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Kardaras G, Christodorescu R, Boariu M, Rusu D, Belova A, Chinnici S, Vela O, Radulescu V, Boia S, Stratul SI. A Low-Cost Protocol Using the Adjunctive Action of Povidone-Iodine Irrigations and Sodium Hypochlorite Rinsing Solution in Step 2 of Periodontal Therapy for Patients with Stage III-IV Periodontitis: A Single-Blind, Randomized Controlled Trial. Dent J (Basel) 2024; 12:144. [PMID: 38786542 PMCID: PMC11119210 DOI: 10.3390/dj12050144] [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: 04/18/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites. Background and Objectives: This single-blind, randomized clinical trial aimed to compare the clinical and microbiological efficacy of a low-cost protocol using povidone-iodine and sodium hypochlorite formulations as adjuncts to non-surgical therapy for patients with stage IV periodontitis when compared with chlorhexidine, the most commonly employed substance to date for antimicrobial regimens in periodontal therapy. Materials and Methods: Forty-five patients were randomly divided into two groups: control (subgingival instrumentation, chlorhexidine-assisted) and test (antiviral medication, subgingival instrumentation with povidone-iodine, sodium hypochlorite rinsing solution, and antibiotics). Clinical measurements and microbiological analyses were performed at baseline and after three months. Results: After three months, notable differences were found in the bacterial detection scores for Porphyromonas gingivalis (a significant reduction in detection frequency was observed in the test compared to the control (p = 0.021)), and there were significant reductions in detection in the test group for Tannerella forsythia and Treponema denticola, showing undetectable levels (p < 0.0001 for both). In the test group, the pocket probing depth median value was reduced significantly (p = 0.0005); similarly, bleeding on probing showed a marked decrease (p < 0.0001). However, changes in clinical attachment loss and full-mouth plaque score were not statistically significant. Conclusions: Using the proposed protocol, substantial improvements in clinical and microbiological parameters were obtained when compared with the current antimicrobial recommendations.
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Affiliation(s)
- Georgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
| | - Ruxandra Christodorescu
- Department V Internal Medicine, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
| | - Alla Belova
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
| | - Salvatore Chinnici
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
| | - Viorelia Radulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (G.K.); (D.R.); (A.B.); (S.C.); (O.V.); (V.R.); (S.B.); (S.-I.S.)
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Isola G, Pesce P, Polizzi A, Lo Giudice A, Cicciù M, Scannapieco FA. Effects of minimally invasive non-surgical therapy on C-reactive protein, lipoprotein-associated phospholipase A 2, and clinical outcomes in periodontitis patients: A 1-year randomized, controlled clinical trial. J Periodontol 2024. [PMID: 38696664 DOI: 10.1002/jper.23-0518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Growing evidence suggests the type of periodontal treatment could differentially influence the reduction of key cardiovascular risk mediators in periodontitis patients. This randomized, controlled clinical trial compared the impact of minimally invasive non-surgical therapy (MINST) with quadrant-wise subgingival instrumentation (Q-SI) on C-reactive protein (CRP) together with lipoprotein-associated phospholipase A2 (Lp-PLA2) levels, and clinical periodontal outcomes in patients with periodontitis. Moreover, it was evaluated if baseline CRP levels impacted the efficacy of non-surgical periodontal therapy protocols. METHODS Forty-two periodontitis patients were enrolled and randomly treated by means of MINST (n = 21) or Q-SI (n = 21). The outcomes assessed were serum CRP and Lp-PLA2, and periodontal parameters (probing depth [PD], clinical attachment level [CAL], full-mouth bleeding score [FMBS]), at baseline and at follow-ups at 1, 3, and 6 months and at 1 year after treatment. RESULTS At 1 year, MINST significantly reduced, among others, mean PD (p = 0.007), mean CAL (p = 0.007), the number of pockets >4 mm (p = 0.011) and ≥6 mm (p = 0.005), and FMBS (p = 0.048) compared to Q-SI. Generalized multivariate analysis evidenced that high baseline CRP (p = 0.039) and FMBS (p = 0.046) levels, together with MINST treatment (p = 0.007) were significant predictors of PD reduction at 1-year follow-up. Moreover, the Jonckheere-Terpstra test showed that patients with high baseline CRP levels gained more benefits from MINST treatment at 1-year follow-up than they did from Q-SI. CONCLUSION Patients receiving MINST showed a greater reduction in CRP levels than patients with Q-SI after 1 year of follow-up. Moreover, patients with high baseline levels of CRP and Lp-PLA2 gained more benefits from the MINST approach at 1-year follow-up.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Ospedale San Martino, Genoa, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Frank A Scannapieco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, New York, USA
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Pardo A, Fiorini V, Zangani A, Faccioni P, Signoriello A, Albanese M, Lombardo G. Topical Agents in Biofilm Disaggregation: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:2179. [PMID: 38673451 PMCID: PMC11050662 DOI: 10.3390/jcm13082179] [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: 03/19/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Background: to evaluate the effectiveness of different topical agents in biofilm disaggregation during non-surgical periodontal therapy. Methods: the search strategy was conducted according to the PRISMA 2020 on Pubmed, Cochrane Library, Scopus, and Web of Science, and it was registered in PROSPERO, ID: CRD42023474232. It included studies comparing non-surgical periodontal therapy (NSPT) with and without the application of topical agents for biofilm disruption. A risk of bias analysis, a qualitative analysis, and a quantitative analysis were performed. Results: out of 1583 records, 11 articles were included: 10 randomized clinical trials and one retrospective analysis. The total number of participants considered in the 11 articles included in the study was 386. The primary outcomes were probing pocket depth (PPD), clinical attachment level (CAL), and bleeding indices. The secondary outcomes were plaque indices, gingival recessions, and microbiological parameters. The meta-analysis revealed the following: [Weighted mean difference (WMD): -0.37; 95% confidence interval (CI) (-0.62, -0.12), heterogeneity I2: 79%, statistical significance p = 0.004]. Conclusions: the meta-analysis of probing pocket depth reduction (PPD) between baseline and follow-up at 3-6 months showed a statistically significant result in favor of sulfonated phenolics gel. The scientific evidence is still limited and heterogeneous; further randomized clinical trials are required.
