, emphasizing the need for standardized protocols, long-term studies, and technological innovations to enhance treatment efficacy and accessibility.
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Affiliation(s)
- Dhafer Al Asmari
- Department of Periodontology and Implant Dentistry, College of Dentistry, Qassim University, Buraydah 51452, Saudi Arabia;
| | - Ali Alenezi
- Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Buraydah 51452, Saudi Arabia
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Hormdee D, Tarawadee N, Rinsathorn W, Puasiri S, Suwannarong W. The Effect of Subgingival Curcumin Gel With and Without Photodynamic Therapy as Adjunctive Periodontal Treatment in Type 2 Diabetes Mellitus Patients: A Split-Mouth Clinical and Microbiological Study. Int J Dent 2025; 2025:2575672. [PMID: 40223866 PMCID: PMC11986935 DOI: 10.1155/ijod/2575672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 12/13/2024] [Accepted: 01/23/2025] [Indexed: 04/15/2025] Open
Abstract
Background: The study aimed to determine the quantity of periodontopathic and total bacteria on subgingival plaque from patients with periodontitis and uncontrolled diabetes and to compare adjunctive periodontal therapy using topical Curcuma longa extract gel with and without photodynamic treatment using blue light-emitting diodes (LEDs). Clinical periodontal parameters such as probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were assessed to evaluate the efficacy of the treatments. Methods: Thirty patients with diabetes mellitus (DM), a history of poor glycemic control, and chronic periodontitis were enrolled in this clinical and microbiological split-mouth study. After conventional periodontal treatment, scaling, and root planing, the most severe sites on the premolar or molar teeth with periodontal pockets measuring ≥5 mm were selected and randomly divided into two groups: the C. longa extract gel group (with a concentration of 25 µg/g) and the photodynamic group (C. longa extract gel 25 µg/g irradiated with blue light energy density = 16.8 J/cm2 for 120 s). All teeth were examined for clinical periodontal parameters data (PD, CAL, plaque index [PI], and BOP) and microbiological data (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, and total bacteria), measured using TaqMan Multiplex real-time polymerase chain reaction, at weeks 0, 1, 2, and 12. The Mann-Whitney U test was utilized to compare clinical outcomes between groups, while the Wilcoxon Signed Rank test at a 95% confidence level was employed to analyze the amount of periodontal pathogens within the same group. Results: After the 12-week follow-up period, significant improvements were observed in all clinical parameters across both groups. However, the reduction in both CAL and BOP was significantly higher in the photodynamic group compared to the curcumin gel alone group, indicating enhanced periodontal health outcomes in the former. Microbiologically, both groups exhibited a decrease in total bacterial count and a reduction in periodontopathic bacteria. Importantly, the photodynamic group demonstrated a significant decrease in F. nucleatum and P. intermedia counts, key pathogens associated with periodontal disease progression. This suggests that photodynamic therapy (PDT), when used with curcumin gel, not only improves clinical parameters but also promotes a favorable shift in the periodontal microbial profile. Conclusion: Our findings highlight that PDT with curcumin gel as a photosensitizer (PS) is more effective than curcumin gel alone in achieving clinical attachment gain, reducing gingival inflammation, and suppressing specific periodontal pathogens. This combined therapy approach holds promise for managing periodontal disease by addressing both clinical symptoms and microbial factors.