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Affiliation(s)
| | | | - Alessandro Zangani
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy; (A.P.); (V.F.); (P.F.); (A.S.); (M.A.); (G.L.)
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Wallin-Bengtsson V, Scherdin-Almhöjd U, Roos-Jansåker AM. Supra- and sub-gingival instrumentation of periodontitis with the adjunctive treatment of a chloramine - a one-year randomized clinical trial study. Acta Odontol Scand 2024; 83:1-6. [PMID: 37962876 DOI: 10.1080/00016357.2023.2281486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
Periodontitis is a bacterial-induced disease and for this reason controlling the microbiota is a necessity. Therapy includes self-performed daily oral hygiene in combination with supra- and sub-gingival instrumentation. An adjunctive antimicrobial agent may improve the outcome. AIMS To assess whether a chloramine (Perisolv®) has an adjunctive effect to non-surgical periodontal therapy and whether non-surgical periodontal therapy affects quality of life. MATERIAL AND METHODS Thirty-eight patients were randomized to a test or a control group. Clinical indices were performed at baseline and at three and twelve months. In the test group, Perisolv® was applied initially and after the sub-gingival instrumentation in pathological pockets. Oral health-related quality of life was measured with the Oral Health Impact Profile (OHIP) instrument at baseline and twelve months. RESULTS In both groups, an initial probing pocket depth (PPD) of > 4 mm and bleeding on probing (BOP) were statistically reduced (p < 0.002 and p < 0.002 respectively) at twelve months and after adjustment for Bonferroni. There were no significant differences between the test and the control group in terms of the number of PPD, BOP or plaque index, or in the mean OHIP score. CONCLUSIONS Chloramine did not have an adjunctive effect, but the overall therapy was significantly efficacious both clinically and in terms of quality of life. TRIAL REGISTRATION Registered at www. CLINICALTRIALS gov:NCT05757921.
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Affiliation(s)
- Viveca Wallin-Bengtsson
- Department of Oral Health, Faculty of Oral Health Science, Kristianstad University, Kristianstad, Sweden.
| | | | - Ann-Marie Roos-Jansåker
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Periodontology, Blekinge Hospital, Karlskrona, Sweden
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Irani D, Jungbauer G, Sculean A, Eick S. Effect of sodium hypochlorite gel on bacteria associated with periodontal disease. Clin Oral Investig 2024; 28:190. [PMID: 38430333 PMCID: PMC10908609 DOI: 10.1007/s00784-023-05446-9] [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: 07/13/2023] [Accepted: 12/17/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVES An adjunct in non-surgical periodontal therapy might be sodium hypochlorite (NaOCl)-based agents. The purpose of the present in vitro study was to get deeper knowledge on the influence of different parameters as time after mixing, pH, and chemical composition of an amino acid 0.475% NaOCl (AA-NaOCl) gel consisting of two components on its anti-biofilm activity. MATERIALS AND METHODS Six-species biofilms were cultured for 5 days, before AA-NaOCl gel was applied. In the different series, the influence of the time after mixing of the two components before application, of the concentration of NaOCl in the gel mixture, of the pH of the gel mixture, and of an exchange of the amino acid component by hyaluronic acid (HA), was analyzed. RESULTS Mixing time point experiments showed that the AA-NaOCl gel is capable of statistically significantly reducing colony-forming unit (cfu) counts up to 30 min after mixing, but only up to 20 min after mixing the reduction was more than 2 log10 cfu. The pH experiments indicate that a reduced pH results in a reduced activity of the NaOCl formulation. NaOCl concentrations in the formulation in the range from 0.475 to 0.2% provide adequate activity on biofilms. A HA/NaOCl gel was equally active against the biofilm as the AA-NaOCl gel. CONCLUSION Mixing of the components should be made in a timeframe of 20 min before applications. An optimization of the composition of the NaOCl formulation might be possible and should be a topic in further in vitro studies. CLINICAL RELEVANCE The AA-NaOCl gel formulation can be mixed up to 20 min before application. Further, the study indicates that the composition of the NaOCl gel formulation can be optimized.
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Affiliation(s)
- Delia Irani
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Gert Jungbauer
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Anton Sculean
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Sigrun Eick
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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Theodoridis K, Arampatzis AS, Liasi G, Tsalikis L, Barmpalexis P, Christofilos D, Assimopoulou AN. 3D-Printed Antibacterial Scaffolds for the Regeneration of Alveolar Bone in Severe Periodontitis. Int J Mol Sci 2023; 24:16754. [PMID: 38069075 PMCID: PMC10706713 DOI: 10.3390/ijms242316754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Current clinical treatment of periodontitis alleviates periodontal symptoms and helps to keep the disease under control for extended periods. Despite this, a significant destruction of the tooth's underlying bone tissue often takes place progressively. Herein, we present a two-way therapeutic approach for local delivery of antibacterial agents and bone tissue regeneration, incorporating ~1% w/w tetracycline hydrochloride (TCH) into a 3D-printed scaffold composed of poly(ε-caprolactone) (PCL). Samples were assessed for their morphological, physicochemical, pharmacokinetic, and antibacterial properties. Furthermore, osteoprecursor cells (MC3T3-E1) were employed to evaluate the osteoinductive potential of the drug-loaded scaffolds. Cell proliferation, viability, and differentiation were determined on all cell-seeded scaffolds. At the end of the culture, PCL-TCH scaffolds promoted abundant collagen organic matrix, demonstrating augmented alkaline phosphatase (ALP) activity and areas of accumulated mineralised bone tissue, despite their belayed cell proliferation. Based on the observed effectiveness of the PCL-TCH scaffolds to inhibit Staphylococcus aureus, these constructs could serve as an alternative bioactive implant that supports bacterial inhibition and favours a 3D microenvironment for bone tissue regeneration in severe periodontitis.
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Affiliation(s)
- Konstantinos Theodoridis
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
| | - Athanasios S. Arampatzis
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
- Natural Products Research Center of Excellence (NatPro-AUTH), Center for Interdisciplinary Research and Innovation of Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
| | - Georgia Liasi
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
| | - Lazaros Tsalikis
- School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Panagiotis Barmpalexis
- Laboratory of Pharmaceutical Technology, Division of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Dimitrios Christofilos
- School of Chemical Engineering & Physics Laboratory, Faculty of Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Andreana N. Assimopoulou
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.T.); (A.S.A.); (G.L.)
- Natural Products Research Center of Excellence (NatPro-AUTH), Center for Interdisciplinary Research and Innovation of Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
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Qi J, Chen J, Pang Y, Guo Y, Chen G, Liu Y, Wang J, Liu E. Association between periodontal disease and osteoporosis in postmenopausal women: A systematic review and meta-analysis. Heliyon 2023; 9:e20922. [PMID: 37920517 PMCID: PMC10618781 DOI: 10.1016/j.heliyon.2023.e20922] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/23/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023] Open
Abstract
Objective To evaluate the relationship between periodontitis and postmenopausal osteoporosis. Methods This research was carried out according to the principles laid down by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. We searched the Web of Science, Embase, PubMed, The Cochrane Library, CNKI, VIP, and WanFang databases from inception to July 1, 2023 to collect all relevant publications, with no restrictions on publication date or Languages. Cochrane's tool for assessing RoB was used to evaluate the RoB for RCTs. The Newcastle-Ottawa Scale was used to assess the RoB for cohort studies and case-control studies. Mean differences (MD) with 95 % confidence intervals (CI) were used for analysis of continuous data. Heterogeneity was measured using the I2 statistic. Revman 5.4 software was used for the meta-analysis. Results 28 observational studies with 19611 patients, including 5813 cases in the postmenopausal osteoporosis group and 13798 cases in the non-osteoporosis group. The studies showed that the degrees of clinical attachment loss (CAL), probing depth (PD), gingival recession (GR), simplified oral hygiene index (OHIS), and percentage of sites with bleeding on probing (BOP) in the postmenopausal osteoporosis group were higher than those in the non-osteoporosis group[CAL(MD = 0.89(mm), 95 % CI [0.48,1.30], p < 0.00001), PD (MD = 0.27(mm), 95 % CI [0.13, 0.41], p = 0.0001), GR (MD = 0.28(mm), 95 % CI [0.20, 0.35], p < 0.00001), OHIS (MD = 1.32,95 % CI [1.12,1.51], p < 0.00001), BOP(MD = 12.71(%), 95 % CI [3.24,22.18], p = 0.009)]. Eleven studies found that bone mineral density (BMD) in the postmenopausal osteoporosis group was lower than that in non-osteoporosis group (MD = -0.41(U/cm2), 95 % CI [-0.77,-0.05], p = 0.03). The combined analysis results of the studies in the two groups showed that there were no significant differences in the loss of alveolar crestal height (ACH)[(MD = -1.76(%),95%CI [-3.64,0.12], p = 0.07)]. Conclusion Postmenopausal osteoporosis patients are more likely to suffer from periodontitis, and the condition is easily aggravated.