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Affiliation(s)
- Doosadee Hormdee
- Division of Periodontology, Department of Oral Biomedical Sciences, Faculty of Dentistry and Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases Associated with Oral Health, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Nisachol Tarawadee
- Division of Periodontology, Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Weena Rinsathorn
- Division of Periodontology, Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Subin Puasiri
- Division of Community Dentistry, Department of Oral Prevention, Faculty of Dentistry, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Waraporn Suwannarong
- Division of Periodontology, Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Bumm CV, Schwendicke F, Pitchika V, Heck K, Walter E, Ern C, Heym R, Werner N, Folwaczny M. Effectiveness of nonsurgical re-instrumentation: Tooth-related factors. J Periodontol 2024. [PMID: 39437224 DOI: 10.1002/jper.24-0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 09/27/2024] [Accepted: 10/01/2024] [Indexed: 10/25/2024]
Abstract
BACKGROUND To investigate tooth-related factors that influence pocket closure (PC) and the reduction of pocket probing depths (PPD) after nonsurgical re-instrumentation (NSRI) as part of step 3 therapy. METHODS A total of 480 patients (10,807 teeth) presenting with residual pockets 6.33 ± 3.79 months after steps 1 and 2 of periodontal therapy were included and retrospectively analyzed before and 5.93 ± 4.31 months after NSRI. Reduction of PPD and PC rates following NSRI were associated with tooth-related factors, namely tooth type, arch, number of roots, furcation involvement (FI), pulp vitality, mobility, type of restoration, presence of plaque, and bleeding on probing (BOP), using mixed-effects regression models. RESULTS NSRI reduced periodontal pockets persisting after initial cause-related therapy by (mean ± SD) 1.32 ± 1.79 mm in PPD, and PC rate was 40%. Moderate pockets (4-5 mm) responded better to NSRI than deep pockets (≥ 6 mm) in terms of PC (51% vs. 16%). Both PPD reduction and PC rates of deep residual pockets were significantly influenced by tooth type, arch, number of roots, and presence of BOP. CONCLUSION Tooth type, arch, number of roots, and presence of BOP at re-evaluation (before NSRI) had a significant and clinically relevant influence on NSRI as part of step 3 therapy. Considering these factors, particularly for deep residual pockets, may allow more tailored re-intervention. PLAIN LANGUAGE SUMMARY The present study aimed to investigate the influence of tooth-related factors on the outcome of repeated nonsurgical therapy of periodontitis. Therefore, 480 patients (10,807 teeth) presenting with clinical symptoms of persistent periodontitis after initial therapy were administered repeated nonsurgical therapy and retrospectively analyzed. Therapy outcomes were associated with tooth-related factors, namely tooth type, tooth location (maxilla/mandible), number of roots, involvement of the root furcation area in multi-rooted teeth, pulp vitality, mobility, restoration, presence of plaque and bleeding upon periodontal probing, using mixed-effects models. The results revealed that repeated nonsurgical therapy was effective in reducing inflammation and clinical signs of disease, with moderate residual periodontal defects responding better than deep defects. Healing of deep defects after repeated nonsurgical therapy; however, was significantly influenced by the factors: tooth type, location, number of roots, and bleeding on probing. Considering these factors, particularly in deep residual defects which are commonly suggested to be treated surgically, may allow less invasiveness and thus a more tailored re-intervention.
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Affiliation(s)
- Caspar Victor Bumm
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Vinay Pitchika
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Elias Walter
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Christina Ern
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Richard Heym
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Nils Werner
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
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6
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Raittio E, Leite FRM, Machado V, Botelho J, Nascimento GG. Do all individuals benefit equally from non-surgical periodontal therapy? Secondary analyses of systematic review data. J Periodontal Res 2024. [PMID: 39319628 DOI: 10.1111/jre.13347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/26/2024]
Abstract
AIMS This study aimed to assess the variability and treatment effect heterogeneity in response to non-surgical periodontal therapy (NSPT). METHODS Data from randomized controlled trials included in two recent systematic reviews on the effect of NSPT on mean clinical attachment loss (CAL), mean probing pocket depth (PPD), percentage of sites with bleeding on probing (%BOP), PPD ≤3 mm (%PD ≤3 mm), and C-reactive protein levels (CRP) at 3-12-month follow-up among adults with systemic diseases or conditions were used. In these trials, the control arms received no treatment, hygiene advice, or supragingival scaling. The Bayesian meta-regression models were utilized to assess the variability ratios between NSPT and control groups. RESULTS Data from 36 trials on mean PPD, 32 trials on mean CAL, eight trials on %PD ≤3 mm, 31 trials on %BOP and 19 trials on CRP were used. Variability in mean CAL and CRP was approximately 10% higher in the NSPT arms than in the control arms, hinting that there may be room for treatment effect heterogeneity. Instead, variability in mean PPD, %BOP, and %PD ≤3 mm was lower in the NSPT arms than in the control arms. CONCLUSION Potential treatment effect heterogeneity in response to NSPT was observed for CRP and mean CAL. However, substantial measurement error in CAL and natural variation in CRP may contribute to these findings. Conversely, treatment effect heterogeneity appears less pronounced for mean PPD, %BOP, and %PD ≤3 mm, potentially due to greater treatment effects in patients with more severe periodontitis and reduced measurement error in these parameters.