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Affiliation(s)
- Jing Qi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
- Stomatology Center of Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jiahui Chen
- Department of Clinical Skills Training Center, The First School of Clinical Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Yunqing Pang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
- School of Stomatology Lanzhou University, Lanzhou, 730000, China
| | - Yufeng Guo
- Stomatology Center of Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Guang Chen
- Department of Stomatology, Affiliated Hospital of Northwest University for Nationalities, Lanzhou, 730000, China
| | - Yuting Liu
- Radiology of Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jing Wang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
- School of Stomatology Lanzhou University, Lanzhou, 730000, China
| | - E. Liu
- Stomatology Center of Gansu Provincial Hospital, Lanzhou, 730000, China
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Kučič AC, Gašperšič R. Minimally invasive non-surgical therapy (MINST) in stage III periodontitis patients: 6-month results of a split-mouth, randomised controlled clinical trial. Clin Oral Investig 2023; 27:2075-2087. [PMID: 37014505 PMCID: PMC10071470 DOI: 10.1007/s00784-023-04994-4] [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: 01/15/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVES To determine if minimally invasive non-surgical therapy (MINST) outperforms classical non-surgical periodontal therapy for stage III periodontitis with primarily suprabony (horizontal) type defects. MATERIALS AND METHODS In a split-mouth randomised controlled trial, 20 patients' dental quadrants were randomly assigned to MINST or classical non-surgical treatment. The primary outcome variable was the number of sites with probing pocket depth ≥ 5 mm and BOP. Treatment method, tooth type, smoking status, and gender were evaluated using a multivariate multilevel logistic regression model. RESULTS After 6 months, the percentage of sites with PD ≥ 5 mm and BOP that healed (MINST = 75.5%; control group = 74.1%; p = 0.98), and the median number of persisting sites (MINST: 6.5, control group: 7.0; p = 0.925) were similar in both groups. In the test and control groups, respectively, median probing pocket depths (2.0 mm vs. 2.1 mm) and clinical attachment level (1.7 mm vs. 2.0 mm) changed significantly (p < 0.05) but similarly. Significantly less gingival recession occurred in the MINST group's deep molar pockets compared to the control group (p = 0.037). Men (OR = 0.52, p = 0.014) and non-molars (OR = 3.84, p 0.001) had altered odds for healing of sites with PD ≥ 5 mm and BOP. CONCLUSIONS MINST reduces gingival recession associated with molar teeth, although it performs similarly to traditional non-surgical therapy in treating stage III periodontitis with predominately horizontal-type defects. CLINICAL RELEVANCE MINST performs similarly to non-surgical periodontal therapy in stage III periodontitis with predominantly suprabony defects. TRIAL REGISTRATION Clinicaltrials.gov (NCT04036513) on June 29, 2019.
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Affiliation(s)
- Alja Cmok Kučič
- Public Health Centre Celje, Gregorčičeva 5, 3000, Celje, Slovenia
| | - Rok Gašperšič
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski Trg 6, 1000, Ljubljana, Slovenia.
- Department of Oral Medicine and Periodontology, Dental Clinic, University Clinical Centre, Hrvatski Trg 6, 1000, LjubljanaLjubljana, Slovenia.
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Alkimavičienė E, Pušinskaitė R, Basevičienė N, Banienė R, Savickienė N, Pacauskienė IM. Efficacy of Proanthocyanidins in Nonsurgical Periodontal Therapy. Int Dent J 2023; 73:195-204. [PMID: 36167610 PMCID: PMC10023589 DOI: 10.1016/j.identj.2022.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/25/2022] [Accepted: 08/16/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of this work was to evaluate the efficacy of proanthocyanidins (PACNs) as an adjunctive periodontal therapy in patients with periodontitis. METHODS Patients with periodontitis (stage III-IV) were included in this randomised clinical study. Patients with periodontitis received 2 different treatment modalities: minimally invasive nonsurgical therapy only (MINST group) or minimally invasive nonsurgical therapy and subgingival application of collagen hydrogels with PACNs (MINST + PACNs group). Clinical periodontal parameters, that is, pocket probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), were evaluated before treatment and after 8 weeks. Concentrations of immunologic markers, matrix metalloproteinase-3 (MMP-3), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in saliva were assessed at baseline and at 8-week follow-up. RESULTS Forty-six patients diagnosed with periodontitis were randomised into 2 groups: 23 patients in the MINST group and 23 patients in the MINST + PACNs group received the intended treatment. PACNs combined with MINST resulted in additional statistically significant PPD reduction and CAL gain in moderate periodontal pockets by 0.5 mm (P < .05) on average compared to MINST alone. Additional use of PACNs did not result in additional statistically significant improvement of BOP or PI values. Application of PACNs showed significant reduction of MMP-3 levels in saliva after 8 weeks (P < .05). CONCLUSIONS Adjunctive use of PACNs in MINST resulted in better clinical outcomes for moderate pockets. Additional use of PACNs improved MMP-3 concentration in saliva more than MINST alone. Biochemical analysis revealed that MMP-3 concentration in saliva reflected the periodontal health state.
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Affiliation(s)
- Evelina Alkimavičienė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Rasa Pušinskaitė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nomeda Basevičienė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Banienė
- Department of Biochemistry, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nijolė Savickienė
- Department of Pharmacognosy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Ribeiro FV, Mehta JJ, Monteiro MF, Moore J, Casati MZ, Nibali L. Minimal invasiveness in nonsurgical periodontal therapy. Periodontol 2000 2023; 91:7-19. [PMID: 36661203 DOI: 10.1111/prd.12476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 01/21/2023]
Abstract
Periodontal treatment is quickly moving towards a philosophy consisting of a less invasive approach. In this context, minimally invasive nonsurgical therapy (MINST) is a promising option. This paper reviews the concepts behind minimal invasiveness in nonsurgical periodontology and reports the state-of the art evidence for this topic. Instruments used and protocols suggested for these applications are introduced and discussed. The original papers reviewed show probing pocket depth (PPD) reductions and clinical attachment level (CAL) gains ranging from 2 to 4 mm between baseline and 6 months to 5 years posttreatment for intrabony defects and from 1.5 to 3 mm between baseline and 2-6 months of follow-up for full-mouth results. These clinical outcomes are accompanied by statistically significant reductions in radiographic bone defect depth and increases in intrabony defect angles posttreatment. Wound healing mechanisms following MINST are presented, and clinical applications and directions for future research are suggested.
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Affiliation(s)
- Fernanda V Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - Jaimini J Mehta
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Mabelle F Monteiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil.,Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Jatinder Moore
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Marcio Z Casati
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil.,Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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11
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El Mobadder M, Nammour S, Grzech-Leśniak Z, Grzech-Leśniak K. Efficacy of the Adjunct Use of Povidone-Iodine or Sodium Hypochlorite with Non-Surgical Management of Periodontitis: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11216593. [PMID: 36362818 PMCID: PMC9658783 DOI: 10.3390/jcm11216593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
This systematic review sought to assess the efficacy of combining either sodium hypochlorite or povidone-iodine as disinfection solutions with non-surgical treatment of periodontitis. An electronic search was conducted through PubMed, Scopus, Web of Science, CENTRAL, and Google Scholar from inception until 10 September 2022. Outcomes included clinical outcomes (probing pocket depth, plaque index, clinical attachment level, relative-horizontal attachment level, bleeding on probing, gingival recession, the position of gingival margin) and biochemical (BAPNA level) properties. A subgroup analysis was conducted according to the assessment timepoint. Ten studies reporting the use of povidone-iodine and five studies reporting the use of sodium hypochlorite were included in this review. Overall, in the meta-analysis of povidone-iodine, no significant changes were noted in any of the assessed outcomes; however, minor changes were noted in probing pocket depth and clinical attachment level at a specific timepoint. Regarding sodium hypochlorite, a significant reduction in all clinical outcomes, except for bleeding on probing, was noted. In conclusion, the use of povidone-iodine does not result in an improvement in clinical outcomes, whereas sodium hypochlorite has promising properties that result in significant improvement in probing pocket depth and clinical attachment level. However, more studies are needed to confirm these observations.