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Affiliation(s)
- Eero Raittio
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Fabio R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore City, Singapore
| | - Vanessa Machado
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Caparica, Portugal
| | - João Botelho
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, Caparica, Portugal
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore City, Singapore
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Werner N, Frasheri I, Heck K, Ern C, Heym R, Bumm CV, Folwaczny M. The association between periodontal microbial biomarkers and primary therapy outcome. Clin Oral Investig 2024; 28:523. [PMID: 39269543 PMCID: PMC11399289 DOI: 10.1007/s00784-024-05904-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 08/27/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE This study aims to analyse the association between the baseline microbial load of selected periodontopathogenic bacteria collected from gingival crevicular fluid (GCF) and the primary outcome of steps I and II therapy. MATERIALS AND METHODS 222 patients with stage III periodontitis were included into this retrospective analysis that received steps 1 and 2 periodontal therapy without adjunctive systemic antibiotics. Baseline GCF samples were quantitatively analysed using ELISA-based kits for levels of periodontopathogens (Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Treponema denticola (Td), and Tannerella forsythia (Tf)) and associated with the primary therapy outcome using a "treat-to-target" therapy endpoint (TE) defined as ≤ 4 sites with PD ≥ 5 mm six months after therapy. RESULTS 38.2% of the patients achieved TE. Patients failing to achieve TE revealed significantly increased levels of Pg, Fn, and Tf at baseline (Pg: p = 0.010, Fn: p = 0.008 Tf: p = 0.004). Multivariate binary logistic regression adjusted for sex, mean probing depth, diabetes, and current smoking status showed an independent relationship between Tf and the TE (aOR 2.570, p = 0.023). CONCLUSION Increased microbial load is associated with decreased responsiveness to therapy. The findings suggest that specifically baseline Tf levels are associated with poorer treatment outcomes and might improve the accuracy of periodontal diagnosis. CLINICAL RELEVANCE The findings of this study support the concept of a critical biomass that is sufficient to induce and maintain an immune response within the periodontal pocket, which ultimately leads to irreversible tissue destruction. However, calculating this level in advance may serve as an early indicator for intervention. KEY FINDING Baseline Tannerella forsythia levels are associated with poorer treatment outcome.
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Affiliation(s)
- Nils Werner
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Goethestr. 70, 80336, Munich, Germany.
| | - Iris Frasheri
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Goethestr. 70, 80336, Munich, Germany
| | - Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Goethestr. 70, 80336, Munich, Germany
| | - Christina Ern
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Goethestr. 70, 80336, Munich, Germany
- Private practice, Munich, Germany
| | - Richard Heym
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Goethestr. 70, 80336, Munich, Germany
- Private practice, Munich, Germany
| | - Caspar Victor Bumm
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Goethestr. 70, 80336, Munich, Germany
- Private practice, Munich, Germany
| | - Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Goethestr. 70, 80336, Munich, Germany
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8
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Kim YR, Kim SR, Son M. Interrupted time series analysis of chronic periodontitis-related procedures before and after the scaling reimbursement policy in Korea. J Clin Periodontol 2024; 51:1188-1198. [PMID: 39128864 DOI: 10.1111/jcpe.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 08/13/2024]
Abstract
AIM To study the use of a quasi-experimental design to assess the effects of scaling reimbursement policies on the incidence of chronic-periodontitis procedures. MATERIALS AND METHODS Interrupted time series analysis was used to compare the effects before and after policy implementation using data on the number of periodontitis-related procedures from the Korean National Health Insurance Service-National Sample Cohort (n = 740,467) and the Health Screening Cohort (n = 337,904). Periodontitis-related procedures with diagnosis codes were categorized into basic (scaling or root planing), intermediate (subgingival curettage) and advanced (tooth extraction, periodontal flap surgery, bone grafting for alveolar bone defects or guided tissue regeneration). Subjects' demographics and comorbidities were considered. The incidence rate of immediate changes and gradual effects before and after policy implementation was assessed. RESULTS Following the policy implementation from July 2013, an immediate increase was observed in total and basic procedures. No significant changes were noted in intermediate and advanced procedures initially. A decrease in the slope of intermediate procedures was observed in both databases. Advanced procedures showed varied trends, with no change in the National Sample Cohort but an increase in the Health Screening Cohort, particularly among subjects with comorbidities. CONCLUSIONS Following the new policy implementation, the number of intermediate procedures decreased while the number of advanced procedures increased, especially among patients with comorbidities. These findings offer valuable insights on policy evaluation.