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Affiliation(s)
- Marwan El Mobadder
- Dental Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland
- Correspondence: or ; Tel.: +961-7134-3767
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
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12
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El Mobadder M, Nammour S, Matys J, Grzech-Leśniak K. Sodium Hypochlorite and Diode Laser in Non-Surgical Treatment of Periodontitis: Clinical and Bacteriological Study with Real Time Polymerase Chain Reaction (PCR). Life (Basel) 2022; 12:life12101637. [PMID: 36295072 PMCID: PMC9605566 DOI: 10.3390/life12101637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 11/20/2022] Open
Abstract
Increasing the disinfection during non-surgical treatment of periodontitis is primordial. This study assesses the effectiveness of sodium hypochlorite and a 980 nm diode laser in non-surgical treatment of periodontitis. Thirty sites of localized periodontitis with a probing pocket depth (PPD) of ≥ 6 mm were included. Fifteen underwent scaling root planing (SRP group) and 15 underwent SRP + 0.5% NaOCl and a 980 nm diode laser (study group). A biological molecular test and real time polymerase chain reaction (RT-PCR) were performed before (T0) and after intervention (T1). Total bacterial count and counts of Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Eubacterium nodatum, Capnocytophaga gingivalis were assessed. Plaque index (PI), bleeding on probing (BOP), gingival recession (GR), PPD and clinical attachment loss (CAL) were evaluated at T0, and 3 and 6 months after. Study group showed a statistically significant reduction of TBC (5.66 × 108 CFU/mL) compared to SRP (6.2 × 109 CFU/mL). Both groups showed a statistically significant reduction of Treponema denticola, Tannerella forsythia, Prevotella intermedia, Peptostrep. (micromonas) micros and Fusobacterium nucleatum; however, a significant reduction of Eubacterium nodatum and Capnocytophaga gingivalis was observed in the study group. At T6, both groups had a statistically significant reduction of PI, BOP, GR, PD and CAL. The study group showed more GR compared to SRP and a significant reduction of PD (4.03 mm ± 0.49) compared to SRP (5.28 mm ± 0.67). This study reveals that NaOCl and a diode laser are effective as an adjunctive to the non-surgical treatment of periodontitis.
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Affiliation(s)
- Marwan El Mobadder
- Dental Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland
- Correspondence: or ; Tel.: +961-71343767
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Jacek Matys
- Dental Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland
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13
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Diehl D, Friedmann A, Liedloff P, Jung RM, Sculean A, Bilhan H. Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery-Retrospective Analysis of a Clinical Case Series. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6508. [PMID: 36233855 PMCID: PMC9571901 DOI: 10.3390/ma15196508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
The comprehensive treatment of periodontitis stage 2 to 4 aims at the resolution of periodontal inflammation and “pocket closure”, which implies a residual probing depth of ≤4 mm and a negative BoP. However, supportive periodontal therapy (SPT) regularly leaves behind persistent periodontal pockets with 5 or more mm in residual PPD and sites that often re-colonize and re-infect. Various adjunctive options for subgingival instrumentation have been proposed to enhance the antimicrobial effects to better control the re-infection of these residual sites. The locally applied adjuncts, based on their anti-inflammatory effect, are sodium hypochlorite antiseptic cleaning gel and cross-linked hyaluronic acid (xHyA). Both recently moved into the focus of clinical research on non-surgical and surgical therapy for periodontitis. The surgical use of xHyA indicates regenerative potential, supporting periodontal regeneration. This case series retrospectively analyzes the clinical benefits of the consecutive flapless application of sodium-hypochlorite-based cleaning gel and xHyA at the SPT to achieve pocket closure, thereby reducing the need for periodontal surgery. In 29 patients, 111 sites received the treatment sequence. At 6-month re-evaluation, an overall PPD reduction exceeding 2 mm was achieved, associated with a similar CAL gain (2.02 mm); the bleeding tendency (BoP) was reduced by >60%. Pocket closure occurred in almost 25% of all the sites. Within their limits, the present data suggest that the proposed combined adjunctive treatment of residual active periodontal sites yielded significant improvement in the clinical parameters. Further studies in RCT format are required to confirm these observations.
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Affiliation(s)
- Daniel Diehl
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
- Institute of Pharmacology and Toxicology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Anton Friedmann
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Pheline Liedloff
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Rico Marvin Jung
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
| | - Hakan Bilhan
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
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14
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Isola G, Lombardi T. Advances in Clinical and Molecular Research of Biomaterials in Dentistry: The New Era for Dental Applications. J Clin Med 2022; 11:jcm11154512. [PMID: 35956127 PMCID: PMC9369395 DOI: 10.3390/jcm11154512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
Biomaterials in dentistry play a fundamental role in the quality of regeneration mechanisms and in healing following different rehabilitation techniques [...]
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
- Correspondence: (G.I.); (T.L.); Tel.: +39-095-378-2638 (G.I.)
| | - Teresa Lombardi
- Department of Health Sciences, Magna Græcia University, 88100 Catanzaro, Italy
- Correspondence: (G.I.); (T.L.); Tel.: +39-095-378-2638 (G.I.)
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15
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Radulescu V, Boariu MI, Rusu D, Roman A, Surlin P, Voicu A, Didilescu AC, Jentsch H, Siciliano VI, Ramaglia L, Vela O, Kardaras G, Sculean A, Stratul SI. Clinical and microbiological effects of a single application of sodium hypochlorite gel during subgingival re-instrumentation: a triple-blind randomized placebo-controlled clinical trial. Clin Oral Investig 2022; 26:6639-6652. [PMID: 35829773 DOI: 10.1007/s00784-022-04618-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/05/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study is to assess the clinical and microbiological effects of a single subgingival administration of sodium hypochlorite gel (NaOCl) and compare it with 1% chlorhexidine (CHX) gel and a placebo gel following mechanical re-instrumentation during supportive periodontal therapy (SPT). MATERIALS AND METHODS Sixty-two patients who had been treated for stage III-IV periodontitis and enrolled in SPT were included in the study based on following criteria: (1) active periodontal therapy completed at least 6 months before enrollment in the study, (2) presence of at least 4 non-adjacent sites with probing pocket depths (PPDs) ≥ 4 mm with bleeding on probing (BOP), or presence of 5-8 mm PPDs with or without BOP. All sites presenting PPD ≥ 4 mm and BOP at baseline and 3-, 6-, and 9-month follow-up timepoints were subgingivally re-instrumented with ultrasounds. Selected patients were randomly assigned into three groups and treated additionally with a single subgingival administration of NaOCl gel (group A); 1% CHX gel (group B); and placebo gel (group C). Main outcome variable was pocket closure at 12 months. Secondary outcome variables were changes in mean PPD, BOP, and clinical attachment level (CAL) along with changes in the numbers of the following five keystone bacterial pathogens: Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythia (T.f.), and Treponema denticola (T.d.). RESULTS At 12 months, pocket closure was obtained in 77.5% in the NaOCl treated sites. The reduction in PPD was higher with CHX than with NaOCl, although a statistically significant adjunctive effect for NaOCl (P = 0.028) was only observed in comparison with placebo only. Mean CAL improved in all groups and at all timepoints, compared to the baseline (P < 0.05). However, after 6 months, CAL gain was statistically significantly higher in the NaOCl treated group than following application of CHX (P = 0.0026). CONCLUSION In SPT patients, a single adjunctive use of a NaOCl gel may provide benefits in controlling inflammation and residual pockets. TRIAL REGISTRATION ISRCTN Registry of Clinical Trials (ISRCTN11387188). CLINICAL RELEVANCE A baseline single application of NaOCl gel in conjunction with mechanical debridement may achieve substantial pocket closure in patients enrolled in SPT; treatment time, cost, and applicability considerations should be taken into account when selecting this therapy.
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Affiliation(s)
- Viorelia Radulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Marius Ion Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Applicative Periodontal Regeneration Research Unit, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Craiova, Romania
| | - Adrian Voicu
- Department of Informatics and Medical Biostatistics, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Andreea Cristiana Didilescu
- Department of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | - Holger Jentsch
- Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | - Vincenzo Iorio Siciliano
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Naples, Italy
| | - Luca Ramaglia
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Naples, Italy
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Giorgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
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16
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Qi J, Liu E, Guo YF, Hu JM, Liu YT, Chen G, Yue HQ. Association between periodontal disease and osteoporosis in postmenopausal women: a protocol for systematic review and meta-analysis. BMJ Open 2021; 11:e049277. [PMID: 34518261 PMCID: PMC8438846 DOI: 10.1136/bmjopen-2021-049277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Periodontal disease and osteoporosis are common chronic diseases, especially for the postmenopausal women. Several original studies explore the association, but there still controversial. Therefore, we will conduct this systematic review and meta-analysis to assess the association between periodontal disease and osteoporosis in postmenopausal women. METHODS AND ANALYSIS This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocols. We will systematically search Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and Scopus from inception to August 2021 to collect all relevant publications, with no restrictions on publication date or languages. Study selection, data extraction and risk of bias assessment will be conducted independently by two trained reviewers independently. The Cochrane's tool for assessing risk of bias, Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality will be used for the risk of bias assessment. OR, HR and risk ratio with 95% CI were considered as the effect size for dichotomous outcomes, weighted mean difference with 95% CI were calculated as the effect size for continuous outcomes. Random-effects models will be used. Heterogeneity between studies will be assessed via the forest plot and I². Publication bias will detected by funnel plots, Begg's test and Egger's test. The subgroup analyses and sensitivity ananlyses will also be used to explore and interpret the heterogeneity. ETHICS AND DISSEMINATION This study does not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021225746.