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Affiliation(s)
- Yu-Rin Kim
- Department of Dental Hygiene, Silla University, Busan, Republic of Korea
| | - Seon-Rye Kim
- Department of Healthcare Management, Youngsan University, Yangsan, Republic of Korea
| | - Minkook Son
- Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea
- Department of Data Sciences Convergence, Dong-A University Interdisciplinary Program, Busan, Republic of Korea
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Al-Sharqi AJB, Abdulkareem A. Microbiological and Salivary Biomarkers Successfully Predict Site-Specific and Whole-Mouth Outcomes of Nonsurgical Periodontal Treatment. J Clin Med 2024; 13:4256. [PMID: 39064296 PMCID: PMC11277870 DOI: 10.3390/jcm13144256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 07/14/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Nonsurgical periodontal treatment (NSPT) is the gold-standard technique for treating periodontitis. However, an individual's susceptibility or the inadequate removal of subgingival biofilms could lead to unfavorable responses to NSPT. This study aimed to assess the potential of salivary and microbiological biomarkers in predicting the site-specific and whole-mouth outcomes of NSPT. Methods: A total of 68 periodontitis patients exhibiting 1111 periodontal pockets 4 to 6 mm in depth completed the active phase of periodontal treatment. Clinical periodontal parameters, saliva, and subgingival biofilm samples were collected from each patient at baseline and three months after NSPT. A quantitative PCR assay was used to detect the presence of Fusobaterium nucleatum and Porphyromonas gingivalis in the biofilm samples. Salivary biomarkers including matrix metalloproteinase (MMP)-9, glutathione S-transferase (GST), and Annexin-1 were assayed both qualitatively (Western blot analysis) and quantitively (ELISA). Results: NSPT yielded significant improvements in all clinical parameters, including a reduction in bacterial load and decreased levels of MMP-9 together with increased concentrations of GST and Annexin-1. The binary logistic regression suggested that the overall accuracy of P. gingivalis identification, probing pocket depth, and interproximal sites was 71.1% in predicting successful site-specific outcomes. The salivary biomarker model yielded an overall accuracy of 79.4% in predicting whole-mouth outcomes following NSPT. Conclusions: At baseline, the presence of shallow periodontal pockets at interdental locations with a lower abundance of P. gingivalis is predictive of a favorable response to NSPT at the site level. Decreased salivary MMP-9 associated with increased GST and Annexin-1 levels can predict successful whole-mouth outcomes following NSPT.