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Affiliation(s)
- Jing Qi
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - E Liu
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Yu-Feng Guo
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Jie-Mei Hu
- Bone density test room of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Yu-Ting Liu
- Radiology of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Guang Chen
- Department of Stomatology, Affiliated Hospital of Northwest University for Nationalities, Lanzhou, Gansu, China
| | - Hai-Quan Yue
- Stomatology Center of Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, Gansu, China
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Wu J, Lin L, Xiao J, Zhao J, Wang N, Zhao X, Tan B. Efficacy of scaling and root planning with periodontal endoscopy for residual pockets in the treatment of chronic periodontitis: a randomized controlled clinical trial. Clin Oral Investig 2021; 26:513-521. [PMID: 34145479 DOI: 10.1007/s00784-021-04029-w] [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: 11/25/2020] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Residual pockets are a risk factor of periodontitis progression. This study evaluated the efficacy of periodontal endoscopy (PE) during scaling and root planning (SRP) of residual pockets in chronic periodontitis patients after initial periodontal treatment. MATERIALS AND METHODS A single-blinded, randomized controlled clinical trial was conducted in systemically healthy subjects presenting at least three residual pockets with a probing depth (PD) ≥ 5 mm in each quadrant. Subjects were randomly allocated to one of two trial groups using a computer-generated program: SRP + PE (test group) or SRP alone (control group). Clinical parameters (PD, clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PLI)) were then measured at baseline, 3-, and 6-month follow-up. RESULTS A total of 1629 sites in 37 patients were examined. Both treatments significantly improved all clinical outcomes (PD, CAL, BOP, and PLI) from baseline to 6 months (P < 0.05), although greater reductions in PD and PLI were observed in the test group at both 3- (PD: 3.45 ± 0.56 vs. 4.14 ± 0.59 mm; PLI: 0.55 ± 0.23 vs. 0.73 ± 0.27) and 6-month follow-up (PD: 3.12 ± 0.63 vs. 4.0 ± 0.68 mm; PLI: 0.49 ± 0.21 vs. 0.72 ± 0.28, respectively; P = 0.001 for PD and P = 0.021 for PLI). No significant differences in CAL or BOP were observed. CONCLUSIONS SRP + PE resulted in significant reductions in PD and PLI compared to SRP alone in residual pockets with a PD ≥ 5 mm. CLINICAL RELEVANCE The findings highlight the benefits of SRP + PE, supporting use as an alternative strategy in nonsurgical periodontal treatment.
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Affiliation(s)
- Juan Wu
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Liangyuan Lin
- Department of Stomatology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jianping Xiao
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Jie Zhao
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Ningxiang Wang
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China
| | - Xingxing Zhao
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Jiangsu, China
| | - Baochun Tan
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China.
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18
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Santonocito S, Polizzi A, Palazzo G, Isola G. The Emerging Role of microRNA in Periodontitis: Pathophysiology, Clinical Potential and Future Molecular Perspectives. Int J Mol Sci 2021; 22:5456. [PMID: 34064286 PMCID: PMC8196859 DOI: 10.3390/ijms22115456] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 02/07/2023] Open
Abstract
During the last few decades, it has been established that messenger ribonucleic acid (mRNA) transcription does not inevitably lead to protein translation, but there are numerous processes involved in post-transcriptional regulation, which is a continuously developing field of research. MicroRNAs (miRNAs) are a group of small non-coding RNAs, which negatively regulate protein expression and are implicated in several physiological and pathological mechanisms. Aberrant expression of miRNAs triggers dysregulation of multiple cellular processes involved in innate and adaptive immune responses. For many years, it was thought that miRNAs acted only within the cell in which they were synthesised, but, recently, they have been found outside cells bound to lipids and proteins, or enclosed in extracellular vesicles, namely exosomes. They can circulate throughout the body, transferring information between cells and altering gene expression in the recipient cells, as they can fuse with and be internalised by the recipient cells. Numerous studies on miRNAs have been conducted in order to identify possible biomarkers that can be used in the diagnosis of periodontal disease. However, as therapeutic agents, single miRNAs can target several genes and influence multiple regulatory networks. The aim of this review was to examine the molecular role of miRNAs and exosomes in the pathophysiology of periodontal disease and to evaluate possible clinical and future implications for a personalised therapeutical approach.
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Affiliation(s)
| | | | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (S.S.); (A.P.); (G.P.)
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19
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Fichera G, Santonocito S, Ronsivalle V, Polizzi A, Torrisi S, Deodato L, Palazzo G, Isola G. Prevalence of Early Childhood Caries in Southern Italy: An Epidemiological Study. Int J Dent 2021; 2021:5106473. [PMID: 34122549 PMCID: PMC8169260 DOI: 10.1155/2021/5106473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to assess the prevalence of Early Childhood Caries (ECC) and oral habits among preschool children from a southern Italian cohort. The survey population consisted of 300 subjects randomly selected among children attending two kindergartens in Catania, Italy. The prevalence of ECC and oral habits were clinically evaluated. During the clinical evaluation, the oral hygiene of children was also assessed. Parents were also interviewed using a brief and simple online questionnaire aimed at investigating eating and oral hygiene habits. The selected sample age ranged between 3 and 5 years. The prevalence of ECC was 9.34%, and the most affected teeth were primary molars. Moreover, the prevalence of oral habits was 44.66%. Only two-thirds of the sample brush their teeth at least once per day. The prevalence of ECC among Sicilian children (9.33%) seems suitable with the rest of the country. The results of the present study evidenced that oral habits showed a high prevalence among preschool children. The level of oral hygiene among preschool children is still not sufficient.
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Affiliation(s)
- Grazia Fichera
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
- 2Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Via Consolare Valeria 1, Messina 98123, Italy
| | - Simona Santonocito
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Vincenzo Ronsivalle
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
- 2Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Via Consolare Valeria 1, Messina 98123, Italy
| | - Alessandro Polizzi
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Salvatore Torrisi
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Ludovica Deodato
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Giuseppe Palazzo
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Gaetano Isola
- 1Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
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