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Affiliation(s)
| | - Ali Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Bab Al Mudam, Baghdad P.O. Box 1417, Iraq;
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10
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Al-Sharqi AJB, Abdulkareem AA, Gul S, Rawlinson A. Impact of Nonsurgical Periodontal Treatment of Periodontitis Stages 2 and 3 on Oral Health-Related Quality of Life. Healthcare (Basel) 2024; 12:1430. [PMID: 39057573 PMCID: PMC11276705 DOI: 10.3390/healthcare12141430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
This study investigates the impact of nonsurgical periodontal treatment (NSPT) on oral health-related quality of life (OHRQoL) in patients with periodontitis stages (S)2 and S3, and the factors associated with the prediction of patient-reported outcomes. Periodontitis patients (n = 68) with moderately deep periodontal pockets were recruited. Responses to the Oral Health Impact Profile (OHIP)-14 questionnaire and clinical parameters including plaque index, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) were recorded. All patients received supra- and subgingival professional mechanical plaque removal. All clinical parameters and questionnaire responses were recorded again 3 months after NSPT. Clinical parameters and OHIP-14 scores for both stages of periodontitis were significantly improved 3 months after treatment. However, participants with periodontitis S3 had significantly higher total OHIP-14, physical pain, and functional limitation domains scores than periodontitis S2 cases. Baseline CAL, BOP, and the presence of PPD in anterior teeth were positively associated with increased OHIP-14 scores after NSPT. NSPT improved OHRQoL in participants with periodontitis S2 and S3. This was more pronounced in participants having periodontitis S3 than S2. Poorer OHRQoL could be anticipated in people having severe CAL, high BOP, and presence of pockets in the anterior teeth.
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Affiliation(s)
- Ali J. B. Al-Sharqi
- Department of Periodontics, College of Dentistry, University of Baghdad, Bab Al Mudam, Baghdad P.O. Box 1417, Iraq;
| | - Ali A. Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Bab Al Mudam, Baghdad P.O. Box 1417, Iraq;
| | - Sarhang Gul
- Medical Laboratory Department, College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaymaniyah P.O. Box 70-236, Iraq;
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq
| | - Andrew Rawlinson
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, Claremont Crescent, Sheffield S10 2TA, UK;
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Tar I, Végh E, Martos R, Soós B, Márton I, Szekanecz Z. Six-Month Follow-Up of Periodontal Condition in Rheumatoid Arthritis and Ankylosing Spondylitis Arthritis Patients Undergoing Anti-Tumour Necrosis Factor-α Therapy. J Clin Med 2024; 13:448. [PMID: 38256582 PMCID: PMC10816203 DOI: 10.3390/jcm13020448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
In our present study, we aimed to assess the effects of anti-TNF therapy on periodontal condition in a mixed cohort of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Moreover, we wished to determine whether the baseline dental condition of these patients would affect response to biological therapy. A cohort of 24 arthritis patients was consecutively recruited before starting anti-TNFα therapy. After the dropout of six patients, we evaluated the dental status of 18 subjects at baseline and after 6 months of biological therapy. Clinical responder (R) and non-responder (NR) status was determined after 6 months of anti-TNF treatment. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), PPDmax, clinical attachment loss (CAL), and CALmax were determined. During the 6-month treatment period, six patients (3 RA and 3 AS) terminated the study prematurely as they did not respond to treatment (NR). Therefore, 18 patients were included in the full analysis. There were no major differences in PI, BOP, PPD, PPD max, CAL, and CALmax, among R and NR patients. TNF inhibition resulted in increased GI (0.65 ± 0.34 vs. 0.88 ± 0.30; p < 0.05), as well as decreased PPDmax (4 ± 1.94 vs. 2.72 ± 1.36; p < 0.05) and CALmax (5.22 ± 2.56 vs. 2.72 ± 1.36; p < 0.05) after 6 months. Eight patients had incomplete canal fillings or dead pulps and/or apical periodontitis; six in the R and two in the NR group. In our present study, anti-TNF therapy seemed to worsen the extent of gingival inflammation (GI); however our results also do not support the reduction of mean CPD and CAL as reported by others.
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Affiliation(s)
- Ildikó Tar
- Department of Oral Medicine, Faculty of Dentistry, University of Debrecen, 4032 Debrecen, Hungary;
| | - Edit Végh
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (E.V.); (B.S.)
| | - Renáta Martos
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, 4032 Debrecen, Hungary; (R.M.); (I.M.)
| | - Boglárka Soós
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (E.V.); (B.S.)
| | - Ildikó Márton
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, 4032 Debrecen, Hungary; (R.M.); (I.M.)
| | - Zoltán Szekanecz
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (E.V.); (B.S.)
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